WorldWideScience

Sample records for assisted anchoring technique

  1. Anchor balloons assisted deep intubation of 5F catheters for ...

    African Journals Online (AJOL)

    2015-07-24

    Jul 24, 2015 ... other lesions that cannot be crossed, even with the aforementioned techniques. Here, we report four ..... balloon technique may damage the anchored branch. The 5F “child‑in‑mother” catheter would be another .... Rev Esp Cardiol (Engl Ed) 2013;66:636‑43. 2. Chambers JW, Feldman RL, Himmelstein SI, ...

  2. Arthroscopic Lateral Meniscus Root Repair With Soft Suture Anchor Technique

    OpenAIRE

    Prasathaporn, Niti; Kuptniratsaikul, Somsak; Kongrukgreatiyos, Kitiphong

    2013-01-01

    Meniscus root tear leads to circumferential hoop tension loss and increases femorotibial contact force, which causes irreversible cartilage degeneration. Biomechanical studies have shown that meniscus root repair provides better femorotibial contact force than meniscectomy. Many techniques for meniscus root repair have been published in recent years. The soft suture anchor is widely used in the glenoid labral repair. It is a small low-profile soft anchor. This article presents a new and simpl...

  3. Anchor coil technique for arteriovenous fistula embolization. A technical note.

    Science.gov (United States)

    Kanemaru, Kazuya; Ezura, Masayuki; Nishiyama, Yoshihisa; Yagi, Takashi; Yoshioka, Hideyuki; Fukumoto, Yuichiro; Horikoshi, Toru; Kinouchi, Hiroyuki

    2014-01-01

    We describe a case of arteriovenous fistula (AVF) successfully treated by coil embolization with an anchor coil inserted in the varix to facilitate dense packing at the shunting site. AVF of the left anterior choroidal artery (AChoA) draining into the ipsilateral basal vein of Rosenthal was incidentally found in a newborn female. A single detachable coil was inserted as an anchor into the varix adjacent to the shunt, and the microcatheter was pulled back to the shunting point. Three more detachable coils were delivered at the shunting point without migration under the support of the anchor coil, and the AVF was successfully obliterated with preservation of AChoA blood flow. The anchor coil technique can reduce the risk of coil migration and the number of coils required.

  4. Temporomandibular Joint Disc Repositioning Using an Orthopedic Suture Anchor: A Modified Disc Anchoring Technique.

    Science.gov (United States)

    Rajkumar, K; Mukhopadhyay, P; Sinha, Ramen

    2016-09-01

    The study assessed the efficacy of orthopedic suture anchor as a modified suture anchor for disc repositioning in case of a closed lock of TMJ. Disc repositioning was undertaken via a mini preauricular approach. The disc was repositioned on the surface of the condyle and stabilized using an orthopedic suture anchor. Postoperatively functional outcomes were assessed in terms of reduction in pain, joint movement and absence of joint noise and clicking sounds. Postoperative MRI was used to assess the disc position and morphological changes in the disc and arthritic changes in the condyle at the end of six months. Patients were post surgically followed up at regular intervals of 1, 3 and 6 months. Patient experienced significant improvement in mouth opening with good functional outcomes and stable repositioning of disc as noticed By MRI at the end of six months. We describe a modified technique of disc repositioning using an orthopedic suture anchor for more favorable disc position and joint function. However the long term functional sequel of the procedure and changes in the articular disc needs to be assessed.

  5. Assisted reproductive techniques.

    Science.gov (United States)

    Huang, Jack Yu Jen; Rosenwaks, Zev

    2014-01-01

    Assisted reproductive technologies (ART) encompass fertility treatments, which involve manipulations of both oocyte and sperm in vitro. This chapter provides a brief overview of ART, including indications for treatment, ovarian reserve testing, selection of controlled ovarian hyperstimulation (COH) protocols, laboratory techniques of ART including in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI), embryo transfer techniques, and luteal phase support. This chapter also discusses potential complications of ART, namely ovarian hyperstimulation syndrome (OHSS) and multiple gestations, and the perinatal outcomes of ART.

  6. Magnetic anchoring guidance system in video-assisted thoracic surgery.

    Science.gov (United States)

    Giaccone, Agnese; Solli, Piergiorgio; Bertolaccini, Luca

    2017-01-01

    The magnetic anchoring guidance system (MAGS) is one of the most promising technological innovations in minimally invasive surgery and consists in two magnetic elements matched through the abdominal or thoracic wall. The internal magnet can be inserted into the abdominal or chest cavity through a small single incision and then moved into position by manipulating the external component. In addition to a video camera system, the inner magnetic platform can house remotely controlled surgical tools thus reducing instruments fencing, a serious inconvenience of the uniportal access. The latest prototypes are equipped with self-light-emitting diode (LED) illumination and a wireless antenna for signal transmission and device controlling, which allows bypassing the obstacle of wires crossing the field of view (FOV). Despite being originally designed for laparoscopic surgery, the MAGS seems to suit optimally the characteristics of the chest wall and might meet the specific demands of video-assisted thoracic surgery (VATS) surgery in terms of ergonomics, visualization and surgical performance; moreover, it involves less risks for the patients and an improved aesthetic outcome.

  7. Salvage of Herniated Flow Diverters Using Stent and Balloon Anchoring Techniques: A Technical Note.

    Science.gov (United States)

    Jagadeesan, Bharathi D; Sandhu, Divyajot; Hong, Kim Jae; Roshan Khanipour, Sara; Grande, Andrew W; Tummala, Ramachandra P

    2017-03-01

    The pipeline embolization device (PED; Medtronic, MN, USA) can sometimes herniate into the aneurysmal sac in an unexpected manner during or shortly after its deployment due to device foreshortening. In this report, we describe 2 endovascular techniques, which can be used to reposition a herniated PED construct into a more favorable alignment. In a 67-year-old patient who had an intraprocedural herniation of a PED device into a giant cavernous aneurysm, a stent anchor technique was used to reverse the herniation, reorient the PED construct, and achieve successful flow diversion. In a different patient with a giant superior hypophyseal aneurysm, a balloon anchor technique followed by deployment of an LVIS Jr (Microvention, Tustin, CA, USA) stent was used to reverse the herniation into the aneurysmal sac. Stent anchor and balloon anchor techniques as described here can be used to reposition PED constructs, which have unexpectedly herniated into the aneurysm sac during attempted flow diversion for the treatment of giant aneurysms.

  8. Anchoring International sets new water depth record

    Energy Technology Data Exchange (ETDEWEB)

    Noble, H.J.

    1983-07-01

    Santa Barbara Channel has a history steeped in firsts in techniques for the production of offshore oil. Landscaped drilling and production islands, production piers, and directional drilling from land rigs to production under the channel, to name a few. The latest such project was handled by Anchoring International, Inc., a pipe line anchoring company headquartered in Houston, Texas. Contracted by Healy Tibbets Construction Company, prime contractor, Anchoring was commissioned to handle a new deep water record breaking anchoring job. The job was to anchor J-tube extensions in 820 feet of water--the deepest pipe line anchoring job ever undertaken. In most shallow water pipe line anchoring jobs, anchors and anchor installation unit placement over the pipe line is handled from a crane topside with visual assist from divers. However, due to the extreme depth of this project, the installation unit with anchors had to be modified for submersible operator-assisted placement capability. Anchoring International handled the anchor design and installation equipment, and submersible operator assistance was furnished by Oceaneering, International. WASP and JIM atmospheric diving systems were used. All ocean bottom activities were monitored topside with the JERED video-equipped remote controlled vehicle. Since the weight of the anchor sets and power installation unit are minimum, the entire operation was conducted from a small boat sufficient to carry dive equipment and the anchor installation unit power supply. A small pedestal crane was used to lower and retrieve the anchor installation unit.

  9. Impingement syndrome of the shoulder following double row suture anchor technique for arthroscopic rotator cuff repair: a case report

    Directory of Open Access Journals (Sweden)

    Rambani Rohit

    2009-06-01

    Full Text Available Abstract Introduction Arthroscopic repair of the rotator cuff is a demanding surgery. Accurate placement of anchors is key to success. Case presentation A 38-year-old woman received arthroscopic repair of her rotator cuff using a double row suture anchor technique. Postoperatively, she developed impingement syndrome which resulted from vertical displacement of a suture anchor once the shoulder was mobilised. The anchor was removed eight weeks following initial surgery and the patient had an uneventful recovery. Conclusion Impingement syndrome following arthroscopic repair of the rotator cuffs using double row suture anchor has not been widely reported. This is the first such case where anchoring has resulted in impingement syndrome.

  10. Impingement syndrome of the shoulder following double row suture anchor technique for arthroscopic rotator cuff repair: a case report

    OpenAIRE

    Rambani Rohit; Hackney Roger G

    2009-01-01

    Abstract Introduction Arthroscopic repair of the rotator cuff is a demanding surgery. Accurate placement of anchors is key to success. Case presentation A 38-year-old woman received arthroscopic repair of her rotator cuff using a double row suture anchor technique. Postoperatively, she developed impingement syndrome which resulted from vertical displacement of a suture anchor once the shoulder was mobilised. The anchor was removed eight weeks following initial surgery and the patient had an u...

  11. Comparison of the Suture Anchor and Transosseous Techniques for Patellar Tendon Repair: A Biomechanical Study.

    Science.gov (United States)

    Lanzi, Joseph T; Felix, Justin; Tucker, Christopher J; Cameron, Kenneth L; Rogers, John; Owens, Brett D; Svoboda, Steven J

    2016-08-01

    Minimizing gap formation and maximizing the strength of patellar tendon repairs are 2 critical factors for successful healing of these injuries. The purpose of this study was to compare transosseous and screw-in anchor repair techniques to determine if there is a difference in gap formation and load to failure of the 2 constructs. The research hypotheses were that the anchor construct would have significantly less gap formation and would also have significantly greater load-to-failure strength. Controlled laboratory study. A total of 24 porcine specimens were randomly assigned into transosseous and 4.75-mm polyetheretherketone (PEEK) screw-in anchor repair groups. The repairs were then completed using 2 No. 2 FiberWire sutures, and each specimen was cyclically loaded on a tensile test machine to 250 N for a total of 1000 cycles. Gap formation was measured at 1, 10, 250, 500, and 1000 cycles. Each specimen was loaded to failure after 1000 cycles. Independent t tests were conducted. Statistically significant gap formation and load-to-failure differences were found between the 2 repair techniques. The mean gap in the anchor group (2.16 ± 1.81 mm) was significantly less than that seen in the transosseous group (5.71 ± 1.58 mm) (P anchor group (669.9 ± 91.8 N) was significantly higher than that of the transosseous group (582.8 ± 92.6 N) (P = .03). The results support the 2 study hypotheses. These findings suggest that the 4.75-mm PEEK screw-in anchor construct may be superior to the transosseous technique for minimizing gap formation and improving load-to-failure strength after surgical repair of the patellar tendon. The use of the suture anchor technique in patellar tendon repair may support early load-bearing rehabilitation. © 2016 The Author(s).

  12. Biomechanical Comparison of All-Suture Anchor Fixation and Interference Screw Technique for Subpectoral Biceps Tenodesis.

    Science.gov (United States)

    Chiang, Florence L; Hong, Chih-Kai; Chang, Chih-Hsun; Lin, Cheng-Li; Jou, I-Ming; Su, Wei-Ren

    2016-07-01

    To compare the biomechanical characteristics of the subpectoral Y-knot all-suture anchor fixation with those of the interference screw technique. Sixteen fresh-frozen human cadaveric shoulders with a mean age of 67.6 ± 5.8 years (range, 52 to 74 years) were studied. The specimens were randomly grouped into 2 experimental biceps tenodesis groups (n = 8): Y-knot all-suture anchor or interference screw. The specimens were cyclically tested to failure by applying tensile forces parallel to the longitudinal axis of the humerus. A preload of 5 N was applied for 2 minutes prior to cyclic loading for 500 cycles from 5 to 70 N at 1 Hz; subsequently, a load-to-failure test at 1 mm/s was performed. The ultimate failure load, stiffness, displacement at cyclic and failure loading, and mode of failure were recorded. The all-suture anchor technique displayed values of ultimate failure load and stiffness comparable to that of the interference screw technique. The displacement at cyclic and failure loading of the all-suture anchor trials were significantly greater than the interference screw (P = .0002). The all-suture anchor specimens experienced anchor pullout and tendon tear equally during the trials, whereas the interference screw group experienced tendon tear in most of the cases and screw pullout in 2 trials. The Y-knot all-suture anchor fixation provides equivalent ultimate failure load and stiffness when compared with the interference screw technique in tenodesis of the proximal biceps tendon from a subpectoral approach. However, the interference screw technique demonstrates significantly less displacement in response to cyclic and failure loading. The all-suture anchor fixation is an alternative technique for subpectoral biceps tenodesis even at greater displacement when compared with the interference screw fixation during cyclic and failure loading. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  13. Amplatzer Vascular Plug Anchoring Technique to Stabilize the Delivery System for Microcoil Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Onozawa, Shiro, E-mail: onozawa@nms.ac.jp; Murata, Satoru, E-mail: genji@nms.ac.jp [Nippon Medical School, Department of Radiology/Center for Advanced Medical Technology (Japan); Mine, Takahiko, E-mail: takahikomine@gmail.com [Tokai University School of Medicine, Department of Radiology, Tokai University Hachioji Hospital (Japan); Sugihara, Fumie, E-mail: giorcubgogo@yahoo.co.jp; Yasui, Daisuke, E-mail: ledhotcp@nms.ac.jp; Kumita, Shin-ichiro, E-mail: s-kumita@nms.ac.jp [Nippon Medical School, Department of Radiology/Center for Advanced Medical Technology (Japan)

    2016-05-15

    PurposeTo evaluate the feasibility of a novel embolization technique, the Amplatzer vascular plug (AVP) anchoring technique, to stabilize the delivery system for microcoil embolization.Materials and methodsThree patients were enrolled in this study, including two cases of internal iliac artery aneurysms and one case of internal iliac arterial occlusion prior to endovascular aortic repair. An AVP was used in each case for embolization of one target artery, and the AVP was left in place. The AVP detachment wire was then used as an anchor to stabilize the delivery system for microcoil embolization to embolize the second target artery adjacent to the first target artery. The microcatheter for the microcoils was inserted parallel to the AVP detachment wire in the guiding sheath or catheter used for the AVP.ResultsThe AVP anchoring technique was achieved and the microcatheter was easily advanced to the second target artery in all three cases.ConclusionThe AVP anchoring technique was found to be feasible to advance the microcatheter into the neighboring artery of an AVP-embolized artery.

  14. Rotator cuff tendon repair morphology comparing 2 single-anchor repair techniques.

    Science.gov (United States)

    Park, Maxwell C; Bui, Christopher; Park, Chong J; Oh, Joo H; Lee, Thay Q

    2013-07-01

    To compare the effect of 2 common rotator cuff repair techniques, for smaller tears limited to the use of a single anchor, on tendon morphology in relation to the footprint. Six matched pairs of human shoulders were dissected, and a standardized 10-mm supraspinatus tendon tear was created. Two single-anchor repairs were performed: simple repair with the anchor on the footprint or inverted-mattress repair with the anchor 1 cm distal-lateral to the footprint. The repaired specimens were frozen in situ with liquid nitrogen. Coronal cross sections through the intact and repaired tendon were made. A digitizer was used to measure variables including tendon area and radius of tendon curvature. Comparing between repairs, we found significantly more gap formation for the simple repair at the repair cross section (3.67 ± 0.32 mm v 0.68 ± 0.10 mm, P = .00050). The simple repair had less tendon area (38.28 ± 2.50 mm(2)v 58.65 ± 4.06 mm(2), P = .0036) and a smaller radius of curvature (8.47 ± 1.39 mm v 32.51 ± 3.94 mm, P = .0046). For the simple repair, there was significantly more gap formation, less tendon area, and a smaller radius of tendon curvature for all repair cross sections compared with the intact cross sections (P anchor, using a distal-lateral anchor position with tape-type suture can provide better maintenance of native tendon morphology and footprint dimensions when compared with repair that uses standard sutures and places the anchor on the footprint. For smaller tears, the inverted-mattress repair described in this article may provide a relatively improved healing environment compared with a simple repair on the footprint, potentially optimizing the prevention of early tear progression. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  15. Complications after subpectoral biceps tenodesis using a dual suture anchor technique.

    Science.gov (United States)

    Abtahi, Amir M; Granger, Erin K; Tashjian, Robert Z

    2014-04-01

    A variety of fixation techniques for subpectoral biceps tenodeses have been described including interference screw and suture anchor fixation. Biomechanical data suggests that dual suture anchor fixation has equivalent strength compared to interference screw fixation. The purpose of the study is to determine the early complication rate after subpectoral biceps tenodesis utilizing a dual suture anchor technique. A total of 103 open subpectoral biceps tenodeses were performed over a 3-year period using a dual suture anchor technique. There were 72 male and 31 female shoulders. The average age at the time of tenodesis was 45.5 years. 41 patients had a minimum of 6 months clinical follow-up (range, 6 to 45 months). The tenodesis was performed for biceps tendonitis, superior labral tears, biceps tendon subluxation, biceps tendon partial tears, and revisions of prior tenodeses. There were a total of 7 complications (7%) in the entire group. There were 4 superficial wound infections (4%). There were 2 temporary nerve palsies (2%) resulting from the interscalene block. One patient had persistent numbness of the ear and a second patient had a temporary phrenic nerve palsy resulting in respiratory dysfunction and hospital admission. One patient developed a pulmonary embolism requiring hospital admission and anticoagulation. There were no hematomas, wound dehiscences, peripheral nerve injuries, or ruptures. In the sub-group of patients with a minimum of 6 months clinical follow-up, the only complication was a single wound infection treated with oral antibiotics. Subpectoral biceps tenodesis utilizing a dual suture anchor technique has a low early complication rate with no ruptures or deep infections. The complication rate is comparable to those previously reported for interference screw subpectoral tenodesis and should be considered as a reasonable alternative to interference screw fixation. Level IV-Retrospective Case Series.

  16. Biomechanical Evaluation of Suture Anchor Versus Transosseous Tunnel Quadriceps Tendon Repair Techniques.

    Science.gov (United States)

    Sherman, Seth L; Copeland, Marilyn E; Milles, Jeffrey L; Flood, David A; Pfeiffer, Ferris M

    2016-06-01

    To evaluate the biomechanical fixation strength of suture anchor and transosseous tunnel repair of the quadriceps tendon in a standardized cadaveric repair model. Twelve "patella-only" specimens were used. Dual-energy X-ray absorptiometry measurement was performed to ensure equal bone quality amongst groups. Specimens were randomly assigned to either a suture anchor repair of quadriceps tendon group (n = 6) or a transosseous tunnel repair group (n = 6). Suture type and repair configuration were equivalent. After the respective procedures were performed, each patella was mounted into a gripping jig. Tensile load was applied at a rate of 0.1 mm/s up to 100 N after which cyclic loading was applied at a rate of 1 Hz between magnitudes of 50 to 150 N, 50 to 200 N, 50 to 250 N, and tensile load at a rate of 0.1 mm/s until failure. Outcome measures included load to failure, displacement at 1st 100 N load, and displacement after each 10th cycle of loading. The measured cyclic displacement to the first 100 N, 50 to 150 N, 50 to 200 N, and 50 to 250 N was significantly less for suture anchors than transosseous tunnels. There was no statistically significant difference in ultimate load to failure between the 2 groups (P = .40). Failure mode for all suture anchors except one was through the soft tissue. Failure mode for all transosseous specimens but one was pulling the repair through the transosseous tunnel. Suture anchor quadriceps tendon repairs had significantly decreased gapping during cyclic loading, but no statistically significant difference in ultimate load to failure when compared with transosseous tunnel repairs. Although suture anchor quadriceps tendon repair appears to be a biomechanically superior construct, a clinical study is needed to confirm this technique as a viable alternative to gold standard transosseous techniques. Although in vivo studies are needed, these results support the suture anchor technique as a viable alternative to

  17. Operative treatment of acromioclavicular joint dislocation: a new technique with suture anchors

    Directory of Open Access Journals (Sweden)

    Zhang Jingwei

    2014-07-01

    Full Text Available 【Abstract】Objective: To evaluate clinical outcome of suture anchors in strengthening both acromioclavicular and coracoclavicular ligaments in the surgical treatment of acromioclavicular joint dislocation. Methods: Twenty-eight patients with acute traumatic Rockwood III, IV and V dislocations of the acromioclavicular joint surgically treated at our institute between October 2010 and January 2012 were recruited. All patients underwent open reduction combined with suture anchors. Function was evaluated using the ConstantMurley shoulder score. Clinical and radiographic shoulder ratings were evaluated using Taft criteria at 3, 6 and 12 months. Results:Two cases with fixation loosening were not included in final statistical analysis. Other patients obtained full joint reposition on immediate postoperative radiographs. Follow-up was performed with an average of 15.6 months (range, 12-19. After early range of motion exercises, 96.2% of the patients (25/26 could abduct and elevate their shoulders more than 90 degrees within postoperative 3 months. There was no infection. Average Constant-Murley score was 96.3 points (range, 94-100 and mean Taft shoulder rating was 10.7 points (range, 8-12 at 12 months. Conclusion: The suture anchor is a relatively simple technique and can avoid screw removal which is helpful in reconstructing both acromioclavicular and coracoclavicular ligaments in acute traumatic acromioclavicular joint dislocation. Key words: Acromioclavicular joint; Dislocations; Surgery; Suture anchors

  18. Predicting the Pullout Capacity of Small Ground Anchors Using Nonlinear Integrated Computing Techniques

    Directory of Open Access Journals (Sweden)

    Mosbeh R. Kaloop

    2017-01-01

    Full Text Available This study investigates predicting the pullout capacity of small ground anchors using nonlinear computing techniques. The input-output prediction model for the nonlinear Hammerstein-Wiener (NHW and delay inputs for the adaptive neurofuzzy inference system (DANFIS are developed and utilized to predict the pullout capacity. The results of the developed models are compared with previous studies that used artificial neural networks and least square support vector machine techniques for the same case study. The in situ data collection and statistical performances are used to evaluate the models performance. Results show that the developed models enhance the precision of predicting the pullout capacity when compared with previous studies. Also, the DANFIS model performance is proven to be better than other models used to detect the pullout capacity of ground anchors.

  19. Traumatic lumbar hernia repair: a laparoscopic technique for mesh fixation with an iliac crest suture anchor.

    Science.gov (United States)

    Links, D J R; Berney, C R

    2011-12-01

    Traumatic lumbar hernia (TLH) is a rare presentation. Traditionally, these have been repaired via an open approach. Recurrence can be a problem due to the often limited tissue available for mesh fixation at the inferior aspect of the hernia defect. We report the successful use of bone suture anchors placed in the iliac crest during transperitoneal laparoscopy for mesh fixation to repair a recurrent TLH. This technique may be particularly useful after previous failed attempts at open TLH repair.

  20. Novel Technique for Proximal Bone Anchoring of Penile Prosthesis After Radial Forearm Free Flap Neophallus.

    Science.gov (United States)

    Cohen, Andrew J; Bhanvadia, Raj R; Pariser, Joseph J; Hatcher, David M; Gottlieb, Lawrence J; Bales, Gregory T

    2017-07-01

    To describe outcomes of bone anchoring of penile implant in a neophallus with an accompanying video focusing on operative technique and salient tips for surgeons performing these procedures. Penile prosthesis insertion allows individuals with a neophallus to achieve erectile function. Lack of corporal bodies to accommodate cylinders makes anchoring of any prosthesis challenging. Anchoring the device to the pubic bone is one strategy to achieve proximal stabilization. A single-institution, retrospective chart review of 10 neophallus patients undergoing penile prosthesis placement from 2006 to 2015 was done. The pubic symphysis is exposed and corticotomy created for placement of the rear tip extender of the implant using a Stryker TPS bone drill. Anchoring sutures through the corticotomy defect, rear tip, and proximal cylinder seat the implant. The remainder of the implantation procedure mirrors that used in native tissue. The overall perioperative complication rate was 20%, with a mean follow-up of 49 months. Seventy percent of the patients required reoperation, with a mean of 1.4 prosthesis revision surgeries per patient. Primary causes of revision included infection, poor fixation of the rear tip, and prosthesis failure. Despite high revision rates, 80% of the patients have fully functioning prosthesis as of last follow-up. Limitations include retrospective study design and the small patient cohort. Penile prosthesis placement in the neophallus is feasible and effective. A bone-anchored rear tip is an option to provide proximal stabilization. Continued efforts to minimize the need for revisions are ongoing and necessary. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. A mobile anchor assisted localization algorithm based on regular hexagon in wireless sensor networks.

    Science.gov (United States)

    Han, Guangjie; Zhang, Chenyu; Lloret, Jaime; Shu, Lei; Rodrigues, Joel J P C

    2014-01-01

    Localization is one of the key technologies in wireless sensor networks (WSNs), since it provides fundamental support for many location-aware protocols and applications. Constraints of cost and power consumption make it infeasible to equip each sensor node in the network with a global position system (GPS) unit, especially for large-scale WSNs. A promising method to localize unknown nodes is to use several mobile anchors which are equipped with GPS units moving among unknown nodes and periodically broadcasting their current locations to help nearby unknown nodes with localization. This paper proposes a mobile anchor assisted localization algorithm based on regular hexagon (MAALRH) in two-dimensional WSNs, which can cover the whole monitoring area with a boundary compensation method. Unknown nodes calculate their positions by using trilateration. We compare the MAALRH with HILBERT, CIRCLES, and S-CURVES algorithms in terms of localization ratio, localization accuracy, and path length. Simulations show that the MAALRH can achieve high localization ratio and localization accuracy when the communication range is not smaller than the trajectory resolution.

  2. A Mobile Anchor Assisted Localization Algorithm Based on Regular Hexagon in Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Guangjie Han

    2014-01-01

    Full Text Available Localization is one of the key technologies in wireless sensor networks (WSNs, since it provides fundamental support for many location-aware protocols and applications. Constraints of cost and power consumption make it infeasible to equip each sensor node in the network with a global position system (GPS unit, especially for large-scale WSNs. A promising method to localize unknown nodes is to use several mobile anchors which are equipped with GPS units moving among unknown nodes and periodically broadcasting their current locations to help nearby unknown nodes with localization. This paper proposes a mobile anchor assisted localization algorithm based on regular hexagon (MAALRH in two-dimensional WSNs, which can cover the whole monitoring area with a boundary compensation method. Unknown nodes calculate their positions by using trilateration. We compare the MAALRH with HILBERT, CIRCLES, and S-CURVES algorithms in terms of localization ratio, localization accuracy, and path length. Simulations show that the MAALRH can achieve high localization ratio and localization accuracy when the communication range is not smaller than the trajectory resolution.

  3. A Mobile Anchor Assisted Localization Algorithm Based on Regular Hexagon in Wireless Sensor Networks

    Science.gov (United States)

    Rodrigues, Joel J. P. C.

    2014-01-01

    Localization is one of the key technologies in wireless sensor networks (WSNs), since it provides fundamental support for many location-aware protocols and applications. Constraints of cost and power consumption make it infeasible to equip each sensor node in the network with a global position system (GPS) unit, especially for large-scale WSNs. A promising method to localize unknown nodes is to use several mobile anchors which are equipped with GPS units moving among unknown nodes and periodically broadcasting their current locations to help nearby unknown nodes with localization. This paper proposes a mobile anchor assisted localization algorithm based on regular hexagon (MAALRH) in two-dimensional WSNs, which can cover the whole monitoring area with a boundary compensation method. Unknown nodes calculate their positions by using trilateration. We compare the MAALRH with HILBERT, CIRCLES, and S-CURVES algorithms in terms of localization ratio, localization accuracy, and path length. Simulations show that the MAALRH can achieve high localization ratio and localization accuracy when the communication range is not smaller than the trajectory resolution. PMID:25133212

  4. [PART-KESSLER TECHNIQUE WITH SUTURE ANCHOR IN REPAIR OF SPONTANEOUS Achilles TENDON RUPTURE].

    Science.gov (United States)

    Qi, Jie; Duan, Liang; Li, Weiwei; Wei, Wenbo

    2016-02-01

    To summarize the application and experience of repairing spontaneous Achilles tendon rupture by part-Kessler technique with suture anchor. Between January 2011 and December 2013, 31 patients with spontaneous Achilles tendon rupture were treated by part-Kessler technique with suture anchor. Of 31 cases, 23 were male and 8 were female, aged 16-53 years (mean, 38 years). The left side was involved in 15 cases and the right side in 16 cases. The causes of injury included sudden heel pain and walking weakness during sports in 22 cases; no surefooted down-stairs, slip, and carrying heavy loads in 9 cases. The distance from broken site to the calcaneus adhension of Achilles tendon was 3-6 cm (mean, 4.2 cm). The time from injury to operation was 7 hours to 4 days (mean, 36.8 hours). All incisions healed by first intention without nerve injury or adhering with skin. The patients were followed up 6-24 months (mean, 15 months). All patients could complete 25 times heel raising without difficulty at 6 months after operation. No Achilles tendon rupture occurred again during follow-up. At 6 months after operation, the range of motion of the ankle joint in dorsiflexion and plantar flexion showed no significant difference between normal and affected sides (t=0.648, P=0.525; t=0.524, P=0.605). The circumference of the affected leg was significantly smaller than that of normal leg at 6 months after operation (t=2.074, P=0.041), but no significant difference was found between affected and normal sides at 12 months after operation (t=0.905, P=0.426). The American Orthopedic Foot and Ankle Society (AOFAS) scores at 6, 12, 18, and 24 months after operation were significantly higher than preoperative score (P0.05). Repairing spontaneous Achilles tendon rupture by part-Kessler technique with suture anchor can supply strong strain and decrease the shear forces of suture. So part-Kessler technique with suture anchor is successful in repairing spontaneous Achilles tendon rupture.

  5. A Simplified Technique for Orientation of a Bone Anchored Auricular Prostheses: a Clinical Report

    Directory of Open Access Journals (Sweden)

    Hussein G. El Charkawi

    2012-08-01

    Full Text Available Background: A simple technique was presented in this clinical report for orientation of a bone anchored auricular prosthesis.Methods: The proposed technique includes drawing the intact ear on a transparent celluloid paper or radiographic film and flipping it to the opposite side and relating it to the fixed anatomical features on the face of patient.Results: The drawing, by this way provides a simple and easy way to duplicate and transfer the exact size and position of the intact ear to the defect side.Conclusions: This technique provides a simple, safe, inexpensive and time saving yet, an accurate and effective surgical template that orients the craniofacial implants to the confines of the definitive auricular prosthesis. It is indicated for restoration of single missing external ear either in aplasia, injuries and total resection.

  6. Simplified technique without skin flap for the bone-anchored hearing aid (BAHA) implant.

    Science.gov (United States)

    Bovo, R

    2008-10-01

    Aim of this report is to present a new surgical technique for the BAHA system implant and to discuss the operational techniques and complications related to this type of surgery. The common technique for the positioning of the Bone-Anchored Hearing Aid (BAHA, Cochlear Limited, Englewood, CO, USA) titanium implant into the temporal bone is based on the use of either a free or a pedunculated skin flap. Reported complications of this type of surgery include skin flap necrosis with healing by second intention, infection of the flap, skin growth over the abutment, failure of osseointegration and implant extrusion. In order to reduce the incidence of these problems, different types of surgery have already been presented over the years. Herewith, a new technique is proposed for implanting a BAHA screw in the temporal bone, that is simple, rapid to perform, and does not require the use of a flap. This technique appears to offer two main advantages: i) the speeding up of the procedure; ii) the low risk of complications, such as infection and necrosis, within the skin surrounding the implant.

  7. Avulsion Fracture of the Calcaneus Treated With a Soft Anchor Bridge and Lag Screw Technique: A Report of Two Cases.

    Science.gov (United States)

    Yoshida, Kazushige; Kasama, Kentaro; Akahane, Tsutomu

    2016-01-01

    The displaced extra-articular avulsion fracture of the calcaneus has been classified as a Böhler type 1c calcaneal fracture, and most cases will require surgical repair. In the present report, we describe 2 patients in whom we performed the soft anchor bridge technique using single loaded suture anchors with lag screws for the repair of Böhler type 1c avulsion fractures of the calcaneus. In one of these patients, clinically relevant osteoporosis complicated the injury. In both cases, bone union was achieved, and by 1.5 months after surgery satisfactory recovery was observed. To our knowledge, the soft anchor bridge technique was first used for the treatment of rotator cuff tears, and the greatest merit of this technique is the ability to generate vertical compression force to the pulled out rotator cuff through the use of knotting sutures. In recent years, the soft anchor bridge technique using 4 suture anchors has also been used for fractures of the greater tuberosity of the humerus, an injury that poses operative difficulties similar to those encountered with an avulsion fracture of the calcaneus owing to the traction force of the rotator cuff and relative weakness of adjacent bone. The outcomes of our patients suggest that the soft anchor bridge technique combined with adjunct lag screws is useful in the fixation of avulsion fractures of the calcaneus. In addition, the result in the elderly patient indicates the possibility of using this technique for patients with osteoporosis. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Comparison of All-Inside Suture Technique with Traditional Pull-out Suture and Suture Anchor Repair Techniques for Flexor Digitorum Profundus Attachment to Bone

    Science.gov (United States)

    Chu, Jennifer Y; Chen, Tony; Awad, Hani A.; Elfar, John; Hammert, Warren C.

    2015-01-01

    Purpose One goal in repairing Zone 1 flexor digitorum profundus (FDP) injuries is to create a tendon-bone construct strong enough to allow early rehabilitation while minimizing morbidity. This study introduces an alternative all-inside suture repair technique and compares it biomechanically with pull-out suture and double suture anchor repairs. Methods Repairs were performed on thirty cadaver fingers. In all-inside suture repairs (n=8), the FDP tendon was attached to bone with two 3-0 Ethibond sutures and tied over the dorsal aspect of distal phalanx. Pull-out suture repairs (n=8) were performed with 2-0 Prolene suture and tied over a dorsal button. There were two suture anchor repair groups: Arthrex Micro Corkscrew anchors preloaded with 2-0 FiberWire suture (n=7) and Depuy Micro Mitek anchors preloaded with 3-0 Orthocord suture (n=7). Repair constructs were tested using a servohydraulic materials testing system and loaded until the repair lost 75% of its strength. Results There were no statistically significant differences in tensile stiffness, ultimate load, or work to failure between the repairs. Failure mode was suture stretch and gap formation >2mm at the repair site for all pull-out suture repairs and 7 of 8 all-inside suture repairs. Two of the Arthrex Micro Corkscrew repairs and five of the Depuy Micro Mitek repairs failed by anchor pull out. Conclusions This cadaveric biomechanical study showed no difference in tensile stiffness, ultimate load, and work to failures between an all-inside suture repair technique for zone 1 FDP repairs and previously described pull-out suture and suture anchor repair techniques. The all-inside suture technique also has the advantages of avoiding an external button and the cost of anchors. Therefore, it should be considered as an alternative to other techniques. Clinical Relevance This study introduces a new FDP reattachment technique that avoids some of the complications of current techniques. PMID:23578439

  9. Suture anchor fixation of displaced olecranon fractures in the elderly: a case series and surgical technique.

    Science.gov (United States)

    Bateman, Dexter K; Barlow, Jonathan D; VanBeek, Corinne; Abboud, Joseph A

    2015-07-01

    Olecranon fractures are common in elderly patients, causing significant morbidity and functional impairment. Traditional surgical treatments are often complicated by hardware failure and prominence, frequently requiring reoperation. To address these concerns, a suture anchor fixation technique was developed and clinically evaluated. A consecutive series of elderly patients treated with this technique from 2006 to 2013 at a single institution were studied. All cases were surgically repaired with nonmetallic fully threaded suture anchors in a double-row fashion. Clinical outcome measures including the shortened Disabilities of the Arm, Shoulder, and Hand score, the Oxford Elbow Score, and the 12-Item Short Form Health Survey score were obtained. Eight female patients with Mayo IIA or IIB fractures were identified. The mean age of the patients at time of operation was 73.5 ± 10.7 years (range, 59.3-88.8 years). The average time from injury to operation was 5.7 ± 3.7 days. The average follow-up was 5.1 ± 2.5 years (range, 0.8-7.4 years). Six patients were available for long-term follow-up; 1 patient had died, and 1 patient was unable to be contacted despite multiple attempts. There were no intraoperative complications or reoperations. All 8 patients healed uneventfully in an acceptable position without displacement. Postoperatively, the average Oxford Elbow Score was 47.17 ± 2.04; the average shortened Disabilities of the Arm, Shoulder, and Hand score was 6.43 ± 9.47; and the average 12-Item Short Form Health Survey scores were 49.02 ± 16.59 and 55.38 ± 4.05 for the physical and mental component scales, respectively. Suture anchor fixation of olecranon fractures in the elderly population provides excellent long-term radiographic and clinical outcomes without hardware complications associated with traditional fixation methods. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  10. Novel Suture Anchor Technique with Continuous Locking Stitch for Collateral Ligament Repair.

    Science.gov (United States)

    Tokunaga, Susumu; Abe, Yoshihiro

    2016-06-01

    Collateral ligaments are difficult to repair due to large amount of fraying in detached ligaments and attenuated stumps that may not provide enough strength after the repair. Although strong locking sutures are used to repair the ligament with proper tension, these damages can cause pull-out failure or relaxation of the repaired ligaments even from undersized load that may extend postoperative splinting or casting time. Furthermore, current suture techniques can repair varus or valgus instability of the elbow and radial or ulnar instability of the fingers, but these techniques do not offer rotatory stability of these areas. We have developed a novel suture anchor technique that has overcome this problem of current suture techniques, and this can be used to correct rotatory instability in the elbow and fingers. We used this procedure in seven cases with injury of collateral ligament in the elbow and eight cases with detached collateral ligaments of finger joint. No patient experienced rerupture or any kind of residual instability. We believe that the proposed method can produce much stronger repair and may shorten the postoperative immobilization period.

  11. Novel ultrasound assisted suture anchor system using the BoneWelding® technology yields a comparable primary stability in osteopenic and healthy human humeri as a benchmark anchor.

    Science.gov (United States)

    Güleçyüz, Mehmet F; Schröder, Christian; Pietschmann, Matthias F; Göbel, Stephanie; Lehmann, Mario; Mayer, Jörg; Ficklscherer, Andreas; Jansson, Volkmar; Müller, Peter E

    2017-12-28

    The aim of this biomechanical study was to evaluate the primary stability of the SportWelding® Sombrero 3.6 mm suture anchor system in osteopenic and healthy cadaveric humeri. The Sombrero® and BioCorkscrew® anchors were deployed in 8 osteopenic and 4 healthy cadaver humeri after the bone mineral density (BMD) measurements of the 32 specimens. Both anchors were loaded with a USP Nr. 2 FiberWire® suture. An established cyclic testing protocol was performed. The maximum failure load (Fmax), the system displacement and the modes of failure were recorded. The Fmax and system displacement of the Sombrero® in osteopenic and healthy humeri was equivalent to the Bio-Corkscrew® benchmark anchor; there were no significant differences in the maximum failure loads and system displacement values. Only anchor and suture dislocations were observed; suture ruptures did not occur. This study shows that the Sombrero® yields similar maximum failure loads and system displacement values as the established Bio-Corkscrew® benchmark anchor. The primary stability of the Sombrero® and Bio-Corkscrew® seems to be independent of the bone mineral quality. This relatively small-sized polymer anchor is independent of the BMD and may be an alternative to established suture anchors in rotator cuff repair. Copyright © 2017 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

  12. Study on the support-anchor combined technique to control perilous rock at the source of avalanche by fracture mechanics

    Science.gov (United States)

    Chen, H. K.; Tang, H. M.

    2013-05-01

    As a kind of existing and potential geological disaster at the source of avalanche on cliffs or steep slopes, perilous rock has developed in the western area of China widely, and it has posed a serious threat to highways, railways, pipelines, cities, and mining for a long time. More than ten years of engineering experience have shown the necessity and importance to pay our attention to the avalanche sources in active collapse mitigation. The support-anchor combined technique is devoted to the active hazard mitigation measures of perilous rock. This paper introduces fracture mechanics to investigate the design procedure of the support-anchor combined technique. To obtain reasonable design parameters of the technique, both stability assessment criterion and three safety classes of protection engineering for perilous rock is proposed, further, stable analysis methods for various types of perilous rock are established by using fracture mechanics. Abiding by the idea that to improve stability coefficient to a higher level, the support force of structure and the anchorage force of anchorbolt from the support-anchor combined technique are introduced into stability analysis methods established above, which can estimate the section dimension of support subunit and the amount of anchorbolt of the technique. Engineering applications of the technique in thousands of protection engineering have identified the remarkable effectiveness

  13. Conservative management equally effective to new suture anchor technique for acute mallet finger deformity: A prospective randomized clinical trial.

    Science.gov (United States)

    Batıbay, Sefa Giray; Akgül, Turgut; Bayram, Serkan; Ayık, Ömer; Durmaz, Hayati

    2017-09-28

    Prospective randomized controlled trial. This study was designed to compare our new suture anchor technique with conservative management in acute Wehbe-Schneider type I A-B and II A-B mallet fingers. Twenty nine patients who presented to our clinic between 2013 and 2015 were randomized for surgical or conservative treatment. Wehbe-Schneider subtype C fractures were excluded. Fourteen were treated with surgery, and 15 were treated with conservative treatment. Primary outcomes were visual analog scale score, active distal interphalangeal (DIP) joint flexion, return to work, extension deficit and DIP joint degeneration. Follow-up time was 12 months. The mean visual analog scale was 2.0, and return to work was on average in 63.2 days in the surgical group and 1.47 and 53.7 days in the conservative group. Extension deficit was 8.1° in the surgical group and 6.1° in the conservative group. The mean DIP flexion at final follow-up was 54.5° (40-65) in the surgery group and 58.3° (45-70) in the conservative group. DIP joint degeneration was observed with X-rays in 4 patients in surgical group, and none of the patients in the conservative group had DIP degeneration at 1 year after treatment. The therapeutic effectiveness of suture anchor technique was not statistically different from conservative treatment. Subluxation seen after fixation treatment with suture anchors may be due to inadequate anchor fixation. DIP joint degeneration was seen significantly more in the surgical group. Our study suggests that the new suture anchor technique is not superior to conservative treatment. Ib. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  14. Arthroscopic rotator cuff repair using a triple-loaded suture anchor and a modified Mason-Allen technique (Alex stitch).

    Science.gov (United States)

    Castagna, Alessandro; Garofalo, Raffaele; Conti, Marco; Borroni, Mario; Snyder, Stephen J

    2007-04-01

    Surgical repair of the rotator cuff must have good resistance and should restore the tendon footprint. To attain this goal, a stitch with a strong biomechanical profile that avoids tissue strangulation should be used. We describe an arthroscopic suture technique undertaken to repair rotator cuff tears with a single triple-loaded suture anchor. The technique consists of a combination of a horizontal mattress and 2 vertical simple sutures that are positioned medial to the mattress suture. The suture anchor used is the 5-mm self-tapping ThRevo (Linvatec). This anchor is loaded with 3 sutures: 2 No. 2 nonabsorbable braided polyester sutures of different colors and a central high-strength No. 2 polyethylene suture. The shape of the anchor eyelet permits all 3 sutures to glide freely. A modified Mason-Allen technique (Alex stitch) that combines a horizontal side-to-side suture and 2 simples sutures as vertical loops is used. With use of the Spectrum suture passing device and shuttle relay system (Linvatec), both limbs of the centrally located polyethylene suture are passed through the cuff from bottom to top, approximately 1 cm from the tendon edge. This suture is not immediately tied. Next, with use of the same system, the other 2 sutures are placed medially and over the previous horizontal suture. Simple sutures are placed at an approximately 30 degrees angle from the center of the anchor; 1 is placed anterior and the other posterior. The sutures are tied through the lateral portal. The mattress horizontal central stitch is always tied first, followed by the 2 vertical sutures. The horizontal mattress suture serves as a "rip stop stitch" and theoretically reduces the possibility of cutting out of the simple sutures.

  15. Triple labrum tears repaired with the JuggerKnot™ soft anchor: Technique and results

    Science.gov (United States)

    Agrawal, Vivek; Pietrzak, William S.

    2015-01-01

    Purpose: The 2-year outcomes of patients undergoing repair of triple labrum tears using an all-suture anchor device were assessed. Materials and Methods: Eighteen patients (17 male, one female; mean age 36.4 years, range: 14.2-62.3 years) with triple labrum tears underwent arthroscopic repair using the 1.4 mm JuggerKnot Soft Anchor (mean number of anchors 11.5, range: 9-19 anchors). Five patients had prior surgeries performed on their operative shoulder. Patients were followed for a mean of 2.0 years (range: 1.6-3.0 years). Constant–Murley shoulder score (CS) and Flexilevel scale of shoulder function (FLEX-SF) scores were measured, with preoperative and final postoperative mean scores compared with a paired Student's t-test (P Anchor tracts appeared to heal with fibrous tissue, complete bony healing, or combined fibro-osseous healing. Conclusion: Our results are encouraging, demonstrating a consistent healing of the anchor tunnels through arthroscopic treatment of complex labrum lesions with a completely suture-based implant. It further demonstrates a meaningful improvement in patient outcomes, a predictable return to activity, and a high rate of patient satisfaction. Level of Evidence: Level IV case series. PMID:26288537

  16. Comparison of an all-inside suture technique with traditional pull-out suture and suture anchor repair techniques for flexor digitorum profundus attachment to bone.

    Science.gov (United States)

    Chu, Jennifer Y; Chen, Tony; Awad, Hani A; Elfar, John; Hammert, Warren C

    2013-06-01

    One goal in repairing zone 1 flexor digitorum profundus (FDP) injuries is to create a tendon-bone construct strong enough to allow early rehabilitation while minimizing morbidity. This study compares an all-inside suture repair technique biomechanically with pull-out suture and double-suture anchor repairs. Repairs were performed on 30 cadaver fingers. In all-inside suture repairs (n = 8), the FDP tendon was attached to bone with two 3-0 Ethibond sutures and tied over the dorsal aspect of distal phalanx. Pull-out suture repairs (n = 8) were performed with 2-0 Prolene suture and tied over a dorsal button. There were 2 suture anchor repair groups: Arthrex Micro Corkscrew anchors preloaded with 2-0 FiberWire suture (n = 7) and Depuy Micro Mitek anchors preloaded with 3-0 Orthocord suture (n = 7). Repair constructs were tested using a servohydraulic materials testing system and loaded until the repair lost 75% of its strength. There were no statistically significant differences in tensile stiffness, ultimate load, or work to failure between the repairs. Failure mode was suture stretch and gap formation greater than 2 mm at the repair site for all pull-out suture repairs and for 7 of 8 all-inside suture repairs. Two of the Arthrex Micro Corkscrew repairs and 5 of the Depuy Micro Mitek repairs failed by anchor pull-out. This cadaveric biomechanical study showed no difference in tensile stiffness, ultimate load, and work to failures between an all-inside suture repair technique for zone 1 FDP repairs and previously described pull-out suture and suture anchor repair techniques. The all-inside suture technique also has the advantages of avoiding an external button and the cost of anchors. Therefore, it should be considered as an alternative to other techniques. This study introduces a new FDP reattachment technique that avoids some of the shortcomings of current techniques. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights

  17. Comparative evaluation of different anchoring techniques for synthetic cruciate ligaments. A biomechanical and animal investigation.

    Science.gov (United States)

    Letsch, R

    1994-01-01

    Under certain well-defined indications alloplastic material may be used in cruciate ligament surgery. The stability and survival of such a synthetic ligament is to a great extent dependent on the anchorage with which it is fastened to the bone. Most fixation methods have proved to be too weak or have revealed other essential drawbacks, resulting in clinical and experimental failure. A new ligament fixation device (LFD) was developed and tested biomechanically and in animal experiments. In the biomechanic investigation the new LFD was compared to single staples, double staples in the belt-buckle technique, and ligament guidance through additional bone tunnels (Z-technique). The tests were carried out on human cadaver knees, plastic bones, and dog stifle joints. The evaluated parameters were linear and maximum load, stiffness, and elongation. In addition, hysteresis tests were performed to assay the long-term resistance of the fixation. The tests showed a significant superiority of the LFD in all measured variables compared to the other anchorages. The pull-out strength, at 1866 +/- 43 N (cadaver knee), was about four times that for the single staple, and about twice as high as that for the double staple and Z-technique. The animal experiments were performed on German shepherd cross-breed dogs. In six animals the anterior cruciate ligaments were excised bilaterally and replaced by a 6-mm Trevira ligament, on one side anchored with staples in the Z-technique, on the other with the LFD. Postoperatively the dogs were allowed to move freely; no additional protection was employed. After 6 months the animals were sacrificed and the knees examined macroscopically, radiologically, microscopically, and by biomechanical testing. After half a year of implantation, the pull-out strength of the alloplastic ligament was 662 +/- 62 N for the LFD and 531 +/- 67 N for the staples. Three ligaments in the staple group and one in the LFD group had ruptured completely, and two ligaments

  18. Clinical Outcome of a Wide-diameter Bone-anchored Hearing Implant and a Surgical Technique With Tissue Preservation

    DEFF Research Database (Denmark)

    Mowinckel, Marius S; Møller, Martin N; Wielandt, Kirsten N

    2016-01-01

    OBJECTIVE: To investigate the clinical outcome of a surgical technique with tissue preservation for a wide bone-anchored hearing implant concerning postoperative complications, skin reactions, implant loss, and implant stability. STUDY DESIGN: Consecutive, prospective case series. SETTING: Tertiary...... referral center. PATIENTS: Twenty-four adult patients with normal skin quality were enrolled. INTERVENTION(S): Implantation of bone-anchored implant was performed using a one-stage linear-incision technique with tissue preservation surgery. MAIN OUTCOME MEASURES(S): Skin and soft tissue reactions according...... to Holgers grading system. Pain and numbness measured according to visual analogue scale. Implant stability quotient values were recorded using resonance frequency analysis. Follow-up at 10 days, 6 weeks, 6 months, and 1 year after surgery. RESULTS: Primary implant stability was good and a significant...

  19. Anatomic suture anchor versus the Broström technique for anterior talofibular ligament repair: a biomechanical comparison.

    Science.gov (United States)

    Waldrop, Norman E; Wijdicks, Coen A; Jansson, Kyle S; LaPrade, Robert F; Clanton, Thomas O

    2012-11-01

    Despite the popularity of the Broström procedure for secondary repair of chronic lateral ankle instability, there have been no biomechanical studies reporting on the strength of this secondary repair method, whether using suture fixation or suture anchors. The purpose of our study was to perform a biomechanical comparison of the ultimate load to failure and stiffness of the traditional Broström technique using only a suture repair compared with a suture anchor repair of the anterior talofibular ligament (ATFL) at time zero. We believed that fixation strength of the suture anchor repair would be closer to the strength of the native ligament and allow more aggressive rehabilitation. Controlled laboratory study. Twenty-four fresh-frozen cadaveric ankles were randomly divided into 4 groups of 6 specimens. One group was an intact control group, and the other groups consisted of the traditional Broström and 2 suture anchor modifications (suture anchors in talus or fibula) of the Broström procedure. The specimens were loaded to failure to determine the strength and stiffness of each construct. In load-to-failure testing, ultimate failure loads of the Broström (68.2 ± 27.8 N; P = .013), suture anchor fibula (79.2 ± 34.3 N; P = .037), and suture anchor talus (75.3 ± 45.6 N; P = .027) repairs were significantly lower than that of the intact (160.9 ± 72.2 N) ATFL group. Stiffness of the Broström (6.0 ± 2.5 N/mm; P = .02), suture anchor fibula (6.8 N/mm ± 2.7; P = .05), and suture anchor talus (6.6 N/mm ± 4.0; P = .04) repairs were significantly lower than that of the intact (12.4 N/mm ± 4.1 N/mm) ATFL group. The 3 repair groups were not significantly different from each other, but all 3 were substantially lower in strength and stiffness when compared to the intact ATFL. The use of suture anchors to repair the ATFL produces a repair that can withstand loads to failure similar to the suture-only Broström repair. However, all 3 repair groups were much weaker than

  20. The Effect of Assistive Anchor-Like Grousers on Wheeled Rover Performance over Unconsolidated Sandy Dune Inclines

    Directory of Open Access Journals (Sweden)

    Ahmad Najmuddin Ibrahim

    2016-09-01

    Full Text Available Typical rovers with wheels equipped with conventional grousers are prone to getting stuck in unconsolidated sandy dune inclines as the wheels tend to sink into the sand. This phenomenon is caused by the motion of the grouser through the sand during the latter half of the rotation, in which the grouser pushes the sand from underneath the wheel upwards and towards the backside of the wheel. This creates a space that the wheel can sink into. To minimize sand movement and subsequent sinkage, we propose the concept of using an “assistive grouser”, which is attached to the side of a conventional rover wheel. The assistive grouser is designed to be able to autonomously maintain a uniform angle relative to the rover body independent of the rotation of the wheels. Rotating the wheel causes the assistive grousers to automatically penetrate into the sand slope surface at a constant angle of attack, thereby acting as an anchor and providing traction for the wheel. Maintaining a uniform grouser angle as opposed to a rotating motion also assists in extracting the grouser out of the sand without moving the sand towards the back of the wheel. Moreover, the angle of the assistive grousers is held constantly by a single dedicated motor, meaning that the angle of the assistive grousers can be optimized to provide the least amount of sinkage for each slope angle. The experimental results showed that for slope angles of 0–30 degrees, the rover equipped with the proposed assistive grousers experienced significantly less sinkage and consumed less current compared to the rover equipped with conventional grousers.

  1. The Effect of Assistive Anchor-Like Grousers on Wheeled Rover Performance over Unconsolidated Sandy Dune Inclines.

    Science.gov (United States)

    Ibrahim, Ahmad Najmuddin; Aoshima, Shinichi; Shiroma, Naoji; Fukuoka, Yasuhiro

    2016-09-15

    Typical rovers with wheels equipped with conventional grousers are prone to getting stuck in unconsolidated sandy dune inclines as the wheels tend to sink into the sand. This phenomenon is caused by the motion of the grouser through the sand during the latter half of the rotation, in which the grouser pushes the sand from underneath the wheel upwards and towards the backside of the wheel. This creates a space that the wheel can sink into. To minimize sand movement and subsequent sinkage, we propose the concept of using an "assistive grouser", which is attached to the side of a conventional rover wheel. The assistive grouser is designed to be able to autonomously maintain a uniform angle relative to the rover body independent of the rotation of the wheels. Rotating the wheel causes the assistive grousers to automatically penetrate into the sand slope surface at a constant angle of attack, thereby acting as an anchor and providing traction for the wheel. Maintaining a uniform grouser angle as opposed to a rotating motion also assists in extracting the grouser out of the sand without moving the sand towards the back of the wheel. Moreover, the angle of the assistive grousers is held constantly by a single dedicated motor, meaning that the angle of the assistive grousers can be optimized to provide the least amount of sinkage for each slope angle. The experimental results showed that for slope angles of 0-30 degrees, the rover equipped with the proposed assistive grousers experienced significantly less sinkage and consumed less current compared to the rover equipped with conventional grousers.

  2. A Biomechanical Evaluation of a 2-Suture Anchor Repair Technique for Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Injuries.

    Science.gov (United States)

    Gil, Joseph A; Chambers, Alison; Shah, Kalpit N; Crisco, Joseph J; Got, Christopher; Akelman, Edward

    2017-08-01

    A complete thumb ulnar collateral ligament (UCL) repaired with 1-suture anchor has been demonstrated to be significantly weaker compared with the intact UCL. The objective of this study is to test the biomechanical strength of a 2-anchor thumb UCL repair. Nine paired fresh-frozen hands were used for this biomechanical analysis. One thumb from each pair was randomized to the control group and one to the repair group. In the control group, the UCL was loaded to failure in tension. In the repair group, the UCL was dissected off of the proximal phalanx, subsequently repaired with a 2-anchor technique, and then tested to failure. The mean yield load was 342 N (95% confidence interval [CI], 215-470 N) in the control group and 68 N (95% CI, 45-91 N) in the repair group. The mean maximum load at failure was 379 N (95% CI, 246-513 N) in the control group and 84 N (95% CI, 62-105 N) in the repair group. The mean stiffness was 72 N/m (95% CI, 48-96 N/m) in the control group and 17 N/m (95% CI, 13-21 N) in the repair group. The mean displacement at failure was 7.8 mm (95% CI, 7-9 mm) in the control group and 7.8 mm (95% CI, 7-9 mm) in the repair group. The 2-anchor repair technique we tested does not acutely reestablish the strength of the insertion of the native insertion of the UCL with this technique.

  3. A safety technique for Mitek anchor suture rupture: a useful trick.

    Science.gov (United States)

    Othman, Diaa; Le Cocq, Heather; Majumder, Sanjib

    2011-09-01

    We propose that the simple method of passing an extra suture through the Mitek anchor eyelet before bony insertion provides a safety net against failure of the preloaded suture and gives extra strength to the core repair. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  4. Techniques for anchoring concepts in mechanics at the FET/HET ...

    African Journals Online (AJOL)

    The intervention consisted of visualization, multifaceted view, situational application and mathematical analysis in the teaching-learning processes of modules FPHY 103 (Kinematics) and FPHY 104 (Dynamics). The post-test evaluated the anchoring of these concepts. The t-test for dependent correlated samples showed a ...

  5. Assisted reproduction techniques in the horse.

    Science.gov (United States)

    Hinrichs, Katrin

    2012-01-01

    This paper reviews current equine assisted reproduction techniques. Embryo transfer is the most common equine ART, but is still limited by the inability to superovulate mares effectively. Immature oocytes may be recovered by transvaginal ultrasound-guided aspiration of immature follicles, or from ovaries postmortem, and can be effectively matured in vitro. Notably, the in vivo-matured oocyte may be easily recovered from the stimulated preovulatory follicle. Standard IVF is still not repeatable in the horse; however, embryos and foals can be produced by surgical transfer of mature oocytes to the oviducts of inseminated recipient mares or via intracytoplasmic sperm injection (ICSI). Currently, ICSI and in vitro embryo culture are routinely performed by only a few laboratories, but reported blastocyst development rates approach those found after bovine IVF (i.e. 25%-35%). Nuclear transfer can be relatively efficient (up to 26% live foal rate per transferred embryo), but few laboratories are working in this area. Equine blastocysts may be biopsied via micromanipulation, with normal pregnancy rates after biopsy, and accurate genetic analysis. Equine expanded blastocysts may be vitrified after collapsing them via micromanipulation, with normal pregnancy rates after warming and transfer. Many of these recently developed techniques are now in clinical use.

  6. Determining the mechanical properties of electrospun poly-ε-caprolactone (PCL) nanofibers using AFM and a novel fiber anchoring technique

    Energy Technology Data Exchange (ETDEWEB)

    Baker, Stephen R.; Banerjee, Soham; Bonin, Keith; Guthold, Martin, E-mail: gutholdm@wfu.edu

    2016-02-01

    Due to its low cost, biocompatibility and slow bioresorption, poly-ε-caprolactone (PCL) continues to be a suitable material for select biomedical engineering applications. We used a combined atomic force microscopy (AFM)/optical microscopy technique to determine key mechanical properties of individual electrospun PCL nanofibers with diameters between 440–1040 nm. Compared to protein nanofibers, PCL nanofibers showed much lower adhesion, as they slipped on the substrate when mechanically manipulated. We, therefore, first developed a novel technique to anchor individual PCL nanofibers to micrometer-sized ridges on a substrate, and then mechanically tested anchored nanofibers. When held at constant strain, tensile stress relaxed with fast and slow relaxation times of 1.0 ± 0.3 s and 8.8 ± 3.1 s, respectively. The total tensile modulus was 62 ± 26 MPa, the elastic (non-relaxing) component of the tensile modulus was 53 ± 36 MPa. Individual PCL fibers could be stretched elastically (without permanent deformation) to strains of 19–23%. PCL nanofibers are rather extensible; they could be stretched to a strain of at least 98%, and a tensile strength of at least 12 MPa, before they slipped off the AFM tip. PCL nanofibers that had aged for over a month at ambient conditions became stiffer and less elastic. Our technique provides accurate nanofiber mechanical data, which are needed to guide construction of scaffolds for cells and other biomedical devices. - Highlights: • Developed technique to anchor single nanofibers on microridges • Determined mechanical properties of e-spun PCL fibers • E-spun PCL fibers have similar mechanical properties as wet fibrin fibers. • E-spun PCL fiber total elastic modulus is ~ 60 MPa. • E-spun PCL fiber extensibility is > 100%.

  7. Dual Anchor Internal Pulse Generator Technique May Lower Risk of Twiddler's Syndrome: A Case Series and Literature Review.

    Science.gov (United States)

    Sobstyl, Michał Roman; Ząbek, Mirosław; Brzuszkiewicz-Kuźmicka, Grażyna; Pasterski, Tomasz

    2017-08-01

    Twiddler's syndrome (TS) is described as a spontaneous rotation or intentional external manipulation of implanted internal pulse generator (IPG) for neurological or cardiac disorders. There have been identified some predisposing factors of the development of TS such as: loose subcutaneous tissue, older age of individuals undergoing deep brain stimulation (DBS) procedures, creation of too large pockets for IPG. Apart from these factors, the construction of IPG itself may predispose to the development of TS. To report the clinical course of three patients with TS. Moreover, the purpose of this study is to present the change in fixation technique of IPG that can prevent the occurrence of TS in patients after DBS procedure. A prospectively collected database of all hardware related complications for patients operated on for various movement disorders was analyzed. In a total number of 347 DBS systems implanted since 1999 we have identified three patients diagnosed with TS. All three patients with TS in our series were implanted with the IPG harboring a single anchoring hole. This complication has never occurred in patients with the IPG harboring two anchoring holes in our center. All three patients underwent revision surgery. During reoperations all connection cables were replaced and IPG sutured with one additional silk stich through the plastic housing to immobilize it properly in subcutaneous pocket. There were no recurrences of TS in our patients. Our case series suggests that a predisposing factor of TS may also be the construction of IPG itself (a single anchoring hole intended for fixation), which naturally represents less fixation of the IPG to the fascia or muscle in the subcutaneous pocket. In this preliminary report we present suggestions to lower the risk of TS, including using dual anchor capable IPGs, reducing pocket volume and using nonabsorbable suture. © 2017 International Neuromodulation Society.

  8. Advanced sperm selection techniques for assisted reproduction.

    Science.gov (United States)

    McDowell, Simon; Kroon, Ben; Ford, Emily; Hook, Ysanne; Glujovsky, Demián; Yazdani, Anusch

    2014-10-28

    Assisted reproductive technologies (ART) such as in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) bring together gametes outside of the body to enhance the probability of fertilisation and pregnancy. Advanced sperm selection techniques are increasingly being employed in ART, most commonly in cycles utilising ICSI. Advanced sperm selection techniques are thought to improve the chance that structurally intact and mature sperm with high DNA integrity are selected for fertilisation. Advanced sperm selection strategies include selection according to surface charge; sperm apoptosis; sperm birefringence; ability to bind to hyaluronic acid; and sperm morphology under ultra-high magnification. These techniques theoretically improve ART outcomes. To evaluate the impact of advanced sperm selection techniques on ART outcomes. Systematic search of electronic databases (Cochrane Menstrual Disorders and Subfertility Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American and Caribbean Health Science Information Database (LILACS)), trials registers (ClinicalTrials.gov, Current Controlled Trials, World Health Organization International Clinical Trials Registry Platform), conference abstracts (Web of Knowledge) and grey literature (OpenGrey) for relevant randomised controlled trials. We handsearched the reference lists of included studies and similar reviews. The search was conducted in May 2014. We included randomised controlled trials (RCTs) comparing an advanced sperm selection technique versus standard IVF or ICSI or versus another advanced sperm selection technique. We excluded studies of sperm selection using ultra-high magnification (intracytoplasmic morphologically selected sperm injection, or IMSI), as they are the subject of a separate Cochrane review. Quasi-randomised and pseudo-randomised trials were

  9. Anchor Modeling

    Science.gov (United States)

    Regardt, Olle; Rönnbäck, Lars; Bergholtz, Maria; Johannesson, Paul; Wohed, Petia

    Maintaining and evolving data warehouses is a complex, error prone, and time consuming activity. The main reason for this state of affairs is that the environment of a data warehouse is in constant change, while the warehouse itself needs to provide a stable and consistent interface to information spanning extended periods of time. In this paper, we propose a modeling technique for data warehousing, called anchor modeling, that offers non-destructive extensibility mechanisms, thereby enabling robust and flexible management of changes in source systems. A key benefit of anchor modeling is that changes in a data warehouse environment only require extensions, not modifications, to the data warehouse. This ensures that existing data warehouse applications will remain unaffected by the evolution of the data warehouse, i.e. existing views and functions will not have to be modified as a result of changes in the warehouse model.

  10. [Adoption: an alternative to assisted reproductive techniques?].

    Science.gov (United States)

    Blanchy, S

    2011-09-01

    Information on adoption must be given to couples who seek treatment for medically-assisted procreation. But is adoption a real alternative? What are the chances for a couple who consults to see its desire for adoption be achieved according to its own situation, the characteristics of the child he wants, and the general situation of adoption? Can adoption, just like assisted procreation, often described by the couples as a "obstacle course", go parallel? Or should one try adoption once assisted reproduction failed? Is the couple willing to suffer the social and legal control of adoption after having supported the medical control of the ART? In all cases, the reality is that two out of three couples engaged in assisted reproduction will have a child whereas scarcely more than one candidate to adoption will be offered to adopt a child after three or four-years procedure. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  11. Bone-anchored hearing aids (BAHA): skin healing process for skin flap technique versus linear incision technique in the first three months after the implantation.

    Science.gov (United States)

    Mudry, A

    2009-01-01

    Since the introduction of the BAHA (bone-anchored hearing aid), two main different surgical procedures have been used to insert the implant: the skin flap technique and the linear incision technique. The aim of this retrospective study is to compare the short terms results (3 months after the implantation, the usual period of skin healing) of the skin healing process in the surgical field and around the BAHA implant of these two different techniques. 113 implantations were done from January 2004 to mid May 2008. Between January 2004 to December 2006, 62 were inserted with the skin flap technique and between January 2007 to mid May 2008, followed by 51 with the linear incision technique. All cases were done by the same surgeon. Four implanted BAHA with the skin flap technique necessitated a revision of the operating field because skin necrosis around the implant and only 1 with the linear incision technique. For the other cases and outside the normal range of fixed controls, the cases with the skin flap technique necessitated 25 unforeseen visits by 21 patients for cleaning and removal of crusts, in contrast to 2 visits by 2 patients for the cases with the linear incision technique. This study clearly demonstrates that the linear incision technique has statistically lower risks of skin problems than the skin flap technique in the first three months post-implantation.

  12. Role of Antioxidants in Assisted Reproductive Techniques.

    Science.gov (United States)

    Agarwal, Ashok; Majzoub, Ahmad

    2017-08-01

    Oxidative stress (OS) has been recognized as a significant cause of suboptimal assisted reproductive outcome. Many of the sperm preparation and manipulation procedures that are necessary in the in vitro environment can result in excessive production of reactive oxygen species (ROS) thereby exposing the gametes and growing embryos to significant oxidative damage. Antioxidants have long been utilized in the management of male subfertility as they can counterbalance the elevated levels of ROS inducing a high state of OS. Few studies have looked into the clinical effectiveness of antioxidants in patients undergoing assisted reproduction. While an overall favorable outcome has been perceived, the specific clinical indication and optimal antioxidant regimen remain unknown. The goal of our review is to explore the sources of ROS in the in vitro environment and provide a clinical scenario-based approach to identify the circumstances where antioxidant supplementation is most beneficial to enhance the outcome of assisted reproduction. Copyright © 2017 Korean Society for Sexual Medicine and Andrology.

  13. Role of Antioxidants in Assisted Reproductive Techniques

    Directory of Open Access Journals (Sweden)

    Ashok Agarwal

    2017-08-01

    Full Text Available Oxidative stress (OS has been recognized as a significant cause of suboptimal assisted reproductive outcome. Many of the sperm preparation and manipulation procedures that are necessary in the in vitro environment can result in excessive production of reactive oxygen species (ROS thereby exposing the gametes and growing embryos to significant oxidative damage. Antioxidants have long been utilized in the management of male subfertility as they can counterbalance the elevated levels of ROS inducing a high state of OS. Few studies have looked into the clinical effectiveness of antioxidants in patients undergoing assisted reproduction. While an overall favorable outcome has been perceived, the specific clinical indication and optimal antioxidant regimen remain unknown. The goal of our review is to explore the sources of ROS in the in vitro environment and provide a clinical scenario-based approach to identify the circumstances where antioxidant supplementation is most beneficial to enhance the outcome of assisted reproduction.

  14. A new anchor augmentation technique with a cancellous screw in osteoporotic rotator cuff repair: an in vitro biomechanical study on sheep humerus specimens.

    Science.gov (United States)

    Uruc, Vedat; Ozden, Raif; Dogramacı, Yunus; Kalacı, Aydıner; Hallaceli, Hasan; Küçükdurmaz, Fatih

    2014-01-01

    The aim of this study was to test a simple technique to augment the pullout resistance of an anchor in an over-drilled sheep humerus model. Sixty-four paired sheep humeri were harvested from 32 male sheep aged 18 months. Specimens were divided into an augmented group and non-augmented group. FASTIN RC 5-mm titanium screw anchors (DePuy Mitek, Raynham, MA) double loaded with suture material (braided polyester, nonabsorbable USP No. 2) were used in both groups. Osteoporosis was simulated by over-drilling with a 4.5-mm drill. Augmentation was performed by fixing 1 of the sutures 1.5 cm inferior to the anchor insertion site with a washer screw. This was followed by a pull-to-failure test at 50 mm/min. The ultimate load (the highest value of strength before anchor pullout) was recorded. A paired t test was used to compare the biomechanical properties of the augmented and non-augmented groups. In all specimens the failure mode was pullout of the anchor. The ultimate failure loads were statistically significantly higher in the augmented group (P anchor to a fully threaded 6.5-mm cancellous screw with a washer, significantly increases the ultimate failure loads in the over-drilled sheep humerus model. Our technique is simple, safe, and inexpensive. It can be easily used in all osteoporotic patients and will contribute to the reduction of anchor failure. This technique might be difficult to apply arthroscopically. Cannulated smaller screws would probably be more practical for arthroscopic use. Further clinical studies are needed. Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  15. Treatment of chronic lateral ankle instability: a modified broström technique using three suture anchors

    Directory of Open Access Journals (Sweden)

    Busconi Brian D

    2009-12-01

    Full Text Available Abstract Ankle sprains are very common injuries seen in the athletic and young population. Majority of patients will improve with a course of rest and physical therapy. However, with conservative management about twenty percent of all patients will go on to develop chronic lateral ankle instability. This manuscript describes our detailed surgical technique of a modification to the original Broström procedure using three suture anchors to anatomically reconstruct the lateral ankle ligaments to treat high demand patients who have developed chronic lateral ankle instability. The rationale for this modification along with patient selection and workup are discussed. Both the functional outcomes at the two year follow up along with the complications and the detailed postoperative rehabilitation protocol for the high demand athletes are also presented. This modified Broström procedure is shown in both illustrative format and intra-operative photos.

  16. Bonding, Bridging, and Linking Social Capital and Self-Rated Health among Chinese Adults: Use of the Anchoring Vignettes Technique.

    Directory of Open Access Journals (Sweden)

    He Chen

    Full Text Available Three main opposing camps exist over how social capital relates to population health, namely the social support perspective, the inequality thesis, and the political economy approach. The distinction among bonding, bridging, and linking social capital probably helps close the debates between these three camps, which is rarely investigated in existing literatures. Moreover, although self-rated health is a frequently used health indicator in studies on the relationship between social capital and health, the interpersonal incomparability of this measure has been largely neglected. This study has two main objectives. Firstly, we aim to investigate the relationship between bonding, bridging, and linking social capital and self-rated health among Chinese adults. Secondly, we aim to improve the interpersonal comparability in self-rated health measurement. We use data from a nationally representative survey in China. Self-rated health was adjusted using the anchoring vignettes technique to improve comparability. Two-level ordinal logistic regression was performed to model the association between social capital and self-rated health at both individual and community levels. The interaction between residence and social capital was included to examine urban/rural disparities in the relationship. We found that most social capital indicators had a significant relationship with adjusted self-rated health of Chinese adults, but the relationships were mixed. Individual-level bonding, linking social capital, and community-level bridging social capital were positively related with health. Significant urban/rural disparities appeared in the association between community-level bonding, linking social capital, and adjusted self-rated health. For example, people living in communities with higher bonding social capital tended to report poorer adjusted self-rated health in urban areas, but the opposite tendency held for rural areas. Furthermore, the comparison between

  17. Outcome of repair of chronic tear of the pectoralis major using corkscrew suture anchors by box suture sliding technique

    Science.gov (United States)

    Joshi, Deepak; Jain, Jitesh Kumar; Chaudhary, Deepak; Singh, Utkarsh; Jain, Vineet; Lal, Ajay

    2016-01-01

    AIM To assess the functional and clinical results of repair of chronic tears of pectoralis major using corkscrew and sliding suture technique. METHODS In this retrospective study, we reviewed the results of pectoralis major repair in 11 chronic cases (> 6 wk) done between September 2011 and December 2014 at our institute. In all cases repair was done by same surgeon using corkscrew suture anchors and box suture sliding technique. At 6 mo, after surgery magnetic resonance imaging was done to see the integrity of the repair. Functional evaluation was done using Penn and ASES scores. Pre and postoperative Isokinetic strength was measured. RESULTS Average follow-up was 48.27 ± 21.0 mo. The Wilcoxon signed rank test was used to evaluate the outcome scores. The average ASES score increased from an average of 54.63 ± 13.0 preoperatively to 95.09 ± 2.60 after surgery at their last follow-up. The average Penn score also increased from 5.72 ± 0.78, 2.81 ± 1.32 and 45.81 ± 1.72 to 9.36 ± 0.80, 8.27 ± 0.90 and 59 ± 1.34 for pain, satisfaction and function respectively. Follow up magnetic resonance imaging (MRI) (at 6 mo) showed continuity and the bulk of pectoralis major muscle in all cases. Average isokinetic strength deficiency in horizontal adduction at 60° was 13.63% ± 6.93% and at 120° was 10.18% ± 4.93% and in flexion at 60° was 10.72% ± 5.08% and at 120° was 6.63% + 3.74%. Results showed that both ASES and Penn score improved significantly (2 tailed P value = 0.0036). CONCLUSION We could conclude from this series that pectoralis major repair even in chronic cases using 5.5 mm corkscrew anchors give excellent functional and cosmetic results. In chronic cases the repairable length of the tendon is not available and sliding suture technique allows for fixation of worn out tendomuscular junction to bone without letting cutting through the muscle. PMID:27795949

  18. Discontinuation Decision in Assisted Reproductive Techniques

    Directory of Open Access Journals (Sweden)

    Ashraf Moini

    2009-01-01

    Full Text Available Background: In vitro fertilization (IVF and intra cytoplasmic sperm injection (ICSI are recognizedas established and increasingly successful forms of treatment for infertility, yet significant numbersof couples discontinue treatment without achieving a live birth. This study aims to identify majorfactors that influence the decision to discontinue IVF/ICSI treatments.Materials and Methods: We studied the data of 338 couples who discontinued their infertilitytreatments after three cycles; based on medical records and phone contact. The main measure wasthe reason for stopping their treatments.Results: Economical problems were cited by 212 couples (62.7%, as their mean income wassignificantly less than other couples (p<0.0001. Lack of success was reported as a reason by229 (67.8%, from whom 165 (72% also had economical problems. Achieving independent-ART pregnancy was the reason for discontinuation in 20 (5.9% couples. Psychological stress,depression and anxiety were reported as other cessation factors by 169 (50%, 148 (43.8% and 182(53.8% couples, respectively.Conclusion: This survey suggests that the most common reasons for assisted reproductivetechnique (ART discontinuation after three cycles are: prior unsuccessful cycles, economicaland psychological problems. Therefore, the substantial proportion of couples could benefit frompsychological intervention, increasing awareness of ART outcomes and health funding to copemore adequately with failed treatments.

  19. Results of arthrospine assisted percutaneous technique for lumbar discectomy

    OpenAIRE

    Mohinder Kaushal

    2016-01-01

    Background: Avaialable minimal invasive arthro/endoscopic techniques are not compatible with 30 degree arthroscope which orthopedic surgeons uses in knee and shoulder arthroscopy. Minimally invasive ?Arthrospine assisted percutaneous technique for lumbar discectomy? is an attempt to allow standard familiar microsurgical discectomy and decompression to be performed using 30? arthroscope used in knee and shoulder arthroscopy with conventional micro discectomy instruments. Materials and Methods:...

  20. Hand-Assisted Laparoscopic Splenectomy: Indications and Technique

    Science.gov (United States)

    Bermas, Honnie; Fenoglio, Michael E.; Haun, William; Moore, John T.

    2004-01-01

    Introduction: Laparoscopic splenectomy has become the procedure of choice for those patients who need to have a splenectomy. The skills required to perform a laparoscopic splenectomy are not easy to learn and therefore may limit the availability of this procedure to patients. Methods: We present a hand-assisted technique that allows the performance of a laparoscopic splenectomy safely and rapidly by surgeons without a great deal of experience with this procedure. Results: A laparoscopic hand-assisted splenectomy was performed by a chief resident who had not performed this procedure before. The operative time was comparable to that of a laparoscopic splenectomy performed by an experienced laparoscopic surgeon at our institution (65 vs 62 min). Conclusions: The hand-assisted technique is useful in a number of laparoscopic situations. We suggest that hand-assisted laparoscopic surgery might be used as an adjunct for surgeons with limited laparoscopic experience and for residents who are learning advanced laparoscopic skills. PMID:14974668

  1. Varicocele repair in the era of modern assisted reproductive techniques.

    Science.gov (United States)

    McIntyre, Matthew; Hsieh, Tung-Chin; Lipshultz, Larry

    2012-11-01

    This review looks at the literature on varicocele repair and its effect on assisted reproductive techniques. The effects of varicocele correction on improved sperm production have been well documented with semen analysis data. What remain to be elucidated are the causes of the varicocele effect and how correction of the resultant pathophysiology may affect the outcomes of modern assisted reproductive technology. Basic science research shows us that varicoceles exert deleterious effects on Leydig cells, Sertoli cells, and germ cells via very different mechanisms. The effects of varicocele correction on the reproductive potential of sperm are less well understood. Clinical research has shown improved semen parameters, DNA integrity, and assisted reproductive technology outcomes after varicocele repair. Varicocele correction presents a possible method to optimize a couples' reproductive potential or decrease the need for complex assisted reproductive technology.

  2. Need for Regulation of Assisted Reproductive Techniques in Africa ...

    African Journals Online (AJOL)

    Reproductive health and population control are part of the goals developing countries are called upon to pursue as part of the millennium development goals (MDGs). Indeed, population health is one of the parameters used in assessing progress towards achievement of these goals. Thus, assisted reproductive techniques ...

  3. Beckwith-Wiedemann Syndrome in assisted reproductive techniques

    African Journals Online (AJOL)

    Assisted Reproductive Techniques (ART) is a crucial treatment for infertile couples and is frequently common. ART entails manipulation of oocyte and sperm in a laboratory: in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI).The key objective of ART is to yield superior quality embryos that are competent for ...

  4. Predisposing factors for adverse skin reactions with percutaneous bone anchored hearing devices implanted with skin reduction techniques.

    Science.gov (United States)

    Candreia, Claudia; Birrer, Ruth; Fistarol, Susanna; Kompis, Martin; Caversaccio, Marco; Arnold, Andreas; Stieger, Christof

    2016-12-01

    We present an analysis of adverse events after implantation of bone anchored hearing device in our patient population with focus on individual risk factors for peri-implant skin reactions. The investigation involved a chart review of adult Baha patients (n = 179) with 203 Bahas implanted with skin reduction techniques between 1993 and 2009, a questionnaire (n = 97) and a free clinical examination (n = 47). Skin reactions were graded by severity from 0 (no skin reaction) to 4 (implant loss resulting from infection) according to Holgers. We analyzed the skin reaction rate (SRR) defined as the number of skin reactions per year and the worst Holgers grade (WHG), which indicates the grade of the worst skin reaction per implant. We defined 20 parameters including the demographic characteristics, surgery details, subjective benefits, handling and individual factors. The most frequent adverse events (85 %) were skin reactions. The average SRR was 0.426 per Baha year. Six parameters showed an association with the SRR or the WHG. The clinically most relevant factors are an elevated Body Mass Index (BMI, p = 0.02) and darker skin type (p = 0.03). The SRR increased with the distance between the tragus and the implant (p = 0.02). Regarding the identified risk factors, the SRR might be reduced by selecting a location for the implant near the pinna and by specific counseling regarding post-operative care for patients with darker skin type or an elevated Body Mass Index (BMI). Few of the factors analyzed were found to influence the SRR and WHG. Since most adverse skin reactions could be treated easily with local therapy, our results suggest that in adult patients, individual risk factors for skin reactions are not a contraindication for Baha implantation. Thus, patients can be selected purely on audiological criteria.

  5. Laparoscopic assisted total gastrectomy for gastric cancer - operative technique.

    Science.gov (United States)

    Smolarek, Sebastian; Salih, Abdelmonim; Kazanowski, Michal; Walsh, Thomas N

    2015-04-01

    For many years, open gastrectomy with lymphadenectomy was the gold standard treatment for gastric cancer. In recent years, however, laparoscopic assisted total gastrectomy with associated D2 lymphadenectomy has gained in popularity. It has a similar oncological outcome to open resection, but has all of the added advantages of a laparoscopic procedure, such as early mobilisation, less postoperative pain and shorter hospital stay. This article describes the operative techniques, including key procedure steps, as well as a guide for using the new OrVil device for the laparoscopic creation of the oesophago-jejunal anastomosis. A video of a laparoscopic assisted total gastrectomy is presented.

  6. Totally robot-assisted biliary pancreatic diversion with duodenal switch: single dock technique and technical outcomes.

    Science.gov (United States)

    Sudan, Ranjan; Podolsky, Erica

    2015-01-01

    The biliopancreatic diversion with duodenal switch (BPD/DS) requires operating in three different abdominal quadrants. Previous techniques have used either two docks or a hybrid technique in which the robot is used only to suture the duodeno-ileal anastomosis, while the rest of the operation was performed laparoscopically. Recently, a modification in technique has allowed all operative steps to be completed robotically with a single dock. The operative technique and its technical results are described. Operative technique is described. Baseline demographics, operative duration, length of stay, and adverse events (intraoperative, 30-days, and 1-year) of all primary totally robot BPD/DS cases are reported. From Nov. 2011 to Jan. 2014, 59 totally robotic BPD/DS operations were attempted. One was completed hybrid, and the rest were totally robotic. No robotic operation was converted to an open operation. Five trocars were placed, the small bowel was anchored to the anterior abdominal wall, and the robot was docked. Mean age was 44 ± 10 years with a mean preoperative BMI of 56 ± 9 kg/m(2). 69 % was female, and 71 % was Caucasian. Mean operative duration was 306 ± 80 min (60 min less than the hybrid technique). There were no mortality, leaks, venous thromboembolism, or bleeding requiring transfusion. Mean length of stay was 4.6 ± 4.3 days. Three patients were readmitted for nausea and vomiting. There was one superficial wound infection, and three patients needed reoperations in the first year, two for strictures, and one for debriding a suture abscess. All key technical components of the BPD/DS were performed with low morbidity and mortality with a single dock. Since the surgeon performed all key parts of the operation from the console, the need for experienced bedside assistance was minimized, resulting in shorter operative duration compared to the hybrid technique.

  7. Comparison of bone tunnel and suture anchor techniques in the modified Broström procedure for chronic lateral ankle instability.

    Science.gov (United States)

    Hu, Chang-Yong; Lee, Keun-Bae; Song, Eun-Kyoo; Kim, Myung-Sun; Park, Kyung-Soon

    2013-08-01

    The modified Broström procedure is frequently used to treat chronic lateral ankle instability. There are 2 common methods of the modified Broström procedure, which are the bone tunnel and suture anchor techniques. To compare the clinical outcomes of the modified Broström procedure using the bone tunnel and suture anchor techniques. Cohort study; Level of evidence, 2. Eighty-one patients (81 ankles) treated with the modified Broström procedure for chronic lateral ankle instability constituted the study cohort. The 81 ankles were divided into 2 groups, namely, a bone tunnel technique (BT group; 40 ankles) and a suture anchor technique (SA group; 41 ankles). The Karlsson score, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, anterior talar translation, and talar tilt angle were used to evaluate clinical and radiographic outcomes. The BT group consisted of 32 men and 8 women with a mean age of 34.8 years at surgery and a mean follow-up duration of 34.2 months. The SA group consisted of 33 men and 8 women with a mean age of 33.3 years at surgery and a mean follow-up duration of 32.8 months. Mean Karlsson scores improved significantly from 57.0 points preoperatively to 94.9 points at final follow-up in the BT group and from 59.9 points preoperatively to 96.4 points at final follow-up in the SA group. Mean AOFAS scores also improved from 64.2 points preoperatively to 97.8 points at final follow-up in the BT group and from 70.3 points preoperatively to 97.4 points at final follow-up in the SA group. Mean anterior talar translations in the BT group and SA group improved from 9.0 mm and 9.2 mm preoperatively to 6.5 mm and 6.8 mm at final follow-up, respectively. Mean talar tilt angles were 12.0° in the BT group and 12.5° in the SA group preoperatively and 8.8° at final follow-up for both groups. No significant differences were found between the 2 groups in terms of the Karlsson score, AOFAS score, anterior talar translation, and talar tilt

  8. Suture anchor placement technique around the insertion of the ventral rectus muscle for the replacement of the prolapsed gland of the third eyelid in dogs: 100 dogs.

    Science.gov (United States)

    Sapienza, John S; Mayordomo, Aloma; Beyer, Anne M

    2014-03-01

    To evaluate a rapid and efficacious procedure to anchor the prolapsed gland of the third eyelid in dogs. This is a retrospective study of 100 affected dogs (122 eyes) with third eyelid gland prolapse that were surgically anchored with a nonabsorbable suture around the insertion of the ventral rectus muscle. Hundred dogs (122 eyes) were included in this study. Twenty-three pure-bred and several mixed-breed dogs were represented with the right eye affected in 60 cases and the left eye in 62 cases. Thirty-four eyes (27.9%) were previously operated on at another facility prior to referral. The average age of the patients was 2.2 years (57 days to 11 years). No recurrences of gland prolapse were observed over the course of study. Minor intraoperative conjunctival perforations were observed and easily repaired at the time of the surgery in 21 cases (17.2%). Five cases demonstrated preexistent keratoconjunctivitis sicca (KCS), and all had improved Schirmer tear test following surgical correction and medical therapy. The suture anchor placement technique provides a cosmetic, rapid, and successful replacement of the prolapsed gland of the third eyelid in dogs. No recurrences were noted. Complications were easily addressed. © 2013 American College of Veterinary Ophthalmologists.

  9. Lipase biofilm deposited by Matrix Assisted Pulsed Laser Evaporation technique

    Energy Technology Data Exchange (ETDEWEB)

    Aronne, Antonio [Department of Chemical Engineering, Materials and Industrial Production, University of Naples “Federico II”, Napoli (Italy); Bloisi, Francesco, E-mail: bloisi@na.infn.it [SPIN – CNR, Naples (Italy); Department of Physics, University of Naples “Federico II”, Napoli (Italy); Calabria, Raffaela; Califano, Valeria [Istituto Motori – CNR, Naples (Italy); Depero, Laura E. [Department of Mechanical and Industrial Engineering, University of Brescia, Brescia (Italy); Fanelli, Esther [Department of Chemical Engineering, Materials and Industrial Production, University of Naples “Federico II”, Napoli (Italy); Federici, Stefania [Department of Mechanical and Industrial Engineering, University of Brescia, Brescia (Italy); Massoli, Patrizio [Istituto Motori – CNR, Naples (Italy); Vicari, Luciano R.M. [SPIN – CNR, Naples (Italy); Department of Physics, University of Naples “Federico II”, Napoli (Italy)

    2015-05-01

    Highlights: • A lipase film was deposited with Matrix Assisted Pulsed Laser Evaporation technique. • FTIR spectra show that laser irradiation do not damage lipase molecule. • Laser fluence controls the characteristics of complex structure generated by MAPLE. - Abstract: Lipase is an enzyme that finds application in biodiesel production and for detection of esters and triglycerides in biosensors. Matrix Assisted Pulsed Laser Evaporation (MAPLE), a technique derived from Pulsed Laser Deposition (PLD) for deposition of undamaged biomolecules or polymers, is characterized by the use of a frozen target obtained from a solution/suspension of the guest material (to be deposited) in a volatile matrix (solvent). The presence of the solvent avoids or at least reduces the potential damage of guest molecules by laser radiation but only the guest material reaches the substrate in an essentially solvent-free deposition. MAPLE can be used for enzymes immobilization, essential for industrial application, allowing the development of continuous processes, an easier separation of products, the reuse of the catalyst and, in some cases, enhancing enzyme properties (pH, temperature stability, etc.) and catalytic activity in non-aqueous media. Here we show that MAPLE technique can be used to deposit undamaged lipase and that the complex structure (due to droplets generated during extraction from target) of the deposited material can be controlled by changing the laser beam fluence.

  10. Comparison of radical prostatectomy techniques: open, laparoscopic and robotic assisted

    Directory of Open Access Journals (Sweden)

    Rodrigo Frota

    2008-06-01

    Full Text Available INTRODUCTION: To review the current status of laparoscopic radical prostatectomy (LRP and robotic assisted radical prostatectomy (RALP in relation to radical retropubic prostatectomy (RRP in the management of localized prostate cancer. MATERIALS AND METHODS: Between 1982 and 2007 published literature was reviewed using the National Library of Medicine database and the following key words: retropubic, laparoscopic, robotic, robot-assisted, and radical prostatectomy. Special emphasis was given to the technical and cost considerations as well as operative, functional and oncologic outcomes. In particular, reports with pioneering work that have contributed to the evolution of the technique, presenting comparative outcomes and with large series encompassing intermediate/long term follow-up, were taken into account. RESULTS: After intermediate term follow-up, LRP and RALP achieved similar oncologic and functional results compared to RRP. However, LRP and RALP were associated with decreased blood loss, faster convalescence and better cosmetics when compared to RRP. The RALP technique is undoubtedly more expensive. CONCLUSIONS: The oncologic and functional outcomes for LRP and RALP are similar to RRP after intermediate term follow-up. Long term follow-up and adequately designed studies will determine the inherent advantages and disadvantages of the individual techniques in the management of localized prostate cancer.

  11. Lifestyle and Outcomes of Assisted Reproductive Techniques: A Narrative Review.

    Science.gov (United States)

    Zeinab, Hamzehgardeshi; Zohreh, Shahhosseini; Samadaee Gelehkolaee, Keshvar

    2015-02-24

    Studies reveal that lifestyles such as physical activity patterns, obesity, nutrition, and smoking, are factors that affect laboratory test results and pregnancy outcomes induced by assisted fertility techniques in infertile couples. The present study is a narrative review of studies in this area. In this study, researchers conducted their computer search in public databases Google Scholar general search engine, and then more specific: Science Direct, ProQuest, SID, Magiran, Irandoc, Pubmed, Scopus, cochrane library, and Psych info; Cumulative Index to Nursing and Allied Health Literature (CINAHL), using Medical Subject Headings (MeSH) keywords: infertility (sterility, infertility), lifestyle (life behavior, lifestyle), Assisted Reproductive Techniques (ART), antioxidant and infertility, social health, spiritual health, mental health, Alcohol and drug abuse, preventive factors, and instruments., and selected relevant articles to the study subject from 2004 to 2013. Firstly, a list of 150 papers generated from the initial search. Then reviewers studied titles and abstracts. Secondly, 111 papers were included. Finally, quality assessment of full text studies was performed by two independent reviewers. Researchers reviewed summary of all articles sought, ultimately used data from 62 full articles to compile this review paper. Review of literature led to arrangement of 9 general categories of ART results' relationship with weight watch and diet, exercise and physical activity, psychological health, avoiding medications, alcohol and drugs, preventing diseases, environmental health, spiritual health, social health, and physical health. The following was obtained from review of studies: since lifestyle is among important, changeable, and influential factors in fertility, success of these methods can be greatly helped through assessment of lifestyle patterns of infertile couples, and design and implementation of healthy lifestyle counseling programs, before and during

  12. First trimester biochemistry in pregnancies conceived using assisted reproduction techniques

    DEFF Research Database (Denmark)

    Tabor, Ann; Ekelund, Charlotte; Nørgaard, Pernille

    Objective: To examine the effects of method of conception on first trimester PAPP-A and free beta-hCG and the dependency of gestational age at the time of sampling on these effects Methods: Data on more than 100 000 spontaneously conceived and on 6 859 pregnancies conceived by assisted reproductive...... techniques (ART) with a first trimester risk assessment performed between 01 January 2008 and 31 October 2010 were retrieved from the Danish National Fetal Medicine Database. ART was defined as pregnancies obtained using in-vitro fertilization or intracytoplasmatic sperm injection. Multiple regression...

  13. Computer-Assisted Technique for Surgical Tooth Extraction

    Directory of Open Access Journals (Sweden)

    Hosamuddin Hamza

    2016-01-01

    Full Text Available Introduction. Surgical tooth extraction is a common procedure in dentistry. However, numerous extraction cases show a high level of difficulty in practice. This difficulty is usually related to inadequate visualization, improper instrumentation, or other factors related to the targeted tooth (e.g., ankyloses or presence of bony undercut. Methods. In this work, the author presents a new technique for surgical tooth extraction based on 3D imaging, computer planning, and a new concept of computer-assisted manufacturing. Results. The outcome of this work is a surgical guide made by 3D printing of plastics and CNC of metals (hybrid outcome. In addition, the conventional surgical cutting tools (surgical burs are modified with a number of stoppers adjusted to avoid any excessive drilling that could harm bone or other vital structures. Conclusion. The present outcome could provide a minimally invasive technique to overcome the routine complications facing dental surgeons in surgical extraction procedures.

  14. Retrospective analysis of skin complications related to bone-anchored hearing aid implant: association with surgical technique, quality of life, and audiological benefit.

    Science.gov (United States)

    Peñaranda, Daniel; Garcia, Juan Manuel; Aparicio, Maria Leonor; Montes, Felipe; Barón, Clemencia; Jiménez, Roberto C; Peñaranda, Augusto

    2017-04-25

    The bone-anchored hearing aid is an effective form of auditory rehabilitation. Due to the nature of the implant, the most common complications are skin related. A number of alternative surgical implantation techniques have been used to reduce the frequency and severity of skin complications, including the U-shaped graft and the linear incision. To assess skin complications and their association with surgical technique, quality of life, and audiological benefit in patients with bone-anchored hearing aids. This was a retrospective study conducted in a tertiary referral center in Bogotá, Colombia. Patients who had been fitted with a bone-anchored hearing aid implant (unilaterally or bilaterally) for at least 6 months were included in the study. The Holgers classification was used to classify skin complications (Grade 0=none; Grade 1=erythema; Grade 2=erythema and discharge; Grade 3=granulation tissue; and Grade 4=inflammation/infection resulting in the removal of the abutment). The Glasgow Benefit Inventory questionnaire was used to determine quality of life, and the Abbreviated Profile of Hearing Aid Benefit questionnaire was used to determine the subjective audiological benefit. A total of 37 patients were included in the study (30 with unilateral implants and 7 with bilateral implant). Of the 44 implants evaluated, 31 (70.3%) were associated with skin complications (7 [15.9%] Grade 1; 4 [9.1%] Grade 2; 15 [34.1%] Grade 3, 5 [11.4%] Grade 4). The U-shaped graft was statistically associated with major complications (Grades 3 and 4) compared with the linear incision technique (p=0.045). No statistically significant differences were found between Abbreviated Profile of Hearing Aid Benefit scores and severity of complications. Similarly, no differences were found between Glasgow Benefit Inventory physical health questions and skin complications. Despite the high frequency, skin complications did not seem to affect quality of life or subjective audiological benefits of

  15. Clinical and radiological outcomes of rotator cuff repair by single-row suture-anchor technique with mini-open approach

    Directory of Open Access Journals (Sweden)

    Serhat Karapınar

    2014-06-01

    Full Text Available Objective: The aim of this study was to evaluate the clinical results and re-rupture rate of single row suture anchor repair with mini open surgical technique, in the treatment of full thickness rotator cuff tear. Methods: Patients with full thickness rotator cuff tears were included. Single row suture anchor technic with mini-open approach was used for treatment. The mean follow-up period was 9.8 months. The preoperative and postoperative functional and clinical status of patients was evaluated by UCLA (University of California at Los Angeles and Constant scoring systems. The re-rupture of the rotator cuff was detected by MRI (Magnetic Resonance Imaging at the last control. Preoperative and postoperative datas were compared to each other. Results: Twenty-three patients, (13 male, 10 female were included. The mean age was 52 years (range 18 to 68 years. At the pre-operative evaluation, the mean results of UCLA score was 11.7, the Constant scores was 26.83 whereas the postoperative scores were found as 29.91, 82.04, respectively. The increases in these scores at the postoperative period were statistically significant (p<0.05. 95% of patients declared that they were satisfied with the treatment. In the control MRI (Magnetic Resonance Imaging only one re-rupture was detected. Conclusion: the results of this study has shown that in the treatment of full thickness rotator cuff tear, mini open, single row suture anchor technique has good clinical results and re-rupture is seen very rarely.

  16. Outcome of twin pregnancies conceived after assisted reproductive techniques

    Directory of Open Access Journals (Sweden)

    A Baxi

    2008-01-01

    Full Text Available Context : There is a continuous controversy regarding the obstetric perinatal outcome of twin pregnancies conceived after assisted reproductive techniques (ART. There is an ongoing discussion whether theses parameters may show poorer results as compared to spontaneous conception. Aims: To evaluate the outcome of multifetal pregnancies and to compare maternal and neonatal complications between spontaneously conceived and assisted reproductive therapy. Settings and Design : Prospective case-control study. Materials and Methods :In this prospective case-control study of 2-year duration, obstetric and perinatal outcomes were compared in 36 ART twin pregnancies (Group A with 138 twins who conceived naturally (Group B. The outcomes were analyzed and used for a comparison between spontaneous and assisted multifetal pregnancies. Statistical Analysis : The continuous variables were analyzed by Student′s t -test and categorical variables were analyzed with Fisher′s exact test. Results : Pregnancy-related complications like pregnancy-induced hypertension, antepartum hemorrhage, were similar in both groups. Incidence of cesarean section, preterm delivery, and hospital stay was significantly more in Group A vs. Group B, P < 0.001. The newborns in the assisted group had more complications than the spontaneous group; most notable were respiratory distress syndrome, newborn intensive care admission, sepsis, and longer hospital stay (4.8 days vs. 1.6 days, P < 0.001. Conclusions : Increased rates of cesarean section and preterm delivery are the main reasons for increased obstetric risk in pregnancies conceived through ART. Preterm birth and neonatal prematurity-related complications were the main cause for longer stay in hospital in ART-conceived twins.

  17. Effervescence Assisted Fusion Technique to Enhance the Solubility of Drugs.

    Science.gov (United States)

    Alam, Mohd Aftab; Al-Jenoobi, Fahad I; Al-Mohizea, Abdullah M; Ali, Raisuddin

    2015-12-01

    The solubility of five poorly soluble drugs was enhanced by using an effervescence assisted solid dispersion (EASD) technique. EASDs were prepared by using modified fusion method. Drug and hydrophilic carrier were melted, and in this molten mixture, effervescence was generated by adding effervescence couple comprising organic acid (citric acid) and carbonic base (sodium bicarbonate). Solubility of drug powders, solid dispersions, and EASDs was determined at 25°C using shake flask method. Atorvastatin calcium, cefuroxime axetil, clotrimazole, ketoconazole, and metronidazole benzoate were estimated using a spectrophotometer at 246, 280, 260, 230, and 232 nm (λ max), respectively. Solubility of atorvastatin calcium (from 100 to 345 μg/ml), cefuroxime axetil (from 441 to 1948 μg/ml), clotrimazole (from 63 to 677 μg/ml), ketoconazole (from 16 to 500 μg/ml), and metronidazole benzoate (from 112 to 208 μg/ml) in EASDs was enhanced by 3.45-, 4.4-, 10.7-, 31.2-, and 1.8-fold, respectively. Scanning electron micrographs of drug powder, solid dispersion, and EASDs were compared. Scanning electron micrographs of EASDs showed a uniform distribution of drug particles in the carrier matrix. Morphology (size and shape) of cefuroxime axetil particles was altered in solid dispersion as well as in EASD. EASDs showed better solubility enhancement than conventional solid dispersions. The present technique is better suitable for drugs having a low melting point or melt without charring. Effervescence assisted fusion technique of preparing solid dispersions can be employed for enhancing solubility, dissolution, and bioavailability of poorly soluble drugs.

  18. A new shock wave assisted sandalwood oil extraction technique

    Science.gov (United States)

    Arunkumar, A. N.; Srinivasa, Y. B.; Ravikumar, G.; Shankaranarayana, K. H.; Rao, K. S.; Jagadeesh, G.

    A new shock wave assisted oil extraction technique from sandalwood has been developed in the Shock Waves Lab, IISc, Bangalore. The fragrant oil extracted from sandalwood finds variety of applications in medicine and perfumery industries. In the present method sandal wood specimens (2.5mm diameter and 25mm in length)are subjected to shock wave loading (over pressure 15 bar)in a constant area shock tube, before extracting the sandal oil using non-destructive oil extraction technique. The results from the study indicates that both the rate of extraction as well as the quantity of oil obtained from sandal wood samples exposed to shock waves are higher (15-40 percent) compared to non-destructive oil extraction technique. The compressive squeezing of the interior oil pockets in the sandalwood specimen due to shock wave loading appears to be the main reason for enhancement in the oil extraction rate. This is confirmed by the presence of warty structures in the cross-section and micro-fissures in the radial direction of the wood samples exposed to shock waves in the scanning electron microscopic investigation. In addition the gas chromatographic studies do not show any change in the q uality of sandal oil extracted from samples exposed to shock waves.

  19. Comparison of Two Techniques of Laparoscopy-Assisted Peritoneal Vaginoplasty.

    Science.gov (United States)

    Wu, Jie; Guo, Ruixia; Chu, Danxia; Wang, Xinyan; Li, Liuxia; Bian, Aiping; Zhao, Qian; Shi, Huirong

    2016-01-01

    Neovagina creation is essential for patients with the Mayer-Rokitansky-Kuster-Hauser syndrome. We compared a technique involved the pushing down of the peritoneum with the technique of separating the peritoneum for laparoscopy-assisted peritoneal vaginoplasty. We collected patients with congenital absence of vagina who underwent laparoscopy-assisted peritoneal vaginoplasty of the First Affiliated Hospital of Zhengzhou University between January 2011 and May 2013. The 2 surgical groups (pushing group and separating group) were compared for various parameters. The values of the following parameters were significantly lower for the pushing group compared with the separating group: mean operating time (78 ± 13 minutes vs 135 ± 28 minutes), mean duration of hospitalization (12.9 ± 2.7 days vs 18.0 ± 3.8 days), mean cost of hospitalization (14 016 ± 1640 RMB vs 18 783 ± 2143 RMB), requirement for a drainage tube (4% vs 27%; χ(2) = 8.864), requirement for analgesic drugs (20% vs 40%; χ(2) = 3.977), and postoperative rehospitalization (3.3% vs 10.0% at 2 months and 6.7% vs 26.7% at 6 months; χ(2) = 4.268 and 5.196). Mean values for blood loss (57 ± 19 mL vs 66 ± 20 mL), time to pass gas (21 ± 4 hours vs 23 ± 7 hours), and length of the reconstructed vagina (9.0 ± 0.4 cm vs 8.9 ± 0.5 cm) were not significantly different between the 2 groups. In addition, mean postoperative Female Sexual Function Index score did not differ significantly between the 2 groups or among the 2 groups and a control group (27.0 ± 4.8 vs 26.7 ± 5.2 vs 27.9 ± 4.5; p > .05). The technique involving pushing down of the peritoneum offers advantages of reduced cost, complications, hospitalization, operative time, and pain over the traditional technique. Sexuality approaches so-called "normal" sexuality. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

  20. Number and accuracy of T-DNA insertions in transgenic banana (Musa spp.) plants characterized by an improved anchored PCR technique.

    Science.gov (United States)

    Pérez-Hernández, Juan Bernardo; Swennen, Rony; Sági, László

    2006-04-01

    Nineteen transgenic banana plants, produced via Agrobacterium-mediated transformation, were analyzed for the integration of T-DNA border regions using an improved anchored PCR technique. The method described is a relatively fast, three-step procedure (restriction digestion of genomic DNA, ligation of 'vectorette'-type adaptors, and a single round of suppression PCR) for the amplification of specific T-DNA border-containing genomic fragments. Most transgenic plants carried a low number of inserts and the method was suitable for a detailed characterization of the integration events, including T-DNA border integrity as well as the insertion of non-T-DNA vector sequences, which occurred in 26% of the plants. Furthermore, the particular band pattern generated by four enzyme/primer combinations for each individual plant served as a fingerprint, allowing the identification of plants representing identical transformation events. Genomic Southern hybridization and nucleotide sequence analysis of amplification products confirmed the data obtained by anchored PCR. Sequencing of seven right or left border junction regions revealed different T-DNA processing events for each plant, indicating a relatively low frequency of precisely nicked T-DNA integration among the plants studied.

  1. Ficoll-400 density gradient method as an effective sperm preparation technique for assisted reproductive techniques.

    Science.gov (United States)

    Highland, Hyacinth N; Rishika, A Sharma; Almira, S Shaikh; Kanthi, P Bansal

    2016-01-01

    Infertility being a burning issue, the male itself contributes about 40% as a cause, as evident by statistical data. However, Assisted Reproductive Technology (ART) has emerged as a powerful tool in the management of infertility. Sperm preparation techniques govern the selection procedure to separate functional spermatozoa which can then be used in IUI, IVF, and ART and for cryopreservation. The present study was aimed at evaluation of sperm preparation techniques for reliability, performance and to determine the most effective, feasible and economical technique. The subjects under study includes males with normal proven fertility (n=40) and the males with unexplained infertility (n=40). Four sperm separation techniques, viz., Swim-up, Swim-down, Sucrose and Ficoll-400 density gradient techniques were evaluated for their efficacy in separation of good quality fraction of spermatozoa. Sperm viability, morphology and maturation status of spermatozoa were taken as evaluation parameters following the standard methods (WHO 2010). Data was analyzed using student's t -test and the four selected techniques were compared with the normal semen samples for scoring the efficiency of the techniques. Out of the several techniques used, Ficoll-400 was found to be more efficient method for separation of spermatozoa. The percentage of change in each parameter was calculated and taken as the index for recovery of potent sperm from the original sperm. Ficoll-400 density gradient yielded higher percentage of live, mature, morphologically normal spermatozoa in an isolated fraction as compared to other three techniques. It was observed that a combination of Ficoll-400 gradient separation with Swim-up technique could give quality spermatozoa which in-turn would directly have an impact on the success of IVF and other ART techniques.

  2. Assisted techniques for vertebral cementoplasty: Why should we do it?

    Energy Technology Data Exchange (ETDEWEB)

    Muto, M., E-mail: mutomar@tiscali.it [Department of Diagnostic Imaging, Section of Neuroradiology—“A. Cardarelli” Hospital, Naples (Italy); Marcia, S. [Section of Radiology—Santissima Trinità Hospital, Cagliari (Italy); Guarnieri, G. [Department of Diagnostic Imaging, Section of Neuroradiology—“A. Cardarelli” Hospital, Naples (Italy); Pereira, V. [Unit of Interventional Neuroradiology–HUG, Geneva (Switzerland)

    2015-05-15

    Assisted techniques (AT) for vertebral cementoplasty include multiple mini-invasive percutaneous systems in which vertebral augmentation is obtained through mechanical devices with the aim to reach the best vertebral height restoration. As an evolution of the vertebroplasty, the rationale of the AT-treatment is to combine the analgesic and stability effect of cement injection with the restoration of a physiological height for the collapsed vertebral body. Reduction of the vertebral body kyphotic deformity, considering the target of normal spine biomechanics, could improve all systemic potential complications evident in patient with vertebral compression fracture (VCF). Main indications for AT are related to fractures in fragile vertebral osseous matrix and non-osteoporotic vertebral lesions due to spine metastasis or trauma. Many companies developed different systems for AT having the same target but different working cannula, different vertebral height restoration system and costs. Aim of this review is to discuss about vertebral cementoplasty procedures and techniques, considering patient inclusion and exclusion criteria as well as all related minor and/or major interventional complications.

  3. Cystoscopic-assisted partial cystectomy: description of technique and results

    Directory of Open Access Journals (Sweden)

    Gofrit ON

    2014-10-01

    Full Text Available Ofer N Gofrit,1 Amos Shapiro,1 Ran Katz,1 Mordechai Duvdevani,1 Vladimir Yutkin,1 Ezekiel H Landau,1 Kevin C Zorn,2 Guy Hidas,1 Dov Pode1 1Department of Urology, Hadassah Hebrew University Hospital, Jerusalem, Israel; 2Department of Surgery, Section of Urology, Montreal, Canada Background: Partial cystectomy provides oncological results comparable with those of radical cystectomy in selected patients with invasive bladder cancer without the morbidity associated with radical cystectomy and urinary diversion. We describe a novel technique of partial cystectomy that allows accurate identification of tumor margins while minimizing damage to the rest of the bladder. Methods: During the study period, 30 patients underwent partial cystectomy for invasive high-grade cancer. In 19 patients, the traditional method of tumor identification was used, ie, identifying the tumor by palpation and cystotomy. In eleven patients, after mobilization of the bladder, flexible cystoscopy was done and the light of the cystoscope was pointed toward one edge of the planned resected ellipse around the tumor, thus avoiding cystotomy. Results: Patients who underwent partial cystectomy using the novel method were similar in all characteristics to patients operated on using the traditional technique except for tumor diameter which was significantly larger in patients operated on using the novel method (4.3±1.5 cm versus 3.11±1.18 cm, P=0.032. Complications were rare in both types of surgery. The 5-year local recurrence-free survival was marginally superior using the novel method (0.8 versus 0.426, P=0.088. Overall, disease-specific and disease-free survival rates were similar. Conclusion: The use of a flexible cystoscope during partial cystectomy is a simple, low-cost maneuver that assists in planning the bladder incision and minimizes injury to the remaining bladder by avoiding the midline cystotomy. Initial oncological results show a trend toward a lower rate of local

  4. Results of arthrospine assisted percutaneous technique for lumbar discectomy

    Science.gov (United States)

    Kaushal, Mohinder

    2016-01-01

    Background: Avaialable minimal invasive arthro/endoscopic techniques are not compatible with 30 degree arthroscope which orthopedic surgeons uses in knee and shoulder arthroscopy. Minimally invasive “Arthrospine assisted percutaneous technique for lumbar discectomy” is an attempt to allow standard familiar microsurgical discectomy and decompression to be performed using 30° arthroscope used in knee and shoulder arthroscopy with conventional micro discectomy instruments. Materials and Methods: 150 patients suffering from lumbar disc herniations were operated between January 2004 and December 2012 by indiginously designed Arthrospine system and were evaluated retrospectively. In lumbar discectomy group, there were 85 males and 65 females aged between 18 and 72 years (mean, 38.4 years). The delay between onset of symptoms to surgery was between 3 months to 7 years. Levels operated upon included L1-L2 (n = 3), L2-L3 (n = 2), L3-L4 (n = 8), L4-L5 (n = 90), and L5-S1 (n = 47). Ninety patients had radiculopathy on right side and 60 on left side. There were 22 central, 88 paracentral, 12 contained, 3 extraforaminal, and 25 sequestrated herniations. Standard protocol of preoperative blood tests, x-ray LS Spine and pre operative MRI and pre anaesthetic evaluation for anaesthesia was done in all cases. Technique comprised localization of symptomatic level followed by percutaneous dilatation and insertion of a newly devised arthrospine system devise over a dilator through a 15 mm skin and fascial incision. Arthro/endoscopic discectomy was then carried out by 30° arthroscope and conventional disc surgery instruments. Results: Based on modified Macnab's criteria, of 150 patients operated for lumbar discectomy, 136 (90%) patients had excellent to good, 12 (8%) had fair, and 2 patients (1.3%) had poor results. The complications observed were discitis in 3 patients (2%), dural tear in 4 patients (2.6%), and nerve root injury in 2 patients (1.3%). About 90% patients were able

  5. Results of arthrospine assisted percutaneous technique for lumbar discectomy

    Directory of Open Access Journals (Sweden)

    Mohinder Kaushal

    2016-01-01

    Full Text Available Background: Avaialable minimal invasive arthro/endoscopic techniques are not compatible with 30 degree arthroscope which orthopedic surgeons uses in knee and shoulder arthroscopy. Minimally invasive “Arthrospine assisted percutaneous technique for lumbar discectomy” is an attempt to allow standard familiar microsurgical discectomy and decompression to be performed using 30° arthroscope used in knee and shoulder arthroscopy with conventional micro discectomy instruments. Materials and Methods: 150 patients suffering from lumbar disc herniations were operated between January 2004 and December 2012 by indiginously designed Arthrospine system and were evaluated retrospectively. In lumbar discectomy group, there were 85 males and 65 females aged between 18 and 72 years (mean, 38.4 years. The delay between onset of symptoms to surgery was between 3 months to 7 years. Levels operated upon included L1-L2 (n = 3, L2-L3 (n = 2, L3-L4 (n = 8, L4-L5 (n = 90, and L5-S1 (n = 47. Ninety patients had radiculopathy on right side and 60 on left side. There were 22 central, 88 paracentral, 12 contained, 3 extraforaminal, and 25 sequestrated herniations. Standard protocol of preoperative blood tests, x-ray LS Spine and pre operative MRI and pre anaesthetic evaluation for anaesthesia was done in all cases. Technique comprised localization of symptomatic level followed by percutaneous dilatation and insertion of a newly devised arthrospine system devise over a dilator through a 15 mm skin and fascial incision. Arthro/endoscopic discectomy was then carried out by 30° arthroscope and conventional disc surgery instruments. Results: Based on modified Macnab's criteria, of 150 patients operated for lumbar discectomy, 136 (90% patients had excellent to good, 12 (8% had fair, and 2 patients (1.3% had poor results. The complications observed were discitis in 3 patients (2%, dural tear in 4 patients (2.6%, and nerve root injury in 2 patients (1.3%. About 90% patients

  6. Evaluation of a laparoscopically assisted ovariectomy technique in cats.

    Science.gov (United States)

    Sakals, Sherisse A; Rawlings, Clarence A; Laity, Jamie; Hofmeister, Erik H; Radlinsky, MaryAnn G

    2018-01-27

    To describe a laparoscopically assisted ovariectomy (LAO) technique in the cat with a bipolar vessel sealing device (BVSD) or suture ligation and to compare the outcomes to open ovariohysterectomy (OO). Randomized prospective study ANIMALS: Healthy, adult, sexually intact female cats (n = 30). Ten cats were assigned to each group: LAO with BVSD (group A), LAO with ligation (group B), and OO with ligation (group C). Surgical times and complications were assessed. Serum glucose and cortisol were measured prior to surgery and at 1, 2, 4, 6, 12, and 24 hours after surgery. Pain was scored by using an interactive visual analog scale (IVAS) at 0, 1, 2, 4, 6, 8, 12, 18, 24, 36, and 48 hours after surgery. Rescue analgesia was provided when IVAS score was 4 or more. Physiological and serum values and IVAS scores were compared among groups with area under the curve (AUC) by using a 1-way ANOVA. Surgical time was shortest for group C (19.1 ± 5.2 minutes; P < .0002); there was no significant difference between groups A (27.7 ± 6.6 minutes) and B (33.2 ± 8.2 minutes). All procedures were completed successfully. No significant differences among groups were found in IVAS scores (P = .36), rescue analgesia (P = .22), glucose AUC (P = .53), or cortisol AUC (P = .27). The LAO technique was accomplished as described in all cats with no complications or failures. Pain scores were not different from cats undergoing OO. LAO can be performed efficiently to maximize the benefits of minimally invasive surgery and is amenable to clinical practice. © 2018 The American College of Veterinary Surgeons.

  7. A simple and secure anchoring system for Caspari's transglenoid multiple suture technique using a biodegradable poly-l-lactic acid button.

    Science.gov (United States)

    Yoneda, M; Hayashida, K; Izawa, K; Shimada, K; Shino, K

    1996-06-01

    To manage a difficulty in tying sutures over the infraspinatus fascia when using Caspari's transglenoid multiple suture technique, we developed a new anchoring system using a biodegradable poly-L-lactic acid (PLLA) button and investigated its clinical efficacy in 28 patients who were followed-up for more than 2 years postoperatively (mean, 26.5 months). Twenty-four patients had Bankart lesions and 4 had detachment of the superior glenoid labrum. The mean age at operation was 22.1 years. The PLLA button measured 8 x 8 x 1.2 mm and had two holes. After multiple sutures were inserted by the routine Caspari technique (mean, 7.3 sutures), the sutures were divided into 2 bundles, passed through the holes in the button, and tied over it on the posterior scapular neck under traction. The arm was immobilized in a Velpeau bandage for 3 weeks after Bankart repair and for 1 to 2 weeks after superior labral repair. The results of Bankart repair were excellent in 13 patients, good in 7, and poor in 4 according to Rowe's rating scale (success rate, 83%), while the outcome of superior labral repair was excellent in 3 and good in 1 according to our own criteria. All 4 patients who showed a poor outcome were contact athletes who developed resubluxation postoperatively. There were no complications, but transient damages to the suprascapular nerve occurred in 2 patients. In conclusion, the PLLA button provided simple and secure suture fixation for the Caspari technique.

  8. Role of hysteroscopy prior to assisted reproduction techniques.

    Science.gov (United States)

    Bakas, Panagiotis; Hassiakos, Dimitrios; Grigoriadis, Charalampos; Vlahos, Nikolaos; Liapis, Angelos; Gregoriou, Odysseas

    2014-01-01

    To determine whether diagnostic hysteroscopy before assisted reproduction techniques (ΑRT) in women without known disease of the uterine cavity is necessary. Prospective cohort clinical study. Reproductive medicine clinic. The study group consisted of 217 infertile women attending the Reproductive Clinic for examination before undergoing ART, either in vitro fertilization or intracytoplasmic sperm injection. Patients underwent transvaginal sonography (TVS) and hysterosalpingography (HSG) for initial evaluation. If there were no abnormal intrauterine findings, diagnostic hysteroscopy was additionally performed. The safety and diagnostic value of hysteroscopy before ART was examined. Diagnostic hysteroscopy was performed successfully, without complications, in all 217 women. Ninety-five (43.7%) had a history of ART failures (group 1), and 122 (56.3%) had undergone no previous ART attempts (group 2). In 148 women (68.2%), findings at hysteroscopy were normal, whereas in 69 (31.8%), hysteroscopy revealed intrauterine lesions (polyps, septa, submucosal leiomyomas, or synechiae) that led to operative hysteroscopy. The most common intrauterine abnormality was the presence of endometrial polyps in 26 patients (12%). The total percentage of abnormal intrauterine findings was higher in women with a history of repeated ART failures in comparison with those with no history of ART attempts. No statistically significant difference in the outcome of in vitro fertilization or intracytoplasmic sperm injection was observed between women with normal hysteroscopic findings and patients with hysteroscopically corrected endometrial disease. Sensitivity of diagnostic hysteroscopy is significantly higher than TVS and HSG in the diagnosis of intrauterine lesions. Diagnostic hysteroscopy should be performed before ART in all patients, including women with normal TVS and/or HSG findings, because a significant percentage of them have undiagnosed uterine disease that may impair the success of

  9. Assisted Reproductive Techniques and Risk of Beckwith-Wiedemann Syndrome.

    Science.gov (United States)

    Mussa, Alessandro; Molinatto, Cristina; Cerrato, Flavia; Palumbo, Orazio; Carella, Massimo; Baldassarre, Giuseppina; Carli, Diana; Peris, Clementina; Riccio, Andrea; Ferrero, Giovanni Battista

    2017-07-01

    The emerging association of assisted reproductive techniques (ART) with imprinting disorders represents a major issue in the scientific debate on infertility treatment and human procreation. We studied the prevalence of Beckwith-Wiedemann syndrome (BWS) in children conceived through ART to define the specific associated relative risk. Patients with BWS born in Piemonte, Italy, were identified and matched with the general demographic data and corresponding regional ART registry. Between 2005 and 2014, live births in Piemonte were 379 872, including 7884 from ART. Thirty-eight patients with BWS were born, 7 from ART and 31 naturally conceived. BWS birth prevalence in the ART group was significantly higher than that of the naturally conceived group (1:1126 vs 1:12 254, P < .001). The absolute live birth risk in the ART group was 887.9 per 1 000 000 vs 83.3 per 1 000 000 in the naturally conceived group, providing a relative risk of 10.7 (95% confidence interval 4.7-24.2). During the 1997-2014 period, 67 patients were diagnosed with BWS out of 663 834 newborns (1:9908 live births). Nine out of the 67 BWS patients were conceived through ART (13.4%), and 8 were molecularly tested, with 4 having an imprinting center 2 loss of methylation, 2 with 11p15.5 paternal uniparental disomy, and 2 negative results. ART entails a 10-fold increased risk of BWS and could be implicated in the pathogenesis of genomic events besides methylation anomalies. These data highlight the need for awareness of ART-associated health risk. Copyright © 2017 by the American Academy of Pediatrics.

  10. Hand-assisted laparoscopic colectomy: evolution to a clinically useful technique.

    Science.gov (United States)

    Ballantyne, Garth H; Leahy, Patrick F

    2004-05-01

    Hand-assisted laparoscopic colectomy has traversed three phases of distinct development. This review was designed to trace the evolution of hand-assisted colectomy from an infrequently used technique to a clinically useful surgical approach to diseases of the colon and rectum. This review compiles previously reported and published experiences with hand-assisted laparoscopic colectomy. During the first phase of development of hand-assisted laparoscopic colectomy, surgeons explored what could be accomplished by a hand inserted into the abdomen through the specimen extraction site as an adjunct to laparoscopic techniques. Case reports and small trials found that manually assisted laparoscopic techniques permitted more rapid completion of laparoscopic-assisted colectomies. In the second phase, surgeons used early devices that facilitated the insertion of the surgeon's hand into the abdomen and helped to maintain the pneumoperitoneum. Larger series and small, randomized trials indicated a time-saving advantage to hand-assisted techniques and similar short-term outcomes as laparoscopic-assisted colectomies. In the current third phase, surgeons are using a new generation of hand-access devices that extend the options for hand-assisted techniques. These devices, like earlier devices, facilitate hand insertion, protect the wound, act as the retrieval site for the specimen, and serve as the portal for construction of extracorporeal anastomoses. In addition, these new devices can serve as laparoscopic trocar sites. This permits selective use of hand-assisted and laparoscopic-assisted techniques at various times in the same operation. These new devices have not undergone clinical trials, and therefore, a final appraisal must await future publication of outcomes. Hand-assisted laparoscopic colectomy has evolved into a clinically useful surgical technique. New devices facilitate the performance of these operations and permit the surgeon to switch between hand-assisted and

  11. Ultrasonic/Sonic Anchor

    Science.gov (United States)

    Bar-Cohen, Yoseph; Sherrit, Stewart

    2009-01-01

    The ultrasonic/sonic anchor (U/S anchor) is an anchoring device that drills a hole for itself in rock, concrete, or other similar material. The U/S anchor is a recent addition to a series of related devices, the first of which were reported in "Ultrasonic/Sonic Drill/Corers With Integrated Sensors"

  12. Applications of NLP Techniques to Computer-Assisted Authoring of Test Items for Elementary Chinese

    Science.gov (United States)

    Liu, Chao-Lin; Lin, Jen-Hsiang; Wang, Yu-Chun

    2010-01-01

    The authors report an implemented environment for computer-assisted authoring of test items and provide a brief discussion about the applications of NLP techniques for computer assisted language learning. Test items can serve as a tool for language learners to examine their competence in the target language. The authors apply techniques for…

  13. Human monitoring, smart health and assisted living techniques and technologies

    CERN Document Server

    Longhi, Sauro; Freddi, Alessandro

    2017-01-01

    This book covers the three main scientific and technological areas critical for improving people's quality of life - namely human monitoring, smart health and assisted living - from both the research and development points of view.

  14. Towards a long-term dataset of ELBARA-II measurements assisting SMOS level-3 land product and algorithm validation at the Valencia Anchor Station

    Directory of Open Access Journals (Sweden)

    R. Fernandez-Moran

    2015-06-01

    Full Text Available The Soil Moisture and Ocean Salinity (SMOS mission was launched on 2nd November 2009 with the objective of providing global estimations of soil moisture and sea salinity. The main activity of the Valencia Anchor Station (VAS is currently to assist in a long-term validation of SMOS land products. This study focus on a level 3 SMOS data validation with in situ measurements carried out in the period 2010-2012 over the VAS. ELBARA-II radiometer is placed in the VAS area, observing a vineyard field considered as representative of a major proportion of an area of 50×50 km, enough to cover a SMOS footprint. Brightness temperatures (TB acquired by ELBARA-II have been compared to those observed by SMOS at the same dates and time. They were also used for the L-MEB model inversion to retrieve soil moisture (SM, which later on have been compared to those provided by SMOS as level 3 data. A good correlation between both TB datasets was found, improving year by year, mainly due to the decrease of precipitations in the analyzed period and the mitigation of radio frequency interferences at L-band. The larger homogeneity of the radiometer footprint as compared to SMOS explains the higher variability of its TB. Periods of more intense precipitation (spring and autumn also presented higher SM, which corroborates the consistency of SM retrieved from ELBARA-II’s observations. However, the results show that SMOS level 3 data underestimate SM as compared to ELBARA-II’s, probably due to the influence of the small soil fraction which is not cultivated in vineyards. SMOS estimations in descending orbit (6 pm had better quality (higher correlation, lower RMSE and bias than the ones in ascending orbit (6 am, when there is a higher soil moisture. Normal 0 21 false false false ES X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso

  15. Repair of acute ulnar collateral ligament injuries of the thumb metacarpophalangeal joint: a retrospective comparison of pull-out sutures and bone anchor techniques.

    Science.gov (United States)

    Katolik, Leonid I; Friedrich, Jeffrey; Trumble, Thomas E

    2008-11-01

    The use of intraosseous suture anchors in the treatment of ruptures of the ulnar collateral ligament of the thumb metacarpophalangeal joint has previously been described. However, no direct comparisons exist of ulnar collateral ligament repair with bone anchor versus repair with a pull-out button and immobilization. Two cohorts of patients with complete rupture of the ulnar collateral ligament of the thumb metacarpophalangeal joint were compared. Thirty patients in each cohort underwent repair of the ulnar collateral ligament with either an intraosseous suture anchor followed by early mobilization or a pull-out suture tied over a button with cast immobilization. Average follow-up was 29 months. At follow-up, range of motion at the metacarpophalangeal and interphalangeal joints for the anchor group averaged 97 percent of that of the contralateral side compared with 86 percent and 87 percent, respectively, for the button group. For the anchor group, pinch strength averaged 101 percent that of the contralateral side compared with 95 percent for the button group. No significant difference was noted between the groups for grip strength. Average tourniquet time for the anchor group was 28 minutes compared with 43 minutes for the button group. Soft-tissue complications were present in 27 percent of patients (eight of 30) in the pull-out button group compared with 7 percent (two of 30) in the anchor group. Cost analysis demonstrates an approximately $140-per-patient savings when using the suture anchor. Both repair methods are safe and effective for treating thumb ulnar collateral ligament injuries. Suture anchors allow for an accelerated rehabilitation protocol, which may account for the improved range of motion and pinch strength at follow-up.

  16. Anchoring of proteins to lactic acid bacteria

    NARCIS (Netherlands)

    Leenhouts, K; Buist, Girbe; Kok, Jan

    1999-01-01

    The anchoring of proteins to the cell surface of lactic acid bacteria (LAB) using genetic techniques is an exciting and emerging research area that holds great promise for a wide variety of biotechnological applications. This paper reviews five different types of anchoring domains that have been

  17. Enhanced neurorehabilitation techniques in the DVBIC Assisted Living Pilot Project.

    Science.gov (United States)

    Hoffman, Stuart W; Shesko, Kristina; Harrison, Catherine R

    2010-01-01

    Traumatic Brain Injury has been labeled the "silent epidemic" in our current wars. Both CBO and the RAND reports predict that the costs of these injuries will be both extensive and enduring. The projected costs are based not only upon the loss contribution of these warriors to our economy, but also the long-term medical and assistive care that will be needed to support these veterans for decades to come. Thus, the primary goal of the Assisted Living Pilot Project (ALPP) at the Defense and Veterans Brain Injury Center - Johnstown (DVBIC-J) is to promote the ability of the injured warrior to move from assisted living to living independently and to be self-supporting by providing a continuum of care. To accomplish this goal the DVBIC-J ALPP is providing full set of traditional services (physical, occupational, speech, psychological/cognitive, social/familial, vocational, and spiritual), along with "cutting-edge" rehabilitative treatment technologies. These cutting-edge therapies include transdisciplinary clinical consultations, interactive patient and family counseling, and telemedicine-teleconferencing for clinical evaluations and family/significant other care participation. These services will be available to those who require assisted living through their progression to community re-entry. The ALPP also serves as a vehicle for clinical trials to investigate the effects of an enriched environment (e.g., recreational therapies, massage, multisensory stimulation, etc.) on neurorehabilitation therapy, rural telemedicine for servicemembers with traumatic brain injury, and long-term outcome measures of those who have received neurorehabilitation services at the DVBIC-J site. DVBIC-J is also developing collaborative projects with universities and private industry to create an incubator for new rehabilitation technologies. The technologies that DVBIC-J will be focusing on will include assistive technologies (to assist cognitive, physical, and communicative impairments

  18. [Clinical analysis of 12 cases of orthognathic surgery with digital computer-assisted technique].

    Science.gov (United States)

    Tan, Xin-ying; Hu, Min; Liu, Chang-kui; Liu, Hua-wei; Liu, San-xia; Tao, Ye

    2014-06-01

    This study was to investigate the effect of the digital computer-assisted technique in orthognathic surgery. Twelve patients from January 2008 to December 2011 with jaw malformation were treated in our department. With the help of CT and three-dimensional reconstruction technique, 12 patients underwent surgical treatment and the results were evaluated after surgery. Digital computer-assisted technique could clearly show the status of the jaw deformity and assist virtual surgery. After surgery all patients were satisfied with the results. Digital orthognathic surgery can improve the predictability of the surgical procedure, and to facilitate patients' communication, shorten operative time, and reduce patients' pain.

  19. Evaluation of an instrument-assisted dynamic prosthetic alignment technique for individuals with transtibial amputation.

    Science.gov (United States)

    Chen, Caroline Wen Jia; Heim, Winfried; Fairley, Karen; Clement, Russell J; Biddiss, Elaine; Torres-Moreno, Ricardo; Andrysek, Jan

    2016-08-01

    A prosthesis that is not optimally aligned can adversely influence the rehabilitation and health of the amputee. Very few studies to date evaluate the effectiveness and utility of instrument-assisted alignment techniques in clinical practice. To compare an instrument-assisted dynamic alignment technique (Compas(™)) to conventional methods. In a crossover study design, dynamic prosthetic alignments were provided to nine individuals with unilateral transtibial amputations to compare conventional and instrument-assisted alignment techniques. The instrument-assisted technique involved a commercially available force and torque sensing dynamic alignment system (Compas). Cadence, pelvic accelerations, and socket moments were assessed. A custom questionnaire was used to gather user perceptions. No differences between alignment techniques were found in global gait measures including cadence and pelvic accelerations. No significant alignment differences were achieved by examination of angular changes between the socket and foot; however, significantly higher below-the-socket moments were found with the instrument-assisted technique. From the questionnaire, six amputees had no preference, while three preferred the conventional alignment. The use of Compas appears to produce similar alignment results as conventional techniques, although with slightly higher moments at the socket. This study provides new information about the clinical utilization of instrument-assisted prosthetic alignment techniques for individuals with transtibial amputation. © The International Society for Prosthetics and Orthotics 2015.

  20. Endometrial injury in women undergoing assisted reproductive techniques.

    Science.gov (United States)

    Nastri, Carolina O; Lensen, Sarah F; Gibreel, Ahmed; Raine-Fenning, Nick; Ferriani, Rui A; Bhattacharya, Siladitya; Martins, Wellington P

    2015-03-22

    Implantation of an embryo within the endometrial cavity is a critical step in assisted reproductive techniques (ART). Previous research has suggested that endometrial injury - intentional damage to the endometrium - can increase the probability of pregnancy in women undergoing ART. To assess the effectiveness and safety of endometrial injury performed before embryo transfer in women undergoing ART. We searched the Cochrane Menstrual Disorders and Subfertility Group (MDSG) Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effects (DARE), MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Latin American Caribbean Health Sciences Literature (LILACS) and ClinicalTrials.gov. The original search was performed in November 2011, and further searches were done in March 2014 and January 2015. Randomised controlled trials comparing intentional endometrial injury before embryo transfer in women undergoing ART, versus no intervention or a sham procedure. Two independent review authors screened studies and extracted data which were checked by a third review author. Two review authors independently assessed risk of bias. We contacted and corresponded with study investigators as required and analysed data using risk ratio (RR) and a random-effects model. We assessed the quality of the evidence by using GRADE (Grades of Recommendation, Assessment, Development and Evaluation) criteria. We included 14 trials that included 1063 women in the intervention groups and 1065 women in the control groups. Thirteen studies compared endometrial injury performed between day 7 of the previous cycle and day 7 of the embryo transfer (ET) cycle versus no injury, and one study compared endometrial injury on the day of oocyte retrieval versus no injury. Overall, eight of the 14 included studies were deemed to be at high risk of bias in at least one domain.In studies comparing endometrial

  1. Long-term ELBARA-II Assistance to SMOS Land Product and Algorithm Validation at the Valencia Anchor Station (MELBEX Experiment 2010-2013)

    Science.gov (United States)

    Lopez-Baeza, Ernesto; Wigneron, Jean-Pierre; Schwank, Mike; Miernecki, Maciej; Kerr, Yann; Casal, Tania; Delwart, Steven; Fernandez-Moran, Roberto; Mecklenburg, Susanne; Coll Pajaron, M. Amparo; Salgado Hernanz, Paula

    The main activity of the Valencia Anchor Station (VAS) is currently now to support the validation of SMOS (Soil Moisture and Ocean Salinity) Level 2 and 3 land products (soil moisture, SM, and vegetation optical depth, TAU). With this aim, the European Space Agency (ESA) has provided the Climatology from Satellites Group of the University of Valencia with an ELBARA-II microwave radiometer under a loan agreement since September 2009. During this time, brightness temperatures (TB) have continuously been acquired, except during normal maintenance or minor repair interruptions. ELBARA-II is an L-band dual-polarization radiometer with two channels (1400-1418 MHz, 1409-1427 MHz). It is continuously measuring over a vineyard field (El Renegado, Caudete de las Fuentes, Valencia) from a 15 m platform with a constant protocol for calibration and angular scanning measurements with the aim to assisting the validation of SMOS land products and the calibration of the L-MEB (L-Band Emission of the Biosphere) -basis for the SMOS Level 2 Land Processor- over the VAS validation site. One of the advantages of using the VAS site is the possibility of studying two different environmental conditions along the year. While the vine cycle extends mainly between April and October, during the rest of the year the area remains under bare soil conditions, adequate for the calibration of the soil model. The measurement protocol currently running has shown to be robust during the whole operation time and will be extended in time as much as possible to continue providing a long-term data set of ELBARA-II TB measurements and retrieved SM and TAU. This data set is also showing to be useful in support of SMOS scientific activities: the VAS area and, specifically the ELBARA-II site, offer good conditions to control the long-term evolution of SMOS Level 2 and Level 3 land products and interpret eventual anomalies that may obscure sensor hidden biases. In addition, SM and TAU that are currently

  2. Computer-assisted virtual autopsy using surgical navigation techniques.

    Science.gov (United States)

    Ebert, Lars Christian; Ruder, Thomas D; Martinez, Rosa Maria; Flach, Patricia M; Schweitzer, Wolf; Thali, Michael J; Ampanozi, Garyfalia

    2015-01-01

    OBJECTIVE; Virtual autopsy methods, such as postmortem CT and MRI, are increasingly being used in forensic medicine. Forensic investigators with little to no training in diagnostic radiology and medical laypeople such as state's attorneys often find it difficult to understand the anatomic orientation of axial postmortem CT images. We present a computer-assisted system that permits postmortem CT datasets to be quickly and intuitively resliced in real time at the body to narrow the gap between radiologic imaging and autopsy. Our system is a potentially valuable tool for planning autopsies, showing findings to medical laypeople, and teaching CT anatomy, thus further closing the gap between radiology and forensic pathology.

  3. ERCP with the Balloon-Assisted Enteroscopy Technique : A Systematic Review

    NARCIS (Netherlands)

    Koornstra, Jan J.; Fry, Lucia; Moenkemueller, Klaus

    2008-01-01

    Background: Endoscopic retrograde cholangiopancreatography (ERCP) is generally difficult with conventional instruments in patients with surgically altered gastrointestinal anatomy. Balloon-assisted enteroscopy is a relatively new technique that allows for access to the papilla of Vater or a

  4. Computer-assisted Navigation in Bone Tumor Surgery: Seamless Workflow Model and Evolution of Technique

    National Research Council Canada - National Science Library

    So, Timothy Y. C; Lam, Ying-Lee; Mak, Ka-Lok

    2010-01-01

    .... Registration techniques vary, although most existing systems use some form of surface matching.We developed and evaluated a workflow model of computer-assisted bone tumor surgery and evaluated (1...

  5. [Being a family today - ethics for assisted reproductive techniques].

    Science.gov (United States)

    Mathieu, S

    2013-09-01

    Currently in France, all the children born as a result of an assisted reproduction procedure, represent 2.5% of all births. Although this proportion is not high, it is not to be neglected, particularly with regard to the sociological issues raised by assisted reproduction technologies (ART) - i.e. removing anonymity of gamete donation, post mortem insemination, ART access to single women and gay couples, surrogacy - to name four of the most prominent debates. What is new with ART is that a new therapeutic target of medicine is being developed, in other words procreation. Now it is no longer necessary for a man and a woman to resort to sex to have a child. This is a profound questioning of the representation of what appeared to be intangible, with some sort of divine aura. How, in this context, developing an ethics for ART? From a fethnographic field survey, we show here how this ethos of ART develops and how, therefore, we consider the multiple ways of being a family today. Copyright © 2013. Published by Elsevier SAS.

  6. The effectiveness of pendulum, K-loop, and distal jet distalization techniques in growing children and its effects on anchor unit: A comparative study

    Directory of Open Access Journals (Sweden)

    Pravinkumar S Marure

    2016-01-01

    Full Text Available Background: A common strategy to correct Class II malocclusions using a nonextraction protocol in children is to move the maxillary molars distally using molar distalization appliances, which usually derive their anchorage from maxillary premolars, causing mesialization of premolars and protrusion of incisors. Objectives: To evaluate the skeletal, dental and soft tissue changes produced by three different distalizing appliances, namely, pendulum, K-loop, and distal jet appliances. Materials and Methods: Sixty-six children of mean age 14.13 years requiring molar distalization were divided into three groups: Group I (pendulum appliance, Group II (K-loop, and Group III (distal jet. Lateral cephalometric films were taken before and after 5 months of molar distalization and following cephalometric parameters were used to assess the effects of maxillary molar distalization, namely, anteroposterior skeletal (SNA/SNB/ANB, vertical skeletal (face height ratio/Frankfort-mandibular plane [FMA]/angle formed between Maxillary plane & Mandibular plane (MM, interdental (overjet/overbite, maxillary dentoalveolar, and soft tissue parameters. Results: There was no significant age difference between the three groups. In overall treatment changes among the three groups, the Anteroposterior skeletal changes were not statistically significant, vertically FMA angle increased by 1.79° ± 2.25° and overbite reduced by 2.38 ± 1.83 mm. The maxillary first molars were distalized by an average of 4.70 ± 3.01 mm (Upper 6 [U6] to pterygoid vertical [PTV]. The maxillary central incisor labial tipping increased to an average of 1.61 ± 2.73 mm and cant of upper lip increased by 3.40° ± 5.88° are statistically significant (P < 0.05. Conclusion: All three distalization techniques in growing children produced significant effects on anchor unit. There was an increase in FMA angle, significant bite opening, proclination of the maxillary incisors and increase in the cant of

  7. The effectiveness of pendulum, K-loop, and distal jet distalization techniques in growing children and its effects on anchor unit: A comparative study.

    Science.gov (United States)

    Marure, Pravinkumar S; Patil, Raju Umaji; Reddy, Sumitra; Prakash, Amit; Kshetrimayum, Nillachandra; Shukla, Rajeevkumar

    2016-01-01

    A common strategy to correct Class II malocclusions using a nonextraction protocol in children is to move the maxillary molars distally using molar distalization appliances, which usually derive their anchorage from maxillary premolars, causing mesialization of premolars and protrusion of incisors. To evaluate the skeletal, dental and soft tissue changes produced by three different distalizing appliances, namely, pendulum, K-loop, and distal jet appliances. Sixty-six children of mean age 14.13 years requiring molar distalization were divided into three groups: Group I (pendulum appliance), Group II (K-loop), and Group III (distal jet). Lateral cephalometric films were taken before and after 5 months of molar distalization and following cephalometric parameters were used to assess the effects of maxillary molar distalization, namely, anteroposterior skeletal (SNA/SNB/ANB), vertical skeletal (face height ratio/Frankfort-mandibular plane [FMA]/angle formed between Maxillary plane & Mandibular plane (MM)), interdental (overjet/overbite), maxillary dentoalveolar, and soft tissue parameters. There was no significant age difference between the three groups. In overall treatment changes among the three groups, the Anteroposterior skeletal changes were not statistically significant, vertically FMA angle increased by 1.79° ± 2.25° and overbite reduced by 2.38 ± 1.83 mm. The maxillary first molars were distalized by an average of 4.70 ± 3.01 mm (Upper 6 [U6] to pterygoid vertical [PTV]). The maxillary central incisor labial tipping increased to an average of 1.61 ± 2.73 mm and cant of upper lip increased by 3.40° ± 5.88° are statistically significant (P < 0.05). All three distalization techniques in growing children produced significant effects on anchor unit. There was an increase in FMA angle, significant bite opening, proclination of the maxillary incisors and increase in the cant of the upper lip.

  8. EFFECTIVENESS OF INSTUMENTAL ASSISTED SOFT TISSUE MOBILIZATION TECHNIQUE WITH STATIC STRETCHING IN SUBJECTS WITH PLANTAR FASCIITIS

    OpenAIRE

    Vinod Babu. K; Lisa Michael Pereira; Sai Kumar. N; Ayyappan. V.R

    2014-01-01

    Background: Instrumental assisted soft tissue mobilization and static stretching found to be effective in plantar fasciitis, however the combined effectiveness of these techniques were unknown. The purpose of this study is to find the effect of Instrumental assisted soft tissue mobilization technique for plantar fascia combined with static stretching of triceps surae for subjects with chronic stage of Plantar Fasciitis on pain intensity, ankle dorsiflexion range of motion and functional disab...

  9. Assisted Reproductive Techniques in Farm Animal - From Artificial Insemination to Nanobiotechnology

    OpenAIRE

    Verma, O. P.; Kumar, R; A Kumar; Chand, S.

    2012-01-01

    It has become evident that advances in farm animal reproduction have become increasingly dependent on advance scientific research in addition to an understanding of the physiological processes involved in reproduction. The use of assisted reproductive techniques (ART) has helped owners to produce offspring from valuable farm animals that were considered infertile using standard breeding techniques. This chapter constitutes an update of recent developments in the field of assisted reproduction...

  10. Defect/oxygen assisted direct write technique for nanopatterning graphene

    DEFF Research Database (Denmark)

    Cagliani, Alberto; Lindvall, Niclas; Larsen, Martin Benjamin Barbour Spanget

    2015-01-01

    High resolution nanopatterning of graphene enables manipulation of electronic, optical and sensing properties of graphene. In this work we present a straightforward technique that does not require any lithographic mask to etch nanopatterns into graphene. The technique relies on the damaged graphene...... to be etched selectively in an oxygen rich environment with respect to non-damaged graphene. Sub-40 nm features were etched into graphene by selectively exposing it to a 100 keV electron beam and then etching the damaged areas away in a conventional oven. Raman spectroscopy was used to evaluate the extent...

  11. Blind percutaneous liver biopsy in infants and children: Comparison of safety and efficacy of percussion technique and ultrasound assisted technique.

    Science.gov (United States)

    Mogahed, Engy A; Mansy, Yasmeen A; Al Hawi, Yasmeen; El-Sayed, Rokaya; El-Raziky, Mona; El-Karaksy, Hanaa

    2016-12-01

    Liver biopsy remains the most reliable method to diagnose various hepatic disorders in children. We aimed to assess the technical success and complication rate of ultrasound (US) assisted percutaneous liver biopsy versus transthoracic percussion guided technique in paediatrics. This randomized controlled study included all cases performing liver biopsy at Paediatric Hepatology Unit, Cairo University Paediatric Hospital over 12months. Patients were 102 cases; 62 were males, with age range 18days to 12years. Fifty seven procedures were done using the percussion guided technique and 45 cases were US assisted. The total number of complicated biopsies was 14 (13.7%), with more serious complications occurring in the percussion group. Complications were more frequent with younger age, lower platelet count, number of passes and occurrence of hypotension. US assisted percutaneous liver biopsy, although more costly, but may be safer to perform particularly in younger age. Copyright © 2016 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.

  12. Rugoscopy: Human identification by computer-assisted photographic superimposition technique

    OpenAIRE

    Mohammed, Rezwana Begum; Patil, Rajendra G.; Pammi, V. R.; Sandya, M. Pavana; Kalyan, Siva V.; Anitha, A.

    2013-01-01

    Background: Human identification has been studied since fourteenth century and it has gradually advanced for forensic purposes. Traditional methods such as dental, fingerprint, and DNA comparisons are probably the most common techniques used in this context, allowing fast and secure identification processes. But, in circumstances where identification of an individual by fingerprint or dental record comparison is difficult, palatal rugae may be considered as an alternative source of material. ...

  13. [Premature twins: clinic comparison, reproductive assisted techniques versus spontaneous conception].

    Science.gov (United States)

    Noriega-Alvarez, Roxana; Iglesias-Leboreiro, José; Bernardez-Zapata, Isabel

    2014-01-01

    Twin pregnancies occur one out of every 800. Due to the increase in maternal age and infertility, the use of assisted reproductive technology (ART) has risen. Thirty five percent of pregnancies solved using ART are twin pregnancies. A RT consists of infertility treatments in which oocytes and sperm are manipulated. The objective of this study was to compare the clinical behavior of premature twins born through ART versus those born after spontaneous conception (SC). Retrolective cohort study. The data was obtained from the records of preterm twins born between August 2010 and August 2013. Preterm twins were categorized in two groups: the ones conceived using ART versus those conceived through SC. Demographic characteristics and neonatal outcomes were compared. The total was of 398 patients: 208 conceived in consequence of ART and 190 through SC. The primary outcome and neonatal morbidities showed no significant difference, only the incidence of necrotizing enterocolitis and the use of parenteral nutrition showed significant difference. The length of hospital stay between groups was similar. In our population of preterm twins, the mode of conception had no detectable effect on mortality or short term morbidities.

  14. Robot-assisted intrafascial simple prostatectomy: novel technique.

    Science.gov (United States)

    Clavijo, Rafael; Carmona, Oswaldo; De Andrade, Robert; Garza, Roberto; Fernandez, Golena; Sotelo, Rene

    2013-03-01

    We describe our initial experience with intrafascial robot-assisted simple prostatectomy (IF-RSP). Potential advantages include reduced blood loss, elimination of the need for postoperative bladder irrigation, and elimination of the risk of residual or future prostate cancer, without interrupting potency or continence. From June 2011 to March 2012, 10 patients with symptomatic prostatomegaly on transrectal ultrasonography (TRUS) (mean 81 g) underwent IF-RSP. Three patients had acute urinary retention. Demographic perioperative and outcome data were recorded up to 1 month follow-up. Average age was 71.7 years (range 60-79 years), estimated blood loss was 375 mL (range 150-900 mL), operative time was 106 minutes (range 60-180 min), hospital stay was 1 day (range 0-3 days), and Foley catheter duration was 8.9 days (range 6-14 days). The drain was removed at a mean 2.8 days (range 0-8 days). Mean prostate volume on preoperative TRUS was 81 cc (range 47-153 cc). Mean specimen weight was 81 g (range 50-150 g). Improvement was noted in the International Prostate Symptom Score (preoperative vs postoperative 18.8 vs 1.7) and peak flow rate (12.4 vs 33.49 mL/min). Sexual Health Inventory for Men score ranged from 12 to 24. All patients were completely continent within 1 month postoperatively, and sexual function was preserved. One patient had urinary tract infection and one patient needed blood transfusion postoperatively. IF-RSP appears to be a feasible procedure in large-volume prostatomegaly. The entire prostate tissue is removed without compromising continence and potency. Larger series and longer-term follow-up are needed to evaluate the proper place of this approach.

  15. Balloon-assisted technique in complex anatomy of transulnar access route

    Directory of Open Access Journals (Sweden)

    Suilbert Rodríguez Blanco

    2015-10-01

    Full Text Available Transulnar and transradial approaches have clear advantages in cardiac catheterization. However, complex anatomical variations can be the cause of failure in the use of this procedure. The case of a patient with complex arterial anatomy who underwent the balloon-assisted technique is reported. This technique is considered to be useful in selected cases.

  16. Rugoscopy: Human identification by computer-assisted photographic superimposition technique.

    Science.gov (United States)

    Mohammed, Rezwana Begum; Patil, Rajendra G; Pammi, V R; Sandya, M Pavana; Kalyan, Siva V; Anitha, A

    2013-07-01

    Human identification has been studied since fourteenth century and it has gradually advanced for forensic purposes. Traditional methods such as dental, fingerprint, and DNA comparisons are probably the most common techniques used in this context, allowing fast and secure identification processes. But, in circumstances where identification of an individual by fingerprint or dental record comparison is difficult, palatal rugae may be considered as an alternative source of material. The present study was done to evaluate the individualistic nature and use of palatal rugae patterns for personal identification and also to test the efficiency of computerized software for forensic identification by photographic superimposition of palatal photographs obtained from casts. Two sets of Alginate impressions were made from the upper arches of 100 individuals (50 males and 50 females) with one month interval in between and the casts were poured. All the teeth except the incisors were removed to ensure that only the palate could be used in identification process. In one set of the casts, the palatal rugae were highlighted with a graphite pencil. All the 200 casts were randomly numbered, and then, they were photographed with a 10.1 Mega Pixel Kodak digital camera using standardized method. Using computerized software, the digital photographs of the models without highlighting the palatal rugae were overlapped over the images (transparent) of the palatal rugae with highlighted palatal rugae, in order to identify the pairs by superimposition technique. Incisors were remained and used as landmarks to determine the magnification required to bring the two set of photographs to the same size, in order to make perfect superimposition of images. The result of the overlapping of the digital photographs of highlighted palatal rugae over normal set of models without highlighted palatal rugae resulted in 100% positive identification. This study showed that utilization of palatal photographs

  17. Medial patellofemoral ligament reconstruction using a bone groove and a suture anchor at patellar: a safe and firm fixation technique and 3-year follow-up study.

    Science.gov (United States)

    Wang, Hong-De; Dong, Jiang-Tao; Gao, Shi-Jun

    2016-11-14

    Graft fixation is critical to the restoration of the medial patella of femoral ligament function and long-term success. Numerous fixations at the patella have been described, while the complications including patellar fractures, violation of the posterior patella and delay of tendon-to-bone healing remain significant challenges. Here, we describe a safe and firm fixation at the patellar for medial patellofemoral ligament (MPFL) reconstruction and explore the safety angle of drilling the suture anchor at different morphology of the patellar. Moreover, we evaluate the results at a 3-year follow-up. Combined bone groove and suture anchor fixation at the patella was performed on 26 patients (16 females, 10 males; mean age 26.3 ± 4.7 years) diagnosed with recurrent patellar dislocation. The drilling direction of the suture anchor referred to the safety angle according to the Wiberg type classification. The safety angle was defined as the angle between the drill tunnel and a line that connected the medial and lateral margins of the patella and was established following computed tomography assessment of 117 patients who were diagnosed with patellar dislocation in our hospital according to the Wiberg type classification (I:29, II:65, III:23). X-ray, Lysholm, Kujala and Tegner scores were obtained preoperatively and at the time of final follow-up. There were no patellar complications, including fracture and redislocation. Average congruence, patella tilt angles and lateral patella angle were significantly changed (P suture anchor should be more vertical. When fixing the patellar of female patients, the drilling suture anchor should be more sloping.

  18. Hypersensitivity to Suture Anchors

    Directory of Open Access Journals (Sweden)

    Masafumi Goto

    2013-01-01

    Full Text Available Hypersensitivity to suture anchor is extremely rare. Herein, we present a case in which hypersensitivity to suture anchor was strongly suspected. The right rotator cuff of a 50-year-old woman was repaired with a metal suture anchor. Three weeks after the surgery, she developed erythema around her face, trunk, and hands, accompanied by itching. Infection was unlikely because no abnormalities were detected by blood testing or by medical examination. Suspicious of a metallic allergy, a dermatologist performed a patch testing 6 months after the first surgery. The patient had negative reactions to tests for titanium, aluminum, and vanadium, which were the principal components of the suture anchor. The anchor was removed 7 months after the first surgery, and the erythema disappeared immediately. When allergic symptoms occur and persist after the use of a metal anchor, removal should be considered as a treatment option even if the patch test result is negative.

  19. Techniques for assisting difficult delivery at caesarean section.

    Science.gov (United States)

    Waterfall, Heather; Grivell, Rosalie M; Dodd, Jodie M

    2016-01-31

    Caesarean section involves making an incision in the woman's abdomen and cutting through the uterine muscle. The baby is then delivered through that incision. Difficult caesarean birth may result in injury for the infant or complications for the mother. Methods to assist with delivery include vacuum or forceps extraction or manual delivery utilising fundal pressure. Medication that relaxes the uterus (tocolytic medication) may facilitate the birth of the baby at caesarean section. Delivery of the impacted head after prolonged obstructed labour can be associated with significant maternal and neonatal complication; to facilitate delivery of the head the surgeon may utilise either reverse breech extraction or head pushing. To compare the use of tocolysis (routine or selective use) with no use of tocolysis or placebo and to compare different extraction methods at the time of caesarean section for outcomes of infant birth trauma, maternal complications (particularly postpartum haemorrhage requiring blood transfusion), and long-term measures of infant and childhood morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2015) and reference lists of retrieved studies. All published, unpublished, and ongoing randomised controlled trials comparing the use of tocolytic agents (routine or selective) at caesarean section versus no use of tocolytic or placebo at caesarean section to facilitate the birth of the baby. Use of instrument versus manual delivery to facilitate birth of the baby. Reverse breech extraction versus head pushing to facilitate delivery of the deeply impacted fetal head. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Seven randomised controlled trials, involving 582 women undergoing caesarean section were included in this review. The risk of bias of included trials was variable, with some trials not adequately describing allocation or

  20. Novel Method for Exchange of Impella Circulatory Assist Catheter: The "Trojan Horse" Technique.

    Science.gov (United States)

    Phillips, Colin T; Tamez, Hector; Tu, Thomas M; Yeh, Robert W; Pinto, Duane S

    2017-07-01

    Patients with an indwelling Impella may require escalation of hemodynamic support or exchange to another circulatory assistance platform. As such, preservation of vascular access is preferable in cases where anticoagulation cannot be discontinued or to facilitate exchange to an alternative catheter or closure device. Challenges exist in avoiding bleeding and loss of wire access in these situations. We describe a single-access "Trojan Horse" technique that minimizes bleeding while maintaining arterial access for rapid exchange of this percutaneous ventricular assist device.

  1. Percutaneous Sacroiliac Screw Placement: A Prospective Randomized Comparison of Robot-assisted Navigation Procedures with a Conventional Technique

    Directory of Open Access Journals (Sweden)

    Jun-Qiang Wang

    2017-01-01

    Conclusions: Accuracy of the robot-assisted technique was superior to that of the freehand technique. Robot-assisted navigation is safe for unstable posterior pelvic ring stabilization, especially in S1, but also in S2. SI screw insertion with robot-assisted navigation is clinically feasible.

  2. Hypersensitivity to Suture Anchors

    OpenAIRE

    Masafumi Goto; Masafumi Gotoh; Yasuhiro Mitsui; Ryo Tanesue; Takahiro Okawa; Fujio Higuchi; Naoto Shiba

    2013-01-01

    Hypersensitivity to suture anchor is extremely rare. Herein, we present a case in which hypersensitivity to suture anchor was strongly suspected. The right rotator cuff of a 50-year-old woman was repaired with a metal suture anchor. Three weeks after the surgery, she developed erythema around her face, trunk, and hands, accompanied by itching. Infection was unlikely because no abnormalities were detected by blood testing or by medical examination. Suspicious of a metallic allergy, a dermatolo...

  3. Robot-assisted techniques and outcomes in the realm of pelvic reconstructive surgery.

    Science.gov (United States)

    Parnell, Brent A; Matthews, Catherine A

    2011-09-01

    Robotic-assisted surgery for the treatment of pelvic organ prolapse continues to grow in popularity as more surgeons adopt this technology. Encompassing all of the benefits of laparoscopic surgery, robotic-assisted techniques allow more surgeons the ability to perform complex tasks such as meticulous deep pelvic dissection and extensive suturing without having to resort to laparotomy. This chapter reviews the techniques involved in the robotic approach to pelvic reconstructive surgery and discusses the currently available information focusing on the outcomes of this procedure.

  4. Anchors for Education Reforms

    Science.gov (United States)

    Alok, Kumar

    2012-01-01

    Education reforms, considering their significance, deserve better methods than mere "trial and error." This article conceptualizes a network of six anchors for education reforms: education policy, education system, curriculum, pedagogy, assessment, and teacher education. It establishes the futility to reform anchors in isolation and…

  5. The place of reconstructive tubal surgery in the era of assisted reproductive techniques.

    Science.gov (United States)

    Gomel, Victor

    2015-12-01

    Assisted reproductive techniques yield high rates of success for women with tubal factor infertility. Because they are potentially effective for all categories of infertility, for two decades, clinical and basic research in infertility has been focused on IVF techniques and outcomes, rather than developing surgical techniques or training infertility subspecialists in tubal microsurgery. Nonetheless, in comparison with IVF, reconstructive tubal surgery is inexpensive and offers multiple opportunities to attempt conception. Performing laparoscopic salpingostomy prior to IVF in women with good prognosis tubal disease may improve the outcome of subsequent IVF, while offering the potential for spontaneous conception. Tubo-tubal anastomosis for reversal of tubal ligation, performed either by a microsurgical technique through a mini-laparotomy or by laparoscopy, is preferable to IVF in younger women with no other fertility factors, because it offers potentially higher cumulative pregnancy rates. Surgery is the only alternative for women with tubal factor infertility who for personal or other reasons are unable to undergo assisted reproductive techniques. Tubal reconstructive surgery and assisted reproductive techniques must be considered complementary forms of treatment for women with tubal factor infertility, and training in tubal reconstructive surgery should be an integral part of subspecialty training in reproductive endocrinology and infertility. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  6. Techniques of Assisted Human Reproduction and the Problematic of Parental Liability

    Directory of Open Access Journals (Sweden)

    Carlos Alexandre Moraes

    2016-06-01

    Full Text Available The present study aims to analyze the issues related to the civil responsibility of parents, when using the assisted human reproductions techniques. Drew up a discussion about the reflections of the principles of responsible parenting and of human dignity in the use of those techniques, delineating one by one of them that can cause damages to the embryo, unborn or child already born. Discussing about the assisted human reproduction techniques, it outlined those allowed by the Federal Medical Council through the Resolution nº 2013/2013 and stood out the legal system omission related to the regulation of the use of those techniques, since the only legal instrument that deals with it, that is the Law nº 11.105/2005, did not specify about it. Was presented therefore, all human assisted reproduction techniques that give rise to a possible potentiation of vulnerability of the embryo as well as to possibly answers regarding to the legal status of the embryo that the doctrine is trying to trace. Finally, we discussed about the civil responsibility forms, relating it to the responsible parenthood and the damages caused from not using those techniques.

  7. Assisted Reproduction Techniques (Art): The State of the Art in Nigeria

    African Journals Online (AJOL)

    Background: Infertility has become a social stigma in our environment because of the erroneous belief that a childless marriage is a failed marriage. This has placed a lot of marriages under pressure. Therefore any solution to infertility is a welcome relief. This is where Assisted Reproduction Techniques (ART) belongs.

  8. Endometrial injury prior to assisted reproductive techniques for recurrent implantation failure: a systematic literature review.

    Science.gov (United States)

    Panagiotopoulou, Nikoletta; Karavolos, Stamatios; Choudhary, Meenakshi

    2015-10-01

    Endometrial injury to improve implantation for women undergoing assisted reproductive techniques has attracted a lot of attention recently and has rapidly become incorporated into clinical practice. The aim of this study is, thus, to assess the effectiveness and safety of endometrial injury performed in the cycle preceding assisted reproductive techniques in women with recurrent implantation failure. Electronic database searches, including MEDLINE, EMBASE, CENTRAL and grey literature, up to 30th May 2015 were conducted with no restrictions. Randomized controlled trials comparing endometrial injury versus placebo or no treatment in the cycle preceding assisted reproductive techniques in women with recurrent implantation failure were selected. The primary outcome was live birth rate. Secondary outcomes were clinical pregnancy, implantation, miscarriage and procedure-related complication rates. Of the 1115 publications identified, 4 met the inclusion criteria. Meta-analysis was not possible due to significant clinical heterogeneity among the included studies. Patients' characteristics differed, as did the intervention used with endometrial injury being performed at different phases of the preceding menstrual cycle. Moreover, the effect of endometrial injury on live birth and clinical pregnancy rates were inconsistent among the included studies. In summary, there is currently insufficient evidence to support the use of endometrial injury in women with recurrent implantation failure undergoing assisted reproductive techniques while the procedure-associated complication rate has not been assessed. Clinical implementation should, thus, be deferred until robust evidence becomes available. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Evaluating a Computer-Assisted Pronunciation Training (CAPT) Technique for Efficient Classroom Instruction

    Science.gov (United States)

    Luo, Beate

    2016-01-01

    This study investigates a computer-assisted pronunciation training (CAPT) technique that combines oral reading with peer review to improve pronunciation of Taiwanese English major students. In addition to traditional in-class instruction, students were given a short passage every week along with a recording of the respective text, read by a native…

  10. Assisted reproductive technology in South Africa: first results generated from the South African Register of Assisted Reproductive Techniques.

    Science.gov (United States)

    Dyer, Silke Juliane; Kruger, Thinus Frans

    2012-02-23

    We present the first report from the South African Register of Assisted Reproductive Techniques. All assisted reproductive technology (ART) centres in South Africa were invited to join the register. Participant centres voluntarily submitted information from 2009 on the number of ART cycles, embryo transfers, clinical pregnancies, age of female partners or egg donors, and use of fertilisation techniques. Data were anonymised, pooled and analysed. The 12 participating units conducted a total of 4 512 oocyte aspirations and 3 872 embryo transfers in 2009, resulting in 1 303 clinical pregnancies. The clinical pregnancy rate (CPR) per aspiration and per embryo transfer was 28.9% and 33.6%, respectively. Fertilisation was achieved by intracytoplasmic sperm injection in two-thirds of cycles. In most cycles, 1 - 2 embryos or blastocysts were transferred. Female age was inversely related to pregnancy rate. The register achieved a high rate of participation. The reported number of ART cycles covers approximately 6% of the estimated ART demand in South Africa. The achieved CPRs compare favourably with those reported for other countries.

  11. Comparison of Three Epithelial Removal Techniques in PRK: Mechanical, Alcohol-assisted, and Transepithelial Laser.

    Science.gov (United States)

    Shapira, Yinon; Mimouni, Michael; Levartovsky, Shmuel; Varssano, David; Sela, Tzahi; Munzer, Gur; Kaiserman, Igor

    2015-11-01

    To compare the visual and refractive results obtained after photorefractive keratectomy (PRK) in patients who underwent one of three different epithelial removal techniques. The authors reviewed the medical files of consecutive eyes with myopia and myopic astigmatism that were treated during a 10-year period by mechanical PRK, alcohol-assisted PRK, or transepithelial PRK (in the phototherapeutic keratectomy mode), and observed for more than 1 year. A total of 3,417 patients (3,417 eyes) were included in this study. At 3 and 6 months postoperatively, the outcome of alcohol-assisted PRK was superior both in efficacy (P mechanical PRK and transepithelial PRK, which were similar. At more than 1 year postoperatively, the mean efficacy index was still high for alcohol-assisted PRK, but low for the transepithelial PRK, corresponding to a mean uncorrected visual acuity of more than one Snellen line lower than those of the other two techniques (P refractive results of the three epithelial removal techniques. The long-term outcomes were best for alcohol-assisted PRK. Copyright 2015, SLACK Incorporated.

  12. Use of fourth arm in da Vinci robot-assisted extraperitoneal laparoscopic prostatectomy: novel technique.

    Science.gov (United States)

    Esposito, Michael P; Ilbeigi, Pedram; Ahmed, Mutahar; Lanteri, Vincent

    2005-09-01

    The da Vinci robot-assisted laparoscopic radical prostatectomy is a relatively new approach that is revolutionizing the surgical treatment of localized prostate cancer. Since its introduction, several improvements have been made in the robot design model, as well as in the surgical technique for prostatectomy. One of the more recent advances in this technology has been the introduction of a four-arm robot model. This modified system allows the operating surgeon to use the fourth arm for key steps and maneuvers during the operation, thereby decreasing the reliance on advanced assistant laparoscopic skills. In this report, we describe our modifications for the extraperitoneal approach for laparoscopic removal of the prostate using the four-arm da Vinci surgical system. During a 24-month period, 154 consecutive patients with clinically localized prostate cancer underwent extraperitoneal robot-assisted laparoscopic radical prostatectomy using the four-arm da Vinci robot system. All cases were videotaped and subsequently reviewed. Important factors regarding extraperitoneal access, patient positioning, port placement, and assistant role with or without the fourth arm were defined. Our experience has revealed that the extraperitoneal approach allows for a more natural patient position during the operation and avoids intraperitoneal organ injury. The addition of the fourth arm to the da Vinci robot provides the operating surgeon with a great deal of independence, which facilitates all aspects of robot-assisted laparoscopic prostatectomy. It allows the operating surgeon to retract tissue during critical steps in this challenging operation and reduces the reliance on highly trained laparoscopic assistants.

  13. Laparoscope-assisted appendectomy in adults: the two-trocar technique.

    Science.gov (United States)

    Fazili, Fiaz Maqbool; Al-Bouq, Yousef; El-Hassan, Osman M; Gaffar, Hossam Fawzi A

    2006-01-01

    Open appendectomy is still the most common method of treating appendicitis. Laparoscopic procedures for removal of the appendix by the "in" technique as an alternative to conventional appendectomy have gained wide popularity, but have been criticized for their technical difficulty and high cost. We assessed the safety and efficacy of the laparoscope-assisted appendectomy (the two-trocar technique) in adults. We retrospectively studied 129 patients who had appendectomy using the laparoscope-assisted two-trocar technique between July 2002 to December 2003. The procedures were done by consultants and surgeons-in-training with experience in minimally invasive and open techniques. Locally modified endoloop and reusable trocars were used to reduce the cost. Appendectomy was performed extra-abdominally after the appendix was identified by using a laparoscope through one port and then delivered outside through the second port using reusable laparoscopy instruments. The two-trocar technique was successful in 101 (78.3%) cases; 14 (10.8%) needed a third trocar to complete the operation extra-abdominally, 6 (4.6%) were converted to open surgery, and 5 (3.8%) had an intra-abdominal laparoscopic appendectomy. The mean operation time was 35 minutes (range, 30-90 minutes). Six cases (4.6%) had infection. The mean hospital stay was 2.8 days (range, 2-7 days). No case of port hernia was reported during the follow-up period (range, 14-30 months). The laparoscope-assisted two-trocar technique for removal of the appendix can be performed as safely and efficiently as the open technique, but at a lower cost than the complete laparoscopic "in" method and does not need much technical expertise. This method is recommended as an alternative procedure to open appendectomy or the complete laparoscopic "in" technique in adults.

  14. A Comparison of Cough Assistance Techniques in Patients with Respiratory Muscle Weakness.

    Science.gov (United States)

    Kim, Sun Mi; Choi, Won Ah; Won, Yu Hui; Kang, Seong Woong

    2016-11-01

    To assess the ability of a mechanical in-exsufflator (MI-E), either alone or in combination with manual thrust, to augment cough in patients with neuromuscular disease (NMD) and respiratory muscle dysfunction. For this randomized crossover single-center controlled trial, patients with noninvasive ventilator-dependent NMD were recruited. The primary outcome was peak cough flow (PCF), which was measured in each patient after a cough that was unassisted, manually assisted following a maximum insufflation capacity (MIC) maneuver, assisted by MI-E, or assisted by manual thrust plus MI-E. The cough augmentation techniques were provided in random order. PCF was measured using a new device, the Cough Aid. All 40 enrolled participants (37 males, three females; average age, 20.9±7.2 years) completed the study. The mean (standard deviation) PCFs in the unassisted, manually assisted following an MIC maneuver, MI-E-assisted, and manual thrust plus MI-E-assisted conditions were 95.7 (40.5), 155.9 (53.1), 177.2 (33.9), and 202.4 (46.6) L/min, respectively. All three interventions significantly improved PCF. However, manual assistance following an MIC maneuver was significantly less effective than MI-E alone. Manual thrust plus MI-E was significantly more effective than both of these interventions. In patients with NMD and respiratory muscle dysfunction, MI-E alone was more effective than manual assistance following an MIC maneuver. However, MI-E used in conjunction with manual thrust improved PCF even further.

  15. Minimally invasive video-assisted submandibular sialadenectomy: surgical technique and results from two institutions.

    Science.gov (United States)

    Parente Arias, Pablo L; Fernández Fernández, Mario M; Varela Vázquez, Patricia; de Diego Muñoz, Beatriz

    2016-08-01

    Submandibular gland excision is traditionally performed using a transcervical approach. However, innovative surgical trials have recently been conducted to investigate techniques that can prevent or reduce visible scarring and nerve injury. The aim of the present study was to evaluate the feasibility of a new approach to submandibular gland excision that is based on the use of a minimally invasive video-assisted technique and an ultrasound scalpel in an endoscopic neck surgery program with a low annual flow of procedures. We retrospectively studied 15 patients with submandibular gland disease who underwent minimally invasive video-assisted submandibular sialadenectomy performed by two surgeons at two institutions. Eight patients had proximally located salivary calculi, three had chronic sialadenitis, and four had benign neoplasms. All dissections were carried out by a single-port gasless approach, using the Miccoli technique, involving endoscope magnification and an ultrasonic scalpel. All 15 submandibular gland resections were performed successfully, with no conversions to conventional open resection. The operative time ranged from 45 to 125 min (median 84 min). A total of 67 % of patients were discharged the day after surgery, and the maximum length of stay was 3 days. One patient experienced postoperative bleeding, and one experienced postoperative infection. There was no neural injury. The incision scar healed well in all cases, and all patients reported excellent cosmetic results. Endoscopic submandibular gland resection using a minimally invasive video-assisted technique, endoscopic magnification, and ultrasonic scalpel was feasible and resulted in excellent surgical outcomes.

  16. Anchor Trial Launch

    Science.gov (United States)

    NCI has launched a multicenter phase III clinical trial called the ANCHOR Study -- Anal Cancer HSIL (High-grade Squamous Intraepithelial Lesion) Outcomes Research Study -- to determine if treatment of HSIL in HIV-infected individuals can prevent anal canc

  17. Nano-organocatalyst: magnetically retrievable ferrite-anchored glutathione for microwave-assisted Paal–Knorr reaction, aza-Michael addition, and pyrazole synthesis

    KAUST Repository

    Polshettiwar, Vivek

    2010-01-01

    Postsynthetic Surface modification of magnetic nanoparticles by glutathione imparts desirable chemical functionality and enables the generation of catalytic sites on the surfaces of ensuing organocatalysts. In this article, we discuss the developments, unique activity, and high selectivity of nano-organocatalysts for microwave-assisted Paal-Knorr reaction, aza-Michael addition, and pyrazole synthesis. Their insoluble character Coupled with paramagnetic nature enables easy separation of these nano-catalysts from the reaction mixture using external magnet, which eliminates the requirement of catalyst filtration. Published by Elsevier Ltd.

  18. Auditors’ Usage of Computer Assisted Audit Tools and Techniques: Empirical Evidence from Nigeria

    OpenAIRE

    Appah Ebimobowei; G.N. Ogbonna; Zuokemefa P. Enebraye

    2013-01-01

    This study examines use of computer assisted audit tool and techniques in audit practice in the Niger Delta of Nigeria. To achieve this objective, data was collected from primary and secondary sources. The secondary sources were from scholarly books and journals while the primary source involved a well structured questionnaire of three sections of thirty seven items with an average reliability of 0.838. The data collected from the questionnaire were analyzed using relevant descriptive statist...

  19. Computer-assisted total knee arthroplasty using mini midvastus or medial parapatellar approach technique

    OpenAIRE

    Feczko, Peter; Engelmann, Lutz; Arts, Jacobus J.; Campbell, David

    2016-01-01

    Background Despite the growing evidence in the literature there is still a lack of consensus regarding the use of minimally invasive surgical technique (MIS) in total knee arthroplasty (TKA). Methods A prospective, randomized, international multicentre trial including 69 patients was performed to compare computer-assisted TKA (CAS-TKA) using either mini-midvastus (MIS group) or standard medial parapatellar approach (conventional group). Patients from 3 centers (Maastricht, Zwickau, Adelaide) ...

  20. Increasing the Intelligence of Virtual Sales Assistants through Knowledge Modeling Techniques

    OpenAIRE

    Molina, Martin

    2001-01-01

    Shopping agents are web-based applications that help consumers to find appropriate products in the context of e-commerce. In this paper we argue about the utility of advanced model-based techniques that recently have been proposed in the fields of Artificial Intelligence and Knowledge Engineering, in order to increase the level of support provided by this type of applications. We illustrate this approach with a virtual sales assistant that dynamically configures a product according to the nee...

  1. Clinical and sonographic evaluation of subpectoral biceps tenodesis with a dual suture anchor technique demonstrates improved outcomes and a low failure rate at a minimum 2-year follow-up.

    Science.gov (United States)

    Jacxsens, Matthijs; Granger, Erin K; Tashjian, Robert Z

    2018-01-01

    The purpose of this study was to evaluate the clinical outcomes and integrity of an open subpectoral biceps tenodesis using a dual suture anchor construct. Patients with at least 2 years of follow-up were retrospectively evaluated for simple shoulder test (SST), American Shoulder and Elbow Surgeons (ASES) score, and visual analog scales (VAS) for pain, function and satisfaction. A physical exam assessed shoulder range of motion and elbow strength. Ultrasonography visualized construct integrity. Of 43 eligible patients, 36 completed questionnaire evaluation and 22 completed an additional physical examination. Indications included superior labral anterior-posterior (SLAP) lesions (4), partial thickness tears (6), instability (6), and tenosynovitis of the biceps tendon (20). Eighteen patients (50%) had an associated rotator cuff tear. Patient-reported outcomes improved pre- vs postoperatively: ASES score (45.4 vs 78.6, P suture anchor technique is a treatment option for SLAP lesions, partial thickness tears, subluxation, and tenosynovitis of the long head of the biceps with high rates of postoperative patient satisfaction, a low failure rate, and improved outcome scores. The presence of a concomitant rotator cuff tear did not influence clinical outcomes.

  2. Ultrasound assisted extraction of food and natural products. Mechanisms, techniques, combinations, protocols and applications. A review.

    Science.gov (United States)

    Chemat, Farid; Rombaut, Natacha; Sicaire, Anne-Gaëlle; Meullemiestre, Alice; Fabiano-Tixier, Anne-Sylvie; Abert-Vian, Maryline

    2017-01-01

    This review presents a complete picture of current knowledge on ultrasound-assisted extraction (UAE) in food ingredients and products, nutraceutics, cosmetic, pharmaceutical and bioenergy applications. It provides the necessary theoretical background and some details about extraction by ultrasound, the techniques and their combinations, the mechanisms (fragmentation, erosion, capillarity, detexturation, and sonoporation), applications from laboratory to industry, security, and environmental impacts. In addition, the ultrasound extraction procedures and the important parameters influencing its performance are also included, together with the advantages and the drawbacks of each UAE techniques. Ultrasound-assisted extraction is a research topic, which affects several fields of modern plant-based chemistry. All the reported applications have shown that ultrasound-assisted extraction is a green and economically viable alternative to conventional techniques for food and natural products. The main benefits are decrease of extraction and processing time, the amount of energy and solvents used, unit operations, and CO2 emissions. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Fatty acid composition of human follicular fluid phospholipids and fertilization rate in assisted reproductive techniques.

    Science.gov (United States)

    Shaaker, Maghsod; Rahimipour, Ali; Nouri, Mohammad; Khanaki, Korosh; Darabi, Masoud; Farzadi, Laya; Shahnazi, Vahideh; Mehdizadeh, Amir

    2012-01-01

    Fatty acids are known to be critically important in multiple biological functions. Phospholipid fatty acids of follicular fluid, an important microenvironment for the development of oocytes, may contribute to the women's fertility and the efficacy of assisted reproduction techniques. The aim of this study was to investigate the effect of fatty acid composition of follicular fluid phospholipids on women undergoing assisted reproductive techniques. Follicular fluid samples were obtained from 100 patients, referred to Tabriz Alzahra Hospital. Seventy-nine subjects underwent in vitro fertilization (IVF) and the remaining 21 underwent intracytoplasmic sperm injection (ICSI). Total lipid of follicular fluid was extracted and fatty acids were analyzed by gas-liquid chromatography. Saturated fatty acids (SFA, P = 0.002) and the ratio of SFA to polyunsaturated fatty acids (P = 0.001) were correlated negatively with a number of mature oocytes after age adjustment. Linoleic acid (P = 0.006) was positively correlated, while the level of arachidonic acid was negatively correlated with fertility percentage after adjustment for body mass index, sperm count, sperm motility. Since phospholipids are one of the major components of lipid metabolism, the results of this study highlight the importance of this component in follicular fluid lipid metabolism. Consequently, it is proposed as an index in determination of the rate of success in assisted reproductive techniques such as IVF/ICSI.

  4. [Treatment of FAI via a minimally invasive ventral approach with arthroscopic assistance. Technique and midterm results].

    Science.gov (United States)

    Laude, F; Sariali, E

    2009-05-01

    Femoroacetabular impingement (FAI) may be considered as an important cause of hip pain among young patients. A new surgical technique using a mini open anterior Hueter approach with arthroscopic assistance was developed in our department in 1999. The goal of our study was to evaluate the midterm clinical results and the quality of life after cam resection, rim trimming, and labrum refixation using this technique. The first 100 hips operated on using this technique were evaluated with the Nonarthritic Hip Score (NAHS) at a mean follow-up of 54 months. The mean age of the patients was 33.4 years, with 50 men and 47 women. At the last follow-up, the mean NAHS score increased significantly from 54.5+/-12 by 29.6 points to 84.3+/-16 (pFAI of the femoral head-neck junction using a mini anterior Hueter approach with arthroscopic assistance is a safe and effective technique in treating young adults with femoroacetabular impingement. This technique offers direct visualization of the anterior femoral head-neck junction and is less invasive than the surgical dislocation approach.

  5. Processing of semen by density gradient centrifugation selects spermatozoa with longer telomeres for assisted reproduction techniques.

    Science.gov (United States)

    Yang, Qingling; Zhang, Nan; Zhao, Feifei; Zhao, Wanli; Dai, Shanjun; Liu, Jinhao; Bukhari, Ihtisham; Xin, Hang; Niu, Wenbing; Sun, Yingpu

    2015-07-01

    The ends of eukaryotic chromosomes contain specialized chromatin structures called telomeres, the length of which plays a key role in early human embryonic development. Although the effect of sperm preparation techniques on major sperm characteristics, such as concentration, motility and morphology have been previously documented, the possible status of telomere length and its relation with sperm preparation techniques is not well-known for humans. The aim of this study was to investigate the role of density gradient centrifugation in the selection of spermatozoa with longer telomeres for use in assisted reproduction techniques in 105 samples before and after sperm processing. After density gradient centrifugation, the average telomere length of the sperm was significantly longer (6.51 ± 2.54 versus 5.16 ± 2.29, P technique for selection of sperm with longer telomeres. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  6. Anchor Levels as a New Tool for the Theory and Measurement of Multiattribute Utility

    NARCIS (Netherlands)

    Wakker, P.P.; Jansen, S.J.T.; Stiggelbout, A.M.

    2004-01-01

    This paper introduces anchor levels as a new tool for multiattribute utility theory. Anchor levels are attribute levels whose values are not affected by other attributes. They allow for new interpretations and generalizations of known representations and utility measurement techniques.

  7. EUS-guided gastroenterostomy: a multicenter study comparing the direct and balloon-assisted techniques.

    Science.gov (United States)

    Chen, Yen-I; Kunda, Rastislav; Storm, Andrew C; Aridi, Hanaa Dakour; Thompson, Christopher C; Nieto, Jose; Siddiqui, Ali A; James, Theodore; Irani, Shayan; Bukhari, Majidah; Gutierrez, Olaya Brewer; Agarwal, Amol; Fayad, Lea; Moran, Robert; Alammar, Nuha; Sanaei, Omid; Canto, Marcia I; Singh, Vikesh K; Baron, Todd H; Khashab, Mouen A

    2017-07-24

    Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is a developing modality in the management of gastric outlet obstruction (GOO) with several technical approaches including the direct and balloon-assisted techniques. The aim of this study is to compare the direct with the balloon-assisted modality while further defining the role of EUS-GE in GOO. Multicenter, retrospective study involving consecutive patients who underwent EUS gastroenterostomy with the direct or balloon-assisted technique for GOO (January 2014-October 2016). The primary outcome is technical success. Secondary outcomes include clinical success (ability to tolerate at least a full fluid diet), procedure time, and rate/severity of adverse events (AE). Seventy-seven patients (42.9% female; mean age 63.2 ± 11.5 years) underwent EUS gastroenterostomy for GOO (n=55 DGE and n=22 BAGE). GOO was of malignant and benign etiology in 67.5% and 32.5% of the patients, respectively. Technical success was achieved in 94.5% of the direct and 90.9% of the balloon-assisted approach (p=0.62). Mean procedure time was shorter with the direct technique (35.1±31.2 minutes vs 89.9±33.3 minutes, p<0.001). Clinical success rate was 92.7% for the direct and 90.9% for balloon-assisted modality (p=0.79), with a mean time to oral intake of 1.41±2.75 days. The AE rate was 6.5% with only one severe AE noted. Rate of AE, postprocedure length of stay, need for re-intervention, and survival were similar between the 2 groups. EUS gastroenterostomy is effective and safe in the management of GOO. The direct technique may be the preferred method given its shorter procedure time when compared with balloon-assisted approach. Prospective trials are needed to confirm these findings. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  8. Microwave-assisted synthesis of the sandwich-like porous Al2O3/RGO nanosheets anchoring NiO nanocomposite as anode materials for lithium-ion batteries

    Science.gov (United States)

    Li, Qian; Yi, Zheng; Cheng, Yong; Wang, XuXu; Yin, Dongming; Wang, Limin

    2018-01-01

    Hybridizing nanostructured metal oxides with reduced graphene oxide (RGO) is highly appropriate for the improvement of electrochemical performance of lithium-ion batteries (LIBs). Herein, a NiAl-layered double hydroxide (LDH) is vertically grown on a RGO by the microwave-assisted method without any surfactant or template. The NiAl-LDH/RGO is used as precursor to synthesize sandwich-like porous Al2O3/RGO anchoring NiO nanocomposite (NiO-Al2O3/RGO) by subsequent calcination and etching process. Furthermore, doping Al2O3 can prevent active materials from agglomeration and generate porous structure in etching process. When used as anode materials for LIBs, the nanocomposite exhibits a high reversible capacity after 100 charge-discharge cycles at a current density of 100 mA g-1. Even at 500 mA g-1, a stable capacity as high as 704 mA h g-1 could be obtained. The enhanced lithium storage performance is mainly ascribed to the presence of the conductive RGO and Al2O3 buffer phase, which can relieve structural collapse and offer high conductivity.

  9. Transoral robotic-assisted thyroidectomy with central neck dissection: preclinical cadaver feasibility study and proposed surgical technique

    OpenAIRE

    Richmon, Jeremy D.; Holsinger, F. Christopher; Kandil, Emad; Moore, Michael W.; Garcia, Jose Armando; Tufano, Ralph P.

    2011-01-01

    Recently, a transoral robotic-assisted technique to access the thyroid gland has been introduced. Despite the advantages this approach may have over other minimally invasive and robotic-assisted techniques, we found that the placement of the camera through the floor of mouth led to restricted freedom of movement. We describe our modification to this technique to overcome this problem. In a study using two fresh human cadavers, the camera port of the da Vinci robot was placed in the midline or...

  10. EFFECTIVENESS OF INSTUMENTAL ASSISTED SOFT TISSUE MOBILIZATION TECHNIQUE WITH STATIC STRETCHING IN SUBJECTS WITH PLANTAR FASCIITIS

    Directory of Open Access Journals (Sweden)

    Vinod Babu. K

    2014-08-01

    Full Text Available Background: Instrumental assisted soft tissue mobilization and static stretching found to be effective in plantar fasciitis, however the combined effectiveness of these techniques were unknown. The purpose of this study is to find the effect of Instrumental assisted soft tissue mobilization technique for plantar fascia combined with static stretching of triceps surae for subjects with chronic stage of Plantar Fasciitis on pain intensity, ankle dorsiflexion range of motion and functional disability. Methods: An experimental study design, selected subjects with chronic Plantar Fasciitis randomized subjects into each Study and Control group. Total of 40 subject’s data who completed study, 20 in each group, was used for analysis. Control group received conventional exercise while Study group received conventional exercises with Instrumental assisted soft tissue mobilization combined with static stretching of triceps surae muscle. Outcome measurements such as Intensity of pain using Numerical Pain Rating Scale-101 (NPRS-101, function disability using Foot Function Index Pain Subscale (FFI and ankle dorsiflexion active range of motion using Goniometer was measured before and after 2 weeks of intervention. Results: There is statistically significant improvement in means of NRS-101, ankle dorsiflexion active range of motion and Foot Function Index Pain Subscale after intervention in both groups. When the post-intervention means were compared between Study and Control group after 2 weeks of treatment there is statistically significant difference in means between the groups whereas study group showed greater percentage of improvement than control group. Conclusion: It is concluded that Instrumental assisted soft tissue mobilization technique combined with static stretching of triceps surae muscle is significantly effective than conventional exercises on reducing pain, improving ankle dorsiflexion range of motion and functional disability for subjects

  11. A comparison of assisted and unassisted proprioceptive neuromuscular facilitation techniques and static stretching.

    Science.gov (United States)

    Maddigan, Meaghan E; Peach, Ashley A; Behm, David G

    2012-05-01

    A comparison of assisted and unassisted proprioceptive neuromuscular facilitation techniques and static stretching. J Strength Cond Res 26(5): 1238-1244, 2012-Proprioceptive neuromuscular facilitation (PNF) stretching often requires a partner. Straps are available allowing an individual to perform PNF stretching alone. It is not known if a strap provides similar improvements in the range of motion (ROM) as partner-assisted PNF or static stretching. The purpose of this study was to compare assisted and unassisted (with a strap) PNF stretching and static stretching. Hip joint ROM, reaction time (RT), and movement time (MT) were measured prestretching and poststretching. Thirteen recreationally active adults participated in this study. The participants were subjected to 5 different stretch interventions in a random order on separate days. Stretch conditions included unassisted PNF stretching using (a) isometric, (b) concentric, and (c) eccentric contractions with a stretch strap, (d) partner-assisted isometric PNF, and (e) static stretching. The RT, MT, dynamic, active, passive hip flexion angle, and angular velocity with dynamic hip flexion were measured before and after the intervention. The ROM improved (p active static, and passive static ROM, but there was no significant difference between the stretching protocols. There was a main effect for time (p stretching conditions negatively impacting dynamic angular velocity (9.2%). Although there was no significant effect on RT, MT showed a negative main effect for time (p active stretching provided similar improvements in the ROM and poststretching performance decrements in MT and angular velocity. Thus, individuals can implement PNF stretching techniques with a partner or alone with a strap to improve ROM, but athletes should not use these techniques before important competitions or training because of the impairment of limb velocity and MT.

  12. Recycling Suture Limbs from Knotless Suture Anchors for Arthroscopic Shoulder Stabilization

    OpenAIRE

    Johnson, Timothy S.; DiPompeo, Christine M.; Ismaeli, Zahra C.; Porter, Polly A.; Nicholson, Shannon L.; Johnson, David C.

    2014-01-01

    Recurrent shoulder instability often leads to labral abnormality that requires surgical intervention that may require fixation with suture anchors. The proposed surgical technique allows the surgeon to achieve 2 points of fixation around the labrum and/or capsule with a single suture secured to the glenoid with a knotless anchor. Instead of cutting and discarding the residual suture limbs after anchor insertion, this technique uses the residual suture limbs of the knotless anchor for a second...

  13. An EMG-assisted model calibration technique that does not require MVCs.

    Science.gov (United States)

    Dufour, Jonathan S; Marras, William S; Knapik, Gregory G

    2013-06-01

    As personalized biologically-assisted models of the spine have evolved, the normalization of raw electromyographic (EMG) signals has become increasingly important. The traditional method of normalizing myoelectric signals, relative to measured maximum voluntary contractions (MVCs), is susceptible to error and is problematic for evaluating symptomatic low back pain (LBP) patients. Additionally, efforts to circumvent MVCs have not been validated during complex free-dynamic exertions. Therefore, the objective of this study was to develop an MVC-independent biologically-assisted model calibration technique that overcomes the limitations of previous normalization efforts, and to validate this technique over a variety of complex free-dynamic conditions including symmetrical and asymmetrical lifting. The newly developed technique (non-MVC) eliminates the need to collect MVCs by combining gain (maximum strength per unit area) and MVC into a single muscle property (gain ratio) that can be determined during model calibration. Ten subjects (five male, five female) were evaluated to compare gain ratio prediction variability, spinal load predictions, and model fidelity between the new non-MVC and established MVC-based model calibration techniques. The new non-MVC model calibration technique demonstrated at least as low gain ratio prediction variability, similar spinal loads, and similar model fidelity when compared to the MVC-based technique, indicating that it is a valid alternative to traditional MVC-based EMG normalization. Spinal loading for individuals who are unwilling or unable to produce reliable MVCs can now be evaluated. In particular, this technique will be valuable for evaluating symptomatic LBP patients, which may provide significant insight into the underlying nature of the LBP disorder. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Meta-analysis of scientific studies related to pesticide application techniques - air assistance and adjuvant addition

    Directory of Open Access Journals (Sweden)

    Gustavo Migliorini de Oliveira

    Full Text Available ABSTRACT: The aim of this study was to investigate the effects of air-assisted boom sprayers and addition of adjuvants in the spray solution on control levels of pesticide sprays against weeds and pathogenic fungi by meta-analysis of scientific literature. To perform the meta-analysis, data were collected from the results presented in scientific papers. By these data, a variable was created, denominated as relative control that was used to quantify and test whether the use of air assistance or adjuvants affects the effectiveness of pesticide sprays. This variable was calculated as a difference between percentage of pesticide control in treatments with air assistance or adjuvants and treatments without these spray techniques. Data were analyzed statistically using the Comprehensive Meta-Analysis software. Results showed that the use of air assistance did not have any effect on the control levels of weeds and pathogenic fungi; whereas, the addition of adjuvants increased these levels by 6.45%.

  15. A minimally invasive surgery robotic assistant for HALS-SILS techniques.

    Science.gov (United States)

    Bauzano, E; Garcia-Morales, I; del Saz-Orozco, P; Fraile, J C; Muñoz, V F

    2013-11-01

    This paper is focused in the design and implementation of a robotic surgical motion controller. The proposed control scheme addresses the issues related to the application of a robot assistant in novel surgical scenario, which combines hand assisted laparoscopic surgery (HALS) with the single incision laparoscopic surgery (SILS) techniques. It is designed for collaborating with the surgeon in a natural way, by performing autonomous movements, in order to assist the surgeon during a surgical maneuver. In this way, it is implemented a hierarchical architecture which includes an upper auto-guide velocity planner connected to a low-level force feedback controller. The first one, based on a behavior approach, computes a collision free trajectory of the surgical instrument tip, held by the robot, for reaching a goal location inside of the abdominal cavity. On the other hand, the force feedback controller uses this trajectory for performing the instrument displacement by taking into account the holonomic movement constraints introduced by the fulcrum point. The aim of this controller is positioning the surgical instrument by minimizing the forces exerted over the abdominal wall due to the fulcrum location uncertainty. The overall system has been integrated in the control architecture of the surgical assistant CISOBOT, designed and developed at the University of Malaga. The whole architecture performance has been tested by means of in vitro trials. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  16. Assisted reproductive techniques and risk of exstrophy-epispadias complex: a German case-control study.

    Science.gov (United States)

    Zwink, Nadine; Jenetzky, Ekkehart; Hirsch, Karin; Reifferscheid, Peter; Schmiedeke, Eberhard; Schmidt, Dominik; Reckin, Sabrina; Obermayr, Florian; Boemers, Thomas M; Stein, Raimund; Reutter, Heiko; Rösch, Wolfgang H; Brenner, Hermann; Ebert, Anne-Karoline

    2013-04-01

    We assessed the risk of exstrophy-epispadias complex in children conceived by in vitro fertilization or intracytoplasmic sperm injection. Data from the German Network for Congenital Uro-REctal malformations were compared to nationwide data from the German In Vitro Fertilization Register and the German Federal Statistical Office. Odds ratios (95% CI) were determined to quantify associations using logistic regression. A total of 123 patients with exstrophy-epispadias complex born in Germany between 1997 and 2011 were recruited through participating departments of pediatric urology and pediatric surgery throughout the country as well as the German self-help organizations Blasenekstrophie/Epispadie e.V. and Kloakenekstrophie. All German live births (10,069,986) between 1997 and 2010 comprised the controls. Overall, 12 subjects (10%) and 129,982 controls (1%) were conceived by in vitro fertilization or intracytoplasmic sperm injection. Conception by assisted reproductive technique was associated with a more than eightfold increased risk of exstrophy-epispadias complex compared to spontaneous conception (OR 8.3, 95% CI 4.6-15.0, p assisted reproductive techniques such as in vitro fertilization and intracytoplasmic sperm injection are associated with a markedly increased risk of having a child born with exstrophy-epispadias complex. However, it remains unclear whether this finding may be due to assisted reproduction per se and/or underlying infertility/subfertility etiology or parent characteristics. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  17. Robot-assisted intracorporeal ileal conduit: Marionette technique and initial experience at Roswell Park Cancer Institute.

    Science.gov (United States)

    Guru, Khurshid; Seixas-Mikelus, Stéfanie A; Hussain, Abid; Blumenfeld, Aaron J; Nyquist, John; Chandrasekhar, Rameela; Wilding, Gregory E

    2010-10-01

    To present our technique and initial experience with patients who underwent robot-assisted intracorporeal creation of ileal conduit and to compare them with patients who underwent extracorporeal ileal diversion after robot-assisted radical cystectomy. Twenty-six patients diagnosed with invasive transitional cell carcinoma of the bladder underwent a robot-assisted radical cystectomy with bilateral extended pelvic lymphadenectomy with ileal conduit diversion. Total intracorporeal ileal conduit creation was performed in the last 13 patients. Operative data and short-term outcomes between the 2 groups were assessed. The novel surgical technique for intracorporeal ileal conduit will be presented. The intracorporeal group (IC) included 2 female and 11 male patients (mean age 71 years). The extracorporeal group (EC) included 4 female and 9 male patients (mean age 66 years). No significant differences were noted between the groups in terms of patient age, BMI, sex, prior surgery, or pathologic stage. Overall operative time and intraoperative complications were similar. No significant differences were noted between the 2 groups in terms of diversion time or estimated blood loss. There were 4 complications recorded in IC patients, including nonspecific colitis, small bowel obstruction requiring exploratory laparotomy with lysis of adhesions, a urine leak that eventually resolved but required a temporary nephrostomy tube, and a fever of unknown origin that resolved without intervention. Robot-assisted intracorporeal ileal conduit can be accomplished safely with acceptable operative times even during early experience. Larger series with favorable results will be required to add this new paradigm to minimally invasive surgery for bladder cancer. Copyright © 2010 Elsevier Inc. All rights reserved.

  18. Effect of embryo freezing on perinatal outcome after assisted reproduction techniques: lessons from the Latin American Registry of Assisted Reproduction.

    Science.gov (United States)

    Schwarze, Juan-Enrique; Crosby, Javier A; Zegers-Hochschild, Fernando

    2015-07-01

    Embryo cryopreservation is an integral part of assisted reproduction techniques; it allows the sequential transfer of all embryos, thus diminishing the risk of multiple pregnancies and associated perinatal complications. To address concerns about the safety of this procedure, neonatal outcome after 43,070 fresh embryo transfers was compared with 12,068 frozen-thawed embryo transfers (FET). After adjusting for maternal age, gestational age, embryo development at time of transfer, number of babies born and gestational order, FET was not found to be associated with an increase in perinatal mortality (odds ratio [OR] 1.72, 95% confidence interval [CI] 0.81 to 3.62); preterm birth (OR 1.05, 95% CI 0.93 to 1.18); or extreme preterm birth (OR 0.82, 95% CI 0.64 to 1.06). Furthermore, after correcting for known confounding factors, FET was found to be associated with an increase in neonatal weight of 39.7 g (95% CI 1.54 to 64.10; P Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  19. Arthroscopic-assisted plate fixation for displaced large-sized comminuted greater tuberosity fractures of proximal humerus: a novel surgical technique.

    Science.gov (United States)

    Park, Sang-Eun; Jeong, Jae-Jung; Panchal, Karnav; Lee, Jong-Yun; Min, Hyung-Ki; Ji, Jong-Hun

    2016-12-01

    The purpose of the present study was to describe the use of a novel hybrid surgical technique-arthroscopic-assisted plate fixation-and evaluate its clinical and anatomical outcomes in the management of large, displaced greater tuberosity (GT) fractures with comminution. From 2009 to 2011, this novel technique was performed in 11 patients [2 men and 9 women; median age, 64 years (range 41-83 years)] with large, comminuted GT fractures, with fragment displacements of >5 mm. The preoperative mean posterior and superior migration of the fractured fragment, as measured on computed tomography (CT), was 19.5 and 5.5 mm, respectively. Two patients had shoulder fracture-dislocation, and three had associated undisplaced surgical neck fracture. The mean duration between injury and surgery was 4 days. The mean follow-up duration was 26 months. At the final follow-up, the mean postoperative ASES, UCLA and SST scores were 84, 29, and 8, respectively. The mean range of motion was as follows: forward flexion, 138°; abduction, 135°; external rotation at the side, 19°; and internal rotation, up to the L2 level. The mean posterior and superior displacements of fracture fragments on postoperative CT scan [0.7 ± 0.8 mm (range 0-2.1 mm) and 2.8 ± 0.5 mm (range 3.4-5.3 mm), respectively] were significantly improved (p fracture fragment was noted in 1 patient at 4 weeks, after corrective reduction and fixation surgery. The novel arthroscopic-assisted anatomical plate fixation technique was found to be effective in reducing large-sized, displaced, comminuted GT fractures and in allowing concurrent management of intra-articular pathologies and early functional rehabilitation. Compared with the conventional plate fixation or arthroscopic suture anchor fixation technique, arthroscopic-assisted plate fixation enabled accurate restoration of the medial footprint of the GT fracture and provided an effective buttress to the large-sized GT fracture fragments. Retrospective

  20. Issues in estimating probability of detection of NDT techniques - A model assisted approach.

    Science.gov (United States)

    Rentala, Vamsi Krishna; Mylavarapu, Phani; Gautam, Jai Prakash

    2018-02-13

    In order to successfully implement Damage Tolerance (DT) methodology for aero-engines, Non-Destructive Testing (NDT) techniques are vital for assessing the remaining life of the component. Probability of Detection (POD), a standard measure of NDT reliability, is usually estimated as per MIL-HDBK-1823A standard. Estimation of POD of any NDT technique can be obtained by both experimental and model assisted methods. POD depends on many factors such as material, geometry, defect characteristics, inspection technique, etc. These requirements put enormous limitations on generating experimental POD curves and hence, Model Assisted Probability of Detection (MAPOD) curves are currently in vogue. In this study, MAPOD approaches were demonstrated by addressing various issues related to selection of crack sizes distribution, challenges involved in censoring and regression, estimation of distribution parameters, etc. Ultrasonic testing on volumetric defects has been identified as a platform to discuss the challenges involved. A COMSOL Multiphysics based FEM numerical model developed to simulate ultrasonic response from a Ti-6Al-4V cylindrical block has been validated experimentally. Further, the individual ultrasonic response from various Flat Bottom Hole (FBH) defects following lognormal distribution has been generated using the numerical model. a 90/95 (detecting a flaw with 90% probability and 95% confidence) value obtained from POD curve showed that the POD value increased with an increase in decision threshold. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Assisted Reproductive Techniques in Farm Animal - From Artificial Insemination to Nanobiotechnology

    Directory of Open Access Journals (Sweden)

    O P Verma

    2012-10-01

    Full Text Available It has become evident that advances in farm animal reproduction have become increasingly dependent on advance scientific research in addition to an understanding of the physiological processes involved in reproduction. The use of assisted reproductive techniques (ART has helped owners to produce offspring from valuable farm animals that were considered infertile using standard breeding techniques. This chapter constitutes an update of recent developments in the field of assisted reproduction includes Artificial insemination, Embryo transfer, in vitro fertilization, embryo cryopreservation, Sexing of semen and embryos, cloning, transgenesis, stem cell technology, embryo genomics, micro and nanotechnology has been included. Recently in some of these fields remarkable progress has been made. None the less, imperfections are remaining and sustained efforts will be required to optimize existing and invent new technologies. Before referring an animal for an ART, the practitioner should be able to identify the underlying cause of subfertility of that animal. Knowing the complexity as well as the risks of these techniques, enables practitioners to refer a sub-fertile animal to the least complex and most appropriate and successful ART that can overcome specific causes of infertility. [Vet. World 2012; 5(5.000: 301-310

  2. LVIS Jr 'shelf' technique: an alternative to Y stent-assisted aneurysm coiling.

    Science.gov (United States)

    Du, Elizabeth Hai Yen; Shankar, Jai Jai Shiva

    2016-02-04

    Wide-necked bifurcation intracranial aneurysms have traditionally not been amenable to coil embolization with the use of a single stent due to the high risk of coil prolapse. Y-configuration double stent-assisted coil embolization ('Y-stenting') of this aneurysm type has been shown to have generally good clinical outcomes, although the technique is complex with various challenges described in the literature. The compliant and flexible closed-cell design of braided stents such as the LVIS Jr allows for the creation of a 'shelf' across the aneurysm neck sufficient to prevent coil prolapse. We describe this novel 'shelf' technique and present a small case series of LVIS Jr stent-assisted wide-necked bifurcation intracranial aneurysm coiling in eight patients. Our small, albeit important, case series demonstrates that the 'shelf' technique is feasible and safe with very good short-term clinical and angiographic outcomes, and may obviate the need for Y-stenting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Anchored Narratives in Reasoning about Evidence

    NARCIS (Netherlands)

    Bex, F.J.; Prakken, H; Verheij, B; van Engers, T M

    2006-01-01

    This paper concerns the reasoning with stories, evidence and generalisations in a legal context. We will make some notions from the existing Anchored Narratives theory more clear by making use of two formal techniques from Al. namely causal-abductive reasoning and default-style argumentation. We

  4. Anchored narratives in reasoning about evidence

    NARCIS (Netherlands)

    Bex, F.J.; Prakken, H.; Verheij, B.

    2006-01-01

    This paper concerns the reasoning with stories, evidence and generalisations in a legal context. We will make some notions from the existing Anchored Narratives theory more clear by making use of two formal techniques from AI, namely causal-abductive reasoning and default-style argumentation. We

  5. Advances in Collection, Transport and Maturation of Equine Oocytes for Assisted Reproductive Techniques.

    Science.gov (United States)

    Carnevale, Elaine M

    2016-12-01

    Assisted reproductive techniques that are based on oocyte manipulations have gained acceptance in the equine industry. Methods to collect and handle immature or maturing oocytes have been developed, and systems to ship oocytes now allow for collection in one location and intracytoplasmic sperm injection (ICSI) in another. Subsequently, ICSI-produced embryos can be transferred onsite, shipped to another location, or cryopreserved. Methods for the collection, identification, culture, maturation, and shipment of equine oocytes are reviewed, with an emphasis on procedures from laboratories providing clinical services with documented success. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Bariatric surgery influences the number and quality of oocytes in patients submitted to assisted reproduction techniques.

    Science.gov (United States)

    Christofolini, Juliana; Bianco, Bianca; Santos, Gustavo; Adami, Fernando; Christofolini, Denise; Barbosa, Caio Parente

    2014-03-01

    To determine differences in follicle stimulation, oocyte retrieval, maturation, and fertilization among patients who underwent bariatric surgery, obese patients, and patients with 18 assisted reproduction techniques and check that these patients may have some impairment in ovarian response. The study comprised three groups: GI: 29 patients who had undergone restrictive and/or malabsorptive bariatric surgery; GII: 57 obese patients (BMI > 30 kg/m²); and GIII: 94 patients (18 reproductive process can be impaired. Bariatric surgery appears to have an important impact on the formation of follicles and oocytes. © 2013 The Obesity Society.

  7. Endoscope-assisted treatment of scaphocephaly: report of a case and new surgical technique

    Directory of Open Access Journals (Sweden)

    Domagoj Jugović

    2015-10-01

    Full Text Available The most common craniosynostosis, scaphocephaly, is the consequence of premature closure of the sagittal suture. Craniosynostosis does not just pose a cosmetic problem, but it can also lead to the permanent neurological deficits. Therefore early diagnosis and treatment are crucial for good outcome. Open surgery with large skin incision is currently the standard procedure. We present our first endoscope-assisted surgical procedure for scaphocephaly. The infant did not need transfusion or intensive therapy after the surgery and skin incision was minimal. This minimal invasive, new surgical technique and its development were described.  

  8. Precision of lumbar intervertebral measurements: does a computer-assisted technique improve reliability?

    Science.gov (United States)

    Pearson, Adam M; Spratt, Kevin F; Genuario, James; McGough, William; Kosman, Katherine; Lurie, Jon; Sengupta, Dilip K

    2011-04-01

    Comparison of intra- and interobserver reliability of digitized manual and computer-assisted intervertebral motion measurements and classification of "instability." To determine if computer-assisted measurement of lumbar intervertebral motion on flexion-extension radiographs improves reliability compared with digitized manual measurements. Many studies have questioned the reliability of manual intervertebral measurements, although few have compared the reliability of computer-assisted and manual measurements on lumbar flexion-extension radiographs. Intervertebral rotation, anterior-posterior (AP) translation, and change in anterior and posterior disc height were measured with a digitized manual technique by three physicians and by three other observers using computer-assisted quantitative motion analysis (QMA) software. Each observer measured 30 sets of digital flexion-extension radiographs (L1-S1) twice. Shrout-Fleiss intraclass correlation coefficients for intra- and interobserver reliabilities were computed. The stability of each level was also classified (instability defined as >4 mm AP translation or 10° rotation), and the intra- and interobserver reliabilities of the two methods were compared using adjusted percent agreement (APA). Intraobserver reliability intraclass correlation coefficients were substantially higher for the QMA technique THAN the digitized manual technique across all measurements: rotation 0.997 versus 0.870, AP translation 0.959 versus 0.557, change in anterior disc height 0.962 versus 0.770, and change in posterior disc height 0.951 versus 0.283. The same pattern was observed for interobserver reliability (rotation 0.962 vs. 0.693, AP translation 0.862 vs. 0.151, change in anterior disc height 0.862 vs. 0.373, and change in posterior disc height 0.730 vs. 0.300). The QMA technique was also more reliable for the classification of "instability." Intraobserver APAs ranged from 87 to 97% for QMA versus 60% to 73% for digitized manual

  9. Prenatal testing among women pregnant after assisted reproductive techniques in Denmark 1995-2000: a national cohort study

    DEFF Research Database (Denmark)

    Gjerris, A.C.; Loft, A.; Pinborg, A.

    2008-01-01

    BACKGROUND: Women pregnant after assisted reproductive techniques (ART) are generally older than women with spontaneously conceived pregnancies, and are consequently more likely to carry a child affected by a chromosomal disorder. Furthermore, a significantly increased rate of chromosomal...

  10. Planned posterior assisted levitation in severe subluxated cataract: Surgical technique and clinical results

    Directory of Open Access Journals (Sweden)

    Tova Lifshitz

    2012-01-01

    Full Text Available We report the surgical technique and outcome of planned posterior assisted levitation (P-PAL in four cases of subluxated cataract. P-PAL was planned as the preferred approach in all cases. A spatula was inserted via the pars plana, the whole lens was lifted to the anterior chamber and then removed through a scleral tunnel incision. Anterior chamber intraocular lenses were implanted in all cases. All four eyes had severe subluxation of the crystalline lenses with marked phacodonesis. Two eyes had history of blunt trauma, and the other two eyes had severe pseudoexfoliation with spontaneous lens subluxation. Follow-up ranged from 1 to 2 years in three cases. The postoperative visual acuity was 20/80 or better. No intraoperative complications were observed. In conclusion, the P-PAL technique was successfully performed during cataract surgery in four eyes with severe subluxated cataracts. There were no complications over the long-term follow-up.

  11. Robot-Assisted Transaxillary Thyroid Surgery—Feasibility and Safety of a Novel Technique

    Directory of Open Access Journals (Sweden)

    Naomi Rabinovics

    2014-04-01

    Full Text Available Developments in technology have led to a rapid progress in robotic endocrine surgery applications. With the advent of minimally invasive techniques in thyroid surgery, robot-assisted transaxillary thyroid surgery (RATS has emerged as one of the most promising approaches. Its main advantages are improved cosmetic outcome, avoiding cervical incisions, thereby increasing patient satisfaction, and improved visualization, arms articulations, and precision, resulting in fewer surgical complications. The main disadvantages are potential new injuries to the brachial plexus, esophagus, and trachea, longer operative time, and increased cost compared to conventional thyroidectomy. In skilled hands, RATS is a safe alternative to conservative thyroidectomy and should be presented to patients with aesthetic concerns. As with any new emerging technique, careful patient selection is crucial, and further evidence must be sought to confirm its indications over time.

  12. Tibial Lengthening Using a Fixator-Assisted Lengthening Plate: A New Technique

    Science.gov (United States)

    Tosun, Haci Bayram; Agir, Ismail; Gumustas, Seyitali; Serbest, Sancar; Uludag, Abuzer; Celik, Suat

    2016-01-01

    Background There are many techniques that are used for limb lengthening. Lengthening a limb over a plate is an alternative choice used in children or when using an intramedullary nail is difficult. Objectives In this study, we presented a new technique for tibial lengthening using a monolateral external fixator over a lengthening plate. Materials and Methods For tibial lengthening, a monolateral external fixator was attached to the composite bone model medially. After a corticotomy was performed, the lengthening plate was placed laterally. Three locking screws were inserted proximally, and two cortical screws were inserted into a lengthening hole that was 1 cm below the osteotomy site. We avoided contact between the screws of the lengthening plate and the pins of the external fixator. During bone lengthening with the monolateral external fixator, the screws at the lengthening hole were able to slide distally with the distal segment of the tibia to allow for tibial elongation. Two locking screws were fixed at the distal locking holes of the plate when the bone elongation was complete. The external fixator was then removed. Results The fixator-assisted lengthening plate allowed bone lengthening without malalignment. There were no mechanical problems associated with the external fixator during the lengthening process. Plate osteosynthesis was stable after the fixator was removed. There was no contact between the screws of plate and the Schanz pins of the external fixator under C-arm fluoroscopy. Conclusions The fixator-assisted lengthening plate technique helps to maintain the stability and alignment at both sides of an osteotomy during tibial elongation. It allows the early removal of the external fixator immediately after lengthening is completed. This technique can be applied in children with open physes and in patients with a narrow medullary canal who are unsuitable for limb lengthening over an intramedullary nail. PMID:28184364

  13. Clinical and molecular analyses of Beckwith-Wiedemann syndrome: Comparison between spontaneous conception and assisted reproduction techniques.

    Science.gov (United States)

    Tenorio, Jair; Romanelli, Valeria; Martin-Trujillo, Alex; Fernández, García-Moya; Segovia, Mabel; Perandones, Claudia; Pérez Jurado, Luis A; Esteller, Manel; Fraga, Mario; Arias, Pedro; Gordo, Gema; Dapía, Irene; Mena, Rocío; Palomares, María; Pérez de Nanclares, Guiomar; Nevado, Julián; García-Miñaur, Sixto; Santos-Simarro, Fernando; Martinez-Glez, Víctor; Vallespín, Elena; Monk, David; Lapunzina, Pablo

    2016-10-01

    Beckwith-Wiedemann syndrome (BWS) is an overgrowth syndrome characterized by an excessive prenatal and postnatal growth, macrosomia, macroglossia, and hemihyperplasia. The molecular basis of this syndrome is complex and heterogeneous, involving genes located at 11p15.5. BWS is correlated with assisted reproductive techniques. BWS in individuals born following assisted reproductive techniques has been found to occur four to nine times higher compared to children with to BWS born after spontaneous conception. Here, we report a series of 187 patients with to BWS born either after assisted reproductive techniques or conceived naturally. Eighty-eight percent of BWS patients born via assisted reproductive techniques had hypomethylation of KCNQ1OT1:TSS-DMR in comparison with 49% for patients with BWS conceived naturally. None of the patients with BWS born via assisted reproductive techniques had hypermethylation of H19/IGF2:IG-DMR, neither CDKN1 C mutations nor patUPD11. We did not find differences in the frequency of multi-locus imprinting disturbances between groups. Patients with BWS born via assisted reproductive techniques had an increased frequency of advanced bone age, congenital heart disease, and decreased frequency of earlobe anomalies but these differences may be explained by the different molecular background compared to those with BWS and spontaneous fertilization. We conclude there is a correlation of the molecular etiology of BWS with the type of conception. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  14. Live birth rates and safety profile using dydrogesterone for luteal phase support in assisted reproductive techniques.

    Science.gov (United States)

    Nadarajah, Ravichandran; Rajesh, Hemashree; Wong, Ker Yi; Faisal, Fazlin; Yu, Su Ling

    2017-06-01

    Assisted reproductive techniques (ARTs) result in a deficient luteal phase, requiring the administration of intramuscular, intravaginal or oral exogenous progesterone. Dydrogesterone, an oral retroprogesterone with good bioavailability, has been used in assisted reproductive cycles with outcomes that are comparable to those of vaginal or intramuscular progesterone. However, there are limited reviews on its use for luteal phase support in ARTs, in terms of pregnancy outcomes and associated fetal anomalies. This study aimed to review the live birth rates and associated fetal anomalies of women who were given dydrogesterone for luteal phase support in assisted reproductive cycles at a tertiary hospital in Singapore. This retrospective descriptive study included 1,050 women who underwent in vitro fertilisation/intracytoplasmic sperm injection at the Centre for Assisted Reproduction of Singapore General Hospital between 2000 and 2011. The women were given dydrogesterone for luteal phase support. The main outcome measures were rates of pregnancy, live birth, miscarriage and fetal anomalies. The pregnancy and live birth rates were 34.7% and 27.7%, respectively. Among those who achieved pregnancy, 17.0% miscarried, 0.8% had ectopic pregnancies and 0.3% had molar pregnancies. Fetal anomalies were detected in 1.9% of pregnancies, all of which were terminated by choice. Since the outcomes of dydrogesterone are comparable to those of intramuscular and vaginal progesterone, it is a reasonable option to provide luteal phase support for women who are uncomfortable with injections or vaginal insertions. Randomised controlled studies are needed to determine the optimal dosage of dydrogesterone for luteal phase support in ARTs.

  15. Assisted reproductive techniques after fertility-sparing treatments in gynaecological cancers.

    Science.gov (United States)

    Zapardiel, Ignacio; Cruz, Maria; Diestro, Maria D; Requena, Antonio; Garcia-Velasco, Juan A

    2016-04-01

    The trend toward late childbearing has made fertility preservation a major issue for women who face gynecological cancer. New techniques in assisted reproductive medicine enable conception after primary treatment of these cancers. Here, we aimed to review the efficacy and safety of assisted reproductive techniques (ART) after fertility-preserving treatment of gynaecological cancers. We conducted a systematic literature review of both prospective and retrospective studies in the PubMed, EMBASE, CENTRAL and SciSearch databases. In the retrieved studies, we evaluated live births, clinical pregnancies, overall survival and disease-free survival. We identified many prospective and retrospective studies on this topic, but no relevant randomized clinical trials. Fertility-sparing treatments with safe oncological outcomes are feasible in endometrial, cervical and ovarian cancer cases. After cancer treatment, ART seem safe and show variable obstetrical outcomes. After fertility-preserving treatment for gynaecological cancers, ART can enable pregnancy to be achieved with apparent oncological safety. The success of such procedures should directly impact clinical practice and management of those patients who require fertility-sparing treatment. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Thromboprophylaxis in women undergoing gynecological surgery or assisted reproductive techniques: new advances and challenges.

    Science.gov (United States)

    Piróg, Magdalena Maria; Jach, Robert; Undas, Anetta

    2016-01-01

    Venous thromboembolism (VTE) affects 0.1-0.3% people each year. The risk of VTE following gynecological surgery and invasive procedures is well established and presents one of the major challenges in gynecological practice. Moreover, commonly use assisted reproductive techniques (ART) are reported to increase the risk of VTE. Despite continued efforts to reduce its incidence, postoperative VTE remains the second most common perioperative complication and the third most common cause of mortality. Several practice guidelines have been developed regarding prophylaxis and treatment of VTE. However, there is a large inconsistency between the recommendations and the medical practice in various centers. Moreover, prophylaxis in gynecological patients and women undergoing ART should be chosen individually for the patient, taking into account the possible risk factors for VTE and perioperative bleeding complications. Until recently, the percentage of women, who have not received anticoagulant prophylaxis or administrated it inadequately may reach 50%. This paper presents the current recommendations regarding thromboprophylaxis in women undergoing gynecological surgery or assisted reproductive techniques and addresses challenging practical issues in this field.

  17. Technique and outcomes of robot-assisted median arcuate ligament release for celiac artery compression syndrome.

    Science.gov (United States)

    Thoolen, Stijn J J; van der Vliet, Walderik J; Kent, Tara S; Callery, Mark P; Dib, Martin J; Hamdan, Allen; Schermerhorn, Marc L; Moser, A James

    2015-05-01

    Celiac artery compression by the median arcuate ligament (MAL) is a potential cause of postprandial abdominal pain and weight loss that overlaps with other common syndromes. Robotic technology may alter the current paradigm for surgical intervention. Open MAL release is often performed with concurrent bypass for celiac stenosis due to the morbidity of reintervention, whereas the laparoscopic approach is associated with high rates of conversion to open due to bleeding. We hypothesized that a robot-assisted technique might minimize conversion events to open, decrease perioperative morbidity, and defer consideration of vascular bypass at the initial operative setting. We retrospectively analyzed patients treated for MAL syndrome by a multidisciplinary team at a tertiary medical center between September 2012 and December 2013. Diagnosis was based on symptom profile and peak systolic velocity (PSV) >200 cm/s during celiac artery duplex ultrasound imaging. All patients underwent robot-assisted MAL release with simultaneous circumferential neurolysis of the celiac plexus. Postoperative celiac duplex and symptom profiles were reassessed longitudinally to monitor outcomes. Nine patients (67% women) were evaluated for postprandial pain (100%) and weight loss (100%). All patients had celiac stenosis by mesenteric duplex ultrasound imaging (median PSV, 342; range, 238-637 cm/s), and cross-sectional imaging indicated a fishhook deformity in five (56%). Robot-assisted MAL release was completed successfully in all nine patients (100%) using a standardized surgical technique. Estimated blood loss was celiac duplex ultrasound imaging, and six patients showed an improved but persistent stenosis (PSV >200 cm/s) compared with preoperative velocities (P celiac stenosis is uncertain. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  18. The Big-Bubble Full Femtosecond Laser-Assisted Technique in Deep Anterior Lamellar Keratoplasty.

    Science.gov (United States)

    Buzzonetti, Luca; Petrocelli, Gianni; Valente, Paola; Iarossi, Giancarlo; Ardia, Roberta; Petroni, Sergio; Parrilla, Rosa

    2015-12-01

    To describe the big-bubble full femtosecond laser-assisted (BBFF) technique, which could be helpful in standardizing the big-bubble technique in deep anterior lamellar keratoplasty (DALK). Ten eyes of 10 consecutive patients affected by keratoconus underwent the BBFF technique using the 150-kHz IntraLase femtosecond laser (Intra-Lase FS Laser; Abbott Medical Optics, Inc., Santa Ana, CA). A 9-mm diameter metal mask with a single fissure 0.7 mm wide oriented at the 12-o'clock position was positioned into the cone, over the laser glass. The laser performed a ring lamellar cut (internal diameter = 3 mm; external diameter = 8 mm) 100 µm above the thinnest point, with the photodisruption effectively occurring only in the corneal stroma corresponding to the fissure to create a deep stromal channel; subsequently, an anterior side cut created an arcuate incision, from the corneal surface to the deep stromal channel on the mask's opening site. The mask was removed and the laser performed a full lamellar cut 200 µm above the thinnest point to create a lamella. After the removal of the lamella, the air needle was inserted into the stromal channel and air was injected to achieve a big bubble. The big bubble was achieved in 9 eyes (all type 1 bubbles) and all procedures were completed as DALK. Preliminary results suggest that the BBFF technique could help in standardizing the big-bubble technique in DALK, reducing the "learning curve" for surgeons who approach this technique and the risks of intraoperative complications. Copyright 2015, SLACK Incorporated.

  19. Validation of an Improved Computer-Assisted Technique for Mining Free-Text Electronic Medical Records.

    Science.gov (United States)

    Duz, Marco; Marshall, John F; Parkin, Tim

    2017-06-29

    The use of electronic medical records (EMRs) offers opportunity for clinical epidemiological research. With large EMR databases, automated analysis processes are necessary but require thorough validation before they can be routinely used. The aim of this study was to validate a computer-assisted technique using commercially available content analysis software (SimStat-WordStat v.6 (SS/WS), Provalis Research) for mining free-text EMRs. The dataset used for the validation process included life-long EMRs from 335 patients (17,563 rows of data), selected at random from a larger dataset (141,543 patients, ~2.6 million rows of data) and obtained from 10 equine veterinary practices in the United Kingdom. The ability of the computer-assisted technique to detect rows of data (cases) of colic, renal failure, right dorsal colitis, and non-steroidal anti-inflammatory drug (NSAID) use in the population was compared with manual classification. The first step of the computer-assisted analysis process was the definition of inclusion dictionaries to identify cases, including terms identifying a condition of interest. Words in inclusion dictionaries were selected from the list of all words in the dataset obtained in SS/WS. The second step consisted of defining an exclusion dictionary, including combinations of words to remove cases erroneously classified by the inclusion dictionary alone. The third step was the definition of a reinclusion dictionary to reinclude cases that had been erroneously classified by the exclusion dictionary. Finally, cases obtained by the exclusion dictionary were removed from cases obtained by the inclusion dictionary, and cases from the reinclusion dictionary were subsequently reincluded using Rv3.0.2 (R Foundation for Statistical Computing, Vienna, Austria). Manual analysis was performed as a separate process by a single experienced clinician reading through the dataset once and classifying each row of data based on the interpretation of the free

  20. Evaluation of ultrasound-assisted Menghini technique in liver graft biopsy

    Directory of Open Access Journals (Sweden)

    Marcel Vieira da Nóbrega

    2009-03-01

    Full Text Available Objective: To report on the experience of implementing ultrasound-assisted Menghini technique in the evaluation of liver transplant dysfunction. Methods: Menghini technique uses a suction needle, through percutaneous access, allowing a fast puncture (less than one second, which can help reduce the incidence of complications. Rresults: A total of 87 biopsies performed with 16-gauge suction needles were studied in a period of 15 months. Ultrasound was used to access the presence of perihepatic liquid or collections, biliary and vascular disorders, to mark a safe puncture site and for post-procedure control. The main biopsy indication was elevation of liver enzymes. In 81 cases, one fragment was collected and satisfactory samples were obtained in 85 procedures (97.7%. Minor complications occurred in six patients (6.9%, five with local pain and one with vagal reaction. There was a major complication (1.1%, hemothorax, which was diagnosed by clinical and radiological control examination and then treated. Cconclusions: Menghini technique to obtain liver tissue is quick, effective and safe, but it has always to follow the general care aspects of any intervention procedure. The ultrasound before and after the procedure helps marking an appropriate puncture site, may enhance the effectiveness of the method and is useful to identify possible early complications.

  1. Balloon-Assisted Microdissection "BAM" Technique for Balloon-Uncrossable Chronic Total Occlusions.

    Science.gov (United States)

    Vo, Minh N; Christopoulos, Georgios; Karmpaliotis, Dimitri; Lombardi, William L; Grantham, J Aaron; Brilakis, Emmanouil S

    2016-04-01

    After successful guidewire passage, failure to cross the occluded segment with a balloon is the most common cause of procedural failure in coronary chronic total occlusion (CTO) intervention. We evaluated the safety and efficacy of the balloon-assisted microdissection (BAM) technique for treating these complex balloon-uncrossable lesions. We identified consecutive cases treated with BAM for balloon-uncrossable CTOs between January 2012 and February 2015 at two experienced CTO percutaneous coronary intervention (PCI) centers and reviewed their clinical and angiographic characteristics and procedural outcomes. During the study period, a total of 17 patients had BAM performed for balloon-uncrossable CTOs. Mean age was 65.5 ± 8.7 years and 94% of patients were males who often had prior myocardial infarction, PCI, and coronary artery bypass graft surgery. The most common CTO target vessel was the right coronary artery. Mean J-CTO score was 2.6 ± 1.1. Despite high lesion complexity, overall procedural success was 94% and BAM facilitated success in approximately one-half of these cases. All BAM failure cases except 1 were successfully recanalized utilizing additional techniques. No patient experienced a major complication. BAM is a simple, inexpensive, and safe technique that can facilitate crossing of balloon-uncrossable CTOs and can be considered as first-line treatment for these complex lesions.

  2. Should HCV discordant couples with a seropositive male partner be treated with assisted reproduction techniques (ART)?

    Science.gov (United States)

    Savasi, Valeria; Oneta, Monica; Parrilla, Bina; Cetin, Irene

    2013-04-01

    The debate on HCV discordant couples requiring assisted reproduction is still open today, and specific guidelines have not yet been established on whether or not physicians should treat HCV discordant couples who require ART. We studied the results of our reproductive assistance with sperm washing in HCV discordant couples, all treated in a single center, including the serological status of mothers and babies, and the outcome of the pregnancies. Prospective study conducted between January 2008 and December 2010 in our Reproductive Center in Sacco Hospital, University of Milan. Thirty-five HCV serodiscordant infertile couples with an HCV viremic positive male partner were enrolled. All of them completed the immuno-virological and fertility triage, and were treated according to our clinical protocols. Forty-seven superovulation and IUI and 38 second-level ART procedures are reported. The pregnancy rates for IUI and ICSI are similar to those reported by the Italian ART register. All the 85 sperm samples were treated with sperm washing technique to reduce HCV in semen and the possible risk of transmission. We did not observe any preterm delivery or negative perinatal outcome. No mothers or babies are infected by HCV. This is the biggest prospective study conducted in a single center involving HCV discordant infertile couples in an ART program. Although sexual transmission of HCV is very low, in subfertile or infertile couples sperm washing should be used to treat HCV positive semen before ART. We suggest that it is not necessary to perform nested PCR to detect HCV RNA in the final swim-up. Since the presence of HCV in semen implies a possible risk of nosocomial contamination, safety regulations must be strictly applied in assisted reproduction laboratories. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  3. Ion-substituted calcium phosphate coatings deposited by plasma-assisted techniques: A review.

    Science.gov (United States)

    Graziani, Gabriela; Bianchi, Michele; Sassoni, Enrico; Russo, Alessandro; Marcacci, Maurilio

    2017-05-01

    One of the main critical aspects behind the failure or success of an implant resides in its ability to fast bond with the surrounding bone. To boost osseointegration, the ideal implant material should exhibit composition and structure similar to those of biological apatite. To this aim, the most common approach is to coat the implant surface with a coating of hydroxyapatite (HA), resembling the main component of mineralized tissues. However, bone apatite is a non-stoichiometric, multi-substituted poorly-crystalline apatite, containing significant amounts of foreign ions, with high biological relevance. Ion-substituted HAs can be deposited by so called "wet methods", which are however poorly reproducible and hardly industrially feasible; at the same time bioactive coatings realized by plasma assisted method, interesting for industrial applications, are generally made of stoichiometric (i.e. un-substituted) HA. In this work, the literature concerning plasma-assisted deposition methods used to deposit ion-substituted HA was reviewed and the last advances in this field discussed. The ions taken into exam are those present in mineralized tissues and possibly having biological relevance. Notably, literature about this topic is scarce, especially relating to in vivo animal and clinical trials; further on, available studies evaluate the performance of substituted coatings from different points of view (mechanical properties, bone growth, coating dissolution, etc.) which hinders a proper evaluation of the real efficacy of ion-doped HA in promoting bone regeneration, compared to stoichiometric HA. Moreover, results obtained for plasma sprayed coatings (which is the only method currently employed for deposition at the industrial scale) were collected and compared to those of novel plasma-assisted techniques, that are expected to overcome its limitations. Data so far available on the topic were discussed to highlight advantages, limitations and possible perspectives of these

  4. Systematic evaluation of the quality of clinical practice guidelines on the use of assisted reproductive techniques.

    Science.gov (United States)

    Gutarra-Vilchez, Rosa Bertha; Barajas-Nava, Leticia; Aleman, Alicia; Solà, Ivan; Gich, Ignasi; Bonfill, Xavier; Alonso-Coello, Pablo

    2014-03-01

    To conduct a systematic evaluation of clinical practice guidelines (CPGs) on the use of assisted reproductive technologies. We searched Medline, the Turning Research into Practice database, and guidelines-specific databases from December 2006 to November 2011. Three reviewers independently assessed each Guideline using the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument. A standardized score was calculated separately for each of the six domains. Fourteen Guidelines were included. Overall, the quality of these was suboptimal. The scores for each AGREE II domain ranged between 37% and 80%. Three (22%) were deemed "Recommended"; nine (64%),"Recommended with modifications"; and two (14%), "Not recommended". Agreement among reviewers was very good (Intraclass Correlation Coefficient: 0.915 [95% CI 0.807-0.970]). The overall quality of the CPGs on Assisted Reproduction Techniques published during the last 5 years is suboptimal. Most Guidelines present significant shortcomings in important domains such as "stakeholder involvement", "rigor of development", and "applicability". Instruments such as the AGREE II and "the Grading of Recommendation Assessment Development and Evaluation" system could prove useful to improve CPGs in this field. Guideline users could benefit from the present results when choosing which guidelines to implement.

  5. Zinc protects sperm from being damaged by reactive oxygen species in assisted reproduction techniques.

    Science.gov (United States)

    Wu, Jinxiang; Wu, Shiqiang; Xie, Yuanzhi; Wang, Zhengyao; Wu, Ruiyun; Cai, Junfeng; Luo, Xiangmin; Huang, Suzhen; You, Liuxia

    2015-04-01

    The aim of this study was to explore the effect of zinc on hydrogen peroxide-induced sperm damage in assisted reproduction techniques. First, sperms were selected from semen samples of 20 healthy men prepared by density gradient centrifugation. Selected sperm were treated with either 0.001% H(2)O(2), 12.5 nM ZnCL(2), 0.001% H(2)O(2) + 12.5 nM ZnCL(2) or 0.9% NaCl(2) (control). After this treatment, the motility, viability, membrane integrity and DNA fragmentation of sperms in each group were analysed by Goodline sperm detection system, optical microscopy and sperm DNA fragmentation assay. Poorer motility, vitality, membrane integrity and more DNA damage were found in sperms treated by H(2)O(2), compared with control. When sperms were treated with both H(2)O(2) and zinc, however, all indicators were improved compared with H(2)O(2) alone. There was a close association between oxidative stimulation and sperm injury; zinc could inhibit hydrogen peroxide-induced damage of sperm in assisted reproductive technology. However, the presence of zinc in culture medium can decrease the sperm quality without addition of peroxide. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  6. Eco Assist Techniques through Real-time Monitoring of BEV Energy Usage Efficiency.

    Science.gov (United States)

    Kim, Younsun; Lee, Ingeol; Kang, Sungho

    2015-06-25

    Energy efficiency enhancement has become an increasingly important issue for battery electric vehicles. Even if it can be improved in many ways, the driver's driving pattern strongly influences the battery energy consumption of a vehicle. In this paper, eco assist techniques to simply implement an energy-efficient driving assistant system are introduced, including eco guide, eco control and eco monitoring methods. The eco guide is provided to control the vehicle speed and accelerator pedal stroke, and eco control is suggested to limit the output power of the battery. For eco monitoring, the eco indicator and eco report are suggested to teach eco-friendly driving habits. The vehicle test, which is done in four ways, consists of federal test procedure (FTP)-75, new european driving cycle (NEDC), city and highway cycles, and visual feedback with audible warnings is provided to attract the driver's voluntary participation. The vehicle test result shows that the energy usage efficiency can be increased up to 19.41%.

  7. Survey on Robot-Assisted Surgical Techniques Utilization in US Pediatric Surgery Fellowships.

    Science.gov (United States)

    Maizlin, Ilan I; Shroyer, Michelle C; Yu, David C; Martin, Colin A; Chen, Mike K; Russell, Robert T

    2017-02-01

    Robotic technology has transformed both practice and education in many adult surgical specialties; no standardized training guidelines in pediatric surgery currently exist. The purpose of our study was to assess the prevalence of robotic procedures and extent of robotic surgery education in US pediatric surgery fellowships. A deidentified survey measured utilization of the robot, perception on the utility of the robot, and its incorporation in training among the program directors of Accreditation Council for Graduate Medical Education (ACGME) pediatric surgery fellowships in the United States. Forty-one of the 47 fellowship programs (87%) responded to the survey. While 67% of respondents indicated the presence of a robot in their facility, only 26% reported its utilizing in their surgical practice. Among programs not utilizing the robot, most common reasons provided were lack of clear supportive evidence, increased intraoperative time, and incompatibility of instrument size to pediatric patients. While 58% of program directors believe that there is a future role for robotic surgery in children, only 18% indicated that robotic training should play a part in pediatric surgery education. Consequently, while over 66% of survey respondents received training in robot-assisted surgical technique, only 29% of fellows receive robot-assisted training during their fellowship. A majority of fellowships have access to a robot, but few utilize the technology in their current practice or as part of training. Further investigation is required into both the technology's potential benefits in the pediatric population and its role in pediatric surgery training.

  8. Endoscope-assisted facelift thyroid surgery: an initial experience using a new endoscopic technique.

    Science.gov (United States)

    Park, Jun-Ook; Kim, Sang-Yeon; Chun, Byung-Joon; Joo, Young-Hoon; Cho, Kwang-Jae; Park, Young Hak; Kim, Min-Sik; Sun, Dong-Il

    2015-06-01

    A new approach to modifying facelift incision was recently developed for robotic thyroid surgery that seemed to be advantageous over other existing approaches. In this study, we aimed to investigate the feasibility and safety of the facelift approach not only for robotic thyroid surgery, but also for endoscope-assisted thyroid surgery. Endoscope-assisted facelift thyroid lobectomy was performed for 11 patients with papillary microcarcinoma. All 11 operations were successfully performed endoscopically. This approach through a modified facelift incision provided safe dissection of the laryngeal nerves and exposed an adequate working space. We identified and preserved all neighboring critical structures (parathyroid gland and superior and recurrent laryngeal nerves) during surgery. The operative duration for simple thyroid lobectomy with central lymph node dissection in 11 patients was 120-180 min (average duration: 140 min). Sensory change around the earlobe occurred in three patients and was recovered within 2 months after surgery in all patients. No patient displayed laryngeal nerve palsy or a low-pitched voice. The facelift approach seems to provide a shorter and more direct route to the thyroid, requiring minimal dissection, and an adequate workspace not only for robotic surgery but also for endoscopic surgery. It is worthwhile to develop and refine the surgical techniques of endoscopic facelift thyroid surgery.

  9. Eco Assist Techniques through Real-time Monitoring of BEV Energy Usage Efficiency

    Directory of Open Access Journals (Sweden)

    Younsun Kim

    2015-06-01

    Full Text Available Energy efficiency enhancement has become an increasingly important issue for battery electric vehicles. Even if it can be improved in many ways, the driver’s driving pattern strongly influences the battery energy consumption of a vehicle. In this paper, eco assist techniques to simply implement an energy-efficient driving assistant system are introduced, including eco guide, eco control and eco monitoring methods. The eco guide is provided to control the vehicle speed and accelerator pedal stroke, and eco control is suggested to limit the output power of the battery. For eco monitoring, the eco indicator and eco report are suggested to teach eco-friendly driving habits. The vehicle test, which is done in four ways, consists of federal test procedure (FTP-75, new european driving cycle (NEDC, city and highway cycles, and visual feedback with audible warnings is provided to attract the driver’s voluntary participation. The vehicle test result shows that the energy usage efficiency can be increased up to 19.41%.

  10. Robot-assisted laparoscopic pectouteropexy: an alternative uterus-sparing technique for pelvic organ prolapse surgery.

    Science.gov (United States)

    Usta, Taner; Karacan, Tolga; Kale, Ahmet; Mutlu, Sevgin; Tıryakı, Talha

    2017-11-01

    The aim of this video is to demonstrate the alternative technique of robot-assisted laparoscopic pectouteropexy for uterus preservation in obese patients with pelvic organ prolapse. We present the case report of a 44-year-old patient with apical pelvic organ prolapse. A pelvic examination was performed during a Valsalva maneuver in the dorsal lithotomy position and in the standing position, and the patient was diagnosed with stage III apical prolapse in accordance with the Pelvic Organ Prolapse Quantification system of the International Continence Society (POP-Q: Аа -1, Ва 0, Вр 0, С +2). We performed the procedure, which was developed as an alternative to sacrocolpopexy or sacrouteropexy, as described by Banerjee and Noé (Arch Gynecol Obstet 284:24-28, 2011). Pectouteropexy is a new method for prolapse surgery that uses the lateral parts of the iliopectineal ligament for bilateral mesh fixation of the descended structures and provides strong apical support. We believe that robot-assisted laparoscopic pectouteropexy is a valuable alternative approach for uterus-preserving pelvic organ prolapse surgery owing to its better robot maneuverability, reduced operating time, and better visualization in obese patients.

  11. Chromosomal Abnormalities in Iranian Infertile Males who are Candidates for Assisted Reproductive Techniques

    Directory of Open Access Journals (Sweden)

    Iman Salahshourifar

    2007-01-01

    Full Text Available Background: The present study offers our contribution on the topic by a retrospective analysis of the prevalence of chromosomal abnormalities in a population of Iranian infertile men attending assisted reproduction programs.Materials and Methods: Cytogenetic analysis was performed according to standard methods on cultured cells obtained from the patient peripheral blood. In all, 874 files belonging to male partner of each couple were classified as follows: azoospermic, oligozoospermic and patients with low sperm quality in respect of morphology and motility.Results: Chromosomal abnormalities were observed in 136(15.5% individuals of the whole population studied including 12.0 %, 1.2 % and 2.0% of azoospermic, oligozoospermic and patients with low sperm quality, respectively. Of those, 116 (13.2% had sex chromosome abnormalities and 20(2.3% had autosomal chromosome abnormalities.Conclusion: We observed high frequency of aneuploidy and sex chromosomal mosaicism in azoospermic men and high structural aberrations in males with low sperm quality. We suggested that type of chromosomal abnormalities had an inverse relation to sperm count. So that, high chromosomal aneuploidy was detected in males with lower sperm count and high structural aberration was detected in males with low sperm quality. Chromosomal abnormalities are a major cause of male infertility. Consequently, Genetic testing and counselling is indicated for infertile men with abnormal semen parameters with either abnormal karyotype or normal karyotype before applying assisted reproductive techniques.

  12. Site-controlled quantum dots fabricated using an atomic-force microscope assisted technique

    Directory of Open Access Journals (Sweden)

    Sakuma Y

    2006-01-01

    Full Text Available AbstractAn atomic-force microscope assisted technique is developed to control the position and size of self-assembled semiconductor quantum dots (QDs. Presently, the site precision is as good as ± 1.5 nm and the size fluctuation is within ± 5% with the minimum controllable lateral diameter of 20 nm. With the ability of producing tightly packed and differently sized QDs, sophisticated QD arrays can be controllably fabricated for the application in quantum computing. The optical quality of such site-controlled QDs is found comparable to some conventionally self-assembled semiconductor QDs. The single dot photoluminescence of site-controlled InAs/InP QDs is studied in detail, presenting the prospect to utilize them in quantum communication as precisely controlled single photon emitters working at telecommunication bands.

  13. A computationally assisted spectroscopic technique to measure secondary electron emission coefficients in radio frequency plasmas

    CERN Document Server

    Daksha, M; Schuengel, E; Korolov, I; Derzsi, A; Koepke, M; Donko, Z; Schulze, J

    2016-01-01

    A Computationally Assisted Spectroscopic Technique to measure secondary electron emission coefficients ($\\gamma$-CAST) in capacitively-coupled radio-frequency plasmas is proposed. This non-intrusive, sensitive diagnostic is based on a combination of Phase Resolved Optical Emission Spectroscopy and particle-based kinetic simulations. In such plasmas (under most conditions in electropositive gases) the spatio-temporally resolved electron-impact excitation/ionization rate features two distinct maxima adjacent to each electrode at different times within each RF period. While one maximum is the consequence of the energy gain of electrons due to sheath expansion, the second maximum is produced by secondary electrons accelerated towards the plasma bulk by the sheath electric field at the time of maximum voltage drop across the adjacent sheath. Due to these different excitation/ionization mechanisms, the ratio of the intensities of these maxima is very sensitive to the secondary electron emission coefficient $\\gamma$...

  14. Perinatal Outcomes of Newborn Infants Conceived by Assisted Reproductive Techniques in Royan Institute

    Directory of Open Access Journals (Sweden)

    Sharareh Dadashloo

    2009-01-01

    Full Text Available Background: The outcomes of such pregnancies have been rarely evaluated in our country. Adescriptive study was planned to assess the health and condition of neonates conceived with assistedtechniques in a one year period.Materials and Methods: At Royan Institute, Tehran, 443 women who became pregnant by oneof the assisted techniques in vitro fertilization (IVF, intrauterine insemination (IUI andintracytoplasmic sperm injection (ICSI enrolled in a descriptive study during 16 month periodbeginning on September, 2007. The sampling method used was non-incidental, consecutive.Questionnaires regarding the contents of the baby birth card were completed after interviews withthe mothers. The time from fertilization of the ovum until delivery was considered as the gestational(conception age. Pregnant mothers were under periodic evaluation until delivery. Women withstillborn babies were followed via phone contact.Results: From a total of 443 conceptions, there were 13 (2.9% pregnancies demised in utero(stillbirths and 10 (2.6% who died during the neonatal period. Additionally, 133 (43% infantswere born after multifetal pregnancies and 96 (31% infants were prematurely born. There were 106(34.3% infants with low birth weight (LBW; less than 2500 g, of which 83 (78.3% LBW infantswere multiplets. After completion of the study, 71 women were still passing their pregnancy periodand no assessed.Conclusion: The most important factor for untoward perinatal events was multifetal pregnancy. Suchpregnancies were more frequently complicated and higher risk. Low birth weight and prematuritywere more frequent in singletons conceived by assisted techniques in respect to control singletons.

  15. Robot-Assisted Extended Pelvic Lymph Nodes Dissection for Prostate Cancer: Personal Surgical Technique and Outcomes

    Directory of Open Access Journals (Sweden)

    Porpiglia Francesco

    2015-12-01

    Full Text Available Objective: Extended pelvic lymph nodes dissection (EPLND allows the removal of a higher number of lymph nodes than limited PLND. The aims of this study were to describe our robot-assisted EPLND (RAEPLND technique with related complications, and to report the number of lymph nodes removed and the rate of lymph nodal metastasis. Materials and Methods: 153 patients underwent RAEPLND prior to robot-assisted radical prostatectomy (RARP. Indications were defined according to Briganti nomogram, to predict risk of lymph-nodal metastasis. Lymphatic packages covering the distal tract of the common iliac artery, the medial portion of the external iliac artery, the external iliac vein and the internal iliac vessels, together with the obturator and the presacral lymphatic packages were removed on both sides. Results: Median preoperative PSA was 7.5 ng/mL (IQR 5.5–11.5. Median operative time was 150 min (135–170. Median RAEPLND alone operative time was 38 min (32.75–41.25; for right and left side, 18 (15–29 and 20 min (15.75–30 (p=0.567. Median number of lymph nodes retrieved per patient was 25 (19.25–30; 13 (11–16 and 11 (8–15 for right and left side. In 19 patients (12.41% metastasis was found at the level of pelvic lymph nodes. Median number of positive lymph nodes was 1 (1–4.6 per patient. Complications occurred in 11 patients (7.3%. Conclusions: the number of lymph nodes removed was comparable to published data about open series, allowing the increase of detection rate of lymph nodal metastasis for minimally invasive approach without compromising complications' rate if performing the procedure following reported technique.

  16. Robot-Assisted Extended Pelvic Lymph Nodes Dissection for Prostate Cancer: Personal Surgical Technique and Outcomes.

    Science.gov (United States)

    Porpiglia, Francesco; De Luca, Stefano; Bertolo, Riccardo; Passera, Roberto; Mele, Fabrizio; Manfredi, Matteo; Amparore, Daniele; Morra, Ivano; Fiori, Cristian

    2015-01-01

    Extended pelvic lymph nodes dissection (EPLND) allows the removal of a higher number of lymph nodes than limited PLND. The aims of this study were to describe our robot-assisted EPLND (RAEPLND) technique with related complications, and to report the number of lymph nodes removed and the rate of lymph nodal metastasis. 153 patients underwent RAEPLND prior to robot-assisted radical prostatectomy (RARP). Indications were defined according to Briganti nomogram, to predict risk of lymph-nodal metastasis. Lymphatic packages covering the distal tract of the common iliac artery, the medial portion of the external iliac artery, the external iliac vein and the internal iliac vessels, together with the obturator and the presacral lymphatic packages were removed on both sides. Median preoperative PSA was 7.5 ng/mL (IQR 5.5-11.5). Median operative time was 150 min (135-170). Median RAEPLND alone operative time was 38 min (32.75-41.25); for right and left side, 18 (15-29) and 20 min (15.75-30) (p=0.567). Median number of lymph nodes retrieved per patient was 25 (19.25-30); 13 (11-16) and 11 (8-15) for right and left side. In 19 patients (12.41%) metastasis was found at the level of pelvic lymph nodes. Median number of positive lymph nodes was 1 (1-4.6) per patient. Complications occurred in 11 patients (7.3%). the number of lymph nodes removed was comparable to published data about open series, allowing the increase of detection rate of lymph nodal metastasis for minimally invasive approach without compromising complications' rate if performing the procedure following reported technique.

  17. Robot-assisted laparoscopic partial nephrectomy: Current review of the technique and literature

    Directory of Open Access Journals (Sweden)

    Singh Iqbal

    2009-01-01

    Full Text Available Aim: To visit the operative technique and to review the current published English literature on the technique, and outcomes following robot-assisted laparoscopic partial nephrectomy (RPN. Materials and Methods: We searched the published English literature and the PubMed (TM for published series of ′robotic partial nephrectomy′ (RPN using the keywords; robot, robot-assisted laparoscopic partial nephrectomy, laparoscopic partial nephrectomy, partial nephrectomy and laparoscopic surgery. Results: The search yielded 15 major selected series of ′robotic partial nephrectomy′; these were reviewed, tracked and analysed in order to determine the current status and role of RPN in the management of early renal neoplasm(s, as a minimally invasive surgical alternative to open partial nephrectomy. A review of the initial peri-operative outcome of the 350 cases of select series of RPN reported in published English literature revealed a mean operating time, warm ischemia time, estimated blood loss and hospital stay, of 191 minutes, 25 minutes, 162 ml and 2.95 days, respectively. The overall computed mean complication rate of RPN in the present select series was about 7.4%. Conclusions: RPN is a safe, feasible and effective minimally invasive surgical alternative to laparoscopic partial nephrectomy for early stage (T 1 renal neoplasm(s. It has acceptable initial renal functional outcomes without the increased risk of major complications in experienced hands. Prospective randomised, controlled, comparative clinical trials with laparoscopic partial nephrectomy (LPN are the need of the day. While the initial oncological outcomes of RPN appear to be favourable, long-term data is awaited.

  18. Career anchors and values from different career management perspectives

    Directory of Open Access Journals (Sweden)

    Rodrigo Cunha da Silva

    2016-06-01

    Full Text Available Purpose – To analyze the relationships between career anchors and young Generation Y professionals’ values, from the career concept perspective. Design/methodology/approach – Research concerning the proposed objective was carried out through quantitative research involving 189 Business Administration majors from a Catholic university in São Paulo, Brazil. We used two instruments to identify the career anchors and values of respondents: Schein (1990 and Schwartz (1994, respectively. We used statistical techniques to explore the relationships between career anchors and values. Findings – Among the results, mention should be made to the statistical relationships found between analyzed career anchors and values. It is also important to stress that, although the Lifestyle career anchor was predominantly present in the conglomerate division, this anchor was the predominant characteristic in the differentiation of the smaller group of respondents, the new career group. The General Management Career Anchor, which presents a lower incidence, is the predominant characteristic of the larger group, referring to organizational careers. As well as the Lifestyle career anchor, the Hedonism value was predominant among respondents. Originality/value – The need to consider the following was found: Generation Y presents generational characteristics that drive people management to propose work structures that offer activities to generate learning, pleasure, self-fulfillment and conciliation between work and personal life.

  19. Chromosome abnormalities and Yq microdeletions in infertile italian couples referred for assisted reproductive technique.

    Science.gov (United States)

    Marchina, E; Imperadori, L; Speziani, M; Omodei, U; Tombesi, S; Barlati, S

    2007-01-01

    This study analyses the prevalence of karyotype aberrations and Yq microdeletions in infertile couples undergoing intracytoplasmic sperm injection (ICSI). Before undergoing ICSI, each partner of 470 infertile couples was screened for karyotype aberrations by QFQ-banding technique on peripheral blood lymphocytes; male partners were also screened for Yq microdeletions. In 2.55% of the couples karyotype aberrations were found including numerical and structural alterations of autosomes and sex chromosomes. The female group had a high prevalence of low-level sex chromosome mosaicism (1.28%) and 5 cases of structural autosomal abnormalities (1.06%). The male group had 7 structural abnormalities of the autosomes (1.49%), 2 supernumerary marker chromosomes (0.42%), one case of low level gonosomal mosaicism (0.21%), and 2 cases of Y chromosome inversion (0.42%). Eight cases of Yq microdeletions (1.70%) were also found. Screening for genetic factors, chromosomal abnormalities and Yq microdeletions is indicated for couples undergoing assisted reproductive techniques due to the higher prevalence of these factors in infertile couples compared to the population as a whole although different chromosome aberrations have been reported elsewhere. (c) 2008 S. Karger AG, Basel

  20. Standardized big-bubble technique in deep anterior lamellar keratoplasty assisted by the femtosecond laser.

    Science.gov (United States)

    Buzzonetti, Luca; Laborante, Antonio; Petrocelli, Gianni

    2010-10-01

    We describe a variant of the big-bubble technique in deep anterior lamellar keratoplasty (DALK) assisted by the IntraLase femtosecond laser, which we call IntraBubble. The use of the 60 kHz IntraLase femtosecond laser allows dissection of the pre-Descemet-plane lamella to a predefined corneal depth and creation of a channel in the posterior stroma 50 μm above the endothelium into which a smooth cannula for air injection can be introduced. We lengthened the channel created by the laser using a pointed dissector. Eleven consecutive patients with keratoconus were treated, and all procedures were completed as DALK. The big bubble was achieved in 8 eyes (73%). In 3 cases (27%), intraoperative microperforations occurred and the procedures were completed with hand dissection without complications. This new application of femtosecond laser technology could lead to standardization of the big-bubble technique in DALK. Copyright © 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  1. Vehicle Assisted Data Delievery Technique To Control Data Dissemination In Vehicular AD - HOC Networks Vanets

    Directory of Open Access Journals (Sweden)

    Sandeep Kumar

    2015-08-01

    Full Text Available Abstract Multi-hop data delivery through vehicular ad hoc networks is complicated by the fact that vehicular networks are highly mobile and frequently disconnected. To address this issue the idea of helper node is opted where a moving vehicles carries the packet until a new vehicle moves into its vicinity and forwards the packet. Different from existing helper node solution use of the predicable vehicle mobility is made which is limited by the traffic pattern and the road layout. Based on the existing traffic pattern a vehicle can find the next road to forward packet a vehicle can find the next road to forward the packet to reduce the delay. Several vehicle-assisted date delievery VADD protocol is proposed to forward the packet to the best road with the road with the lowest data delivery delay. Experiment results are used to evaluate the proposed solutions. Results show that the proposed VADD protocol outperform existing solution in terms of packet delivery ratio data packet delay and protocol overhead. Among the proposed VADD protocols the Hybrid probe HVADD protocol has much better performance. In this Solution the helper node technique is provider with which the helper node will contain destination node path and the path in routine table continuously changes with the help of helper node technique.

  2. Anchoring visions in organizations

    DEFF Research Database (Denmark)

    Simonsen, Jesper

    1999-01-01

    as by those involved in the actual implementation. A model depicting a recent trend within systems development is presented: Organizations rely on purchasing generic software products and/or software development outsourced to external contractors. A contemporary method for participatory design, where......This paper introduces the term 'anchoring' within systems development: Visions, developed through early systems design within an organization, need to be deeply rooted in the organization. A vision's rationale needs to be understood by those who decide if the vision should be implemented as well...

  3. Simple suture and anchor in rabbit hips

    Science.gov (United States)

    Garcia Filho, Fernando Cal; Guarniero, Roberto; de Godoy Júnior, Rui Maciel; Pereira, César Augusto Martins; Matos, Marcos Almeida; Garcia, Lucas Cortizo

    2012-01-01

    Objective Using biomechanical studies, this research aims to compare hip capsulorrhaphy in rabbits, carried out with two different techniques: capsulorrhaphy with simple sutures and with anchors. Method Thirteen New Zealand Albino (Oryctolaguscuniculus) male rabbits, twenty-six hip joints, were used. First, a pilot project was performed with three rabbits (six hip joints). This experiment consisted of ten rabbits divided into two groups: group 1 underwent capsulorrhaphy on both right and left hips with simple suture using polyglycolic acid absorbable thread, and group 2 underwent capsulorrhaphy with titanium anchors. After a four-week postoperative period, the animals were euthanized and the hip joints were frozen. On the same day of the biomechanical studies, after the hip joints were previously unfrozen, the following parameters were evaluated: rigidity, maximum force, maximum deformity and energy. Results There was no relevant statistical difference in rigidity, maximum force, maximum deformity and energy between the simple suture and anchor groups. Conclusion Through biomechanical analyses, using parameters of rigidity, maximum force, maximum deformity and energy, it has been shown that capsulorrhaphy with simple suture and with anchors has similar results in rabbit hip joints. Level of Evidence II, Prospective Comparative Study. PMID:24453618

  4. Career anchors of dentist leaders.

    Science.gov (United States)

    Tuononen, Tiina; Lammintakanen, Johanna; Suominen, Anna Liisa

    2016-08-01

    The work of a health care leader is demanding; in order to cope, leaders need motivation and support. The occurrence of intrinsic factors called career anchors (combination of one's competence, motives and values) could be a contributing factor in dentist leaders' career decisions. The aim of our study was to identify dentist leaders' career anchors and their association to dentist leaders' retention or turnover of the leadership position. Materials were gathered in 2014 via an electronic questionnaire from 156 current (Leaders) or former (Leavers) Finnish dentist leaders. Career anchor evaluation was conducted by the questionnaire and scoring-table taken from Edgar Schein's Career Anchors Self-Assessment. Both the most and the least important career anchors were detected by the highest and lowest scores and their occurrence reported as percentages. Associations between career anchor scores and tendency to stay were analyzed with logistic regression. 'Technical/Functional Competence' and 'Lifestyle' were most frequently reported as the most important and 'Entrepreneurial Creativity' and 'General Managerial Competence' as the least important career anchors. However, a higher level of 'General Managerial Competence' anchor was most significantly associated with staying in a leadership position. Instead, 'Pure Challenge' and 'Lifestyle' decreased the odds to stay. The knowledge of the important and essential career anchors of dentist leaders' and individuals' could perform crucial part in career choices and also in planning education, work opportunities and human resource policies promoting retention of dentist leaders and probably also other health care leaders.

  5. Utility of antioxidants during assisted reproductive techniques: an evidence based review.

    Science.gov (United States)

    Agarwal, Ashok; Durairajanayagam, Damayanthi; du Plessis, Stefan S

    2014-11-24

    Assisted reproductive technology (ART) is a common treatment of choice for many couples facing infertility issues, be it due to male or female factor, or idiopathic. Employment of ART techniques, however, come with its own challenges as the in vitro environment is not nearly as ideal as the in vivo environment, where reactive oxygen species (ROS) build-up leading to oxidative stress is kept in check by the endogenous antioxidants system. While physiological amounts of ROS are necessary for normal reproductive function in vivo, in vitro manipulation of gametes and embryos exposes these cells to excessive ROS production either by endogenous or exogenous environmental factors. In this review, we discuss the sources of ROS in an in vitro clinical setting and the influence of oxidative stress on gamete/embryo quality and the outcome of IVF/ICSI. Sources of ROS and different strategies of overcoming the excessive generation of ROS in vitro are also highlighted. Endogenously, the gametes and the developing embryo become sources of ROS. Multiple exogenous factors act as potential sources of ROS, including exposure to visible light, composition of culture media, pH and temperature, oxygen concentration, centrifugation during spermatozoa preparation, ART technique involving handling of gamete/embryo and cryopreservation technique (freeze/thawing process). Finally, the use of antioxidants as agents to minimize ROS generation in the in vitro environment and as oral therapy is highlighted. Both enzymatic and non-enzymatic antioxidants are discussed and the outcome of studies using these antioxidants as oral therapy in the male or female or its use in vitro in media is presented. While results of studies using certain antioxidant agents are promising, the current body of evidence as a whole suggests the need for further well-designed and larger scale randomized controlled studies, as well as research to minimize oxidative stress conditions in the clinical ART setting.

  6. Cloning and assisted reproductive techniques: influence on early development and adult phenotype.

    Science.gov (United States)

    Sakai, Randall R; Tamashiro, Kellie L K; Yamazaki, Yukiko; Yanagimachi, Ryuzo

    2005-06-01

    Over the past 40 years, our increased understanding and development of cell and molecular biology has allowed even greater advances in reproductive biology. This is most evident by the development of various aspects of assisted reproductive techniques (ART), generation of transgenic animals, and most recently generation of mammals through somatic cell cloning. To date, cloning from adult somatic cells has been successful in at least 10 mammalian species. Although generating viable cloned mammals from adult cells is technically feasible and the list of successes will only continue to grow with time, prenatal and perinatal mortality is high and live cloned offspring have not been without health problems. The success of many of the proposed applications of the cloning technique obviously depends upon the health and survival of founder animals generated by nuclear transfer. This article summarizes the health consequences of cloning in mice, and discusses possible mechanisms through which these conditions may arise. In addition, we discuss the effects of ART in animal models and in humans. ART also involves some of the same procedures used in cloning, and there are reports that offspring generated by ART sometimes display aberrant phenotypes as well. It is important to point out that although these techniques do sometimes produce abnormalities, the majority of offspring are born apparently normal and survive to adulthood. Additionally, we must emphasize that the effects of ART and cloning observed in animal models do not necessarily indicate that they will occur in humans. In this article, we review studies examining the phenotype of animals generated by cloning and various ART, and discuss clinical implications of these findings. (c) 2005 Wiley-Liss, Inc.

  7. Lightness, brightness, and anchoring.

    Science.gov (United States)

    Anderson, Barton L; Whitbread, Michael; de Silva, Chamila

    2014-08-07

    The majority of work in lightness perception has evaluated the perception of lightness using flat, matte, two-dimensional surfaces. In such contexts, the amount of light reaching the eye contains a conflated mixture of the illuminant and surface lightness. A fundamental puzzle of lightness perception is understanding how it is possible to experience achromatic surfaces as specific achromatic shades in the face of this ambiguity. It has been argued that the perception of lightness in such contexts implies that the visual system imposes an "anchoring rule" whereby a specific relative luminance (the highest) serves as a fixed point in the mapping of image luminance onto the lightness scale ("white"). We conducted a series of experiments to explicitly test this assertion in contexts where this mapping seemed most unlikely-namely, low-contrast images viewed in dim illumination. Our results provide evidence that the computational ambiguity in mapping luminance onto lightness is reflected in perceptual experience. The perception of the highest luminance in a two-dimensional Mondrian display varied monotonically with its brightness, ranging from midgray to white. Similar scaling occurred for the lowest luminance and, by implication, all other luminance values. We conclude that the conflation between brightness and lightness in two-dimensional Mondrian displays is reflected in perception and find no support for the claim that any specific relative luminance value acts as a fixed anchor point in this mapping function. © 2014 ARVO.

  8. Bone anchored hearing aids "BAHAs" in children

    OpenAIRE

    Priwin, Claudia

    2006-01-01

    BACKGROUND: The technique for applying bone-anchored hearing aids (BAHAs) by the use of osseointegration is today widely established for both adults and children. The BAHA concept is suitable for patients with recurrent ear infections or car malformations who cannot use conventional hearing aids, which are placed altogether or partially in the ear canal. Long-term results are well documented in adults but are lacking in children. Most patients are fitted with unilateral BAHA...

  9. Initial Clinical Experience With Surgical Technique of Robot-assisted Transperitoneal Laparoscopic Partial Nephrectomy

    Directory of Open Access Journals (Sweden)

    Cheng-Kuang Yang

    2009-12-01

    Conclusion: Robot-assisted LPN is feasible and may be a viable alternative to open or LPN in selected patients with small exophytic renal tumors. Compared with standard LPN, the robotic assisted LPN approach with precise renal reconstruction under a safe warm ischemia time is feasible and can be easily adopted by those with experience in robot-assisted surgery.

  10. Suture Anchor Fixation in Osteoporotic Bone: A Biomechanical Study in an Ovine Model.

    Science.gov (United States)

    Horoz, Levent; Hapa, Onur; Barber, F Alan; Hüsemoğlu, Buğra; Özkan, Mustafa; Havitçioğlu, Hasan

    2017-01-01

    To evaluate the load to failure strength of anchor techniques suitable for osteoporotic bone. Using an osteoporotic ovine model in 72 humeri, 6 fixation techniques were tested. Group 1: two interlocking 5-mm anchors with fewer, wider threads; group 2: one 5-mm anchor; group 3: one 5-mm anchor reinforced laterally by a 6.5-mm cancellous screw; group 4: one 5-mm anchor in an area reinforced with a cancellous plug; group 5: two interlocking 5-mm anchors with smaller threads; group 6: one 5-mm smaller threaded anchor. After a 10-N preload, the specimens were cyclically loaded between 10 N and 30 N for 50 cycles and then destructively tested. Peak-to-peak displacement, cyclic elongation, ultimate load, stiffness, and failure mode were recorded. Group 1 had lower peak-to-peak displacement than group 3 (P = .001), group 5 (P = .001), and group 6 (P = .033). In addition, group 1 showed lower cyclic elongation than group 3 (P = .001), group 5 (P = .035), and group 6 (P = .001). Group 1 had a higher ultimate load than group 2 (P = .002), group 3 (P = .019), and group 6 (P = .006). Group 1 also showed higher stiffness than group 2 (P = .007) and group 3 (P = .022). Mode of failure was predominantly caused by anchor pullout for all of the groups except group 3, which mainly failed by suture rupture. Two interlocking suture anchors are stronger than a single anchor in osteoporotic bone. The anchor with fewer, wider threads and a smaller core diameter showed greater strength and less elongation than the other constructs. Reinforcement by cancellous autografting increased suture anchor strength. Considering concerns about suture anchor pullout from osteoporotic bone, interlocking a second suture anchor with the first increases load to failure resistance. Anchors with small core diameters and fewer but wider threads are more efficient in osteoporotic bone. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  11. A surgical glove port technique for laparoscopic-assisted ovariohysterectomy for pyometra in the bitch.

    Science.gov (United States)

    Becher-Deichsel, Anja; Aurich, Jörg E; Schrammel, Nadine; Dupré, Gilles

    2016-07-15

    The objective of the study was to describe the feasibility of a glove port technique for laparoscopic-assisted surgical treatment of canine pyometra. In this retrospective case series, a total of 10 female dogs (median age 7 years, range 5.5-10.5 years; median weight 37.0 kg, range 12.9-64.0 kg) with pyometra were included. A multiaccess port was created from a surgical glove attached to an Alexis wound retractor and placed in the ventral midline between the middle and caudal third of the distance between umbilicus and pubic rim. A vessel sealing device was used for transection of the ovarian pedicle. The port size was selected on the basis of maximum uterine diameter determined by ultrasound. Median incision length was 5.0 cm (range 3.1-7.7 cm) for a maximum uterine diameter of 4.0 cm (range 2.0-7.0 cm). Median surgical time was 57 minutes (range 48-65 minutes). No case had to be converted to open celiotomy. Complications included one case of minor, self-limiting splenic trauma by the endoscope. In eight dogs, the distended uterine horns endangered safe access to the ovarian pedicle, and the vessel sealing device was inserted through a second cannula placed periumbilically. Extension of the original incision was necessary to exteriorize organs in two dogs. All dogs recovered quickly and were discharged either on the day of surgery or 1 day thereafter. In conclusion, a surgical glove port technique in combination with an Alexis wound retractor is feasible for surgical laparoscopic treatment of canine pyometra up to a diameter of 7 cm. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Percutaneous Sacroiliac Screw Placement: A Prospective Randomized Comparison of Robot-assisted Navigation Procedures with a Conventional Technique.

    Science.gov (United States)

    Wang, Jun-Qiang; Wang, Yu; Feng, Yun; Han, Wei; Su, Yong-Gang; Liu, Wen-Yong; Zhang, Wei-Jun; Wu, Xin-Bao; Wang, Man-Yi; Fan, Yu-Bo

    2017-11-05

    Sacroiliac (SI) screw fixation is a demanding technique, with a high rate of screw malposition due to the complex pelvic anatomy. TiRobot™ is an orthopedic surgery robot which can be used for SI screw fixation. This study aimed to evaluate the accuracy of robot-assisted placement of SI screws compared with a freehand technique. Thirty patients requiring posterior pelvic ring stabilization were randomized to receive freehand or robot-assisted SI screw fixation, between January 2016 and June 2016 at Beijing Jishuitan Hospital. Forty-five screws were placed at levels S1 and S2. In both methods, the primary end point screw position was assessed and classified using postoperative computed tomography. Fisher's exact probability test was used to analyze the screws' positions. Secondary end points, such as duration of trajectory planning, surgical time after reduction of the pelvis, insertion time for guide wire, number of guide wire attempts, and radiation exposure without pelvic reduction, were also assessed. Twenty-three screws were placed in the robot-assisted group and 22 screws in the freehand group; no postoperative complications or revisions were reported. The excellent and good rate of screw placement was 100% in the robot-assisted group and 95% in the freehand group. The P value (0.009) showed the same superiority in screw distribution. The fluoroscopy time after pelvic reduction in the robot-assisted group was significantly shorter than that in the freehand group (median [Q1, Q3]: 6.0 [6.0, 9.0] s vs. median [Q1, Q3]: 36.0 [21.5, 48.0] s; χ2 = 13.590, respectively, P robot-assisted group than that for the freehand group (median [Q1, Q3]: 2.0 [2.0, 2.7] min vs. median [Q1, Q3]: 19.0 [15.5, 45.0] min; χ2 = 20.952, respectively, P robot-assisted group was significantly less than that in the freehand group (median [Q1, Q3]: 1.0 [1.0,1.0] time vs. median [Q1, Q3]: 7.0 [1.0, 9.0] times; χ2 = 15.771, respectively, P robot-assisted technique was superior to that of

  13. Epstein on Anchors and Grounds

    Directory of Open Access Journals (Sweden)

    Guala Francesco

    2016-03-01

    Full Text Available The distinction between anchors and grounds is one of the most innovative contributions of The Ant Trap. In this commentary I will argue that the distinction suffers from an ambiguity between tokens and types. This leads Epstein to endorse pluralism about anchors and grounds, a position that is not justified in the book and to which there are plausible alternatives.

  14. Assisted reproductive techniques in Latin America: The Latin American Registry, 2013.

    Science.gov (United States)

    Zegers-Hochschild, Fernando; Schwarze, Juan Enrique; Crosby, Javier A; Musri, Carolina; Urbina, Maria Teresa

    2016-05-01

    Multinational data on assisted reproduction techniques undertaken in 2013 were collected from 158 institutions in 15 Latin American countries. Individualized cycle-based data included 57,456 initiated cycles. Treatments included autologous IVF and intracytoplasmic sperm injection (ICSI), frozen embryo transfers, oocyte donations. In autologous reproduction, 29.22% of women were younger than 35 years, 40.1% were 35-39 years and 30.6% were 40 years or older. Overall delivery rate per oocyte retrieval was 20.6% for ICSI and 25.4% for IVF. Multiple births included 20.7% for twins and 1.1% for triplets and over. In oocyte donations, twins reached 30% and triplets 1.4%. In singletons, pre-term births were 7.5%: 36.58% in twins and 65.52% in triplets. The relative risk for prematurity was 4.9 (95% CI 4.5 to 5.3) in twins and 8.7 (95% CI 7.6 to 10.0) in triplets and above. Perinatal mortality was 29.4 per 1000 in singletons, 39.9 per 1000 in twins and 71.6 per 1000 in high order multiples. Elective single embryo transfer represented only 2% of cycles, with delivery rate of 39.1% in women aged 34 years or less. Given the effect of multiple births and prematurity, it is mandatory to reduce the number of embryos transferred in the region.

  15. The association of placenta previa and assisted reproductive techniques: a meta-analysis.

    Science.gov (United States)

    Karami, Manoochehr; Jenabi, Ensiyeh; Fereidooni, Bita

    2017-06-06

    Several epidemiological studies have determined that assisted reproductive techniques (ART) can increase the risk of placenta previa. To date, only a meta-analysis has been performed for assessing the relationship between placenta previa and ART. This meta-analysis was conducted to estimate the association between placenta previa and ART in singleton and twin pregnancies. A literature search was performed in major databases PubMed, Web of Science, and Scopus from the earliest possible year to April 2017. The heterogeneity across studies was explored by Q-test and I 2 statistic. The publication bias was assessed using Begg's and Egger's tests. The results were reported using odds ratio (OR) and relative risk (RR) estimates with its 95% confidence intervals (CI) using a random-effects model. The literature search yielded 1529 publications until September 2016 with 1,388,592 participants. The overall estimate of OR was 2.67 (95%CI: 2.01, 3.34) and RR was 3.62 (95%CI: 0.21, 7.03) based on singleton pregnancies. The overall estimate of OR was 1.50 (95%CI: 1.26, 1.74) based on twin pregnancies. We showed based on odds ratio reports in observational studies that ART procedures are a risk factor for placenta previa.

  16. Assisted reproductive techniques in Latin America: The Latin American Registry, 2014.

    Science.gov (United States)

    Zegers-Hochschild, Fernando; Schwarze, Juan Enrique; Crosby, Javier A; Musri, Carolina; Urbina, Maria Teresa

    2017-09-01

    Multinational data on assisted reproduction techniques undertaken in 2014 were collected from 159 institutions in 15 countries in Latin America. Treatments included IVF/ ICSI, FET, OD, PGD and fertility preservation (FP). 41.34% of IVF/ICSI cycles were performed in women aged 35 to 39 years and 23.35% in women aged 40 and older. After removing cases with total freezing, delivery rate per oocyte retrieval was 25.05% for ICSI and 27.41% for IVF. Multiple births included 20.78% twins and 0.92 % triplets and over. In OD, twins reached 28.93% and triplets 1.07 %. Preterm deliveries reached 16.4% in singletons, 55.02% in twins and 76% in triplets. Perinatal mortality in 18,162 births was 23 per 1000 in singletons, 35 per 1000 in twins, and 36 per 1000 in high-order multiples. Elective single embryo transfer (eSET) represented only 2.63 % of fresh transfers, with a delivery rate of 32.15% per transfer. Elective double embryo transfer (eDET) represented 23.74% of transfers, with a delivery rate of 41.03% per transfer. Among babies born during this period 11,373 (62.6%) were singletons; 6,398 (35.2%) twins, and 391 (2.2%), triplets and more. Given the effect of multiple births on prematurity, morbidity and perinatal mortality, reinforcing the existing trend of reducing the number of embryos transferred is mandatory.

  17. Maternal, perinatal and long-term outcomes after assisted reproductive techniques (ART): implications for clinical practice.

    Science.gov (United States)

    Talaulikar, Vikram Sinai; Arulkumaran, Sabaratnam

    2013-09-01

    The use of assisted reproductive techniques (ART) is on the rise throughout the world and the number of babies born as a result of ART has reached an estimated total of 5 million since the world's first, Louise Brown, was born in 1978. Data from many prospective and retrospective studies have suggested increased risks of adverse maternal, perinatal and long-term outcomes after ART compared to natural conception. Recent research suggests that underlying maternal factors rather than ART methods themselves play a significant role in causing such outcomes. Couples attempting ART need to be provided with accurate and reliable information on risks of adverse reproductive outcomes and reassured that absolute risks appear small. Clinicians need to remain vigilant about increased risk of pregnancy complications and formulate a plan of care for the woman, from periconception to the puerperium, which aims to prevent or minimise maternal and perinatal morbidity. This review attempts to summarise the available data on reproductive outcomes after ART and provide guidance to the obstetricians and primary care physicians about management of ART pregnancies. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. Assisted reproductive techniques in Latin America: The Latin American Registry, 2014

    Science.gov (United States)

    Zegers-Hochschild, Fernando; Schwarze, Juan Enrique; Crosby, Javier A.; Musri, Carolina; Urbina, Maria Teresa

    2017-01-01

    Multinational data on assisted reproduction techniques undertaken in 2014 were collected from 159 institutions in 15 countries in Latin America. Treatments included IVF/ ICSI, FET, OD, PGD and fertility preservation (FP). 41.34% of IVF/ICSI cycles were performed in women aged 35 to 39 years and 23.35% in women aged 40 and older. After removing cases with total freezing, delivery rate per oocyte retrieval was 25.05% for ICSI and 27.41% for IVF. Multiple births included 20.78% twins and 0.92 % triplets and over. In OD, twins reached 28.93% and triplets 1.07 %. Preterm deliveries reached 16.4% in singletons, 55.02% in twins and 76% in triplets. Perinatal mortality in 18,162 births was 23 per 1000 in singletons, 35 per 1000 in twins, and 36 per 1000 in high-order multiples. Elective single embryo transfer (eSET) represented only 2.63 % of fresh transfers, with a delivery rate of 32.15% per transfer. Elective double embryo transfer (eDET) represented 23.74% of transfers, with a delivery rate of 41.03% per transfer. Among babies born during this period 11,373 (62.6%) were singletons; 6,398 (35.2%) twins, and 391 (2.2%), triplets and more. Given the effect of multiple births on prematurity, morbidity and perinatal mortality, reinforcing the existing trend of reducing the number of embryos transferred is mandatory PMID:28837023

  19. The personal lift-assist device and lifting technique: a principal component analysis.

    Science.gov (United States)

    Sadler, Erin M; Graham, Ryan B; Stevenson, Joan M

    2011-04-01

    The personal lift-assist device (PLAD) is a non-motorised, on-body device that acts as an external force generator using the concept of stored elastic energy. In this study, the effect of the PLAD on the lifting kinematics of male and female lifters was investigated using principal component analysis. Joint kinematic data of 15 males and 15 females were collected using an opto-electronic system during a freestyle, symmetrical-lifting protocol with and without wearing the PLAD. Of the 31 Principal Components (PCs) retained in the models, eight scores were significantly different between the PLAD and no-PLAD conditions. There were no main effects for gender and no significant interactions. Results indicated that the PLAD similarly affected the lifting kinematics of males and females; demonstrating significantly less lumbar and thoracic flexion and significantly greater hip and ankle flexion when wearing the PLAD. These findings add to the body of work that suggest the PLAD may be a safe and effective ergonomic aid. STATEMENT OF RELEVANCE: The PLAD is an ergonomic aid that has been shown to be effective at reducing low back demands during manual materials handling tasks. This body of work establishes that the PLAD encourages safe lifting practices without adversely affecting lifting technique.

  20. Dydrogesterone support following assisted reproductive technique (ART) reduces the risk of pre-eclampsia.

    Science.gov (United States)

    Ali, Anizah Bt; Ahmad, Mohd Faizal B; Kwang, Ng Beng; Shan, Lim Pei; Shafie, Nasir Mohamed; Omar, Mohd Hashim

    2016-09-01

    Pre-eclampsia (PE) contributes to poor maternal morbidity and mortality. Progesterone is hypothesised to reduce the risk of PE. To determine the effect of progestogen supplementation during assisted reproductive technique (ART) in reducing the incidence of PE. A retrospective comparative analysis among 1140 pregnancies between January 2006 and March 2015 conducted in a tertiary centre. A total of 570 pregnancies who conceived following ART with progesterone supplementation (study group) and an age-matched spontaneous pregnancies, without progesterone supplementation (control group, n=570) were included in the analysis. The study group received progesterone support following ART or intrauterine insemination (IUI) until 14-16 weeks' gestation. The rate of PE was significantly lower in the study group compared to control group (8.4% vs. 14.2%, p<0.05). Women supplemented with dydrogesterone only showed a lower PE incidence as compared to women received a combination of dydrogesterone and hydroxyprogesterone caproate, however, it was not statistically significant (6.9% vs. 9.9%; 6.9%; p=0.2).

  1. Sublimation-assisted graphene transfer technique based on small polyaromatic hydrocarbons

    Science.gov (United States)

    Chen, Mingguang; Stekovic, Dejan; Li, Wangxiang; Arkook, Bassim; Haddon, Robert C.; Bekyarova, Elena

    2017-06-01

    Advances in the chemical vapor deposition (CVD) growth of graphene have made this material a very attractive candidate for a number of applications including transparent conductors, electronics, optoeletronics, biomedical devices and energy storage. The CVD method requires transfer of graphene on a desired substrate and this is most commonly accomplished with polymers. The removal of polymer carriers is achieved with organic solvents or thermal treatment which makes this approach inappropriate for application to plastic thin films such as polyethylene terephthalate substrates. An ultraclean graphene transfer method under mild conditions is highly desired. In this article, we report a naphthalene-assisted graphene transfer technique which provides a reliable route to residue-free transfer of graphene to both hard and flexible substrates. The quality of the transferred graphene was characterized with atomic force microscopy, scanning electron microscopy, and Raman spectroscopy. Field effect transistors, based on the naphthalene-transfered graphene, were fabricated and characterized. This work has the potential to broaden the applications of CVD graphene in fields where ultraclean graphene and mild graphene transfer conditions are required.

  2. Use of ion-assisted techniques for determining the structure of TiO2 nanotubes

    Science.gov (United States)

    Renz, Renata P.; Vargas, André L. M.; Hübler, Roberto

    2015-12-01

    In recent years, several researchers have reported obtaining titanium dioxide nanotubes presenting a variety of advanced and functional properties for high-performance applications, e.g., for solar and fuel cells, gas sensor, self-cleaning and biomedical devices. Electrochemical oxidation of titanium has been widely used as a method for fabrication of self-organized titanium oxide nanotubes (TiO2 NTs), since it is a simple and inexpensive process, which allows a great control over the size and configuration of the formed structure. Normally, the morphological and structural characterizations are based on images from scanning or transmission electron microscopy. The use of characterization techniques assisted by energetic ion beams, such as RBS or MEIS, can simultaneously evaluate the composition and structural properties of the nanotubes. In this work, titanium oxide nanotubes were obtained by electrochemical oxidation of commercially pure titanium via constant-voltage experiments varying the growth time and the potential applied in order to access the formation dynamics of the NTs, including inner and outer diameters as function of the length, and the formation of the end lace type porous layer. The characterizations made by RBS were compared by analysis of top and cross-sectional FEG-SEM images demonstrating a good compromise between them.

  3. Preparation and Characterization of Amorphous B Powders by Salt-Assisted SHS Technique

    Directory of Open Access Journals (Sweden)

    Yujing Ou

    2015-01-01

    Full Text Available To use the salt-assisted SHS technique to prepare B powders was proposed. Calculation results found that the adiabatic combustion temperature of the B2O3-Mg reaction system was 2604 K, higher than the 1800 K criterion of self-propagating temperature, which meant that the SHS application was feasible. When 0, 10%, 20%, 30%, 40%, 50%, and 60% NaCl content were added, the adiabatic combustion temperature of the reaction system decreased linearly. When 60% NaCl content was added, the adiabatic combustion temperature was 1799 K (lower than 1800 K, unsuitable for self-propagating reaction, which was consistent with the experimental results. Through scanning electron microscope (SEM, energy disperse spectroscopy (EDS, and particle size analysis, the influence of different addition of NaCl on the morphology, average particle size, and purity of prepared B powder was investigated. EDS and chemical analysis indicated that the purity of prepared B powder was over 96% and the average particle size was within the range of 0.4~0.8 μm when the content of NaCl was 50%. The analysis of X-ray diffraction (XRD and selected area electron diffraction (SAED proved that the prepared B powder was amorphous.

  4. Evaluation of mitral valve replacement anchoring in a phantom

    Science.gov (United States)

    McLeod, A. Jonathan; Moore, John; Lang, Pencilla; Bainbridge, Dan; Campbell, Gordon; Jones, Doug L.; Guiraudon, Gerard M.; Peters, Terry M.

    2012-02-01

    Conventional mitral valve replacement requires a median sternotomy and cardio-pulmonary bypass with aortic crossclamping and is associated with significant mortality and morbidity which could be reduced by performing the procedure off-pump. Replacing the mitral valve in the closed, off-pump, beating heart requires extensive development and validation of surgical and imaging techniques. Image guidance systems and surgical access for off-pump mitral valve replacement have been previously developed, allowing the prosthetic valve to be safely introduced into the left atrium and inserted into the mitral annulus. The major remaining challenge is to design a method of securely anchoring the prosthetic valve inside the beating heart. The development of anchoring techniques has been hampered by the expense and difficulty in conducting large animal studies. In this paper, we demonstrate how prosthetic valve anchoring may be evaluated in a dynamic phantom. The phantom provides a consistent testing environment where pressure measurements and Doppler ultrasound can be used to monitor and assess the valve anchoring procedures, detecting pararvalvular leak when valve anchoring is inadequate. Minimally invasive anchoring techniques may be directly compared to the current gold standard of valves sutured under direct vision, providing a useful tool for the validation of new surgical instruments.

  5. Not all Anchors Weigh Equally.

    Science.gov (United States)

    Greenstein, Michael; Velazquez, Alexandra

    2017-11-01

    The anchoring bias is a reliable effect wherein a person's judgments are affected by initially presented information, but it is unknown specifically why this effect occurs. Research examining this bias suggests that elements of both numeric and semantic priming may be involved. To examine this, the present research used a phenomenon wherein people treat numeric information presented differently in Arabic numeral or verbal formats. We presented participants with one of many forms of an anchor that represented the same value (e.g., twelve hundred or 1,200). Thus, we could examine how a concept's meaning and its absolute numeric value affect anchoring. Experiments 1 and 2 showed that people respond to Arabic and verbal anchors differently. Experiment 3 showed that these differences occurred largely because people tend to think of numbers in digit format. This suggests that one's conceptual understanding of the anchored information matters more than its strict numeric value.

  6. Intelligent Educational Systems for Anchored Instruction?

    Science.gov (United States)

    Kumar, David D.

    1995-01-01

    Explores the potential for using Intelligent Educational Systems (IES) for anchoring instruction in macro contexts in science education. Topics include anchored instruction; situated cognition; problem solving; cognitivism; interactive video environments; and examples of combining IES and anchored instruction. (LRW)

  7. Oral contraceptive pill, progestogen or estrogen pre-treatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques (Review)

    NARCIS (Netherlands)

    Smulders, B.; Oirschot, S.M. van; Farquhar, C.; Rombauts, L.; Kremer, J.A.M.

    2010-01-01

    BACKGROUND: For many subfertile women, assisted reproductive techniques (ART) is the only hope for a pregnancy and live birth. The combined oral contraceptive pill (OCP) given prior to the hormone therapy in an IVF cycle may result in better pregnancy outcomes of ART. OBJECTIVES: To assess whether

  8. Au-controlled enhancement of photoluminescence of NiS nanostructures synthesized via a microwave-assisted hydrothermal technique

    CSIR Research Space (South Africa)

    Linganiso, EC

    2014-11-01

    Full Text Available Nickel sulphide (NiS) nanostructures decorated with gold (Au) nanoparticles (NPs) were synthesized via a microwave-assisted hydrothermal technique. Binary phase NiS (a and ß) crystalline nanostructures, bare, and decorated with Au NPs were obtained...

  9. Spectral Analysis of Surface Wave for Empirical Elastic Design of Anchored Foundations

    Directory of Open Access Journals (Sweden)

    S. E. Chen

    2012-01-01

    Full Text Available Helical anchors are vital support components for power transmission lines. Failure of a single anchor can lead to the loss of an entire transmission line structure which results in the loss of power for downstream community. Despite being important, it is not practical to use conventional borehole method of subsurface exploration, which is labor intensive and costly, for estimating soil properties and anchor holding capacity. This paper describes the use of an empirical and elasticity-based design technique coupled with the spectral analysis of surface wave (SASW technique to provide subsurface information for anchor foundation designs. Based on small-strain wave propagation, SASW determines shear wave velocity profile which is then correlated to anchor holding capacity. A pilot project involving over 400 anchor installations has been performed and demonstrated that such technique is reliable and can be implemented into transmission line structure designs.

  10. Assisted reproduction techniques in Latin America: the Latin American Registry, 2014.

    Science.gov (United States)

    Zegers-Hochschild, Fernando; Schwarze, Juan Enrique; Crosby, Javier; Musri, Carolina; Urbina, Maria Teresa

    2017-09-01

    Multinational data on assisted reproduction techniques (IVF and intractytoplasmic sperm injection [ICSI], frozen embryo transfer, oocyte donation, preimplantation genetic diagnosis and fertility preservation) were collected from 159 institutions in 15 Latin American countries. A total of 41.34% of IVF-ICSI cycles were conducted in women aged 35-39 years and 23.35% in women aged 40 years and older. After removing freeze-all cases, delivery rate per oocyte retrieval was 25.05% for ICSI and 27.41% for IVF. Multiple births included 20.78% twins and 0.92% triplets and over. In oocyte donation, twins reached 28.93% and triplets 1.07%. Preterm deliveries reached 16.4% in singletons, 55.02% in twins and 76% in triplets. Perinatal mortality in 18,162 births was 23 per 1000 in singletons, 35 per 1000 in twins, and 36 per 1000 in high-order multiples. Elective single embryo transfer represented 2.63% of fresh transfers, with a 32.15% delivery rate per transfer. Elective double embryo transfer represented 23.74% of transfers, with a 41.03% delivery rate per transfer; 11,373 babies (62.6%) were singletons; 6398 (35.2%) twins, and 391 (2.2%), triplets and more. Given the effect of multiple births on prematurity, morbidity and perinatal mortality, reinforcing the existing trend of reducing the number of embryos transferred is mandatory. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  11. Robotic-assisted resection of liver and diaphragm recurrent ovarian carcinoma: description of technique.

    Science.gov (United States)

    Holloway, Robert W; Brudie, Lorna A; Rakowski, Joseph A; Ahmad, Sarfraz

    2011-03-01

    To describe port placement and operative technique for resection of right hepatic and full-thickness diaphragm metastatic ovarian carcinoma in a patient with recurrent disease using the da Vinci® Surgical System. A 60-year-old female with recurrent platinum sensitive ovarian cancer presented with disease confined to the liver by PET-CT scan. The lesion measured 3.4 cm on the dome of the right hepatic lobe. After two attempts at intra-hepatic arterial chemo-embolization the lesion remained stable. She subsequently agreed to robotic-assisted resection of the right lobe liver mass after refusing laparotomy for 9 months. Pnuemoperitoneum was established in the left upper quadrant by directly inserting a 5-mm laparoscope. There were no midline adhesions. The 12-mm camera port was placed in the midclavicular line on the right 10 cm off the costal margin with the right and left operative arms 10 cm from the camera near the costal margin, and the third arm in the right flank. The robot was docked from the right shoulder. Resection was accomplished with a monopolar spatula in the right, fenestrated bipolar grasper in the left, and double fenestrated grasper in the third operative arm. Adhesions between diaphragm and liver were separated, the liver lesion was excised, the diaphragm lesion was resected full thickness, and diaphragm was closed with running prolene. Surgicel® was placed on the liver for hemostasis. Console time was 82 min and the patient discharged on day-5 after drainage of a cytology negative pleural effusion day-4. Robotic resection of liver and full-thickness diaphragm lesions is possible. The port placement used in this patient was efficient and without operative arm collisions. Patients with isolated upper-abdominal recurrence are candidates for robotic secondary cytoreduction. Copyright © 2010 Elsevier Inc. All rights reserved.

  12. Microwave-assisted chemical insertion: a rapid technique for screening cathodes for Mg-ion batteries

    Energy Technology Data Exchange (ETDEWEB)

    Kaveevivitchai, Watchareeya; Huq, Ashfia; Manthiram, Arumugam

    2016-12-19

    We report an ultrafast microwave-assisted solvothermal method for chemical insertion of Mg2+ ions into host materials using magnesium acetate [Mg(CH3COO)2] as a metal-ion source and diethylene glycol (DEG) as a reducing agent. For instance, up to 3 Mg ions per formula unit of a microporous host framework Mo2.5+yVO9+z could be inserted in as little as 30 min at 170–195 °C in air. This process is superior to the traditional method which involves the use of organometallic reagents, such as di-n-butylmagnesium [(C4H9)2Mg] and magnesium bis(2,6-di-tert-butylphenoxide) [Mg-(O-2,6-But2C6H3)2], and requires an inert atmosphere with extremely long reaction times. Considering the lack of robust electrolytes for Mg-ion batteries, this facile approach can be readily used as a rapid screening technique to identify potential Mg-ion electrode hosts without the necessity of fabricating electrodes and assembling electrochemical cells. Due to the mild reaction conditions, the overall structure and morphology of the Mg-ion inserted products are maintained and the compounds can be used successfully as a cathode in Mg-ion batteries. The combined synchrotron X-ray and neutron diffraction Rietveld analysis reveals the structure of the Mg-inserted compounds and gives an insight into the interactions between the Mg ions and the open-tunnel host framework.

  13. A Methylene Blue–assisted Technique for Harvesting Lymph Nodes After Radical Surgery for Gastric Cancer

    Science.gov (United States)

    Aoyama, Toru; Fujikawa, Hirohito; Cho, Haruhiko; Ogata, Takashi; Shirai, Junya; Hayashi, Tsutomu; Rino, Yasushi; Masuda, Munetaka; Oba, Mari S.; Morita, Satoshi

    2015-01-01

    Harvesting lymph nodes (LNs) after gastrectomy is essential for accurate staging. This trial evaluated the efficiency and quality of a conventional method and a methylene blue–assisted method in a randomized manner. The key eligibility criteria were as follows: (i) histologically proven adenocarcinoma of the stomach; (ii) clinical stage I-III; (iii) R0 resection planned by gastrectomy with D1+ or D2 lymphadenectomy. The primary endpoint was the ratio of the pathologic number of harvested LNs per time (minutes) as an efficacy measure. The secondary endpoint was the number of harvested LNs, as a quality measure. Between August 2012 and December 2012, 60 patients were assigned to undergo treatment using the conventional method (n=29) and the methylene blue dye method (n=31). The baseline demographics were mostly well balanced between the 2 groups. The number of harvested LNs (mean±SD) was 33.6±11.9 in the conventional arm and 43.4±13.9 in the methylene blue arm (P=0.005). The ratio of the number of the harvested LNs per time was 1.12±0.46 LNs/min in the conventional arm and 1.49±0.59 LNs/min in the methylene blue arm (P=0.010). In the subgroup analyses, the quality and efficacy were both superior for the methylene blue dye method compared with the conventional method. The methylene blue technique is recommended for harvesting LNs during gastric cancer surgery on the basis of both the quality and efficacy. PMID:25356528

  14. Innovations and techniques for balloon-enteroscope-assisted endoscopic retrograde cholangiopancreatography in patients with altered gastrointestinal anatomy

    Science.gov (United States)

    Yamauchi, Hiroshi; Kida, Mitsuhiro; Imaizumi, Hiroshi; Okuwaki, Kosuke; Miyazawa, Shiro; Iwai, Tomohisa; Koizumi, Wasaburo

    2015-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) remains challenging in patients who have undergone surgical reconstruction of the intestine. Recently, many studies have reported that balloon-enteroscope-assisted ERCP (BEA-ERCP) is a safe and effective procedure. However, further improvements in outcomes and the development of simplified procedures are required. Percutaneous treatment, Laparoscopy-assisted ERCP, endoscopic ultrasound-guided anterograde intervention, and open surgery are effective treatments. However, treatment should be noninvasive, effective, and safe. We believe that these procedures should be performed only in difficult-to-treat patients because of many potential complications. BEA-ERCP still requires high expertise-level techniques and is far from a routinely performed procedure. Various techniques have been proposed to facilitate scope insertion (insertion with percutaneous transhepatic biliary drainage (PTBD) rendezvous technique, Short type single-balloon enteroscopes with passive bending section, Intraluminal injection of indigo carmine, CO2 inflation guidance), cannulation (PTBD or percutaneous transgallbladder drainage rendezvous technique, Dilation using screw drill, Rendezvous technique combining DBE with a cholangioscope, endoscopic ultrasound-guided rendezvous technique), and treatment (overtube-assisted technique, Short type balloon enteroscopes) during BEA-ERCP. The use of these techniques may allow treatment to be performed by BEA-ERCP in many patients. A standard procedure for ERCP yet to be established for patients with a reconstructed intestine. At present, BEA-ERCP is considered the safest and most effective procedure and is therefore likely to be recommended as first-line treatment. In this article, we discuss the current status of BEA-ERCP in patients with surgically altered gastrointestinal anatomy. PMID:26074685

  15. Modified Anchor Shaped Post Core Design for Primary Anterior Teeth

    Directory of Open Access Journals (Sweden)

    R. Rajesh

    2014-01-01

    Full Text Available Restoring severely damaged primary anterior teeth is challenging to pedodontist. Many materials are tried as a post core but each one of them has its own drawbacks. This a case report describing a technique to restore severely damaged primary anterior teeth with a modified anchor shaped post. This technique is not only simple and inexpensive but also produces better retention.

  16. Robotic Ankle for Omnidirectional Rock Anchors

    Science.gov (United States)

    Parness, Aaron; Frost, Matthew; Thatte, Nitish

    2013-01-01

    Future robotic exploration of near-Earth asteroids and the vertical and inverted rock walls of lava caves and cliff faces on Mars and other planetary bodies would require a method of gripping their rocky surfaces to allow mobility without gravitational assistance. In order to successfully navigate this terrain and drill for samples, the grippers must be able to produce anchoring forces in excess of 100 N. Additionally, the grippers must be able to support the inertial forces of a moving robot, as well gravitational forces for demonstrations on Earth. One possible solution would be to use microspine arrays to anchor to rock surfaces and provide the necessary load-bearing abilities for robotic exploration of asteroids. Microspine arrays comprise dozens of small steel hooks supported on individual suspensions. When these arrays are dragged along a rock surface, the steel hooks engage with asperities and holes on the surface. The suspensions allow for individual hooks to engage with asperities while the remaining hooks continue to drag along the surface. This ensures that the maximum possible number of hooks engage with the surface, thereby increasing the load-bearing abilities of the gripper. Using the microspine array grippers described above as the end-effectors of a robot would allow it to traverse terrain previously unreachable by traditional wheeled robots. Furthermore, microspine-gripping robots that can perch on cliffs or rocky walls could enable a new class of persistent surveillance devices for military applications. In order to interface these microspine grippers with a legged robot, an ankle is needed that can robotically actuate the gripper, as well as allow it to conform to the large-scale irregularities in the rock. The anchor serves three main purposes: deploy and release the anchor, conform to roughness or misalignment with the surface, and cancel out any moments about the anchor that could cause unintentional detachment. The ankle design contains a

  17. Career anchors of dentist leaders

    OpenAIRE

    Tuononen Tiina; Lammintakanen Johanna; Suominen Anna Liisa

    2016-01-01

    Objective: The work of a health care leader is demanding; in order to cope, leaders need motivation and support. The occurrence of intrinsic factors called career anchors (combination of one’s competence, motives and values) could be a contributing factor in dentist leaders’ career decisions. The aim of our study was to identify dentist leaders’ career anchors and their association to dentist leaders’ retention or turnover of the leadership position. Material and methods: Materials were g...

  18. The Holding Power of Anchors

    Indian Academy of Sciences (India)

    The essential principle in the action of all anchors is that a surface set at an acute angle to the ground will dig in if pulled horizontally. In order that an anchor may function properly it must satisfy two conditions. The first is that in whatever position it may fall as it strikes the sea floor, it must begin to dig in as soon as the pull ...

  19. 77 FR 65496 - Commercial Acquisition; Anchor Tenancy

    Science.gov (United States)

    2012-10-29

    ... SPACE ADMINISTRATION 48 CFR Part 1812 RIN 2700-AD64 Commercial Acquisition; Anchor Tenancy AGENCY... limited conditions, to issue Anchor Tenancy contracts. Anchor Tenancy means ``an arrangement in which the... inaccurate prohibition on anchor tenancy contracts. The prohibition is included in the NFS based on The Space...

  20. [Incidence and management of monozygotic twin conceived by assisted reproductive techniques].

    Science.gov (United States)

    Mo, Lijing; Jin, Congcong; Wu, Yonggen; Wang, Peiyu; Lin, Jia; Zhao, Junzhao

    2015-08-01

    To analysis the incidence and management of monozygotic twin (MZT) conceived by assisted reproductive techniques (ART). A retrospective analysis of clinical pregnancies and MZT that resulted from ART was performed in Reproductive Medical Center, the First Affiliated Hospital, Wenzhou Medical University between January 2011 and January 2014. A total of 5 908 pregnancies were diagnosed: 2 012 twins, 157 high-order multiple pregnancy (HOMP), including 4 quadruplets. Overall, 51 MZT pregnancies were identified of them including 32 cases HOMP and 19 cases MZT. The incidence of MZT resulting from cleavage-stage embryo transfer was similar to blastocyst transfer (P = 0.960). The percent of MZT resulting from in vitro fertilization [0.93% (28/3 022)], frozen-thawed embryo transfer [0.87% (13/1 502)] and intracytoplamic sperm injection [0.72% (10/1 384)] did not show statistical significance (P = 0.794). The expectantly managed MZT was associated with a significantly greater likelihood of miscarriage [6/19 vs 5.11% (101/1 976)], and low birth weight infant [73.91% (17/23) vs 42.89% (1 453/3 388), P < 0.01], when compared with dizygotic twin (DZT) did not undergo selective embryo reduction (SER). In monozygotic (MZ)-triplets with SER to 2 fetuses or to 1 fetus, there was no cases of preterm birth or low birth weight infant observed in MZ-triplets with SER to 1 fetus; when compared with MZ-triplets with SER to 2 fetuses, the low birth weight infant [56.00% (14/25), P = 0.021] has statistical significance. The likelihood of the survival of two babies was lower in MZ-triplets with SER to 2 fetuses when compared with non-MZ triplets with SER to 2 fetuses [42.86% (9/21) vs 75.21% (91/121), P = 0.003]. The incidence of MZT pregnancies following ART is high. It plays a significant role in the occurrence of HOMP. MZT pregnancies are at an increased risk of adverse outcomes, it should transform to a single embryo thansfer (SET) program to reduce them incideuce. Reduction of MZT

  1. Comparison of Two Embryo Scoring Systems for Prediction of Outcome in Assisted Reproductive Techniques Cycles

    Directory of Open Access Journals (Sweden)

    Navid Fotoohi Ghiam

    2011-12-01

    Full Text Available Cumulative embryo score (CES is one of the many embryo scoring methods which have been developed to help clinicians to transfer high quality embryos and predict pregnancy rate in assisted reproductive techniques (ART cycles. Regarding the existing difference in CES calculation this study was done to compare two methods in order to determine the more practical and preferable one. In a retrospective, cross sectional descriptive analytical study, a total of 508 ART cycles in infertile patients treated from November 2002 until March 2004, were evaluated using two methods of CES calculation in embryonic scoring to predict ART outcome. According to one method, CES was obtained by adding the individual scores of all transferred embryos. Whereas in the other reference method, CES was calculated by the sum of each embryo score multiplied by its number of blastomeres on the day of transfer. The mean score of transferred embryos (MSTE was referred to CES divided by the total number of embryos transferred in either method. A total of 109 clinical pregnancies (pregnancy rate 21.5% including 96 singletons, 10 twins and triplets occurred in the 508 ART cycles. The pregnancy rate was strongly correlated to CES & MSTE. According to one method, CES was 12.6±6.4 in pregnant versus 9.2±5.8 in non-pregnant group (P<0.0001. According to the other one, in the pregnant group CES was 86.7±48 versus 68.7±55 in the non-pregnant group (P<0.002. Both methods showed a significant difference. Regarding MSTE, using the first method, in the pregnant group it was 3±0.6 versus 2.8±0.7 in the non-pregnant group (P<0.011 whereas with the other approach it was 21.3±8.6 in the pregnant group versus 19.9±9.07 in non-pregnant (P<0.152 showing that the first method can also predict pregnancy outcome with MSTE. Considering that both MSTE and CES in the first method can significantly predict outcome in ART cycles, it seems this method is preferable and more useful in practice

  2. Psychological adjustment in adolescents conceived by assisted reproduction techniques: a systematic review.

    Science.gov (United States)

    Ilioi, Elena Cristiana; Golombok, Susan

    2015-01-01

    Adolescence is a transitional time for identity formation and relationships with parents. While people born through assisted reproduction techniques (ART) appear to be well adjusted in childhood, it is unclear whether these findings carry into adolescence, and whether diverse ART have different psychological outcomes. This review summarizes what is known about the psychological adjustment and family relationships of the growing number of children born through ART who are reaching adolescence. The Pubmed, Web of Knowledge, PsycINFO and Scopus databases were searched systematically for peer reviewed papers focusing on adolescent psychological adjustment and parent-adolescent relationships in families created by ART. Key search inclusion criteria included all papers published in English relating to adolescents aged between 11 and 18 years. Seventeen publications with varied methodologies were identified by this review. Only papers relating to in vitro fertilization (IVF), egg donation and donor insemination were identified. Results were categorized according to ART that used the parents' own gametes (IVF) and those that involved reproductive donation (egg donation, and donor insemination). Compared with naturally conceived adolescents and standardized normative samples, adolescents born through all ARTs seemed to be equally well adjusted, and to have positive parent-adolescent relationships. Some differences were however identified based on the type of ART used. In particular, the sex of the parent and child, along with age and process of disclosure of the adolescent's conception were identified as key mediators of parent-adolescent relationships in families created by donor insemination. The studies in this review indicate that children born through ART have positive parent-adolescent relationships and are well adjusted, with some slight differences based on different ART. The generalizability of findings may be limited by the general low level of disclosure to

  3. Psychological adjustment in adolescents conceived by assisted reproduction techniques: a systematic review

    Science.gov (United States)

    Ilioi, Elena Cristiana; Golombok, Susan

    2015-01-01

    BACKGROUND Adolescence is a transitional time for identity formation and relationships with parents. While people born through assisted reproduction techniques (ART) appear to be well adjusted in childhood, it is unclear whether these findings carry into adolescence, and whether diverse ART have different psychological outcomes. This review summarizes what is known about the psychological adjustment and family relationships of the growing number of children born through ART who are reaching adolescence. METHODS The Pubmed, Web of Knowledge, PsycINFO and Scopus databases were searched systematically for peer reviewed papers focusing on adolescent psychological adjustment and parent–adolescent relationships in families created by ART. Key search inclusion criteria included all papers published in English relating to adolescents aged between 11 and 18 years. RESULTS Seventeen publications with varied methodologies were identified by this review. Only papers relating to in vitro fertilization (IVF), egg donation and donor insemination were identified. Results were categorized according to ART that used the parents' own gametes (IVF) and those that involved reproductive donation (egg donation, and donor insemination). Compared with naturally conceived adolescents and standardized normative samples, adolescents born through all ARTs seemed to be equally well adjusted, and to have positive parent–adolescent relationships. Some differences were however identified based on the type of ART used. In particular, the sex of the parent and child, along with age and process of disclosure of the adolescent's conception were identified as key mediators of parent–adolescent relationships in families created by donor insemination. CONCLUSIONS The studies in this review indicate that children born through ART have positive parent–adolescent relationships and are well adjusted, with some slight differences based on different ART. The generalizability of findings may be limited

  4. Ultrasound-assisted powder-coating technique to improve content uniformity of low-dose solid dosage forms

    DEFF Research Database (Denmark)

    Genina, Natalja; Räikkönen, Heikki; Antikainen, Osmo

    2010-01-01

    tabletting process, whereas the physical mixture of the powders was subject to segregation. In conclusion, the ultrasound-assisted technique presented here is an effective tool for homogeneous drug coating of powders of irregular particle shape and broad particle size distribution, improving content......An ultrasound-assisted powder-coating technique was used to produce a homogeneous powder formulation of a low-dose active pharmaceutical ingredient (API). The powdered particles of microcrystalline cellulose (MCC; Avicel® PH-200) were coated with a 4% m/V aqueous solution of riboflavin sodium...... of the drug content. The tablets (n = 950) prepared from the coated powder showed significantly improved weight and content uniformity in comparison with the reference tablets compressed from a physical binary powder mixture. This was due to the coated formulation remaining uniform during the entire...

  5. Fabrication of concave refractive microlens arrays in solgel glass by a simple proximity-effect-assisted reflow technique

    Science.gov (United States)

    He, Miao; Yuan, Xiaocong; Bu, Jing; Cheong, Wai Chye

    2004-05-01

    We report a simple method for fabricating a concave refractive microlens array (MLA) in solgel glass by using a proximity-effect-assisted reflow technique. The solgel concave refractive MLA that we fabricated had excellent surface smoothness; good dimensional conformity, with an 8.23% nonuniformity of the microlens elements; and structural perfection, with a biggest deviation of 1% from a perfect concave spherical crown. The relative error between the measured and the designed values of the concave MLA's focal length was only 1.83%. Compared with the conventional fabrication techniques for concave MLAs, the proposed method has significant advantages including simplicity, low cost, good element conformity, and smooth device surface.

  6. Temperature measurement of plasma-assisted flames: comparison between optical emission spectroscopy and 2-color laser induced fluorescence techniques

    KAUST Repository

    Lacoste, Deanna A.

    2015-03-30

    Accurate thermometry of highly reactive environments, such as plasma-assisted combustion, is challenging. With the help of conical laminar premixed methane-air flames, this study compares two thermometry techniques for the temperature determination in a combustion front enhanced by nanosecond repetitively pulsed (NRP) plasma discharges. Based on emission spectroscopic analysis, the results show that the rotational temperature of CH(A) gives a reasonable estimate for the adiabatic flame temperature, only for lean and stoichiometric conditions. The rotational temperature of N2(C) is found to significantly underestimate the flame temperature. The 2-color OH-PLIF technique gives correct values of the flame temperature.

  7. A new concept of assistive virtual keyboards based on a systematic review of text entry optimization techniques

    Directory of Open Access Journals (Sweden)

    Renato de Sousa Gomide

    Full Text Available Abstract Introduction: Due to the increasing popularization of computers and the internet expansion, Alternative and Augmentative Communication technologies have been employed to restore the ability to communicate of people with aphasia and tetraplegia. Virtual keyboards are one of the most primitive mechanisms for alternatively entering text and play a very important role in accomplishing this task. However, the text entry for this kind of keyboard is much slower than entering information through their physical counterparts. Many techniques and layouts have been proposed to improve the typing performance of virtual keyboards, each one concerning a different issue or solving a specific problem. However, not all of them are suitable to assist seriously people with motor impairment. Methods: In order to develop an assistive virtual keyboard with improved typing performance, we performed a systematic review on scientific databases. Results: We found 250 related papers and 52 of them were selected to compose. After that, we identified eight essentials virtual keyboard features, five methods to optimize data entry performance and five metrics to assess typing performance. Conclusion: Based on this review, we introduce a concept of an assistive, optimized, compact and adaptive virtual keyboard that gathers a set of suitable techniques such as: a new ambiguous keyboard layout, disambiguation algorithms, dynamic scan techniques, static text prediction of letters and words and, finally, the use of phonetic and similarity algorithms to reduce the user's typing error rate.

  8. Scapholunate ligament reconstruction using the palmaris longus tendon and suture anchor fixation in chronic scapholunate instability

    Directory of Open Access Journals (Sweden)

    Maulik Jagdish Gandhi

    2016-01-01

    Conclusion: This technique avoids the use of drill holes to weave tendon through bone, uses an easy to access graft, and exploits the superior pullout strength of anchors while offering satisfactory functional outcomes that are comparable to alternative tenodesis techniques.

  9. High-Quality Large-Magnification Polymer Lens from Needle Moving Technique and Thermal Assisted Moldless Fabrication Process.

    Science.gov (United States)

    Amarit, Ratthasart; Kopwitthaya, Atcha; Pongsoon, Prasit; Jarujareet, Ungkarn; Chaitavon, Kosom; Porntheeraphat, Supanit; Sumriddetchkajorn, Sarun; Koanantakool, Thaweesak

    2016-01-01

    The need of mobile microscope is escalating as well as the demand of high quality optical components in low price. We report here a novel needle moving technique to fabricate milli-size lens together with thermal assist moldless method. Our proposed protocol is able to create a high tensile strength structure of the lens and its base which is beneficial for exploiting in convertinga smart phone to be a digital microscope. We observe that no bubble trapped in a lens when this technique is performed which can overcome a challenge problem found in a typical dropping technique. We demonstrate the symmetry, smoothness and micron-scale resolution of the fabricated structure. This proposed technique is promising to serve as high quality control mass production without any expensive equipment required.

  10. High-Quality Large-Magnification Polymer Lens from Needle Moving Technique and Thermal Assisted Moldless Fabrication Process.

    Directory of Open Access Journals (Sweden)

    Ratthasart Amarit

    Full Text Available The need of mobile microscope is escalating as well as the demand of high quality optical components in low price. We report here a novel needle moving technique to fabricate milli-size lens together with thermal assist moldless method. Our proposed protocol is able to create a high tensile strength structure of the lens and its base which is beneficial for exploiting in convertinga smart phone to be a digital microscope. We observe that no bubble trapped in a lens when this technique is performed which can overcome a challenge problem found in a typical dropping technique. We demonstrate the symmetry, smoothness and micron-scale resolution of the fabricated structure. This proposed technique is promising to serve as high quality control mass production without any expensive equipment required.

  11. Arthroscopic Transtendinous Biceps Tenodesis With All-Suture Anchor.

    Science.gov (United States)

    Shih, Chien-An; Chiang, Florence L; Hong, Chih-Kai; Lin, Cheng-Wei; Wang, Ping-Hui; Jou, I-Ming; Su, Wei-Ren

    2017-06-01

    There are several methods for long head of the biceps (LHB) tenodesis, yet the optimal option is still debatable. Here we introduce a technique for arthroscopic suprapectoral biceps tenodesis with an all-suture anchor, the transtendinous biceps tenodesis technique. The LHB tenodesis is performed by using the Y-Knot anchor (1.3-mm). A standard suprapectoral approach is used for the tenodesis. A 1.3-mm drill bit is used to drill through the midportion of the biceps tendon and underlying bone to make a pilot hole. Next, the Y-Knot anchor is passed through the tendon and anchored on the underlying bone. A wrapping suture technique is then used to wrap around, tension, and secure the LHB tendon with the aid of a shuttling polydioxanone suture. The construct is fixed by tying down both suture limbs in a nonsliding fashion. This Technical Note describes an alternative method for all-arthroscopic suprapectoral biceps tenodesis using an all-suture anchor with a small diameter to minimize trauma to the tendon.

  12. A reusable suture anchor for arthroscopy psychomotor skills training.

    Science.gov (United States)

    Tillett, Edward D; Rogers, Rainie; Nyland, John

    2003-03-01

    For residents to adequately develop the early arthroscopy psychomotor skills required to better learn how to manage the improvisational situations they will encounter during actual patient cases, they need to experience sufficient practice repetitions within a contextually relevant environment. Unfortunately, the cost of suture anchors can be a practice repetition-limiting factor in learning arthroscopic knot-tying techniques. We describe a technique for creating inexpensive reusable suture anchors and provide an example of their application to repair the anterior glenoid labrum during an arthroscopy psychomotor skills laboratory training session.

  13. Cannula-Assisted Flap Elevation (CAFE): a novel technique for developing flaps during skin-sparing mastectomies.

    Science.gov (United States)

    Grant, Michael D

    2015-02-01

    One of the most challenging procedures in breast surgery is the skin-sparing mastectomy (SSM). Various techniques and incisions have evolved that characterize this procedure; however, what is common in all of them is the smaller the incision, the more difficult it is to develop the skin flaps. A procedure was developed that incorporates the use of liposuction cannulas (without suction) to create the skin flaps. The technique and results are described in this manuscript. From October of 2012 to April 2014, 289 mastectomies (171 patients) were performed using the CAFE procedure on women of all shapes and sizes. Postoperatively, no problems were experienced with flap viability using this technique. The main difference in side effects between the CAFE technique and other standard techniques for developing flaps in SSMs was more bruising than normal, but this resolved rapidly. The results for use of this technique were consistently impressive. The learning curve for this procedure is very short, especially for those who perform SSMs using sharp technique (scissors). Residents and fellows became proficient with the CAFE technique in a relatively short amount of time. Plastic surgeons were pleased with the cosmetic outcomes of their reconstructions that follow this type of mastectomy. Patients were extremely satisfied with their reconstructions as well. Incorporating the use of liposuction cannulas (without suction) makes the creation of flaps for SSM a relatively simple and rapid method. It is especially useful to assist in developing skin flaps with even the smallest of skin incisions.

  14. TREATMENT OF OSTEOCHONDRAL LESIONS OF THE TALUS BY MEANS OF THEARTHROSCOPY-ASSISTED MICROPERFORATION TECHNIQUE

    Science.gov (United States)

    de Lima, Everton; de Queiroz, Felipe; Lopes, Osmar Valadão; Spinelli, Leandro de Freitas

    2015-01-01

    Objective: To evaluate patients affected by osteochondral fractures of the talus who were treated surgically by means of arthroscopy-assisted microperforation. Methods: A retrospective study was carried out on 24 patients with osteochondral lesions of the talus who underwent microperforation assisted by videoarthroscopy of the ankle. They were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) score system before and after the operation. Results: There were 19 men and 5 women, with a mean age of 35.3 years (minimum of 17 years and maximum of 54 years). The minimum follow-up was two years (maximum of 39 months). All the patients showed an improvement in AOFAS score after surgery, with an average improvement of around 22.5 points. Conclusion: Videoarthroscopy-assisted microperforation is a good option for treating osteochondral lesions of the talus and provides good functional results. PMID:27027076

  15. Interference-Assisted Techniques for Transmission and Multiple Access in Optical Communications

    Science.gov (United States)

    Guan, Xun

    communication (VLC) by adopting PNC, with a newly proposed phase-aligning method. PNC could improve the throughput at the bottlenecking relay node in a VLC system, and the proposed phase aligning method can improve the BER performance. The second part of this thesis discusses another interference-assisted technology in communication, that is, non-orthogonal multiple access (NOMA). NOMA multiplexes signals from multiple users in another dimension: power domain, with a non-orthogonal multiplexing in other dimensions such as time, frequency and code. Three schemes are proposed in this part. The first and the second schemes both realize NOMA in VLC, with different multiuser detection (MUD) techniques and a proposed phase pre-distortion method. Although both can decrease the system BER compared to conventional NOMA, the scheme using joint detection (JD) outperforms the one using successive interference cancellation (SIC). The third scheme investigated in this part is a combination of NOMA and a multicarrier precoding (MP) technology based on an orthogonal circulant transform matrix (OCT). This combination can avoid the complicated adaptive bit loading or electronic equalization, making NOMA more attractive in a practical system.

  16. Techniques and Recommendations for the Inclusion of Users with Autism in the Design of Assistive Technologies

    Science.gov (United States)

    Francis, Peter; Mellor, David; Firth, Lucy

    2009-01-01

    The increasing numbers of technology platforms offer opportunities to develop new visual assistive aids for people with autism. However, their involvement in the design of such aids is critical to their short-term uptake and longer term use. Using a three-round Delphi study involving seven Australian psychologists specializing in treating people…

  17. Robot-assisted minimally invasive distal pancreatectomy is superior to the laparoscopic technique.

    Science.gov (United States)

    Daouadi, Mustapha; Zureikat, Amer H; Zenati, Mazen S; Choudry, Haroon; Tsung, Alan; Bartlett, David L; Hughes, Steven J; Lee, Ken K; Moser, A James; Zeh, Herbert J

    2013-01-01

    Laparoscopic distal pancreatectomy (LDP) reduces postoperative morbidity, hospital stay, and recovery as compared with open distal pancreatectomy. Technical limitations of laparoscopic surgery may limit patient eligibility and require conversion to open or hand-assisted surgery to maintain patient safety. We hypothesized that robot-assisted distal pancreatectomy (RADP) was superior to LDP as a result of improved surgical manipulation and visualization, potentially expanding the indications for minimally invasive pancreatectomy. We performed a retrospective analysis of all minimally invasive distal pancreatectomies at University of Pittsburgh Medical Center between January 2004 and February 2011. We compared the perioperative outcomes, 90-day morbidity and mortality of our first 30 RADPs to 94 consecutive historical control LDPs. Patients undergoing RADP and LDP demonstrated equivalent age, sex, race, American Society of Anesthesiologists' score, and tumor size. Postoperative length of hospital stay and rates of pancreatic fistula, blood transfusion, and readmission were not statistically different. Patients in the RADP group did not require conversion to open surgery unlike the LDP group (16%, P robotically (43%) than laparoscopically (15%) (P robotic-assisted group with higher rates of margin negative resection and improved lymph node yield for both benign and malignant lesions (P probability of malignancy in the robotic cohort. We concluded that robotic assistance may broaden indications for minimally invasive pancreatectomy.

  18. Pediatric Robot-assisted Redo Pyeloplasty With Buccal Mucosa Graft: A Novel Technique.

    Science.gov (United States)

    Ahn, Jennifer J; Shapiro, Michael E; Ellison, Jonathan S; Lendvay, Thomas S

    2017-03-01

    To report a novel approach of pediatric robot-assisted redo pyeloplasty with buccal mucosa graft (BMG). An Institutional Review Board-approved retrospective review of all patients undergoing robot-assisted redo pyeloplasty with BMG at our institution was performed. For all patients, the following ports were used: one 8.5 mm camera, two 8 mm robotic, and one 5 mm assistant. Initial dissection was performed laparoscopically and robotically, and the ureter was incised longitudinally along the anterior surface. The robot was undocked, and BMG was harvested from the inner cheek. The robot was then redocked, and grafts were delivered via the 8 mm robotic port and anastomosed as anterior onlay grafts using 5-0 or 6-0 absorbable monofilament suture. Omentum was quilted over the graft as a vascular backing. Ureteral stents were placed intraoperatively and left in situ for 8 weeks. Foley catheters were removed on postoperative day 3. All patients received intravenous ampicillin and gentamicin preoperatively, with antibiotics discontinued within 24 hours. Three patients underwent robot-assisted redo pyeloplasty with BMG. Patient characteristics are seen in Table 1. Mean number of prior surgeries for ureteropelvic junction obstruction repair was 2 (1-3), and mean length of stricture was 4.3 cm (2.5-6). At a median follow-up of 10 months (5-26), all patients are asymptomatic with stable or improved ultrasound. Robot-assisted redo pyeloplasty with BMG is safe and feasible in the pediatric population. Long-term follow-up is needed to determine the durability of these grafts. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. [Effect of abrasion on three types of sutures in a metallic anchor].

    Science.gov (United States)

    Acosta Rodríguez, Eduardo; Almazán Díaz, Arturo

    2007-01-01

    It is necessary to slide the suture into the articulation in the arthroscopic techniques, this produce friction and abrasion of the suture, this is the principal cause of failure in the union of anchor-suture. We used a Fastak 2.4 anchor, Sawbones, No 2 Ethibond, No 2 Fiberwire and No 2 Herculine. Each suture was introduce to the anchor eyelet and was cycled in four times with 40N. The angles of traction were 0 degrees and 45 degrees at the same direction of the anchor eyelet and 45 degrees with different direction of the anchor eyelet. Five sutures were used in every test. We performed the Kolmogorov-Smirnof and "t" Student tests. In all the tests there were a significant differences. The strength of the suture is affected by the abrasion in the anchor eyelet.

  20. Long-term outcomes for different vaginal cuff closure techniques in robotic-assisted laparoscopic hysterectomy: A randomized controlled trial.

    Science.gov (United States)

    Tsafrir, Ziv; Palmer, Matthew; Dahlman, Marisa; Nawfal, A Karim; Aoun, Joelle; Taylor, Andrew; Fisher, Jay; Theoharis, Evan; Eisenstein, David

    2017-03-01

    This randomized controlled trial aimed to evaluate the outcomes of different vaginal cuff closure techniques in robotic-assisted total laparoscopic hysterectomy. Ninety women undergoing robotic-assisted total laparoscopic hysterectomy for benign disease were randomized to three vaginal cuff closure techniques: running 2.0 V-Lock™ (Arm 1), 0 Vicryl™ figure-of-eight (Arm 2), and running 0 Vicryl™ with Lapra-Ty(®) (Arm 3). Patients' records were reviewed for age, body mass index, smoking status and relevant co-morbidities. Operative times for vaginal closure and total length of surgery, estimated blood loss, and peri-operative complications were collected. Patients were evaluated at 2 and 6 weeks post-operatively, and interviewed 1year following surgery by a telephone survey. Outcomes evaluated were vaginal cuff dehiscence, pain, dyspareunia and bleeding. The study arms did not differ with respect to estimated blood loss (50mL in each arm; p=0.34), median vaginal cuff closure time (14.5, 12 and 13min, respectively; p=0.09) or readmission (p=0.55). In the 1-year follow-up (54/90 respondents; 60%), there were no significant differences among study arms for vaginal bleeding, cuff infection or dyspareunia. Only women belonging to arm 3 reported vaginal pain (0%, 0% and 23%, respectively; p=0.01). No cases of vaginal cuff dehiscence were observed. The type of closure technique has no significant impact on patient outcomes. In the absence of a clear advantage of one technique over the others, the decision regarding the preferred method to close the vaginal cuff in robotic-assisted total laparoscopic hysterectomy should be based on surgeons' preference and cost effectiveness. Copyright © 2016. Published by Elsevier B.V.

  1. Microgravity Drill and Anchor System

    Science.gov (United States)

    Parness, Aaron; Frost, Matthew A.; King, Jonathan P.

    2013-01-01

    This work is a method to drill into a rock surface regardless of the gravitational field or orientation. The required weight-on-bit (WOB) is supplied by a self-contained anchoring mechanism. The system includes a rotary percussive coring drill, forming a complete sampling instrument usable by robot or human. This method of in situ sample acquisition using micro - spine anchoring technology enables several NASA mission concepts not currently possible with existing technology, including sampling from consolidated rock on asteroids, providing a bolt network for astronauts visiting a near-Earth asteroid, and sampling from the ceilings or vertical walls of lava tubes and cliff faces on Mars. One of the most fundamental parameters of drilling is the WOB; essentially, the load applied to the bit that allows it to cut, creating a reaction force normal to the surface. In every drilling application, there is a minimum WOB that must be maintained for the system to function properly. In microgravity (asteroids and comets), even a small WOB could not be supported conventionally by the weight of the robot or astronaut. An anchoring mechanism would be needed to resist the reactions, or the robot or astronaut would push themselves off the surface and into space. The ability of the system to anchor itself to a surface creates potential applications that reach beyond use in low gravity. The use of these anchoring mechanisms as end effectors on climbing robots has the potential of vastly expanding the scope of what is considered accessible terrain. Further, because the drill is supported by its own anchor rather than by a robotic arm, the workspace is not constrained by the reach of such an arm. Yet, if the drill is on a robotic arm, it has the benefit of not reflecting the forces of drilling back to the arm s joints. Combining the drill with the anchoring feet will create a highly mobile, highly stable, and highly reliable system. The drilling system s anchor uses hundreds of

  2. Percutaneous Repair Technique for Acute Achilles Tendon Rupture with Assistance of Kirschner Wire.

    Science.gov (United States)

    He, Ze-yang; Chai, Ming-xiang; Liu, Yue-ju; Zhang, Xiao-ran; Zhang, Tao; Song, Lian-xin; Ren, Zhi-xin; Wu, Xi-rui

    2015-11-01

    The aim of this study is to introduce a self-designed, minimally invasive technique for repairing an acute Achilles tendon rupture percutaneously. Comparing with the traditional open repair, the new technique provides obvious advantages of minimized operation-related lesions, fewer wound complications as well as a higher healing rate. However, a percutaneous technique without direct vision may be criticized by its insufficient anastomosis of Achilles tendon and may also lead to the lengthening of the Achilles tendon and a reduction in the strength of the gastrocnemius. To address the potential problems, we have improved our technique using a percutaneous Kirschner wire leverage process before suturing, which can effectively recover the length of the Achilles tendon and ensure the broken ends are in tight contact. With this improvement in technique, we have great confidence that it will become the treatment of choice for acute Achilles tendon ruptures. © 2015 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

  3. The Case of Sacrococcygeal Teratoma in an IVF Pregnancy: Is There any Association between Congenital Tumors and Assisted Reproduction Techniques?

    Science.gov (United States)

    Tempe, Anjali; Singh, Nilanchali; Sharma, Ila; Agarwal, Satish

    2014-04-01

    Sacrococcygeal teratoma (SCT) is a rare congenital tumor and its association with IVF pregnancy is not clear. There are limited reports of congenital tumors in IVF pregnancy. The exact embryogenesis of SCT is not known but a genetic etiology has been reported. Whether these congenital tumors have any association with assisted reproductive techniques remains obscure. In this study, a case of SCT in an IVF pregnancy with donor oocytes was reported. IVF was performed for bilateral tubal blockade and poor ovarian reserve. It was diagnosed antenatally by ultrasonography. Successful surgical treatment was performed in postnatal period and six months follow-up remained uneventful. The purpose of reporting this case is to emphasize on the possibility of association of congenital tumors with assisted reproductive techniques and hence, the need for screening in these pregnancies. An association could not be detected based on few case reports and therefore, large population based studies are required to elucidate the effect of these reproductive techniques on occurrence of congenital tumors.

  4. Anchoring strategies for bimetallic species in zeolites

    Energy Technology Data Exchange (ETDEWEB)

    Bein, T.

    1993-03-01

    We explore a new approach by introducing heterobinuclear organometallic compounds for linking catalytic functions to zeolite frameworks. With two different metals present, the complexes are being anchored to the support via one oxophilic metal, ligand exchange and catalytic reactions may proceed at the second metal center. Anchoring chemistry, thermal stability and reactivity of Me[sub 3]SnMn(CO)[sub 5] in zeolite NaY and acid forms of zeolite Y was studied with X-ray absorption spectroscopy (Sn, Mn edge EXAFS) and in-situ FTIR/TPD-MS techniques. Subsequently, the tin-cobalt complex Me[sub 3]SnCo(CO)[sub 4] has been a focus of detailed synthetic and spectroscopic studies. The reactivity of tricarbonyl (cyclopentadienyl) (trimethylstannyl) molybdenum in new mesoporous hosts has been explored. A recent development is the design of vanadium oxo species in different micro- and mesoporous hosts. These are of great interest for the selective reduction of nitrogen oxides by ammonia, and selective oxidation of different hydrocarbons, such as xylenes, olefines and alkanes. Combination analytical techniques used to probe local structural changes at the molecular level, include EXAFS (Extended X-Ray Absorption Fine Structure) spectroscopy utilizing synchrotron radiation, in situ FT-IR coupled to thermodesorption/MS, UV-NIR, and CCD Raman.

  5. Operative technique and early experience for robotic-assisted laparoscopic nephroureterectomy (RALNU) using da Vinci Xi

    National Research Council Canada - National Science Library

    Darwiche, Fadi; Swain, Sanjaya; Kallingal, George; Punnen, Sanoj; Manoharan, Murugesan; Parekh, Dipen J; Gonzalgo, Mark L

    2015-01-01

    .... The da Vinci Xi surgical system was released in April of 2014. We describe our operative technique and early experience for RALNU using the da Vinci Xi system highlighting unique features of this surgical...

  6. Data mining techniques for assisting the diagnosis of pressure ulcer development in surgical patients.

    Science.gov (United States)

    Su, Chao-Ton; Wang, Pa-Chun; Chen, Yan-Cheng; Chen, Li-Fei

    2012-08-01

    Pressure ulcer is a serious problem during patient care processes. The high risk factors in the development of pressure ulcer remain unclear during long surgery. Moreover, past preventive policies are hard to implement in a busy operation room. The objective of this study is to use data mining techniques to construct the prediction model for pressure ulcers. Four data mining techniques, namely, Mahalanobis Taguchi System (MTS), Support Vector Machines (SVMs), decision tree (DT), and logistic regression (LR), are used to select the important attributes from the data to predict the incidence of pressure ulcers. Measurements of sensitivity, specificity, F(1), and g-means were used to compare the performance of four classifiers on the pressure ulcer data set. The results show that data mining techniques obtain good results in predicting the incidence of pressure ulcer. We can conclude that data mining techniques can help identify the important factors and provide a feasible model to predict pressure ulcer development.

  7. Bone Anchored Hearing Aid

    Science.gov (United States)

    2002-01-01

    Executive Summary Objective The objective of this health technology policy assessment was to determine the effectiveness and cost-effectiveness of bone-anchored hearing aid (BAHA) in improving the hearing of people with conduction or mixed hearing loss. The Technology The (BAHA) is a bone conduction hearing device that includes a titanium fixture permanently implanted into the mastoid bone of the skull and an external percutaneous sound processor. The sound processor is attached to the fixture by means of a skin penetrating abutment. Because the device bypasses the middle ear and directly stimulates the cochlea, it has been recommended for individuals with conduction hearing loss or discharging middle ear infection. The titanium implant is expected to last a lifetime while the external sound processor is expected to last 5 years. The total initial device cost is approximately $5,300 and the external sound processor costs approximately $3,500. Review of BAHA by the Medical Advisory Secretariat The Medical Advisory Secretariat’s review is a descriptive synthesis of findings from 36 research articles published between January 1990 and May 2002. Summary of Findings No randomized controlled studies were found. The evidence was derived from level 4 case series with relative small sample sizes (ranging from 30-188). The majority of the studies have follow-up periods of eight years or longer. All except one study were based on monaural BAHA implant on the side with the best bone conduction threshold. Safety Level 4 evidence showed that BAHA has been be implanted safely in adults and children with success rates of 90% or higher in most studies. No mortality or life threatening morbidity has been reported. Revision rates for tissue reduction or resiting were generally under 10% for adults but have been reported to be as high as 25% in pediatric studies. Adverse skin reaction around the skin penetration site was the most common complication reported. Most of these

  8. Répercussions des techniques de procréation assistée sur les droits ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    L'opinion générale veut que les techniques de procréation médicalement assistée soient destinées à un très petit nombre de femmes fortunées en Inde. Cependant, cette industrie, en raison de ses liens étroits avec le secteur du tourisme médical, déjà fortement encouragé, connaît une croissance telle que ses ...

  9. Bilateral simultaneous robot-assisted pyelolithotomy for large (>6 cm) kidney stones: technique and review of literature.

    Science.gov (United States)

    Rajiv, Yadav; Kumar, Abhay; Poonam, Yadav

    2015-09-01

    With wide availability and demonstrable efficacy of endourological techniques, open surgery for renal stone disease has largely been replaced in contemporary urological practice. However, with increasing experience of laparoscopy and robotic surgery in urology, the principle of open renal surgery is being revisited. In certain situations, laparoscopic or robotic pyelolithomy may be an excellent minimally invasive alternative to percutaneous nephrolithomy with its unique advantages. We present a case of bilateral large kidney stones managed with bilateral simultaneous robot-assisted laparoscopic pyelolithotomy with excellent results.

  10. A volatile tracer-assisted headspace analytical technique for determining the swelling capacity of superabsorbent polymers.

    Science.gov (United States)

    Zhang, Shu-Xin; Jiang, Ran; Chai, Xin-Sheng

    2017-09-01

    This paper reports on a new method for the determination of swelling capacity of superabsorbent polymers by a volatile tracer-assisted headspace gas chromatography (HS-GC). Toluene was used as a tracer and added to the solution for polymers swelling test. Based on the differences of the tracer partitioned between the vapor and hydrogel phase before and after the polymer's swelling capacity, a transition point (corresponding to the material swelling capacity) can be observed when plotting the GC signal of toluene vs. the ratio of solution added to polymers. The present method has good precision (RSDpolymers at the elevated temperatures. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Osteoid osteoma of the spine: a novel technique using combined computer-assisted and gamma probe-guided high-speed intralesional drill excision

    NARCIS (Netherlands)

    van Royen, B.J.; Baayen, J.C.; Pijpers, R.; Noske, D.P.; Schakenraad, D.; Wuisman, P.I.J.M.

    2005-01-01

    Study Design. A report of five cases of thoracolumbar osteoid osteoma treated with combined computer-assisted and γ probe-guided high-speed drill excision. Objectives. To document the surgical technique consisting of a combination of both computer-assisted and γ probe-guided high-speed drill

  12. Computer-assisted preoperative simulation for positioning and fixation of plate in 2-stage procedure combining maxillary advancement by distraction technique and mandibular setback surgery

    Directory of Open Access Journals (Sweden)

    Hideyuki Suenaga

    2016-01-01

    Conclusion: The implementation of the computer-assisted preoperative simulation for the positioning and fixation of plate in 2-stage orthognathic procedure using distraction technique and mandibular setback surgery yielded good results.

  13. Emerging techniques for assisting and accelerating food freezing processes: A review of recent research progresses.

    Science.gov (United States)

    Cheng, Lina; Sun, Da-Wen; Zhu, Zhiwei; Zhang, Zi

    2017-03-04

    Freezing plays an important role in food preservation and the emergence of rapid freezing technologies can be highly beneficial to the food industry. This paper reviews some novel food freezing technologies, including high-pressure freezing (HPF), ultrasound-assisted freezing (UAF), electrically disturbed freezing (EF) and magnetically disturbed freezing (MF), microwave-assisted freezing (MWF), and osmo-dehydro-freezing (ODF). HPF and UAF can initiate ice nucleation rapidly, leading to uniform distribution of ice crystals and the control of their size and shape. Specifically, the former is focused on increasing the degree of supercooling, whereas the latter aims to decrease it. Direct current electric freezing (DC-EF) and alternating current electric freezing (AC-EF) exhibit different effects on ice nucleation. DC-EF can promote ice nucleation and AC-EF has the opposite effect. Furthermore, ODF has been successfully used for freezing various vegetables and fruit. MWF cannot control the nucleation temperature, but can decrease supercooling degree, thus decreasing the size of ice crystals. The heat and mass transfer processes during ODF have been investigated experimentally and modeled mathematically. More studies should be carried out to understand the effects of these technologies on food freezing process.

  14. Assisted reproductive techniques for cattle breeding in developing countries: a critical appraisal of their value and limitations.

    Science.gov (United States)

    Rodriguez-Martinez, H

    2012-01-01

    Commercialization of animal biotechnologies, including those related to reproduction [also known as assisted reproductive techniques (ARTS)], is an increasing reality in developing countries, following the enormous flow of information around us and the increasing global commercial interests in areas where cattle production has its major assets. The present review discusses the achievements of various biotechnological tools for reproduction in cattle including semen handling for artificial insemination (AI), superovulation and embryo transfer (MOET), in vitro handling of oocytes and production of embryos, reproductive cloning and emerging technologies (sex selection, gene targeting and nuclear transfer for livestock transgenesis, genomics for marker-assisted selection, etc.). The application of these technologies for cattle breeding is critically discussed in relation to their impact in the improvement of the efficiency of dairy and beef production in developed and - particularly - in developing countries, which ultimately rule the possibilities of a competitive and sound production of food for human consumption. Despite the remarkable progress made and the punctual importance of some of the above-mentioned technologies, AI remains the most important assisted reproductive technology (ART) in developing countries. Any attempt to gain widespread of any other ART under the predominant economical conditions in developing countries ought to match the simplicity and the success of AI as a breeding tool. © 2012 Blackwell Verlag GmbH.

  15. Adaptive Data Processing Technique for Lidar-Assisted Control to Bridge the Gap between Lidar Systems and Wind Turbines: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Schlipf, David; Raach, Steffen; Haizmann, Florian; Cheng, Po Wen; Fleming, Paul; Scholbrock, Andrew, Krishnamurthy, Raghu; Boquet, Mathieu

    2015-12-14

    This paper presents first steps toward an adaptive lidar data processing technique crucial for lidar-assisted control in wind turbines. The prediction time and the quality of the wind preview from lidar measurements depend on several factors and are not constant. If the data processing is not continually adjusted, the benefit of lidar-assisted control cannot be fully exploited, or can even result in harmful control action. An online analysis of the lidar and turbine data are necessary to continually reassess the prediction time and lidar data quality. In this work, a structured process to develop an analysis tool for the prediction time and a new hardware setup for lidar-assisted control are presented. The tool consists of an online estimation of the rotor effective wind speed from lidar and turbine data and the implementation of an online cross correlation to determine the time shift between both signals. Further, initial results from an ongoing campaign in which this system was employed for providing lidar preview for feed-forward pitch control are presented.

  16. ARGUMENTS ON USING COMPUTER-ASSISTED AUDIT TECHNIQUES (CAAT AND BUSINESS INTELLIGENCE TO IMPROVE THE WORK OF THE FINANCIAL AUDITOR

    Directory of Open Access Journals (Sweden)

    Ciprian-Costel, MUNTEANU

    2014-11-01

    Full Text Available In the 21st century, one of the most efficient ways to achieve an independent audit and quality opinion is by using information from the organization database, mainly documents in electronic format. With the help of Computer-Assisted Audit Techniques (CAAT, the financial auditor analyzes part or even all the data about a company in reference to other information within or outside the entity. The main purpose of this paper is to show the benefits of evolving from traditional audit techniques and tools to modern and , why not, visionary CAAT, which are supported by business intelligence systems. Given the opportunity to perform their work in IT environments, the auditors would start using the tools of business intelligence, a key factor which contributes to making successful business decisions . CAAT enable auditors to test large amount of data quickly and accurately and therefore increase the confidence they have in their opinion.

  17. Anchoring effect on first passage process in Taiwan financial market

    Science.gov (United States)

    Liu, Hsing; Liao, Chi-Yo; Ko, Jing-Yuan; Lih, Jiann-Shing

    2017-07-01

    Empirical analysis of the price fluctuations of financial markets has received extensive attention because a substantial amount of financial market data has been collected and because of advances in data-mining techniques. Price fluctuation trends can help investors to make informed trading decisions, but such decisions may also be affected by a psychological factors-the anchoring effect. This study explores the intraday price time series of Taiwan futures, and applies diffusion model and quantitative methods to analyze the relationship between the anchoring effect and price fluctuations during first passage process. Our results indicate that power-law scaling and anomalous diffusion for stock price fluctuations are related to the anchoring effect. Moreover, microscopic price fluctuations before switching point in first passage process correspond with long-term price fluctuations of Taiwan's stock market. We find that microscopic trends could provide useful information for understanding macroscopic trends in stock markets.

  18. A new device for bone anchor fixation in laparoscopic sacrocolpopexy: the Franciscan laparoscopic bone anchor inserter.

    NARCIS (Netherlands)

    Weiden, R.M. van der; Withagen, M.I.J.; Bergkamp, A.B.; Mannaerts, G.H.

    2005-01-01

    BACKGROUND: A laparoscopic modification of the sacrocolpopexy procedure with mesh and bone anchor fixation with the Franciscan laparoscopic bone anchor inserter was developed. METHODS: We developed a laparoscopic bone anchor inserter for the placement of a titanium bone anchor in sacral segment 3 as

  19. 76 FR 30301 - Commercial Acquisition; Anchor Tenancy

    Science.gov (United States)

    2011-05-25

    ...-AD64 Commercial Acquisition; Anchor Tenancy AGENCY: National Aeronautics and Space Administration... Competitiveness Act (CSCA) of 1992. NASA may enter into multi-year anchor tenancy contracts for commercial space goods or services. Anchor Tenancy means ``an arrangement in which the United States Government agrees to...

  20. 21 CFR 872.3130 - Preformed anchor.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Preformed anchor. 872.3130 Section 872.3130 Food... DEVICES DENTAL DEVICES Prosthetic Devices § 872.3130 Preformed anchor. (a) Identification. A preformed anchor is a device made of austenitic alloys or alloys containing 75 percent or greater gold or metals of...

  1. On the Theory of Ground Anchors

    Science.gov (United States)

    1975-01-01

    the A.B. Chance Company (Fig. 57). These anchors were geometrically similar to the familiar Never-Creep anchors on the market today. However, in an...1. part ’. Sandegren. E.. P.O. Sahlstrom and If. Sutile (1973) Behavior of anchored sheet-pile %.til exposed to frost action. Sartryck och

  2. How old is too old? A contribution to the discussion on age limits for assisted reproduction technique access.

    Science.gov (United States)

    Kocourková, Jiřina; Konečná, Hana; Burcin, Boris; Kučera, Tomáš

    2015-05-01

    In 2012, the Czech Republic established the women's age limit for access to assisted reproduction techniques at age 49 years. In this paper, the acceptability of this age limit from the children's perspective in the Czech Republic is assessed. Although the necessity of balancing the interests of parents and children is acknowledged, little research has taken children's interests into account. We have attempted to map out 'children's interests', asking older children and adolescents (aged 11-25 years) how old they would prefer their parents to be: Czech respondents would prefer to have younger parents. This finding is consistent with the optimal biological childbearing age rather than with the current postponement to a later age. So far, assisted reproduction techniques have been largely regarded as a medical treatment justifying the current women's age limit of 49 years. Had the children's perspective been taken into account, this age limit might have been lower than 49 years. We propose that reproductive health policy should adequately reflect multiple perspectives as an integral part of a multi-layered support system of a society. Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  3. Super paramagnetic core-shells anchored onto silica grafted with C8/NH2nano-particles for ultrasound-assisted magnetic solid phase extraction of imipramine and desipramine from plasma.

    Science.gov (United States)

    Ahmadi, Farhad; Mahmoudi-Yamchi, Tahereh; Azizian, Homa

    2018-03-01

    In current work the Fe 3 O 4 magnetic nano-particles anchored to core-shells of SiO 2 which grafted by C 8 /NH 2 dual mixed groups, have been synthesized. The magnetic nano-particles were characterized by scanning electron microscopy, X-ray diffraction spectroscopy, and zeta-potential reader. The resulted nano-particles have spherical structure with diameters in the range of 105 to 110 nm. A magnetic solid phase extraction method was developed for extraction of imipramine and desipramine from human plasma samples under ultrasonic conditions by using of prepared NPs as sorbent. The MNPs were dispersion in plasma under sonicated conditions, accumulated by an external magnetic field and washed with Briton-Robinson buffer-acetonitrile solution (0.05 mol l -1 , pH = 5, 10%V/V). The drugs were removed by methanol and quantified by gas chromatography. The calibration curves (correlation coefficient > 0.99) for IMP and DES were linear in the concentration range of 0.005 to 5 and 0.01 to 4 μg ml -1 , respectively. The LOD, LOQ, intra and inter-day precision values were measured too. The proposed Fe 3 O 4 /SiO 2 /C 8 /NH 2 MNPs could be applied for 3.0 times. Copyright © 2018. Published by Elsevier B.V.

  4. Endoscopic-assisted transaxillary breast augmentation: minimizing complications and maximizing results with improvements in patient selection and technique.

    Science.gov (United States)

    Kolker, Adam R; Austen, William G; Slavin, Sumner A

    2010-05-01

    The use of the transaxillary incision has enabled augmentation mammoplasty with a scarless breast. However, the classic technique has been associated with high rates of asymmetry, malposition, and high riding implants. With the addition of endoscopic assistance, retropectoral pocket visualization and better control of the lower pole has been facilitated. Nevertheless, pitfalls in patient selection and technique abound. In this study, the authors experience with endoscopic transaxillary breast augmentation is reviewed, with particular attention to both the anatomic characteristics associated with favorable and unfavorable outcomes and technical nuances that have improved aesthetic results. One hundred and ninety-seven endoscopic transaxillary breast augmentations were performed during this study. All patients underwent augmentation with saline implants, with a mean volume of 298 mL. Preoperative pseudoptosis or grade I ptosis was present in 14 patients, and 4 patients had mild or moderate tuberous deformity. Thirty-four patients had short lower pole anatomy, with areola-to-inframammary crease length of breast shape (2 with tuberous deformities and 1 with ptosis). Seven patients (3.5%) underwent revision for malposition (5 superior and 2 inferior). There were no infections, seromas, postoperative hematomas, or significant encapsulations. Patient selection is of paramount importance in minimizing complications and optimizing the results of endoscopic-assisted transaxillary breast augmentation. Patients with deficient lower breast poles, sharply defined inframammary creases with short areola-to-fold distances, pectoralis major muscular hypertrophy, ptosis or pseudoptosis, and any form of tuberous breast deformity should be identified carefully and considered judiciously. Technical refinements that maximize safety and improve the aesthetic results with endoscopic-assisted transaxillary breast augmentation are described.

  5. Dynamic Fuzzy-Logic Based Path Planning for Mobility-Assisted Localization in Wireless Sensor Networks.

    Science.gov (United States)

    Alomari, Abdullah; Phillips, William; Aslam, Nauman; Comeau, Frank

    2017-08-18

    Mobile anchor path planning techniques have provided as an alternative option for node localization in wireless sensor networks (WSNs). In such context, path planning is a movement pattern where a mobile anchor node's movement is designed in order to achieve a maximum localization ratio possible with a minimum error rate. Typically, the mobility path planning is designed in advance, which is applicable when the mobile anchor has sufficient sources of energy and time. However, when the mobility movement is restricted or limited, a dynamic path planning design is needed. This paper proposes a novel distributed range-free movement mechanism for mobility-assisted localization in WSNs when the mobile anchor's movement is limited. The designed movement is formed in real-time pattern using a fuzzy-logic approach based on the information received from the network and the nodes' deployment. Our proposed model, Fuzzy-Logic based Path Planning for mobile anchor-assisted Localization in WSNs (FLPPL), offers superior results in several metrics including both localization accuracy and localization ratio in comparison to other similar works.

  6. Intrapartum and neonatal outcomes in singleton pregnancies following conception by assisted reproduction techniques.

    Science.gov (United States)

    Rozdarz, Kellie M; Flatley, Christopher J; Kumar, Sailesh

    2017-12-01

    To characterise maternal demographics and ascertain whether clinically important differences exist in the intrapartum and neonatal outcomes associated with assisted reproductive technology (ART). A retrospective study was undertaken between January 2007 and December 2013 of all singleton pregnancies conceived via ART at a major tertiary unit in Brisbane, Australia. Intrapartum outcomes were mode of delivery and indication for emergency caesarean. Neonatal outcomes investigated were gestation at delivery, birth weight, Apgar scores, acidosis at birth, respiratory distress, need for resuscitation, admission to neonatal intensive care and stillbirth. There were 4733 (7.4%) ART and 59 277 (92.6%) spontaneous conception pregnancies. Women who conceived using ART were less likely to have a spontaneous vaginal delivery (odds ratio (OR) 0.60, 95% CI 0.57-0.64) and were more likely to require operative or assisted birth: elective caesarean (adjusted OR (aOR) 1.31, 95% CI 1.22-1.40), emergency caesarean (aOR 1.19, 95% CI 1.09-1.28), or instrumental delivery (aOR 1.45, 95% CI 1.32-1.58). Neonates who were conceived using ART were less likely to be born at term (aOR 0.64, 95% CI 0.58-0.71) and have lower birth weights. No differences were observed in rates of respiratory distress, admission to the neonatal intensive care unit, or stillbirth between the ART and spontaneous conception cohorts. The odds of neonatal acidosis (OR 0.71, 95% CI0.63-0.81) were lower in the ART cohort. Although higher rates of operative deliveries were seen for women who conceive using ART, neonatal outcomes were generally no different between the two cohorts. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  7. Video-Assisted Laser Resection of Lung Metastases-Feasibility of a New Surgical Technique.

    Science.gov (United States)

    Meyer, Christian; Bartsch, Detlef; Mirow, Nikolas; Kirschbaum, Andreas

    2017-08-01

    Background Our pilot study describes our initial experience to do a laser resection of lung metastases under video-assisted thoracoscopic control via a minithoracotomy. With this approach, if needed, mediastinal lymphadenectomy is also possible. Methods In this study, 15 patients (11 men and 4 women, mean age: 60 years) with resectable lung metastases of different solid primary tumors (colorectal cancer in seven patients, melanoma in three patients, renal cell carcinoma in two patients, and one each with oropharyngeal cancer, breast cancer, and seminoma) were included. An anterior minithoracotomy incision (approximately 5-7 cm length) was created in the fifth intercostal space and a soft tissue retractor (Alexis Protector; Applied Medical) was positioned. Two additional working ports were inserted. The entire lung was palpated via the minithoracotomy. All detected lung metastases were removed under thoracoscopic control. Nonanatomic resections were performed using a diode-pumped neodymium-doped yttrium aluminium garnet laser (LIMAX120; KLS Martin GmbH & Co KG) with a laser power of 80 W in a noncontact modus. Deeper parenchymal lesions were sutured. Results A total of 29 lung metastases up to 30 mm in size were resected and all metastases diagnosed on preoperative imaging were detected. All diagnosed lung metastases were completely resected (R0). The median operation time was 102 (range: 85-120) minutes. Median blood loss was 47.6 mL and no postoperative complications occurred. Neither local recurrences nor new lung metastases were observed within 6 months after the procedures. Conclusion Video-assisted laser resection of lung metastases is safe, effective, and fulfills the requirements of modern lung metastases surgery. Georg Thieme Verlag KG Stuttgart · New York.

  8. Subfertility and assisted reproduction techniques are associated with poorer cardiometabolic profiles in childhood

    NARCIS (Netherlands)

    Pontesilli, Martina; Painter, Rebecca C.; Grooten, Iris J.; van der Post, Joris A.; Mol, Ben Willem; Vrijkotte, Tanja G. M.; Repping, Sjoerd; Roseboom, Tessa J.

    2015-01-01

    The effects of artificial reproductive techniques and subfertility on cardiovascular and metabolic profiles of children aged 5-6 years were investigated using data from the Amsterdam Born Children and their Development study. Of the 2577 children, 34 were conceived through ovulation induction, 51

  9. Research and Teaching: Assessment of Graduate Teaching Assistants Enrolled in a Teaching Techniques Course

    Science.gov (United States)

    Zehnder, Caralyn

    2016-01-01

    At the authors' public liberal arts institution, biology masters students are required to enroll in BIOL 5050: Teaching Techniques. Course topics include designing effective lectures, assessment, classroom management, diversity in the classroom, and active learning strategies. The impact of this type of training on graduate students' attitudes and…

  10. Embryo transfer techniques: an American Society for Reproductive Medicine survey of current Society for Assisted Reproductive Technology practices.

    Science.gov (United States)

    Toth, Thomas L; Lee, Malinda S; Bendikson, Kristin A; Reindollar, Richard H

    2017-04-01

    To better understand practice patterns and opportunities for standardization of ET. Cross-sectional survey. Not applicable. Not applicable. An anonymous 82-question survey was emailed to the medical directors of 286 Society for Assisted Reproductive Technology member IVF practices. A follow-up survey composed of three questions specific to ET technique was emailed to the same medical directors. Descriptive statistics of the results were compiled. The survey assessed policies, protocols, restrictions, and specifics pertinent to the technique of ET. There were 117 (41%) responses; 32% practice in academic settings and 68% in private practice. Responders were experienced clinicians, half of whom had performed technique. Multiple steps in the ET process were identified as "highly conserved;" others demonstrated discordance. ET technique is divided among [1] trial transfer followed immediately with ET (40%); [2] afterload transfer (30%); and [3] direct transfer without prior trial or afterload (27%). Embryos are discharged in the upper (66%) and middle thirds (29%) of the endometrial cavity and not closer than 1-1.5 cm from fundus (87%). Details of each step were reported and allowed the development of a "common" practice ET procedure. ET training and practices vary widely. Improved training and standardization based on outcomes data and best practices are warranted. A common practice procedure is suggested for validation by a systematic literature review. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  11. Nursing and midwifery students' experiences with the course of infertility and assisted reproductive techniques: A focus group study from Turkey.

    Science.gov (United States)

    Isbir, Gozde Gokçe; Ozan, Yeter Durgun

    2018-01-01

    Nurses and midwifes without sufficient knowledge of infertilitare not likely to provide counseling and support for people suffering from infertility. This study aimed to evaluate nursing and midwifery students' experiences with the Course on Infertility and Assisted Reproductive Techniques. Our study had a qualitative descriptive design. Total number of the participants was 75. The analysis revealed five primary themes and twenty-one sub-themes. The themes were (1) action, (2) learner centered method, (3) interaction, (4) nursing competencies, and (5) evaluation. The active learning techniques enabled the students to retrieve the knowledge that they obtained for a long time, contributed to social and cultural development and improved skills required for selfevaluation, communication and leadership, enhanced critical thinking, skills increased motivation and satisfaction and helped with knowledge integration. Infertility is a biopsychosocial condition, and it may be difficult for students to understand what infertile individuals experience. The study revealed that active learning techniques enabled the students to acquire not only theoretical knowledge but also an emotional and psychosocial viewpoint and attitude regarding infertility. The content of an infertility course should be created in accordance with changes in the needs of a given society and educational techniques. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. A biomechanical analysis of anterior Bankart repair using suture anchors.

    Science.gov (United States)

    Nho, Shane J; Frank, Rachel M; Van Thiel, Geoffrey S; Wang, Fan Chia; Wang, Vincent M; Provencher, Matthew T; Verma, Nikhil N

    2010-07-01

    Arthroscopic repair of anterior Bankart lesions is typically done with single-loaded suture anchors tied with simple stitch configuration. The knotless suture anchor will have similar biomechanical properties compared with two types of conventional suture anchors. Controlled laboratory study. Fresh-frozen shoulders were dissected and an anteroinferior Bankart lesion was created. For phase 1, specimens were randomized into either simple stitch (SSA) or knotless suture anchors (KSA) and loaded to failure. For phase 2, specimens were randomized into 1 of 4 repair techniques and cyclically loaded then loaded to failure: (1) SSA, (2) suture anchor with horizontal mattress configuration, (3) double-loaded suture anchor with simple stitch configuration, or (4) KSA. Data recorded included mode of failure, ultimate load to failure, load at 2 mm of displacement, as well as displacement during cyclical loading. For phase 1, the load required to 2 mm displacement of the repair construct was significantly greater in SSA (66.5 +/- 21.7 N) than KSA (35.0 +/- 12.5 N, P = .02). For phase 2, there was a statistically significant difference in ultimate load to failure among the 4groups, with both the single-loaded suture anchor with simple stitch (184.0 +/- 64.5 N), horizontal mattress stitch (189.0 +/- 65.3N), and double-loaded suture anchor with simple stitch (216.7 +/- 61.7 N) groups having significantly (P .05) among the 4 groups in displacement after cyclical loading or load at 2 mm of displacement. Both knotless and simple anchor configurations demonstrated similar single loads to failure (without cycling); however, the knotless device required less single load to displace 2 mm. All repair stitches, including simple, horizontal, and double-loaded performed similarly. The findings may suggest that with cyclical loading up to 25 N there is no difference in gapping greater than 2mm, but a macrotraumatic event may demonstrate a difference in fixation during the initial

  13. Robot-assisted laparoendoscopic single-site pyeloplasty: technique using the da Vinci Si robotic platform.

    Science.gov (United States)

    Seideman, Casey A; Tan, Yung K; Faddegon, Stephen; Park, Samuel K; Best, Sara L; Cadeddu, Jeffrey A; Olweny, Ephrem O

    2012-08-01

    Conventional laparoscopic dismembered pyeloplasty (LP) is an established alternative to open pyeloplasty given equivalent intermediate-term outcomes and decreased morbidity. Laparoendoscopic single-site (LESS) pyeloplasty has the potential to further decrease the morbidity of LP, while yielding superior cosmesis. It is, however, technically very challenging even with the use of an accessory port, largely because of the difficulty of intracorporeal suturing through a single umbilical incision. Application of the da Vinci robotic surgical platform to LESS pyeloplasty (R-LESS) has the potential to overcome these limitations. We describe our technique for R-LESS pyeloplasty using the da Vinci Si robot. We have found that use of the robotic system in conjunction with certain technique modifications helps to reduce the technical difficulty of LESS pyeloplasty and to shorten the physical learning curve associated with the procedure.

  14. Inertial Measurement Unit-Assisted Implantation of Thoracic, Lumbar, and Sacral Pedicle Screws Improves Precision of a Freehand Technique.

    Science.gov (United States)

    Jost, Gregory F; Walti, Jonas; Mariani, Luigi; Schaeren, Stefan; Cattin, Philippe

    2017-07-01

    A method applying inertial measurement units (IMUs) was developed to implant pedicle screws in the thoracic and lumbosacral spine. This was compared with a freehand technique. The study was done on 9 human cadavers. For each cadaver, a preoperative computed tomography (CT) scan was performed to measure the axial and sagittal tilt angles of the screw trajectories from T1 to S1. After the entry points were defined on the exposed spine, the IMU-equipped pedicle finder and screwdriver were used to reproduce these tilt angles and implant half of the screws. The other half was implanted with a freehand technique. Fluoroscopy was not used. The screw trajectories were analyzed on postoperative CTs. A hundred and sixty-two screws were placed with use of the IMUs and 162 screws were implanted by freehand. The IMU-guided technique matched the planned trajectories significantly better than the freehand technique (axial tilt P measured tilt angles of the screws were 3.3 degrees ± 3.5 degrees for the axial plane (median 2 degrees, range 0-23 degrees) and 3.4 degrees ± 3 degrees for the sagittal plane (median 3 degrees, range 0-13 degrees). For the freehand technique, the mean offsets between the planned and postoperatively measured tilt angles of the screws were 5.6 degrees ± 4.5 degrees for the axial plane (median 5 degrees, range 0-31 degrees) and 6.7 degrees ± 5.4 degrees for the sagittal plane (median 6 degrees, range 0-33 degrees). IMU-assisted implantation of pedicle screws may enhance the performance of a freehand technique in the thoracic and lumbosacral spine. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Computer-assisted surgery and intraoral welding technique for immediate implant-supported rehabilitation of the edentulous maxilla: case report and technical description.

    Science.gov (United States)

    Albiero, Alberto Maria; Benato, Renato

    2016-09-01

    Complications are frequently reported when combining computer assisted flapless surgery with an immediate loaded prefabricated prosthesis. The authors have combined computer-assisted surgery with the intraoral welding technique to obtain a precise passive fit of the immediate loading prosthesis. An edentulous maxilla was rehabilitated with four computer assisted implants welded together intraorally and immediately loaded with a provisional restoration. A perfect passive fit of the metal framework was obtained that enabled proper osseointegration of implants. Computer assisted preoperative planning has been shown to be effective in reducing the intraoperative time of the intraoral welding technique. No complications were observed at 1 year follow-up. This guided-welded approach is useful to achieve a passive fit of the provisional prosthesis on the inserted implants the same day as the surgery, reducing intraoperative time with respect to the traditional intraoral welding technique. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  16. Arthroscopic repair of the posterior root of the medial meniscus using knotless suture anchor: A technical note.

    Science.gov (United States)

    Eun, Sang Soo; Lee, Sang Ho; Sabal, Luigi Andrew

    2016-08-01

    There are numerous methods for repairing posterior root tears of the medial meniscus (PRTMM). Repair techniques using suture anchors through a high posteromedial portal have been reported. The present study found that using a knotless suture anchor instead of suture anchor seemed easier and faster because it avoided passing the sutures through the meniscus and tying a knot in a small space. This study describes a knotless suture anchor technique through a high posteromedial portal, and its clinical results. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. Proximal occlusion of hydrosalpinges by Essure(®) before assisted reproduction techniques: a French survey.

    Science.gov (United States)

    Legendre, Guillaume; Moulin, Julie; Vialard, Jean; Ziegler, Dominique D E; Fanchin, Renato; Pouly, Jean Luc; Watrelot, Antoine; Belaisch Allart, Joëlle; Massin, Nathalie; Fernandez, Hervé

    2014-10-01

    To study the feasibility and results (live-birth and complication rates) of placement of Essure(®) microinserts before assisted reproductive technology (ART) treatment of women with hydrosalpinx when laparoscopy should be avoided. Study design National survey of 45 French hospital centres providing ART reporting a retrospective analysis of 43 women with unilateral or bilateral hydrosalpinges and Essure(®) placement. The results of the following ART cycle were studied for 54 embryo transfers. The placement success rate reached 92.8% (65/70 tubes), and the mean number of visible intrauterine coils was 1.61 (range: 0-6). Pyosalpinx occurred in one case, and expulsion of the device into the uterus in two others. Of 43 women, 29 (67.4%) had a total of 54 fresh or frozen embryos transferred. The clinical pregnancy rate was 40.7% (22/54) and the live-birth rate 25.9% (14/54). The implantation rate was 29.3% (27/92). Essure(®) placement is an effective method for occlusion of hydrosalpinges before IVF. Monitoring the live-birth rate confirms that this option is the strongest in cases when laparoscopy is impossible or contraindicated. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Is there a critical endometrioma size associated with reduced ovarian responsiveness in assisted reproduction techniques?

    Science.gov (United States)

    Coccia, Maria Elisabetta; Rizzello, Francesca; Barone, Stefano; Pinelli, Sara; Rapalini, Erika; Parri, Cristiana; Caracciolo, Domenico; Papageorgiou, Savvas; Cima, Gianpaolo; Gandini, Loredana

    2014-08-01

    This study investigated the relationships between ovarian endometrioma size, ovarian responsiveness and the number of retrieved oocytes following ovarian stimulation. A prospective study was conducted in a public clinical assisted reproduction centre. A total of 64 infertile women with monolateral endometriomas undergoing IVF or intracytoplasmic sperm injection were included in the study. The total number of follicles, number of follicles ≥ 16 mm and number of oocytes retrieved of ovaries containing endometrioma and normal ovaries were compared. Multivariate linear regression was used to assess whether number of follicles and collected oocytes varied by endometrioma size, age, basal FSH concentration. Significantly lower numbers of follicles ≥ 16 mm (P = 0.024) and oocytes retrieved (P = 0.001) in the ovaries containing endometrioma were observed. In patients with endometriomas ≥ 30 mm, endometrioma size was the most influential contributor to the total number of follicles and oocytes retrieved. Ovarian endometriomas result in reduced response to ovarian stimulation, compared with the response of the contralateral normal ovary in the same individual. In case of endometriomas Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  19. Advanced driver assistance system: Road sign identification using VIAPIX system and a correlation technique

    Science.gov (United States)

    Ouerhani, Y.; Alfalou, A.; Desthieux, M.; Brosseau, C.

    2017-02-01

    We present a three-step approach based on the commercial VIAPIX® module for road traffic sign recognition and identification. Firstly, detection in a scene of all objects having characteristics of traffic signs is performed. This is followed by a first-level recognition based on correlation which consists in making a comparison between each detected object with a set of reference images of a database. Finally, a second level of identification allows us to confirm or correct the previous identification. In this study, we perform a correlation-based analysis by combining and adapting the Vander Lugt correlator with the nonlinear joint transformation correlator (JTC). Of particular significance, this approach permits to make a reliable decision on road traffic sign identification. We further discuss a robust scheme allowing us to track a detected road traffic sign in a video sequence for the purpose of increasing the decision performance of our system. This approach can have broad practical applications in the maintenance and rehabilitation of transportation infrastructure, or for drive assistance.

  20. Fabrication of Lightweight Radiation Shielding Composite Materials by Field Assisted Sintering Technique (FAST)

    Science.gov (United States)

    Prasad, Narasimha; Trivedi, Sudhir; Chen, Henry; Kutcher, Susan; Zhang, Dajie; Singh, Jogender

    2017-01-01

    Advances in radiation shielding technologies are needed to protect humans and electronic components from all threats of space radiation over long durations. In this paper, we report on the use of the innovative and novel fabrication technology known as Field Assisted Sintering Technology (FAST) to fabricate lightweight material with enhanced radiation shielding strength to safeguard humans and electronics suitable for next generation space exploration missions. The base materials we investigated were aluminum (Al), the current standard material for space hardware, and Ultra-High Molecular Weight Polyethylene (UHMWPE), which has high hydrogen content and resistance to nuclear reaction from neutrons, making it a good shielding material for both gamma radiation and particles. UHMWPE also has high resistance to corrosive chemicals, extremely low moisture sensitivity, very low coefficient of friction, and high resistance to abrasion. We reinforced the base materials by adding high density (ie, high atomic weight) metallic material into the composite. These filler materials included: boron carbide (B4C), tungsten (W), tungsten carbide (WC) and gadolinium (Gd).

  1. Diode laser assisted minimal invasive sphenoidotomy for endoscopic transphenoidal pituitary surgery: our technique and results.

    Science.gov (United States)

    Lee, Jih-Chin; Lai, Wen-Sen; Ju, Da-Tong; Chu, Yueng-Hsiang; Yang, Jinn-Moon

    2015-03-01

    During endoscopic sinus surgery (ESS), intra-operative bleeding can significantly compromise visualization of the surgical field. The diode laser that provides good hemostatic and vaporization effects and excellent photocoagulation has been successfully applied in endoscopic surgery with several advantages. The current retrospective study demonstrates the feasibility of diode laser-combined endoscopic sinus surgery on sphenoidotomy. The patients who went through endoscopic transphenoidal pituitary surgery were enrolled. During the operation, the quality of the surgical field was assessed and graded by the operating surgeon using the scale proposed by Boezaart. The mean operation time was 37.80 ± 10.90 minutes. The mean score on the quality of surgical field was 1.95. A positive correlation between the lower surgical field quality score and the shorter surgical time was found with statistical significance (P < 0.0001). No infections, hemorrhages, or other complications occurred intra- or post-operatively. The diode laser-assisted sphenoidotomy is a reliable and safe approach of pituitary gland surgery with minimal invasiveness. It is found that application of diode laser significantly improved quality of surgical field and shortened operation time. © 2015 Wiley Periodicals, Inc.

  2. Retroperitoneal approach for robot-assisted partial nephrectomy: technique and early outcomes.

    Science.gov (United States)

    Porreca, A; D'Agostino, D; Dente, D; Dandrea, M; Salvaggio, A; Cappa, E; Zuccala, A; Del Rosso, A; Chessa, F; Romagnoli, D; Mengoni, F; Borghesi, M; Schiavina, R

    2017-12-07

    The aim of our study is to present early outcomes of our series of retroperitoneal-RAPN (Robot Assisted Partial Nephrectomy). From September 2010 until December 2015, we performed 81 RAPN procedures (44 at left kidney and 37 at right). Average size was 3cm (1-9). Average PADUA score 7.1 (5-10). Average surgical time (overall and only robot time), ischemia time, blood loss, pathological stage, complications and hospital stay have been recorded. All of the cases were completed successfully without any operative complication or surgical conversion. Average surgical time was 177 minutes (75-340). Operative time was 145 minutes (80-300), overall blood loss was 142cc (60-310cc). In 30 cases the pedicle was late clamped with an average ischemia time of 4 minutes (2-7). None of the patient had positive surgical margins at definitive histology (49pT1a, 12pT1b, 3pT2a, 2pT3a). Hospital stay was 3 days (2-7). The retroperitoneal robotic partial nephrectomy approach is safe and allows treatment of even quite complex tumors. It also combines the already well known advantages guaranteed by the da Vinci® robotic surgical system, with the advantages of the retroperitoneoscopic approach. Copyright® by the International Brazilian Journal of Urology.

  3. Suture slippage in knotless suture anchors resulting in subacromial-subdeltoid bursitis.

    Science.gov (United States)

    Hayeri, Mohammad Reza; Keefe, Daniel T; Chang, Eric Y

    2016-05-01

    Rotator cuff repair using a suture bridge and knotless suture anchors is a relatively new, but increasingly used technique. The suture bridge technique creates an anatomically similar and more secure rotator cuff repair compared with conventional arthroscopic techniques and the use of knotless anchors eliminates the challenges associated with knot tying during arthroscopic surgery. However, previous in vitro biomechanical tests have shown that the hold of the suture in a knotless suture anchor is far lower than the pullout strength of the anchor from bone. Up until now slippage has been a theoretical concern. We present a prospectively diagnosed case of in vivo suture loosening after rotator cuff repair using a knotless bridge technique resulting in subacromial-subdeltoid bursitis.

  4. Extrusion of bone anchor suture following flexor digitorum profundus tendon avulsion injury repair.

    LENUS (Irish Health Repository)

    Tiong, William H C

    2011-09-01

    Flexor digitorum profundus (FDP) zone I tendon avulsion injury is traditionally repaired with a pullout suture technique. More recently, bone anchor sutures have been used as a viable alternative and have largely replaced areas in hand surgery where pullout suture technique was once required. To date, there have been very few complications reported related to bone anchor suture use in FDP tendon reattachment to the bone. We report a very unusual case of extrusion of bone anchor through the nailbed, 6 years after zone I FDP tendon avulsion injury repair and a brief review of literature.

  5. Anchoring bias in online voting

    Science.gov (United States)

    Yang, Zimo; Zhang, Zi-Ke; Zhou, Tao

    2012-12-01

    Voting online with explicit ratings could largely reflect people's preferences and objects' qualities, but ratings are always irrational, because they may be affected by many unpredictable factors like mood, weather and other people's votes. By analyzing two real systems, this paper reveals a systematic bias embedding in the individual decision-making processes, namely people tend to give a low rating after a low rating, as well as a high rating following a high rating. This so-called anchoring bias is validated via extensive comparisons with null models, and numerically speaking, the extent of bias decays with voting interval in a logarithmic form. Our findings could be applied in the design of recommender systems and considered as important complementary materials to previous knowledge about anchoring effects on financial trades, performance judgments, auctions, and so on.

  6. [Assisted reproductive techniques in single women: Which proposals for which demands?].

    Science.gov (United States)

    Decanter, C

    2016-05-01

    The French bio-ethic law concerning ART is more restricted than in other countries. Techniques can only be applied in heterosexual couples presenting a documented infertility. Nevertheless, concerns about fertility planning are numerous in young women, leading to a growing demand of reproductive medicine consultations. Two situations can be distinguished: firstly, single patients wishing sperm donation and, secondly, single patients who wish to preserve their fertility for future parenting project. This latter situation can be discussed in the French legislative context while the other will require soliciting the neighboring European teams. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  7. Anchoring Vignettes and Response Consistency

    OpenAIRE

    Arie Kapteyn; Smith, James P.; Arthur van Soest

    2011-01-01

    The use of anchoring vignettes to correct for differential item functioning rests upon two identifying assumptions: vignette equivalence and response consistency. To test the second assumption the authors conduct an experiment in which respondents in an Internet panel are asked to both describe their health in a number of domains and rate their health in these domains. In a subsequent interview respondents are shown vignettes that are in fact descriptions of their own health. Under response c...

  8. Risk of gestational diabetes mellitus in patients undergoing assisted reproductive techniques.

    Science.gov (United States)

    Ashrafi, M; Gosili, R; Hosseini, R; Arabipoor, A; Ahmadi, J; Chehrazi, M

    2014-05-01

    To compare the incidence of gestational diabetes mellitus (GDM) between pregnancies conceived spontaneously and pregnancies conceived following assisted reproductive technology (ART). This cross-sectional study evaluated the medical records of 215 women who conceived spontaneously and 145 women who conceived following ART from September 2011 to October 2012. Exclusion criteria were: polycystic ovary syndrome, maternal age ≥40 years, family history of diabetes in first-degree relatives, pre-pregnancy diabetes, glucose intolerance treated with hypoglycaemic agent (e.g. metformin), history of GDM, history of stillbirth, recurrent miscarriage, history of baby with birth weight ≥4kg (macrosomia), parity >3, Cushing syndrome, congenital adrenal hyperplasia and hypothyroidism. For better comparison of the incidence of GDM, the ART group was further subdivided into: (i) an in-vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) group (n=95); and (ii) an intrauterine insemination (IUI) group (n=50). The diagnosis of GDM was based on the criteria of the American Diabetes Association. The incidence of GDM was significantly higher in the IVF/ICSI and IUI groups (43% and 26%, respectively) compared with the spontaneous pregnancy group (10%). Age, pre-pregnancy body mass index (BMI) and weight gain in pregnancy were similar among women with GDM in all three groups. In addition, the incidence of pregnancy-induced hypertension was significantly higher in the IVF/ICSI group (21%) compared with the spontaneous pregnancy group (7%). Logistic regression analysis demonstrated four strong risk factors for GDM: age, BMI, mode of ART and progesterone use during pregnancy. This study indicated that the risk of GDM is two-fold higher in women with singleton pregnancies conceived following ART compared with women who conceived spontaneously. In addition, progesterone use during pregnancy was found to be an important risk factor for GDM. This subject requires further study

  9. Robot-assisted anatrophic nephrolithotomy: description of technique and early results.

    Science.gov (United States)

    King, Sherita A; Klaassen, Zachary; Madi, Rabii

    2014-03-01

    To assess the feasibility and report early outcomes of robot-assisted anatrophic nephrolithotomy (RAN) as a treatment modality for patients with complex staghorn calculi. In this single-center prospective study, seven consecutive patients underwent RAN for complex staghorn calculi. After dissection to the renal hilum and clamping of the renal vessels, a nephrotomy was made along the Brodel line and dissection carried through the collecting system to the calculus. The stone was extracted, and the collecting system and parenchyma were closed in layers; no cooling of the kidney was performed. The mean patient age was 47±16 years, mean body mass index was 31.9±10.0 kg/m(2), and five of seven patients had complete staghorn calculi. Mean warm ischemia time was 35±7 minutes, mean robotic time was 158±51 minutes, and mean estimated blood loss was 121±39 mL. Mean length of stay was 3.0±1.7 days, and there was one perioperative complication. Five of seven patients had >90% reduction in stone burden, and two (29%) patients were completely stone free. Mean follow-up time was 5.1±4.3 months, and there was no decrease in postoperative estimated glomerular filtration rate compared with preoperative values. Our preliminary experience with RAN demonstrates a safe procedure with encouraging outcomes as a minimally invasive treatment modality for patients with extensive stone burden. Longer follow-up to determine the effect of RAN on renal function is needed.

  10. Factors affected by surgical technique when treating total colonic aganglionosis: laparoscopy-assisted versus open surgery.

    Science.gov (United States)

    Miyano, Go; Ochi, Takanori; Lane, Geoffrey J; Okazaki, Tadaharu; Yamataka, Atsuyuki

    2013-04-01

    We compared laparoscopy-assisted Duhamel (Lap-D) with open surgery (Duhamel or Soave = D/S) for treating total colonic aganglionosis (TCA) in children to establish what factors may affect outcome. Fourteen TCA cases treated between 1990 and 2010 were reviewed. Open D/S (O-D/S) through a vertical midline abdominal incision was routine from 1990 to 2005, whereupon Lap-D became routine. Lap-D involves laparoscopic colon resection, ileostomy take-down, and ileum pull-through through an additional Pfannenstiel incision. We compared pre-operative nutrition, operating time, intraoperative blood loss, duration until oral challenge, postoperative analgesic usage, incidence of enterocolitis, early complications that arose within 30 days of surgery, and late complications, and wound cosmesis 1 year postoperatively (Grade-1: unacceptable, Grade-2: passable, Grade-3: excellent). Six had O-D/S (2D, 4S) and eight had Lap-D. Differences in patient demographics, mean ages/weights at surgery, average length of the aganglionic segment from the terminal ileum, operating time, and time taken for oral challenge were all not significant, full feeding took longer in O-D/S (6.7 vs. 5.9 days). Preoperative central vein intravenous hyperalimentation was required for one case in O-D/S and two cases in Lap-D. These three required hospitalization for at least 30 days postoperatively and parenteral nutrition after discharge. Although there were no intraoperative complications in either group, there was one case of transient ileus in O-D/S that resolved conservatively. Cosmesis was significantly better in Lap-D (O-D/S = 1.2; Lap-D = 2.1; p < 0.05). Cosmesis was the only factor that was significantly different between Lap-D and O-D/S; all other factors were similar.

  11. Application of Assistive Computer Vision Methods to Oyama Karate Techniques Recognition

    Directory of Open Access Journals (Sweden)

    Tomasz Hachaj

    2015-09-01

    Full Text Available In this paper we propose a novel algorithm that enables online actions segmentation and classification. The algorithm enables segmentation from an incoming motion capture (MoCap data stream, sport (or karate movement sequences that are later processed by classification algorithm. The segmentation is based on Gesture Description Language classifier that is trained with an unsupervised learning algorithm. The classification is performed by continuous density forward-only hidden Markov models (HMM classifier. Our methodology was evaluated on a unique dataset consisting of MoCap recordings of six Oyama karate martial artists including multiple champion of Kumite Knockdown Oyama karate. The dataset consists of 10 classes of actions and included dynamic actions of stands, kicks and blocking techniques. Total number of samples was 1236. We have examined several HMM classifiers with various number of hidden states and also Gaussian mixture model (GMM classifier to empirically find the best setup of the proposed method in our dataset. We have used leave-one-out cross validation. The recognition rate of our methodology differs between karate techniques and is in the range of 81% ± 15% even to 100%. Our method is not limited for this class of actions but can be easily adapted to any other MoCap-based actions. The description of our approach and its evaluation are the main contributions of this paper. The results presented in this paper are effects of pioneering research on online karate action classification.

  12. One-incision versus two-incision techniques for arthroscopically assisted anterior cruciate ligament reconstruction in adults.

    Science.gov (United States)

    Rezende, Fernando C; Moraes, Vinícius Y; Franciozi, Carlos Es; Debieux, Pedro; Luzo, Marcus V; Belloti, João Carlos

    2017-12-15

    Anterior cruciate ligament (ACL) tears are serious knee injuries that are frequently treated surgically in the form of arthroscopically assisted reconstruction with grafts from the patella or hamstrings tendons. We reviewed the evidence for the choice of arthroscopically assisted ACL reconstruction technique in terms of whether it should involve one incision (femoral tunnel drilled from inside the knee joint under arthroscopic visualisation) or two incisions (femoral tunnel drilled from outside to inside the knee joint). To assess the effects (benefits and harms) of one-incision versus two-incision techniques for arthroscopically assisted ACL reconstruction in adults. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Latin American and Caribbean Health Sciences (LILACS), the World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov, reference lists, and conference abstracts. The date of the search was 16 August 2017. Randomised and quasi-randomised controlled clinical trials evaluating one-incision versus two-incision techniques for arthroscopically assisted ACL reconstruction in adults. Two review authors independently searched and selected studies, and extracted data and assessed the risk of bias of the eligible studies. We undertook limited pooling of data using the fixed-effect model. We included five trials (four randomised and one quasi-randomised) evaluating a total of 320 participants who were mainly in their 20s. All participants underwent ACL reconstruction with patella tendon grafts. All five included trials were at a high risk of bias, particularly performance bias. Based on these limitations and the insufficiency of the available data resulting in imprecision of effect estimates, we judged the quality of the evidence as very low for all outcomes. This means that we are uncertain of the findings of the

  13. Electrostatically anchored branched brush layers.

    Science.gov (United States)

    Liu, Xiaoyan; Dedinaite, Andra; Rutland, Mark; Thormann, Esben; Visnevskij, Ceslav; Makuska, Ricardas; Claesson, Per M

    2012-11-06

    A novel type of block copolymer has been synthesized. It consists of a linear cationic block and an uncharged bottle-brush block. The nonionic bottle-brush block contains 45 units long poly(ethylene oxide) side chains. This polymer was synthesized with the intention of creating branched brush layers firmly physisorbed to negatively charged surfaces via the cationic block, mimicking the architecture (but not the chemistry) of bottle-brush molecules suggested to be present on the cartilage surface, and contributing to the efficient lubrication of synovial joints. The adsorption properties of the diblock copolymer as well as of the two blocks separately were studied on silica surfaces using quartz crystal microbalance with dissipation monitoring (QCM-D) and optical reflectometry. The adsorption kinetics data highlight that the diblock copolymers initially adsorb preferentially parallel to the surface with both the cationic block and the uncharged bottle-brush block in contact with the surface. However, as the adsorption proceeds, a structural change occurs within the layer, and the PEO bottle-brush block extends toward solution, forming a surface-anchored branched brush layer. As the adsorption plateau is reached, the diblock copolymer layer is 46-48 nm thick, and the water content in the layer is above 90 wt %. The combination of strong electrostatic anchoring and highly hydrated branched brush structures provide strong steric repulsion, low friction forces, and high load bearing capacity. The strong electrostatic anchoring also provides high stability of preadsorbed layers under different ionic strength conditions.

  14. Wound closure of leg fasciotomy: comparison of vacuum-assisted closure versus shoelace technique. A randomised study.

    Science.gov (United States)

    Kakagia, D; Karadimas, E J; Drosos, G; Ververidis, A; Trypsiannis, G; Verettas, D

    2014-05-01

    Fasciotomies, though essential for the prevention and management of compartment syndromes, may increase morbidity and prolong hospitalisation. Two widely applied methods of delayed primary closure are compared in leg fasciotomy wounds. Two groups, each of 25 patients with leg fasciotomies due to fractures and soft tissue injuries, who were randomly assigned to be treated either by vacuum assisted closure (VAC®, n=42 wounds, group V) or by the shoelace technique (n=40 wounds, group S), were evaluated in this study. Wound length, time to definite closure, complications, need for additional interventions and daily treatment costs were data collected and statistically assessed. Wound closure time was significantly higher in group V compared to group S (p=0.001; 95% CI of the difference, 1.8-6.3 days). Five group V patients required split thickness skin grafts. In six group S patients, the vessel loops had to be replaced. The mean daily cost of negative pressure therapy alone was 135 euro (range 117-144 euro), whilst the mean daily cost of treatment for the shoelace technique was 14 euro ranging from 8 to 18 euro (p=closure of leg fasciotomy wounds. VAC® requires longer time to definite wound closure and is far more expensive than the shoelace technique, especially when additional skin grafting is required. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Development of a novel technique to assess the vulnerability of micro-mechanical system components to environmentally assisted cracking.

    Energy Technology Data Exchange (ETDEWEB)

    Enos, David George; Goods, Steven Howard

    2006-11-01

    Microelectromechanical systems (MEMS) will play an important functional role in future DOE weapon and Homeland Security applications. If these emerging technologies are to be applied successfully, it is imperative that the long-term degradation of the materials of construction be understood. Unlike electrical devices, MEMS devices have a mechanical aspect to their function. Some components (e.g., springs) will be subjected to stresses beyond whatever residual stresses exist from fabrication. These stresses, combined with possible abnormal exposure environments (e.g., humidity, contamination), introduce a vulnerability to environmentally assisted cracking (EAC). EAC is manifested as the nucleation and propagation of a stable crack at mechanical loads/stresses far below what would be expected based solely upon the materials mechanical properties. If not addressed, EAC can lead to sudden, catastrophic failure. Considering the materials of construction and the very small feature size, EAC represents a high-risk environmentally induced degradation mode for MEMS devices. Currently, the lack of applicable characterization techniques is preventing the needed vulnerability assessment. The objective of this work is to address this deficiency by developing techniques to detect and quantify EAC in MEMS materials and structures. Such techniques will allow real-time detection of crack initiation and propagation. The information gained will establish the appropriate combinations of environment (defining packaging requirements), local stress levels, and metallurgical factors (composition, grain size and orientation) that must be achieved to prevent EAC.

  16. Extravesical robot-assisted laparoscopic ureteral reimplantation for vesicoureteral reflux: initial experience in Japan with the ureteral advancement technique.

    Science.gov (United States)

    Hayashi, Yutaro; Mizuno, Kentaro; Kurokawa, Satoshi; Nakane, Akihiro; Kamisawa, Hideyuki; Nishio, Hidenori; Moritoki, Yoshinobu; Tozawa, Keiichi; Kohri, Kenjiro; Kojima, Yoshiyuki

    2014-10-01

    To report our initial experience with robot-assisted laparoscopic extravesical ureteral reimplantation using the ureteral advancement technique. A total of 15 ureters from nine patients (age range 2-25 years) underwent robot-assisted laparoscopic extravesical ureteral reimplantation for the management of vesicoureteral reflux. The reflux was classified as grade I in one ureter, grade II in two ureters, grade III in seven ureters, grade IV in three ureters and grade V in two ureters. One of the five female patients had a bilateral duplex system, and reflux was observed in all four ureters. The da Vinci surgical system was utilized. Ureteral advancement was carried out in all cases. We also compared the operative outcomes between conventional laparoscopic procedure and robotic surgery. The console time was 211.5 ± 87.4 min (median ± standard deviation) in the bilateral cases and 144.0 ± 40.8 min in the unilateral cases. Urethral catheters were removed at one or two postoperative days. None of the patients suffered postoperative complications, such as urine leakage or urinary retention. Postoperative voiding cystourethrography showed that the reflux had been resolved in 14 of the 15 ureters (success rate 93.3%). In the remaining case, the reflux grade decreased from III to I. The operative outcomes of robotic surgery were favorable and safe compared with conventional laparoscopic procedure. Our preliminary results showed that robot-assisted laparoscopic surgery is a feasible and useful approach to extravesical ureteral reimplantation, even for patients with bilateral reflux. © 2014 The Japanese Urological Association.

  17. Time-of-flight camera technique for augmented reality in computer-assisted interventions

    Science.gov (United States)

    Mersmann, Sven; Müller, Michael; Seitel, Alexander; Arnegger, Florian; Tetzlaff, Ralf; Dinkel, Julien; Baumhauer, Matthias; Schmied, Bruno; Meinzer, Hans-Peter; Maier-Hein, Lena

    2011-03-01

    Augmented reality (AR) for enhancement of intra-operative images is gaining increasing interest in the field of navigated medical interventions. In this context, various imaging modalities such as ultrasound (US), C-Arm computed tomography (CT) and endoscopic images have been applied to acquire intra-operative information about the patient's anatomy. The aim of this paper was to evaluate the potential of the novel Time-of-Flight (ToF) camera technique as means for markerless intra-operative registration. For this purpose, ToF range data and corresponding CT images were acquired from a set of explanted non-transplantable human and porcine organs equipped with a set of marker that served as targets. Based on a rigid matching of the surfaces generated from the ToF images with the organ surfaces generated from the CT data, the targets extracted from the planning images were superimposed on the 2D ToF intensity images, and the target visualization error (TVE) was computed as quality measure. Color video data of the same organs were further used to assess the TVE of a previously proposed marker-based registration method. The ToF-based registration showed promising accuracy yielding a mean TVE of 2.5+/-1.1 mm compared to 0.7+/-0.4 mm with the marker-based approach. Furthermore, the target registration error (TRE) was assessed to determine the anisotropy in the localization error of ToF image data. The TRE was 8.9+/- 4.7 mm on average indicating a high localization error in the viewing direction of the camera. Nevertheless, the young ToF technique may become a valuable means for intra-operative surface acquisition. Future work should focus on the calibration of systematic distance errors.

  18. Economic evaluation of alternative assisted reproduction techniques in management of infertility in Greece

    Science.gov (United States)

    Fragoulakis, Vassilis; Kourlaba, Georgia; Tarlatzis, Basil; Mastrominas, Minas; Maniadakis, Nikolaos

    2012-01-01

    Background The purpose of this study was to compare Gonal-F®, a recombinant follicle-stimulating hormone, with Menopur®, a highly purified human menopausal gonadotrophin (hpHMG) in assisted reproduction in Greece. Methods A decision tree in combination with a Markov model was used to assess the clinical and economical impact of comparators for up to three consecutive cycles. Transition probabilities were derived from the literature and validated by clinical experts. Cost components were derived from the electronic databases of selected private and public clinics. A probabilistic sensitivity analysis was performed to deal with uncertainty and to construct a cost-effectiveness acceptability curve. Results There was a statistically significant difference in favor of the recombinant follicle-stimulating hormone arm compared with hpHMG, which was associated with 52 more births (95% uncertainty interval 26–78, P = 0.001) per 1000 patients. The cost per birth was estimated at €16,906 and €17,286 in the recombinant follicle-stimulating hormone and hpHMG arms, respectively. The cost per in vitro fertilization was estimated at €4365 in the recombinant follicle-stimulating hormone arm and €3815 in the hpHMG arm, indicating a difference of €550. The incremental cost per birth for recombinant follicle-stimulating hormone versus hpHMG was estimated at €14,540, while the incremental cost per life-year was estimated at €175.41. Conclusion Recombinant follicle-stimulating hormone may represent a cost-effective choice compared with hpHMG when used for ovarian stimulation for a pharmacoeconomic point of view in the Greek public health care setting. However, it must be noted that in clinical practice both agents may be used together to increase the number of follicles, oocytes, embryos, and/or pregnancies in treated patients, an approach which has not been evaluated in Greece or reported in the literature due to obvious limitations. PMID:22888264

  19. Economic evaluation of alternative assisted reproduction techniques in management of infertility in Greece

    Directory of Open Access Journals (Sweden)

    Fragoulakis V

    2012-07-01

    Full Text Available Vassilis Fragoulakis,1 Georgia Kourlaba,1 Basil Tarlatzis,2 Minas Mastrominas,3 Nikolaos Maniadakis,11Department of Health Services Management, National School of Public Health, Athens; 2Unit of Human Reproduction, 1st Dept of OB/GYN, Medical School of Aristotle University of Thessaloniki, Thessaloniki; 3Embryogenesis Centre for Reproductive and Fertility Studies, Athens, GreeceBackground: The purpose of this study was to compare Gonal-F®, a recombinant follicle-stimulating hormone, with (Menopur®, a highly purified human menopausal gonadotrophin (hpHMG in assisted reproduction in Greece.Methods: A decision tree in combination with a Markov model was used to assess the clinical and economical impact of comparators for up to three consecutive cycles. Transition probabilities were derived from the literature and validated by clinical experts. Cost components were derived from the electronic databases of selected private and public clinics. A probabilistic sensitivity analysis was performed to deal with uncertainty and to construct a cost-effectiveness acceptability curve.Results: There was a statistically significant difference in favor of the recombinant follicle-stimulating hormone arm compared with hpHMG, which was associated with 52 more births (95% uncertainty interval 26–78, P = 0.001 per 1000 patients. The cost per birth was estimated at €16,906 and €17,286 in the recombinant follicle-stimulating hormone and hpHMG arms, respectively. The cost per in vitro fertilization was estimated at €4365 in the recombinant follicle-stimulating hormone arm and €3815 in the hpHMG arm, indicating a difference of €550. The incremental cost per birth for recombinant follicle-stimulating hormone versus hpHMG was estimated at €14,540, while the incremental cost per life-year was estimated at €175.41.Conclusion: Recombinant follicle-stimulating hormone may represent a cost-effective choice compared with hpHMG when used for ovarian stimulation

  20. An electromagnetic signals monitoring and analysis wireless platform employing personal digital assistants and pattern analysis techniques

    Science.gov (United States)

    Ninos, K.; Georgiadis, P.; Cavouras, D.; Nomicos, C.

    2010-05-01

    This study presents the design and development of a mobile wireless platform to be used for monitoring and analysis of seismic events and related electromagnetic (EM) signals, employing Personal Digital Assistants (PDAs). A prototype custom-developed application was deployed on a 3G enabled PDA that could connect to the FTP server of the Institute of Geodynamics of the National Observatory of Athens and receive and display EM signals at 4 receiver frequencies (3 KHz (E-W, N-S), 10 KHz (E-W, N-S), 41 MHz and 46 MHz). Signals may originate from any one of the 16 field-stations located around the Greek territory. Employing continuous recordings of EM signals gathered from January 2003 till December 2007, a Support Vector Machines (SVM)-based classification system was designed to distinguish EM precursor signals within noisy background. EM-signals corresponding to recordings preceding major seismic events (Ms≥5R) were segmented, by an experienced scientist, and five features (mean, variance, skewness, kurtosis, and a wavelet based feature), derived from the EM-signals were calculated. These features were used to train the SVM-based classification scheme. The performance of the system was evaluated by the exhaustive search and leave-one-out methods giving 87.2% overall classification accuracy, in correctly identifying EM precursor signals within noisy background employing all calculated features. Due to the insufficient processing power of the PDAs, this task was performed on a typical desktop computer. This optimal trained context of the SVM classifier was then integrated in the PDA based application rendering the platform capable to discriminate between EM precursor signals and noise. System's efficiency was evaluated by an expert who reviewed 1/ multiple EM-signals, up to 18 days prior to corresponding past seismic events, and 2/ the possible EM-activity of a specific region employing the trained SVM classifier. Additionally, the proposed architecture can form a

  1. Arthroscopic-Assisted Treatment of a Reversed Hill-Sachs Lesion: Description of a New Technique Using Cerament

    Directory of Open Access Journals (Sweden)

    S. Bark

    2015-01-01

    Full Text Available Purpose. Impaction fractures of the anterior aspect of the humeral head, the reversed Hill-Sachs lesion, are common in posterior shoulder dislocation. We present a new technique to address these lesions arthroscopic-assisted with the use of a bone substitute. Methods. We report the case of a 45-year-old male with a reversed Hill-Sachs lesion after posterior shoulder dislocation. Initially a glenohumeral arthroscopy is performed to address concomitant intra-articular injuries. Guided by the k-wire a cannulated sizer was inserted for reduction of the fracture under arthroscopic visualization. For reduction of the impacted part of the humeral head the subcortical defect was filled with an injectable bone substitute (Cerament to prevent secondary dislocation. Results. X-ray at follow-up 6 months after the index procedure documents the bony remodeling of the bone substitute. At that time the patient was pain-free (VAS 0 and satisfied with the outcome (Constant score: 78, Rand-36 score: 84, Rowe score: 81 with a good ROM. Conclusions. In conclusion, arthroscopic-assisted reconstruction of reversed Hill-Sachs lesions with an injectable bone substitute is feasible and may provide patients with all the benefits of an anatomic reconstruction with decreased risks related to open surgery.

  2. [Interceptive treatment of maxillary hypoplasia with the use of bone anchors. A review of the literature].

    Science.gov (United States)

    Vermeulen, F M J; De Clerck, H J; van Beek, H; Becking, A G

    2014-02-01

    A Class III malocclusion is mainly caused by a hypoplastic maxilla and therefore the treatment is principally aimed at stimulating the growth of the maxilla. Disadvantages of conventional treatment methods are that treatment effects are mainly dentoalveolar rather than skeletal and that there is often an increase in the height of the lowerface. Moreover, patients are not always cooperative about wearing extra-oral appliances. Because of these disadvantages, a new treatment approach has been developed which makes use of skeletal anchoring. In this new technique, called 'bone anchored maxillary protraction, bone anchors are placed on both sides of the maxilla and the mandibula, onto which Class III elastics are attached. The literature shows that good results have been achieved with this method. Disadvantages of this method are that the placement of the bone anchors requires a surgical procedure and that complications, like the loosening or breaking of the anchors, can occur.

  3. The attitudes of infertile couples towards assisted reproductive techniques in Yazd, Iran: A cross sectional study in 2014.

    Science.gov (United States)

    Afshani, Seyed Alireza; Abdoli, Ali Mohammad; Hashempour, Mehrieh; Baghbeheshti, Maryam; Zolfaghari, Mohammad

    2016-12-01

    Knowledge about assisted reproductive techniques (ART) and its procedures affect the attitude of infertile people. Making decisions about the use of ART is affected by one's perception and attitude. The aim of this cross-sectional study was to determine the attitude of infertile couples toward applying ART, and to investigate its related factors. A randomized cross-sectional study was conducted on 184 infertile couples who had referred to the Research and Clinical Center of Infertility, Yazd, Iran for diagnosis and treatment in June 2014. The data was collected using a two-part questionnaire containing demographic and attitudinal statements. For data analysis, SPSS statistical software and statistical tests of mean differences (t-test), Pearson correlation and analysis of variance were used. A significant relationship between spouse's attitude (p0.05). In conclusion, making a decision and accepting ART can be influenced by couple's attitude, their family's attitude and applied knowledge of ART.

  4. Nano-coating of beta-galactosidase onto the surface of lactose by using an ultrasound-assisted technique

    DEFF Research Database (Denmark)

    Genina, Natalja; Räikkönen, Heikki; Heinämäki, Jyrki

    2010-01-01

    . Stability of protein-coated lactose was due to the absence of water within the powder, as it was dry after the treatment procedure. In conclusion, we were able to attach the polypeptide to the core particles and determine precisely the coating efficiency of the surface-treated powder using a simple approach.......We nano-coated powdered lactose particles with the enzyme beta-galactosidase using an ultrasound-assisted technique. Atomization of the enzyme solution did not change its activity. The amount of surface-attached beta-galactosidase was measured through its enzymatic reaction product D......-galactose using a standardized method. A near-linear increase was obtained in the thickness of the enzyme coat as the treatment proceeded. Interestingly, lactose, which is a substrate for beta-galactosidase, did not undergo enzymatic degradation during processing and remained unchanged for at least 1 month...

  5. Novel technique of creating a seal for the vacuum-assisted closure system application in complex head and neck wounds.

    Science.gov (United States)

    Tian, Brian; Iyer, N Gopalakrishna; Tan, Hiang Khoon; Tay, Ai Choo; Soo, Khee Chee; Tan, Ngian Chye

    2016-12-01

    Achieving a good seal for the application of the vacuum-assisted closure (VAC) system in complex head and neck wounds is difficult. A case series of 4 patients who developed postoperative orocutaneous or pharyngocutaneous fistulas were studied. A sterile green glove was used as a sealant together with the VAC system. With utilization of a green glove, a good seal for the VAC system was obtained. This gave ample time to cleanse the wound and allow granulation tissue to form before proceeding on to the next stage of treatment. A green glove technique allows for a good seal for the VAC system to work, especially when applied to complex head and neck wounds. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2523-E2526, 2016. © 2016 Wiley Periodicals, Inc.

  6. Gonioscopy-assisted transluminal trabeculotomy, ab interno trabeculotomy: technique report and preliminary results.

    Science.gov (United States)

    Grover, Davinder S; Godfrey, David G; Smith, Oluwatosin; Feuer, William J; Montes de Oca, Ildamaris; Fellman, Ronald L

    2014-04-01

    To introduce a minimally invasive, ab interno approach to a circumferential 360-degree trabeculotomy and to report the preliminary results. Retrospective, noncomparative cases series. Eighty-five eyes of 85 consecutive patients who sought treatment at Glaucoma Associates of Texas with uncontrolled open-angle glaucoma and underwent gonioscopy-assisted transluminal trabeculotomy (GATT) for whom there was at least 6 months of follow-up data. Retrospective chart review of patients who underwent GATT by 4 of the authors (D.S.G., D.G.G., O.S., R.L.F.) between October 2011 and October 2012. The surgery was performed in adults with various open-angle glaucomas. Intraocular pressure (IOP), glaucoma medications, visual acuity, and intraoperative as well as postoperative complications. Eighty-five patients with an age range of 24 to 88 years underwent GATT with at least 6 months of follow-up. In 57 patients with primary open-angle glaucoma, the IOP decreased by 7.7 mmHg (standard deviation [SD], 6.2 mm Hg; 30.0% [SD, 22.7%]) with an average decrease in glaucoma medications of 0.9 (SD, 1.3) at 6 months. In this group, the IOP decreased by 11.1 mmHg (SD, 6.1 mmHg; 39.8% [SD, 16.0%]) with 1.1 fewer glaucoma medications at 12 months. In the secondary glaucoma group of 28 patients, IOP decreased by 17.2 mmHg (SD, 10.8 mmHg; 52.7% [SD, 15.8%]) with an average of 2.2 fewer glaucoma medications at 6 months. In this group, the IOP decreased by 19.9 mmHg (SD, 10.2 mmHg; 56.8% [SD, 17.4%]) with an average of 1.9 fewer medications (SD, 2.1) at 12 months. Treatment was considered to have failed in 9% (8/85) of patients because of the need for further glaucoma surgery. The cumulative proportion of failure at 1 year ranged from 0.1 to 0.32, depending on the group. Lens status or concurrent cataract surgery did not have a statistically significant effect on IOP in eyes that underwent GATT at either 6 or 12 months (P > 0.35). The most common complication was transient hyphema, seen in

  7. Power Management Based Current Control Technique for Photovoltaic-Battery Assisted Wind-Hydro Hybrid System

    Science.gov (United States)

    Ram Prabhakar, J.; Ragavan, K.

    2013-07-01

    This article proposes new power management based current control strategy for integrated wind-solar-hydro system equipped with battery storage mechanism. In this control technique, an indirect estimation of load current is done, through energy balance model, DC-link voltage control and droop control. This system features simpler energy management strategy and necessitates few power electronic converters, thereby minimizing the cost of the system. The generation-demand (G-D) management diagram is formulated based on the stochastic weather conditions and demand, which would likely moderate the gap between both. The features of management strategy deploying energy balance model include (1) regulating DC-link voltage within specified tolerances, (2) isolated operation without relying on external electric power transmission network, (3) indirect current control of hydro turbine driven induction generator and (4) seamless transition between grid-connected and off-grid operation modes. Furthermore, structuring of the hybrid system with appropriate selection of control variables enables power sharing among each energy conversion systems and battery storage mechanism. By addressing these intricacies, it is viable to regulate the frequency and voltage of the remote network at load end. The performance of the proposed composite scheme is demonstrated through time-domain simulation in MATLAB/Simulink environment.

  8. CTAB assisted growth and characterization of nanocrystalline CuO films by ultrasonic spray pyrolysis technique

    Science.gov (United States)

    Singh, Iqbal; Kaur, Gursharan; Bedi, R. K.

    2011-09-01

    An aqueous solution of cupric nitrate trihydrate (Cu(NO 3) 2·3H 2O) modified with cetyltrimetylammonium bromide (CTAB) is used to deposit CuO films on glass substrate by chemical spray pyrolysis technique. The thermal analysis shows that the dried CTAB doped precursor decomposes by an exothermic reaction and suggests that minimum substrate temperature for film deposition should be greater than 270 °C. X-ray diffraction (XRD) studies indicate the formation of monoclinic CuO with preferential orientation along (0 0 2) plane for all film samples. The CTAB used as cationic surfactant in precursor results in the suppression of grain growth in films along the (1 1 0), (0 2 0) and (2 2 0) crystal planes of CuO. Surfactant modified films showed an increase in crystallite size of 14 nm at substrate temperature of 300 °C. The scanning electron micrographs (FESEM) confirm the uniform distribution of facets like grains on the entire area of substrate. CTAB modified films show a significant reduction in the particle agglomeration. Electrical studies of the CuO films deposited at substrate temperature of 300 °C with and without surfactant reveal that the CTAB doping increase the activation energy of conduction by 0.217 eV and room temperature response to ammonia by 9%. The kinetics of the ammonia gas adsorption on the film surface follows the Elovich and Diffusion models.

  9. Simultaneous spectrophotometric determination of glimepiride and pioglitazone in binary mixture and combined dosage form using chemometric-assisted techniques

    Science.gov (United States)

    El-Zaher, Asmaa A.; Elkady, Ehab F.; Elwy, Hanan M.; Saleh, Mahmoud Abo El Makarim

    2017-07-01

    In the present work, pioglitazone and glimepiride, 2 widely used antidiabetics, were simultaneously determined by a chemometric-assisted UV-spectrophotometric method which was applied to a binary synthetic mixture and a pharmaceutical preparation containing both drugs. Three chemometric techniques - Concentration residual augmented classical least-squares (CRACLS), principal component regression (PCR), and partial least-squares (PLS) were implemented by using the synthetic mixtures containing the two drugs in acetonitrile. The absorbance data matrix corresponding to the concentration data matrix was obtained by the measurements of absorbencies in the range between 215 and 235 nm in the intervals with Δλ = 0.4 nm in their zero-order spectra. Then, calibration or regression was obtained by using the absorbance data matrix and concentration data matrix for the prediction of the unknown concentrations of pioglitazone and glimepiride in their mixtures. The described techniques have been validated by analyzing synthetic mixtures containing the two drugs showing good mean recovery values lying between 98 and 100%. In addition, accuracy and precision of the three methods have been assured by recovery values lying between 98 and 102% and R.S.D. % ˂0.6 for intra-day precision and ˂1.2 for inter-day precision. The proposed chemometric techniques were successfully applied to a pharmaceutical preparation containing a combination of pioglitazone and glimepiride in the ratio of 30: 4, showing good recovery values. Finally, statistical analysis was carried out to add a value to the verification of the proposed methods. It was carried out by an intrinsic comparison between the 3 chemometric techniques and by comparing values of present methods with those obtained by implementing reference pharmacopeial methods for each of pioglitazone and glimepiride.

  10. The Social Impact of the Offer of Assisted Reproductive Techniques (ART) in a University Hospital in Rio de Janeiro.

    Science.gov (United States)

    Costa, Tonia; Corrêa, Marilena C D V

    2015-02-01

    The aim of this study is to report the procedures undertaken in the laboratory of semen of a university hospital specialized in human reproduction in Rio de Janeiro, principally Homologous Artificial Insemination (HAI) taking into account a more social aspect. This descriptive and retrospective study was based on documentary research. The source of information included medical records and registers containing the procedures performed in the laboratory of semen and the HAI. Testimonies, questionings and suggestions given by the couples during the process were also registered. The couples were clearly informed about the techniques and many times they externalized their demands, doubts and desires in relation to the procedures, treatment and issues concerning their wish to have children and start a family. The discussion shows concerns over the techniques and theories used in this context when performing procedures in the laboratory of semen. The bond to the service remains based on the idea that "now my dream of having kids will come true". Nevertheless, for the operationalization of the access to ARTs, at the public sector of medicine, we should count on the implementation of the National Politics in Assisted Reproduction. It did not take place and today it has even been removed, no longer being in force. It makes very clear the distance between the "accomplishment of the desire for children" and the reality of the provision of means and resources for ART at the medical public level in Brazil.

  11. Fabrication of anticorrosive multilayer onto magnesium alloy substrates via spin-assisted layer-by-layer technique

    Energy Technology Data Exchange (ETDEWEB)

    Cai Kaiyong, E-mail: Kaiyong_cai@cqu.edu.cn [Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400044 (China); Sui Xiaojing; Hu Yan [Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400044 (China); Zhao Li [China National Centre for Biotechnology Development, No. 16, Xi Si Huan Zhong Lu, Haidian District, Beijing 100036 (China); Lai Min; Luo Zhong; Liu Peng; Yang Weihu [Key Laboratory of Biorheological Science and Technology (Chongqing University), Ministry of Education, College of Bioengineering, Chongqing University, Chongqing 400044 (China)

    2011-12-01

    To improve the corrosion resistance of magnesium alloy, we reported a novel approach for the fabrication of anticorrosive multilayers onto AZ91D substrates. The multilayers were composed of poly(ethylene imine) (PEI), poly(styrene sulfonate) (PSS) and 8-hydroxyquinoline (8HQ). They were deposited onto AZ91D substrates via a spin-assisted layer-by-layer (LbL) technique. The multilayered structure was stabilized with glutaraldehyde (GA) as crossing linker. It was confirmed by Fourier transform infrared spectroscopy (FT-IR). Surface morphologies and elemental compositions of the formed anticorrosive multilayers were characterized with scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS), respectively. The corrosion performance of the multilayer coated AZ91D substrates was characterized by hydrogen evolution. The results of electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization measurements suggested that the multilayered coating improved the corrosion resistance of AZ91D substrates. In vitro study revealed that the multilayered coating was cytocompatible. The study provides a potential alternative for the fabrication of corrosion resistant magnesium alloy-based implants. Highlights: {yields} Corrosion protective multilayers have been constructed onto AZ91D substrates via layer by layer technique. {yields} The multilayered structured containing 8-hydroxyquinoline highly improves the corrosion resistance of AZ91D substrates. {yields} The novel multilayered coating is potentially important for developing corrosion resistant magnesium alloy-based implants.

  12. Synthesis of conductive semi-transparent silver films deposited by a Pneumatically-Assisted Ultrasonic Spray Pyrolysis Technique

    Energy Technology Data Exchange (ETDEWEB)

    Zaleta-Alejandre, E.; Balderas-Xicoténcatl, R. [Centro de Investigación y de Estudios Avanzados-IPN, Departamento de Física, , Apdo. Postal 14-470, Del, Gustavo A. Madero, C.P. 07000, México, D.F. (Mexico); Arrieta, M.L. Pérez [Universidad Autónoma de Zacatecas, Unidad Académica de Física, Calzada Solidaridad esq. Paseo, La Bufa s/n, C.P. 98060, Zacatecas, México (Mexico); Meza-Rocha, A.N.; Rivera-Álvarez, Z. [Centro de Investigación y de Estudios Avanzados-IPN, Departamento de Física, , Apdo. Postal 14-470, Del, Gustavo A. Madero, C.P. 07000, México, D.F. (Mexico); Falcony, C., E-mail: cfalcony@fis.cinvestav.mx [Centro de Investigación y de Estudios Avanzados-IPN, Departamento de Física, , Apdo. Postal 14-470, Del, Gustavo A. Madero, C.P. 07000, México, D.F. (Mexico)

    2013-10-01

    Highlights: • We deposited metallic silver films without post-deposition annealing. • The spray pyrolysis technique is of low cost and scalable for industrial applications. • We obtained deposition rate of 60 nm min{sup −1} at 300 °C. • The average resistivity was 1E−7 Ω m. • Semi-transparent silver films were obtained at 350 °C and deposition time of 45 s. -- Abstract: The synthesis and characterization of nanostructured silver films deposited on corning glass by a deposition technique called Pneumatically-Assisted Ultrasonic Spray Pyrolysis are reported. Silver nitrate and triethanolamine were used as silver precursor and reducer agent, respectively. The substrate temperatures during deposition were in the range of 300–450 °C and the deposition times from 30 to 240 s. The deposited films are polycrystalline with cubic face-centered structure, and crystalline grain size less than 30 nm. Deposition rates up to 600 Å min{sup −1} were obtained at substrate temperature as low as 300 °C. The electrical, optical, and morphological properties of these films are also reported. Semi-transparent conductive silver films were obtained at 350 °C with a deposition time of 45 s.

  13. Current techniques to improve outcomes for early return of urinary continence following robot-assisted radical prostatectomy.

    Science.gov (United States)

    Yanagida, Tomohiko; Koguchi, Tomoyuki; Hata, Junya; Yabe, Michihiro; Sato, Yuichi; Akaihata, Hidenori; Kawashima, Yohei; Kataoka, Masao; Ogawa, Soichiro; Kumagai, Shin; Kumagai, Ken; Haga, Nobuhiro; Kushida, Nobuhiro; Ishibashi, Kei; Aikawa, Ken; Kojima, Yoshiyuki

    2014-01-01

    Although open retropubic radical prostatectomy has been the most commonly used surgical technique for patients with localized prostate cancer for decades, robot-assisted radical prostatectomy (RARP) has recently become an alternative option and widely used in Japan as well as around the world. RARP has been shown to have higher postoperative continent rates than retropubic and laparoscopic radical prostatectomy; however, urinary incontinence has remained one of the most significant causes for concern among patients who seek surgical treatment for prostate cancer, even after the introduction of RARP. The literature has shown that certain technical modifications to improve urinary continence are advocated as potential aids to reduce the risk of urinary incontinence after RARP. These modifications might be divided into 3 categories to realize the improvement of early return of urinary continence after RARP: 1) preservation, 2) reconstruction, and 3) reinforcement of the anatomic structures in the pelvis, which will make a new supporting system after radical prostatectomy. In this review, we discuss the intraoperative techniques to improve outcomes for early return of urinary continence following RARP, and provide a critical summary of current knowledge on its outcome in the literature.

  14. Formation of plano-convex micro-lens array in fused silica glass using CO2 laser assisted reshaping technique

    CERN Document Server

    Sohn, Ik-Bu; Yoo, Dongyoon; Noh, Young-Chul; Ahsan, Md Shamim; Sung, Jae-Hee; Lee, Seong-Ku

    2016-01-01

    We report on fabricating high-fill-factor plano-convex spherical and square micro-lens arrays on fused silica glass surface using CO2 laser assisted reshaping technique. Initially, periodic micro-pillars have been encoded on the glass surface by means of a femtosecond laser beam. Afterwards, the micro-pillars are polished several times by irradiating a CO2 laser beam on top of the micro-pillars. Consequently, spherical micro-lens array with micro-lens size of 50 um x 50 um and square micro-lens array with micro-lens size of 100 um x 100 um are formed on fused silica glass surface. We also study the intensity distribution of light passed through the spherical micro-lens array engraved glass sample. The simulation result shows that, the focal length of the spherical micro-lens array is 35 um. Furthermore, we investigate the optical properties of the micro-lens array engraved glass samples. The proposed CO2 laser based reshaping technique is simple and fast that shows promises in fabrication arrays of smooth mic...

  15. Impact and Effectiveness of Dual Aspiration Technique in Stent-Assisted Mechanical Thrombectomy: Recent Improvements in Acute Stroke Management

    Energy Technology Data Exchange (ETDEWEB)

    Hopf-Jensen, S., E-mail: hopfsi@diako.de; Preiß, M.; Marques, L.; Lehrke, S. [Diakonissenhospital Flensburg, Department of Diagnostic and Interventional Radiology and Neuroradiology (Germany); Schattschneider, J.; Stolze, H. [Diakonissenhospital Flensburg, Department of Neurology (Germany); Müller-Hülsbeck, S. [Diakonissenhospital Flensburg, Department of Diagnostic and Interventional Radiology and Neuroradiology (Germany)

    2016-11-15

    Background and PurposeTo evaluate feasibility and impact of dual aspiration technique (DAT) within stent-assisted mechanical thrombectomy on procedural parameters and clinical outcome.Materials and MethodsWithin 16 months, 76 consecutive patients (mean age 70.7 year; range 33–89) underwent stent-assisted mechanical thrombectomy. Of 52 enrolled patients (68.4 %) with occlusion of the anterior circulation, 22 patients (42.3 %) underwent DAT; 30 patients (57.7 %) were treated in conventional monoaspiration technique (MAT). Epidemiological data, clinical and imaging characteristics (mRS, NIHSS, ASPECTS) as well as procedural details were analyzed (TICI, number of retrieval, procedure time). Clinical outcome was determined with mRS at discharge and after 90 days.ResultsIn the context of DAT additional carotid artery stenting was required in 45.5 % (10/22) in underlying tandem lesion (vs. 0/30 MAT). No differences were found in NIHSS at admission (MAT: 20.5, range 15–29; DAT: 18.6; range 11–25), mRS at admission (MAT: 4.6 vs. DAT: 4.57) or ASPECT score (MAT: 8.3, ±1.5; DAT: 8.4, ±1.5; P > 0.05). TICI ≥ 2b/3 was conducted in 90 % (MAT) and 100 % (DAT), respectively. The procedure time was longer in the MAT group (65 min, ±25.9, range 18–126) compared to the DAT group (49.7 min, ±15, range 32–101; P = 0.016). The clinical outcome increased from admission to discharge and in follow-up after 90 days (mRS ≥ 2: MAT: 53.3 %, DAT: 54.5 %; P > 0.05).ConclusionsThe dual aspiration technique with an additional intermediate guide catheter placed closed to the stent retriever leads to decreased procedure time in the anterior circulation. Even in cases with higher thrombus load and treated in DAT, clinical outcome improved.

  16. A novel technique: Carbon dioxide gas-assisted total peritonectomy, diaphragm and intestinal meso stripping in open surgery for advanced ovarian cancer (Çukurova technique).

    Science.gov (United States)

    Khatib, Ghanim; Guzel, Ahmet Baris; Gulec, Umran Kucukgoz; Vardar, Mehmet Ali

    2017-09-01

    Most of the ovarian cancers are diagnosed at advanced stages. As peritoneal carcinomatosis increases, especially when it extends to the diaphragm and intestinal mesos, probability of obtaining complete cytoreduction is reduced. Complete cytoreduction (residue zero: R0) is one of the main factors affecting survival [1-3]. Here we present a novel technique of stripping the peritoneal surfaces as a part of cytoreductive surgery in such cases. A 55year-old woman diagnosed with peritoneal carcinomatosis was considered appropriate for primary cytoreduction after assessment of her thorax-abdominopelvic tomography, which revealed resectable intra-abdominal disease. Upon laparotomy, omental cake adherent to pelvis-filling mass, disseminated implants on the diaphragm, meso of the descending colon and small intestine were observed. The mass invaded the rectosigmoid colon, uterus, adnexa and the bladder resulting in frozen pelvis. Palpable retroperitoneal pelvic and para-aortic lymph nodes were detected. On the other side, stomach, anti-mesenteric surfaces and mesentery root of the small bowel were tumor-free. Hence, upon these perioperative and preoperative imaging findings, complete cytoreduction was thought to be achievable. Therefore, primary cytoreduction was performed. Total omentectomy, hysterectomy with bilateral salpingo-oophorectomy, rectosigmoid low anterior resection and retroperitoneal lymphadenectomy were performed. With the assistance of an injector needle connected to the insufflator tube (as in laparoscopic surgery), carbon dioxide gas was blown into the right retroperitoneal area and subsequently peritoneum was rapidly stripped up to the right diaphragm. The same procedure was then applied to the diaphragm and meso of the bowels, respectively. Owing to this technique, total stripping of all involved peritoneal surfaces was clearly facilitated and R0 goal was reached. Gas insufflation caused convenient detachment of the peritoneal surfaces along their

  17. Attaching transmitters to waterbirds using one versus two subcutaneous anchors: Retention and survival trade-offs

    Science.gov (United States)

    Lewis, Tyler; Esler, Daniel N.; Uher-Koch, Brian D.; Dickson, Rian D.; Anderson, Eric M.; Evenson, Joseph R.; Hupp, Jerry; Flint, Paul L.

    2017-01-01

    A major challenge of wildlife telemetry is choosing an attachment technique that maximizes transmitter retention while minimizing negative side effects. For waterbirds, attachment of transmitters with subcutaneous anchors has been an effective and well-established technique, having been used on >40 species. This method was recently modified to include a second subcutaneous anchor, presumably increasing transmitter retention beyond that of single-anchor attachments. This putative benefit may be offset, however, by increased health risks related to additional incisions and subcutaneous protrusions. To test this potential trade-off, we attached radiotransmitters to molting and wintering surf (Melanitta perspicillata) and white-winged scoters (M. fusca) during 2008 and 2009 in Washington State and southeast Alaska, USA, using single- (121 scoters) and double-anchor (128 scoters) attachment techniques. We estimated daily probabilities of survival and radio retention for each group, this being apparent retention for wintering scoters because we could not differentiate shed transmitters from flighted emigration. For scoters during the flightless remigial molt, we found that addition of a second anchor increased cumulative retention probability (±SE) over a 49-day period from 0.69 ± 0.11 for single-anchor to 0.88 ± 0.07 for double-anchor attachments, while having no effect on survival. However, during winter, scoters with double-anchor attachments experienced no improvement in apparent retention, while having significantly lower survival during their first 14 days following transmitter attachment; of 15 mortalities during this period, 11 had 2 subcutaneous anchors. From day 15 onward, winter survival rates were nearly identical for single- versus double-anchor attachments, indicating that adverse effects of subcutaneous anchors were mainly limited to the 14-day postattachment period. Overall, given that the survival cost of adding a second subcutaneous anchor

  18. Inferior anchor cortical perforation with arthroscopic Bankart repair: a cadaveric study.

    Science.gov (United States)

    Lim, Tae Kang; Koh, Kyoung Hwan; Lee, Sang Hak; Shon, Min Soo; Bae, Tae Soo; Park, Won Hah; Yoo, Jae Chul

    2013-01-01

    The aims of this study were to evaluate the incidence of anchor penetration of the far cortex of the glenoid neck after arthroscopic Bankart repair and to compare the biomechanical properties of anchors in the 4- and 5:30- to 6-o'clock positions on the glenoid. Twelve (6 matched pairs) fresh-frozen human cadaveric shoulders were used to simulate arthroscopic Bankart repair in the lateral decubitus position. The most inferior anchor (5:30 to 6 o'clock) and that above it (4 o'clock) were inserted via the anteroinferior portal on the glenoid using the standard technique. After both anchor insertions, anchor perforation of the glenoid far cortex was identified. Biomechanical properties were measured to determine cyclic displacement of anchors at 100 and 500 cycles, stiffness, yield load, and ultimate failure strength. All 12 suture anchors (100%) at 5:30 to 6 o'clock penetrated throughout the far cortex, whereas only 4 anchors (33%) at 4 o'clock did so (P = .005). The mean distance the anchor tip traveled into far cortex was significantly longer at 5:30 to 6 o'clock than at 4 o'clock (6.8 ± 1.6 mm v 2.0 ± 1.6 mm, P = .001). In terms of mechanical strength, anchors at 5:30 to 6 o'clock had greater 100- and 500-cycle mean displacements than those at 4 o'clock (3.0 ± 0.5 mm v 2.5 ± 0.3 mm, P = .018 for 100 cycles; 3.5 ± 0.7 mm v 2.8 ± 0.3 mm, P = .018 for 500 cycles), although no differences in ultimate failure strength after cyclic loading were found between 2 positions (133.4 ± 40.3 and 133.7 ± 29.2 N, respectively; P = .985). For arthroscopic Bankart repair, insertion of the most inferior anchor via the anteroinferior portal with standard technique, in the lateral decubitus position, carries a high risk of perforating the inferior far cortex of the glenoid (100% in our study). This may result in mechanical weakness of the most inferior repair specifically in the early postoperative period. Perforation of the glenoid far cortex by the most inferior anchor and

  19. Inferior suture anchor placement during arthroscopic Bankart repair: influence of portal placement and curved drill guide.

    Science.gov (United States)

    Frank, Rachel M; Mall, Nathan A; Gupta, Deepti; Shewman, Elizabeth; Wang, Vincent M; Romeo, Anthony A; Cole, Brian J; Bach, Bernard R; Provencher, Matthew T; Verma, Nikhil N

    2014-05-01

    During arthroscopic Bankart repair, inferior anchor placement is critical to a successful outcome. Low anterior anchors may be placed with a standard straight guide via midglenoid portal, with a straight guide with trans-subscapularis placement, or with curved guide systems. Purpose/ To evaluate glenoid suture anchor trajectory, position, and biomechanical performance as a function of portal location and insertion technique. It is hypothesized that a trans-subscapularis portal or curved guide will improve anchor position, decrease risk of opposite cortex breach, and confer improved biomechanical properties. Controlled laboratory study. Thirty cadaveric shoulders were randomized to 1 of 3 groups: straight guide, midglenoid portal (MG); straight guide, trans-subscapularis portal (TS); and curved guide, midglenoid portal (CG). Three BioRaptor PK 2.3-mm anchors were inserted arthroscopically, with an anchor placed at 3, 5, and 7 o'clock. Specimens were dissected with any anchor perforation of the opposite cortex noted. An "en face" image was used to evaluate actual anchor position on a clockface scale. Each suture anchor underwent cyclic loading (10-60 N, 250 cycles), followed by a load-to-failure test (12.5 mm/s). Fisher exact test and mixed effects regression modeling were used to compare outcomes among groups. Anchor placement deviated from the desired position by 9.9° ± 11.4° in MG specimens, 11.1° ± 13.8° in TS, and 13.1° ± 14.5° in CG. After dissection, opposite cortex perforation at 5 o'clock occurred in 50% of MG anchors, 0% of TS, and 40% of CG. Of the 90 anchors tested, 17 (19%) failed during cyclic loading, with a similar failure rate across groups (P = .816). The maximum load was significantly higher for the 3-o'clock anchors when compared with the 5-o'clock anchors, regardless of portal or guide (P = .021). For the 5-o'clock position, there were significantly fewer "out" anchors in the TS group versus the CG or MG group (P = .038). There was no

  20. Anchor handling tug operations: a practical guide to the operation of modern anchor handling tugs engaged in anchor handling and towing operations

    National Research Council Canada - National Science Library

    Clark, I.C; Hancox, M

    2012-01-01

    ... --Turning and manoeuvring modern anchor handling vessels --The AHTS design and towing operations --The dangers of very high speed loads during deep water anchor handling operations --The dangers...

  1. Delayed Repair of Infected Ruptured Patellar Tendon using Suture Anchors

    Directory of Open Access Journals (Sweden)

    Himanshu Kataria

    2017-10-01

    Full Text Available Patellar tendon rupture are rare injuries that are easily missed in acute phases if careful clinical examination is not carried out. The delayed condition is further difficult to treat and augmentation of end to end repair is generally required. However, literature presents no such case of delayed presentation with presence of infection. We here present one such case of delayed presentation of patellar tendon rupture at three weeks in a 52-year-old male patient. Usual techniques were not sufficient to allow early rehabilitation. Technique of suture anchors was planned for repair after thorough debridement. After this intervention, patient was put on aggressive rehabilitation protocol and he gained excellent range of motion. Patient was followed for one year and he showed no loss of movement or signs of infection. We thus recommend using anchor suture repair of patellar tendon that provides a stable and rigid fixation with possibility of early active rehabilitation even in delayed setting.

  2. Knotless Suture Anchor With Suture Tape Quadriceps Tendon Repair Is Biomechanically Superior to Transosseous and Traditional Suture Anchor-Based Repairs in a Cadaveric Model.

    Science.gov (United States)

    Kindya, Michael C; Konicek, John; Rizzi, Angelo; Komatsu, David E; Paci, James M

    2017-01-01

    To compare the biomechanical properties of a knotless suture anchor with suture tape quadriceps tendon repair technique with transosseous and suture anchor repair techniques. Twenty matched pairs of cadaveric knees underwent a quadriceps tendon avulsion followed by repair via the use of transosseous tunnels with #2 high-strength sutures, 5.5-mm biocomposite fully threaded suture anchors with #2 high-strength sutures, or 4.75-mm biocomposite knotless suture anchors with suture tape. Ten knees were repaired via transosseous repair and 10 via fully threaded suture anchor repair, and their matched specimens were repaired with suture tape and knotless anchors. Biomechanical analysis included displacement during cyclic loading over 250 cycles, construct stiffness, ultimate load to failure, and failure mode analysis. Compared with transosseous repairs, quadriceps tendons repaired with knotless suture tape demonstrated significantly less displacement during cyclic loading (cycles 1-20 3.6 ± 1.3 vs 6.3 ± 1.9 mm, P = .003; cycles 20-250 2.0 ± 0.4 vs 3.1 ± 0.9 mm, P = .011), improved construct stiffness (67 ± 25 vs 26 ± 12 N/mm, P = .001), and greater ultimate load to failure (616 ± 149 vs 413 ± 107 N, P = .004). Our repair technique also demonstrated improved biomechanical parameters compared with fully threaded suture anchor repair in initial displacement during cyclic loading (cycles 1-20 3.0 ± 0.8 vs 5.1 ± 0.9 mm, P suture anchor with suture tape repair technique is biomechanically superior in cyclic displacement, construct stiffness, and ultimate load to failure compared with transosseous and fully threaded suture anchor techniques in cadaveric specimens. The demonstration that our repair technique is biomechanically superior to previously described techniques in a cadaveric setting suggests that consideration should be given to this technique. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  3. [Analysis of the demographic profile of patients treated for infertility using assisted reproductive techniques in 2005-2010].

    Science.gov (United States)

    Milewski, Robert; Milewska, Anna Justyna; Czerniecki, Jan; Leśniewska, Monika; Wołczyński, Sławomir

    2013-07-01

    Analysis of the demographic profile of patients, causes for infertility and effectiveness of infertility treatment methods in the years 2005-2010. Retrospective research was conducted to analyze data of 1705 randomly selected couples who underwent in vitro fertilization procedure at the Department of Reproduction and Gynecological Endocrinology Medical University of Bialystok, between 2005 and 2010. The analyzed data included mainly causes for infertility age of the female and male subjects, place of residence and final treatment results. The percentage of pregnancy rate increased significantly to approximately 40% in 2007. The contribution of male and female infertility factors remained at a similar level, but the idiopathic factor continued to steadily increase (to 20% in the last years of the study). We observed a greater prevalence of the male factor among couples living in cities compared to inhabitants of rural areas (42.3% vs. 34.3%, p = 0.004), whereas the tubal factor dominated among couples living in the countryside when compared to city dwellers (29.7% vs. 21.6%, p = 0.001). The average age of women entering treatment was significantly higher in cities than the countryside (p assisted reproductive techniques led to an increase in the efficacy of infertility treatment. Environmental factors, availability of treatment and level of awareness about womens health proved to have the strongest effect on the distribution of infertility causes between urban and rural areas. Significant efforts should be made, especially in cities, to decrease the average age of women's reproductive decisions and also to shorten the time to the first contact with the specialist after unsuccessful attempts at conception. It is also crucial to initiate the reimbursement of infertility treatment using ART (Assisted Reproductive Technology).

  4. Robot-assisted laparoscopic colpectomy in female-to-male transgender patients; technique and outcomes of a prospective cohort study.

    Science.gov (United States)

    Groenman, Freek; Nikkels, Charlotte; Huirne, Judith; van Trotsenburg, Mick; Trum, Hans

    2017-08-01

    Gender-affirming surgeries in female-to-male (FtM) transgender patients include mostly hysterectomy, bilateral salpingo-oophorectomy and mastectomy. Sometimes further surgery is performed, such as phalloplasty. Colpectomy may be performed to overcome gender dysphoria and disturbing vaginal discharge; furthermore, it may be important in reducing the risk of fistulas due to the phalloplasty procedure with urethral elongation. Colpectomy prior to the reconstruction of the neourethra seems to reduce fistula rates on the very first anastomosis. Therefore, at our center, colpectomy has become a standard procedure prior to phalloplasty and metoidioplasty with urethral elongation. Colpectomy is known as a procedure with potentially serious complications, e.g., extensive bloodloss, vesicovaginal fistula or rectovaginal fistula. Colpectomy performed via the vaginal route can be a challenging procedure due to lack of exposure of the surgical field, as many patients are virginal. Therefore, we investigated whether robot-assisted laparoscopic hysterectomy with bilateral salpingo-oophorectomy (TLH-BSO) followed by robot-assisted laparoscopic colpectomy (RaLC) is an alternative for the vaginal approach. Robot TLH/BSO and RaLC as a single-step procedure was performed in 36 FtM patients in a prospective cohort study. Median length of the procedure was 230 min (197-278), which reduced in the second half of the patients, median blood loss was 75 mL (30-200), and median discharge was 3 days (2-3) postoperatively. One patient with a major complication (postoperative bleeding with readmission and transfusion) was reported. To our knowledge, this is the first report of RaLC. Our results show that RaLC combined with robot TLH-BSO is feasible as a single-step surgical procedure in FtM transgender surgery. Future studies are needed to compare this technique to the two-step surgical approach and on its outcome and complication rates of subsequent phalloplasty.

  5. Biomechanical properties of suture anchor repair compared with transosseous sutures in patellar tendon ruptures: a cadaveric study.

    Science.gov (United States)

    Ettinger, Max; Dratzidis, Antonios; Hurschler, Christof; Brand, Stephan; Calliess, Tilman; Krettek, Christian; Jagodzinski, Michael; Petri, Maximilian

    2013-11-01

    Ruptures of the patellar tendon are debilitating injuries requiring surgical repair. Reliable data about the most appropriate suture technique and suture material are missing. The standard procedure consists of refixing the tendon with sutures in transpatellar tunnels, sometimes combined with augmentation. Suture anchors provide at least equal results concerning gap formation during cyclic loading and ultimate failure load compared with transosseous suture repair. Controlled laboratory study. A total of 30 human cadaveric patellar tendons underwent tenotomy followed by repair with 5.5-mm titanium suture anchors, 5.5-mm resorbable hydroxyapatite suture anchors, or transpatellar suture tunnels with No. 2 Ultrabraid and the Krackow whipstitch technique. Biomechanical analysis included pretensioning the constructs at 20 N for 30 seconds and then cyclic loading of 250 cycles between 20 and 100 N at 1 Hz in a servohydraulic testing machine with measurement of elongation. After this, ultimate failure load and failure mode analysis was performed. Compared with transosseous sutures, tendon repairs with suture anchors yielded significantly less gap formation during cyclic loading (P suture anchor in the hydroxyapatite anchor group and rupture of the suture in the titanium anchor group and-at lower load to failure-in the transosseous group. Patellar tendon repair with suture anchors yields significantly better biomechanical results than repair with the commonly applied transosseous sutures. These findings may be of relevance for future clinical treatment of patellar tendon ruptures. Randomized controlled clinical trials comparing suture anchors to transosseous suture repair are desirable.

  6. 33 CFR 164.19 - Requirements for vessels at anchor.

    Science.gov (United States)

    2010-07-01

    ... anchor. 164.19 Section 164.19 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND... vessels at anchor. The master or person in charge of each vessel that is anchored shall ensure that: (a) A proper anchor watch is maintained; (b) Procedures are followed to detect a dragging anchor; and (c...

  7. 24 CFR 3285.402 - Ground anchor installations.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Ground anchor installations. 3285....402 Ground anchor installations. (a) Ground anchor certification and testing. Each ground anchor must... registered architect must certify, the ground anchor for use in a classified soil (refer to § 3285.202...

  8. Profound Transcriptomic Differences Found between Sperm Samples from Sperm Donors vs. Patients Undergoing Assisted Reproduction Techniques Tends to Disappear after Swim-up Sperm Preparation Technique

    Directory of Open Access Journals (Sweden)

    Marcos Meseguer

    2010-01-01

    Full Text Available Background: Although spermatozoa delivers its RNA to oocytes at fertilization, its biologicalrole is not well characterized. Our purpose was to identify the genes differentially and exclusivelyexpressed in sperm samples both before and after the swim-up process in control donors andinfertile males with the purpose to identify their functional significance in male fertility.Materials and Methods: This was a nested case-control study. Ten sperm samples were obtainedfrom infertile patients [n=5 (two aliquots each from five samples; one before the swim-upprocess and one after] and donors [n=5 (two aliquots from five samples, one before the swim-upprocess and one after]. Oligonucleotide microarrays were employed to study the genome-wideexpression of pooled samples from infertile patients vs. donors. A total of four microarrays wereperfomed: two with sperm sample aliquots before swim-up and two with sperm samples aliquotsafter swim-up, from both the case and control groups. The results were evaluated to detect whichgenes expressed differentially [fold change (FC>5 and p<0.05] and which genes were exclusiveto each of the groups, both before and after swim-up.Results: Profound differences were detected between the fresh sperm samples of donors vs.infertile patients with respect to both differentially and exclusively expressed genes. Neverthelessthese differences seemed to decrease after the swim-up selection process.Conclusion: There are important differences between the expression profiles of sperm samplesof fertile donors vs. infertile patients who require assisted reproduction techniques (ART. Thesedifferences are potential forecasters of fertility success, although their reliability needs to beexplored further.

  9. Anchor Bolt Position in Base Plate In Terms Of T and J Anchor Bolt

    Directory of Open Access Journals (Sweden)

    b Osman Mohamad Hairi

    2017-01-01

    Full Text Available Generally, L anchor bolt system has been used for a long period of time in construction industry as one of the distributing load structures. However, there are some weaknesses in L anchor bolt which may straighten and pullup when charged with tensile load. Current practices prefer to use other types of anchor bolt systems, such as headed studs anchor bolt system to replace the L anchor bolt design. There has been lack of studies to prove that it is more effective in terms of performance. A new T anchor bolt which was basically modified from headed studs anchor bolt was proposed in this study to compare its performance of tensile loading in concrete failure to typical L design. This study aims to determine whether the T anchor bolt system gives better performance as compared to an L anchor bolt system. The performance was rated based on tensile loading on concrete failure pattern. A pullout test was conducted on two different anchor bolt systems, namely L and T. The anchor bolt embedded depth, h in concrete were varied according to their hook or bend radius. Each sample was repeated twice. There were totally eight samples. The hook or bend radius used were 50 mm and 57.5 mm for sample L1 and L2, respectively. 90-degree bend were used on sample T1 and T2. Based on test results, it can be seen that the performance of concrete failure pattern under tensile load on both L and T anchor bolt design samples with 200 mm embedment depth was better than deeper embedment depth of 230 mm. But the L anchor bolt design gives the best results as compared to T design. Although T anchor bolt design shows higher resistance before first bond failure to the concrete sample. T anchor bolt was analysed and needed deeper embedment depth to allow formation of cone pull-out shape to acquire better performance.

  10. Observed Score Equating Using a Mini-Version Anchor and an Anchor with Less Spread of Difficulty: A Comparison Study

    Science.gov (United States)

    Liu, Jinghua; Sinharay, Sandip; Holland, Paul; Feigenbaum, Miriam; Curley, Edward

    2011-01-01

    Two different types of anchors are investigated in this study: a mini-version anchor and an anchor that has a less spread of difficulty than the tests to be equated. The latter is referred to as a midi anchor. The impact of these two different types of anchors on observed score equating are evaluated and compared with respect to systematic error…

  11. Manipulation of local optical properties and structures in molybdenum-disulfide monolayers using electric field-assisted near-field techniques

    OpenAIRE

    Junji Nozaki; Musashi Fukumura; Takaaki Aoki; Yutaka Maniwa; Yohei Yomogida; Kazuhiro Yanagi

    2017-01-01

    Remarkable optical properties, such as quantum light emission and large optical nonlinearity, have been observed in peculiar local sites of transition metal dichalcogenide monolayers, and the ability to tune such properties is of great importance for their optoelectronic applications. For that purpose, it is crucial to elucidate and tune their local optical properties simultaneously. Here, we develop an electric field-assisted near-field technique. Using this technique we can clarify and tune...

  12. The effect of anxiety and depression scores of couples who underwent assisted reproductive techniques on the pregnancy outcomes.

    Science.gov (United States)

    Terzioglu, Fusun; Turk, Rukiye; Yucel, Cigdem; Dilbaz, Serdar; Cinar, Ozgur; Karahalil, Bensu

    2016-06-01

    The aim of this study was to determine the effect of anxiety and depression scores of couples who underwent Assisted Reproductive Techniques (ART) on pregnancy outcomes. This study was conducted as a prospective and comparative study with 217 couples. The study data was collected by using a semi-structured questionnaire and the Turkish version of the State-Trait Anxiety Inventory (STAI), and Beck Depression Inventory (BDI). The questionnaire, STAI and BDI were applied to couples who initiated ART treatment. Couples' state anxiety scores were re-evaluated after embryo transfer (ET). A significant relationship was found between the depression score of women and pregnancy outcome (p 0.05) and lower depression scores (p <0.05) than spouses of women with a positive pregnancy outcome. Study results indicated that the anxiety and depression scores of couples who had achieved a positive pregnancy result were lower than for couples with a negative result. The results of this study will contribute to the health professionals especially to the nurses who spend the most time with couples in providing consulting services and supporting psychological status of couples during ART process in Turkey.

  13. The European Court legitimates access of Italian couples to assisted reproductive techniques and to pre-implantation genetic diagnosis.

    Science.gov (United States)

    Turillazzi, Emanuela; Frati, Paola; Busardò, Francesco Paolo; Gulino, Matteo; Fineschi, Vittorio

    2015-07-01

    On 28 August 2012, the European Court of Human Rights (ECHR) issued a judgment regarding the requirements for the legitimate access of couples to assisted reproductive techniques (ART) and to pre-implantation genetic diagnosis (PGD). This judgment concerns the case of an Italian couple who found out after their first child was born with cystic fibrosis that they were healthy carriers of the disease. When the woman became pregnant again in 2010 and underwent fetal screening, it was found that the unborn child also had cystic fibrosis, whereupon she had the pregnancy terminated on medical grounds. In order to have the embryo genetically screened prior to implantation under the procedure of PGD, the couple sought to use in vitro fertilisation to have another child. Since article 1 of the Italian law strictly limits access to ART to sterile/infertile couples or those in which the man has a sexually transmissible disease, the couple appealed to the European court, raising the question of the violation of articles 8 and 14 of the European Convention on Human Rights. The applicants lodged a complaint that they were not allowed legitimate access to ART and to PGD to select an embryo not affected by the disease. The European Court affirmed that the prohibition imposed by Italian law violated article 8 of the European Convention on Human Rights. Focusing on important regulatory and legal differences among EU Nations in providing ART treatments and PGD, we derived some important similarities and differences. © The Author(s) 2014.

  14. Investigation of the association between the outcomes of sperm chromatin condensation and decondensation tests, and assisted reproduction techniques.

    Science.gov (United States)

    Irez, T; Sahmay, S; Ocal, P; Goymen, A; Senol, H; Erol, N; Kaleli, S; Guralp, O

    2015-05-01

    The main purpose of this prospective study is to examine possible influences of abnormalities of sperm nuclear condensation and chromatin decondensation with sodium dodecyl sulphate (SDS)-EDTA on outcomes of intrauterine insemination (IUI) or intracytoplasmic sperm injection (ICSI) cycles. Semen samples from 122 IUI and 236 ICSI cycles were evaluated. Before semen preparation for IUI or ICSI, basic semen analysis was performed and a small portion from each sample was spared for fixation. The condensation of sperm nuclear chromatin was evaluated with acidic aniline blue, followed by sperm chromatin decondensation by SDS-EDTA and evaluation under light microscope. Ongoing pregnancy rate was 24% and 26.2% in the IUI and ICSI groups respectively. The chromatin condensation rate was significantly higher in the ongoing pregnancy-positive group compared to the negative group, both in IUI (P = 0.042) and ICSI groups (P = 0.027), and it was positively correlated with ongoing pregnancy rate in both IUI and ICSI groups (P = 0.015, r = 0.214 and P = 0.014, r = 0.312 respectively). Chromatin decondensation rates were not significantly different in neither of the groups. These results indicate that IUI and ICSI outcome is influenced by the rate of spermatozoa with abnormal chromatin condensation. Sperm chromatin condensation with aniline blue is useful for selecting assisted reproduction techniques (ART) patients. © 2014 Blackwell Verlag GmbH.

  15. Assisted reproduction technique outcomes for fresh versus deferred cryopreserved day-2 embryo transfer: a retrospective matched cohort study.

    Science.gov (United States)

    Bourdon, Mathilde; Santulli, Pietro; Gayet, Vanessa; Maignien, Chloé; Marcellin, Louis; Pocate-Cheriet, Khaled; Chapron, Charles

    2017-03-01

    Ovarian stimulation could adversely affect endometrial receptivity and consequently embryo implantation. One emerging strategy is the 'freeze-all' approach. Most studies have focused on blastocyst transfers, with limited research on day-2 deferred cryopreserved embryo transfers. In this large retrospective cohort study, outcomes were compared between day-2 fresh versus deferred cryopreserved embryo transfers. After matching by age and number of previous cycles, 325 cycles were included in the fresh group and 325 in the deferred cryopreserved embryo transfers group: no significant differences were found between groups in implantation (0.20 ± 0.33 versus 0.17 ± 0.31, respectively) and ongoing pregnancy rates (21.85% versus 18.46%). Independent predictors for ongoing pregnancy after a multiple logistic regression analysis were the women's age (OR = 0.92; 95% CI 0.88 to 0.97), body mass index (OR = 0.94; 95% CI 0.89 to 0.99), the number of two pronuclei embryos (OR = 1.19; 95% CI 1.04 to 1.40) and at least one grade 1 embryo transferred (OR = 1.97; 95% CI 1.26 to 3.05). In the case of a day-2 embryo transfer, outcomes after treatment with assisted reproduction techniques are similar for fresh versus deferred cryopreserved embryo transfers when pre-transfer progesterone exposures are similar in the two groups. Copyright © 2016 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  16. Minimally Invasive, Spring-Assisted Correction of Sagittal Suture Synostosis: Technique, Outcome, and Complications in 83 Cases.

    Science.gov (United States)

    van Veelen, Marie-Lise C; Kamst, Nathalie; Touw, Carolina; Mauff, Katya; Versnel, Sarah; Dammers, Ruben; de Jong, T H Rob; Prasad, Vani; Mathijssen, Irene M

    2018-02-01

    This series describes the results of minimally invasive strip craniotomy with additional spring distraction. Included are the first 83 consecutive patients who underwent this procedure (January 1, 2010, to January 1, 2014). Outcome parameters were collected prospectively and included surgical parameters and complications, the occurrence of papilledema, skull growth, cephalic index, and photographic scores. Duration of surgery was 63 minutes, 19 percent required blood transfusion, and complications were minor. Postoperative papilledema occurred in two patients (2.4 percent). Head growth increased after insertion of the springs and declined afterward to 0.7 SD, comparable to earlier cohorts in the authors' center. The cephalic index increased from 67 before surgery to 74 after surgery and showed a small decrease during the 4-year follow-up. Photographic scores confirmed the initial improvement and showed a trend to further improvement during follow-up. In this cohort, spring-assisted, minimally invasive strip craniotomy was safe and effective. Results were similar to those from other techniques but with smaller incisions, shorter interventions, reduced blood loss, and a lower incidence of postoperative papilledema. Therapeutic, IV.

  17. Simple Technique of Exfoliation and Dispersion of Multilayer Graphene from Natural Graphite by Ozone-Assisted Sonication

    Directory of Open Access Journals (Sweden)

    Zaw Lin

    2017-05-01

    Full Text Available Owing to its unique properties, graphene has attracted tremendous attention in many research fields. There is a great space to develop graphene synthesis techniques by an efficient and environmentally friendly approach. In this paper, we report a facile method to synthesize well-dispersed multilayer graphene (MLG without using any chemical reagents or organic solvents. This was achieved by the ozone-assisted sonication of the natural graphite in a water medium. The frequency or number of ozone treatments plays an important role for the dispersion in the process. The possible mechanism of graphene exfoliation and the introduction of functional groups have been postulated. The experimental setup is unique for ozone treatment and enables the elimination of ozone off-gas. The heat generated by the dissipation of ultrasonic waves was used as it is, and no additional heat was supplied. The graphene dispersion was stable, and no evidence of aggregation was observed---even after several months. The characterization results show that well-dispersed MLG was successfully synthesized without any significant damage to the overall structure. The graphene obtained by this method has potential applications in composite materials, conductive coatings, energy storage, and electronic devices.

  18. Simple Technique of Exfoliation and Dispersion of Multilayer Graphene from Natural Graphite by Ozone-Assisted Sonication.

    Science.gov (United States)

    Lin, Zaw; Karthik, Paneer Selvam; Hada, Masaki; Nishikawa, Takeshi; Hayashi, Yasuhiko

    2017-05-27

    Owing to its unique properties, graphene has attracted tremendous attention in many research fields. There is a great space to develop graphene synthesis techniques by an efficient and environmentally friendly approach. In this paper, we report a facile method to synthesize well-dispersed multilayer graphene (MLG) without using any chemical reagents or organic solvents. This was achieved by the ozone-assisted sonication of the natural graphite in a water medium. The frequency or number of ozone treatments plays an important role for the dispersion in the process. The possible mechanism of graphene exfoliation and the introduction of functional groups have been postulated. The experimental setup is unique for ozone treatment and enables the elimination of ozone off-gas. The heat generated by the dissipation of ultrasonic waves was used as it is, and no additional heat was supplied. The graphene dispersion was stable, and no evidence of aggregation was observed---even after several months. The characterization results show that well-dispersed MLG was successfully synthesized without any significant damage to the overall structure. The graphene obtained by this method has potential applications in composite materials, conductive coatings, energy storage, and electronic devices.

  19. A facile synthesis of ZnWO{sub 4} nanoparticles by microwave assisted technique and its application in photocatalysis

    Energy Technology Data Exchange (ETDEWEB)

    Garadkar, K.M., E-mail: kmg_chem@unishivaji.ac.in [Nanomaterials Research Laboratory, Department of Chemistry, Shivaji University, Kolhapur 416 004, MS (India); Ghule, L.A. [Nanomaterials Research Laboratory, Department of Chemistry, Shivaji University, Kolhapur 416 004, MS (India); Sapnar, K.B.; Dhole, S.D. [Microtron Accelerator Laboratory, Department of Physics, University of Pune, Pune 411 007, MS (India)

    2013-03-15

    Highlights: ► Nanocrystalline ZnWO{sub 4} particles were successfully prepared by a microwave method. ► Spherical morphology with a 10 nm size. ► The band is 3.4 eV. ► The photodegradation of RhB was 95% within 25 min. - Abstract: A simple microwave assisted technique has been successfully developed to synthesize ZnWO{sub 4} nanoparticles. The X-ray diffraction results indicated that the synthesized nanoparticles exhibited only wolframite structure. Structural, morphological and optical properties of ZnWO{sub 4} nanoparticles have been analyzed by XRD, SEM, TEM EDAX, UV–vis and FT-IR spectral measurements. The transmission electron microscopy (TEM) image revealed that particle size of ZnWO{sub 4} nanoparticles was found to be 10 nm, the band-gap of ZnWO{sub 4} nanoparticles was found to be 3.4 eV. The photocatalytic activities for aqueous Rhodamine B and Methylene Blue samples were investigated and observed that ZnWO{sub 4} nanoparticles exhibited highly enhanced photocatalytic activity towards RhB than MB.

  20. Coordination of Industrial Symbiosis through Anchoring

    Directory of Open Access Journals (Sweden)

    Li Sun

    2017-04-01

    Full Text Available This paper aims to contribute to understanding the dynamics of industrial symbiosis. More specifically, we focus on the dynamics of anchoring as they can be observed in the Chinese context of eco-industrial development. We define anchoring as those activities that (typically local actors perform to create local physical and institutional conditions conducive to the emergence and further development of industrial symbiosis in a specific regional industrial system. We argue that, in the study of industrial symbiosis dynamics, it is conceptually more useful to focus on anchoring as an activity, rather than anchor tenants as actors. Based on a systematic literature review, we distinguish two types of anchoring activities: institutional and physical. We analyze anchoring dynamics in the case of Qijiang Industrial Symbiosis (Chongqing Municipality in China. We have identified the physical and institutional anchoring activities, the actors responsible for these activities, and how different anchoring activities build on each other over time. Our case study shows that the attempt to bring about industrial symbiosis in the Qijiang industrial park can be described in a richer way than just ‘governmental planning’.

  1. Coordination of industrial symbiosis through anchoring

    NARCIS (Netherlands)

    Sun, Li; Spekkink, Wouter; Cuppen, E.H.W.J.; Korevaar, G.

    2017-01-01

    This paper aims to contribute to understanding the dynamics of industrial symbiosis. More specifically, we focus on the dynamics of anchoring as they can be observed in the Chinese context of eco-industrial development. We define anchoring as those activities that (typically local) actors perform

  2. Method of fabrication of anchored nanostructure materials

    Science.gov (United States)

    Seals, Roland D; Menchhofer, Paul A; Howe, Jane Y; Wang, Wei

    2013-11-26

    Methods for fabricating anchored nanostructure materials are described. The methods include heating a nano-catalyst under a protective atmosphere to a temperature ranging from about 450.degree. C. to about 1500.degree. C. and contacting the heated nano-catalysts with an organic vapor to affix carbon nanostructures to the nano-catalysts and form the anchored nanostructure material.

  3. Sons conceived by assisted reproduction techniques inherit deletions in the azoospermia factor (AZF) region of the Y chromosome and the DAZ gene copy number

    DEFF Research Database (Denmark)

    Mau Kai, C; Juul, A; McElreavey, K

    2008-01-01

    number, supplemented with haplogroup typing in deleted patients, were performed, in combination with clinical assessments in 264 fathers and their sons conceived by assisted reproduction techniques (ART), and in 168 fertile men with normal sperm concentration. RESULTS: In the ART fathers group...

  4. Size-dependent and intra-band photoluminescence of NiS2 nano-alloys synthesized by microwave assisted hydrothermal technique

    CSIR Research Space (South Africa)

    Linganiso, C

    2013-03-01

    Full Text Available Journal of Alloys and Compounds March 2013/ Vol 552, pp 345-350 Size-dependent and intra-band photoluminescence of NiS2 nano- alloys synthesized by microwave assisted hydrothermal technique Ella Cebisa Linganiso a,b, Sabelo Dalton Mhlanga b...

  5. The use of bone anchoring in the surgical management of female stress urinary incontinence.

    Science.gov (United States)

    Appell, R A

    1997-01-01

    Recent reviews have noted failures of transvaginal surgical procedures designed to cure female stress urinary incontinence (SUI). Modifications continue to be applied to improve the transvaginal approach, including anchoring of the supporting sutures to the pelvic bones, reduction of the transvaginal dissection to help reduce further prolapse, and simpler techniques to allow a wider use of sling procedures. This paper reports on the use of a bone-anchoring technique and preservation of the endopelvic fascia in both transvaginal suspension surgery for hypermobility and sling surgery for intrinsic sphincteric deficiency. Results show an 81.7% cure rate in 71 patients who underwent the bone-anchor suspension and were followed for at least 3 years; a 97.5% cure rate in 40 patients who underwent an in situ sling procedure with bone anchoring and were followed for at least 2 years; and a 94% cure rate in 78 patients who underwent a sling procedure with autologous or synthetic material and bone anchoring and were followed for at least 2 years. The use of this bone-anchoring technique and preservation of the endopelvic fascia appears to enhance the success rate without increasing the risk to the patient and, as minimally invasive procedures, reduce the surgery time and the length of hospitalization, thus reducing costs.

  6. Ringstone anchors from Gujarat, west coast of India

    Digital Repository Service at National Institute of Oceanography (India)

    Gaur, A.S.; Sundaresh; Tripati, S.; Bandodkar, S.N.

    of Dwarka and Somanath have yielded several ringstone anchors along with other stone anchors such as triangular and grapnel types. The raw material used for these ring stones comprises basalt, sandstone and limestone. Earlier, these anchors were identified...

  7. The effect of accuracy motivation on anchoring and adjustment: do people adjust from provided anchors?

    Science.gov (United States)

    Simmons, Joseph P; LeBoeuf, Robyn A; Nelson, Leif D

    2010-12-01

    Increasing accuracy motivation (e.g., by providing monetary incentives for accuracy) often fails to increase adjustment away from provided anchors, a result that has led researchers to conclude that people do not effortfully adjust away from such anchors. We challenge this conclusion. First, we show that people are typically uncertain about which way to adjust from provided anchors and that this uncertainty often causes people to believe that they have initially adjusted too far away from such anchors (Studies 1a and 1b). Then, we show that although accuracy motivation fails to increase the gap between anchors and final estimates when people are uncertain about the direction of adjustment, accuracy motivation does increase anchor-estimate gaps when people are certain about the direction of adjustment, and that this is true regardless of whether the anchors are provided or self-generated (Studies 2, 3a, 3b, and 5). These results suggest that people do effortfully adjust away from provided anchors but that uncertainty about the direction of adjustment makes that adjustment harder to detect than previously assumed. This conclusion has important theoretical implications, suggesting that currently emphasized distinctions between anchor types (self-generated vs. provided) are not fundamental and that ostensibly competing theories of anchoring (selective accessibility and anchoring-and-adjustment) are complementary. PsycINFO Database Record (c) 2010 APA, all rights reserved.

  8. Should hand-assisted retroperitoneoscopic nephrectomy replace the standard laparoscopic technique for living donor nephrectomy? A meta-analysis.

    Science.gov (United States)

    Elmaraezy, Ahmed; Abushouk, Abdelrahman Ibrahim; Kamel, Moaz; Negida, Ahmed; Naser, Omar

    2017-04-01

    We performed this meta-analysis to compare hand-assisted retroperitoneoscopic (HARP) and traditional laparoscopic (TLS) techniques for living donor nephrectomy. We searched PubMed, Cochrane Central, EMBASE, and Web of science for prospective studies, comparing HARP and TLS techniques. Data were extracted from eligible studies and pooled as risk ratios (RR) or standardized mean difference (SMD), using RevMan software (version 5.3 for windows). We performed a sensitivity analysis to test the robustness of our evidence and a subgroup analysis to stratify intraoperative complications on Clavien-Dindo score. Seven studies (498 patients) were included in the final analysis. HARP was superior to TLS in terms of shortening the operative duration (SMD = -0.84, 95% CI [-1.18 to -0.50]) and warm ischemia time (SMD = -0.93, 95% CI [-1.13 to -0.72]). There was no significant difference between HARP and TLS in terms of blood loss (SMD = 0.13, 95% CI [-0.50 to 0.76]), hospital stay (SMD = -0.27, 95% CI [-0.70 to 0.15]) or graft survival (RR = 0.97, 95% CI [0.92 to 1.02]). The overall risk ratio of intraoperative complications did not differ significantly between the two groups (RR = 0.62, 95% CI [0.31 to 1.21]). Our meta-analysis shows that HARP was associated with a shorter surgery duration and less warm ischemia time than TLS. However, no significant differences were found between the two groups in terms of graft survival or intraoperative complication rates. We recommend HARP over TLS for living donor nephrectomy; however, future studies with larger sample sizes are recommended to compare both techniques in terms of operative safety and quality of life outcomes. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  9. Anterior glenoid perforation with suture anchor causing subscapularis irritation and pain.

    Science.gov (United States)

    Marx, Robert G; Verkuil, Lana; Wilson, Sean; Foo, Li Foong

    2013-07-01

    Suture anchors for labral repair have been associated with complications including suprascapular notch encroachment and osteolysis. We present a case of suture anchor penetration of the anterior glenoid neck leading to pain secondary to subscapularis muscle irritation in a 14-year-old boy. The patient had labral repair and subsequent anterior shoulder pain which resolved after anchor removal. Chondrolysis of the glenohumeral joint has been described following labral repair with knotless anchors. There have also been cases of injury to the suprascapular nerve following labral repair. However, we are not aware of any reports describing suture anchor penetration of the anterior glenoid neck leading to pain secondary to subscapularis muscle irritation. Labral repair has become a common and routine procedure, but complications can occur. We report a new complication related to osseous penetration of the anterior glenoid neck of the scapula by a suture anchor. We identified the complication using magnetic resonance imaging, an important part in reproducible, noninvasive, and objective assessment of the postoperative shoulder. We also present the technique for anchor removal used to resolve the patient's anterior shoulder pain.

  10. Frequency of Hearing Defect and Ear Abnormalities in Newborns Conceived by Assisted Reproductive Techniques in Royan Institute

    Directory of Open Access Journals (Sweden)

    Seyed Ebrahim Ahmadi

    2010-01-01

    Full Text Available Background: Assisted reproductive techniques (ART are used with increasing frequencyworldwide. The present research was conducted to determine the effects of ART on hearing defectsand ear abnormalities.Materials and Methods: In a descriptive, cross-sectional, non-randomized study, the status ofhearing and ear abnormalities was assessed in 300 newborns conceived by ART at Royan Institute,Tehran, Iran. This study was performed over a sixteen month period.Data were collected from parents, otoscopic examinations and transiently evoked otoacousticemissions (TEOAE tests of the newborns. The external ear was assessed by otoscopic examination,followed by the TEOAE test (an objective test that does not need the infant’s collaboration whichwas performed by an audiologist. In this test, the OAE wave was registered after a click (stimulusat 5-20 millisecond intervals with an 82 dB SPL altitude. Data were analyzed by statistical tests.Results: Of the 300 cases examined by otoscopy, two cases (0.66% had bilateral malformationin the auricle, two (0.66% had unilateral perforation of the tympanic membrane, five (1.66%had unilateral retraction of the tympanic membrane, eight (2.66% had bilateral retraction of thetympanic membrane, one (0.33% had unilateral tympanic membrane inflammation, one (0.33%had bilateral tympanic membrane inflammation and one case (0.33% had wax obstruction of theexternal ear canal.A total of 289 out of 300 newborns undewent the TEOAE test. Of these, three cases (1.03% did nothave a bilateral registered wave and were diagnosed with bilateral hearing loss.Conclusion: This study shows that hearing and ear screening in newborns conceived by ARTis contemplative and emphasizes the profitability of continual check up in these infants.

  11. Hybrid theatre and alternative localization techniques in conventional and single-port video-assisted thoracoscopic surgery

    Science.gov (United States)

    Zhao, Ze-Rui; Lau, Rainbow W. H.

    2016-01-01

    Management of pulmonary nodules in terms of diagnosis and intraoperative localization can be challenging, especially in the minimal invasive video-assisted thoracoscopic surgery (VATS) approach, and may be even more difficult with single port VATS with limited access. The ability to localize small lesions intraoperatively is particularly important for excisional biopsy for diagnostic frozen section, as well as to guide sublobar resection. Some of the common techniques to aid localization include preoperative percutaneous hookwire localization, colour dye or radio-dye labelling injection of the nodule or adjacent site to allowing visualization or detection by radioactive counter intraoperatively. The use of hybrid operating room (OR) for intraoperative localization of lung nodules was first reported in 2013, and was called image guided VATS (iVATS). Subsequently, we have expanded the iVATS application for single port VATS major lung resection of small or ground-glass opacity lesions. By performing an on-table cone-beam CT scan, real-time and accurate assessment of the pulmonary lesion can be made, which can aid the localization process. Other types of physical or colour marker that can be deployed percutaneously in the hybrid OR immediate before surgery can enhance haptic feedback and sensitivity of digital palpation, as well as provide a radiopaque nidus for radiological confirmation. In the past decade, the electromagnetic navigation bronchoscopy (ENB) technology had developed into a useful adjunct technology for the localization of peripheral lung nodules by injection of marking agent or deployment of fiducial to the lesion through the endobronchial route causing much lower marking agent diffusion and artefacts. Recently, the combination of hybrid OR and ENB for lung nodule localization and marking has further increased the accuracy and applicability of the technology. The article will be exploring the latest development of the above approaches to lung nodule

  12. Répercussions des techniques de procréation assistée sur les droits ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Welcome kit for parliamentarians policy brief : assisted reproductive technologies (ARTs). Téléchargez le PDF. Articles de revue. Abetting surrogacy. Téléchargez le PDF. Articles de revue. Assisted reproductive technologies : for whose benefit? Téléchargez le PDF. Articles de revue. Five [5] yrs in making, holes in draft law.

  13. Employing the nominal group technique to explore the views of pharmacists, pharmacy assistants and women on community pharmacy weight management services and educational resources.

    Science.gov (United States)

    Fakih, Souhiela; Marriott, Jennifer L; Hussainy, Safeera Y

    2016-04-01

    The objectives of this study were to investigate how pharmacists, pharmacy assistants and women feel about community pharmacy involvement in weight management, and to identify what pharmacists, pharmacy assistants and women want in weight management educational resources. Three homogenous and one heterogeneous nominal group (NG) sessions of up to 120-min duration were conducted with nine women, ten pharmacists and eight pharmacy assistants. The NG technique was used to conduct each session to determine the most important issues that should be considered surrounding community pharmacy weight management services and development of any educational resources. The heterogeneous NG session was used to finalise what women, pharmacists and pharmacy assistants want in educational resources. Overall, pharmacists, pharmacy assistants and women believe that pharmacy staff have an important role in the management of overweight and obesity because of their accessibility, trust and the availability of products in pharmacy. Regarding the most suitable healthcare professional(s) to treat overweight and obesity, the majority of participants believed that no one member of the healthcare team was most suitable and that overweight and obesity needs to be treated by a multidisciplinary team. The importance of having weight management educational resources for pharmacy staff and women that come from trustworthy resources without financial gain or commercialisation was also emphasised. Pharmacists, pharmacy assistants and women feel that community pharmacies have a definite role to play in weight management. Pharmacy-specific weight management educational resources that are readily available to pharmacy staff and women are highly desirable. © 2015 Royal Pharmaceutical Society.

  14. Measurement accuracy of foramen of vesalius for safe percutaneous techniques using computer-assisted three-dimensional landmarks.

    Science.gov (United States)

    Ozer, Mehmet Asim; Govsa, Figen

    2014-03-01

    The presence and description of anatomical findings about the foramen of Vesalius (FV) is important in the surgical procedure on the trigeminal nerve and/or trigeminal ganglion. This is an evaluation area for percutaneous techniques. A morphological analysis of the FVs was made in a total of 344 sides of the basis cranii of adult skulls by computerized photogrammetry using standardized digital photographs. The FV was identified in 60 specimens (34.8%). The FV was observed to be present bilaterally in 16 specimens (9.3%). The incidence of unilateral FV was 25.5% of the skulls, of which in 26 specimens (15.1%) it occurred on the left side, and in 18 specimens (10.4%) on the right side. The FV was observed to present a double opening in two specimens. The diameters of the FV were found to be 0.86 ± 0.21 (right) and 1.07 ± 0.37 mm (left). The incidence of openings with a diameter of FV 0.5 mm or more was found to be 45%. The area of the FV was calculated as 1.09 ± 0.51, and 1.4 ± 0.83 mm(2) on the right and the left, respectively. The mean distances of FV to the foramen ovale were measured as 2.30 ± 1.14 mm (right) and 2.46 ± 0.89 mm (left). The mean distances of FV to foramen spinosum were found to be 10.76 ± 1.26 mm (right) and 10.42 ± 1.29 mm (left). The findings suggest that the diameter of FV as <0.5 mm was safer to work with, while the opening types bigger than 0.5 mm opening types were highly risky for percutaneous techniques on the foramen ovale. In our study, a clear standardization has been achieved. The findings were the data obtained through computer-assisted three dimensional landmarks, appropriate for use in three dimensional planning.

  15. Curvilinear relationship between age and assisted reproduction technique success: retrospective analyses of US National ART Surveillance System data from 2010-2014.

    Science.gov (United States)

    Yavas, Yalcin

    2017-12-01

    In assisted reproduction technique cycles using fresh autologous embryos, the pattern by which outcomes per started cycle (live birth and clinical pregnancy) and per clinical pregnancy (live birth and miscarriage) change with age was determined. A dataset was created with 488,351 cycles. Success rates changed with age following well-fitted, ∩-shaped curvilinear (quadratic, cubic, quartic) regressions. These rates increased steadily from age 30 years old with infertility should not delay assisted reproduction, if it is their only option. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  16. Comparison between suture anchor and transosseous suture for the modified-Broström procedure.

    Science.gov (United States)

    Cho, Byung-Ki; Kim, Yong-Min; Kim, Dong-Soo; Choi, Eui-Sung; Shon, Hyun-Chul; Park, Kyoung-Jin

    2012-06-01

    This prospective, randomized study was conducted to compare clinical outcomes of the modified Broström procedure using suture anchor or transosseous suture technique for chronic ankle instability. Forty patients were followed for more than 2 years after modified Broström procedure. Twenty procedures using a suture anchor and 20 procedures using a transosseous suture were performed by one surgeon. The clinical evaluation consisted of the Karlsson scale and the Sefton grading system. Talar tilt and anterior talar translation were measured on anterior and varus stress radiographs. The Karlsson scale had improved significantly to 90.8 points in the suture anchor group, and to 89.2 points in the transosseous suture group. According to Sefton grading system, 18 patients (90%) in suture anchor group and 17 patients (85%) in transosseous suture group achieved satisfactory results. The talar tilt angle and anterior talar translation improved significantly to 5.9 degrees and 4.2 mm in suture anchor group, and to 5.4 degrees and 4.1 mm in transosseous suture group, respectively. No significant differences existed in clinical and functional outcomes between the two techniques for ligament reattachment. Both modified Broström procedures using the suture anchor and transosseous suture seem to be effective treatment methods for chronic lateral ankle instability.

  17. Anchoring Revisited: The Role of the Comparative Question

    Science.gov (United States)

    Grau, Ina; Bohner, Gerd

    2014-01-01

    When people estimate a numeric value after judging whether it is larger or smaller than a high or low anchor value (comparative question), estimates are biased in the direction of the anchor. One explanation for this anchoring effect is that people selectively access knowledge consistent with the anchor value as part of a positive test strategy. Two studies (total N = 184) supported the alternative explanation that people access knowledge consistent with their own answer to the comparative question. Specifically, anchoring effects emerged when the answer to the comparative question was unexpected (lower than the low anchor or higher than the high anchor). For expected answers (lower than the high anchor or higher than the low anchor), however, anchoring effects were attenuated or reversed. The anchor value itself was almost never reported as an absolute estimate. PMID:24454953

  18. Stone anchors from Minicoy Island, Lakshadweep, India

    Digital Repository Service at National Institute of Oceanography (India)

    Tripati, S.

    mariners. The logo of the Nautical Archaeology Society, seen on the cover of IJNA, has been taken from a bichrome Cypriot jug of the 7th century BC. It depicts a vessel with two oars, with a helmsman at the stern, and another crewman raising or lowering... a ring-stone anchor at the bow (Fig. 9) (Fenwick, 2000). This anchor is tied with a rope, without a wooden stock, and the size of the hole appears to be wide. In the Maldives, such anchors are made of round coral stones with a forked timber...

  19. Anchored nanostructure materials and method of fabrication

    Science.gov (United States)

    Seals, Roland D; Menchhofer, Paul A; Howe, Jane Y; Wang, Wei

    2012-11-27

    Anchored nanostructure materials and methods for their fabrication are described. The anchored nanostructure materials may utilize nano-catalysts that include powder-based or solid-based support materials. The support material may comprise metal, such as NiAl, ceramic, a cermet, or silicon or other metalloid. Typically, nanoparticles are disposed adjacent a surface of the support material. Nanostructures may be formed as anchored to nanoparticles that are adjacent the surface of the support material by heating the nano-catalysts and then exposing the nano-catalysts to an organic vapor. The nanostructures are typically single wall or multi-wall carbon nanotubes.

  20. Sutures and suture anchors--update 2006.

    Science.gov (United States)

    Barber, F Alan; Herbert, Morley A; Coons, David A; Boothby, Michael H

    2006-10-01

    To evaluate recently introduced sutures and suture anchors for single pull load to failure strength and failure mode. Suture anchors were tested in fresh porcine metaphyseal cortex and cancellous troughs with the use of an established protocol. An Instron machine applied tensile loads parallel to the axis of insertion at a rate of 12.5 mm/sec until failure, and mean anchor failure strengths were calculated. The mode of failure (anchor pull-out, suture eyelet cut-out, or suture failure) was recorded. Anchors tested included the BioRaptor 2.9, BioZip, Super Revo, Impact, Allograft cortical anchor, SpiraLok, Herculon, AxyaLoop titanium anchors 3, 5, and 6.5 mm, AxyaLoop bioabsorbable anchors 3, 5, and 6.5, ParaFix titanium anchors 3, 5, and 6.5, ParaSorb BioAnchors 3, 5.5, and 6.5, and Bio-Corkscrew FT. Sutures were also tested through an established protocol for load to failure. Sutures tested consisted of Orthocord, Ultrabraid (White and CoBraid), ForceFiber, Hi-Fi, MagnumWire, and Maxbraid Polyethylene Plus. Mean failure loads were as follows: BioRaptor 238 N, BioZip 366 N, double-loaded Super Revo 486 N, triple-loaded Super Revo 362 N, Impact 202 N, Allograft cortical anchor 240 N, SpiraLok 289 N, Herculon 819 N, AxyaLoop titanium anchors 3.0 (335 N), 5.0 (485 N), and 6.5 mm (465 N), AxyaLoop bioabsorbable anchors 3 (143 N), 5 (395 N), and 6.5 (369 N), ParaFix titanium anchors 3 (335 N), 5 (485 N), and 6.5 (465 N), ParaSorb BioAnchors 3 (143 N), 5.5 (395 N), and 6.5 (369 N), and Bio-Corkscrew FT (260 N). The sutures all broke at the mid point of their tested strands away from the grips. Mean suture strength for No. 2 Orthocord was 92 N; for No. 2 Ultrabraid CoBraid and White, strengths were 265 N and 280 N, respectively; strength for No. 2 Force Fiber was 289 N, for No. 2 Hi-Fi 250 N, for No. 2 MagnumWire 303 N, and for No. 2 Maxbraid Polyethylene Plus 256 N. Newer suture products showed significant improvements in load to failure values when compared with braided

  1. The biomechanical performance of a new forked knotless biceps tenodesis compared to a knotless and suture anchor tenodesis.

    Science.gov (United States)

    Lorbach, Olaf; Trennheuser, Christian; Kohn, Dieter; Anagnostakos, Konstantinos

    2016-07-01

    Biomechanical comparison of three different fixation techniques for a proximal biceps tenodesis. Eighteen human cadaver specimens were used for the testing. A tenodesis of the proximal biceps tendon was performed using a double-loaded suture anchor (5.5-mm Corkscrew, Arthrex), a knotless anchor (5.5-mm SwiveLock, Arthrex) or a forked knotless anchor (8-mm SwiveLock, Arthrex). Reconstructions were cyclically loaded for 50 cycles from 10-60 to 10-100 N. Cyclic displacement and ultimate failure loads were determined, and mode of failure was evaluated. Cyclic displacement at 60 N revealed a mean of 3.3 ± 1.1 mm for the Corkscrew, 5.4 ± 1.4 mm for the 5.5-mm SwiveLock and 2.9 ± 1.6 mm for the 8-mm forked SwiveLock. At 100 N, 5.1 ± 2.2 mm were seen for the Corkscrew anchor, 8.7 ± 2.5 mm for the 5.5-mm SwiveLock and 4.8 ± 3.3 mm for the 8-mm forked SwiveLock anchor. Significant lower cyclic displacement was seen for the Corkscrew anchor (p anchor (p anchor at 60 N. An ultimate load to failure of 109 ± 27 N was found for the Corkscrew anchor, 125 ± 25 N were measured for the 5.5-mm SwiveLock anchor, and 175 ± 42 N were found for the 8-mm forked SwiveLock anchor. Significant differences were seen between the 8-mm SwiveLock compared to the 5.5-mm SwiveLock (p anchor (p anchor. The new 8-mm forked SwiveLock anchor significantly enhances construct stability compared to a 5.5-mm double-loaded Corkscrew anchor as well as the 5.5-mm SwiveLock suture anchor. However, a restrictive postoperative rehabilitation seems to be important in all tested reconstructions in order to avoid early failure of the construct.

  2. Secondary anchor targeted cell release.

    Science.gov (United States)

    Ansari, Ali; Lee-Montiel, Felipe T; Amos, Jennifer R; Imoukhuede, P I

    2015-11-01

    Personalized medicine offers the promise of tailoring therapy to patients, based on their cellular biomarkers. To achieve this goal, cellular profiling systems are needed that can quickly and efficiently isolate specific cell types without disrupting cellular biomarkers. Here we describe the development of a unique platform that facilitates gentle cell capture via a secondary, surface-anchoring moiety, and cell release. The cellular capture system consists of a glass surface functionalized with APTES, d-desthiobiotin, and streptavidin. Biotinylated mCD11b and hIgG antibodies are used to capture mouse macrophages (RAW 264.7) and human breast cancer (MCF7-GFP) cell lines, respectively. The surface functionalization is optimized by altering assay components, such as streptavidin, d-desthiobiotin, and APTES, to achieve cell capture on 80% of the functionalized surface and cell release upon biotin treatment. We also demonstrate an ability to capture 50% of target cells within a dual-cell mixture. This engineering advancement is a critical step towards achieving cell isolation platforms for personalized medicine. © 2015 Wiley Periodicals, Inc.

  3. Oral contraceptive pill, progestogen or oestrogen pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques

    NARCIS (Netherlands)

    Farquhar, C.; Rombauts, L.; Kremer, J.A.M.; Lethaby, A.; Ayeleke, R.O.

    2017-01-01

    BACKGROUND: Among subfertile women undergoing assisted reproductive technology (ART), hormone pills given before ovarian stimulation may improve outcomes. OBJECTIVES: To determine whether pretreatment with the combined oral contraceptive pill (COCP) or with a progestogen or oestrogen alone in

  4. Starting point anchoring effects in choice experiments

    DEFF Research Database (Denmark)

    Ladenburg, Jacob; Olsen, Søren Bøye

    Anchoring is acknowledged as a potential source of considerable bias in Dichotomous Choice Contingent Valuation studies. Recently, another stated preference method known as Choice Experiments has gained in popularity as well as the number of applied studies. However, as the elicitation...... of preferences in Choice Experiments resembles the Dichotomous Choice format, there is reason to suspect that Choice Experiments are equally vulnerable to anchoring bias. Employing different sets of price levels in a so-called Instruction Choice Set presented prior to the actual choice sets, the present study...... finds that preferences elicited by Choice Experiments can be subject to starting point anchoring bias. Different price levels provoked significantly different distributions of choice in two otherwise identical choice set designs. On a more specific level, the results indicate that the anchoring...

  5. Archaeometallurgical investigation of the iron anchor from the Tantura F shipwreck

    Energy Technology Data Exchange (ETDEWEB)

    Aronson, A. [Faculty of Engineering, Tel Aviv University, Ramat Aviv 69978 (Israel); Ashkenazi, D., E-mail: dana@eng.tau.ac.il [Faculty of Engineering, Tel Aviv University, Ramat Aviv 69978 (Israel); Barkai, O.; Kahanov, Y. [Leon Recanati Institute for Maritime Studies, University of Haifa, Haifa 31905 (Israel)

    2013-04-15

    The Tantura F shipwreck was a coaster or a fishing vessel about 15.7 m long, discovered in the Dor/Tantura lagoon, Israel in 1995. It was dated to between the mid-7th and the end of the 8th centuries CE. Among the finds excavated were two T-shaped type iron anchors. Of the two anchors, one (anchor A) was thoroughly studied by archaeometallurgical methods in order to identify forge-welding lines, to determine the welding quality and to understand the manufacturing technology. The examinations included X-ray radiography, XRF analysis, optical microscopy, SEM/EDS observation and analysis, OES analysis and microhardness tests. The investigation included characterization of the composition, microstructure, thermal treatments, forge-welding junctions and slag analysis. The results revealed a heterogeneous microstructure, rich in glassy, fayalite and wüstite slag. Iron based phases included ferrite, pearlite, cementite and Widmanstätten plates, all typical to wrought iron. The forge-welds of Anchor A were located. Each arm was made of one piece, weighing about 2.5–3 kg and the shank was made of a few 1.5–2 kg pieces. The second anchor (anchor B) was only briefly examined visually and with a few radiographs, which support the results from anchor A. The research results revealed significant information about T-shaped anchors and their manufacturing process, including hot-working processes without any additional heat treatments, and folding techniques. The microstructure was similar to other ancient simple tools such as saws, sickles, axes and mortise chisels, and though the technology to make complicated structures and objects, such as swords, existed at that time, the anchors did not require this sophistication; thus simpler techniques were used, presumably because they were more cost-effective. - Highlights: ► Tantura F was a coaster dated to mid-7th–end-8th centuries. ► Two iron anchors were discovered at the Tantura F shipwreck-site. ► Anchor A was

  6. Experimental and theoretical analysis of CFRP reinforced concrete beam anchored by CF anchors

    Science.gov (United States)

    Zhuang, Ning; Ma, Ye-ming; Dong, Hong-han; Chen, Da

    2017-04-01

    Carbon fiber-reinforced polymer (CFRP) sheets is used to strengthen RC members widely. However, in the actual projects, premature separation of the CFRP sheet from the concrete surface is observed frequently, key issue in CFRP application is the performance of the connection between the CFRP sheet and the peripheral RC members. This paper presented the results of an experimental study to investigate mechanical properties of carbon fiber (CF) anchor dowels, a new CFRP anchoring method, and based on the experimental results, obtained the bearing capacity calculation formula of concrete beam strengthened with CFRP anchoring by carbon fiber anchor dowels .

  7. Video-assisted thoracoscopic surgery under O-arm navigation system guidance for the treatment of thoracic disk herniations: surgical techniques and early clinical results.

    Science.gov (United States)

    Hur, Jung-Woo; Kim, Jin-Sung; Cho, Dong-Young; Shin, Jong-Mok; Lee, Jun-Ho; Lee, Sang-Ho

    2014-11-01

    This study describes the surgical technique and clinical results of video-assisted thoracoscopic surgery (VATS) assisted by an O-arm-based navigation system, used for the treatment of thoracic disk herniation (TDH). The trend toward the use of minimally invasive procedures with endoscopic visualization of the thoracic cavity in thoracic spine surgery has evolved. It is difficult to develop a new set of visuomotor skills unique to endoscopic procedures and understand the three-dimensional (3D) anatomy while performing a two-dimensional (2D) imaging procedure. Adding image guidance would have a positive impact on these procedures, making them safer and more precise. We report the results of 10 patients who underwent diskectomy for TDH using VATS assisted by an O-arm-based navigation system and describe the surgical technique. The average duration of the symptoms was 2.8 years; average operation time, 326.9 minutes; and average additional time required for the image guidance surgery using the O-arm-based navigation, ∼ 29.4 minutes. No complications occurred during the surgical procedure or the immediate postoperative period. The advantages of using navigational assistance during the surgical procedure include better visualization of the operative field, more accurate surgical planning, and optimization of the surgical approach involving the establishment of the correct drilling trajectory and safe decompression of the spinal cord, as well as the possibility of intraoperative control of bone resection. Georg Thieme Verlag KG Stuttgart · New York.

  8. Efficacy of Highly Purified Urinary FSH versus Recombinant FSH in Chinese Women over 37 Years Undergoing Assisted Reproductive Techniques

    Directory of Open Access Journals (Sweden)

    Xuemei Liu

    2015-02-01

    Full Text Available Background: Urine derived follicle-stimulating hormone (uFSH contains a higher proportion of acidic isoforms, whereas recombinant FSH (rFSH contains a higher proportion of less-acidic isoforms. Less-acidic isoforms have a faster clearance, and thus a shorter half-life than the acidic FSH isoforms. The slow clearance of the acidic isoforms has a longer half-life and higher biological activity. This study was designed to determine whether uFSH or rFSH is more effective in older Chinese women undergoing assisted reproductive techniques (ART. Materials and Methods: This is a prospective, randomized, controlled cohort study. A total of 508 Chinese women over 37 years were randomized into two following study groups for their in vitro fertilization (IVF or intracytoplasmic sperm injection (ICSI cycles: i. group A (n=254 were treated with rFSH, and ii. group B (n=254 were treated with uFSH. Both groups were suppressed with a gonadotropin-releasing hormone (GnRH analogue using a long down-regulation protocol. The main outcomes for comparison were days of stimulation, estradiol (E2 on the day of human chorionic gonadotropin (hCG administration, number of oocytes collected, amount of FSH used, quantity of FSH/oocyte, endometrial thickness at hCG day, M П oocyte rate, 2PN zygote rate, grade І embryo rate, number of embryos cryopreserved, pregnancy rate, implantation rate, abortion rate and the rate of no transferable embryos. Results: Twenty two cycles including 16 cycles with poor ovarian response and six cycles with ovarian hyperstimulation syndrome were cancelled. There were 243 cycles left in each group. The patients treated with uFSH had a significantly higher 2PN zygote rate (87.4 vs. 76.6%, p0.05. Conclusion: This study showed that uFSH produced a significantly higher proportion of grade І embryos than rFSH in older Chinese women and there was a significantly lower chance of no transferable embryos in uFSH cycles. The clinical efficacy of the two

  9. Computer-assisted total knee arthroplasty using mini midvastus or medial parapatellar approach technique: A prospective, randomized, international multicentre trial.

    Science.gov (United States)

    Feczko, Peter; Engelmann, Lutz; Arts, Jacobus J; Campbell, David

    2016-01-13

    Despite the growing evidence in the literature there is still a lack of consensus regarding the use of minimally invasive surgical technique (MIS) in total knee arthroplasty (TKA). A prospective, randomized, international multicentre trial including 69 patients was performed to compare computer-assisted TKA (CAS-TKA) using either mini-midvastus (MIS group) or standard medial parapatellar approach (conventional group). Patients from 3 centers (Maastricht, Zwickau, Adelaide) with end-stage osteoarthritis of the knee were randomized to either an MIS group with dedicated instrumentation or a conventional group to receive cruciate retaining CAS-TKA without patella resurfacing. The primary outcome was to compare post operative pain and range of motion (ROM). The secondary outcome was to measure the duration of surgery, blood loss, chair rise test, quadriceps strength, anterior knee pain, Knee Society Score (KSS),WOMAC scores, mechanical leg axis and component alignment. Patients in the MIS group (3.97 ± 2.16) had significant more pain at 2 weeks than patients in the conventional group (2.77 ± 1.43) p = 0.003. There was no significant difference in any of the other primary outcome parameters. Surgery time was significantly longer (p loss (p = 0.002) in the MIS group as compared to the conventional group. The difference of the mean mechanical leg alignment between the groups was not statistically significant (-0.43° (95% CI -1.50-0.64); p = 0.43). There was no significant difference of component alignment between the two surgical groups with respect to flexion/extension (p = 0.269), varus/valgus (p = 0.653) or rotational alignment (p = 0.485) of the femur component and varus valgus alignment (p = 0.778) or posterior slope (p = 0.164) of the tibial component. There was no advantage of the MIS approach compared to a conventional approach CAS-TKA in any of the primary outcome measurements assessed, however the MIS approach was

  10. The Use of Comics-Based Cases in Anchored Instruction

    Science.gov (United States)

    Kneller, Matthew F.

    2009-01-01

    The primary purpose of this research was to understand how comics fulfill the role of anchor in an anchored instruction learning environment. Anchored instruction addresses the inert knowledge problem through the use of realistic multimedia stories, or "anchors," that embed a problem and the necessary data to solve it within the narrative. In the…

  11. Further Study of the Choice of Anchor Tests in Equating

    Science.gov (United States)

    Trierweiler, Tammy J.; Lewis, Charles; Smith, Robert L.

    2016-01-01

    In this study, we describe what factors influence the observed score correlation between an (external) anchor test and a total test. We show that the anchor to full-test observed score correlation is based on two components: the true score correlation between the anchor and total test, and the reliability of the anchor test. Findings using an…

  12. Intra-operative navigation for orbital reconstruction to correct diplopia and enophthalmos with endoscopic assisted technique: first case report in Thailand.

    Science.gov (United States)

    Kanjanakomut, Lek

    2014-09-01

    In an orbital fracture involving diplopia, enophthalmos is a major problem to be corrected because ofsoft tissue swelling and limited incision, which causes inaccurate restoration oforbital anatomy and reestablishing orbital volume. Pre-operative computerized planning combined with intra-operative navigation and endoscopy are used to create the accurate anatomical orbital position and effectively correct the posttraumatic diplopia and enophthalmos. An 18-year-old Thai male with diplopia and enophthalmospresented aposttraumatic left orbital fracture two months prior Three-dimensional CTscan of the facial bone confirmed the fracture. The patient required surgical treatment for correction of the orbital fracture. The intra-operative navigator and endoscopy-assisted technique were used. Pre- and post-operative pictures were compared, indicated the successful correction of enophthalmos and clinical correction of diplopia. Intra-operative navigator combined with endoscopy-assisted technique were a new surgical procedure that could correct the orbital deformity problem involving enophthalmos and diplopia more effective.

  13. Anchor balloons assisted deep intubation of 5F catheters for ...

    African Journals Online (AJOL)

    A number of treatment strategies for complex coronary lesions have been utilized in varying clinical settings over the last decade. However, cardiologists still encounter some difficult scenarios such as variant coronary artery origins, severely calcified and highly tortuous lesions. We report four cases in which the stents failed ...

  14. Anchoring effects on early autobiographical memories.

    Science.gov (United States)

    Greenberg, Daniel L; Bishara, Anthony J; Mugayar-Baldocchi, Marino A

    2017-10-01

    Studies of childhood memory typically show that our earliest memories come from between three and four years of age. This finding is not universal, however. The age estimate varies across cultures and is affected by social influences. Research from the judgments and decision-making literature suggests that these estimates might also involve a judgment under uncertainty. Therefore, they might be susceptible to less social influences such as heuristics and biases. To investigate this possibility, we conducted two experiments that used anchoring paradigms to influence participants' estimates of their age during early autobiographical memories. In Experiment 1, participants answered either a high-anchor or a low-anchor question, and were warned that the anchor was uninformative; they went on to estimate their age during their earliest autobiographical memory. In Experiment 2, we replicated Experiment 1 and extended the design to examine additional early autobiographical memories. In both experiments, participants in the low-anchor condition gave earlier age estimates than those in the high-anchor condition. These results provide new insights into the methods used to investigate autobiographical memory. Moreover, they show that reports of early autobiographical memories can be influenced by a relatively light touch - a change to a single digit in a single question.

  15. The Filiation by Assisted Human Reproductions Techniques in the Argentinian Civil and Commercial Code. An Advance that Allows to Harmonize the Rule with the Reality

    Directory of Open Access Journals (Sweden)

    Adriana Noemí Krasnow

    2017-07-01

    Full Text Available This article describes the contributions and changes that the Argentinian Civil and Commercial Code introduce in the filiation. The focus of attention is moved to the assisted human reproduction techniques in relation with the informed consent as an exteriorization of the will to procreate. Moreover, it is intended a study space about two proceedings that were silenced in the norm as the gestational surrogacy and the post mortem fertilization.

  16. The Outcome of Assisted Reproductive Techniques among Couples with Male Factors at Prince Khalid Bin Sultan Fertility Centre, Kingdom of Saudi Arabia

    OpenAIRE

    Hytham Bahaeldin Mukhtar; Amani Shaman; Hyder Osman Mirghani; Ayman Adnan Almasalmah

    2017-01-01

    BACKGROUND: Thirty-three percent of infertility due to paternal factors, there are an increasing proportion of couples who decide to conceive by assisted reproductive techniques (ART). The outcome prediction is pivotal for decision making. AIM: We aimed to study the pregnancy outcomes of different ART with male factors infertility. METHODS: This retrospective cross-sectional study conducted at Tabuk, Kingdom of Saudi Arabia. One hundred fifteen patients' records reviewed using a struc...

  17. Comparison of the outcomes of limbal-based trabeculectomy with and without anchor sutures.

    Science.gov (United States)

    Miyawaki, Takaya; Yaguchi, Shigeo; Hanemoto, Tsukasa; Ando, Mikihiko; Kozawa, Tadahiko

    2010-01-01

    To retrospectively evaluate the efficacy and safety of limbal-based trabeculectomy with anchor sutures compared to standard limbal-based trabeculectomy. Limbal-based trabeculectomy was performed with a new technique using anchor sutures, which involved tying the conjunctiva to the sclera at a deep fornix incision to prevent bleb localization induced by slippage of the conjunctival suture scar toward the scleral flap. In this retrospective, comparative, interventional case series, 45 eyes that underwent limbal-based trabeculectomy with anchor sutures and 27 eyes that underwent standard limbal-based trabeculectomy were analyzed (primary surgery). At a target intraocular pressure of 15 mm Hg, the 3-year survival rate using Kaplan-Meier analysis was 76.2% in the limbal-based trabeculectomy with anchor sutures group and 55.6% in the standard limbal-based trabeculectomy group. Bleb morphology analysis using the Moorfields Bleb Grading System showed that blebs in the limbal-based trabeculectomy with anchor sutures group were more diffused than those in the standard limbal-based trabeculectomy group. Limbal-based trabeculectomy with anchor sutures appears to be an effective method for decreasing intraocular pressure and improving morphology of blebs. Copyright 2010, SLACK Incorporated.

  18. Anchors as Semantic Primes in Value Construction: An EEG Study of the Anchoring Effect.

    Directory of Open Access Journals (Sweden)

    Qingguo Ma

    Full Text Available Previous research regarding anchoring effects has demonstrated that human judgments are often assimilated to irrelevant information. Studies have demonstrated that anchors influence the economic valuation of various products and experiences; however, the cognitive explanations of this effect remain controversial, and its neural mechanisms have rarely been explored. In the current study, we conducted an electroencephalography (EEG experiment to investigate the anchoring effect on willingness to accept (WTA for an aversive hedonic experience and the role of anchors in this judgment heuristic. The behavioral results demonstrated that random numbers affect participants' WTA for listening to pieces of noise. The participants asked for higher pay after comparing their WTA with higher numbers. The EEG results indicated that anchors also influenced the neural underpinnings of the valuation process. Specifically, when a higher anchor number was drawn, larger P2 and late positive potential amplitudes were elicited, reflecting the anticipation of more intensive pain from the subsequent noise. Moreover, higher anchors induced a stronger theta band power increase compared with lower anchors when subjects listened to the noises, indicating that the participants felt more unpleasant during the actual experience of the noise. The levels of unpleasantness during both anticipation and experience were consistent with the semantic information implied by the anchors. Therefore, these data suggest that a semantic priming process underlies the anchoring effect in WTA. This study provides proof for the robustness of the anchoring effect and neural evidence of the semantic priming model. Our findings indicate that activated contextual information, even seemingly irrelevant, can be embedded in the construction of economic value in the brain.

  19. Surgical repair of central slip avulsion injuries with Mitek bone anchor--retrospective analysis of a case series.

    LENUS (Irish Health Repository)

    Chan, Jeffrey C Y

    2007-01-01

    The purpose of this study is to describe our technique of central slip repair using the Mitek bone anchor and to evaluate the treatment outcome. Eight digits in eight patients were reconstructed using the bone anchor: three little fingers, two middle fingers, two index fingers and one ring finger. There were two immediate and six delayed repairs (range from one day to eight months). Four patients had pre-operative intensive splinting and physiotherapy to restore passive extension of the proximal interphalangeal joint prior to central slip reconstruction. All patients have made good progress since surgery. No patient requires a second procedure and none of the bone anchors have dislodged or loosened. We conclude that the Mitek bone anchor is a reliable technique to achieve soft tissue to bone fixation in central slip avulsion injuries. We recommend that this technique be considered as a treatment option for patients requiring surgical repair.

  20. Measuring liquid crystal anchoring energy strength by spectroscopic ellipsometry

    Science.gov (United States)

    Marino, A.; Tkachenko, V.; Santamato, E.; Bennis, N.; Quintana, X.; Otón, J. M.; Abbate, G.

    2010-04-01

    We describe an experimental procedure for accurate measurement of anchoring energy strength of liquid crystal cells. This technique is based on the possibility of gathering a large amount of very precise data about the linear optical response of the cell in different experimental conditions, using spectroscopic ellipsometry. Then, a careful data analysis exploiting data inversion method, supplemented by simulations from the elastic theory, is able to provide the searched information. The technique has been applied to vertical aligned nematic cells, chosen for its widespread use in the present display market. The results obtained in this particular case together with a thorough comparison with existing alternative techniques, suggest that our technique can be an optimum candidate for the industrial implementation of such measurement. A particular example is fully worked out, giving a result with a precision of 1.5% and an accuracy of 10%.

  1. First case of combined robot-assisted thymectomy and transaxillary thyroidectomy: technique and robot-docking optimization.

    Science.gov (United States)

    Luzzi, L; Corzani, R; Burali, G; Ciampelli, L; Ghisalberti, M; Meniconi, F; Astaneh, A; Baldi, M R; D'Onofrio, P; Ciabatti, P G

    2017-06-01

    Robot-assisted thymectomy and total transaxillary thyroidectomy represent two excellent therapeutic options for functional and oncological diseases of these two organs. We report the first case in literature of combined robot-assisted resection. The patient was positioned in supine position with the left arm raised cranially 90°-120° to expose the axillary area. After completing the thymectomy we rotated 30° counter-clockwise the robot for the second surgical time. This led to an optimization of disposable instruments and a gain in terms of hospitalization and postoperative recovery for the patient. To perform these two procedures it was enough to rotate 30° the robot.

  2. Codend selectivity in a commercial Danish anchor seine

    DEFF Research Database (Denmark)

    Noack, Thomas; Frandsen, Rikke; Krag, Ludvig Ahm

    2017-01-01

    Danish seining (or anchor seining) is a fishing technique that is gaining increasing attention because itis considered to be a fuel-efficient fishing method with low environmental impact. However, scientificdocumentation of the selectivity characteristics of Danish seines is lacking, and the gear...... generally isgrouped with bottom trawls and Scottish seines in fisheries management legislation. In this study, wedeveloped a codend cover to estimate the selectivity of a standard commercial Danish seine codendfor four fish species. The data for the dominant species, dab (Limanda limanda) and plaice...

  3. Aberrant DNA methylation of imprinted loci in human spontaneous abortions after assisted reproduction techniques and natural conception.

    Science.gov (United States)

    Zheng, Hai-Yan; Tang, Yan; Niu, Jing; Li, Pu; Ye, De-Sheng; Chen, Xin; Shi, Xiao-Yun; Li, Li; Chen, Shi-Ling

    2013-01-01

    Do assisted reproduction techniques (ARTs) affect DNA methylation of imprinted genes and does aberrant methylation of imprinted genes account for the incidence of human spontaneous abortion (SA)? Our results show that imprinting errors of imprinted genes may contribute to human SA, and the occurrence of aberrant methylation of imprinted genes in ART pregnancies was comparable with that in natural pregnancies. Animal data and human studies demonstrated that in vitro culture of embryos can cause methylation defects in individual genes, which might affect subsequent embryonic development and contribute to SA. However, our previous studies showed an abnormal methylation pattern of PEG1 in human aborted chrionic villus samples (CVS) but an increased occurrence of aberrant methylation in CVS from ART-derived pregnancies was not observed. CVS were collected from women who underwent abortion procedures in the Department of Gynecology and Obstetrics in Nanfang Hospital from May 2008 to July 2011. Muscle samples (MS) were obtained from aborted fetuses and stillbirths. The samples were divided into four experimental groups: (A) SA/stillbirth after ART (n = 75), (B) multi-fetal reduction after ART (n = 73), (C) SA/stillbirth of natural pregnancies (n = 90) and (D) induced abortion (IA) of natural pregnancies (n = 82). The mean ± SD age of patients was 31.0 ± 4.1 (range: 18-45 years). The DNA methylation patterns of one paternally methylated (H19) and two maternally methylated (LIT1 and SNRPN) genes were analyzed in CVS and MS using pyrosequencing and bisulfite sequencing PCR. Clear hypo-methylation (90%) were not detected in LIT1 and SNRPN but two regions of hyper-methylation (91.7 and 91.4%) were observed in H19. The mean percentage of methylation in the SA samples (groups A and C) was higher than that in the IA samples (groups B and D; P<0.05). Box plot analyses showed that in the 165 SA samples, methylation values for 40/495 (8.1%) differentially methylated regions of the

  4. Noninvasive prenatal testing (NIPT) in twin pregnancies with treatment of assisted reproductive techniques (ART) in a single center

    DEFF Research Database (Denmark)

    Tan, YueQiu; Gao, Ya; Lin, Ge

    2016-01-01

    Objective: The objective of the study is to report the performance of noninvasive prenatal testing (NIPT) in twin pregnancies after the treatment of assisted reproductive technology (ART). Method: In two years period, 565 pregnant women with ART twin pregnancies were prospectively tested by NIPT...

  5. Neuronavigation-Assisted Aspiration and Electro-Acupuncture for Hypertensive Putaminal Hemorrhage: A Suitable Technique on Hemiplegia Rehabilitation.

    Science.gov (United States)

    Zhang, Yuhai; Al-Aref, Rami; Fu, Haixia; Yang, Yunxue; Feng, Yugong; Zhao, Chao; Dong, Jun; Sun, Guoqing

    2017-01-01

    To identify whether neuronavigation-assisted aspiration (NA) combined with electro-acupuncture (EA) provides better motor recovery in events of hypertensive putaminal hematoma (HPH) sized 30 to 50 ml. This study aims to examine whether neuronavigation-assisted aspiration and electro-acupuncture have additional value to cerebral hemorrhage motor rehabilitation. 240 patients with HPH sized 30 to 50 ml and admitted within 6 to 10 hours after stroke ictus were included in this study. Group 1 contained 60 patients who underwent neuronavigation-assisted aspiration and electro-acupuncture (NAEA), group 2 contained 60 patients who underwent neuronavigation-assisted aspiration (NA), group 3 contained 60 patients who underwent electro-acupuncture (EA), and group 4 contained 60 patients who received conservative therapy consisting solely of medications. All the patients received the same therapeutic plan on admission and functional exercises three days after stroke onset. Electro-acupuncture was performed on the third day of admission; motor recovery was examined on weeks zero and eight by blinded assessors. Outcome measures included Fugl-Meyer assessment, modified Ashworth Scale and Functional Independence Measure. Group one showed significantly improved motor outcomes compared to group four (p hemiplegia secondary to HPH.

  6. Preparation of rifampicin/poly(d,l-lactice) nanoparticles for sustained release by supercritical assisted atomization technique

    CSIR Research Space (South Africa)

    Labuschagne, Philip W

    2014-11-01

    Full Text Available In this work supercritical assisted atomization (SAA) process was used for the co-precipitation of poly(d,l-lactide) (PDLLA) and rifampicin (RIF) as nanoparticles for sustained release applications. The effect of the variation of PDLLA/RIF ratio...

  7. Integration of the InTime Technique in the Neurodynamic Program of Assistance to Children with Learning Disabilities

    Science.gov (United States)

    Ratner, Faina Lazarevna; Efimova, Victoria Leonidovna; Efimov, Oleg Igorevich

    2015-01-01

    The article describes the results of application of the "inTime" neuroacoustic training by Advanced Brain Technologies (USA) when they were organizing assistance to children who had learning disabilities. This training optimizes the functional state of the brain by using sounds of various frequency and rhythm. The effectiveness of the…

  8. Arthroscopically Assisted Reconstruction of Acute Acromioclavicular Joint Dislocations: Anatomic AC Ligament Reconstruction With Protective Internal Bracing—The “AC-RecoBridge” Technique

    Science.gov (United States)

    Izadpanah, Kaywan; Jaeger, Martin; Ogon, Peter; Südkamp, Norbert P.; Maier, Dirk

    2015-01-01

    An arthroscopically assisted technique for the treatment of acute acromioclavicular joint dislocations is presented. This pathology-based procedure aims to achieve anatomic healing of both the acromioclavicular ligament complex (ACLC) and the coracoclavicular ligaments. First, the acromioclavicular joint is reduced anatomically under macroscopic and radiologic control and temporarily transfixed with a K-wire. A single-channel technique using 2 suture tapes provides secure coracoclavicular stabilization. The key step of the procedure consists of the anatomic repair of the ACLC (“AC-Reco”). Basically, we have observed 4 patterns of injury: clavicular-sided, acromial-sided, oblique, and midportion tears. Direct and/or transosseous ACLC repair is performed accordingly. Then, an X-configured acromioclavicular suture tape cerclage (“AC-Bridge”) is applied under arthroscopic assistance to limit horizontal clavicular translation to a physiological extent. The AC-Bridge follows the principle of internal bracing and protects healing of the ACLC repair. The AC-Bridge is tightened on top of the repair, creating an additional suture-bridge effect and promoting anatomic ACLC healing. We refer to this combined technique of anatomic ACLC repair and protective internal bracing as the “AC-RecoBridge.” A detailed stepwise description of the surgical technique, including indications, technical pearls and pitfalls, and potential complications, is given. PMID:26052493

  9. Career anchors and learning plan (part one

    Directory of Open Access Journals (Sweden)

    Daniela Brečko

    2006-12-01

    Full Text Available The article is divided into three parts. The first part concentrates on how important career is for an individual, organization and society. The author establishes that understanding of career has changed dramatically and does not only refer to climbing up the career ladder, but also moving off or even down the career ladder. The notion of career, as a lifelong and professional path, encompasses all aspects of human personality and their roles acquired through one's life. On basis of vast and longitudinal research, where the author has studied career anchors of individuals, it is the objective of the author to find out on basis of what grounds do the individuals decide to take certain directions in their careers and how learning contributes to such decisions. As a source the author has used Shein's theory of career anchors. Part one describes in greater detail 8 different career anchors and introduces their main features with the findings of the research, which refer to the analysis of professions (work positions and established career anchors. The author thus verifies the hypothesis that career anchors do exist in our area.

  10. Robot-assisted laparoscopic approach for artificial urinary sphincter implantation in 11 women with urinary stress incontinence: surgical technique and initial experience.

    Science.gov (United States)

    Biardeau, Xavier; Rizk, Jérôme; Marcelli, François; Flamand, Vincent

    2015-05-01

    Artificial urinary sphincter (AUS) implantation is recommended for women suffering urinary stress incontinence. Robot-assisted laparoscopy allows improved dexterity and visibility compared to traditional laparoscopy, potentially providing significant advantages for deep pelvic surgery. To report our surgical technique and initial experience in transperitoneal robot-assisted laparoscopic AUS implantation in women with urinary stress incontinence. Eleven eligible patients with AUS implantation or revision using robot-assisted laparoscopy for urinary stress incontinence were included between January 2012 and February 2014 at Department of Urology, Lille University Hospital. Procedures were performed with the assistance of a four-arm da Vinci robot. The urethrovaginal space was dissected after transperitoneal access to the Retzius space. An 11-mm port placed in the right iliac fossa allowed introduction of the AUS device. The cuff and balloon tubes were externalised via a 5-mm suprapubic incision. The peritoneum was finally sutured. Clinical data were prospectively collected before, during, and after the procedure. Results were classified as complete continence (no leakage and no pad usage), social continence (leakage and/or pad usage with no impact on social life), or failure (leakage and/or pad usage impacting social life). After mean follow-up of 17.6 mo (interquartile range 10.8-26 mo), eight patients (72.7%) had a successful AUS implantation, of whom seven (87.5%) reported complete continence and one had social continence. Two vaginal injuries and two bladder injuries occurred intraoperatively. Two patients experienced early minor postoperative complications and two had a major postoperative complication. Robot-assisted laparoscopic AUS implantation is a feasible procedure. Further studies will better assess the place of robot-assisted laparoscopy in AUS implantation. We investigated the treatment of 11 patients with stress urinary incontinence using robot-assisted

  11. Interference Screw vs. Suture Anchor Fixation for Open Subpectoral Biceps Tenodesis: Does it Matter?

    Directory of Open Access Journals (Sweden)

    Gobezie Reuben

    2008-09-01

    Full Text Available Abstract Background Bioabsorbable interference screw fixation has superior biomechanical properties compared to suture anchor fixation for biceps tenodesis. However, it is unknown whether fixation technique influences clinical results. Hypothesis We hypothesize that subpectoral interference screw fixation offers relevant clinical advantages over suture anchor fixation for biceps tenodesis. Study Design Case Series. Methods We performed a retrospective review of a consecutive series of 88 patients receiving open subpectoral biceps tenodesis with either interference screw fixation (34 patients or suture anchor fixation (54 patients. Average follow up was 13 months. Outcomes included Visual Analogue Pain Scale (0–10, ASES score, modified Constant score, pain at the tenodesis site, failure of fixation, cosmesis, deformity (popeye and complications. Results There were no failures of fixation in this study. All patients showed significant improvement between their preoperative and postoperative status with regard to pain, ASES score, and abbreviated modified Constant scores. When comparing IF screw versus anchor outcomes, there was no statistical significance difference for VAS (p = 0.4, ASES score (p = 0.2, and modified Constant score (P = 0.09. One patient (3% treated with IF screw complained of persistent bicipital groove tenderness, versus four patients (7% in the SA group (nonsignificant. Conclusion Subpectoral biceps tenodesis reliably relieves pain and improves function. There was no statistically significant difference in the outcomes studied between the two fixation techniques. Residual pain at the site of tenodesis may be an issue when suture anchors are used in the subpectoral location.

  12. Robotic assisted versus pure laparoscopic surgery of the adrenal glands: a case-control study comparing surgical techniques.

    Science.gov (United States)

    Morelli, Luca; Tartaglia, Dario; Bronzoni, Jessica; Palmeri, Matteo; Guadagni, Simone; Di Franco, Gregorio; Gennai, Andrea; Bianchini, Matteo; Bastiani, Luca; Moglia, Andrea; Ferrari, Vincenzo; Fommei, Enza; Pietrabissa, Andrea; Di Candio, Giulio; Mosca, Franco

    2016-11-01

    The role of the da Vinci Robotic System ® in adrenal gland surgery is not yet well defined. The goal of this study was to compare robotic-assisted surgery with pure laparoscopic surgery in a single center. One hundred and 16 patients underwent minimally invasive adrenalectomies in our department between June 1994 and December 2014, 41 of whom were treated with a robotic-assisted approach (robotic adrenalectomy, RA). Patients who underwent RA were matched according to BMI, age, gender, and nodule dimensions, and compared with 41 patients who had undergone laparoscopic adrenalectomies (LA). Statistical analysis was performed using the Student's t test for independent samples, and the relationship between the operative time and other covariates were evaluated with a multivariable linear regression model. P surgery (p surgery.

  13. A Vision-Based Driver Nighttime Assistance and Surveillance System Based on Intelligent Image Sensing Techniques and a Heterogamous Dual-Core Embedded System Architecture

    Directory of Open Access Journals (Sweden)

    Jenq-Haur Wang

    2012-02-01

    Full Text Available This study proposes a vision-based intelligent nighttime driver assistance and surveillance system (VIDASS system implemented by a set of embedded software components and modules, and integrates these modules to accomplish a component-based system framework on an embedded heterogamous dual-core platform. Therefore, this study develops and implements computer vision and sensing techniques of nighttime vehicle detection, collision warning determination, and traffic event recording. The proposed system processes the road-scene frames in front of the host car captured from CCD sensors mounted on the host vehicle. These vision-based sensing and processing technologies are integrated and implemented on an ARM-DSP heterogamous dual-core embedded platform. Peripheral devices, including image grabbing devices, communication modules, and other in-vehicle control devices, are also integrated to form an in-vehicle-embedded vision-based nighttime driver assistance and surveillance system.

  14. Mechanism of transformation in Mycobacteria using a novel shockwave assisted technique driven by in-situ generated oxyhydrogen

    OpenAIRE

    Datey, Akshay; Subburaj, Janardhanraj; Gopalan, Jagadeesh; Chakravortty, Dipshikha

    2017-01-01

    We present a novel method for shockwave-assisted bacterial transformation using a miniature oxyhydrogen detonation-driven shock tube. We have obtained transformation efficiencies of about 1.28???106, 1.7???106, 5???106, 1???105, 1???105 and 2???105 transformants/?g of DNA for Escherichia coli, Salmonella Typhimurum, Pseudomonas aeruginosa, Mycobacterium smegmatis, Mycobacterium tuberculosis (Mtb) and Helicobacter pylori respectively using this method which are significantly higher than those ...

  15. Robot-assisted Level II-III Inferior Vena Cava Tumor Thrombectomy: Step-by-Step Technique and 1-Year Outcomes.

    Science.gov (United States)

    Chopra, Sameer; Simone, Giuseppe; Metcalfe, Charles; de Castro Abreu, Andre Luis; Nabhani, Jamal; Ferriero, Mariaconsiglia; Bove, Alfredo Maria; Sotelo, Rene; Aron, Monish; Desai, Mihir M; Gallucci, Michele; Gill, Inderbir S

    2017-08-01

    Level II-III inferior vena cava (IVC) tumor thrombectomy for renal cell carcinoma is among the most challenging urologic oncologic surgeries. In 2015, we reported the initial series of robot-assisted level III caval thrombectomy. To describe our University of Southern California technique in a step-by-step fashion for robot-assisted IVC level II-III tumor thrombectomy. Twenty-five selected patients with renal neoplasm and level II-III IVC tumor thrombus underwent robot-assisted surgery with a minimum 1-yr follow-up (July 2011 to March 2015). Our standardized anatomic-based "IVC-first, kidney-last" technique for robot-assisted IVC thrombectomy focuses on minimizing the chances of an intraoperative tumor thromboembolism and major hemorrhage. Baseline demographics, pathology data, 90-d and 1-yr complications, and oncologic outcomes at last follow-up were assessed. Robot-assisted IVC thrombectomy was successful in 24 patients (96%) (level III: n=11; level II: n=13); one patient was electively converted to open surgery for failure to progress. Median data included operative time of 4.5h, estimated blood loss was 240ml, hospital stay 4 d; five patients (21%) received intraoperative blood transfusion. All surgical margins were negative. Complications occurred in four patients (17%): two were Clavien 2, one was Clavien 3a, and one was Clavien 3b. All patients were alive at a 16-mo median follow-up (range: 12-39 mo). Robotic IVC tumor thrombectomy is feasible for level II-III thrombi. To maximize intraoperative safety and chances of success, a thorough understanding of applied anatomy and altered vascular collateral flow channels, careful patient selection, meticulous cross-sectional imaging, and a highly experienced robotic team are essential. We present the detailed operative steps of a new minimally invasive robot-assisted surgical approach to treat patients with advanced kidney cancer. This type of surgery can be performed safely with low blood loss and excellent

  16. Single Balloon Enteroscopy-Assisted ERCP Using Rendezvous Technique for Sharp Angulation of Roux-en-Y Limb in a Patient with Bile Duct Stones

    Directory of Open Access Journals (Sweden)

    Takao Itoi

    2009-01-01

    Full Text Available The acute angulation of Roux-en-Y (R-Y limb precludes endoscopic access for endoscopic retrograde cholangiopancreatography (ERCP even using a balloon enteroscopy. Here, we describe a case of successful single balloon enteroscopy (SBE-assisted ERCP using a rendezvous technique in a patient with sharply angulated R-Y limb in a 79-year-old woman who had bile duct stones. Method. At first, a guidewire was passed antegradely through the major papilla after the needle puncture using percutaneous transhepatic biliary drainage technique. A hydrophilic guidewire with an ERCP catheter was antegradely advanced beyond the Roux limb. After a guidewire was firmly grasped by a snare forceps, it was pulled out of the body, resulting that the enteroscope could advance to the papilla. After papillary dilation, complete removal of bile duct stones was achieved without any procedure-related complication. In conclusion, although further study is needed, SBE-assisted ERCP using a rendezvous technique may have a potential for selected patients.

  17. Patella fracture after medial patellofemoral ligament reconstruction using suture anchors.

    Science.gov (United States)

    Dhinsa, Baljinder Singh; Bhamra, Jagmeet Singh; James, Chris; Dunnet, William; Zahn, Helmut

    2013-12-01

    The medial patellofemoral ligament (MPFL) acts as a soft tissue restraint to lateral subluxation of the patella, and is frequently damaged following patellar dislocation. A number of techniques for repair or reconstructions of the MPFL have been reported. We report two cases of patellar fracture following MPFL reconstruction utilizing suture anchors and bone tunnels that do not completely traverse the patella. The first case occurred seven months after surgery and the second case was at six weeks following surgery. There have been previous reports of patellar fracture following MPFL reconstruction, particularly when patellar tunnels completely traverse the patella. The authors decided to use suture anchors to reduce the risk of patellar fracture, and they feel that the fractures reported in this paper resulted from surgical error rather than system error. We feel that this is an important learning point when initially using this technique, and should be disseminated to other surgeons who undertake this surgery. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Anchoring strategies for bimetallic species in zeolites. Progress report

    Energy Technology Data Exchange (ETDEWEB)

    Bein, T.

    1993-03-01

    We explore a new approach by introducing heterobinuclear organometallic compounds for linking catalytic functions to zeolite frameworks. With two different metals present, the complexes are being anchored to the support via one oxophilic metal, ligand exchange and catalytic reactions may proceed at the second metal center. Anchoring chemistry, thermal stability and reactivity of Me{sub 3}SnMn(CO){sub 5} in zeolite NaY and acid forms of zeolite Y was studied with X-ray absorption spectroscopy (Sn, Mn edge EXAFS) and in-situ FTIR/TPD-MS techniques. Subsequently, the tin-cobalt complex Me{sub 3}SnCo(CO){sub 4} has been a focus of detailed synthetic and spectroscopic studies. The reactivity of tricarbonyl (cyclopentadienyl) (trimethylstannyl) molybdenum in new mesoporous hosts has been explored. A recent development is the design of vanadium oxo species in different micro- and mesoporous hosts. These are of great interest for the selective reduction of nitrogen oxides by ammonia, and selective oxidation of different hydrocarbons, such as xylenes, olefines and alkanes. Combination analytical techniques used to probe local structural changes at the molecular level, include EXAFS (Extended X-Ray Absorption Fine Structure) spectroscopy utilizing synchrotron radiation, in situ FT-IR coupled to thermodesorption/MS, UV-NIR, and CCD Raman.

  19. Vortex-assisted liquid-liquid-liquid microextraction (VALLLME) technique: A new microextraction approach for direct liquid chromatography and capillary electrophoresis analysis.

    Science.gov (United States)

    Makahleh, Ahmad; Yap, Hui Fang; Saad, Bahruddin

    2015-10-01

    A new, rapid and sensitive microextraction technique named vortex-assisted liquid-liquid-liquid microextraction (VALLLME) is proposed. The complete extraction process involves two steps. First, a vortex-assisted liquid-liquid microextraction (VALLME) procedure was used to extract the analytes from a relatively large volume of sample (donor phase) to a small volume of organic solvent (intermediate phase). Next, a micro-vortex-assisted liquid-liquid extraction (µ-VALLE) was used to extract the target analytes from the intermediate phase to a smaller volume of aqueous solution (acceptor phase). The final extract (acceptor phase) can be directly injected into the high performance liquid chromatography or capillary electrophoresis units without any further treatments. The selection of the intermediate phase and the manipulation of pH are key parameters that ensure good extraction efficiency of the technique. The proposed technique has been successfully applied for the determination of carvedilol (used as model analyte) in biological fluid samples. The optimum extraction conditions were: toluene as intermediate phase (150 μL); pH of the donor phase, 9.5; vortex time of the VALLME, 45 s (maximum speed, 2500 rpm); 0.1M HCl (15 μL) as acceptor phase; vortexing time of the µ-VALLME, 75 s (maximum stirring speed, 2500 rpm) and salt concentration in the donor phase, 5% (w/v). Under these conditions, enrichment factors of 51- and 418-fold for VALLME step and VALLLME procedure, respectively, were achieved. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Optical monitoring of surface anchoring changes for nematic liquid crystal based chemical and biological sensors

    Science.gov (United States)

    Zou, Yang

    In this dissertation, optically monitoring the surface anchoring changes of liquid crystal (LC) due to the chemical or biological bindings is presented. The deformation of LC director with different anchoring energies is simulated using Finite Element Method and continuum theory of nematic LC. The optical properties of the LC film are simulated using the Finite Difference Time Domain method. First, the interference color method was used to monitor the anchoring change. The calculated and experimental interference colors of liquid crystal films due to the optical retardation of two orthogonal electromagnetic components at different surface anchoring conditions and applied voltages are studied. The calculated colors were converted into sRGB parameters so that the corresponding colors can be displayed on a color computer monitor and printed out on a color printer. A gold micro-structure was fabricated and used to control the optical retardation. Polarizing micrographs were collected and compared with the calculated colors. Second, the influence of a bias voltage on the surface-driven orientational transition of liquid crystals resulted from the weakening anchoring and anchoring transition is analyzed theoretically and experimentally. The same interdigitated Au micro-structure was used in the nematic LC based chemical and biological sensors. With a suitable bias electric field, the process of the weakening anchoring energy and the uniform surface-driven orientational transition due to targeted molecules binding to a functionalized surface were observed optically. Finally, measurement of optical transmission was used to monitor the anchoring change. Polarizing micrographs were collected and compared with simulated textures. Experimental and simulation results both demonstrate the optical method can effectively monitor the surface anchoring change due to the presence of targeted analytes. These results show that these optical techniques are suitable for LC based sensing

  1. Polycrystalline BiFeO{sub 3} thin film synthesized via sol-gel assisted spin coating technique for photosensitive application

    Energy Technology Data Exchange (ETDEWEB)

    Bogle, K. A., E-mail: kashinath.bogle@gmail.com; Narwade, R. D.; Mahabole, M. P.; Khairnar, R. S. [Thin Films and Devices Laboratory, School of Physical Sciences, Swami Ramanand Teerth Marathwada University, Nanded – 431606 (India); Phatangare, A. B.; Dahiwale, S. S. [Department of Physics, Savitribai Phule Pune University, Pune – 411007 (India)

    2016-05-06

    We are reporting photosensitivity property of BiFeO{sub 3} thin film under optical illumination. The thin film used for photosensitivity work was fabricated via sol-gel assisted spin coating technique. I-V measurements on the Cu/BiFeO{sub 3}/Al structure under dark condition show a good rectifying property and show dramatic blue shit in threshold voltage under optical illumination. The microstructure, morphology and elemental analysis of the films were characterized by using XRD, UV-Vis, FTIR, SEM and EDS.

  2. Monogenean anchor morphometry: systematic value, phylogenetic signal, and evolution

    Directory of Open Access Journals (Sweden)

    Tsung Fei Khang

    2016-02-01

    Full Text Available Background. Anchors are one of the important attachment appendages for monogenean parasites. Common descent and evolutionary processes have left their mark on anchor morphometry, in the form of patterns of shape and size variation useful for systematic and evolutionary studies. When combined with morphological and molecular data, analysis of anchor morphometry can potentially answer a wide range of biological questions. Materials and Methods. We used data from anchor morphometry, body size and morphology of 13 Ligophorus (Monogenea: Ancyrocephalidae species infecting two marine mugilid (Teleostei: Mugilidae fish hosts: Moolgarda buchanani (Bleeker and Liza subviridis (Valenciennes from Malaysia. Anchor shape and size data (n = 530 were generated using methods of geometric morphometrics. We used 28S rRNA, 18S rRNA, and ITS1 sequence data to infer a maximum likelihood phylogeny. We discriminated species using principal component and cluster analysis of shape data. Adams’s Kmult was used to detect phylogenetic signal in anchor shape. Phylogeny-correlated size and shape changes were investigated using continuous character mapping and directional statistics, respectively. We assessed morphological constraints in anchor morphometry using phylogenetic regression of anchor shape against body size and anchor size. Anchor morphological integration was studied using partial least squares method. The association between copulatory organ morphology and anchor shape and size in phylomorphospace was used to test the Rohde-Hobbs hypothesis. We created monogeneaGM, a new R package that integrates analyses of monogenean anchor geometric morphometric data with morphological and phylogenetic data. Results. We discriminated 12 of the 13 Ligophorus species using anchor shape data. Significant phylogenetic signal was detected in anchor shape. Thus, we discovered new morphological characters based on anchor shaft shape, the length between the inner root point and the

  3. Monogenean anchor morphometry: systematic value, phylogenetic signal, and evolution.

    Science.gov (United States)

    Khang, Tsung Fei; Soo, Oi Yoon Michelle; Tan, Wooi Boon; Lim, Lee Hong Susan

    2016-01-01

    Background. Anchors are one of the important attachment appendages for monogenean parasites. Common descent and evolutionary processes have left their mark on anchor morphometry, in the form of patterns of shape and size variation useful for systematic and evolutionary studies. When combined with morphological and molecular data, analysis of anchor morphometry can potentially answer a wide range of biological questions. Materials and Methods. We used data from anchor morphometry, body size and morphology of 13 Ligophorus (Monogenea: Ancyrocephalidae) species infecting two marine mugilid (Teleostei: Mugilidae) fish hosts: Moolgarda buchanani (Bleeker) and Liza subviridis (Valenciennes) from Malaysia. Anchor shape and size data (n = 530) were generated using methods of geometric morphometrics. We used 28S rRNA, 18S rRNA, and ITS1 sequence data to infer a maximum likelihood phylogeny. We discriminated species using principal component and cluster analysis of shape data. Adams's K mult was used to detect phylogenetic signal in anchor shape. Phylogeny-correlated size and shape changes were investigated using continuous character mapping and directional statistics, respectively. We assessed morphological constraints in anchor morphometry using phylogenetic regression of anchor shape against body size and anchor size. Anchor morphological integration was studied using partial least squares method. The association between copulatory organ morphology and anchor shape and size in phylomorphospace was used to test the Rohde-Hobbs hypothesis. We created monogeneaGM, a new R package that integrates analyses of monogenean anchor geometric morphometric data with morphological and phylogenetic data. Results. We discriminated 12 of the 13 Ligophorus species using anchor shape data. Significant phylogenetic signal was detected in anchor shape. Thus, we discovered new morphological characters based on anchor shaft shape, the length between the inner root point and the outer root

  4. Monogenean anchor morphometry: systematic value, phylogenetic signal, and evolution

    Science.gov (United States)

    Soo, Oi Yoon Michelle; Tan, Wooi Boon; Lim, Lee Hong Susan

    2016-01-01

    Background. Anchors are one of the important attachment appendages for monogenean parasites. Common descent and evolutionary processes have left their mark on anchor morphometry, in the form of patterns of shape and size variation useful for systematic and evolutionary studies. When combined with morphological and molecular data, analysis of anchor morphometry can potentially answer a wide range of biological questions. Materials and Methods. We used data from anchor morphometry, body size and morphology of 13 Ligophorus (Monogenea: Ancyrocephalidae) species infecting two marine mugilid (Teleostei: Mugilidae) fish hosts: Moolgarda buchanani (Bleeker) and Liza subviridis (Valenciennes) from Malaysia. Anchor shape and size data (n = 530) were generated using methods of geometric morphometrics. We used 28S rRNA, 18S rRNA, and ITS1 sequence data to infer a maximum likelihood phylogeny. We discriminated species using principal component and cluster analysis of shape data. Adams’s Kmult was used to detect phylogenetic signal in anchor shape. Phylogeny-correlated size and shape changes were investigated using continuous character mapping and directional statistics, respectively. We assessed morphological constraints in anchor morphometry using phylogenetic regression of anchor shape against body size and anchor size. Anchor morphological integration was studied using partial least squares method. The association between copulatory organ morphology and anchor shape and size in phylomorphospace was used to test the Rohde-Hobbs hypothesis. We created monogeneaGM, a new R package that integrates analyses of monogenean anchor geometric morphometric data with morphological and phylogenetic data. Results. We discriminated 12 of the 13 Ligophorus species using anchor shape data. Significant phylogenetic signal was detected in anchor shape. Thus, we discovered new morphological characters based on anchor shaft shape, the length between the inner root point and the outer root

  5. Isolation by the 5 anchored PCR technique and characterization of ...

    Indian Academy of Sciences (India)

    Shin P. K. S, Li H. Y. and Cheung S. G. 2009 Horseshoe crabs in Hong Kong: current population status and human exploitation. In Biology and conservation of horseshoe crabs (ed. J. T. Tanacredi, M. L. Botton and D. R. Smith), pp. 347–360. Springer, New York, USA. Winnepennincks B., Backeljau T. and Wachter R. D. ...

  6. Microfluidics-Assisted TIRF Imaging to Study Single Actin Filament Dynamics.

    Science.gov (United States)

    Shekhar, Shashank

    2017-12-11

    Dynamic assembly of actin filaments is essential for many cellular processes. The rates of assembly and disassembly of actin filaments are intricately controlled by regulatory proteins that interact with the ends and the sides of filaments and with actin monomers. TIRF-based single-filament imaging techniques have proven instrumental in uncovering mechanisms of actin regulation. In this unit, novel single-filament approaches using microfluidics-assisted TIRF imaging are described. These methods can be used to grow anchored actin filaments aligned in a flow, thus making the analysis much easier as compared to open flow cell approaches. The microfluidic nature of the system also enables rapid change of biochemical conditions and allows simultaneous imaging of a large number of actin filaments. Support protocols for preparing microfluidic chambers and purifying spectrin-actin seeds used for nucleating anchored filaments are also described. © 2017 by John Wiley & Sons, Inc. Copyright © 2017 John Wiley & Sons, Inc.

  7. Silver nanoparticles anchored reduced graphene oxide for enhanced electrocatalytic activity towards methanol oxidation

    Science.gov (United States)

    Kumar, Sanjeev; Mahajan, Mani; Singh, Rajinder; Mahajan, Aman

    2018-02-01

    In this report, silver nanoparticles (Ag NPs) anchored reduced graphene oxide (rGO) sheets (rGO/Ag) nanohybrid has been explored as anode material in direct methanol fuel cells (DMFCs). The synthesized rGO/Ag nanohybrid is characterized by XRD, XPS, FTIR spectroscopy and HRTEM techniques. Cyclic voltammograms demonstrate that the rGO/Ag nanohybrid exhibits higher electrocatalytic activity in comparison to rGO sheets for methanol oxidation reaction (MOR). This enhancement is attributed to the synergetic effect produced by the presence of more active sites provided by Ag NPs anchored on a conducting network of large surface area rGO sheets.

  8. Extraction of bioactives from Orthosiphon stamineus using microwave and ultrasound-assisted techniques: Process optimization and scale up.

    Science.gov (United States)

    Chan, Chung-Hung; See, Tiam-You; Yusoff, Rozita; Ngoh, Gek-Cheng; Kow, Kien-Woh

    2017-04-15

    This work demonstrated the optimization and scale up of microwave-assisted extraction (MAE) and ultrasonic-assisted extraction (UAE) of bioactive compounds from Orthosiphon stamineus using energy-based parameters such as absorbed power density and absorbed energy density (APD-AED) and response surface methodology (RSM). The intensive optimum conditions of MAE obtained at 80% EtOH, 50mL/g, APD of 0.35W/mL, AED of 250J/mL can be used to determine the optimum conditions of the scale-dependent parameters i.e. microwave power and treatment time at various extraction scales (100-300mL solvent loading). The yields of the up scaled conditions were consistent with less than 8% discrepancy and they were about 91-98% of the Soxhlet extraction yield. By adapting APD-AED method in the case of UAE, the intensive optimum conditions of the extraction, i.e. 70% EtOH, 30mL/g, APD of 0.22W/mL, AED of 450J/mL are able to achieve similar scale up results. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. A Retrospective Study on Advanced Maternal Age and Assisted Reproductive Techniques, Medico-Legal Advice, "Food for Thought".

    Science.gov (United States)

    Frati, Paola; Foldes-Papp, Zeno; Panici, Pierluigi B; Brunelli, Roberto; Zaami, Simona; Busardò, Francesco P; Fineschi, Vittorio

    2016-01-01

    Pregnancy in advanced reproductive age is nowadays part of the social and welfare scenario. The effects and assessment of the risks and complications in women over the age of 43 must still be more specifically defined. The aim of this study is to compare the outcomes between spontaneous pregnancies with those induced by assisted reproductive technology (ART) in women ≥ 43 years. This retrospective observational study enrolled 114 women with an age of ≥ 43 divided as follows: 74 with spontaneous pregnancies and 40 with ART-induced pregnancy. For statistical analysis, a t-test was used to compare the parameters analyzed for quantitative variables and χ2 was used for qualitative variables. A p-value ≤ 0.05 was considered statistically significant. Statistical Analysis was performed using the program SPSS 16.0 for Windows. The statistically significant differences between IVF and spontaneous pregnancy groups were respectively: gestational hypertension (30% vs 6.8%), preeclampsia (17.5% vs 2.7%), preterm delivery (47.5% vs 13.5%), IUGR (17.5% vs 4.1%), caesarian section (95% vs 70.3%), length of recovery (8.6±7.2 vs 5.9±3) and mean birth weight (2641± 695 g vs 3207±496 g). Women in advanced reproductive age (≥ 43 years) who undergo assisted fertilization procedures are at a higher risk of complications compared to women of the same age with spontaneous pregnancies.

  10. Anchoring Singapore Philanthropy in Southeast Asia | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Anchoring Singapore Philanthropy in Southeast Asia. Philanthropy in Singapore has traditionally had a charitable and local orientation. However, given the country's growing wealth and strong ties (trade, investment, migration) with its less advantaged neighbours, it is expected that considerable philanthropic capital will ...

  11. Anchoring Singapore Philanthropy in Southeast Asia | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Anchoring Singapore Philanthropy in Southeast Asia. Philanthropy in Singapore has traditionally had a charitable and local orientation. However, given the country's growing wealth and strong ties (trade, investment, migration) with its less advantaged neighbours, it is expected that considerable philanthropic capital will ...

  12. Multimodality of Learning Through Anchored Instruction

    Science.gov (United States)

    Love, Mary Susan

    2004-01-01

    Multimodality of learning results from the intertextual relationship between multimodal design and other meaning-making modes. Meaning making is becoming more multimodal because language is continually reshaped by new forms of communication media. This article examines anchored instruction from a multimodal perspective. The first section includes…

  13. Anchoring the Panic Disorder Severity Scale

    Science.gov (United States)

    Keough, Meghan E.; Porter, Eliora; Kredlow, M. Alexandra; Worthington, John J.; Hoge, Elizabeth A.; Pollack, Mark H.; Shear, M. Katherine; Simon, Naomi M.

    2012-01-01

    The Panic Disorder Severity Scale (PDSS) is a clinician-administered measure of panic disorder symptom severity widely used in clinical research. This investigation sought to provide clinically meaningful anchor points for the PDSS both in terms of clinical severity as measured by the Clinical Global Impression-Severity Scale (CGI-S) and to extend…

  14. The bone-anchored hearing aid

    DEFF Research Database (Denmark)

    Foghsgaard, Søren

    2014-01-01

    The bone-anchored hearing aid (Baha) was introduced in 1977 by Tjellström and colleagues and has now been used clinically for over 30 years. Generally, the outcomes are good, and several studies have shown improved audiological- and quality of life outcomes. The principle of the Baha is, that sound...

  15. Metabolic anchor reactions for robust biorefining.

    Science.gov (United States)

    Jouhten, Paula; Huerta-Cepas, Jaime; Bork, Peer; Patil, Kiran Raosaheb

    2017-03-01

    Microbial cell factories based on renewable carbon sources are fundamental to a sustainable bio-economy. The economic feasibility of producer cells requires robust performance balancing growth and production. However, the inherent competition between these two objectives often leads to instability and reduces productivity. While algorithms exist to design metabolic network reduction strategies for aligning these objectives, the biochemical basis of the growth-product coupling has remained unresolved. Here, we reveal key reactions in the cellular biochemical repertoire as universal anchor reactions for aligning cell growth and production. A necessary condition for a reaction to be an anchor is that it splits a substrate into two or more molecules. By searching the currently known biochemical reaction space, we identify 62 C-C cleaving anchor reactions, such as isocitrate lyase (EC 4.1.3.1) and L-tryptophan indole-lyase (EC 4.1.99.1), which are relevant for biorefining. The here identified anchor reactions mark network nodes for basing growth-coupled metabolic engineering and novel pathway designs. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  16. International Lunar Network (ILN) Anchor Nodes

    Science.gov (United States)

    Cohen, Barbara A.

    2009-01-01

    This slide presentation reviews the United States' contribution to the International Lunar Network (ILN) project, the Anchor Nodes project. The ILN is an initiative of 9 national space agencies to establish a set of robotic geophysical monitoring stations on the surface of the Moon. The project is aimed at furthering the understanding of the lunar composition, and interior structure.

  17. Weighing Anchor in the "Ragged Times"

    Science.gov (United States)

    Perry, Tonya B.

    2012-01-01

    In today's middle school classroom, grouping is an essential learning tool that enhances students' ability to collaborate with others and deepen their own thinking. Implementing group work effectively, though, can be a challenge, especially since groups tend to end their work at "ragged" or staggered times. Creating "anchor activities"--respectful…

  18. Stone anchors from the Okhamandal region, Gujarat Coast, India

    Digital Repository Service at National Institute of Oceanography (India)

    Sundaresh; Gaur, A.S.; Gudigar, P.; Tripati, S.; Vora, K.H.; Bandodkar, S.N.

    During marine archaeological explorations since 1983, off Dwarka, a large number of stone anchors were discovered and dated to 1400 BC, comparing with anchors found in Mediterranean waters. In recent archaeological explorations off Dwarka, Bet...

  19. Lower total cell numbers in mouse preimplantation embryos cultured in human assisted reproductive technique (ART) media are not induced by apoptosis.

    Science.gov (United States)

    Schulte, Katharina; Ehmcke, Jens; Schlatt, Stefan; Boiani, Michele; Nordhoff, Verena

    2015-12-01

    A common feature of assisted reproductive techniques such as IVF or intracytoplasmic sperm injection is the IVC of oocytes or preimplantation embryos in artificial culture media. The IVC conditions are selected to mimic the environment of the female genital tract. We have shown that murine preimplantation embryos respond to different culture media with changes in developmental rates, cellular lineage composition, and gene expression patterns. In this study, we explored whether apoptosis is responsible for cell loss in mouse preimplantation embryos after exposure to different human culture media. We examined total embryonic cell count as well as the pattern of protein expression for caspase-9 (intrinsic pathway), caspase-8 (extrinsic pathway), and the executioner caspase-3 via immunohistochemical staining. Total cell counts decline in embryos cultured either in innovative sequential medium 1 and Blast Assist (Origio) or human tubal fluid and MultiBlast (Irvine Scientific) when compared to KSOM(aa). Few cells were caspase-9 and -3 positive in all experimental groups. Staining for caspase-8 was almost undetectable. We conclude that embryonic cell loss is not associated with higher rates of intrinsic apoptotic cell loss. Our results suggest that the culture medium-dependent decline in total cell count and the developmental restriction in embryos cultured in innovative sequential medium 1/Blast Assist and human tubal fluid/MultiBlast are related to processes affecting cell proliferation. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Is video-assisted thoracoscopic diaphragmatic plication a widespread technique for diaphragmatic hernia in adults? Review of the literature and results of a national survey.

    Science.gov (United States)

    Rombolá, Carlos A; Genovés Crespo, Marta; Tárraga López, Pedro J; García Jiménez, María Dolores; Honguero Martínez, Antonio F; León Atance, Pablo; Rodríguez Ortega, Claudia R; Triviño Ramírez, Ana; Rodríguez Montes, José Antonio

    2014-01-01

    Diaphragmatic plication is the most accepted treatment for symptomatic diaphragmatic hernia in adults. The fact that this pathology is infrequent and this procedure not been widespread means that this is an exceptional technique in our field. To estimate its use in the literature, we carried out a review in English and Spanish, to which we added our series. We found only six series that contribute 59 video-assisted mini-thoractomy for diaphragmatic plications in adults, and none in Spanish. Our series will be the second largest with 18 cases. Finally, we conducted a survey in all the Spanish Thoracic Surgery units in Spain: none reported more than 10 cases operated by thoracoscopy in the last 8 years (except our series) and most continue employing thoracotomy as the main approach. We believe that many patients with symptomatic diaphragmatic hernia could benefit from the use of such techniques. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  1. A Retrograde Transvenous Embolization Technique with Balloon-Assisted Arterial Aspiration for a Peripheral Arteriovenous Malformation with a Venous Pouch

    Energy Technology Data Exchange (ETDEWEB)

    Kuhara, Asako, E-mail: kuhara-asako@med.kurume-u.ac.jp; Tanaka, Norimitsu; Koganemaru, Masamichi; Kugiyama, Tomoko [Kurume University School of Medicine, Department of Radiology (Japan); Kiyokawa, Kensuke [Kurume University School of Medicine, Department of Plastic & Reconstructive Surgery and Maxillofacial Surgery (Japan); Abe, Toshi [Kurume University School of Medicine, Department of Radiology (Japan)

    2017-05-15

    Management of arteriovenous malformations (AVMs) is challenging, and there is no consensus regarding either the ideal approach or the treatment timing. Percutaneous embolization is the most frequent approach currently used and is considered the first-line technique for AVMs. There is an ongoing discussion about the best technical approach to embolize AVMs. AVMs associated with a dominant outflow vein (DOV) are rare. Embolization of both the DOV and the nidus is considered more effective. Herein, we report a novel technique of transvenous embolization of a DOV under negative pressure from an arterial balloon catheter in a case of a peripheral AVM. This technique allows the embolization of the DOV and the nidus retrogradely.

  2. Progesterone level on the day of hCG administration in relation to the pregnancy rates of patients undergoing assisted reproduction techniques.

    Science.gov (United States)

    Oliveira, Renato de; Cabral, Fernanda Godoy; Carvalho, Waldemar de Almeida Pereira; Cordts, Emerson Barchi; Bianco, Bianca; Barbosa, Caio Parente

    2017-01-01

    To evaluate the predictive capacity for pregnancy of the progesterone level on the day of administering human chorionic gonadotropin, in women submitted to assisted reproductive techniques. An observational study with 914 women submitted to assisted reproductive techniques from August 2014 to June 2016. Total pregnancy rate was 34.58%; in that, the pregnancy rate in women 38 years was, respectively, 42.3%, 38.7% and 16.1% (p<0.001). For embryo transfer in the same cycle, and progesterone of 1.3ng/dL, sensitivity was 4.78%, specificity, 84.18%, accuracy, 56.72%, positive likelihood ratio of 0.3019, and negative likelihood ratio of 1.1312, with receiver operating characteristic curve of 0.46 (95%CI: 0.42-0.49). The progesterone level on the day of administering human chorionic gonadotropin of 1.3ng/dL differs from that empirically adopted at the study site (1.7ng/dL), and has a better predictive capacity for pregnancy in the patients studied. However, the low sensitivity of this examination raises questions about its real importance.

  3. Brain ultrasound features in multiple births due to spontaneous conception compared with assisted reproductive techniques: a cross-sectional, population-based study.

    Science.gov (United States)

    Smilari, P; Praticò, A D; Salafia, S; Praticò, E R; Cilauro, S; Saporito, A; Pavone, P; Ruggieri, M

    2014-02-01

    Multiple pregnancies from spontaneous conception and obtained by assisted reproductive techniques (ART) are associated with a disproportionate share of complications compared with natural singleton pregnancies. The outcome of multiple pregnancies obtained by ART is still the subject of controversial opinions in the medical literature as they are associated with increased rates of perinatal complications, and perinatal mortality, as well as maternal complications. Aim of this study was to determine whether there are differences between these two groups of infants. We examined the imaging findings by means of brain ultrasound (performed at birth and sequentially up to their 6th month of age) in a cohort of 296 twins and triplets born following different techniques of assisted fertilization (63 pregnancies; 119 neonates) vs. spontaneous conception (94 pregnancies; 177 neonates). We did record, by means of X square corrected test, statistically significant differences (P=0.002) between the two populations at birth in the number of normal ultrasound scans (ARTassisted conceptions (P=0.959) at long-term follow-up have been noticed.

  4. The Outcome of Assisted Reproductive Techniques among Couples with Male Factors at Prince Khalid Bin Sultan Fertility Centre, Kingdom of Saudi Arabia.

    Science.gov (United States)

    Mukhtar, Hytham Bahaeldin; Shaman, Amani; Mirghani, Hyder Osman; Almasalmah, Ayman Adnan

    2017-08-15

    Thirty-three percent of infertility due to paternal factors, there are an increasing proportion of couples who decide to conceive by assisted reproductive techniques (ART). The outcome prediction is pivotal for decision making. We aimed to study the pregnancy outcomes of different ART with male factors infertility. This is retrospective cross-sectional study conducted at Tabuk, Kingdom of Saudi Arabia. One hundred fifteen patients' records reviewed using a structured checklist to collect demographic data, sperm (concentration, motility, and morphology). Female with significant infertility factor were excluded. Chi-square was used for the outcome of various ART. Out of 115 couples with male factors; treated by Intracytoplasmic Sperm Injection (ICSI), In Vitro Fertilization (IVF) and Intrauterine Insemination (IUI); the mean age was 35.2 ± 6.3 years for men and 29.7 ± 5.1 for females. IVF had the highest success rate overall and had a high pregnancy rate with oligospermia and asthenospermia. ICSI has a good outcome for those with azoospermia, severe oligospermia, and teratozoospermia. IUI must be tried as a first line treatment when semen concentration is more than 10 million sperm/ml. all are not significant (P > 0.05). No significant differences were reported in the pregnancy outcome between various assisted reproductive techniques, smoking, type of infertility and medication.

  5. Does video-assisted thoracic surgery provide a safe alternative to conventional techniques in patients with limited pulmonary function who are otherwise suitable for lung resection?

    Science.gov (United States)

    Oparka, Jonathan; Yan, Tristan D; Ryan, Eilise; Dunning, Joel

    2013-07-01

    A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was: does video-assisted thoracic surgery provide a safe alternative to conventional techniques in patients with limited pulmonary function who are otherwise suitable for lung resection? Altogether, more than 280 papers were found using the reported search, of which 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. One of the largest studies reviewed was a retrospective review of the Society of Thoracic Surgeons database. The authors compared 4531 patients who underwent lobectomy by video-assisted thoracic surgery (VATS) with 8431 patients who had thoracotomy. In patients with a predicted postoperative forced expiratory volume in 1 s (ppoFEV1%) of surgery is performed via VATS compared with traditional open techniques. The literature also suggests that patients in whom pulmonary function is poor have similar perioperative outcomes to those with normal function when a VATS approach to resection is adopted.

  6. Emergency HeartWare Ventricular Assist Device (HVAD) exchange due to pump thrombosis using minimally invasive technique.

    Science.gov (United States)

    Antończyk, Remigiusz; Trejnowska, Ewa; Pacholewicz, Jerzy; Wolny, Tomasz; Nadziakiewicz, Paweł; Antończyk, Karolina; Copik, Izabela; Piontek, Magdalena; Jasińska, Małgorzata; Filipiak, Krzysztof; Głowacki, Maciej; Gawlikowski, Maciej; Borowicz, Marcin; Kustosz, Roman; Waszak, Jacek; Przybyłowski, Piotr; Zembala, Marian; Zakliczyński, Michał; Zembala, Michał Oskar

    2017-03-01

    Left ventricular assist device (LVAD) thrombosis remains a dreadful complication of mechanical circulatory support, with an incidence of 8-12% depending on the pump type and patient's comorbidities. Fibrinolysis may be considered early in pump thrombosis, but when contraindicated a pump exchange remains the only alternative. This short report documents an emergency LVAD exchange in a 55-year-old man who underwent LVAD (HeartWare Inc) implantation in 2013 as a bridge to transplantation. Four months after the initial surgery, he suffered from a hemorrhagic stroke despite properly managed anticoagulation. On February 17th, 2017 he was re-admitted with LVAD pump thrombosis. As fibrinolysis was contraindicated, an emergency pump exchange was performed via a limited thoracic incision in order to minimize surgical trauma, reduce intraoperative complications and facilitate immediate post-operative recovery. This report documents the very first LVAD pump exchange as well as the first one performed via a minimally invasive approach in Poland.

  7. Surgeons’ Volume-Outcome Relationship for Lobectomies and Wedge Resections for Cancer Using Video-Assisted Thoracoscopic Techniques

    Directory of Open Access Journals (Sweden)

    Guy David

    2012-01-01

    Full Text Available This study examined the effect of surgeons’ volume on outcomes in lung surgery: lobectomies and wedge resections. Additionally, the effect of video-assisted thoracoscopic surgery (VATS on cost, utilization, and adverse events was analyzed. The Premier Hospital Database was the data source for this analysis. Eligible patients were those of any age undergoing lobectomy or wedge resection using VATS for cancer treatment. Volume was represented by the aggregate experience level of the surgeon in a six-month window before each surgery. A positive volume-outcome relationship was found with some notable features. The relationship is stronger for cost and utilization outcomes than for adverse events; for thoracic surgeons as opposed to other surgeons; for VATS lobectomies rather than VATS wedge resections. While there was a reduction in cost and resource utilization with greater experience in VATS, these outcomes were not associated with greater experience in open procedures.

  8. Strategies and methodologies to develop techniques for computer-assisted analysis of gas phase formation during altitude decompression

    Science.gov (United States)

    Powell, Michael R.; Hall, W. A.

    1993-01-01

    It would be of operational significance if one possessed a device that would indicate the presence of gas phase formation in the body during hypobaric decompression. Automated analysis of Doppler gas bubble signals has been attempted for 2 decades but with generally unfavorable results, except with surgically implanted transducers. Recently, efforts have intensified with the introduction of low-cost computer programs. Current NASA work is directed towards the development of a computer-assisted method specifically targeted to EVA, and we are most interested in Spencer Grade 4. We note that Spencer Doppler Grades 1 to 3 have increased in the FFT sonogram and spectrogram in the amplitude domain, and the frequency domain is sometimes increased over that created by the normal blood flow envelope. The amplitude perturbations are of very short duration, in both systole and diastole and at random temporal positions. Grade 4 is characteristic in the amplitude domain but with modest increases in the FFT sonogram and spectral frequency power from 2K to 4K over all of the cardiac cycle. Heart valve motion appears to characteristic display signals: (1) the demodulated Doppler signal amplitude is considerably above the Doppler-shifted blow flow signal (even Grade 4); and (2) demodulated Doppler frequency shifts are considerably greater (often several kHz) than the upper edge of the blood flow envelope. Knowledge of these facts will aid in the construction of a real-time, computer-assisted discriminator to eliminate cardiac motion artifacts. There could also exist perturbations in the following: (1) modifications of the pattern of blood flow in accordance with Poiseuille's Law, (2) flow changes with a change in the Reynolds number, (3) an increase in the pulsatility index, and/or (4) diminished diastolic flow or 'runoff.' Doppler ultrasound devices have been constructed with a three-transducer array and a pulsed frequency generator.

  9. A comparison of assisted cough techniques in stable patients with severe respiratory insufficiency due to amyotrophic lateral sclerosis.

    Science.gov (United States)

    Senent, Cristina; Golmard, Jean-Louis; Salachas, François; Chiner, Eusebi; Morelot-Panzini, Capucine; Meninger, Vincent; Lamouroux, Catherine; Similowski, Thomas; Gonzalez-Bermejo, Jesus

    2011-01-01

    Cough can be impaired in ALS. This can result in peak cough flows (PCFs) too low for an adequate airway clearance (techniques that aim at a better elimination of airway secretions, but which are effective, especially in bulbar patients, is not known. We designed the present investigation to compare the PCFs produced by a range of manual and mechanical techniques in patients with ALS, in non-bulbar but also in bulbar patients. In the whole study population, PCFs ranged from 84 (35-118) l/mn for the spontaneous cough manoeuvre to 488 (243-605) l/min for the in/exsufflator (p = 0.0005). In the bulbar group, these values were 42 (35-130) l/min versus 436 (244-630) l/min, respectively (p = 0.008), and 89 (40-106) l/min versus 491 (192-580) l/min, respectively, in the non-bulbar group (p = 0.019). There was no statistically significant difference between the bulbar and the non-bulbar groups. The in/exsufflator was not always the best tool. We conclude that capacity of coughing efforts to produce efficient peak cough flows can be dramatically improved with different tools, even in patients with very severe bulbar symptoms and that it appears useful to test an array of techniques to optimally tailor cough improvement techniques to individual patients.

  10. Smart Collections: Can Artificial Intelligence Tools and Techniques Assist with Discovering, Evaluating and Tagging Digital Learning Resources?

    Science.gov (United States)

    Leibbrandt, Richard; Yang, Dongqiang; Pfitzner, Darius; Powers, David; Mitchell, Pru; Hayman, Sarah; Eddy, Helen

    2010-01-01

    This paper reports on a joint proof of concept project undertaken by researchers from the Flinders University Artificial Intelligence Laboratory in partnership with information managers from the Education Network Australia (edna) team at Education Services Australia to address the question of whether artificial intelligence techniques could be…

  11. Students' Anchoring Predisposition: An Illustration from Spring Training Baseball

    Science.gov (United States)

    Mohrweis, Lawrence C.

    2014-01-01

    The anchoring tendency results when decision makers anchor on initial values and then make final assessments that are adjusted insufficiently away from the initial values. The professional literature recognizes that auditors often risk falling into the judgment trap of anchoring and adjusting (Ranzilla et al., 2011). Students may also be unaware…

  12. 33 CFR 401.14 - Anchor marking buoys.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Anchor marking buoys. 401.14... OF TRANSPORTATION SEAWAY REGULATIONS AND RULES Regulations Condition of Vessels § 401.14 Anchor marking buoys. A highly visible anchor marking buoy of a type approved by the Manager and the Corporation...

  13. [Repair of rotator cuff tear by allogenic cortical bone anchor with suture bridge].

    Science.gov (United States)

    Wang, Ming-xin; Liu, Yu-jie; He, Wei; Li, Hai-feng; An, Bai-jing

    2012-07-03

    To evaluate the repair of rotator cuff tear by allogenic cortical bone anchors with the technique of suture bridge. A total of 18 patients with rotator cuff tear were recruited during the period of June 2006 to June 2009. There were 7 males and 11 females with an average age of 45.2 years old (range: 34 - 65). The locations included left shoulder (n = 11) and right shoulder (n = 7). Rotator cuff tear was repaired by allogenic cortical bone anchors with the technique of suture bridge under arthroscopy. The efficacy was evaluated by University of California Los Angeles (UCLA) standard score. The average follow-up period was 17.6 months (range: 12 - 36). The excellent rate of treatment was 100%. All rotator cuff tears were healed. Only 2 cases had minor pain and there was no limitation of joint activity. The bone anchor fully integrated with the subject area at Month 3 post-operation. The advantages of repairing rotator cuff tear by allograft cortical bone anchors with the technique of suture bridge includes minimal trauma, a large tendon bone area, firm fixation and a low cost. It is a better approach of repairing rotator cuff tear.

  14. Retzus-sparing robotic-assisted laparoscopic radical prostatectomy: a step–by-step technique description of this first brazilian experience

    Directory of Open Access Journals (Sweden)

    Marcos Tobias-Machado

    Full Text Available Abstract Introduction: Retzus-sparing robotic-assisted radical prostatectomy(RARP is a newly approach that preserve the Retzus structures and provide better recovery of continence and erectile function. In Brazil, this approach has not yet been previously reported. Objective: Our goal is to describe Step-by-Step the Retzus-sparing RARP surgical technique and report our first Brazilian experience. Methods: We present a case of a 60-year-old white man with low risk prostate cancer. Surgical materials were four arms Da Vinci robotic platform system, six transperitoneal portals, two prolene wires and Polymer Clips. This surgical technique was step-by-step described according to Galfano et al. One additional step was added as a modification of Galfano et al. Primary technique description: The closure of the Denovellier fascia. Results: We have operated one patient with this technique. The operative time was 180minutes, console time was135 min, the blood loss was 150ml, none perioperative or postoperative complications was found, hospital stay of 01 day. The anatomopathological classification revealed a pT2aN0M0 specimen with free surgical margins. The patient achieved continence immediately after bladder stent retrieval. Full erection reported after 30 days of surgery. Conclusion: Retzus-sparing RARP approach is feasible and reproducible. However, further comparative studies are necessary to demonstrate potential benefits in continence and sexual outcomes over the standard approaches.

  15. Effect of Additional Sutures per Suture Anchor in Arthroscopic Bankart Repair: A Review of Single-loaded Versus Double-loaded Suture Anchors.

    Science.gov (United States)

    Chen, Jeffrey S; Novikov, David; Kaplan, Daniel J; Meislin, Robert J

    2016-07-01

    To directly compare single-loaded suture anchors (SSA) with double-loaded suture anchors (DSA) to help surgeons optimize the operative technique, time, and cost of Bankart repairs. A literature review was performed using the PubMed and SCOPUS databases. Studies that directly compared SSA and DSA for Bankart repairs, or indirectly compared them by collecting relevant data despite a different objective, were included. A total of two studies were included, both of which were cadaveric laboratory studies. A total of 28 shoulders were tested. Tests conducted include loading to failure and cyclic loading. One study found SSA to be biomechanically equivalent to DSA, and one found DSA to be superior. Based on limited cadaveric study, DSA are at least equivalent biomechanically to SSA, and may be superior. By using DSA, surgeons create repair constructs that are as strong as, or stronger than, those made with SSA, but with fewer anchors. This reduces the amount of holes drilled and implants placed in the glenoid, while also minimizing cost. Quantifying the benefit of additional sutures in a suture anchor can help optimize the quality of repair, time, and cost in arthroscopic shoulder repair. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  16. [Congenital bilateral absence of vas deferens: From diagnosis to assisted reproductive techniques - the experience of three centers].

    Science.gov (United States)

    Beauvillard, D; Perrin, A; Drapier, H; Ravel, C; Fréour, T; Férec, C; De Braekeleer, M; Amice, V

    2015-05-01

    To review the management with assisted reproductive technologies (ART) of men with congenital bilateral absence of vas deferens (CBAVD), associated with cystic fibrosis or not, after surgical retrieval [epididymal aspiration (MESA) or testicular biopsy (TESE)]. Multicenter retrospective study made of 2 groups: CBAVD and cystic fibrosis (CF) or CBAVD only (CF-RD). Two centers performed MESA (Brest and Nantes) and one TESE (Rennes). Sperm numeration, motility, vitality, morphology and nuclear maturity were measured in both centers performing MESA. Fertilization rate (TF) and cumulated progressive pregnancy rate by retrieved oocyte (TGC) were compared between centers following ART. Ninety patients underwent surgical retrieval between January 1996 and March 2013, 30 in the CF group and 60 in the CF-RD group. Semen parameters were comparable between groups and centers. Fifty-eight (22 in the CF group and 36 in the CF-RD group) patients received ART between April 1996 and October 2014. TF was 50% and 52% and TGC 26% and 32% in the CF group and CF-RD groups, respectively. The results did not differ between groups but TGC was higher in Rennes than in the other two centers. Both semen parameters and ART results are comparable and similar to those reported in the literature. As shown by the results obtained in Rennes, TESE seems to be more effective. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  17. Noninvasive prenatal testing (NIPT) in twin pregnancies with treatment of assisted reproductive techniques (ART) in a single center.

    Science.gov (United States)

    Tan, Yueqiu; Gao, Ya; Lin, Ge; Fu, Meili; Li, Xihong; Yin, Xuyang; Du, Juan; Li, Jing; Li, Wen; Peng, Huanhuan; Yuan, Yuying; Chen, Fang; Jiang, Fuman; Zhang, Hongyun; Lu, Guangxiu; Gong, Fei; Wang, Wei

    2016-07-01

    The objective of the study is to report the performance of noninvasive prenatal testing (NIPT) in twin pregnancies after the treatment of assisted reproductive technology (ART). In two years period, 565 pregnant women with ART twin pregnancies were prospectively tested by NIPT for screening for trisomy 21 (T21), 18 (T18), and 13 (T13) by sequencing cell-free DNA in maternal plasma. Positive NIPT results were confirmed by karyotyping, while negative results were interviewed after delivery. Pregnant decision based on NIPT and confirmation results was discussed during post-test counseling. In total of 565 cases, NIPT had a failure rate of 0.9% (5/565). Four cases of T21 were identified by NIPT and confirmed by karyotyping, resulting in 100% (95%CI 39.8%-100%) positive predictive value. Among 556 cases with NIPT negative results, 506 cases (91.0%) were confirmed by follow-up of postnatal phenotypes, while 33 cases (5.9%) had adverse pregnant outcomes with unconfirmed reasons because of the lack of cytogenetic samples. The remaining 17 cases (3.1%) refused follow-up. No false negative result was reported. With apparently high positive predictive value and low false positive rate, NIPT has the potential to be used as a good alternative approach of conventional prenatal screening at the first trimester in ART twin pregnancy. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

  18. A potential high risk for fatty liver disease was found in mice generated after assisted reproductive techniques.

    Science.gov (United States)

    Gu, Leilei; Zhang, Jingjing; Zheng, Meimei; Dong, Guoying; Xu, Jingyi; Zhang, Wuyue; Wu, Yibo; Yang, Yang; Zhu, Hui

    2018-02-01

    Abnormal gametogenesis and embryonic development may lead to poor health status of the offspring. The operations involved in the assisted reproductive technologies (ARTs) occur during the key stage of gametogenesis and early embryonic development. To assess the potential risk of abnormal lipid metabolism in the liver of adult ARTs offspring, two ARTs mice models derived from preimplantation genetic diagnosis (PGD group) and in vitro cultured embryos without biopsy (IVEM group) were constructed. And control mice were from in vivo naturally conceived (Normal group). The results showed that ARTs offspring had increased body weight and body fat content comparing to normal group. An increasing volume and amount of lipid droplets as well as lipid droplet fusion were found in the hepatocytes of ARTs mice, and a significantly increased liver TG content was also shown in the ARTs mice, which due to the increased TG synthesis and decreased TG transport in the liver. All the results indicated that the manipulations involved in ARTs might play an important role in the lipid accumulation of adult offspring. By analyzing the DNA methylation profiles of 7.5dpc embryos, we proposed that methylation deregulation of the genes related to liver development in ARTs embryos might contribute to the abnormal phenotype in the offspring. The study demonstrated that ARTs procedures have adverse effect on liver development which resulted in abnormal lipid metabolism and induced the potential high risk of fatty liver in adulthood. © 2017 Wiley Periodicals, Inc.

  19. Accurate Determination of Glacier Surface Velocity Fields with a DEM-Assisted Pixel-Tracking Technique from SAR Imagery

    Directory of Open Access Journals (Sweden)

    Shiyong Yan

    2015-08-01

    Full Text Available We obtained accurate, detailed motion distribution of glaciers in Central Asia by applying digital elevation model (DEM assisted pixel-tracking method to L-band synthetic aperture radar imagery. The paper firstly introduces and analyzes each component of the offset field briefly, and then describes the method used to efficiently and precisely compensate the topography-related offset caused by the large spatial baseline and rugged terrain with the help of DEM. The results indicate that the rugged topography not only forms the complex shapes of glaciers, but also affects the glacier velocity estimation, especially with large spatial baseline. The maximum velocity, 0.85 m∙d−1, was observed in the middle part on the Fedchenko Glacier, which is the world’s longest mountain glacier. The motion fluctuation on its main trunk is apparently influenced by mass flowing in from tributaries, as well as angles between tributaries and the main stream. The approach presented in this paper was proved to be highly appropriate for monitoring glacier motion and will provide valuable sensitive indicators of current and future climate change for environmental analysis.

  20. A prospective randomized controlled trial for assessment of perineal hydrodissection technique for nervesparing robot assisted radical prostatectomy.

    Science.gov (United States)

    Hatiboglu, G; Simpfendörfer, T; Uhlmann, L; Bergero, M A; Macher-Goeppinger, S; Pahernik, S; Hadaschik, B; Hohenfellner, M; Teber, D

    2017-12-01

    This study prospectively evaluated the safety and efficacy of perineal hydrodissection in robot assisted nervesparing prostatectomy. Patients were randomized for perineal, ultrasound guided hydrodissection (HD) before radical prostatectomy and compared with standard treatment (ST). Follow-up was done every 3 months, including erectile function (IIEF5-score), reported grade of erection, ability for sexual intercourse, continence, PSA. 21 patients were enrolled to this prospective study, 10 for ST and 11 for HD. No significant differences in demographic and preoperative oncological data between both groups were identified. Blood loss and time for surgery did not differ significantly. HD resulted in 66% (4/6) rate of positive surgical margins (PSM) in pT3 tumors vs 50% in ST (1/2; P = 0.67). Follow-up revealed higher IIEF scores, better ability for sexual intercourse and early continence in HD. Erectile function after radical prostatectomy was improved by perineal hydrodissection in this proof of principal study. However, careful patient selection and further studies are needed as perineal hydrodissection could result in increased positive surgical margins in pT3a tumors. Copyright © 2017 John Wiley & Sons, Ltd.

  1. MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques

    Energy Technology Data Exchange (ETDEWEB)

    Imschweiler, Thomas; Freiwald, Bianka; Kubik-Huch, Rahel A. [Kantonspital Baden AG, Institute for Radiology, Baden (Switzerland); Haueisen, Harald [Kantonspital Aarau AG, Institute for Radiology, Aarau (Switzerland); Kampmann, Gert [Clinica Sant' Anna, Lugano, Sorengo (Switzerland); Rageth, Luzi [Adjumed Services AG, Zurich (Switzerland); Seifert, Burkhardt [Institute for Social and Preventive Medicine, University of Zurich, Division of Biostatistics, Zuerich (Switzerland); Rageth, Christoph [Breast Centre, Zurich (Switzerland)

    2014-01-15

    To analyse the development of MRI-guided vacuum-assisted biopsy (VAB) in Switzerland and to compare the procedure with stereotactically guided and ultrasound-guided VAB. We performed a retrospective analysis of VABs between 2009 and 2011. A total of 9,113 VABs were performed. Of these, 557 were MRI guided. MRI-guided VAB showed the highest growth rate (97 %) of all three procedures. The technical success rates for MRI-guided, stereotactically guided and ultrasound-guided VAB were 98.4 % (548/557), 99.1 % (5,904/5,960) and 99.6 % (2,585/2,596), respectively. There were no significant differences (P = 0.12) between the MRI-guided and the stereotactically guided procedures. The technical success rate for ultrasound-guided VAB was significantly higher than that for MRI-guided VAB (P < 0.001). There were no complications using MRI-guided VAB requiring open surgery. The malignancy diagnosis rate for MRI-guided VAB was similar to that for stereotactically guided VAB (P = 0.35). MRI-guided VAB is a safe and accurate procedure that provides insight into clinical breast findings. (orig.)

  2. The influence of microwave-assisted drying techniques on the rehydration behavior of blueberries (Vaccinium corymbosum L.).

    Science.gov (United States)

    Zielinska, Magdalena; Markowski, Marek

    2016-04-01

    The aim of this study was to determine the effect of: (a) different drying methods, (b) hot air temperature in a convection oven, and (c) the moisture content of fruits dehydrated by multi-stage drying which involves a transition between different stages of drying, on the rehydration kinetics of dry blueberries. Models describing rehydration kinetics were also studied. Blueberries dehydrated by multi-stage microwave-assisted drying, which involved a hot air pre-drying step at 80 °C until the achievement of a moisture content of 1.95 kg H2O kg(-1)DM, were characterized by significantly higher rates of initial and successive rehydration as well as smaller initial loss of soluble solids in comparison with the samples dried by other methods. The highest initial rehydration rate and the smallest loss of soluble solids after 30 min of soaking were determined at 0.46 min(-1) and 0.29 kg DM kg(-1)DM, respectively. The Peleg model and the first-order-kinetic model fit the experimental data well. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Mechanism of transformation in Mycobacteria using a novel shockwave assisted technique driven by in-situ generated oxyhydrogen.

    Science.gov (United States)

    Datey, Akshay; Subburaj, Janardhanraj; Gopalan, Jagadeesh; Chakravortty, Dipshikha

    2017-08-17

    We present a novel method for shockwave-assisted bacterial transformation using a miniature oxyhydrogen detonation-driven shock tube. We have obtained transformation efficiencies of about 1.28 × 106, 1.7 × 106, 5 × 106, 1 × 105, 1 × 105 and 2 × 105 transformants/µg of DNA for Escherichia coli, Salmonella Typhimurum, Pseudomonas aeruginosa, Mycobacterium smegmatis, Mycobacterium tuberculosis (Mtb) and Helicobacter pylori respectively using this method which are significantly higher than those obtained using conventional methods. Mtb is the most difficult bacteria to be transformed and hence their genetic modification is hampered due to their poor transformation efficiency. Experimental results show that longer steady time duration of the shockwave results in higher transformation efficiencies. Measurements of Young's modulus and rigidity of cell wall give a good understanding of the transformation mechanism and these results have been validated computationally. We describe the development of a novel shockwave device for efficient bacterial transformation in complex bacteria along with experimental evidence for understanding the transformation mechanism.

  4. An automatic, vigorous-injection assisted dispersive liquid-liquid microextraction technique for stopped-flow spectrophotometric detection of boron.

    Science.gov (United States)

    Alexovič, Michal; Wieczorek, Marcin; Kozak, Joanna; Kościelniak, Paweł; Balogh, Ioseph S; Andruch, Vasil

    2015-02-01

    A novel automatic vigorous-injection assisted dispersive liquid-liquid microextraction procedure based on the use of a modified single-valve sequential injection manifold (SV-SIA) was developed and applied for determination of boron in water samples. The major novelties in the procedure are the achieving of efficient dispersive liquid-liquid microextraction by means of single vigorous-injection (250 µL, 900 µL s(-1)) of the extraction solvent (n-amylacetate) into aqueous phase resulting in the effective dispersive mixing without using dispersive solvent and after self-separation of the phases, as well as forwarding of the extraction phase directly to a Z-flow cell (10 mm) without the use of a holding coil for stopped-flow spectrophotometric detection. The calibration working range was linear up to 2.43 mg L(-1) of boron at 426nm wavelength. The limit of detection, calculated as 3s of a blank test (n=10), was found to be 0.003 mg L(-1), and the relative standard deviation, measured as ten replicable concentrations at 0.41 mg L(-1) of boron was determined to be 5.6%. The validation of the method was tested using certified reference material. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Fluorescence-assisted visualization of facial nerve during mastoidectomy: A novel technique for preventing iatrogenic facial paralysis.

    Science.gov (United States)

    Chen, Shao-Ching; Wang, Mao-Che; Wang, Wei-Hsin; Lee, Cheng-Chia; Yang, Tsui-Fen; Lin, Chun-Fu; Wang, Jui-To; Liao, Chih-Hsiang; Chang, Chih-Chang; Chen, Min-Hsiung; Shih, Yang-Hsin; Hsu, Sanford P C

    2015-04-01

    Mastoidectomy can be risky due to the chance of iatrogenic facial nerve dysfunction. Avoiding injuries to the mastoid segment of the facial nerve is mandatory when drilling the bone. With advancements in intraoperative near-infrared indocyanine green (ICG) video angiography, we describe the application of a novel fluorescent guidance technique during mastoidectomies to identify the facial canal with safety. Mastoidectomies were performed as the key step in the presigmoid, petrosal or translabyrinthine approaches in 16 patients with different pathologies located at the cerebellopontine angle or petroclival region. After the facial canal was drilled to paper thin, ICG was injected via the central venous catheter. Compared with the dark bony portion, the vessels inside the vasa nervorum were highlighted as a result. The fluorescence guides the operator through the course of the facial nerve and facilitates opening of the internal auditory canal and the dissection of tumors. All 16 facial nerves were recognized during mastoidectomies under fluorescence guidance for varied periods of enhancing time (range, 23-50s). In all, one to four attempts after repeated drilling works to enhance the facial nerve were required before these nerves could be clearly seen. The tumor resection procedure yielded the following results: grossly total removal in seven patients, near total removal in five, and subtotal removal in three. Complete obliteration of a giant vertebral artery aneurysm in one patient was seen in the follow-up angiogram. The post-mastoidectomy facial nerve function, examined by triggered EMG, was preserved in all 16 patients, and no patients had postoperative facial palsy worse than House-Brackmann grade IV after 6 months of follow-up. With this novel technique, the course of the facial nerve can be confirmed during mastoidectomy, which reduces the possibility of iatrogenic facial nerve dysfunction. This fluorescence technique is especially helpful in establishing

  6. A novel silk suture-assisted laparoscopic technique for the repair of a gastrocolic fistula in a pediatric patient

    Directory of Open Access Journals (Sweden)

    Seher Mughal

    2016-10-01

    Full Text Available Percutaneous placement of gastrostomy was first described in 1980. Since then it has become widely used in pediatric surgery throughout the world. Inherent in the technique is the possibility of inadvertent damage to adjacent anatomical structures, most commonly the transverse colon. Management previously had involved laparotomy and correction of the gastrocolic fistula. Here we describe a novel laparoscopic approach to the repair of a gastrocolic fistula following percutaneous gastrostomy, avoiding the morbidity of laparotomy in an immunocompromised patient with a rotund abdomen secondary to steroid usage.

  7. Cerclage Wiring Through a Mini-Open Approach to Assist Reduction of Subtrochanteric Fractures Treated With Cephalomedullary Fixation: Surgical Technique.

    Science.gov (United States)

    Codesido, Pablo; Mejía, Ana; Riego, Jonathan; Ojeda-Thies, Cristina

    2017-08-01

    Despite advances in the management of subtrochanteric fractures, in particular with the use of cephalomedullary nails, outcomes remain worse than other fractures of the proximal femur. Because an anatomic reduction is needed to offer the best results, several methods of reduction, using clamps and wires have been described. Reduction of fractures in elderly patients is especially complicated because of poor bone quality, comorbidities, and unfavorable fracture patterns. We describe a new technique of reduction and cerclage wiring through a mini-open approach for isolated subtrochanteric, as well as intertrochanteric fractures with extension into the subtrochanteric area, and report our results in a series of patients.

  8. Composite materials formed with anchored nanostructures

    Science.gov (United States)

    Seals, Roland D; Menchhofer, Paul A; Howe, Jane Y; Wang, Wei

    2015-03-10

    A method of forming nano-structure composite materials that have a binder material and a nanostructure fiber material is described. A precursor material may be formed using a mixture of at least one metal powder and anchored nanostructure materials. The metal powder mixture may be (a) Ni powder and (b) NiAl powder. The anchored nanostructure materials may comprise (i) NiAl powder as a support material and (ii) carbon nanotubes attached to nanoparticles adjacent to a surface of the support material. The process of forming nano-structure composite materials typically involves sintering the mixture under vacuum in a die. When Ni and NiAl are used in the metal powder mixture Ni.sub.3Al may form as the binder material after sintering. The mixture is sintered until it consolidates to form the nano-structure composite material.

  9. Scale Anchoring with the Rasch Model.

    Science.gov (United States)

    Wyse, Adam E

    Scale anchoring is a method to provide additional meaning to particular scores at different points along a score scale by identifying representative items associated with the particular scores. These items are then analyzed to write statements of what types of performance can be expected of a person with the particular scores to help test takers and other stakeholders better understand what it means to achieve the different scores. This article provides simple formulas that can be used to identify possible items to serve as scale anchors with the Rasch model. Specific attention is given to practical considerations and challenges that may be encountered when applying the formulas in different contexts. An illustrative example using data from a medical imaging certification program demonstrates how the formulas can be applied in practice.

  10. Electrochromic mirror using viologen-anchored nanoparticles

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Han Na [Electronics and Telecommunications Research Institute, Nature-mimic I/O interface Research Section, 218 Gajeong-roYuseong-gu, Daejeon 305-700 (Korea, Republic of); University of Science and Technology, Advanced Device Technology, 217 Gajeong-roYuseong-gu, Daejeon 305-350 (Korea, Republic of); Cho, Seong M.; Ah, Chil Seong; Song, Juhee; Ryu, Hojun; Kim, Yong Hae [Electronics and Telecommunications Research Institute, Nature-mimic I/O interface Research Section, 218 Gajeong-roYuseong-gu, Daejeon 305-700 (Korea, Republic of); Kim, Tae-Youb, E-mail: youby@etri.re.kr [Electronics and Telecommunications Research Institute, Nature-mimic I/O interface Research Section, 218 Gajeong-roYuseong-gu, Daejeon 305-700 (Korea, Republic of); University of Science and Technology, Advanced Device Technology, 217 Gajeong-roYuseong-gu, Daejeon 305-350 (Korea, Republic of)

    2016-10-15

    Highlights: • Three types of ECM device were fabricated using viologen-anchored ECDs. • The devices were investigated according to their optical structures. • The anti-reflection material affects the reflectance and the coloration efficiency. • The device design of ECMs is a crucial factor for clear reflected images. - Abstract: Electrochromic mirrors (ECMs) that are used in automobile mirrors need to have high reflectance, a high contrast ratio, and a clear image. In particular, it is critical that distortions of clear images are minimized for safety. Therefore, an ECM is fabricated using viologen-anchored nanoparticles and a magnesium fluoride (MgF{sub 2}) layer with an anti-reflection function. The ECM has approximately 30.42% in the reflectance dynamic range and 125 cm{sup 2}/C high coloration efficiency.

  11. Running sutures anchored with square knots are unreliable.

    Science.gov (United States)

    Aanning, H L; Van Osdol, Andrew; Allamargot, Chantal; Becker, Brandt E; Howard, Thomas C; Likness, Micah L; Merkwan, Courtney E; Tarver, Dan D

    2012-09-01

    A previous study showed that running polypropylene sutures anchored with square knots retain only 75% of their strength compared with half hitches. The aim of this study was to investigate whether anchor knot geometry similarly affects the tensile strength of other types of sutures used in continuous closures. Monofilament and multifilament sutures (all 3-0) were anchored with either square knots or half hitches to 1 tensionometer post, and the running ends were secured to the other. The force required to break the running suture and the site of suture failure were recorded. The running sutures anchored with square knots retained only 50% to 84% of the strength of the identical sutures secured with half hitches (P suture anchored with half hitches is stronger and safer in comparison with the same suture anchored with square knots. This study provokes a fundamental reconsideration of the use of square knots to anchor running sutures. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Resisting anchoring effects: The roles of metric and mapping knowledge.

    Science.gov (United States)

    Smith, Andrew R; Windschitl, Paul D

    2015-10-01

    The biasing influence of anchors on numerical estimates is well established, but the relationship between knowledge level and the susceptibility to anchoring effects is less clear. In two studies, we addressed the potential mitigating effects of having knowledge in a domain on vulnerability to anchoring effects in that domain. Of critical interest was a distinction between two forms of knowledge-metric and mapping knowledge. In Study 1, participants who had studied question-relevant information-that is, high-knowledge participants-were less influenced by anchors than were participants who had studied irrelevant information. The results from knowledge measures suggested that the reduction in anchoring was tied to increases in metric rather than mapping knowledge. In Study 2, participants studied information specifically designed to influence different types of knowledge. As we predicted, increases in metric knowledge-and not mapping knowledge-led to reduced anchoring effects. Implications for debiasing anchoring effects are discussed.

  13. Test Score Equating Using a Mini-Version Anchor and a Midi Anchor: A Case Study Using SAT[R] Data

    Science.gov (United States)

    Liu, Jinghua; Sinharay, Sandip; Holland, Paul W.; Curley, Edward; Feigenbaum, Miriam

    2011-01-01

    This study explores an anchor that is different from the traditional miniature anchor in test score equating. In contrast to a traditional "mini" anchor that has the same spread of item difficulties as the tests to be equated, the studied anchor, referred to as a "midi" anchor (Sinharay & Holland), has a smaller spread of…

  14. Papineau technique combined with vacuum-assisted closure for open tibial fractures: clinical outcomes at five years.

    Science.gov (United States)

    Bao, Tongzhu; Han, Fang; Xu, Feng; Yang, Yi; Shu, Xun; Chen, Ken; Qi, Baiwen; Wei, Shijun; Yu, Aixi

    2017-08-28

    Treatment of open tibial fractures with soft tissue and segmental bone defects is difficult. This study reports our results for treating these injuries with a combination of Papineau open bone grafting and vacuum-assisted wound closure (VAC). The records of 19 patients with open tibial fractures with soft tissue and segmental bone defects treated with bone grafting and VAC from 2004 to 2010 were retrospectively reviewed. Outcomes included: time to complete granulation tissue coverage, wound healing, and bone union; length of hospitalization; frequency of debridement; number of deep tissue infections. Initial surgery was performed within 48 hours of injury. Ten fractures were Orthopaedic Trauma Association classification 41-A3, one was 41-C3, seven were 43-A3, and one was 43-C3. No surgical complications occurred, and the mean length of hospitalization was 11.0 ± 3.0 weeks (range, 7-18 weeks). The mean follow-up time was 59.35 ± 8.76 months. The mean time for complete wound healing was 7.76 ± 1.52 weeks (range, 6-11 weeks). Bone union was achieved in all patients at a mean of 33.88 ± 8.37 weeks (range, 23-53 weeks). Only one patient developed a deep tissue infection, which was treated with antibiotics and debridements, and complete bone union wound healing was achieved. Based on Paley grade, five outcomes were excellent, eight were good, and four were fair. The combination of VAC and open bone grafting results in good outcome for patients with open tibial fractures and severe bone and soft-tissue defects.

  15. Chemical biology of Glycosylphosphatidylinositol (GPI) anchors

    Indian Academy of Sciences (India)

    Admin

    PTEN and SHIP2 expressed in wide variety of cells. SHIP is expressed only in blood cells. SHIP i. d i t ll. sSHIP is expressed in stem cells. Approx 50% of human cancers contain PTEN mutations. Page 6. CSIR-IIIM. Relationship of PI and GPI anchors. (biosynthesis and topology). O. HO. HO. OH. O. P. O. O. O-. H2N. HO. O.

  16. BAHA: Bone-Anchored Hearing Aid

    OpenAIRE

    Hagr, Abdulrahman

    2007-01-01

    Bone-Anchored Hearing Aid (BAHA) has proven performance and advantages for patients with aural atresia or chronic ear drainage who cannot wear air-conduction hearing aids. The BAHA has both cosmetic and acoustic advantages over most conventional hearing aids and hence is becoming increasingly popular. Moreover, BAHA improves the quality of life and has also significantly reduces ear discharge. This extensive review of the literature pertaining to BAHA discus the history, the indications, the ...

  17. Manipulation of local optical properties and structures in molybdenum-disulfide monolayers using electric field-assisted near-field techniques.

    Science.gov (United States)

    Nozaki, Junji; Fukumura, Musashi; Aoki, Takaaki; Maniwa, Yutaka; Yomogida, Yohei; Yanagi, Kazuhiro

    2017-04-05

    Remarkable optical properties, such as quantum light emission and large optical nonlinearity, have been observed in peculiar local sites of transition metal dichalcogenide monolayers, and the ability to tune such properties is of great importance for their optoelectronic applications. For that purpose, it is crucial to elucidate and tune their local optical properties simultaneously. Here, we develop an electric field-assisted near-field technique. Using this technique we can clarify and tune the local optical properties simultaneously with a spatial resolution of approximately 100 nm due to the electric field from the cantilever. The photoluminescence at local sites in molybdenum-disulfide (MoS2) monolayers is reversibly modulated, and the inhomogeneity of the charge neutral points and quantum yields is suggested. We successfully etch MoS2 crystals and fabricate nanoribbons using near-field techniques in combination with an electric field. This study creates a way to tune the local optical properties and to freely design the structural shapes of atomic monolayers using near-field optics.

  18. Surgical Technique for Arthroscopy-Assisted Anatomical Reconstruction of Acromioclavicular and Coracoclavicular Ligaments Using Autologous Hamstring Graft in Chronic Acromioclavicular Joint Dislocations.

    Science.gov (United States)

    Chernchujit, Bancha; Parate, Prashant

    2017-06-01

    Injuries to the acromioclavicular (AC) joint are becoming common with contact sports and bike accidents. It is well known that in AC dislocations, the first structure to fail is the AC capsule followed by the trapezoid and conoid ligaments. The function of these ligaments must be restored to restore the anatomy and physiology of the AC joint to get the best results. Until now, no technique has emerged as the gold standard for restoration of the AC joint anatomy and function. In our technique, the stress is on recreating the anatomy to make it more individualized based on individual variations. This Technical Note describes a procedure to reconstruct the coracoclavicular ligaments and AC joint by an arthroscopy-assisted technique. Arthroscopy helps to diagnose additional intra-articular pathologies that can be treated simultaneously, and better preparation of the undersurface of the coracoid helps in bone-to-graft healing. Our approach is more individualized as clavicle tunneling is done according to the size of the coracoid base instead of a fixed distance. Vertical stability is provided by coracoclavicular ligament reconstruction, horizontal stability is provided by AC ligament reconstruction, and the articular disc is recreated by soft-tissue graft interposition, thus restoring the complete anatomy.

  19. Electropermanent magnetic anchoring for surgery and endoscopy.

    Science.gov (United States)

    Tugwell, Josef; Brennan, Philip; O'Shea, Conor; O'Donoghue, Kilian; Power, Timothy; O'Shea, Michael; Griffiths, James; Cahill, Ronan; Cantillon-Murphy, Padraig

    2015-03-01

    The use of magnets for anchoring of instrumentation in minimally invasive surgery and endoscopy has become of increased interest in recent years. Permanent magnets have significant advantages over electromagnets for these applications; larger anchoring and retraction force for comparable size and volume without the need for any external power supply. However, permanent magnets represent a potential hazard in the operating field where inadvertent attraction to surgical instrumentation is often undesirable. The current work proposes an interesting hybrid approach which marries the high forces of permanent magnets with the control of electromagnetic technology including the ability to turn the magnet OFF when necessary. This is achieved through the use of an electropermanent magnet, which is designed for surgical retraction across the abdominal and gastric walls. Our electropermanent magnet, which is hand-held and does not require continuous power, is designed with a center lumen which may be used for trocar or needle insertion. The device in this application has been demonstrated successfully in the porcine model where coupling between an intraluminal ring magnet and our electropermanent magnet facilitated guided insertion of an 18 Fr Tuohy needle for guidewire placement. Subsequent investigations have demonstrated the ability to control the coupling distance of the system alleviating shortcomings with current methods of magnetic coupling due to variation in transabdominal wall thicknesses. With further refinement, the magnet may find application in the anchoring of endoscopic and surgical instrumentation for minimally invasive interventions in the gastrointestinal tract.

  20. Anchored design of protein-protein interfaces.

    Directory of Open Access Journals (Sweden)

    Steven M Lewis

    Full Text Available Few existing protein-protein interface design methods allow for extensive backbone rearrangements during the design process. There is also a dichotomy between redesign methods, which take advantage of the native interface, and de novo methods, which produce novel binders.Here, we propose a new method for designing novel protein reagents that combines advantages of redesign and de novo methods and allows for extensive backbone motion. This method requires a bound structure of a target and one of its natural binding partners. A key interaction in this interface, the anchor, is computationally grafted out of the partner and into a surface loop on the design scaffold. The design scaffold's surface is then redesigned with backbone flexibility to create a new binding partner for the target. Careful choice of a scaffold will bring experimentally desirable characteristics into the new complex. The use of an anchor both expedites the design process and ensures that binding proceeds against a known location on the target. The use of surface loops on the scaffold allows for flexible-backbone redesign to properly search conformational space.This protocol was implemented within the Rosetta3 software suite. To demonstrate and evaluate this protocol, we have developed a benchmarking set of structures from the PDB with loop-mediated interfaces. This protocol can recover the correct loop-mediated interface in 15 out of 16 tested structures, using only a single residue as an anchor.

  1. Microwave-assisted extraction and rapid isolation of ursolic acid from the leaves of Eucalyptus × hybrida Maiden and its quantification using HPLC-diode array technique.

    Science.gov (United States)

    Verma, Subash C; Jain, Chhoten L; Kumari, Amita; Padhi, Madan M; Devalla, Ramesh B

    2013-04-01

    Ursolic acid (UA) is the most important bioactive phytoconstituent of Eucalyptus × hybrida Maiden leaves and exhibits anticancer, antimutagenic, anti-inflammatory, antioxidative, and antiprotozoal activities. In this study, microwave-assisted extraction technique was employed for rapid isolation of UA from the leaves of Eucalyptus × hybrida and simultaneously HPLC-diode array method was developed for the quantification of UA. Effects of several experimental parameters on the extraction efficiencies of UA, such as type and volume of extraction solvents, microwave power and extraction time, were evaluated. The optimal extraction conditions were found to be 20 mL of a mixture of chloroform/methanol, 60:40; liquid-to-material ratio, 4:1; preleaching time, 10 min; microwave power, 600 W; temperature, 50°C; and microwave irradiation time, 5 min. Under the optimum conditions, the yield of UA was found to be 1.95 ± 0.08% in the dry leaves of Eucalyptus × hybrida. The results showed that microwave-assisted extraction is a more rapid extraction method with higher yield and lower solvent consumptions than the conventional method. It is a faster, convenient, and appropriate method and it may be used for rapid isolation and quantification of UA and other important phytoconstituents present in the leaves of Eucalyptus × hybrida. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  2. Teaching residents pediatric fiberoptic intubation of the trachea: traditional fiberscope with an eyepiece versus a video-assisted technique using a fiberscope with an integrated camera.

    Science.gov (United States)

    Wheeler, Melissa; Roth, Andrew G; Dsida, Richard M; Rae, Bronwyn; Seshadri, Roopa; Sullivan, Christine L; Heffner, Corri L; Coté, Charles J

    2004-10-01

    The authors' hypothesis was that a video-assisted technique should speed resident skill acquisition for flexible fiberoptic oral tracheal intubation (FI) of pediatric patients because the attending anesthesiologist can provide targeted instruction when sharing the view of the airway as the resident attempts intubation. Twenty Clinical Anesthesia year 2 residents, novices in pediatric FI, were randomly assigned to either the traditional group (traditional eyepiece FI) or the video group (video-assisted FI). One of two attending anesthesiologists supervised each resident during FI of 15 healthy children, aged 1-6 yr. The time from mask removal to confirmation of endotracheal tube placement by end-tidal carbon dioxide detection was recorded. Intubation attempts were limited to 3 min; up to three attempts were allowed. The primary outcome measure, time to success or failure, was compared between groups. Failure rate and number of attempts were also compared between groups. Three hundred patient intubations were attempted; eight failed. On average, the residents in the video group were faster, were three times more likely to successfully intubate at any given time during an attempt, and required fewer attempts per patient compared to those in the traditional group. The video system seems to be superior for teaching residents fiberoptic intubation in children.

  3. The Intra-articular "Wave Sign" as a Landmark for Suture Anchor Placement in Arthroscopic Remplissage.

    Science.gov (United States)

    Kahlenberg, Cynthia A; Garcia, Grant H; Degen, Ryan M; Liu, Joseph N; Dines, Joshua S

    2017-09-01

    In arthroscopic remplissage, surgeons may inadvertently pass sutures through the teres minor rather than the infraspinatus tendon. This misplacement of the sutures may lead to poor outcomes. The authors describe the novel use of the posterior band of the inferior glenohumeral ligament, known as the "wave sign," as a reliable intra-articular landmark for suture anchor placement to improve suture passage accuracy. Twelve cadaveric shoulders underwent arthroscopic remplissage by a fellowship-trained surgeon. During the first phase of the study, remplissage was performed on 6 specimens with standard technique. The intra-articular wave sign was visualized on all specimens. Specimens were dissected to the level of the joint, and the location of each suture anchor and suture pass was noted. Using the results from the first set of specimens, the surgeon performed remplissage in the second set of 6 specimens using specific measurements from intra-articular landmarks. On dissection of the initial 6 specimens, 75% of sutures were passed through the infraspinatus and 25% were passed through the teres minor. For the remaining 6 specimens, care was taken to place 1 suture anchor at the superior edge of the wave sign and 1 suture anchor 1 cm superior to the wave sign. When suture anchors were successfully passed above the superior tip of the wave sign, the likelihood of infraspinatus tendon penetration was 17 times greater. Placement of the suture anchors at or above the superior tip of the intra-articular wave sign most reliably produced capsulotenodesis of the infraspinatus muscle. [Orthopedics. 2017; 40(5):e831-e835.]. Copyright 2017, SLACK Incorporated.

  4. Perinatal complications and neonatal outcomes of twin pregnancies conceived by assisted reproductive techniques and those conceived spontaneously: A retrospective analysis of 811 cases

    Directory of Open Access Journals (Sweden)

    Jin YU

    2017-11-01

    Full Text Available Objective To investigate the general situations of gravida, pregnancy complications, childbirth and neonatal outcomes of twin pregnancies conceived by assisted reproductive techniques (ART and those conceived spontaneously. Methods A retrospective analysis was carried out on the basic information, perinatal complications, delivery information and neonatal outcomes of twin pregnancies received by ART (ART group, n=518 and those conceived spontaneously (SC group, n=293. Results Gravida age was older in ART group than in SC group (P0.05. Conclusion Twin pregnancy conceived by ART may lead to higher incidences of gestational diabetes mellitus and abnormal placenta and more postpartum hemorrhage, but no significant difference existed in the neonatal outcomes between twin pregnancies conceived by ART and those conceived spontaneously. DOI: 10.11855/j.issn.0577-7402.2017.11.12

  5. Use of virtual assisted lung mapping (VAL-MAP), a bronchoscopic multispot dye-marking technique using virtual images, for precise navigation of thoracoscopic sublobar lung resection.

    Science.gov (United States)

    Sato, Masaaki; Omasa, Mitsugu; Chen, Fengshi; Sato, Toshihiko; Sonobe, Makoto; Bando, Toru; Date, Hiroshi

    2014-06-01

    We have developed a novel bronchoscopic multiple marking technique to assist resection of hardly palpable lung tumors. Because 3-dimensional virtual images were used and multiple markings made on the lung surface to provide "geometric" information, we termed this technique "virtual assisted lung mapping" (VAL-MAP). The safety and efficacy of VAL-MAP were evaluated. Virtual bronchoscopy was used to select 2 to 4 appropriate bronchial branches for marking. Bronchoscopy was conducted with the patient under local anesthesia. A metal-tip catheter was inserted into a selected bronchus and advanced to the pleura. The location of the catheter tip was fluoroscopically confirmed, and 1 mL of indigo carmine was injected. This procedure was repeated to complete all the planned markings. Post-VAL-MAP computed tomography was used to visualize the localization of the multiple markings on 3-dimensional virtual images, which were used as references in the subsequent operation. Of the 95 marking attempts made for 37 tumors in 30 patients, 88 (92.6%) were identified and contributed to the surgery. No clinically evident complications were associated with the procedure. A total of 15 wedge resections and 18 segmentectomies were thoracoscopically conducted, with a successful resection rate of 100%. Multiple markings of the VAL-MAP were complementary, enabling us to achieve complete resection even when 1 of the markings failed. The markings were visible even on interlobar fissures, at the apex, and on the diaphragm, which conventional percutaneous marking can hardly reach. VAL-MAP was safely conducted with satisfactory outcomes in our early experience. Additional confirmation of its safety and efficacy is necessary. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  6. Computer assisted mandibular reconstruction using a custom-made titan mesh tray and removable denture based on the top-down treatment technique.

    Science.gov (United States)

    Ikawa, Tomoko; Shigeta, Yuko; Hirabayashi, Rio; Hirai, Shinya; Hirai, Kentaro; Harada, Naohiko; Kawamura, Noboru; Ogawa, Takumi

    2016-10-01

    The purpose of this report is to propose a computer assisted mandibular reconstruction procedure, utilizing a custom-made Ti-mesh tray with particulate cancellous bone and marrow, and a removable denture. This procedure was based on the top-down treatment technique, and reviews the case of a representative patient with mandibular continuity defect. The patient was a 74-year old female with a chief complaint of facial asymmetry and masticatory dysfunction. Due to gingival carcinoma, she underwent a segmental mandibulectomy on the left mandibule. On the VR space, using 3-D reconstructed computer tomography data, the residual right-side mandibular fragment was repositioned based on the condylar position and the occlusal relation. The mandibular fragment was then mirrored for a central sagittal plane. The position of the mirrored object was slightly arranged with the occlusal relation. Through the above operations, the landmark configuration, for the custom-made Ti-mesh tray as a virtual simulation model, was fabricated. On the physical model, we produced a custom-made Ti-mesh tray with a commercial Ti-mesh sheet. Surgical treatment was carried out using the tray. The denture pattern was designed by a dental technician on the VR space, fabricated using a 3D printer, and modified to create an impression tray with resin. Using the impression, the temporary removable denture was fabricated. We propose a computer assisted design for a custom-made Ti-mesh tray and a removable denture, based on the Top-down treatment concept. We feel this technique is advantageous in reconstructing functional occlusion, and in accurately regaining dental and facial esthetics. Copyright © 2016 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  7. Effect of the Impeller Design on Degasification Kinetics Using the Impeller Injector Technique Assisted by Mathematical Modeling

    Directory of Open Access Journals (Sweden)

    Diego Abreu-López

    2017-04-01

    Full Text Available A mathematical model was developed to describe the hydrodynamics of a batch reactor for aluminum degassing utilizing the rotor-injector technique. The mathematical model uses the Eulerian algorithm to represent the two-phase system including the simulation of vortex formation at the free surface, and the use of the RNG k-ε model to account for the turbulence in the system. The model was employed to test the performances of three different impeller designs, two of which are available commercially, while the third one is a new design proposed in previous work. The model simulates the hydrodynamics and consequently helps to explain and connect the performances in terms of degassing kinetics and gas consumption found in physical modeling previously reported. Therefore, the model simulates a water physical model. The model reveals that the new impeller design distributes the bubbles more uniformly throughout the ladle, and exhibits a better-agitated bath, since the transfer of momentum to the fluids is better. Gas is evenly distributed with this design because both phases, gas and liquid, are dragged to the bottom of the ladle as a result of the higher pumping effect in comparison to the commercial designs.

  8. Early anchor displacement after arthroscopic rotator cuff repair.

    Science.gov (United States)

    Skaliczki, Gábor; Paladini, Paolo; Merolla, Giovanni; Campi, Fabrizio; Porcellini, Giuseppe

    2015-05-01

    Arthroscopic rotator cuff repair is a success and became the mainstream method of reconstruction in recent years. Due to the technical development in shoulder surgery, novel suture anchors and high-strength sutures are widely used providing convincing fixation, however anchor pullout still remains a problem. The aim of our study was to observe early anchor movement on a large patient cohort, and identify clinical, biological and technical variables that can lead to this complication. A total of 5,327 patients who had arthroscopic rotator cuff reconstruction for full thickness tear were included in the study. Radiographs taken immediately after surgery were observed and occurrent anchor displacement was recorded. Patient-specific, tendon-specific, bone-specific and implant-specific variables were studied. Any possible relationship between these factors and anchor displacement was investigated. Early anchor movement occurred in six cases (0.1%). The involvement of two or more tendons, retraction of the tendon by more than 2 cm and the use of four anchors was associated with higher incidence of anchor displacement, however the difference was not significant. Based on our study, anchor pullout occurring immediately after surgery is a relatively rare complication. Instead of timing the radiologic examination directly after the procedure, assessment of the anchors' position four to six weeks after surgery should be considered.

  9. Biomechanical comparison of an all-soft suture anchor with a modified Broström-Gould suture repair for lateral ligament reconstruction.

    Science.gov (United States)

    Brown, Christopher A; Hurwit, Daniel; Behn, Anthony; Hunt, Kenneth J

    2014-02-01

    Anatomic repair is indicated for patients who have recurrent lateral ankle instability despite nonoperative measures. There is no difference in repair stiffness, failure torque, or failure angle between specimens repaired with all-soft suture anchors versus the modified Broström-Gould technique with sutures only. Controlled laboratory study. In 10 matched pairs of human cadaveric ankles, the anterior talofibular ligament (ATFL) was incised from its origin on the fibula. After randomization, 1 ankle was repaired to its anatomic insertion using two 1.4-mm JuggerKnot all-soft suture anchors; the other ankle was repaired with a modified Broström-Gould technique using 2-0 FiberWire. All were augmented using the inferior extensor retinaculum. All ankles were mounted to the testing machine in 20° of plantar flexion and 15° of internal rotation and loaded to failure after the repair. Stiffness, failure torque, and failure angle were recorded and compared using a paired Student t test with a significance level set at P anchors pulled out of bone. The primary mode of failure was pulling through the ATFL tissue. There was no statistical difference in strength or stiffness between a 1.4-mm all-soft suture anchor and a modified Broström-Gould repair with 2-0 FiberWire. The primary mode of failure was at the tissue level rather than knot failure or anchor pullout. The particular implant choice (suture only, tunnel, anchor) in repairing the lateral ligament complex may not be as important as the time to biological healing. The suture-only construct as described in the Broström-Gould repair was as strong as all-soft suture anchors, and the majority of the ankles failed at the tissue level. For those surgeons whose preference is to use anchor repair, this novel all-soft suture anchor may be an alternative to other larger anchors, as none failed by pullout.

  10. A new training model for robot-assisted urethrovesical anastomosis and posterior muscle-fascial reconstruction: the Verona training technique.

    Science.gov (United States)

    Cacciamani, G; De Marco, V; Siracusano, S; De Marchi, D; Bizzotto, L; Cerruto, M A; Motton, G; Porcaro, A B; Artibani, W

    2017-06-01