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Sample records for early laparoendoscopic rendezvous

  1. Early laparoendoscopic rendezvous for acute biliary pancreatitis: preliminary results.

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    Borzellino, G; Lombardo, F; Minicozzi, A M; Donataccio, M; Cordiano, C

    2010-02-01

    Early restored patency of the papilla has been hypothesized to reduce complications and mortality of acute biliary pancreatitis. The aim of this study was to evaluate the role of urgent laparoscopic cholecystectomy with intraoperative cholangiography and rendezvous when necessary in acute biliary pancreatitis natural history. Patients observed in the early stage of an acute biliary pancreatitis were included in the study. Operative risk assessment based on American Society of Anesthesiologists (ASA) score allowed the performance of urgent laparoscopic cholecystectomy within 72 h from onset of symptoms in 55 patients and a delayed intervention during the same admission in 21 patients. Intraoperative cholangiography was performed in all cases, and clearance of common bile duct was performed by flushing when possible, or rendezvous when necessary. Evolution of pancreatitis was evaluated with clinical and radiological monitoring. Urgent laparoscopic cholecystectomy was performed in all cases without conversion. At intraoperative cholangiography common bile duct was free in 25 patients, a papillary spasm was observed in 9, and common bile duct stones in 21 patients. Patency of the papilla was restored by flushing in 13 patients, while a rendezvous was necessary in 17 patients. The rate of organ failure and pancreatic necrosis was 1.8%, overall mortality was 1.8%, and overall morbidity 21.8%. No infectious complications of peripancreatic collections were observed. Urgent laparoscopic cholecystectomy with selective intraoperative rendezvous may be considered as a treatment option in the early stage of acute biliary pancreatitis.

  2. Current status of laparoendoscopic rendezvous in the treatment of cholelithiasis with concomitant choledocholithiasis.

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    Baloyiannis, Ioannis; Tzovaras, George

    2015-06-25

    The current evidence in favor of the laparoendoscopic rendezvous is promising and demonstrates the main advantages of this technique in regard to shorter hospital stay and selective cannulation of the common bile duct (CBD), avoiding thus the inadvertent cannulation of the pancreatic duct. In addition, in the rendezvous technique the contrast medium is not injected retrogradely as during the traditional endoscopic retrograde cholangiopancreatography (ERCP), when the medium accidentally could be injected under pressure into the pancreatic duct. The RV technique minimizes that risk. Both these main advantages of the RV technique over the classic ERCP, are related with a significant lower incidence of hyperamylasemia and post-ERCP pancreatitis, compared with the traditional two stage procedure. Choledocholithiasis is present in 10% to 15% of patients undergoing cholecystectomy. To date, the ideal management of CBD stones remains controversial. Prospective randomized trials have shown that laparoscopic management of the CBD stones, as a single stage procedure, is the most efficient and cost effective method of treatment. Laparoendoscopic rendezvous has been proposed as an alternative single stage approach. Several studies have shown the effective use of this technique in the treatment of CBD stones by improving patient compliance and clinical results including shorter hospital stay, higher success rate and less cost. The current evidence about the use of this technique presented in this review article is promising and demonstrates the main advantages of the procedure.

  3. Laparoendoscopic rendezvous in the treatment of cholecysto-choledocholitiasis: a single series of 200 patients.

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    La Barba, Giuliano; Gardini, Andrea; Cavargini, Elena; Casadei, Alessandro; Morgagni, Paolo; Bazzocchi, Francesca; D'Acapito, Fabrizio; Cavaliere, Davide; Curti, Roberta; Tringali, Domenico; Cucchetti, Alessandro; Ercolani, Giorgio

    2018-02-27

    Although the ideal management of cholecysto-choledocholitiasis is controversial, the two-stage approach, namely the common bile duct (CBD) clearance through endoscopic retrograde cholangiopancreatography (ERCP) followed by laparoscopic cholecystectomy, remains the standard way of management. However, whenever feasible, the one-stage approach, using the so-called "laparoendoscopic rendezvous" (LERV) technique, offers some advantages, mainly reducing the hospital stay and the risk of post-ERCP pancreatitis. The aim of this study was to evaluate the safety and the efficacy of the one-stage approach, and to compare our results with data from available large studies. We reviewed our series of consecutive patients with cholecysto-choledocholitiasis treated by LERV from January 2003, to October 2016. Both elective and emergency cases were included. The primary end-point was the efficacy to obtain the CBD stones clearance. Secondary end-points were morbidity and mortality, operative time, conversion rate, and in-hospital stay. A total of 200 patients underwent a LERV procedure for the intra-operative diagnosis by intra-operative cholangiogram of cholecysto-choledocholitiasis. In 187 patients (93.5%), it was possible to cannulate the cystic duct with the jag-wire. Success rate was 95%. Conversion rate was 3%. The mean operative time was 135 min and the mean in-hospital stay was 4 days. 29 (14.5%) were the early complications, six mild pancreatitis. Four patients required re-operation during the hospital stay. 11 patients (5.5%) developed late complications during a median follow-up of 57.7 months. Our results confirm that LERV technique is a safe procedure with high success rates for the treatment of cholecysto-choledocholitiasis. The major advantages include the single-stage treatment, the shorter hospital stay, and the lower incidence of post-ERCP pancreatitis.

  4. Efficacy of the Laparoendoscopic "Rendezvous" to Treat Cholecystocholedocholithiasis in 210 Consecutive Patients: A Single Center Experience.

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    La Greca, Gaetano; Pesce, Antonio; Vitale, Marco; Mannino, Maurizio; Di Marco, Federica; Di Blasi, Michele; Lombardo, Rosario; Puleo, Stefano; Russello, Domenico; Latteri, Saverio

    2017-08-01

    The simultaneous laparoendoscopic "rendezvous" (LERV) represents an alternative to sequential or totally laparoscopic approaches for patients affected by cholecystocholedocholithiasis. The aim of this study was to analyze the results in a large series of 210 consecutive patients. From 2002 to 2016 all patients affected by cholecystocholedocholithiasis were treated with a standardized "tailored" LERV. The relevant technical features of the procedure were recorded. An analysis of feasibility, effectiveness in stone clearance, and safety was performed. Among 214 patients with common bile duct stones, 210 were treated with LERV and 4 with open rendezvous approach. Intraoperative cholangiography confirmed common bile duct stones in 179 patients (85.2%) or sludge in 18 (8.5%) and in 98.9% stone clearance was obtained endoscopically. Endoscopic papilla cannulation was feasible in 161 patients (76.7%), whereas in 49 (23.3%) a transcystic guidewire was needed. The overall LERV feasibility was 96.6%. The conversion rate to open surgery was 3.3%. Minor morbidity was observed in 1.9% of cases, mortality in 0.47%, and the mean hospital stay was 4.3 days. These results confirm the high effectiveness of LERV. This approach to treat cholecystocholedocholithiasis should be preferred and therefore implemented where a strong collaboration between surgeons and endoscopists is possible.

  5. "Ultra-rapid" sequential treatment in cholecystocholedocholithiasis: alternative same-day approach to laparoendoscopic rendezvous.

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    Borreca, Dario; Bona, Alberto; Bellomo, Maria Paola; Borasi, Andrea; De Paolis, Paolo

    2015-12-01

    There is still no consensus about timing of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography in the treatment of cholecystocholedocholithiasis. The aim of our retrospective study is to analyze the optimal timing of surgical treatment in patients presenting concurrent choledocholithiasis, choosing to perform a sequential endoscopic plus surgical approach, introducing a same-day two-stage alternative. All cases of cholecystocholedocholithiasis occurred between January 2007 and December 2014 in "Gradenigo" Hospital (Turin-Italy) were reviewed. Patients were divided into three groups, based on the timing of cholecystectomy after endoscopic retrograde cholangiopancreatography, and compared. Out of 2233 cholecystectomies performed in the mentioned time interval, have been identified 93 patients that fulfill the selection criteria. 36 patients were treated with a same-day approach, while 29 within first 72 h and 28 with delayed surgery. The overall length of stay was significantly lower in patients that were treated with a same-day approach (4.7 days), compared with other groups (p = 0.001), while no significant differences were found in terms of length of surgical intervention, intraoperative complications and conversions to open procedure, postoperative stay, morbidity and mortality. Patients treated with delayed surgery had a 18 % recurrency rate of biliary events, with an odds ratio of 14.13 (p = 0.018). Same-day two-stage approach should be performed in suitable patients at the index admission, reducing overall risks, improving the patients' quality-of-life, preventing recurrency, leading to a significant cost abatement; furthermore, this approach allows same outcomes of laparoendoscopic rendezvous, avoiding technical and organizational troubles.

  6. Cost analysis of laparoendoscopic rendezvous versus preoperative ERCP and laparoscopic cholecystectomy in the management of cholecystocholedocholithiasis.

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    Garbarini, Aldo; Reggio, Dario; Arolfo, Simone; Bruno, Marco; Passera, Roberto; Catalano, Giorgia; Barletti, Claudio; Salizzoni, Mauro; Morino, Mario; Petruzzelli, Luca; Arezzo, Alberto

    2017-08-01

    Evidence from controlled trials and meta-analyses suggests that laparoendoscopic rendezvous (LERV) is preferable to sequential treatment in the management of common bile duct stones. With this retrospective analysis of a prospective database that included consecutive patients treated for cholecystocholedocholithiasis at our institution between January 2007 and July 2015, we compared LERV with sequential treatment. The primary endpoint was global cost, defined as the cost/patient/hospital stay, and the secondary end points were efficacy and morbidity. Fisher's exact test or Mann-Whitney test was used. Of a total of 249 consecutive patients, 143 underwent LERV (group A) and 106 a two-stage procedure (group B). Based on an average cost of €613 for 1 day of hospital stay in the General Surgery Department, the overall median cost of treatment was €6403 for group A and €8194 for group B (p < 0.001). Operative time was significantly shorter (p < 0.001), and length of hospital stay was significantly longer for group B (p < 0.001). No mortality in either group was observed. The postoperative complications rate was significantly higher in group B than in group A (24.5 vs. 10.5%; p = 0.003). No significant difference in the postoperative pancreatitis rate or the number of patients with increased serum amylase at 24 h was observed in either group. Our study suggests that LERV is preferable to sequential treatment not only in terms of less morbidity, but also of lower costs accrued by a shorter hospital stay. However, the longer operative time raises multiple organizational issues in the coordination of surgery and endoscopy services.

  7. Laparoendoscopic Rendezvous for Concomitant Cholecystocholedocholithiasis: A Successful Modality Even in the Most Difficult Presentations Including Pregnancy.

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    Shirah, Bader Hamza; Mikwar, Zaher Abdulaziz; Ahmad, Akram Neyaz; Dahlan, Yaser Mohammed

    2016-01-01

    Background . Laparoendoscopic rendezvous (LERV) technique is emerging as an attractive treatment option for concomitant cholecystocholedocholithiasis. In this paper, we report our experience in performing the LERV technique in patients with unusual presentations in terms of anatomical difficulty, pregnancy, multiple comorbid diseases, and postlaparotomy. We aim to highlight the effectiveness of the LERV technique in some clinical situations where conventional methods would fail or carry high risks in adequately managing concomitant cholecystocholedocholithiasis. Methods . Four patients diagnosed to have concomitant cholecystocholedocholithiasis with associated difficult presentation or comorbid diseases were treated using the LERV technique. One patient presented with difficult anatomy where ERCP failed at initial attempts. Another patient was pregnant (first trimester). A third patient had complex comorbid diseases (bronchial asthma, hypertension, congestive heart failure, and end-stage renal disease on regular hemodialysis). A fourth patient had previous laparotomy and sigmoidectomy for diverticular disease and had severe hospital phobia. Results . All patients tolerated the LERV technique very well; no intraoperative occurrence was reported. The mean operative time was 86.3 ± 17.2 minutes; mean time of the endoscopic part was 29.4 ± 3.57 minutes. The mean blood loss was 44.3 ± 18.2 mL (range 20-85). Residual stone, postoperative complications, postoperative morbidity, and postoperative mortality were 0 (0%). Postoperative short hospital stay was reported in all patients, average 3 days (range 2-4). Conclusion . LERV procedure is a safe and effective treatment option for the management of concomitant cholecystocholedocholithiasis, even in difficult situations where other methods would fail or carry high risks, or in patients presenting with severe comorbid diseases or pregnancy. This procedure may emerge as an attractive alternative option for high

  8. Laparoendoscopic Rendezvous for Concomitant Cholecystocholedocholithiasis: A Successful Modality Even in the Most Difficult Presentations Including Pregnancy

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    Bader Hamza Shirah

    2016-01-01

    Full Text Available Background. Laparoendoscopic rendezvous (LERV technique is emerging as an attractive treatment option for concomitant cholecystocholedocholithiasis. In this paper, we report our experience in performing the LERV technique in patients with unusual presentations in terms of anatomical difficulty, pregnancy, multiple comorbid diseases, and postlaparotomy. We aim to highlight the effectiveness of the LERV technique in some clinical situations where conventional methods would fail or carry high risks in adequately managing concomitant cholecystocholedocholithiasis. Methods. Four patients diagnosed to have concomitant cholecystocholedocholithiasis with associated difficult presentation or comorbid diseases were treated using the LERV technique. One patient presented with difficult anatomy where ERCP failed at initial attempts. Another patient was pregnant (first trimester. A third patient had complex comorbid diseases (bronchial asthma, hypertension, congestive heart failure, and end-stage renal disease on regular hemodialysis. A fourth patient had previous laparotomy and sigmoidectomy for diverticular disease and had severe hospital phobia. Results. All patients tolerated the LERV technique very well; no intraoperative occurrence was reported. The mean operative time was 86.3±17.2 minutes; mean time of the endoscopic part was 29.4±3.57 minutes. The mean blood loss was 44.3±18.2 mL (range 20–85. Residual stone, postoperative complications, postoperative morbidity, and postoperative mortality were 0 (0%. Postoperative short hospital stay was reported in all patients, average 3 days (range 2–4. Conclusion. LERV procedure is a safe and effective treatment option for the management of concomitant cholecystocholedocholithiasis, even in difficult situations where other methods would fail or carry high risks, or in patients presenting with severe comorbid diseases or pregnancy. This procedure may emerge as an attractive alternative option for high

  9. Laparoendoscopic rendezvous may be an effective alternative to a failed preoperative endoscopic retrograde cholangiopancreatography in patients with cholecystocholedocholithiasis.

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    Tsiopoulos, Fotios; Kapsoritakis, Andreas; Psychos, Athanassios; Manolakis, Anastasios; Oikonomou, Konstantinos; Tzovaras, George; Baloyiannis, Ioannis; Tsikrika, Alexandra; Potamianos, Spyros

    2018-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP), followed by laparoscopic cholecystectomy (LC), remains the standard way of management for patients with cholecystocholedocholithiasis. Laparoendoscopic rendezvous (LERV), a combined procedure for removing the gallbladder laparoscopically and clearing the common bile duct (CBD) endoscopically at the same time, could be an attractive alternative. The aim of this study was to compare LERV with classic ERCP in patients with cholecystocholedocholithiasis. 886 patients with cholecystocholedocholithiasis were treated either with the LERV technique (90 patients), or with the 2-stage approach, which includes preoperative ERCP followed by LC (796 patients). The primary endpoint was any difference in the success of CBD cannulation and clearance; secondary endpoints were the detection of differences in morbidity (especially post-ERCP pancreatitis [PEP]), and the feasibility of the two approaches. Successful cannulation of the CBD was more frequent with conventional ERCP compared with the LERV technique (89.8% vs. 75.5%, P=0.0001). LERV appears to be as effective as conventional ERCP for complete CBD clearance (85.5% vs. 82.8%, P<0.1). None of the patients in the LERV group had an episode of clinical PEP, whereas in the conventional ERCP group there were 23 episodes of PEP and one death. The median amylase level was higher in patients undergoing conventional ERCP group compared to patients in LERV group. Classic ERCP has a higher rate of successful CBD cannulation and a similar rate of CBD clearance compared to LERV.

  10. A modified technique reduced operative time of laparoendoscopic rendezvous endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy for concomitant gallstone and common bile ductal stone.

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    Liu, Wei; Wang, Qunwei; Xiao, Jing; Zhao, Liying; Huang, Jiangsheng; Tan, Zhaohui; Li, Pengfei

    2014-01-01

    Laparoendoscopic rendezvous (LERV) endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy (LC+ERCP/LERV) are considered an optimal approach for concomitant gallstones and common bile duct stones. The rendezvous technique is essential for the success of procedure. We applied two different LERV techniques, traditional technique and modified technique, in 60 consecutive cases from January 2011 to November 2012. 32 cases who underwent modified technique (group 1) from February 2012 to November 2012 were retrospectively compared to 28 cases (group 2) who underwent traditional technique from January 2011 to January 2012. There was no significant difference between two groups with respect to preoperative demographic features. Although the difference was not statistically significant, the procedure was successfully performed in 31 cases (96.9%) in group 1 and 24 cases (86.2%) in group 2. The mean operative time and time of endoscopic part were 82.6 ± 19.6 min and 26.5 ± 5.99 min in group 1 which were significantly shorter than those in group 2 (118.0 ± 23.1 min and 58.7 ± 13.3 min, resp.). There was no postoperative pancreatitis and mortality in both groups. The mean hospital stay, blood loss, incidence of complications, and residual stone were of no difference in both groups. This study proved that this modified technique can effectively reduce the operative time and time of endoscopic part of LC+ERCP/LERV compared with traditional technique.

  11. A Modified Technique Reduced Operative Time of Laparoendoscopic Rendezvous Endoscopic Retrograde Cholangiopancreatography Combined with Laparoscopic Cholecystectomy for Concomitant Gallstone and Common Bile Ductal Stone

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    Wei Liu

    2014-01-01

    Full Text Available Laparoendoscopic rendezvous (LERV endoscopic retrograde cholangiopancreatography (ERCP and laparoscopic cholecystectomy (LC+ERCP/LERV are considered an optimal approach for concomitant gallstones and common bile duct stones. The rendezvous technique is essential for the success of procedure. We applied two different LERV techniques, traditional technique and modified technique, in 60 consecutive cases from January 2011 to November 2012. 32 cases who underwent modified technique (group 1 from February 2012 to November 2012 were retrospectively compared to 28 cases (group 2 who underwent traditional technique from January 2011 to January 2012. There was no significant difference between two groups with respect to preoperative demographic features. Although the difference was not statistically significant, the procedure was successfully performed in 31 cases (96.9% in group 1 and 24 cases (86.2% in group 2. The mean operative time and time of endoscopic part were 82.6 ± 19.6 min and 26.5 ± 5.99 min in group 1 which were significantly shorter than those in group 2 (118.0 ± 23.1 min and 58.7 ± 13.3 min, resp.. There was no postoperative pancreatitis and mortality in both groups. The mean hospital stay, blood loss, incidence of complications, and residual stone were of no difference in both groups. This study proved that this modified technique can effectively reduce the operative time and time of endoscopic part of LC+ERCP/LERV compared with traditional technique.

  12. Randomised study on single stage laparo-endoscopic rendezvous (intra-operative ERCP) procedure versus two stage approach (Pre-operative ERCP followed by laparoscopic cholecystectomy) for the management of cholelithiasis with choledocholithiasis.

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    Sahoo, Manash Ranjan; Kumar, Anil T; Patnaik, Aashish

    2014-07-01

    The 'Rendezvous' technique consists of laparoscopic cholecystectomy (LC) standards with intra-operative cholangiography followed by endoscopic sphincterotomy. The sphincterotome is driven across the papilla through a guidewire inserted by the transcystic route. In this study, we intended to compare the two methods in a prospective randomised trial. From 2005 to 2012, we enrolled 83 patients with a diagnosis of cholecysto-choledocolithiasis. They were randomised into two groups. In 'group-A',41 patients were treated with two stages management, first by pre-operative endoscopic retrograde cholangiopancreatography (ERCP) and common bile duct (CBD) clearance and second by LC. In 'group-B', 42 patients were treated with LC and intra-operative cholangiography; and when diagnosis of choledocholithiasis was confirmed, patients had undergone one stage management of by Laparo-endoscopic Rendezvous technique. In arm-A and arm-B groups, complete CBD clearance was achieved in 29 and 38 patients, respectively. Failure of the treatment in arm-A was 29% and in arm-B was 9.5%. In arm-A, selective CBD cannulation was achieved in 33 cases (80.5%) and in arm-B in 39 cases (93%). In arm-Agroup, post-ERCP hyperamylasia was presented in nine patients (22%) and severe pancreatitis in five patients (12%) versus none of the patients (0%) in arm-B group, respectively. Mean post-operative hospital stay in arm-A and arm-B groups are 10.9 and 6.8 days, respectively. One stage laparo-endoscopic rendezvous approach increases selective cannulation of CBD, reduces post-ERCP pancreatitis, reduces days of hospital stay, increases patient's compliance and prevents unnecessary intervention to CBD.

  13. Randomised study on single stage laparo-endoscopic rendezvous (intra-operative ERCP procedure versus two stage approach (Pre-operative ERCP followed by laparoscopic cholecystectomy for the management of cholelithiasis with choledocholithiasis

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    Manash Ranjan Sahoo

    2014-01-01

    Full Text Available Introduction : The ′Rendezvous′ technique consists of laparoscopic cholecystectomy (LC standards with intra-operative cholangiography followed by endoscopic sphincterotomy. The sphincterotome is driven across the papilla through a guidewire inserted by the transcystic route. In this study, we intended to compare the two methods in a prospective randomised trial. Materials And Methods: From 2005 to 2012, we enrolled 83 patients with a diagnosis of cholecysto-choledocolithiasis. They were randomised into two groups. In ′group-A′,41 patients were treated with two stages management, first by pre-operative endoscopic retrograde cholangiopancreatography (ERCP and common bile duct (CBD clearance and second by LC. In ′group-B′, 42 patients were treated with LC and intra-operative cholangiography; and when diagnosis of choledocholithiasis was confirmed, patients had undergone one stage management of by Laparo-endoscopic Rendezvous technique. Results: In arm-A and arm-B groups, complete CBD clearance was achieved in 29 and 38 patients, respectively. Failure of the treatment in arm-A was 29% and in arm-B was 9.5%. In arm-A, selective CBD cannulation was achieved in 33 cases (80.5% and in arm-B in 39 cases (93%. In arm-Agroup, post-ERCP hyperamylasia was presented in nine patients (22% and severe pancreatitis in five patients (12% versus none of the patients (0% in arm-B group, respectively. Mean post-operative hospital stay in arm-A and arm-B groups are 10.9 and 6.8 days, respectively. Conclusion: One stage laparo-endoscopic rendezvous approach increases selective cannulation of CBD, reduces post-ERCP pancreatitis, reduces days of hospital stay, increases patient′s compliance and prevents unnecessary intervention to CBD.

  14. Large Conization and Laparoendoscopic Single-Port Pelvic Lymphadenectomy in Early-Stage Cervical Cancer for Fertility Preservation

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    Polat Dursun

    2013-01-01

    Full Text Available Fertility preservation in early-stage cervical cancer is a hot topic in gynecologic oncology. Although radical vaginal trachelectomy (RVT is suggested as a fertility preserving approach, there are some serious concerns like cervical stenosis, second trimester loss, preterm delivery in survivors, and lack of residual tumor in the majority of the surgical specimens. Therefore, less radical surgical operations have been proposed in early-stage cervical carcinomas. On the other hand, single-incision laparoscopic surgery (SILS is an evolving endoscopic approach for minimal access surgery. In this report, we present a case with early-stage cervical cancer who wishes to preserve fertility. We successfully performed single-port pelvic lymphadenectomy and large conization to preserve fertility potential of the patient. We think that combination of less radical approach like conization and single-port pelvic lymphadenectomy might be less minimally invasive and is still an effective surgical approach in well-selected cases with cervical carcinomas. Incorporation of single-port laparoscopy into the minimally invasive fertility sparing management of the cervical cancer will improve patients outcome with less complications and better cosmesis. Further studies are needed to reach a clear conclusion.

  15. Trojan Tour and Rendezvous (TTR): A New Frontiers Mission to Explore the Origin and Evolution of the Early Solar System

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    Bell, J. F., III; Olkin, C.; Castillo, J. C.

    2015-12-01

    The orbital properties, compositions, and physical properties of the diverse populations of small outer solar system bodies provide a forensic map of how our solar system formed and evolved. Perhaps the most potentially diagnostic, but least explored, of those populations are the Jupiter Trojan asteroids, which orbit at ~5 AU in the L4 and L5 Lagrange points of Jupiter. More than 6200 Jupiter Trojans are presently known, but these are predicted to be only a small fraction of the 500,000 to 1 million Trojans >1 km in size. The Trojans are hypothesized to be either former Kuiper Belt Objects (KBOs) that were scattered into the inner solar system by early giant planet migration and then trapped in the 1:1 Jupiter mean motion resonance, or bodies formed near 5 AU in a much more quiescent early solar system, and then trapped at L4 and L5. The 2011 Planetary Science Decadal Survey identified important questions about the origin and evolution of the solar system that can be addressed by studying of the Trojan asteroids, including: (a) How did the giant planets and their satellite systems accrete, and is there evidence that they migrated to new orbital positions? (b) What is the relationship between large and small KBOs? Is the small population derived by impact disruption of the large one? (c) What kinds of surface evolution, radiation chemistry, and surface-atmosphere interactions occur on distant icy primitive bodies? And (d) What are the sources of asteroid groups (Trojans and Centaurs) that remain to be explored by spacecraft? The Trojan Tour and Rendezvous (TTR) is a New Frontiers-class mission designed to answer these questions, and to test hypotheses for early giant planet migration and solar system evolution. Via close flybys of a large number of these objects,, and orbital characterization of at least one large Trojan, TTR will enable the first-time exploration of this population. Our primary mission goals are to characterize the overall surface geology

  16. Endoscopic retrograde cholangiopancreatography with rendezvous cannulation reduces pancreatic injury.

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    Swahn, Fredrik; Regnér, Sara; Enochsson, Lars; Lundell, Lars; Permert, Johan; Nilsson, Magnus; Thorlacius, Henrik; Arnelo, Urban

    2013-09-28

    To examine whether rendezvous endoscopic retrograde cholangiopancreatography (ERCP) is associated with less pancreatic damage, measured as leakage of proenzymes, than conventional ERCP. Patients (n = 122) with symptomatic gallstone disease, intact papilla and no ongoing inflammation, were prospectively enrolled in this case-control designed study. Eighty-one patients were subjected to laparoscopic cholecystectomy and if intraoperative cholangiography suggested common bile duct stones (CBDS), rendezvous ERCP was performed intraoperatively (n = 40). Patients with a negative cholangiogram constituted the control group (n = 41). Another 41 patients with CBDS, not subjected to surgery, underwent conventional ERCP. Pancreatic proenzymes, procarboxypeptidase B and trypsinogen-2 levels in plasma, were analysed at 0, 4, 8 and 24 h. The proenzymes were determined in-house with a double-antibody enzyme linked immunosorbent assay. Pancreatic amylase was measured by an enzymatic colourimetric modular analyser with the manufacturer's reagents. All samples were blinded at analysis. Post ERCP pancreatitis (PEP) occurred in 3/41 (7%) of the patients cannulated with conventional ERCP and none in the rendezvous group. Increased serum levels indicating pancreatic leakage were significantly higher in the conventional ERCP group compared with the rendezvous ERCP group regarding pancreatic amylase levels in the 4- and 8-h samples (P = 0.0015; P = 0.03), procarboxypeptidase B in the 4- and 8-h samples (P rendezvous cannulation technique compared with patients that underwent cholecystectomy alone (control group). Post procedural concentrations of pancreatic amylase and procarboxypeptidase B were significantly correlated with pancreatic duct cannulation and opacification. Rendezvous ERCP reduces pancreatic enzyme leakage compared with conventional ERCP cannulation technique. Thus, laparo-endoscopic technique can be recommended with the ambition to minimise the risk for post ERCP

  17. Laparoendoscopic management of concomitant gallbladder stones and common bile duct stones: what is the best technique?

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    El-Geidie, Ahmed Abdel-Raouf

    2011-08-01

    The intraoperative use of endoscopic retrograde cholangiopancreatography (ERCP) during laparoscopic cholecystectomy (LC) is a safe, single-stage option for the management of concomitant gallstones (GS) and common bile duct stones (CBDS). This study aims to compare between 2 techniques of combined laparoendoscopic management, which are laparoendoscopic Rendez-vous (LC/LERV) technique and standard ERCP after the completion of LC intraoperative endoscopic sphincterotomy (IOES). Patients with GS and suspected CBDS were included. They were divided into 2 groups; LC/LERV and LC/IOES. Both groups were compared for failure of endoscopic sphincterotomy/stone extraction, operative time, conversion rate, mortality/morbidity, and length of hospital stay. Between October 2007 and February 2010, 98 patients with GS and CBDS were eligible for inclusion in the study. They were prospectively randomized into 2 groups; LC/LERV (N=45) and LC/IOES (N=53). There were no differences in preoperative parameters between both groups. There was a significant difference in operative time (shorter for LC/IOES). No difference was noted in success/failure rate, post-ERCP pancreatitis. Both Standard ERCP after the completion of LC and LC/LERV are valid single-session management for CBD stones, but LC-ERCP may be preferred.

  18. Laparoendoscopic single site (LESS) cholecystectomy.

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    Hodgett, Steven E; Hernandez, Jonathan M; Morton, Connor A; Ross, Sharona B; Albrink, Michael; Rosemurgy, Alexander S

    2009-02-01

    The journey from conventional "open" operations to truly "minimally invasive" operations naturally includes progression from operations involving multiple trocars and multiple incisions to operations involving access through the umbilicus alone. Laparoscopic operations through the umbilicus alone, laparoendoscopic single site surgery (LESS), offer improved cosmesis and hopes for less pain and improved recovery. This study was undertaken to evaluate our initial experience with LESS cholecystectomy and to compare our initial experience to concurrent outcomes with more conventional multiport, multi-incision laparoscopic cholecystectomy. All patients referred for cholecystectomy over a 6-month period were offered LESS. Outcomes, including blood loss, operative time, complications, and length of stay were recorded. Outcomes with our first LESS cholecystectomies were compared to an uncontrolled group of concurrent patients undergoing multiport, multi-incision laparoscopic cholecystectomy at the same hospital by the same surgeon. Twenty-nine patients of median age 50 years undergoing LESS cholecystectomy from November 2007 until May 2008 were compared to 29* patients, median age 48 years, undergoing standard multiport, multiple-incision laparoscopic cholecystectomy over the same time period. Median operative time for patients undergoing LESS cholecystectomy was 72 min and was not different from that of patients undergoing multiport, multi-incision laparoscopic cholecystectomy (p = 0.81). Median length of hospital stay was 1.0 day for patients undergoing LESS cholecystectomy and was not different from patients undergoing standard laparoscopic cholecystectomy (p = 0.46). Operative estimated blood loss was less than 100 cc for all patients. No patients undergoing attempted LESS cholecystectomy had conversions to "open" operations; two patients had an additional trocar(s) placed distant from the umbilicus to aid in exposure. Three patients undergoing LESS cholecystectomy had

  19. Hyperbolic Rendezvous at Mars: Risk Assessments and Mitigation Strategies

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    Jedrey, Ricky; Landau, Damon; Whitley, Ryan

    2015-01-01

    Given the current interest in the use of flyby trajectories for human Mars exploration, a key requirement is the capability to execute hyperbolic rendezvous. Hyperbolic rendezvous is used to transport crew from a Mars centered orbit, to a transiting Earth bound habitat that does a flyby. Representative cases are taken from future potential missions of this type, and a thorough sensitivity analysis of the hyperbolic rendezvous phase is performed. This includes early engine cutoff, missed burn times, and burn misalignment. A finite burn engine model is applied that assumes the hyperbolic rendezvous phase is done with at least two burns.

  20. Spacecraft rendezvous and docking

    DEFF Research Database (Denmark)

    Jørgensen, John Leif

    1999-01-01

    The phenomenons and problems encountered when a rendezvous manoeuvre, and possible docking, of two spacecrafts has to be performed, have been the topic for numerous studies, and, details of a variety of scenarios has been analysed. So far, all solutions that has been brought into realization has...... been based entirely on direct human supervision and control. This paper describes a vision-based system and methodology, that autonomously generates accurate guidance information that may assist a human operator in performing the tasks associated with both the rendezvous and docking navigation...

  1. Laparoendoscopic Single-Site Pyelolithotomy With Use of a Carter-Thomason Needle Grasper

    OpenAIRE

    Seo, Ill Young; Rim, Joung Sik

    2013-01-01

    Purpose To study the feasibility and safety of the procedure, we present our early experience with laparoendoscopic single-site (LESS) pyelolithotomy performed by use of a Carter-Thomason needle grasper. Materials and Methods Four patients underwent LESS pyelolithotomy for the removal of renal pelvic stones. The patients' mean age was 57.8 years, and their mean body mass index was 23.01. We used a homemade single-port device made with a surgical glove that was inserted into a 2.5-cm periumbil...

  2. Laparoendoscopic single site in pelvic surgery

    Science.gov (United States)

    Sanchez-Salas, Rafael; Clavijo, Rafael; Barret, Eric; Sotelo, Rene

    2012-01-01

    Laparoendoscopic single site (LESS) has recently gained momentum as feasible techniques for minimal access surgery. Our aim is to describe the current status of laparoendoscopic single site (LESS) in pelvic surgery. A comprehensive revision of the literature in LESS pelvic surgery was performed. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-01 to 30-11-11. References outside the search period were obtained selected manuscript΄s bibliography. Search terms included: pelvic anatomy, less in gynecology, single port colectomy, urological less, single port, single site, NOTES, LESS and single incision. 314 manuscripts were initially identified. Out of these, 46 manuscripts were selected based in their pelvic anatomy or surgical content; including experimental experience, clinical series and literature reviews. LESS drastically limit the surgeon's ability to perform in the operative field and the latter becomes hardened by the lack of space in anatomical location like the pelvis. Potential advantages of LESS are gained with the understanding that the surgical procedure is more technically challenging. Pelvic surgical procedures related to colorectal surgery, gynecology and urology have been performed with LESS technique and information available is mostly represented by case reports and short case series. Comparative series remain few. LESS pelvic surgery remain in its very beginning and due to the very specific anatomical conditions further development of LESS surgery in the mentioned area can be clearly be facilitated by using robotic technology. Standardization ad reproducibility of techniques are mandatory to further develop LESS in the surgical arena.. PMID:22557719

  3. Laparoendoscopic single site in pelvic surgery

    Directory of Open Access Journals (Sweden)

    Rafael Sanchez-Salas

    2012-01-01

    Full Text Available Laparoendoscopic single site (LESS has recently gained momentum as feasible techniques for minimal access surgery. Our aim is to describe the current status of laparoendoscopic single site (LESS in pelvic surgery. A comprehensive revision of the literature in LESS pelvic surgery was performed. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-01 to 30-11-11. References outside the search period were obtained selected manuscript΄s bibliography. Search terms included: pelvic anatomy, less in gynecology, single port colectomy, urological less, single port, single site, NOTES, LESS and single incision. 314 manuscripts were initially identified. Out of these, 46 manuscripts were selected based in their pelvic anatomy or surgical content; including experimental experience, clinical series and literature reviews. LESS drastically limit the surgeon′s ability to perform in the operative field and the latter becomes hardened by the lack of space in anatomical location like the pelvis. Potential advantages of LESS are gained with the understanding that the surgical procedure is more technically challenging. Pelvic surgical procedures related to colorectal surgery, gynecology and urology have been performed with LESS technique and information available is mostly represented by case reports and short case series. Comparative series remain few. LESS pelvic surgery remain in its very beginning and due to the very specific anatomical conditions further development of LESS surgery in the mentioned area can be clearly be facilitated by using robotic technology. Standardization ad reproducibility of techniques are mandatory to further develop LESS in the surgical arena..

  4. 14 CFR 1214.111 - Rendezvous services.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Rendezvous services. 1214.111 Section 1214....111 Rendezvous services. (a) A rendezvous mission involves the rendezvous of the Space Shuttle orbiter... conditions for both dedicated and shared flight rendezvous services will be negotiated on a case-by-case...

  5. 75 FR 44794 - Rendezvous International v.

    Science.gov (United States)

    2010-07-29

    ... FEDERAL MARITIME COMMISSION [Docket No. 10-07] Rendezvous International v. Chief Cargo Services, Inc., Kaiser Apparel, Inc., Edco Logistics, Inc., Oriental Logistics, Inc., and Razor Enterprise... Federal Maritime Commission (``Commission'') by Rendezvous International (``Rendezvous''), hereinafter...

  6. Rendezvous and docking tracker

    Science.gov (United States)

    Ray, Art J.; Ross, Susan E.; Deming, Douglas R.

    1986-01-01

    A conceptual solid-state rendezvous and docking tracker (RDT) has been devised for generating range and attitude data for a docking vehicle relative to a target vehicle. Emphasis is placed on the approach of the Orbiter to a link with the Space Station. Three laser illuminators ring the optical axis of the lens a directed toward retroreflectors on the target vehicle. Each retroreflector is equipped with a bandpass filter for a designated illumination frequency. Data are collected sequentially over a 20 deg field of view as the range closes to 100-1000 m. A fourth ranging retroreflector 0.3 m from center is employed during close-in maneuvers. The system provides tracking data on motions with 6 deg of freedom, and furnishes 500 msec updates (to be enhanced to 100 msec) to the operator at a computer console.

  7. History of Space Shuttle Rendezvous

    Science.gov (United States)

    Goodman, John L.

    2011-01-01

    This technical history is intended to provide a technical audience with an introduction to the rendezvous and proximity operations history of the Space Shuttle Program. It details the programmatic constraints and technical challenges encountered during shuttle development in the 1970s and over thirty years of shuttle missions. An overview of rendezvous and proximity operations on many shuttle missions is provided, as well as how some shuttle rendezvous and proximity operations systems and flight techniques evolved to meet new programmatic objectives. This revised edition provides additional information on Mercury, Gemini, Apollo, Skylab, and Apollo/Soyuz. Some chapters on the Space Shuttle have been updated and expanded. Four special focus chapters have been added to provide more detailed information on shuttle rendezvous. A chapter on the STS-39 mission of April/May 1991 describes the most complex deploy/retrieve mission flown by the shuttle. Another chapter focuses on the Hubble Space Telescope servicing missions. A third chapter gives the reader a detailed look at the February 2010 STS-130 mission to the International Space Station. The fourth chapter answers the question why rendezvous was not completely automated on the Gemini, Apollo, and Space Shuttle vehicles.

  8. Rendezvous maneuvers using Genetic Algorithm

    International Nuclear Information System (INIS)

    Dos Santos, Denílson Paulo Souza; De Almeida Prado, Antônio F Bertachini; Teodoro, Anderson Rodrigo Barretto

    2013-01-01

    The present paper has the goal of studying orbital maneuvers of Rendezvous, that is an orbital transfer where a spacecraft has to change its orbit to meet with another spacecraft that is travelling in another orbit. This transfer will be accomplished by using a multi-impulsive control. A genetic algorithm is used to find the transfers that have minimum fuel consumption

  9. Autonomous spacecraft rendezvous and docking

    Science.gov (United States)

    Tietz, J. C.; Almand, B. J.

    A storyboard display is presented which summarizes work done recently in design and simulation of autonomous video rendezvous and docking systems for spacecraft. This display includes: photographs of the simulation hardware, plots of chase vehicle trajectories from simulations, pictures of the docking aid including image processing interpretations, and drawings of the control system strategy. Viewgraph-style sheets on the display bulletin board summarize the simulation objectives, benefits, special considerations, approach, and results.

  10. STS-134 Re-Rendezvous Design History

    Science.gov (United States)

    Stuit, Timothy D.

    2011-01-01

    In preparation to provide the capability for the Orion spacecraft to rendezvous with the International Space Station (ISS), a new suite of relative navigation sensors are in development and will be tested on one of the final Space Shuttle missions to ISS. The National Aeronautics and Space Administration (NASA) commissioned a flight test of prototypes of the instruments on STS-134, in order to test their performance in the space environment during the nominal rendezvous and docking, as well as a re-rendezvous dedicated to testing the prototype sensors following the undocking of the Space Shuttle Orbiter at the end of the mission. Unlike the initial rendezvous and docking, the re-rendezvous profile would replicate the newly designed Orion coelliptic approach trajectory, something never before attempted with the Shuttle Orbiter. Therefore, there were a number of new parameters that needed to be conceived of, designed, and tested for this re-rendezvous to make the flight test successful. And all of this work had to be integrated with the normal operations of the ISS and Shuttle and had to conform to the constraints of the mission and vehicles. The result of this work is a separation and re-rendezvous trajectory design that will prove not only the design of the relative navigation sensors for the Orion vehicle, but also will serve as a proof of concept for the Orion rendezvous trajectory itself. This document presents the analysis and decision making process involved in attaining the final STS-134 re-rendezvous design.

  11. Comprehensive asynchronous symmetric rendezvous algorithm in ...

    Indian Academy of Sciences (India)

    Meenu Chawla

    2017-11-10

    Nov 10, 2017 ... Simulation results affirm that CASR algorithm performs better in terms of average time-to-rendezvous as compared ... process; neighbour discovery; symmetric rendezvous algorithm. 1. .... dezvous in finite time under the symmetric model. The CH ..... CASR algorithm in Matlab 7.11 and performed several.

  12. [Optimization of education for laparoendoscopic technologies in Ukraine].

    Science.gov (United States)

    Lesovoĭ, V N; Savenkov, V I; Tomin, M S

    2014-09-01

    International experience of training of surgeons, including urologists, in laparoendoscopic technologies, was analyzed. Practical course "The Fundamentals of aparoscopic Surgery" (FLS) and the European program of education for basic laparoscopic urologic skills (E-BLUS), which are used in specialized centers, constitute a standard programs of development of basic endosurgical skills. Such centers in Ukraine are absent. The project of complex system of a simulating education, testing and certification of surgeons, who are trained in endovideosurgical technologies, is proposed. While performing surveying of Ukrainian surgeons there were revealed the problems in a process of their education and introduction of highly technological methods: insufficient equipment with modern apparatuses, absence of a standardized pro- gram of education. The staged program of education was elaborated, taking into account progressive international experience and adopted to our environment and con ditions.

  13. Robotic laparoendoscopic single-site surgery: From present to future

    Directory of Open Access Journals (Sweden)

    Ayhan Verit

    2012-01-01

    Full Text Available The continued effort of improving cosmesis and reducing morbidity in urologic surgery has given rise to novel alternatives to traditional minimally invasive techniques: Laparoendoscopic Single-site Surgery (LESS and Natural Orifice Transluminal Endoscopic Surgery (NOTES. Despite the development of specialized access devices and instruments, the performance of complex procedures using LESS has been challenging due to loss of triangulation and instrument clashing. A robotic interface may represent the key factor in overcoming the critical restrictions related to NOTES and LESS. Although encouraging, current clinical evidence related to R-LESS remains limited as the current da Vinci® robotic platform has not been specifically designed for LESS. Robotic innovations are imminent and are likely to govern major changes to the current landscape of scarless surgery.

  14. Current status and future perspectives in laparoendoscopic single-site and natural orifice transluminal endoscopic urological surgery.

    Science.gov (United States)

    Autorino, Riccardo; Stein, Robert J; Lima, Estevão; Damiano, Rocco; Khanna, Rakesh; Haber, Georges-Pascal; White, Michael A; Kaouk, Jihad H

    2010-05-01

    Objective of this study is to provide an evidence-based analysis of the current status and future perspectives of scarless urological surgery. A PubMed search has been performed for all relevant urological literature regarding natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS). In addition, experience with LESS and NOTES at our own institution has been considered. All clinical and investigative reports for LESS and NOTES procedures in the urological literature have been considered. A wide variety of clinical procedures in urology have been successfully completed by using LESS techniques. Thus far, experience with NOTES has largely been investigational, although early clinical reports are emerging. Further development of instrumentation and platforms is necessary for both techniques to become more widely adopted throughout the urological community.

  15. Defining the learning curve of laparoendoscopic single-site Heller myotomy.

    Science.gov (United States)

    Ross, Sharona B; Luberice, Kenneth; Kurian, Tony J; Paul, Harold; Rosemurgy, Alexander S

    2013-08-01

    Initial outcomes suggest laparoendoscopic single-site (LESS) Heller myotomy with anterior fundoplication provides safe, efficacious, and cosmetically superior outcomes relative to conventional laparoscopy. This study was undertaken to define the learning curve of LESS Heller myotomy with anterior fundoplication. One hundred patients underwent LESS Heller myotomy with anterior fundoplication. Symptom frequency and severity were scored using a Likert scale (0 = never/not bothersome to 10 = always/very bothersome). Symptom resolution, additional trocars, and complications were compared among patient quartiles. Median data are presented. Preoperative frequency/severity scores were: dysphagia = 10/8 and regurgitation = 8/7. Additional trocars were placed in 12 patients (10%), of whom all were in the first two quartiles. Esophagotomy/gastrotomy occurred in three patients. Postoperative complications occurred in 9 per cent. No conversions to "open" operations occurred. Length of stay was 1 day. Postoperative frequency/severity scores were: dysphagia = 2/0 and regurgitation = 0/0; scores were less than before myotomy (P Heller myotomy with anterior fundoplication well palliates symptoms of achalasia with no apparent scar. Placement of additional trocars only occurred early in the experience. For surgeons proficient with the conventional laparoscopic approach, the learning curve of LESS Heller myotomy with anterior fundoplication is short and safe, because proficiency is quickly attained.

  16. Management of Gastropleural Fistula after Revisional Bariatric Surgery: A Hybrid Laparoendoscopic Approach.

    Science.gov (United States)

    Ghanem, Omar M; Abu Dayyeh, Barham K; Kellogg, Todd A

    2017-10-01

    Gastropleural fistula (GPF) is a serious complication after bariatric surgery. Multiple treatment modalities including pharmacologic, endoscopic, and revisional surgery have been proposed. We present a case of a GPF managed successfully with a laparoendoscopic approach utilizing a fistula plug. A 43-year-old male patient presented with a GPF after a revisional bariatric surgery. A laparoendoscopic approach including lysis of adhesions, identification of the fistula, plugging the fistula with a BioGore A® fistula plug, placement an enteric stent, placement of a feeding tube, and surgical drainage was performed. The multimedia video illustrates the technique used. Postoperatively, upper gastrointestinal (UGI) imaging showed no evidence of leak. The enteric stent was removed after 2 months after verifying complete healing of the fistula. A laparoendoscopic approach to GPF repair with the use of fistula plug is effective, safe, and feasible.

  17. The Modular Clock Algorithm for Blind Rendezvous

    Science.gov (United States)

    2009-03-26

    and Computer Engineering Graduate School of Engineering and Management Air Force Institute of Technology Air University Air Education and Training...capabilities in spectrum management and particularly in harvesting unused portions of pre-allocated band- width under DSA. The term “cognitive radio” was...of rendezvous and our role as the waiter . However, if the “child” refuses to move from non-common spectrum, rendezvous cannot occur. Bluetooth

  18. Rendezvous and Docking for Space Exploration

    Science.gov (United States)

    Machula, M. F.; Crain, T.; Sandhoo, G. S.

    2005-01-01

    To achieve the exploration goals, new approaches to exploration are being envisioned that include robotic networks, modular systems, pre-positioned propellants and in-space assembly in Earth orbit, Lunar orbit and other locations around the cosmos. A fundamental requirement for rendezvous and docking to accomplish in-space assembly exists in each of these locations. While existing systems and technologies can accomplish rendezvous and docking in low earth orbit, and rendezvous and docking with crewed systems has been successfully accomplished in low lunar orbit, our capability must extend toward autonomous rendezvous and docking. To meet the needs of the exploration vision in-space assembly requiring both crewed and uncrewed vehicles will be an integral part of the exploration architecture. This paper focuses on the intelligent application of autonomous rendezvous and docking technologies to meet the needs of that architecture. It also describes key technology investments that will increase the exploration program's ability to ensure mission success, regardless of whether the rendezvous are fully automated or have humans in the loop.

  19. Laparoendoscopic pfannenstiel nephrectomy using conventional laparoscopic instruments - preliminary experience

    Directory of Open Access Journals (Sweden)

    Anibal W. Branco

    2010-12-01

    Full Text Available PURPOSE: To confirm the feasibility of the laparoendoscopic Pfannenstiel nephrectomy using conventional laparoscopic instruments. MATERIALS AND METHODS: Since March 2009, laparoscopic nephrectomy through a Pfannenstiel incision has been performed in selected patients in our service. The Veress needle was placed through the umbilicus which allowed carbon dioxide inflow. One 5 mm (or 10 mm trocar was placed at the umbilicus for the laparoscope, to guide the placement of three trocars over the Pfannenstiel incision. Additional trocars were placed as follows: a 10 mm in the midline, a 10 mm ipsilateral to the kidney to be removed (2 cm away from the middle one, and a 5 mm contralateral to the kidney to be removed (2 cm away from the middle one. The entire procedure was performed using conventional laparoscopic instruments. At the end of the surgery, trocars were removed and all three incisions were united into a single Pfannenstiel incision for specimen retrieval. RESULTS: Five nephrectomies were performed following this technique: one atrophic kidney, one kidney donation, two renal cancers and one bilateral renal atrophy. Median operative time was 100 minutes and median intraoperative blood loss was 100 cc. No intraoperative complications occurred and no patients required blood transfusion. Median length of hospital stay was 1 day (range 1 to 2 days. CONCLUSIONS: The use of the Pfannenstiel incision for laparoscopic nephrectomy seems to be feasible even when using conventional laparoscopic instruments, and can be considered a potential alternative for traditional laparoscopic nephrectomy.

  20. Laparoendoscopic single site cholecystectomy: the first 100 patients.

    Science.gov (United States)

    Hernandez, Jonathan M; Morton, Connor A; Ross, Sharona; Albrink, Michael; Rosemurgy, Alexander S

    2009-08-01

    Laparoendoscopic single site (LESS) surgery promises improved cosmesis and possibly less pain. However, given the small series reported to date, true estimates of the advantages and possible disadvantages of LESS surgery remain unknown. This study was undertaken to evaluate the first 100 patients undergoing LESS cholecystectomy at our institution. Patients referred for cholecystectomy since November 2007 were considered for LESS cholecystectomy. Outcomes, including blood loss, operative time, complications, and length of stay, were recorded. Outcomes are compared with an uncontrolled concurrent group of patients undergoing multi-incision laparoscopic (i.e., conventional) cholecystectomy. One hundred patients with a median age of 44 years underwent LESS cholecystectomy; 30 patients with a median age of 46 years underwent conventional cholecystectomy over the same time period. Median operative time (70 vs 66 minutes, P = 0.67, Mann-Whitney) and hospital length of stay (1 vs 1 day, P = 0.81, Mann-Whitney) were not different for patients undergoing LESS or multi-incision cholecystectomies, respectively. Five patients undergoing LESS cholecystectomy had postoperative complications: cystic duct stump leak (one), pain control issues (three), and urinary retention (one). LESS cholecystectomy is a safe and effective alternative to conventional cholecystectomy. It can be undertaken without added operative time and provides patients with minimal, if any, scarring.

  1. The Rendezvous Monitoring Display Capabilities of the Rendezvous and Proximity Operations Program

    Science.gov (United States)

    Brazzel, Jack; Spehar, Pete; Clark, Fred; Foster, Chris; Eldridge, Erin

    2013-01-01

    The Rendezvous and Proximity Operations Program (RPOP) is a laptop computer- based relative navigation tool and piloting aid that was developed during the Space Shuttle program. RPOP displays a graphical representation of the relative motion between the target and chaser vehicles in a rendezvous, proximity operations and capture scenario. After being used in over 60 Shuttle rendezvous missions, some of the RPOP display concepts have become recognized as a minimum standard for cockpit displays for monitoring the rendezvous task. To support International Space Station (ISS) based crews in monitoring incoming visiting vehicles, RPOP has been modified to allow crews to compare the Cygnus visiting vehicle s onboard navigated state to processed range measurements from an ISS-based, crew-operated Hand Held Lidar sensor. This paper will discuss the display concepts of RPOP that have proven useful in performing and monitoring rendezvous and proximity operations.

  2. The experience and awareness of laparoendoscopic procedures among Polish surgeons in everyday clinical practice.

    Science.gov (United States)

    Mitura, Kryspin; Dąbrowiecki, Stanisław; Śmietański, Maciej; Matyja, Andrzej

    2017-01-01

    In 2012, a total of 56 647 inguinal hernia repairs were performed in Poland. However, the absence of a uniform hernia repair register obscures the current herniology status in Poland, especially regarding laparoendoscopic procedures. To determine the awareness of laparoendoscopic procedures among Polish surgeons and to ascertain their everyday clinical practice. The data were collected at the national hernia conference in 2016, during an interactive session for surgeons with a special interest in herniology. They could respond to the survey items using the VoxVote application. All items and response options were displayed on participants' smartphones. The questions were related to transabdominal preperitoneal/totally extraperitoneal (TAPP/TEP) hernia repair. The surgeons responded to 27 questions regarding routine inguinal hernia repair. One hundred and six surgeons from all regions of Poland participated in the survey. 19.2% of respondents never inform patients about the possibility of performing laparoendoscopic repair. 45.2% admitted that they had referred a patient with a difficult inguinal hernia to another hospital or surgeon. Seventy-five percent stated they would be willing to perform TAPP/TEP if the reimbursement rates were more favourable. In bilateral hernias, 61.6% of the respondents perform a two-step open repair, while only 25% perform a single-stage laparoendoscopic repair of bilateral hernia. In women, only 13.3% perform laparoendoscopic hernia repairs, and 19.0% do not use mesh. The skill level to perform TAPP/TEP repair is still inadequate among Polish surgeons. The absence of accurate data makes it impossible to verify whether the treatment methods used are compliant with the guidelines.

  3. Laparoendoscopic single site surgery in urology: A single centre experience

    Directory of Open Access Journals (Sweden)

    Arvind P Ganpule

    2012-01-01

    Full Text Available Objective : To analyze our experience of 87 cases with single port surgery, which is also known as laparoendoscopic single site surgery (LESS. Materials and Methods: Case records of all LESS procedures performed between December 2007 and June 2010 were analysed. The procedures performed were donor nephrectomy (n=45, simple nephrectomy (n=27, radical nephrectomy (n=5, pyeloplasty (n=9, and ureteroneocystostomy (n=1. Parameters analysed were operating room (OR time, estimated blood loss (EBL, visual analogue score (VAS, and complications in all patients undergoing LESS procedure and additionally, warm ischaemia time (WIT and graft outcome in patients undergoing LESS donor nephrectomy. In reconstructive procedures, the functional assessment was performed with a diuretic renogram at 6 months. Results: In LESS donor nephrectomy, the mean WIT was 6.9 ± 1.9 min. Mean serum creatinine in recipients at 1 month was 0.96 ± 0.21 mg%. We encountered one instance each of renal artery injury, renal vein injury, large bowel injury, minor cortical laceration at the upper pole and two instances of diaphragmatic injury. In LESS simple nephrectomy, the average OR time was 148.7 ± 52.2 min and hospital stay was 3.7 ± 1.2 days. There was one instance of large bowel injury during specimen retrieval. In LESS radical nephrectomy, the average OR time was 202.5 ± 35.7 min and average hospital stay was 4.2 ± 1.3 days. 6 patients of LESS pyeloplasty completed follow up with a diuretic renogram showing a good drainage. LESS ureteroneocystostomy could also be performed successfully without any complications. Conclusion: LESS surgery can be accomplished safely in nephrectomy and reconstructive procedures such as pyeloplasty and ureteroneocystostomy with equivalent outcomes as standard laparoscopy and with added benefits of cosmesis and quicker convalescence. LESS donor nephrectomy is a technically feasible procedure; current status of procedure needs to be proved with

  4. Electro-optical rendezvous and docking sensors

    Science.gov (United States)

    Tubbs, David J.; Kesler, Lynn O.; Sirko, Robert J.

    1991-01-01

    Electro-optical sensors provide unique and critical functionality for space missions requiring rendezvous, docking, and berthing. McDonnell Douglas is developing a complete rendezvous and docking system for both manned and unmanned missions. This paper examines our sensor development and the systems and missions which benefit from rendezvous and docking sensors. Simulation results quantifying system performance improvements in key areas are given, with associated sensor performance requirements. A brief review of NASA-funded development activities and the current performance of electro-optical sensors for space applications is given. We will also describe current activities at McDonnell Douglas for a fully functional demonstration to address specific NASA mission needs.

  5. On-Board Rendezvous Targeting for Orion

    Science.gov (United States)

    Weeks, Michael W.; DSouza, Christopher N.

    2010-01-01

    The Orion On-board GNC system is among the most complex ever developed for a space mission. It is designed to operate autonomously (independent of the ground). The rendezvous system in particular was designed to operate on the far side of the moon, and in the case of loss-of-communications with the ground. The vehicle GNC system is designed to retarget the rendezvous maneuvers, given a mission plan. As such, all the maneuvers which will be performed by Orion, have been designed and are being incorporated into the flight code.

  6. Robust Parametric Control of Spacecraft Rendezvous

    Directory of Open Access Journals (Sweden)

    Dake Gu

    2014-01-01

    Full Text Available This paper proposes a method to design the robust parametric control for autonomous rendezvous of spacecrafts with the inertial information with uncertainty. We consider model uncertainty of traditional C-W equation to formulate the dynamic model of the relative motion. Based on eigenstructure assignment and model reference theory, a concise control law for spacecraft rendezvous is proposed which could be fixed through solving an optimization problem. The cost function considers the stabilization of the system and other performances. Simulation results illustrate the robustness and effectiveness of the proposed control.

  7. Multiple NEO Rendezvous Using Solar Sails

    Science.gov (United States)

    Johnson, Les; Alexander, Leslie; Fabisinski, Leo; Heaton, Andy; Miernik, Janie; Stough, Rob; Wright, Roosevelt; Young, Roy

    2012-01-01

    Mission concept is to assess the feasibility of using solar sail propulsion to enable a robotic precursor that would survey multiple Near Earth Objects (NEOs) for potential future human visits. Single spacecraft will rendezvous with and image 3 NEOs within 6 years of launch

  8. Multiple NEO Rendezvous Using Solar Sail Propulsion

    Science.gov (United States)

    Johnson, Les; Alexander, Leslie; Fabisinski, Leo; Heaton, Andy; Miernik, Janie; Stough, Rob; Wright, Roosevelt; Young, Roy

    2012-01-01

    The NASA Marshall Space Flight Center (MSFC) Advanced Concepts Office performed an assessment of the feasibility of using a near-term solar sail propulsion system to enable a single spacecraft to perform serial rendezvous operations at multiple Near Earth Objects (NEOs) within six years of launch on a small-to-moderate launch vehicle. The study baselined the use of the sail technology demonstrated in the mid-2000 s by the NASA In-Space Propulsion Technology Project and is scheduled to be demonstrated in space by 2014 as part of the NASA Technology Demonstration Mission Program. The study ground rules required that the solar sail be the only new technology on the flight; all other spacecraft systems and instruments must have had previous space test and qualification. The resulting mission concept uses an 80-m X 80-m 3-axis stabilized solar sail launched by an Athena-II rocket in 2017 to rendezvous with 1999 AO10, Apophis and 2001 QJ142. In each rendezvous, the spacecraft will perform proximity operations for approximately 30 days. The spacecraft science payload is simple and lightweight; it will consist of only the multispectral imager flown on the Near Earth Asteroid Rendezvous (NEAR) mission to 433 Eros and 253 Mathilde. Most non-sail spacecraft systems are based on the Messenger mission spacecraft. This paper will describe the objectives of the proposed mission, the solar sail technology to be employed, the spacecraft system and subsystems, as well as the overall mission profile.

  9. Rendezvous endoscopic recanalization for complete esophageal obstruction.

    Science.gov (United States)

    Fusco, Stefano; Kratt, Thomas; Gani, Cihan; Stueker, Dietmar; Zips, Daniel; Malek, Nisar P; Goetz, Martin

    2018-03-30

    Complete esophageal obstruction after (chemo)radiation for head and neck cancers is rare. However, inability to swallow one's own saliva strongly inflicts upon quality of life. Techniques for endoscopic recanalization in complete obstruction are not well established. We assessed the efficacy and safety of rendezvous recanalization. We performed a retrospective review of all patients who underwent endoscopic recanalization of complete proximal esophageal obstruction after radiotherapy between January 2009 and June 2016. Technical success was defined as an ability to pass an endoscope across the recanalized lumen, clinical success by changes in the dysphagia score. Adverse events were recorded prospectively. 19 patients with complete obstruction (dysphagia IV°), all of whom had failed at least one trial of conventional dilatation, underwent recanalization by endoscopic rendezvous, a combined approach through a gastrostomy and perorally under fluoroscopic control. Conscious sedation was used in all patients. In 18/19 patients (94.7%), recanalization was technically successful. In 14/18 patients (77.8%), the post-intervention dysphagia score changed to ≤ II. Three patients had their PEG removed. Factors negatively associated with success were obstruction length of 50 mm; and tumor recurrence for long-term success. No severe complications were recorded. Rendezvous recanalization for complete esophageal obstruction is a reliable and safe method to re-establish luminal patency. Differences between technical and clinical success rates highlight the importance of additional functional factors associated with dysphagia. Given the lack of therapeutic alternatives, rendezvous recanalization is a valid option to improve dysphagia.

  10. Rendezvous effects in the diffusion process on bipartite metapopulation networks.

    Science.gov (United States)

    Cao, Lang; Li, Xun; Wang, Bing; Aihara, Kazuyuki

    2011-10-01

    Epidemic outbreaks have been shown to be closely related to the rendezvous-induced transmission of infection, which is caused by casual contact with infected individuals in public gatherings. To investigate rendezvous effects in the spread of infectious diseases, we propose an epidemic model on metapopulation networks bipartite-divided into two sets of location and rendezvous nodes. At a given transition rate γ(kk')(p), each individual transfers from location k to rendezvous p (where rendezvous-induced disease incidence occurs) and thereafter moves to location k'. We find that the eigenstructure of a transition-rate-dependent matrix determines the epidemic threshold condition. Both analytical and numerical results show that rendezvous-induced transmission accelerates the progress of infectious diseases, implying the significance of outbreak control measures including prevention of public gatherings or decentralization of a large-scale rendezvous into downsized ones.

  11. Survey of orbital dynamics and control of space rendezvous

    Directory of Open Access Journals (Sweden)

    Luo Yazhong

    2014-02-01

    Full Text Available Rendezvous orbital dynamics and control (RODC is a key technology for operating space rendezvous and docking missions. This paper surveys the studies on RODC. Firstly, the basic relative dynamics equation set is introduced and its improved versions are evaluated. Secondly, studies on rendezvous trajectory optimization are commented from three aspects: the linear rendezvous, the nonlinear two-body rendezvous, and the perturbed and constrained rendezvous. Thirdly, studies on relative navigation are briefly reviewed, and then close-range control methods including automated control, manual control, and telecontrol are analyzed. Fourthly, advances in rendezvous trajectory safety and robust analysis are surveyed, and their applications in trajectory optimization are discussed. Finally, conclusions are drawn and prospects of studies on RODC are presented.

  12. Surgery in biliary lithiasis: from the traditional "open" approach to laparoscopy and the "rendezvous" technique.

    Science.gov (United States)

    Tarantino, Giuseppe; Magistri, Paolo; Ballarin, Roberto; Assirati, Giacomo; Di Cataldo, Antonio; Di Benedetto, Fabrizio

    2017-12-15

    According to the current literature, biliary lithiasis is a worldwide-diffused condition that affects almost 20% of the general population. The rate of common bile duct stones (CBDS) in patients with symptomatic cholelithiasis is estimated to be 10% to 33%, depending on patient's age. Compared to stones in the gallbladder, the natural history of secondary CBDS is still not completely understood. It is not clear whether an asymptomatic choledocholithiasis requires treatment or not. For many years, open cholecystectomy with choledochotomy and/or surgical sphincterotomy and cleaning of the bile duct were the gold standard to treat both pathologies. Development of both endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic surgery, together with improvements in diagnostic procedures, influenced new approaches to the management of CBDS in association with gallstones. We decided to systematically review the literature in order to identify all the current therapeutic options for CBDS. A systematic literature search was performed independently by two authors using PubMed, EMBASE, Scopus and the Cochrane Library Central. The therapeutic approach nowadays varies greatly according to the availability of experience and expertise in each center, and includes open or laparoscopic common bile duct exploration, various combinations of laparoscopic cholecystectomy and ERCP and combined laparoendoscopic rendezvous. Although ERCP followed by laparoscopic cholecystectomy is currently preferred in the majority of hospitals worldwide, the optimal treatment for concomitant gallstones and CBDS is still under debate, and greatly varies among different centers. Copyright © 2017 The Editorial Board of Hepatobiliary & Pancreatic Diseases International. Published by Elsevier B.V. All rights reserved.

  13. Learning curve for laparoendoscopic single-site surgery for an experienced laparoscopic surgeon

    OpenAIRE

    Pao-Ling Torng; Kuan-Hung Lin; Jing-Shiang Hwang; Hui-Shan Liu; I-Hui Chen; Chi-Ling Chen; Su-Cheng Huang

    2013-01-01

    Objectives: To assess the learning curve and safety of laparoendoscopic single-site (LESS) surgery of gynecological surgeries. Materials and methods: Sixty-three women who underwent LESS surgery by a single experienced laparoscopic surgeon from February 2011 to August 2011 were included. Commercialized single-incision laparoscopic surgery homemade ports were used, along with conventional straight instruments. The learning curve has been defined as the additional surgical time with respect ...

  14. Designing the STS-134 Re-Rendezvous: A Preparation for Future Crewed Rendezvous Missions

    Science.gov (United States)

    Stuit, Timothy D.

    2011-01-01

    In preparation to provide the capability for the Orion spacecraft, also known as the Multi-Purpose Crew Vehicle (MPCV), to rendezvous with the International Space Station (ISS) and future spacecraft, a new suite of relative navigation sensors are in development and were tested on one of the final Space Shuttle missions to ISS. The National Aeronautics and Space Administration (NASA) commissioned a flight test of prototypes of the Orion relative navigation sensors on STS-134, in order to test their performance in the space environment during the nominal rendezvous and docking, as well as a re-rendezvous dedicated to testing the prototype sensors following the undocking of the Space Shuttle orbiter at the end of the mission. Unlike the rendezvous and docking at the beginning of the mission, the re-rendezvous profile replicates the newly designed Orion coelliptic approach trajectory, something never before attempted with the shuttle orbiter. Therefore, there were a number of new parameters that needed to be conceived of, designed, and tested for this rerendezvous to make the flight test successful. Additionally, all of this work had to be integrated with the normal operations of the ISS and shuttle and had to conform to the constraints of the mission and vehicles. The result of this work is a separation and rerendezvous trajectory design that would not only prove the design of the relative navigation sensors for the Orion vehicle, but also would serve as a proof of concept for the Orion rendezvous trajectory itself. This document presents the analysis and decision making process involved in attaining the final STS-134 re-rendezvous design.

  15. Flocking and rendezvous in distributed robotics

    CERN Document Server

    Francis, Bruce A

    2016-01-01

    This brief describes the coordinated control of groups of robots using only sensory input – and no direct external commands. Furthermore, each robot employs the same local strategy, i.e., there are no leaders, and the text also deals with decentralized control, allowing for cases in which no single robot can sense all the others. One can get intuition for the problem from the natural world, for example, flocking birds. How do they achieve and maintain their flying formation? Recognizing their importance as the most basic coordination tasks for mobile robot networks, the brief details flocking and rendezvous. They are shown to be physical illustrations of emergent behaviors with global consensus arising from local interactions. The authors extend the consideration of these fundamental ideas to describe their operation in flying robots and prompt readers to pursue further research in the field.  Flocking and Rendezvous in Distributed Robotics will provide graduate students a firm grounding in the subject, w...

  16. [Endoscopic ultrasound guided rendezvous for biliary drainage].

    Science.gov (United States)

    Knudsen, Marie Høxbro; Vilmann, Peter; Hassan, Hazem; Karstensen, John Gésdal

    2015-04-27

    Endoscopic retrograde cholangiography (ERCP) is currently standard treatment for biliary drainage. Endoscopic ultrasound guided rendezvous (EUS-RV) is a novel method to overcome an unsuccessful biliary drainage procedure. Under endoscopic ultrasound guidance a guidewire is passed via a needle from the stomach or duodenum to the common bile duct and from there on to the duodenum enabling ERCP. With a relatively high rate of success EUS-RV should be considered as an alternative to biliary drainage and surgical intervention.

  17. Automated rendezvous and capture development infrastructure

    Science.gov (United States)

    Bryan, Thomas C.; Roe, Fred; Coker, Cynthia

    1992-01-01

    The facilities at Marshall Space Flight Center and JSC to be utilized to develop and test an autonomous rendezvous and capture (ARC) system are described. This includes equipment and personnel facility capabilities to devise, develop, qualify, and integrate ARC elements and subsystems into flight programs. Attention is given to the use of a LEO test facility, the current concept and unique system elements of the ARC, and the options available to develop ARC technology.

  18. Trajectory control with continuous thrust applied to a rendezvous maneuver

    International Nuclear Information System (INIS)

    Santos, W G; Rocco, E M

    2013-01-01

    A rendezvous mission can be divided into the following phases: launch, phasing, far range rendezvous, close range rendezvous and mating (docking or berthing). This paper aims to present a close range rendezvous with closed loop controlled straight line trajectory. The approaching is executed on V-bar axis. A PID controller and continuous thrust are used to eliminate the residual errors in the trajectory. A comparative study about the linear and nonlinear dynamics is performed and the results showed that the linear equations become inaccurate insofar as the chaser moves away from the target

  19. Multi-Agent Rendezvousing with a Finite Set of Candidate Rendezvous Points

    NARCIS (Netherlands)

    Fang, J.; Morse, A. S.; Cao, M.

    2008-01-01

    The discrete multi-agent rendezvous problem we consider in this paper is concerned with a specified set of points in the plane, called “dwell-points,” and a set of mobile autonomous agents with limited sensing range. Each agent is initially positioned at some dwell-point, and is able to determine

  20. Usage and User Experience of Communication before and during Rendezvous

    Science.gov (United States)

    Colbert, Martin

    2005-01-01

    This paper reports a field evaluation of the mobile phone as a "package" of device and services. The evaluation compares 44 university students' usage and user experience of communication before and during rendezvous. During a rendezvous (en route), students rated many aspects of the experience of phone use less favourably than before a rendezvous…

  1. Laparoendoscopic Single-Site Surgery (LESS for a Large Ovarian Tumour: First Clinical Case Report

    Directory of Open Access Journals (Sweden)

    Yao Dong Chua

    2011-01-01

    Main Outcome Measure(s. Conversion to standard laparoscopic technique or laparotomy, estimated blood loss, operative time , extent of scarring, occurrence of intra- and perioperative surgical complications, technical adequacy, and clinical outcome. Result(s. No conversion to standard laparoscopic technique or laparotomy, and no intraoperative or postoperative complications were observed. Total operative time was 99 minutes. The patient was discharged home on postoperative day one. Conclusion(s. Laparoendoscopic single-site bilateral salpingo-oophorectomy of a large ovarian tumour is feasible with standard laparoscopic instruments. It is safe and effective, with good results in terms of excellent cosmesis and minimal postoperative pain.

  2. The comet rendezvous asteroid flyby mission

    International Nuclear Information System (INIS)

    Morrison, D.; Neugebauer, M.; Weissman, P.R.

    1989-01-01

    The Comet Rendezvous Asteroid Flyby (CRAF) mission is designed to answer the many questions raised by the Halley missions by exploring a cometary nucleus in detail, following it around its orbit and studying its changing activity as it moves closer to and then away from the Sun. In addition, on its way to rendezvous with the comet, CRAF will fly by a large, primitive class main belt asteroid and will return valuable data for comparison with the comet results. The selected asteroid is 449 Hamburga with a diameter of 88 km and a surface composition of carbonaceous chondrite meteorites. The expected flyby date is January, 1998. The CRAF spacecraft will continue to make measurements in orbit around the cometary nucleus as they both move closer to the Sun, until the dust and gas hazard becomes unsafe. At that point the spacecraft will move in and out between 50 and 2,500 kilometers to study the inner coma and the cometary ionosphere, and to collect dust and gas samples for onboard analysis. Following perihelion, the spacecraft will make a 50,000 km excursion down the comet's tail, further investigating the solar wind interaction with the cometary atmosphere. The spacecraft will return to the vicinity of the nucleus about four months after perihelion to observe the changes that have taken place. If the spacecraft remains healthy and adequate fuel is still onboard, an extended mission to follow the comet nucleus out to aphelion is anticipated

  3. Laparoendoscopic single-site adrenalectomy versus conventional laparoscopic surgery: a systematic review and meta-analysis of observational studies.

    Science.gov (United States)

    Wang, Linhui; Wu, Zhenjie; Li, Mingmin; Cai, Chen; Liu, Bing; Yang, Qing; Sun, Yinghao

    2013-06-01

    To assess the surgical efficacy and potential advantages of laparoendoscopic single-site adrenalectomy (LESS-AD) compared with conventional laparoscopic adrenalectomy (CL-AD) based on published literature. An online systematic search in electronic databasesM including Pubmed, Embase, and the Cochrane Library, as well as manual bibliography searches were performed. All studies that compared LESS-AD with CL-AD were included. The outcome measures were the patient demographics, tumor size, blood loss, operative time, time to resumption of oral intake, hospital stay, postoperative pain, cosmesis satisfaction score, rates of complication, conversion, and transfusion. A meta-analysis of the results was conducted. A total of 443 patients were included: 171 patients in the LESS-AD group and 272 patients in the CL-AD group (nine studies). There was no significant difference between the two groups in any of the demographic parameters expect for lesion size (age: P=0.24; sex: P=0.35; body mass index: P=0.79; laterality: P=0.76; size: P=0.002). There was no significant difference in estimated blood loss, time to oral intake resumption, and length of stay between the two groups. The LESS-AD patients had a significantly lower postoperative visual analog pain score compared with the CL-AD group, but a longer operative time was noted. Both groups had a comparable cosmetic satisfaction score. The two groups had a comparable rate of complication, conversion, and transfusion. In early experience, LESS-AD appears to be a safe and feasible alternative to its conventional laparoscopic counterpart with decreased postoperative pain noted, albeit with a longer operative time. As a promising and emerging minimally invasive technique, however, the current evidence has not verified other potential advantages (ie, cosmesis, recovery time, convalescence, port-related complications, etc.) of LESS-AD.

  4. Demonstration of Autonomous Rendezvous Technology (DART) Project Summary

    Science.gov (United States)

    Rumford, TImothy E.

    2003-01-01

    Since the 1960's, NASA has performed numerous rendezvous and docking missions. The common element of all US rendezvous and docking is that the spacecraft has always been piloted by astronauts. Only the Russian Space Program has developed and demonstrated an autonomous capability. The Demonstration of Autonomous Rendezvous Technology (DART) project currently funded under NASA's Space Launch Initiative (SLI) Cycle I, provides a key step in establishing an autonomous rendezvous capability for the United States. DART's objective is to demonstrate, in space, the hardware and software necessary for autonomous rendezvous. Orbital Sciences Corporation intends to integrate an Advanced Video Guidance Sensor and Autonomous Rendezvous and Proximity Operations algorithms into a Pegasus upper stage in order to demonstrate the capability to autonomously rendezvous with a target currently in orbit. The DART mission will occur in April 2004. The launch site will be Vandenburg AFB and the launch vehicle will be a Pegasus XL equipped with a Hydrazine Auxiliary Propulsion System 4th stage. All mission objectives will be completed within a 24 hour period. The paper provides a summary of mission objectives, mission overview and a discussion on the design features of the chase and target vehicles.

  5. Expert system isssues in automated, autonomous space vehicle rendezvous

    Science.gov (United States)

    Goodwin, Mary Ann; Bochsler, Daniel C.

    1987-01-01

    The problems involved in automated autonomous rendezvous are briefly reviewed, and the Rendezvous Expert (RENEX) expert system is discussed with reference to its goals, approach used, and knowledge structure and contents. RENEX has been developed to support streamlining operations for the Space Shuttle and Space Station program and to aid definition of mission requirements for the autonomous portions of rendezvous for the Mars Surface Sample Return and Comet Nucleus Sample return unmanned missions. The experience with REMEX to date and recommendations for further development are presented.

  6. Mars Sample Return - Launch and Detection Strategies for Orbital Rendezvous

    Science.gov (United States)

    Woolley, Ryan C.; Mattingly, Richard L.; Riedel, Joseph E.; Sturm, Erick J.

    2011-01-01

    This study sets forth conceptual mission design strategies for the ascent and rendezvous phase of the proposed NASA/ESA joint Mars Sample Return Campaign. The current notional mission architecture calls for the launch of an acquisition/cache rover in 2018, an orbiter with an Earth return vehicle in 2022, and a fetch rover and ascent vehicle in 2024. Strategies are presented to launch the sample into a coplanar orbit with the Orbiter which facilitate robust optical detection, orbit determination, and rendezvous. Repeating ground track orbits exist at 457 and 572 km which provide multiple launch opportunities with similar geometries for detection and rendezvous.

  7. Mars Sample Return: Launch and Detection Strategies for Orbital Rendezvous

    Science.gov (United States)

    Woolley, Ryan C.; Mattingly, Richard L.; Riedel, Joseph E.; Sturm, Erick J.

    2011-01-01

    This study sets forth conceptual mission design strategies for the ascent and rendezvous phase of the proposed NASA/ESA joint Mars Sample Return Campaign. The current notional mission architecture calls for the launch of an acquisition/ caching rover in 2018, an Earth return orbiter in 2022, and a fetch rover with ascent vehicle in 2024. Strategies are presented to launch the sample into a nearly coplanar orbit with the Orbiter which would facilitate robust optical detection, orbit determination, and rendezvous. Repeating ground track orbits existat 457 and 572 km which would provide multiple launch opportunities with similar geometries for detection and rendezvous.

  8. Combined antegrade and retrograde ureteral stenting: the rendezvous technique

    International Nuclear Information System (INIS)

    Macri, A.; Magno, C.; Certo, A.; Basile, A.; Scuderi, G.; Crescenti, F.; Famulari, C.

    2005-01-01

    Ureteral stenting is a routine procedure in endourology. To increase the success rate in difficult cases, it may be helpful to use the rendezvous technique, a combined antegrade and retrograde approach. We performed 16 urological rendezvous in 11 patients with ureteral strictures or urologic lesions. The combined approach was successful in all patients, without morbidity or mortality. In our experience the rendezvous technique increased the success rate of antegrade ureteral stenting from 78.6 to 88.09% (p>0.05). This procedure is a valid option in case of failure of conventional ureteral stenting

  9. Rendezvous missions with minimoons from L1

    Science.gov (United States)

    Chyba, M.; Haberkorn, T.; Patterson, G.

    2014-07-01

    We propose to present asteroid capture missions with the so-called minimoons. Minimoons are small asteroids that are temporarily captured objects on orbits in the Earth-Moon system. It has been suggested that, despite their small capture probability, at any time there are one or two meter diameter minimoons, and progressively greater numbers at smaller diameters. The minimoons orbits differ significantly from elliptical orbits which renders a rendezvous mission more challenging, however they offer many advantages for such missions that overcome this fact. First, they are already on geocentric orbits which results in short duration missions with low Delta-v, this translates in cost efficiency and low-risk targets. Second, beside their close proximity to Earth, an advantage is their small size since it provides us with the luxury to retrieve the entire asteroid and not only a sample of material. Accessing the interior structure of a near-Earth satellite in its morphological context is crucial to an in-depth analysis of the structure of the asteroid. Historically, 2006 RH120 is the only minimoon that has been detected but work is ongoing to determine which modifications to current observation facilities is necessary to provide detection algorithm capabilities. In the event that detection is successful, an efficient algorithm to produce a space mission to rendezvous with the detected minimoon is highly desirable to take advantage of this opportunity. This is the main focus of our work. For the design of the mission we propose the following. The spacecraft is first placed in hibernation on a Lissajoux orbit around the liberation point L1 of the Earth-Moon system. We focus on eight-shaped Lissajoux orbits to take advantage of the stability properties of their invariant manifolds for our transfers since the cost to minimize is the spacecraft fuel consumption. Once a minimoon has been detected we must choose a point on its orbit to rendezvous (in position and velocities

  10. Autonomous rendezvous and capture development infrastructure

    Science.gov (United States)

    Bryan, Thomas C.; Roe, Fred; Coker, Cindy; Nelson, Pam; Johnson, B.

    1991-01-01

    In the development of the technology for autonomous rendezvous and docking, key infrastructure capabilities must be used for effective and economical development. This involves facility capabilities, both equipment and personnel, to devise, develop, qualify, and integrate ARD elements and subsystems into flight programs. One effective way of reducing technical risks in developing ARD technology is the use of the ultimate test facility, using a Shuttle-based reusable free-flying testbed to perform a Technology Demonstration Test Flight which can be structured to include a variety of additional sensors, control schemes, and operational approaches. This conceptual testbed and flight demonstration will be used to illustrate how technologies and facilities at MSFC can be used to develop and prove an ARD system.

  11. Rendezvous, un juego de Lewis Carroll

    Directory of Open Access Journals (Sweden)

    José Manuel Sánchez Muñoz

    2011-10-01

    Full Text Available Todos en mayor o menor medida asociamos el nombre de Lewis Carrolla la literatura, sobre todo a la de temática infantil, con títulos a sus espaldas como Alicia en el País de las Maravillas, Alicia a través del espejo, o La Caza del Snark. Pero además de literato, Lewis Carrol fue un hombre con bastantes inquietudes en torno a la matemática, la lógica y el pensamiento filosófico. Pero no todo el mundo es conocedor de su faceta como creativo en el campo de los juegos. Rendezvous es una de sus más sorprendentes invenciones,un juego de inteligencia para todos los públicos, cuyas directrices hacen de él un entretenimiento bastante original.

  12. Analysis for orbital rendezvous of Chang'E-5 using SBI technique

    Science.gov (United States)

    Huang, Y.; Shan, Q.; Li, P.

    2016-12-01

    Chang'E-5 will be launched in later 2017/early 2018 using a new generation rocket from Wenchang satellite launch center, Hainan, China. It is a lunar sampling return mission, and it is the first time for China to carry out orbital rendezvous and docking in the Moon. How to achieve orbital rendezvous successfully in the Moon is very important in Chang'E-5 mission. Orbital rendezvous will be implemented between an orbiter and an ascender 200 km above the Moon. The ground tracking techniques include range, Doppler and VLBI, and they will be used to track the orbiter and the ascender when the ascender is about 70 km farther away from the orbiter. Later the ascender will approach the orbiter automatically. As a successful example, in Chang'E-3, the differential phase delay (delta delay) data between the rover and the lander are obtained with a random error of about 1 ps, and the relative position of the rover is determined with an accuracy of several meters by using same beam VLBI (SBI) technique. Here the application of the SBI technique for Chang'E-5 orbital rendezvous is discussed. SBI technique can be used to track the orbiter and the ascender simultaneously when they are in the same beam. Delta delay of the two probes can be derived, and the measurement accuracy is much higher than that of the traditional VLBI data because of the cancelation of common errors. Theoretically it can result in a more accurate relative orbit between the two probes. In the simulation, different strategies are discussed to analyze the contribution of SBI data to the orbit accuracy improvement especially relative orbit between the orbiter and ascender. The simulation results show that the relative position accuracy of the orbiter and ascender can reach about 1 m with delta delay data of 10 ps.

  13. Optimal Non-Coplanar Launch to Quick Rendezvous

    National Research Council Canada - National Science Library

    Sears, Gregory

    1997-01-01

    The purpose of this study was to determine the feasibility of launching a Delta Clipper-like vehicle on an optimal, non-coplanar trajectory to rendezvous with an earth orbiting object in one orbit or less...

  14. Optimal Rendezvous and Docking Simulator for Elliptical Orbits, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — It is proposed to develop and implement a simulation of spacecraft rendezvous and docking guidance, navigation, and control in elliptical orbit. The foundation of...

  15. Automatic rendezvous and docking systems functional and performance requirements

    Science.gov (United States)

    1985-01-01

    A generalized mission design scheme which utilizes a standard mission profile for all OMV rendezvous operations, recognizes typical operational constraints, and minimizes propellant penalties due to nodal regression effects was developed. This scheme has been used to demonstrate a unified guidance and navigation maneuver processor (the UMP), which supports all mission phases through station-keeping. The initial demonstration version of the Orbital Rendezvous Mission Planner (ORMP) was provided for evaluation purposes, and program operation was discussed.

  16. Near-Earth Asteroid Rendezvous: mission overview

    Science.gov (United States)

    Cheng, A. F.; Santo, A. G.; Heeres, K. J.; Landshof, J. A.; Farquhar, R. W.; Gold, R. E.; Lee, S. C.

    1997-10-01

    The Near-Earth Asteroid Rendezvous (NEAR) mission, the first launch of NASA's Discovery Program, will be the first mission to orbit an asteroid. NEAR will make the first comprehensive scientific measurements of an asteroid's surface composition, geology, physical properties, and internal structure. NEAR launched successfully on February 17, 1996, aboard a Delta II-7925. It will orbit the 20-km-diameter near-Earth asteroid 433 Eros for about 1 year, at a minimum orbit radius of about 35 km from the center of the asteroid. The NEAR is a solar-powered, three-axis stabilized spacecraft with a launch mass including propellant of 805 kg. NEAR uses X band telemetry to the NASA Deep Space Network, with the data rates at Eros up to 8.8 kbits/s using a 34-m High Efficiency (HEF) dish, and up to 26.5 kbits/s using a 70-m dish. A solid-state recorder is accommodated with a memory capacity of 1.8 Gbytes. Attitude control is to 1.7 mrad, line-of-sight pointing stability is within 50 μrad over 1 s, and post processing attitude knowledge is within 50 μrad. NEAR accommodates 56 kg of instruments and provides them with 84 W. The instruments are a multispectral imager (MSI), a near-infrared spectrograph (NIS), an X ray/gamma ray spectrometer (XRS/GRS), a magnetometer (MAG), and a laser rangefinder (NLR), while a radio science (RS) investigation uses the coherent X band transponder. NEAR will make a flyby of the C-type asteroid 253 Mathilde in June 1997 and will rendezvous with 433 Eros in February 1999. It will execute an initial slow flyby of Eros, with a flyby speed of 5 m/s and a closest approach distance of 500 km. Subsequently, its orbit will be lowered to 35 km. The NEAR Mission Operations Center and the Science Data Center are at the Johns Hopkins Applied Physics Laboratory. The Science Data Center will maintain the entire NEAR data set on-line, and data from all instruments can be accessed by every member of the NEAR Science Team. Data, including images, are released over

  17. Left Transperitoneal Adrenalectomy with a Laparoendoscopic Single-Site Surgery Combined Technique: Initial Case Reports

    Directory of Open Access Journals (Sweden)

    Yasuhiro Sumino

    2011-01-01

    Full Text Available Laparoendoscopic single-site surgery (LESS is a step toward the development of minimally invasive surgery. It is initially difficult for surgeons with limited experience to perform the surgery. We describe two cases of left adrenalectomy with a LESS combined with the addition of an accessory port. After a 2.5-cm skin incision was made at the level of the paraumbilicus to insert the primary 12-mm trocar for the laparoscope, a 5-mm nonbladed trocar was placed through the skin incision side-by-side with the primary trocar. A second 3-mm nonbladed trocar was then placed along the anterior axillary line; a multichannel trocar was not used as a single port. Both adrenalectomies were completed successfully. In patients with a minor adrenal tumor, a combined technique using LESS and an additional port is easier than LESS alone and may, therefore, be a bridge between the conventional laparoscopic approach and LESS.

  18. [Clinical retrospective control study of single-port laparoendoscopic and multi-port laparoscopic ovarian cystectomy].

    Science.gov (United States)

    Liu, X; Wen, M K; Liu, H Y; Sun, D W; Lang, J H; Fan, Q B; Shi, H H

    2017-10-25

    Objective: To investigate clinical outcomes of laparoendoscopic single-site ovarian cystectomy compared with traditional multi-port laparoscopic ovarian cystectomy. Methods: Data of 81 patients with ovarian cystectomy from January 2016 to May 2017, the single-site group ( n= 40) and the multi-port group ( n= 41) in Peking Union Medical College Hospital were retrospectively collected. The outcomes of single-site and multi-port groups were analyzed and compared, including: postoperative fever, operation time, blood loss, hemoglobin change, surgical complications, postoperative pain score, postoperative analgesic requirements, body image scale and cosmetic score, length of hospital stay, postoperative total cost. Results: No complication was found in two groups. No difference was found in postoperative fever, blood loss, hemoglobin change, postoperative pain score, length of hospital stay, and total cost between the two groups (all P> 0.05). Operation time was (50±20) minutes in single-site group, and (40±15) minutes in multi-port group; postoperative analgesic requirements was 28%(11/40) in single-site group, and 7%(4/41) in multi-port group; cosmetic score was 22.6±2.6 in single-site group, and 17.3±2.6 in multi-port group; body image scale was 5.7±1.2 in single-site group, and 6.2±1.2 in multi-port group; these four clinical parameters were statistical differences (all P< 0.05). Conculsion: Laparoendoscopic single-site ovarian cystectomy is feasible and safe, although it could't relieve the postoperative pian, it do offer a higher cosmetic satisfaction.

  19. Laparoendoscopic single-site Heller myotomy with anterior fundoplication for achalasia.

    Science.gov (United States)

    Barry, Linda; Ross, Sharona; Dahal, Sujat; Morton, Connor; Okpaleke, Chinyere; Rosas, Melissa; Rosemurgy, Alexander S

    2011-06-01

    Laparoendoscopic single-site (LESS) surgery is beginning to include advanced laparoscopic operations such as Heller myotomy with anterior fundoplication. However, the efficacy of LESS Heller myotomy has not been established. This study aimed to evaluate the authors' initial experience with LESS Heller myotomy for achalasia. Transumbilical LESS Heller myotomy with concomitant anterior fundoplication for achalasia was undertaken for 66 patients after October 2007. Outcomes including operative time, complications, and length of hospital stay were recorded and compared with those for an earlier contiguous group of 66 consecutive patients undergoing conventional multi-incision laparoscopic Heller myotomy with anterior fundoplication. Symptoms before and after myotomy were scored by the patients using a Likert scale ranging from 0 (never/not severe) to 10 (always/very severe). Data were analyzed using the Mann-Whitney U test, the Wilcoxon matched-pairs test, and Fisher's exact test where appropriate. Patients undergoing LESS Heller myotomy were similar to those undergoing conventional laparoscopic Heller myotomy in gender, age, body mass index (BMI), blood loss, and length of hospital stay. However, the patients undergoing LESS Heller myotomies had operations of significantly longer duration (median, 117 vs. 93 min with the conventional laparoscopic approach) (pHeller myotomy, additional ports/incisions were required. No patients were converted to "open" operations, and no patients had procedure-specific complications. Symptom reduction was dramatic and satisfying after both LESS and conventional laparoscopic myotomy with fundoplication. The symptom reduction was similar with the two procedures. The LESS approach left no apparent umbilical scar. Heller myotomy with anterior fundoplication effectively treats achalasia. The findings showed LESS Heller myotomy with anterior fundoplication to be feasible, safe, and efficacious. Although the LESS approach increases operative

  20. Interstellar rendezvous missions employing fission propulsion systems

    International Nuclear Information System (INIS)

    Lenard, Roger X.; Lipinski, Ronald J.

    2000-01-01

    There has been a conventionally held nostrum that fission system specific power and energy content is insufficient to provide the requisite high accelerations and velocities to enable interstellar rendezvous missions within a reasonable fraction of a human lifetime. As a consequence, all forms of alternative mechanisms that are not yet, and may never be technologically feasible, have been proposed, including laser light sails, fusion and antimatter propulsion systems. In previous efforts, [Lenard and Lipinski, 1999] the authors developed an architecture that employs fission power to propel two different concepts: one, an unmanned probe, the other a crewed vehicle to Alpha Centauri within mission times of 47 to 60 years. The first portion of this paper discusses employing a variant of the ''Forward Resupply Runway'' utilizing fission systems to enable both high accelerations and high final velocities necessary for this type of travel. The authors argue that such an architecture, while expensive, is considerably less expensive and technologically risky than other technologically advanced concepts, and, further, provides the ability to explore near-Earth stellar systems out to distances of 8 light years or so. This enables the ability to establish independent human societies which can later expand the domain of human exploration in roughly eight light-year increments even presuming that no further physics or technology breakthroughs or advances occur. In the second portion of the paper, a technology requirement assessment is performed. The authors argue that reasonable to extensive extensions to known technology could enable this revolutionary capability

  1. Visual Control for Multirobot Organized Rendezvous.

    Science.gov (United States)

    Lopez-Nicolas, G; Aranda, M; Mezouar, Y; Sagues, C

    2012-08-01

    This paper addresses the problem of visual control of a set of mobile robots. In our framework, the perception system consists of an uncalibrated flying camera performing an unknown general motion. The robots are assumed to undergo planar motion considering nonholonomic constraints. The goal of the control task is to drive the multirobot system to a desired rendezvous configuration relying solely on visual information given by the flying camera. The desired multirobot configuration is defined with an image of the set of robots in that configuration without any additional information. We propose a homography-based framework relying on the homography induced by the multirobot system that gives a desired homography to be used to define the reference target, and a new image-based control law that drives the robots to the desired configuration by imposing a rigidity constraint. This paper extends our previous work, and the main contributions are that the motion constraints on the flying camera are removed, the control law is improved by reducing the number of required steps, the stability of the new control law is proved, and real experiments are provided to validate the proposal.

  2. Transumbilical laparoendoscopic single-site radical prostatectomy and cystectomy with the aid of a transurethral port: a feasibility study.

    Science.gov (United States)

    Su, Jian; Zhu, Qingyi; Yuan, Lin; Zhang, Yang; Zhang, Qingling; Wei, Yunfei

    2018-01-01

    To describe the surgical technique and report early outcomes of transurethral assisted laparoendoscopic single-site (LESS) radical prostatectomy (RP) and LESS radical cystectomy (RC) in a single institution. Between December 2014 and March 2016, a total of 114 LESS RPs and RCs were performed, comprising 68 LESS RPs, 38 LESS RCs with cutaneous ureterostomy (CU) and eight LESS RCs with orthotopic ileal neobladder (OIN). Access was achieved via a single-port, with four channels placed through a transumblical incision. After the apex of prostate was separated from the urethra, a self-developed port ('Zhu's port') was inserted through the urethra to facilitate resection of prostate and urethrovesical anastomosis. The peri-operative and postoperative data were collected and analysed retrospectively. Patients were followed up postoperatively for evidence of long-term side effects. All the procedures were completed successfully. No conversion to conventional laparoscopic surgery was necessary. For LESS RP, the average operating time was 152 min. Estimated blood loss was 117 mL. The mean hospital stay was 16.4 days after surgery. For LESS RC with CU and LESS RC with OIN, the mean operating times were 215 and 328 min, mean estimated blood loss was 175 and 252 mL, and mean hospital stay was 9.4 and 18.2 days, respectively. Six patients required blood transfusion (5.26%). Intra-operative complications occurred in two patients (1.75%), and postoperative complications in nine (7.89%). Fourteen out of 68 (20.6%) patients who underwent LESS RP had positive surgical margins. Follow-up ranged from 10 to 30.6 months. In the prostate cancer cases, good urinary control was observed in 35.3%, 97.1% and 100% of patients at 1, 6 and 12 months after the operation, respectively, while biochemical recurrence was observed in 11.8% patients. In the bladder cancer cases, two patients had local recurrence and two patients had distant metastasis. Our results showed that LESS RP and LESS RC

  3. EUS-guided biliary rendezvous using a short hydrophilic guidewire.

    Science.gov (United States)

    Dhir, Vinay; Kwek, Boon Eu Andrew; Bhandari, Suryaprakash; Bapat, Mukta; Maydeo, Amit

    2011-10-01

    BACKGROUND AND STUDY AIMS: EUS-guided rendezvous technique for biliary access requires expert manipulation of the guidewire across the downstream stricture or papilla. Published literature reports usage of the long-wire system to prevent loss of wire during scope exchange. We studied the efficacy of using a short hydrophilic guidewire in EUS-guided rendezvous. PATIENTS AND METHODS: This is a retrospective study conducted in a tertiary care referral centre. 15 patients underwent EUS-guided biliary rendezvous with short wire. EUS-guided transduodenal/transgastric puncture of the biliary system was performed, followed by anterograde placement of a hydrophilic short-wire (260 cm) across the downstream stricture and/or papilla. Retrograde access was then achieved by retrieving the trans-papillary wire, followed by standard ERCP intervention. Main outcome measurements were rates of procedural success and complications. RESULTS: EUS-guided biliary rendezvous was successful in 14 patients (93.3%). Failure was seen in one patient due to a tight malignant biliary stricture. One patient had peri-choledochal bile tracking which did not require any specific treatment. CONCLUSIONS: Short-wire system in EUS-guided biliary rendezvous is highly effective and safe. It is a useful salvage procedure for biliary cannulation in patients with accessible papilla.

  4. Endoskopisk ultralydvejledt rendezvous til intern drænage ved galdevejsobstruktion

    DEFF Research Database (Denmark)

    Knudsen, Marie Høxbro; Vilmann, Peter; Hassan, Hazem

    2015-01-01

    Endoscopic ultrasound guided rendezvous for biliary drainage Endoscopic retrograde cholangiography (ERCP) is currently standard treatment for biliary drainage. Endoscopic ultrasound guided rendezvous (EUS-RV) is a novel method to overcome an unsuccessful biliary drainage procedure. Under endoscopic...

  5. A Study of Control Laws for Microsatellite Rendezvous with a Noncooperative Target

    National Research Council Canada - National Science Library

    Tschirhart, Troy

    2003-01-01

    This study investigated the feasibility of using a microsatellite to accomplish an orbital rendezvous with a noncooperative target, with a focus on the control laws necessary for achieving such a rendezvous...

  6. Endoscopic ultrasonography-guided rendezvous technique.

    Science.gov (United States)

    Tsuchiya, Takayoshi; Itoi, Takao; Sofuni, Atsushi; Tonozuka, Ryosuke; Mukai, Shuntaro

    2016-04-01

    Endoscopic retrograde cholangiopancreatography (ERCP) requires deep biliary cannulation. When deep biliary cannulation is failed, the endoscopic ultrasonography rendezvous technique (EUS-RV) is a useful salvage method. From the previous 15 articles that included 382 EUS-RV cases, the overall success rate of EUS-RV is 81 % with a complication rate of 10 %. In EUS-RV, the bile duct is punctured under EUS guidance and a guidewire is advanced into the duodenum via the papilla. The EUS scope is then switched to a duodenoscope and inserted into the bile duct over the guidewire exiting the papilla, or the guidewire is grasped with forceps and passed through the working channel; the catheter can then be inserted through the papilla over the wire. There are three puncture routes for EUS-RV: transgastric puncture of the intrahepatic bile duct (IHBD), transduodenal puncture of the extrahepatic bile duct (EHBD) via the proximal duodenum (D1), and transduodenal puncture of the EHBD via the second portion of the duodenum (D2). The puncture route for each patient should be selected based on the patient condition. GW selection for EUS-RV is critical, a hydrophilic GW is useful for this procedure. Although EUS-RV is now performed relatively routinely in a few high-volume centers, procedure standardization and the development of exclusive devices for EUS-RV are still underway. The development of exclusive devices for EUS-RV and prospective comparative studies with other salvage methods are needed to truly evaluate the procedure's usefulness and safety.

  7. Two-phase framework for optimal multi-target Lambert rendezvous

    OpenAIRE

    Bang, Jun; Ahn, Jaemyung

    2017-01-01

    This paper proposes a two-phase framework to solve an optimal multi-target Lambert rendezvous problem. The first phase solves a series of single-target rendezvous problems for all departure-arrival object pairs to generate the elementary solutions, which provides candidate rendezvous trajectories (elementary solutions). The second phase formulates a variant of traveling salesman problem (TSP) using the elementary solutions prepared in the first phase and determines the best rendezvous sequenc...

  8. Automated space vehicle control for rendezvous proximity operations

    Science.gov (United States)

    Lea, Robert N.

    1988-01-01

    Rendezvous during the unmanned space exploration missions, such as a Mars Rover/Sample Return will require a completely automatic system from liftoff to docking. A conceptual design of an automated rendezvous, proximity operations, and docking system is being implemented and validated at the Johnson Space Center (JSC). The emphasis is on the progress of the development and testing of a prototype system for control of the rendezvous vehicle during proximity operations that is currently being developed at JSC. Fuzzy sets are used to model the human capability of common sense reasoning in decision making tasks and such models are integrated with the expert systems and engineering control system technology to create a system that performs comparably to a manned system.

  9. Model predictive control for spacecraft rendezvous in elliptical orbit

    Science.gov (United States)

    Li, Peng; Zhu, Zheng H.

    2018-05-01

    This paper studies the control of spacecraft rendezvous with attitude stable or spinning targets in an elliptical orbit. The linearized Tschauner-Hempel equation is used to describe the motion of spacecraft and the problem is formulated by model predictive control. The control objective is to maximize control accuracy and smoothness simultaneously to avoid unexpected change or overshoot of trajectory for safe rendezvous. It is achieved by minimizing the weighted summations of control errors and increments. The effects of two sets of horizons (control and predictive horizons) in the model predictive control are examined in terms of fuel consumption, rendezvous time and computational effort. The numerical results show the proposed control strategy is effective.

  10. Robust H∞ Control for Spacecraft Rendezvous with a Noncooperative Target

    Directory of Open Access Journals (Sweden)

    Shu-Nan Wu

    2013-01-01

    Full Text Available The robust H∞ control for spacecraft rendezvous with a noncooperative target is addressed in this paper. The relative motion of chaser and noncooperative target is firstly modeled as the uncertain system, which contains uncertain orbit parameter and mass. Then the H∞ performance and finite time performance are proposed, and a robust H∞ controller is developed to drive the chaser to rendezvous with the non-cooperative target in the presence of control input saturation, measurement error, and thrust error. The linear matrix inequality technology is used to derive the sufficient condition of the proposed controller. An illustrative example is finally provided to demonstrate the effectiveness of the controller.

  11. Test Results for the Automated Rendezvous and Capture System

    Science.gov (United States)

    Cruzen, Craig; Dabney, Richard; Lomas, James

    1999-01-01

    The Automated Rendezvous and Capture (AR&C) system was designed and tested at NASA's Marshall Space Flight Center (MSFC) to demonstrate technologies and mission strategies for automated rendezvous and docking of spacecraft in Earth orbit, The system incorporates some of the latest innovations in Global Positioning, System space navigation, laser sensor technologies and automated mission sequencing algorithms. The system's initial design and integration was completed in 1998 and has undergone testing at MSFC. This paper describes the major components of the AR&C system and presents results from the official system tests performed in MSFC's Flight Robotics Laboratory with digital simulations and hardware in the loop tests. The results show that the AR&C system can safely and reliably perform automated rendezvous and docking missions in the absence of system failures with 100 percent success. When system failures are included, the system uses its automated collision avoidance maneuver logic to recover in a safe manner. The primary objective of the AR&C project is to prove that by designing a safe and robust automated system, mission operations cost can be reduced by decreasing the personnel required for mission design, preflight planning and training required for crewed rendezvous and docking missions.

  12. Ternary and hybrid controllers for the rendezvous of unicycles

    NARCIS (Netherlands)

    Jafarian, Matin

    2015-01-01

    This paper presents the rendezvous (consensus) of the orientations and average positions of a group of unicycles. We assume that the decentralized controllers designed for consensus of the average positions take only values in the set {-1; 0; +1}. In addition, we introduce a hybrid controller to

  13. Optimization of Spacecraft Rendezvous and Docking using Interval Analysis

    NARCIS (Netherlands)

    Van Kampen, E.; Chu, Q.P.; Mulder, J.A.

    2010-01-01

    This paper applies interval optimization to the fixed-time multiple impulse rendezvous and docking problem. Current methods for solving this type of optimization problem include for example genetic algorithms and gradient based optimization. Unlike these methods, interval methods can guarantee that

  14. Autonomous Mars ascent and orbit rendezvous for earth return missions

    Science.gov (United States)

    Edwards, H. C.; Balmanno, W. F.; Cruz, Manuel I.; Ilgen, Marc R.

    1991-01-01

    The details of tha assessment of autonomous Mars ascent and orbit rendezvous for earth return missions are presented. Analyses addressing navigation system assessments, trajectory planning, targeting approaches, flight control guidance strategies, and performance sensitivities are included. Tradeoffs in the analysis and design process are discussed.

  15. Evolution of segmental anesthesia for Laparo-Endoscopic Single Site (LESS) cholecystectomy.

    Science.gov (United States)

    Ross, S B; Mangar, D; Karlnoski, R; Patel, R S; Camporesi, E M; Barry, L K; Luberice, K; Sprenker, C J; Rosemurgy, A S

    2012-06-01

    Transumbilical Laparo-Endoscopic Single Site (LESS) surgery promises improved cosmesis, quick recovery, reduced postoperative pain and shorter length of hospital stay. Since only a simple umbilical incision is used, LESS surgery can be completed with segmental epidural anesthesia. This study describes the evolution of our technique of LESS cholecystectomy from a combination of spinal and epidural anesthesia to thoracic epidural alone and presents our experience with its safety, the observed morbidity, and the reported patient satisfaction. In August 2009, a prospective evaluation of LESS cholecystectomy with regional anesthesia was undertaken. We recruited patients with chronic cholecystitis or symptomatic cholelithasis. Blood loss, operative time, complications, and length of hospital stay were measured. Preoperatively and 14 days postoperatively, outcome and symptom resolution were scored. Fifteen consecutive patients underwent LESS cholecystectomy; first with combined spinal-epidural (CSE), and then with thoracic epidural anesthesia alone. Immediate postoperative pain and discomfort were well tolerated. VAS scores upon admission to PACU were 0.4 (1.7±2.2). At postoperative day 14, the patients scored high values for "Satisfaction", 10 (10±1.0) and "Cosmesis", 10 (9.3±1.5). LESS cholecystectomy with epidural anesthesia can be undertaken safely. Patient satisfaction and cosmesis are particularly prominent amongst our patients. Our experience supports further utilization of epidural anesthesia for selected patients undergoing LESS cholecystectomy.

  16. Laparoendoscopic single-site surgery in gynaecology: A new frontier in minimally invasive surgery

    Directory of Open Access Journals (Sweden)

    Fader Amanda

    2011-01-01

    Full Text Available Review Objective: To review the recent developments and published literature on laparoendoscopic single-site (LESS surgery in gynaecology. Recent Findings: Minimally invasive surgery has become a standard of care for the treatment of many benign and malignant gynaecological conditions. Recent advances in conventional laparoscopy and robotic-assisted surgery have favorably impacted the entire spectrum of gynaecological surgery. With the goal of improving morbidity and cosmesis, continued efforts towards refinement of laparoscopic techniques have lead to minimization of size and number of ports required for these procedures. LESS surgery is a recently proposed surgical term used to describe various techniques that aim at performing laparoscopic surgery through a single, small-skin incision concealed within the umbilicus. In the last 5 years, there has been a surge in the developments in surgical technology and techniques for LESS surgery, which have resulted in a significant increase in utilisation of LESS across many surgical subspecialties. Recently published outcomes data demonstrate feasibility, safety and reproducibility for LESS in gynaecology. The contemporary LESS literature, extent of gynaecological procedures utilising these techniques and limitations of current technology will be reviewed in this manuscript. Conclusions: LESS surgery represents the newest frontier in minimally invasive surgery. Comparative data and prospective trials are necessary in order to determine the clinical impact of LESS in treatment of gynaecological conditions.

  17. Is Laparoendoscopic Single-Site Adrenalectomy a Feasible Alternative in Treating Aldosterone-Producing Adenoma?

    Directory of Open Access Journals (Sweden)

    Che-Hsiung Wu

    2016-01-01

    Full Text Available Objective. To compare laparoendoscopic single-site (LESS and conventional multiport adrenalectomy in patients with aldosterone-producing adenoma (APA. Material and Methods. We retrospectively reviewed patients who had been clinically confirmed with unilateral APA and who underwent LESS or multiport adrenalectomy between 2009 and 2014. Perioperative data were obtained for all patients. Blood pressure and the levels of serum aldosterone, renin, and potassium were checked periodically. Results. We identified 45 APA patients in the LESS group and 71 in the multiport group. The baseline characteristics were matched between two groups. All adrenalectomies were completed successfully, except one with laparoscopic conversion in the single-port group and one open conversion in the multiport group. After a mean follow-up around one year, there were no significant group differences in the improvement of hypertension, number of types of medication taken, and cure of hypokalemia after operation. Conclusions. Our study confirm that LESS adrenalectomy achieved similar clinical and functional outcomes as conventional multiport adrenalectomy for management of unilateral APA.

  18. The learning curve of laparoendoscopic single-site (LESS) cholecystectomy: definable, short, and safe.

    Science.gov (United States)

    Hernandez, Jonathan; Ross, Sharona; Morton, Connor; McFarlin, Kellie; Dahal, Sujat; Golkar, Farhaad; Albrink, Michael; Rosemurgy, Alexander

    2010-11-01

    The applications of laparoendoscopic single-site (LESS) surgery, including cholecystectomy, are occurring quickly, although little is generally known about issues associated with the learning curve of this new technique including operative time, conversion rates, and safety. We prospectively followed all patients undergoing LESS cholecystectomy, and compared operations undertaken at our institutions in cohorts of 25 patients with respect to operative times, conversion rates, and complications. One-hundred fifty patients of mean age 46 years underwent LESS cholecystectomy. No significant differences in operative times were demonstrable between any of the 25-patient cohorts operated on at our institution. A significant reduction in operative times (p < 0.001) after completion of 75 LESS procedures was, however, identified with the experience of a single surgeon. No significant reduction in the number of procedures requiring an additional trocar(s) or conversion to open operations was observed after completion of 25 LESS cholecystectomies. Complication rates were low, and not significantly different between any 25-patient cohorts. For surgeons proficient with multi-incision laparoscopic cholecystectomy, the learning curve for LESS cholecystectomy begins near proficiency. Operative complications and conversions were infrequent and unchanged across successive 25-patient cohorts, and were similar to those reported for multi-incision laparoscopic cholecystectomy after the learning curve. Copyright © 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Compact teleoperated laparoendoscopic single-site robotic surgical system: Kinematics, control, and operation.

    Science.gov (United States)

    Isaac-Lowry, Oran Jacob; Okamoto, Steele; Pedram, Sahba Aghajani; Woo, Russell; Berkelman, Peter

    2017-12-01

    To date a variety of teleoperated surgical robotic systems have been developed to improve a surgeon's ability to perform demanding single-port procedures. However typical large systems are bulky, expensive, and afford limited angular motion, while smaller designs suffer complications arising from limited motion range, speed, and force generation. This work was to develop and validate a simple, compact, low cost single site teleoperated laparoendoscopic surgical robotic system, with demonstrated capability to carry out basic surgical procedures. This system builds upon previous work done at the University of Hawaii at Manoa and includes instrument and endoscope manipulators as well as compact articulated instruments designed to overcome single incision geometry complications. A robotic endoscope holder was used for the base, with an added support frame for teleoperated manipulators and instruments fabricated mostly from 3D printed parts. Kinematics and control methods were formulated for the novel manipulator configuration. Trajectory following results from an optical motion tracker and sample task performance results are presented. Results indicate that the system has successfully met the goal of basic surgical functionality while minimizing physical size, complexity, and cost. Copyright © 2017 John Wiley & Sons, Ltd.

  20. Short rendezvous missions for advanced Russian human spacecraft

    Science.gov (United States)

    Murtazin, Rafail F.; Budylov, Sergey G.

    2010-10-01

    The two-day stay of crew in a limited inhabited volume of the Soyuz-TMA spacecraft till docking to ISS is one of the most stressful parts of space flight. In this paper a number of possible ways to reduce the duration of the free flight phase are considered. The duration is defined by phasing strategy that is necessary for reduction of the phase angle between the chaser and target spacecraft. Some short phasing strategies could be developed. The use of such strategies creates more comfortable flight conditions for crew thanks to short duration and additionally it allows saving spacecraft's life support resources. The transition from the methods of direct spacecraft rendezvous using one orbit phasing (first flights of " Vostok" and " Soyuz" vehicles) to the currently used methods of two-day rendezvous mission can be observed in the history of Soviet manned space program. For an advanced Russian human rated spacecraft the short phasing strategy is recommended, which can be considered as a combination between the direct and two-day rendezvous missions. The following state of the art technologies are assumed available: onboard accurate navigation; onboard computations of phasing maneuvers; launch vehicle with high accuracy injection orbit, etc. Some operational requirements and constraints for the strategies are briefly discussed. In order to provide acceptable phase angles for possible launch dates the experience of the ISS altitude profile control can be used. As examples of the short phasing strategies, the following rendezvous missions are considered: direct ascent, short mission with the phasing during 3-7 orbits depending on the launch date (nominal or backup). For each option statistical modeling of the rendezvous mission is fulfilled, as well as an admissible phase angle range, accuracy of target state vector and addition fuel consumption coming out of emergency is defined. In this paper an estimation of pros and cons of all options is conducted.

  1. Treatment for retained [corrected] common bile duct stones during laparoscopic cholecystectomy: the rendezvous technique.

    Science.gov (United States)

    Borzellino, Giuseppe; Rodella, Luca; Saladino, Edoardo; Catalano, Filippo; Politi, Leonardo; Minicozzi, Annamaria; Cordiano, Claudio

    2010-12-01

    To determine the feasibility and efficacy of the laparoscopic intraoperative rendezvous technique for common bile duct stones (CBDS). Case series. Verona University Hospital, Verona, Italy. A total of 110 patients were enrolled in the study; 47 had biliary colic; 39, acute cholecystitis; 19, acute biliary pancreatitis; and 5, acute biliary pancreatitis with associated acute cholecystitis. In all patients, CBDS diagnosis was reached by intraoperative cholangiography. Intraoperative endoscopy with rendezvous performed during laparascopic cholecystectomy for confirmed CBDS; for such a procedure, a transcystic guide wire was positioned into the duodenum. Intraoperative endoscopy with rendezvous was performed for retrieved CBDS during a laparoscopic cholecystectomy. Laparoscopic rendezvous feasibility, morbidity, postprocedure pancreatitis, and mortality. The laparoscopic rendezvous proved to be feasible in 95.5% (105 of 110 patients). The rendezvous failed in 3 cases of successfully performed laparoscopic cholecystectomy, and a conversion of the laparoscopy was needed in 2 cases of successful rendezvous. Two major complications and 2 cases of bleeding were registered after sphincterotomy was successfully performed with rendezvous, and severe acute pancreatitis complicated a traditional sphincterotomy performed after a failed rendezvous. Rendezvous is a feasible option for treatment of CBDS; it allows one to perform only 1 stage of treatment, even in acute cases such as cholecystitis and pancreatitis. Positioning of the guide wire may allow reduced complications secondary to papilla cannulation but not those of the endoscopic sphincterotomy.

  2. Totally Transanal Laparo-Endoscopic Single-Site ProctoColectomy-Ileoanal J-Pouch (TLPC-J: An Experimental Study of a Novel Approach

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Vahdad

    2015-09-01

    Full Text Available Background: The natural orifice transluminal endoscopic surgery (NOTES has become a commonly considered novel approach in the surgical field. The NOTES provide possibility of operation through the natural orifice and decreases the intentional puncture of the systemic organ and subsequent complications. Totally transanal laparo-endoscopic single-site proctoColectomy-Ileoanal J-Pouch (TLPC-J is a novel method in minimally invasive surgery for total colectomy. The main goal of this study is to perform this new method on an animal model, to assess probable complication and to resolve probable issues by using patients that are candidate for total colectomy. Method: Five dogs were prepared in lithotomy position. The TLPC-I procedure consists of endorectal technique with full thickness rectal dissection starting 1 cm orally from the dentate line above the peritoneal reflection and the proximal bowel was replaced into the abdominal cavity. Afterwards, the TriPort system was inserted in the anal canal and mesentrial resection of the total colon, mobilization of a distal ileal segment and intracorporeal suture of an ileal J-loop was accomplished by this system. An incision in the J-loop was conducted transanally. The J-pouch was created with an Endo-GIA® and sutured to the rectal wall. Results: All animals survived and passed stool with clear post operation situation. There was no infection in site of anastomosis. Conclusion: The TLPC-I provides the possibility of surgery without abdominal wall incision and decreases post operation complication such as pain, abdominal wound infection and wound dehiscence. This technique increases the quality of life and surgeons can discharge the patients early.

  3. Robotic-assisted laparoendoscopic single-site surgery (R-LESS) in urology: an evidence-based analysis.

    Science.gov (United States)

    Barret, E; Sanchez-Salas, R; Ercolani, M; Forgues, A; Rozet, F; Galiano, M; Cathelineau, X

    2011-06-01

    The objective of this manuscript is to provide an evidence-based analysis of the current status and future perspectives of robotic laparoendoscopic single-site surgery (R-LESS). A PubMed search has been performed for all relevant urological literature regarding natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS). All clinical and investigative reports for robotic LESS and NOTES procedures in the urological literature have been considered. A significant number of clinical urological procedures have been successfully completed utilizing R-LESS procedures. The available experience is limited to referral centers, where the case volume is sufficient to help overcome the challenges and learning curve of LESS surgery. The robotic interface remains the best fit for LESS procedures but its mode of use continues to evolve in attempts to improve surgical technique. We stand today at the dawn of R-LESS surgery, but this approach may well become the standard of care in the near future. Further technological development is needed to allow widespread adoption of the technique.

  4. Quantifying the cognitive cost of laparo-endoscopic single-site surgeries: Gaze-based indices.

    Science.gov (United States)

    Di Stasi, Leandro L; Díaz-Piedra, Carolina; Ruiz-Rabelo, Juan Francisco; Rieiro, Héctor; Sanchez Carrion, Jose M; Catena, Andrés

    2017-11-01

    Despite the growing interest concerning the laparo-endoscopic single-site surgery (LESS) procedure, LESS presents multiple difficulties and challenges that are likely to increase the surgeon's cognitive cost, in terms of both cognitive load and performance. Nevertheless, there is currently no objective index capable of assessing the surgeon cognitive cost while performing LESS. We assessed if gaze-based indices might offer unique and unbiased measures to quantify LESS complexity and its cognitive cost. We expect that the assessment of surgeon's cognitive cost to improve patient safety by measuring fitness-for-duty and reducing surgeons overload. Using a wearable eye tracker device, we measured gaze entropy and velocity of surgical trainees and attending surgeons during two surgical procedures (LESS vs. multiport laparoscopy surgery [MPS]). None of the participants had previous experience with LESS. They performed two exercises with different complexity levels (Low: Pattern Cut vs. High: Peg Transfer). We also collected performance and subjective data. LESS caused higher cognitive demand than MPS, as indicated by increased gaze entropy in both surgical trainees and attending surgeons (exploration pattern became more random). Furthermore, gaze velocity was higher (exploration pattern became more rapid) for the LESS procedure independently of the surgeon's expertise. Perceived task complexity and laparoscopic accuracy confirmed gaze-based results. Gaze-based indices have great potential as objective and non-intrusive measures to assess surgeons' cognitive cost and fitness-for-duty. Furthermore, gaze-based indices might play a relevant role in defining future guidelines on surgeons' examinations to mark their achievements during the entire training (e.g. analyzing surgical learning curves). Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Laparoendoscopic single-site extraperitoneal inguinal hernia repair: initial experience in 10 patients.

    Science.gov (United States)

    Do, Minh; Liatsikos, Evangelos; Beatty, John; Haefner, Tim; Dunn, Ian; Kallidonis, Panagiotis; Stolzenburg, Jens-Uwe

    2011-06-01

    Recent technical advances and a trend toward laparoscopic single incision surgery have led us to explore the feasibility of laparoendoscopic single-site (LESS) hernia repair. We present our technique and initial experience with LESS extraperitoneal inguinal hernia repair in 10 consecutive men with unilateral inguinal hernias. Age range was 43.7 (28-64) years. Mean body mass index was 28 (range 24-30). Six were left inguinal hernias. There were six indirect and four direct hernias. Three patients had undergone previous open appendectomy. Incarcerated or bilateral hernias were excluded from our initial series. All cases were performed by three surgeons who were experienced in conventional totally extraperitoneal laparoscopic hernia repair as well as experienced in LESS. A literature review of current single-port inguinal hernia repair data is also presented. The mean operative time was 53 minutes (range 45-65  min). The average length of skin incision was 2.8  cm (range 2.3-3.2  cm). No drain was necessary in any of the patients, while no recordable bleeding was observed. There were no intraoperative or immediate postoperative complications. Hospitalization period was 2 days for all patients. After a limited follow-up of 1 month, there have been no recurrences and no complaints of testicular pain. The results of the current series compare favorably with those found in a literature review. LESS extraperitoneal inguinal hernia repair is both feasible and safe, although more technically demanding than its conventional laparoscopic counterpart. Although the cosmetic result with the former approach may prove superior, there are standing questions regarding the complications and long-term outcome. Randomized and if possible blinded trials that compare conventional and single-incision laparoscopic hernia repair may help to distinguish the most advantageous technique.

  6. [Transgastric laparo-endoscopic approach for difficult access lesions. Experimental mode].

    Science.gov (United States)

    Tapia-Vega, Marcel Adalid; Morales-Chávez, Carlos Ernesto; Aguirre-Olmedo, Itzé; Cuendis-Velázquez, Adolfo; Rojano-Rodríguez, Martín Edgardo; Cárdenas-Lailson, Luis Eduardo

    2014-01-01

    Gastric neoplasms can be treated by laparoscopy in a safe and efficient way. Some lesions are not accessible to laparoscopic surgery due to their location. A transgastric approach is proposed as an alternative. Show the results with the application of an endoscopic laparotomy in an animal model that maintains functional anatomy, to resect the posterior gastric neoplasms of the stomach wall, close to the cardia and pre-pyloric region. The laparo-endoscopic technique for resection of gastric neoplasms located in the posterior wall was developed in twelve pigs at the Hospital General Gea González from May to December 2011. An endoscopy was performed to establish the site of insertion of intragastric trocars. Three gastrotomies were made in the anterior wall; under endoscopic and laparoscopic vision the trocars were inserted. The stomach was insufflated with CO2. The lesion was resected maintaining a 20 mm circumferencial margin. The gastrotomies were sutured. The statistic analysis was made with t Student and exact Fisher tests. One-hundred percent of resections were achieved in an average time of 102.33 minutes (± 4.50). Two complications and no transoperatory deceases occurred. The technique we describe allows an appropriate approach to gastric lesions located in the posterior wall, those near to the esophagogastric juntion and the prepiloric region, due to the excellent exposure managed by working inside the stomach with a laparoscopic vision and the two intragastric movile ports. The laparoscopic transgastric approach is feasible and safe for the resection of gastric neoplasms located in the posterior wall, those close to the esophago-gastric junction, and the pre-pyloric region.

  7. Laparoendoscopic transgastric histoacryl injection of gastric varices: a new surgical approach.

    Science.gov (United States)

    Kassem, Mohamed I; El-Haddad, Hani M; El-Bahrawi, Hassan A

    2013-02-01

    Gastric varices (GVs) are a common finding in Egyptian patients with portal hypertension due to cirrhosis or schistosomal hepatic fibrosis. These patients present with an acute attack or history of hematemesis. Endoscopic histoacryl injection is the standard treatment in Egypt; however, because of technical difficulties it is possible to inject only a little amount of this material, as it may endanger the channels of the flexible endoscope. We thought of a new surgical laparoendoscopic technique to obviate the need for repeated endoscopies and complete obliteration of GVs. This study was conducted on 20 patients with portal hypertension and GVs. After the patient was placed under general anesthesia, a small gastrostomy was done in the anterior gastric wall through which a 10-mm trocar was inserted for the laparoscopic camera. Injection of GVs was done via a spinal needle or a central venous line needle inserted directly. Injection of an adequate amount of histoacryl was done under direct vision. This study was conducted from July 2009 to August 2011 on 20 patients with GVs. The age range was from 22 to 56 years, with a mean age of 39.8±7.85 years. There were 14 men (70%) and 6 women (30%). Fourteen patients (70%) showed complete obliteration of GVs after one session of treatment, whereas 6 patients (30%) had unsatisfactory results and were subjected to another session. GVs were completely obliterated after the second session in 4 patients. Two cases of recurrence of GVs were operated on. This new technique enabled us to inject GVs with a suitable amount of glue material under direct vision without harming the endoscope. Use of this procedure is recommended in patients fit for surgery and those who had failed endoscopic injection sclerotherapy.

  8. Robust Tracking Control for Rendezvous in Near-Circular Orbits

    Directory of Open Access Journals (Sweden)

    Neng Wan

    2013-01-01

    Full Text Available This paper investigates a robust guaranteed cost tracking control problem for thrust-limited spacecraft rendezvous in near-circular orbits. Relative motion model is established based on the two-body problem with noncircularity of the target orbit described as a parameter uncertainty. A guaranteed cost tracking controller with input saturation is designed via a linear matrix inequality (LMI method, and sufficient conditions for the existence of the robust tracking controller are derived, which is more concise and less conservative compared with the previous works. Numerical examples are provided for both time-invariant and time-variant reference signals to illustrate the effectiveness of the proposed control scheme when applied to the terminal rendezvous and other astronautic missions with scheduled states signal.

  9. Comet rendezvous mission design using Solar Electric Propulsion

    Science.gov (United States)

    Sackett, L. L.; Hastrup, R. C.; Yen, C.-W. L.; Wood, L. J.

    1979-01-01

    A dual comet (Halley Flyby/Tempel 2 Rendezvous) mission, which is planned to be the first to use the Solar Electric Propulsion System (SEPS), is to be launched in 1985. The purpose of this paper is to describe how the mission design attempts to maximize science return while working within spacecraft and other constraints. Science requirements and desires are outlined and specific instruments are considered. Emphasis is on the strategy for operations in the vicinity of Tempel 2, for which a representative profile is described. The mission is planned to extend about one year past initial rendezvous. Because of the large uncertainty in the comet environment the Tempel 2 operations strategy must be highly adaptive.

  10. Use of automated rendezvous trajectory planning to improve spacecraft operations efficiency

    Science.gov (United States)

    Mulder, Tom A.

    1991-01-01

    The current planning process for space shuttle rendezvous with a second Earth-orbiting vehicle is time consuming and costly. It is a labor-intensive, manual process performed pre-mission with the aid of specialized maneuver processing tools. Real-time execution of a rendezvous plan must closely follow a predicted trajectory, and targeted solutions leading up to the terminal phase are computed on the ground. Despite over 25 years of Gemini, Apollo, Skylab, and shuttle vehicle-to-vehicle rendezvous missions flown to date, rendezvous in Earth orbit still requires careful monitoring and cannot be taken for granted. For example, a significant trajectory offset was experienced during terminal phase rendezvous of the STS-32 Long Duration Exposure Facility retrieval mission. Several improvements can be introduced to the present rendezvous planning process to reduce costs, produce more fuel-efficient profiles, and increase the probability of mission success.

  11. Trajectory Control of Rendezvous with Maneuver Target Spacecraft

    Science.gov (United States)

    Zhou, Zhinqiang

    2012-01-01

    In this paper, a nonlinear trajectory control algorithm of rendezvous with maneuvering target spacecraft is presented. The disturbance forces on the chaser and target spacecraft and the thrust forces on the chaser spacecraft are considered in the analysis. The control algorithm developed in this paper uses the relative distance and relative velocity between the target and chaser spacecraft as the inputs. A general formula of reference relative trajectory of the chaser spacecraft to the target spacecraft is developed and applied to four different proximity maneuvers, which are in-track circling, cross-track circling, in-track spiral rendezvous and cross-track spiral rendezvous. The closed-loop differential equations of the proximity relative motion with the control algorithm are derived. It is proven in the paper that the tracking errors between the commanded relative trajectory and the actual relative trajectory are bounded within a constant region determined by the control gains. The prediction of the tracking errors is obtained. Design examples are provided to show the implementation of the control algorithm. The simulation results show that the actual relative trajectory tracks the commanded relative trajectory tightly. The predicted tracking errors match those calculated in the simulation results. The control algorithm developed in this paper can also be applied to interception of maneuver target spacecraft and relative trajectory control of spacecraft formation flying.

  12. Fatal central venous air embolism: a rare complication of esophageal dilation by rendezvous.

    Science.gov (United States)

    Zald, Philip B; Andersen, Peter E

    2011-03-01

    Esophageal dilation by rendezvous is a useful technique for the treatment of complicated esophageal strictures. We present a case of a 74-year-old man with chronic dysphagia caused by a complete cervical esophageal stricture that developed after external beam radiotherapy for treatment of papillary thyroid carcinoma. During attempted dilation using the rendezvous technique, the patient suffered a fatal pulmonary air embolism. The technique of esophageal dilation by rendezvous, complications, and risk factors for development of venous air embolism are discussed. To the best of our knowledge, this is the first report in the literature of fatal venous air embolism after dilation by rendezvous. Copyright © 2009 Wiley Periodicals, Inc.

  13. Orbit Determination for a Microsatellite Rendezvous with a Non-Cooperative Target

    National Research Council Canada - National Science Library

    Foster, Brian

    2003-01-01

    This study investigated the minimum requirements to establish a satellite tracking system architecture for a hostile "parasitic microsatellite" to rendezvous with a larger, non-cooperative target satellite...

  14. Combined Sector and Channel Hopping Schemes for Efficient Rendezvous in Directional Antenna Cognitive Radio Networks

    Directory of Open Access Journals (Sweden)

    AbdulMajid M. Al-Mqdashi

    2017-01-01

    Full Text Available Rendezvous is a prerequisite and important process for secondary users (SUs to establish data communications in cognitive radio networks (CRNs. Recently, there has been a proliferation of different channel hopping- (CH- based schemes that can provide rendezvous without relying on any predetermined common control channel. However, the existing CH schemes were designed with omnidirectional antennas which can degrade their rendezvous performance when applied in CRNs that are highly crowded with primary users (PUs. In such networks, the large number of PUs may lead to the inexistence of any common available channel between neighboring SUs which result in a failure of their rendezvous process. In this paper, we consider the utilization of directional antennas in CRNs for tackling the issue. Firstly, we propose two coprimality-based sector hopping (SH schemes that can provide efficient pairwise sector rendezvous in directional antenna CRNs (DIR-CRNs. Then, we propose an efficient CH scheme that can be combined within the SH schemes for providing a simultaneous sector and channel rendezvous. The guaranteed rendezvous of our schemes are proven by deriving the theoretical upper bounds of their rendezvous delay metrics. Furthermore, extensive simulation comparisons with other related rendezvous schemes are conducted to illustrate the significant outperformance of our schemes.

  15. Endoscopic ultrasonography-guided pancreatic duct access: techniques and literature review of pancreatography, transmural drainage and rendezvous techniques.

    Science.gov (United States)

    Itoi, Takao; Kasuya, Kazuhiko; Sofuni, Atsushi; Itokawa, Fumihide; Kurihara, Toshio; Yasuda, Ichiro; Nakai, Yousuke; Isayama, Hiroyuki; Moriyasu, Fuminori

    2013-05-01

    Endoscopic ultrasonography-guided (EUS)-guided pancreatic interventions have gained increasing attention. Here we review EUS-guided pancreatic duct (PD) access techniques and outcomes. EUS-guided PD intervention is divided into two types, antegrade and rendezvous techniques, following EUS-guided pancreatography. In the antegrade technique, pancreaticoenterostomy is carried out by stent placement between the PD and the stomach, duodenum, or jejunum. Transenteric antegrade PD stenting is conducted by stent placement, advancing anteriorly into the PD through the pancreatic tract. The rendezvous technique is carried out by using a guidewire through the papilla or anastomotic site for retrograde stent insertion. In terms of EUS-guided PD stenting, 11 case reports totaling 75 patients (35 normal anatomy, 40 altered anatomy) have been published. The technical success rate was greater than 70%. Early adverse events, including severe hematoma and severe pancreatitis,occurred in seven (63.6%) of 11 reports. Regarding the rendezvous technique, 12 case reports totaling 52 patients (22 normal anatomy, 30 altered anatomy) have been published. The technical success rate ranged from 25% to 100%. It was 48% in one report that involved more than 20 cases. Once stents were placed, all patients became free of symptoms. Early mild adverse events occurred in four (36.4%) of 11 reports. In conclusion, although it can be risky because of possible serious or even fatal adverse events, including pancreatic juice leakage, perforation and severe acute pancreatitis, EUS-PD access seems to be promising for treating symptomatic pancreatic diseases caused by PD stricture and pancreaticoenterostomy stricture. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.

  16. A rendez-vous with history

    CERN Multimedia

    Corinne Pralavorio

    2010-01-01

    François de Rose, one of the founding fathers of CERN, visited the Laboratory. On this occasion, CERN organised a ceremony for his 100th birthday.   François de Rose, guided through the CERN control centre by Pierre Strubin from the Technology department. It was a moving, almost surreal, scene. On Wednesday 24 November, François de Rose, one of the founding fathers of CERN, visited the CERN Control Centre. In the early 1950s, François de Rose, a French diplomat, helped establish CERN along with some of the greatest physicists of the time. Standing in a futuristic room that only science fiction writers could have imagined when CERN began, the diplomat – who turned 100 only a few days before his visit - marvelled at the progress that had been made in nearly 60 years. Taking in the rush of operators – including those from PS, an accelerator which he inaugurated as President of the Council in 1960 – François de Rose...

  17. Stricture location predicts swallowing outcomes following endoscopic rendezvous procedures.

    Science.gov (United States)

    Adams, Katherine N; Shah, Rupali N; Buckmire, Robert A

    2017-06-01

    Complete pharyngoesophageal strictures may be encountered by the otolaryngologist as a consequence of radiation/chemoradiotherapy therapies for head and neck cancer. A combined anterograde and retrograde dilation procedure (rendezvous procedure) has proven to be a useful surgical intervention in these cases. We assess the long-term swallowing outcomes of this patient cohort including gastrostomy tube (G-tube) reliance, swallowing quality of life, and variables that contribute to improved swallowing outcomes. Retrospective chart review. A retrospective chart review of 18 consecutive patients treated with rendezvous procedures between April 2007 and May 2015 was carried out. Data were collected from chart review and follow-up telephone calls including demographics, surgical/postoperative course details, and Eating Assessment Tool (EAT-10) (swallowing quality of life) scores. The completion rate of the procedure was 83% (15 completed/3 procedures aborted). Average follow-up was 22 months. Thirteen of 15 (86.7%) achieved an oral diet, and 7/15 (46.7%) had their G-tube removed. G-tube-independent (GTI) patients had an average stricture length of 2.33 cm and an average distance from the incisors of 17.4 cm compared to G-tube dependent-(GTD) patients who had an average stricture length of 2.63 cm and 14.6 cm mean distance from the incisors (P = .66 and .0343, respectively). Final EAT-10 scores averaged 20.1 in GTI patients and 33.8 in GTD patients (P = .022). Stricture/incisor distance and EAT-10 scores demonstrated a moderate to strong negative correlation (r = -0.67). Following the endoscopic rendezvous procedure, swallowing outcomes and G-tube status is related to the distance of the stricture from the incisors. 2b Laryngoscope, 127:1388-1391, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Current status of natural orifice trans-endoscopic surgery (NOTES and laparoendoscopic single site surgery (LESS in urologic surgery

    Directory of Open Access Journals (Sweden)

    Rafael E. Sanchez-Salas

    2010-08-01

    Full Text Available Laparoendoscopic single site surgery (LESS and natural orifice transluminal endoscopic surgery (NOTES represent novel approaches in urological surgery. To perform a review of the literature in order describe the current status of LESS and NOTES in Urology. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-02 to 15-05-09. Search terms included single port, single site, NOTES, LESS and single incision. A total of 412 manuscripts were initially identified. Out of these, 64 manuscripts were selected based in their urological content. The manuscript features subheadings for experimental and clinical studies, as NOTES-LESS is a new surgical technique and its future evolution will probably rely in initial verified feasibility. A subheading for reviews presents information regarding common language and consensus for the techniques. The issue of complications published in clinical series and the future needs of NOTES-LESS, are also presented.

  19. PREDICTION BASED CHANNEL-HOPPING ALGORITHM FOR RENDEZVOUS IN COGNITIVE RADIO NETWORKS

    Directory of Open Access Journals (Sweden)

    Dhananjay Kumar

    2012-12-01

    Full Text Available Most common works for rendezvous in cognitive radio networks deal only with two user scenarios involving two secondary users and variable primary users and aim at reducing the time-to-rendezvous. A common control channel for the establishment of communication is not considered and hence the work comes under the category of ‘Blind Rendezvous’. Our work deal with multi-user scenario and provides a methodology for the users to find each other in the very first time slot spent for rendezvous or otherwise called the firstattempt- rendezvous. The secondary users make use of the history of past communications to enable them to predict the frequency channel that the user expects the rendezvous user to be. Our approach prevents greedy decision making between the users involved by the use of a cut-off time period for attempting rendezvous. Simulation results show that the time-to-rendezvous (TTR is greatly reduced upon comparison with other popular rendezvous algorithms.

  20. The mobile agent rendezvous problem in the ring

    CERN Document Server

    Kranakis, Evangelos; Marcou, Euripides

    2010-01-01

    Mobile agent computing is being used in fields as diverse as artificial intelligence, computational economics and robotics. Agents' ability to adapt dynamically and execute asynchronously and autonomously brings potential advantages in terms of fault-tolerance, flexibility and simplicity. This monograph focuses on studying mobile agents as modelled in distributed systems research and in particular within the framework of research performed in the distributed algorithms community. It studies the fundamental question of how to achieve rendezvous, the gathering of two or more agents at the same n

  1. Virtual reality applications to automated rendezvous and capture

    Science.gov (United States)

    Hale, Joseph; Oneil, Daniel

    Virtual Reality (VR) is a rapidly developing Human/Computer Interface (HCI) technology. The evolution of high-speed graphics processors and development of specialized anthropomorphic user interface devices, that more fully involve the human senses, have enabled VR technology. Recently, the maturity of this technology has reached a level where it can be used as a tool in a variety of applications. This paper provides an overview of: VR technology, VR activities at Marshall Space Flight Center (MSFC), applications of VR to Automated Rendezvous and Capture (AR&C), and identifies areas of VR technology that requires further development.

  2. Comparison of different sets of instruments for laparoendoscopic single-site surgery in a surgical simulator with novices.

    Science.gov (United States)

    Wang, Dong; Shi, Long-Qing; Wang, Jing-Min; Jiang, Xiao-Hua; Ji, Zhen-Ling

    2016-04-01

    Given the parallel entry of working instruments through a single incision in laparoendoscopic single-site surgery, loss of triangulation in the abdominal cavity and counteracting movements of the instruments are inevitable obstacles. Some specially designed devices have emerged to ameliorate these challenges. Twenty-four novice participants were randomized into four groups using assigned instruments, conventional straight instruments, single-curved instruments, double-curved instruments and articulating instruments, respectively, to perform two basic tasks (peg transferring and pattern cutting) 14 times in a modified simulator. A test of the tasks and a resection of the intestine segment of a rat were performed. The task scores and evaluation of intraoperative skills during the resection of the intestine segment were recorded. The instrument of modified National Aeronautics and Space Administration Task Load Index (NASA-TLX) was completed. The task scores of the groups using single-curved instruments and articulating instruments were better than the other two groups on the simulator tasks, consistent with the evaluation of intraoperative skills during the resection of intestine segment. As the proficiency with the instruments increased, the task scores improved, as demonstrated by the learning curve. The workload measured by the modified NASA-TLX tool demonstrated that the groups using articulating instruments and double-curved instruments had a heavier workload in most of the categories compared with the other two groups. Single-curved and articulating instruments are more effective than conventional straight and double-curved devices, and are favourable in laparoendoscopic single-site surgery for novice learners. © 2013 Royal Australasian College of Surgeons.

  3. An automated rendezvous and capture system design concept for the cargo transfer vehicle and Space Station Freedom

    Science.gov (United States)

    Fuchs, Ron; Marsh, Steven

    1991-01-01

    A rendezvous sensor system concept was developed for the cargo transfer vehicle (CTV) to autonomously rendezvous with and be captured by Space Station Freedom (SSF). The development of requirements, the design of a unique Lockheed developed sensor concept to meet these requirements, and the system design to place this sensor on the CTV and rendezvous with the SSF are described .

  4. Modified rendezvous intrahepatic bile duct cannulation technique to pass a PTBD catheter in ERCP.

    Science.gov (United States)

    Lee, Tae Hoon; Park, Sang-Heum; Lee, Sae Hwan; Lee, Chang-Kyun; Lee, Suck-Ho; Chung, Il-Kwun; Kim, Hong Soo; Kim, Sun-Joo

    2010-11-14

    The rendezvous procedure combines an endoscopic technique with percutaneous transhepatic biliary drainage (PTBD). When a selective common bile duct cannulation fails, PTBD allows successful drainage and retrograde access for subsequent rendezvous techniques. Traditionally, rendezvous procedures such as the PTBD-assisted over-the-wire cannulation method, or the parallel cannulation technique, may be available when a bile duct cannot be selectively cannulated. When selective intrahepatic bile duct (IHD) cannulation fails, this modified rendezvous technique may be a feasible alternative. We report the case of a modified rendezvous technique, in which the guidewire was retrogradely passed into the IHD through the C2 catheter after end-to-end contact between the tips of the sphincterotome and the C2 catheter at the ampulla's orifice, in a 39-year-old man who had been diagnosed with gallbladder carcinoma with a metastatic right IHD obstruction. Clinically this procedure may be a feasible and timesaving technique.

  5. An autonomous rendezvous and docking system using cruise missile technologies

    Science.gov (United States)

    Jones, Ruel Edwin

    1991-01-01

    In November 1990 the Autonomous Rendezvous & Docking (AR&D) system was first demonstrated for members of NASA's Strategic Avionics Technology Working Group. This simulation utilized prototype hardware from the Cruise Missile and Advanced Centaur Avionics systems. The object was to show that all the accuracy, reliability and operational requirements established for a space craft to dock with Space Station Freedom could be met by the proposed system. The rapid prototyping capabilities of the Advanced Avionics Systems Development Laboratory were used to evaluate the proposed system in a real time, hardware in the loop simulation of the rendezvous and docking reference mission. The simulation permits manual, supervised automatic and fully autonomous operations to be evaluated. It is also being upgraded to be able to test an Autonomous Approach and Landing (AA&L) system. The AA&L and AR&D systems are very similar. Both use inertial guidance and control systems supplemented by GPS. Both use an Image Processing System (IPS), for target recognition and tracking. The IPS includes a general purpose multiprocessor computer and a selected suite of sensors that will provide the required relative position and orientation data. Graphic displays can also be generated by the computer, providing the astronaut / operator with real-time guidance and navigation data with enhanced video or sensor imagery.

  6. Laparoendoscopic single-site myomectomy and the use of fibrin sealant (Tisseel

    Directory of Open Access Journals (Sweden)

    Angelito Magno

    2015-11-01

    Full Text Available Myomectomy remains the standard surgical treatment for women with uterine myoma, who wish to preserve their fertility. However, it is often associated with increased blood loss and adhesion formation. Laparoscopic myomectomy has multiple advantages over open myomectomy1. A newer approach, laparoendoscopic single-site surgery, also known as LESS, has been developed and applied in gynecologic field.2 This is a case of a 41-year-old G2P1 patient, with the complaints of irregular menstrual cycles and lower abdominal pain for 6 months. Transvaginal ultrasound showed uterine myoma at the anterior corpus, measuring 6 × 5 cm2. The procedure is started by grasping the bilateral edges of the umbilicus with Allis forceps. A vertical incision, 1.5–2 cm, is made from the superficial skin of the umbilicus to the ventral peritoneum. A wound retractor of appropriate size is inserted and adjusted. A multiple instrument access port (LagisEndosurgical, Taichung, Taiwan is placed over the wound retractor (Figure 1. Prior to the procedure, inspection of the pelvic organs is performed to determine the pathology. Vasopressin is injected over the area of the myoma to decrease blood loss. Location of the myoma is then identified. Uterine incision is made on the serosa over the area of the myoma using the monopolar scissors. Using a bipolar instrument LigaSure®, ValleyLab, Inc., Boulder, Colorado, the incision is extended until the myoma is exposed. The myoma is grasped gently using the tenaculum forcep, and dissected bluntly along with it's pseudocapsule using the tip of suction irrigation gear. At the base of the myoma where feeding vessels may be located, coagulation by the advanced bipolar, is performed to prevent bleeding. The specimen is removed through the umbilicus. A sliding knot is made at the tail of one zero monofilament suture to fasten the anchor of the first knot. The uterus is then repaired with a continuous non-locking method. Hemostasis is

  7. The Evolution of the Rendezvous Profile During the Space Shuttle Program

    Science.gov (United States)

    Summa, William R.

    2010-01-01

    The rendezvous and proximity operations approach design techniques for space shuttle missions has changed significantly during the life of the program in response to new requirements that were not part of the original mission design. The flexibility of the shuttle onboard systems design and the mission planning process has allowed the program to meet these requirements. The design of the space shuttle and the shift from docking to grappling with a robotic ann prevented use of legacy Apollo rendezvous techniques. Over the life of the shuttle program the rendezvous profile has evolved due to several factors, including lowering propellant consumption and increasing flexibility in mission planning. Many of the spacecraft that the shuttle rendezvoused with had unique requirements that drove the creation of mission-unique proximity operations. The dockings to the Russian Mir space station and International Space Station (ISS) required further evolution of rendezvous and proximity operations techniques and additional sensors to enhance crew situational awareness. After the Columbia accident, a Rendezvous Pitch Maneuver (RPM) was added to allow tile photography from ISS. Lessons learned from these rendezvous design changes are applicable to future vehicle designs and operations concepts.

  8. Gossip-based solutions for discrete rendezvous in populations of communicating agents.

    Science.gov (United States)

    Hollander, Christopher D; Wu, Annie S

    2014-01-01

    The objective of the rendezvous problem is to construct a method that enables a population of agents to agree on a spatial (and possibly temporal) meeting location. We introduce the buffered gossip algorithm as a general solution to the rendezvous problem in a discrete domain with direct communication between decentralized agents. We compare the performance of the buffered gossip algorithm against the well known uniform gossip algorithm. We believe that a buffered solution is preferable to an unbuffered solution, such as the uniform gossip algorithm, because the use of a buffer allows an agent to use multiple information sources when determining its desired rendezvous point, and that access to multiple information sources may improve agent decision making by reinforcing or contradicting an initial choice. To show that the buffered gossip algorithm is an actual solution for the rendezvous problem, we construct a theoretical proof of convergence and derive the conditions under which the buffered gossip algorithm is guaranteed to produce a consensus on rendezvous location. We use these results to verify that the uniform gossip algorithm also solves the rendezvous problem. We then use a multi-agent simulation to conduct a series of simulation experiments to compare the performance between the buffered and uniform gossip algorithms. Our results suggest that the buffered gossip algorithm can solve the rendezvous problem faster than the uniform gossip algorithm; however, the relative performance between these two solutions depends on the specific constraints of the problem and the parameters of the buffered gossip algorithm.

  9. Gossip-based solutions for discrete rendezvous in populations of communicating agents.

    Directory of Open Access Journals (Sweden)

    Christopher D Hollander

    Full Text Available The objective of the rendezvous problem is to construct a method that enables a population of agents to agree on a spatial (and possibly temporal meeting location. We introduce the buffered gossip algorithm as a general solution to the rendezvous problem in a discrete domain with direct communication between decentralized agents. We compare the performance of the buffered gossip algorithm against the well known uniform gossip algorithm. We believe that a buffered solution is preferable to an unbuffered solution, such as the uniform gossip algorithm, because the use of a buffer allows an agent to use multiple information sources when determining its desired rendezvous point, and that access to multiple information sources may improve agent decision making by reinforcing or contradicting an initial choice. To show that the buffered gossip algorithm is an actual solution for the rendezvous problem, we construct a theoretical proof of convergence and derive the conditions under which the buffered gossip algorithm is guaranteed to produce a consensus on rendezvous location. We use these results to verify that the uniform gossip algorithm also solves the rendezvous problem. We then use a multi-agent simulation to conduct a series of simulation experiments to compare the performance between the buffered and uniform gossip algorithms. Our results suggest that the buffered gossip algorithm can solve the rendezvous problem faster than the uniform gossip algorithm; however, the relative performance between these two solutions depends on the specific constraints of the problem and the parameters of the buffered gossip algorithm.

  10. Orion Handling Qualities During ISS Rendezvous and Docking

    Science.gov (United States)

    Hart, Jeremy J.; Stephens, J. P.; Spehar, P.; Bilimoria, K.; Foster, C.; Gonzalex, R.; Sullivan, K.; Jackson, B.; Brazzel, J.; Hart, J.

    2011-01-01

    The Orion spacecraft was designed to rendezvous with multiple vehicles in low earth orbit (LEO) and beyond. To perform the required rendezvous and docking task, Orion must provide enough control authority to perform coarse translational maneuvers while maintaining precision to perform the delicate docking corrections. While Orion has autonomous docking capabilities, it is expected that final approach and docking operations with the International Space Station (ISS) will initially be performed in a manual mode. A series of evaluations was conducted by NASA and Lockheed Martin at the Johnson Space Center to determine the handling qualities (HQ) of the Orion spacecraft during different docking and rendezvous conditions using the Cooper-Harper scale. This paper will address the specifics of the handling qualities methodology, vehicle configuration, scenarios flown, data collection tools, and subject ratings and comments. The initial Orion HQ assessment examined Orion docking to the ISS. This scenario demonstrates the Translational Hand Controller (THC) handling qualities of Orion. During this initial assessment, two different scenarios were evaluated. The first was a nominal docking approach to a stable ISS, with Orion initializing with relative position dispersions and a closing rate of approximately 0.1 ft/sec. The second docking scenario was identical to the first, except the attitude motion of the ISS was modeled to simulate a stress case ( 1 degree deadband per axis and 0.01 deg/sec rate deadband per axis). For both scenarios, subjects started each run on final approach at a docking port-to-port range of 20 ft. Subjects used the THC in pulse mode with cues from the docking camera image, window views, and range and range rate data displayed on the Orion display units. As in the actual design, the attitude of the Orion vehicle was held by the automated flight control system at 0.5 degree deadband per axis. Several error sources were modeled including Reaction

  11. Percutaneous rendezvous technique for the management of a bile duct injury.

    Science.gov (United States)

    Meek, James; Fletcher, Savannah; Crumley, Kristen; Culp, W C; Meek, Mary

    2018-02-01

    The rendezvous technique typically involves combined efforts of interventional radiology, endoscopy, and surgery. It can be done solely percutaneously, whereby the interventionalist gains desired access to one point in the body by approaching it from two different access sites. We present the case of a woman who underwent cholecystectomy complicated by a bile duct injury. A percutaneous rendezvous procedure enabled placement of an internal-external drain from the intrahepatic ducts through the biloma and distal common bile duct and into the duodenum. Thus, a percutaneous rendezvous technique is feasible for managing a bile duct injury when endoscopic retrograde cholangio-pancreatography or percutaneous transhepatic cholangiogram alone has been unsuccessful.

  12. Totally percutaneous rendezvous techniques for the treatment of bile strictures and leakages.

    Science.gov (United States)

    De Robertis, Riccardo; Contro, Alberto; Zamboni, Giulia; Mansueto, Giancarlo

    2014-04-01

    Some challenging pathologic conditions of the biliary tract cannot be treated with endoscopy alone, and a combined approach with rendezvous techniques is frequently needed. Three different totally percutaneous rendezvous techniques were successfully applied in three cases. The rendezvous techniques were performed either with bilateral catheterization of bile ducts to treat a challenging type IV biliary stenosis and iatrogenic biliary damage or with biliary catheterization and percutaneous puncture of the anastomotic loop to treat a biliodigestive anastomosis failure with bile leakage. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

  13. Percutaneous rendezvous technique for the management of a bile duct injury

    Directory of Open Access Journals (Sweden)

    James Meek, DO

    2018-02-01

    Full Text Available The rendezvous technique typically involves combined efforts of interventional radiology, endoscopy, and surgery. It can be done solely percutaneously, whereby the interventionalist gains desired access to one point in the body by approaching it from two different access sites. We present the case of a woman who underwent cholecystectomy complicated by a bile duct injury. A percutaneous rendezvous procedure enabled placement of an internal-external drain from the intrahepatic ducts through the biloma and distal common bile duct and into the duodenum. Thus, a percutaneous rendezvous technique is feasible for managing a bile duct injury when endoscopic retrograde cholangio-pancreatography or percutaneous transhepatic cholangiogram alone has been unsuccessful.

  14. A Comparison Between Orion Automated and Space Shuttle Rendezvous Techniques

    Science.gov (United States)

    Ruiz, Jose O,; Hart, Jeremy

    2010-01-01

    The Orion spacecraft will replace the space shuttle and will be the first human spacecraft since the Apollo program to leave low earth orbit. This vehicle will serve as the cornerstone of a complete space transportation system with a myriad of mission requirements necessitating rendezvous to multiple vehicles in earth orbit, around the moon and eventually beyond . These goals will require a complex and robust vehicle that is, significantly different from both the space shuttle and the command module of the Apollo program. Historically, orbit operations have been accomplished with heavy reliance on ground support and manual crew reconfiguration and monitoring. One major difference with Orion is that automation will be incorporated as a key element of the man-vehicle system. The automated system will consist of software devoted to transitioning between events based on a master timeline. This effectively adds a layer of high level sequencing that moves control of the vehicle from one phase to the next. This type of automated control is not entirely new to spacecraft since the shuttle uses a version of this during ascent and entry operations. During shuttle orbit operations however many of the software modes and hardware switches must be manually configured through the use of printed procedures and instructions voiced from the ground. The goal of the automation scheme on Orion is to extend high level automation to all flight phases. The move towards automation represents a large shift from current space shuttle operations, and so these new systems will be adopted gradually via various safeguards. These include features such as authority-to-proceed, manual down modes, and functional inhibits. This paper describes the contrast between the manual and ground approach of the space shuttle and the proposed automation of the Orion vehicle. I will introduce typical orbit operations that are common to all rendezvous missions and go on to describe the current Orion automation

  15. Robust control for constant thrust rendezvous under thrust failure

    Directory of Open Access Journals (Sweden)

    Qi Yongqiang

    2015-04-01

    Full Text Available A robust constant thrust rendezvous approach under thrust failure is proposed based on the relative motion dynamic model. Firstly, the design problem is cast into a convex optimization problem by introducing a Lyapunov function subject to linear matrix inequalities. Secondly, the robust controllers satisfying the requirements can be designed by solving this optimization problem. Then, a new algorithm of constant thrust fitting is proposed through the impulse compensation and the fuel consumption under the theoretical continuous thrust and the actual constant thrust is calculated and compared by using the method proposed in this paper. Finally, the proposed method having the advantage of saving fuel is proved and the actual constant thrust switch control laws are obtained through the isochronous interpolation method, meanwhile, an illustrative example is provided to show the effectiveness of the proposed control design method.

  16. Guidance and navigation for rendezvous with an uncooperative target

    Science.gov (United States)

    Telaar, J.; Schlaile, C.; Sommer, J.

    2018-06-01

    This paper presents a guidance strategy for a rendezvous with an uncooperative target. In the applied design reference mission, a spiral approach is commanded ensuring a collision-free relative orbit due to e/i-vector separation. The dimensions of the relative orbit are successively reduced by Δv commands which at the same time improve the observability of the relative state. The navigation is based on line-of-sight measurements. The relative state is estimated by an extended Kalman filter (EKF). The performance of this guidance and navigation strategy is demonstrated by extensive Monte Carlo simulations taking into account all major uncertainties like measurement errors, Δv execution errors, and differential drag.

  17. Rendezvous, proximity operations and capture quality function deployment report

    Science.gov (United States)

    Lamkin, Stephen L. (Editor)

    1991-01-01

    Rendezvous, Proximity Operations, and Capture (RPOC) is a missions operations area which is extremely important to present and future space initiatives and must be well planned and coordinated. To support this, a study team was formed to identify a specific plan of action using the Quality Function Deployment (QFD) process. This team was composed of members from a wide spectrum of engineering and operations organizations which are involved in the RPOC technology area. The key to this study's success is an understanding of the needs of potential programmatic customers and the technology base available for system implementation. To this end, the study team conducted interviews with a variety of near term and future programmatic customers and technology development sponsors. The QFD activity led to a thorough understanding of the needs of these customers in the RPOC area, as well as the relative importance of these needs.

  18. Rendezvous, proximity operations and capture quality function deployment report

    Science.gov (United States)

    Lamkin, Stephen L.

    1991-12-01

    Rendezvous, Proximity Operations, and Capture (RPOC) is a missions operations area which is extremely important to present and future space initiatives and must be well planned and coordinated. To support this, a study team was formed to identify a specific plan of action using the Quality Function Deployment (QFD) process. This team was composed of members from a wide spectrum of engineering and operations organizations which are involved in the RPOC technology area. The key to this study's success is an understanding of the needs of potential programmatic customers and the technology base available for system implementation. To this end, the study team conducted interviews with a variety of near term and future programmatic customers and technology development sponsors. The QFD activity led to a thorough understanding of the needs of these customers in the RPOC area, as well as the relative importance of these needs.

  19. A modified Rendezvous ERCP technique in duodenal diverticulum.

    Science.gov (United States)

    Odabasi, Mehmet; Yildiz, Mehmet Kamil; Abuoglu, Haci Hasan; Eris, Cengiz; Ozkan, Erkan; Gunay, Emre; Aktekin, Ali; Muftuoglu, Ma Tolga

    2013-11-16

    To postoperative endoscopic retrograde cholangiopancreatography (ERCP) failure, we describe a modified Rendezvous technique for an ERCP in patients operated on for common bile duct stone (CBDS) having a T-tube with retained CBDSs. Five cases operated on for CBDSs and having retained stones with a T-tube were referred from other hospitals located in or around Istanbul city to the ERCP unit at the Haydarpasa Numune Education and Research Hospital. Under sedation anesthesia, a sterile guide-wire was inserted via the T-tube into the common bile duct (CBD) then to the papilla. A guide-wire was held by a loop snare and removed through the mouth. The guide-wire was inserted into the sphincterotome via the duodenoscope from the tip to the handle. The duodenoscope was inserted down to the duodenum with a sphincterotome and a guide-wire in the working channel. With the guidance of a guide-wire, the ERCP and sphincterotomy were successfully performed, the guide-wire was removed from the T-tube, the stones were removed and the CBD was reexamined for retained stones by contrast. An ERCP can be used either preoperatively or postoperatively. Although the success rate in an isolated ERCP treatment ranges from up to 87%-97%, 5%-10% of the patients require two or more ERCP treatments. If a secondary ERCP fails, the clinicians must be ready for a laparoscopic or open exploration. A duodenal diverticulum is one of the most common failures in an ERCP, especially in patients with an intradiverticular papilla. For this small group of patients, an antegrade cannulation via a T-tube can improve the success rate up to nearly 100%. The modified Rendezvous technique is a very easy method and increases the success of postoperative ERCP, especially in patients with large duodenal diverticula and with intradiverticular papilla.

  20. Deep Interior: Multiple-Rendezvous Prospecting of NEOs

    Science.gov (United States)

    Kakuda, R. Y.; Asphaug, E.; Belton, M. J. S.; Gulkis, S.; Huebner, W. F.

    2000-10-01

    This is an international multiple-rendezvous mission designed to prospect the deep interior and subsurface geophysical properties of diverse near-Earth objects, using reflection radar tomography, imaging, gravity, and explosions. What we learn will greatly influence future missions and guide strategies for the diversion, disruption, or utilization of potentially hazardous objects. Deep Interior. Low-frequency radar to determine internal variations of complex permittivity at resolutions approaching 20 m. Map inclusions or voids, fracture geometries, and compositional or structural boundaries. Subsurface. High-frequency radar to determine depth of regolith, existence and nature of cometary mantle, geology beneath and around craters, and subsurface expressions to surface geology. Topography and Geodesy. Stereogrammetric imaging with 1 m/pixel spatial resolution, supplemented by radar altimetry in shadowed regions, to determine detailed shape, volume, and spin state. Compare with radar sounding to learn how internal structure is manifested on the surface. Mass and Density. Total mass and lower moments of the internal mass distribution by mapping the exterior gravitational field. Look for mass concentrations. Surface microphysics and composition. Map color, albedo, and scattering properties of the surface over sunlit regions in six optical filters. Material properties. Deploy grenades to characterize the mechanics and dynamics of surface materials. Record 8 frame/sec, 20 cm/pixel videos of crater formation and ejecta dynamics, to enable simple and direct laboratory constraints on material density, cohesion and porosity. Dust. Look for dust lofted by surface waves propagating from the explosions, to constrain elastic properties and attenuation. Observe longer-term dynamics and optical properties of dust "atmosphere" generated by human activity. Cometary Activity. At comet 107P/Wilson-Harrington, look for expressions of past cometary activity, and for possible awakening

  1. An Application of Linear Covariance Analysis to the Design of Responsive Near-Rendezvous Missions

    National Research Council Canada - National Science Library

    Visser, Benjamin L

    2007-01-01

    This thesis investigates a new class of launch vehicles capable of being released from an aircraft which ultimately have the goal of achieving near-rendezvous conditions at orbital altitudes up to 800 km...

  2. AggieSat: Autonomous Rendezvous and Docking Technology Demonstrator, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Current autonomous rendezvous and docking (AR&D) capability in low Earth orbit (LEO) is constrained by sensor and effector mass, power, and accuracy limits. To...

  3. Spacecraft Rendezvous Guidance in Cluttered Dynamical Environments via Extreme Learning Machines, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — DeepAnalytX, Inc. proposes to investigate a new approach to perform real-time, closed-loop optimal and robust rendezvous guidance in space environments comprising a...

  4. Comparison between magnetic anchoring and guidance system camera-assisted laparoendoscopic single-site surgery nephrectomy and conventional laparoendoscopic single-site surgery nephrectomy in a porcine model: focus on ergonomics and workload profiles.

    Science.gov (United States)

    Han, Woong Kyu; Tan, Yung K; Olweny, Ephrem O; Yin, Gang; Liu, Zhuo-Wei; Faddegon, Stephen; Scott, Daniel J; Cadeddu, Jeffrey A

    2013-04-01

    To compare surgeon-assessed ergonomic and workload demands of magnetic anchoring and guidance system (MAGS) laparoendoscopic single-site surgery (LESS) nephrectomy with conventional LESS nephrectomy in a porcine model. Participants included two expert and five novice surgeons who each performed bilateral LESS nephrectomy in two nonsurvival animals using either the MAGS camera or conventional laparoscope. Task difficulty and workload demands of the surgeon and camera driver were assessed using the validated National Aeronautics and Space Administration Task Load Index (NASA-TLX) questionnaire. Surgeons were also asked to score 6 parameters on a Likert scale (range 1=low/easy to 5=high/hard): procedure-associated workload, ergonomics, technical challenge, visualization, accidental events, and instrument handling. Each step of the nephrectomy was also timed and instrument clashing was quantified. Scores for each parameter on the Likert scale were significantly lower for MAGS-LESS nephrectomy. Mean number of internal and external clashes were significantly lower for the MAGS camera (pNASA-TLX workload ratings by the surgeon and camera driver showed that MAGS resulted in a significantly lower workload than the conventional laparoscope during LESS nephrectomy (p<0.05). The use of the MAGS camera during LESS nephrectomy lowers the task workload for both the surgeon and camera driver when compared to conventional laparoscope use. Subjectively, it appears to also improve surgeons' impressions of ergonomics and technical challenge. Pending approval for clinical use, further evaluation in the clinical setting is warranted.

  5. Clinical utility of an endoscopic ultrasound-guided rendezvous technique via various approach routes.

    Science.gov (United States)

    Kawakubo, Kazumichi; Isayama, Hiroyuki; Sasahira, Naoki; Nakai, Yousuke; Kogure, Hirofumi; Hamada, Tsuyoshi; Miyabayashi, Koji; Mizuno, Suguru; Sasaki, Takashi; Ito, Yukiko; Yamamoto, Natsuyo; Hirano, Kenji; Tada, Minoru; Koike, Kazuhiko

    2013-09-01

    The endoscopic ultrasound-guided rendezvous techniques (EUS-rendezvous) provide reliable biliary access after failed endoscopic retrograde cholangiopancreatography (ERCP) cannulation. We evaluated the clinical utility of an EUS-rendezvous technique using various approach routes. Patients undergoing EUS-rendezvous for biliary access after failed bile duct cannulation in ERCP were included. EUS-rendezvous was performed via three approach routes depending on the patient's condition: transgastric, transduodenal in a short endoscopic position, or transduodenal in a long endoscopic position. The main outcomes were the technical success rates. Secondary outcomes were procedure time and complications. Fourteen patients (median age, 77 years) underwent EUS-rendezvous for biliary access resulting from failed biliary cannulation. The reasons for biliary drainage were malignant biliary obstruction in five patients and choledocholithiasis in nine. Transgastric, transduodenal in a short position, and transduodenal in a long position EUS-rendezvous was performed in five, five, and four patients, respectively. Bile duct puncture occurred in the left intrahepatic duct in four patients, right hepatic duct in one, middle common bile duct in four, and lower common bile duct in five. The technical success rate was 100 %. In four patients, the approach route was modified from transduodenal in a short position to transduodenal in a long position or transgastric route. The median procedure time was 81 min. One case each of biliary peritonitis and pancreatitis occurred and were managed conservatively. EUS-rendezvous provided safe and reliable transpapillary bile duct access after failed ERCP cannulation. The selection of the appropriate approach routes, depending on patient condition, is critical.

  6. Intra-urinoma Rendezvous Using a Transconduit Approach to Re-establish Ureteric Integrity

    International Nuclear Information System (INIS)

    Anderson, Hugh; Alyas, Faisal; Edwin, Patrick Joseph

    2005-01-01

    Ureteric discontinuity following injury has been traditionally treated surgically. With the advent of improved interventional instrumentation it is possible to stent these lesions percutaneously, retrogradely or failing that using a combined (rendezvous) technique. We describe an intra-urinoma rendezvous procedure combining a percutaneous antegrade-transconduit retrograde technique of stent insertion to successfully re-establish ureteric integrity that was used following the failure of a percutaneous retrograde approach. We illustrate its usefulness as an alternative to surgery

  7. Cooperative Rendezvous and Docking for Underwater Robots Using Model Predictive Control and Dual Decomposition

    DEFF Research Database (Denmark)

    Nielsen, Mikkel Cornelius; Johansen, Tor Arne; Blanke, Mogens

    2018-01-01

    This paper considers the problem of rendezvous and docking with visual constraints in the context of underwater robots with camera-based navigation. The objective is the convergence of the vehicles to a common point while maintaining visual contact. The proposed solution includes the design of a ...... of a distributed model predictive controller based on dual decomposition, which allows for optimization in a decentralized fashion. The proposed distributed controller enables rendezvous and docking between vehicles while maintaining visual contact....

  8. Over-the-catheter precut to gain access to the biliary duct during ERCP rendezvous.

    Science.gov (United States)

    Manes, Gianpiero; Baratti, Cinzia; Ardizzone, Sandro; Ferla, Fabio; Spiropoulos, Jean; Corsi, Fabio; Foschi, Diego; Trabucchi, Emilio; Bianchi Porro, Gabriele

    2008-10-01

    Endoscopic retrograde cholangiopancreatography (ERCP) rendezvous during laparoscopic cholecystectomy is an efficient and safe method to treat cholecystocholedocholithiasis. Advancing a guidewire through the cystic duct into the duodenum and withdrawing it in the accessory channel of duodenoscope may be, however, laborious. Moreover, rendezvous performed in the typical manner needs the use of several costly accessories. We herein describe a simpler and cheaper method to gain access to the biliary duct at rendezvous. Twenty-four consecutive patients undergoing ERCP rendezvous during laparoscopic cholecystectomy were considered. A catheter was introduced in the cystic duct and advanced into the duodenum. Access to the bile duct was than achieved by means of a precut sphincterotomy performed over the catheter emerging from the papilla. Cannulation was successful in all but two patients, in whom ERCP was performed in the conventional manner. The only complication was a case of mild post-sphincterotomy bleeding. In comparison with the typical rendezvous technique our procedure allowed savings of about 250, since its performance only requires a catheter and a knife sphincterotome. Over-the-catheter precut during ERCP rendezvous is a feasible and safe method which avoids the need for the manipulation of several accessories and guidewires, and thus results in money and time savings.

  9. Repeated rendezvous treatment of PTBD and ERCP in patients with recurrent obstructive jaundice.

    Science.gov (United States)

    Liu, Yingdi; Meng, Jianyun; Wang, Jianhua; Wang, Zhiqiang; Wang, Xiangdong; Linghu, Enqiang; Li, Wen; Yang, Yunsheng

    2010-01-01

    Repeated applications of rendezvous technique combining percutaneous transhepatic biliary drainage (PTBD) with endoscopic retrograde cholangiopancreatography (ERCP) (PE) in patients with recurrent obstructive jaundice have not been reported. The present study aimed to evaluate treatment effects of this technique in patients who previously received the same rendezvous treatment. Repeated PE rendezvous procedure was performed in 27 patients who received the same procedure previously and had recurrent obstructive jaundice. Twenty-two patients were treated by second-time rendezvous procedure and five patients by third-time. The clinical characteristics and therapeutic effects were retrospectively analyzed. By means of repeated rendezvous technique, 26 patients gained access to the bile duct and were successfully implanted new stents, only one failed with stent implantation. Total serum bilirubin level decreased within one week from 221.89 +/- 64.70 micromol/L to 156.0 +/- 32.2 micromol/L in patients with second-time treatment and from 297.07 +/- 109.12 micromol/L to 238.77 +/- 36.81 micromol/L in patients with third-time treatment. There was no severe complications observed that are associated with repeated PE procedure. Rendezvous procedure of PTBD and ERCP could be used repeatedly and effectively for patients who present recurrent obstructive jaundice after ERCP failure.

  10. Rendezvous and Docking Technology for Space Flight%空间交会对接技术

    Institute of Scientific and Technical Information of China (English)

    郑永煌

    2011-01-01

    空间交会对接是载人航天工程非常重要的基本技术.在介绍空间交会对接技术发展历史和中国首次交会对接取得圆满成功的基础上,阐述了空间交会对接技术的基本概念、技术难点、控制方式和交会对接过程,并着重介绍了四种交会对接机构的特点.最后介绍了中国首次交会对接任务规划、天宫一号目标飞行器和神舟八号飞船的特点以及两次空间交会对接过程.%Rendezvous and Docking is a very important basic technology of Manned Space Engineering. Firstly, rendezvous and docking technology development history is provided, and the significance of China first rendezvous and docking success is presented. Secondly, the basic conception, technology difficulty, control mode and docking process of rendezvous and docking technology are explained.Thirdly, four docking mechanism characteristics are special provided. Finally, China first rendezvous and docking mission planning,characteristic of Tiangong-1 target flight vehicle and Shenzhou-8 spacecraft and two rendezvous and docking successes are presented.

  11. Multicenter Experience with Nonischemic Multiport Laparoscopic and Laparoendoscopic Single-Site Partial Nephrectomy Utilizing Bipolar Radiofrequency Ablation Coagulator

    Directory of Open Access Journals (Sweden)

    Wassim M. Bazzi

    2011-01-01

    Full Text Available Objective. To investigate feasibility of multiport and laparoendoscopic single-site (LESS nonischemic laparoscopic partial nephrectomy (NI-LPN utilizing bipolar radiofrequency coagulator. Methods. Multicenter retrospective review of 60 patients (46 multiport/14 LESS undergoing NI-LPN between 4/2006 and 9/2009. Multiport and LESS NI-LPN utilized Habib 4X bipolar radiofrequency coagulator to form a hemostatic zone followed by nonischemic tumor excision and renorrhaphy. Demographics, tumor/perioperative characteristics, and outcomes were analyzed. Results. 59/60 (98.3% successfully underwent NI-LPN. Mean tumor size was 2.35 cm. Mean operative time was 160.0 minutes. Mean estimated blood loss was 131.4 mL. Preoperative/postoperative creatinine (mg/dL was 1.02/1.07 (=.471. All had negative margins. 12 (20% patients developed complications. 3 (5% developed urine leaks. No differences between multiport and LESS-PN were noted as regards demographics, tumor size, outcomes, and complications. Conclusion. Initial experience demonstrates that nonischemic multiport and LESS-PN is safe and efficacious, with excellent short-term preservation of renal function. Long-term data are needed to confirm oncological efficacy.

  12. Robot-Assisted Laparoendoscopic Single-Site Partial Nephrectomy With the Novel Da Vinci Single-Site Platform: Initial Experience

    Science.gov (United States)

    Komninos, Christos; Tuliao, Patrick; Kim, Dae Keun; Choi, Young Deuk; Chung, Byung Ha

    2014-01-01

    Purpose To report our initial clinical cases of robotic laparoendoscopic single-site (R-LESS) partial nephrectomy (PN) performed with the use of the novel Da Vinci R-LESS platform. Materials and Methods Three patients underwent R-LESS PN from November 2013 through February 2014. Perioperative and postoperative outcomes were collected and intraoperative difficulties were noted. Results Operative time and estimated blood loss volume ranged between 100 and 110 minutes and between 50 and 500 mL, respectively. None of the patients was transfused. All cases were completed with the off-clamp technique, whereas one case required conversion to the conventional (multiport) approach because of difficulty in creating the appropriate scope for safe tumor resection. No major postoperative complications occurred, and all tumors were resected in safe margins. Length of hospital stay ranged between 3 and 7 days. The lack of EndoWrist movements, the external collisions, and the bed assistant's limited working space were noticed to be the main drawbacks of this surgical method. Conclusions Our initial experience with R-LESS PN with the novel Da Vinci platform shows that even though the procedure is feasible, it should be applied in only appropriately selected patients. However, further improvement is needed to overcome the existing limitations. PMID:24955221

  13. The influence of spatial ability and experience on performance during spaceship rendezvous and docking.

    Science.gov (United States)

    Du, Xiaoping; Zhang, Yijing; Tian, Yu; Huang, Weifen; Wu, Bin; Zhang, Jingyu

    2015-01-01

    Manual rendezvous and docking (manual RVD) is a challenging space task for astronauts. Previous research showed a correlation between spatial ability and manual RVD skills among participants at early stages of training, but paid less attention to experts. Therefore, this study tried to explore the role of spatial ability in manual RVD skills in two groups of trainees, one relatively inexperienced and the other experienced operators. Additionally, mental rotation has been proven essential in RVD and was tested in this study among 27 male participants, 15 novices, and 12 experts. The participants performed manual RVD tasks in a high fidelity simulator. Results showed that experience moderated the relation between mental rotation ability and manual RVD performance. On one hand, novices with high mental rotation ability tended to perform that RVD task more successfully; on the other hand, experts with high mental rotation ability showed not only no performance advantage in the final stage of the RVD task, but had certain disadvantages in their earlier processes. Both theoretical and practical implications were discussed.

  14. The Influence of Spatial Ability and Experience on Spacecraft Rendezvous and Docking Operation Performance

    Directory of Open Access Journals (Sweden)

    Xiaoping eDu

    2015-07-01

    Full Text Available Manual rendezvous and docking (manual RVD is a challenging space task for astronauts. Previous research showed a correlation between spatial ability and manual RVD skills among participants at early stages of training, but paid less attention to experts. Therefore, this study tried to explore the role of spatial ability in manual RVD skills in two groups of trainees, one relatively inexperienced and the other experienced operators. Additionally, mental rotation has been proven essential in RVD and was tested in this study among 27 male participants, 15 novices and 12 experts. The participants performed manual RVD tasks in a high fidelity simulator. Results showed that experience moderated the relation between mental rotation ability and manual RVD performance. On one hand, novices with high mental rotation ability tended to perform that RVD task more successfully; on the other hand, experts with high mental rotation ability showed not only no performance advantage in the final stage of the RVD task, but had certain disadvantages in their earlier processes. Both theoretical and practical implications were discussed.

  15. The influence of spatial ability and experience on performance during spaceship rendezvous and docking

    Science.gov (United States)

    Du, Xiaoping; Zhang, Yijing; Tian, Yu; Huang, Weifen; Wu, Bin; Zhang, Jingyu

    2015-01-01

    Manual rendezvous and docking (manual RVD) is a challenging space task for astronauts. Previous research showed a correlation between spatial ability and manual RVD skills among participants at early stages of training, but paid less attention to experts. Therefore, this study tried to explore the role of spatial ability in manual RVD skills in two groups of trainees, one relatively inexperienced and the other experienced operators. Additionally, mental rotation has been proven essential in RVD and was tested in this study among 27 male participants, 15 novices, and 12 experts. The participants performed manual RVD tasks in a high fidelity simulator. Results showed that experience moderated the relation between mental rotation ability and manual RVD performance. On one hand, novices with high mental rotation ability tended to perform that RVD task more successfully; on the other hand, experts with high mental rotation ability showed not only no performance advantage in the final stage of the RVD task, but had certain disadvantages in their earlier processes. Both theoretical and practical implications were discussed. PMID:26236252

  16. NEP for a Kuiper Belt Object rendezvous mission

    International Nuclear Information System (INIS)

    Lipinski, Ronald J.; Lenard, Roger X.; Wright, Steven A.; Houts, Michael G.; Patton, Bruce; Poston, David I.

    2000-01-01

    Kuiper Belt Objects (KBOs) are a recently-discovered set of solar system bodies which lie at about the orbit of Pluto (40 AU) out to about 100 astronomical units (AU). There are estimated to be about 100,000 KBOs with a diameter greater than 100 km. KBOs are postulated to be composed of the pristine material which formed our solar system and may even have organic materials in them. A detailed study of KBO size, orbit distribution, structure, and surface composition could shed light on the origins of the solar system and perhaps even on the origin of life in our solar system. A rendezvous mission including a lander would be needed to perform chemical analysis of the surface and sub-surface composition of KBOs. These requirements set the size of the science probe at around a ton. Mission analyses show that a fission-powered system with an electric thruster could rendezvous at 40 AU in about 13.0 years with a total DV of 46 km/s. It would deliver a 1000-kg science payload while providing ample onboard power for relaying data back to earth. The launch mass of the entire system (power, thrusters, propellant, navigation, communication, structure, science payload, etc.) would be 7984 kg if it were placed into an earth-escape trajectory (C=0). Alternatively, the system could be placed into a 700-km earth orbit with more propellant, yielding a total mass in LEO of 8618 kg, and then spiral out of earth orbit to arrive at the KBO in 14.3 years. To achieve this performance, a fission power system with 100 kW of electrical power and a total mass (reactor, shield, conversion, and radiator) of about 2350 kg. Three possible configurations are proposed: (1) a UZrH-fueled, NaK-cooled reactor with a steam Rankine conversion system, (2) a UN-fueled gas-cooled reactor with a recuperated Brayton conversion system, and (3) a UN-fueled heatpipe-cooled reactor with a recuperated Brayton conversion system. (Boiling and condensation in the Rankine system is a technical risk at present.) All

  17. NEP for a Kuiper Belt Object Rendezvous Mission

    International Nuclear Information System (INIS)

    HOUTS, MICHAEL G.; LENARD, ROGER X.; LIPINSKI, RONALD J.; PATTON, BRUCE; POSTON, DAVID I.; WRIGHT, STEVEN A.

    1999-01-01

    Kuiper Belt Objects (KBOs) are a recently-discovered set of solar system bodies which lie at about the orbit of Pluto (40 AU) out to about 100 astronomical units (AU). There are estimated to be about 100,000 KBOS with a diameter greater than 100 km. KBOS are postulated to be composed of the pristine material which formed our solar system and may even have organic materials in them. A detailed study of KBO size, orbit distribution, structure, and surface composition could shed light on the origins of the solar system and perhaps even on the origin of life in our solar system. A rendezvous mission including a lander would be needed to perform chemical analysis of the surface and sub-surface composition of KBOS. These requirements set the size of the science probe at around a ton. Mission analyses show that a fission-powered system with an electric thruster could rendezvous at 40 AU in about 13.0 years with a total ΔV of 46 krnk. It would deliver a 1000-kg science payload while providing ample onboard power for relaying data back to earth. The launch mass of the entire system (power, thrusters, propellant, navigation, communication, structure, science payload, etc.) would be 7984 kg if it were placed into an earth-escape trajectory (C=O). Alternatively, the system could be placed into a 700-km earth orbit with more propellant,yielding a total mass in LEO of 8618 kg, and then spiral out of earth orbit to arrive at the KBO in 14.3 years. To achieve this performance, a fission power system with 100 kW of electrical power and a total mass (reactor, shield, conversion, and radiator) of about 2350 kg. Three possible configurations are proposed: (1) a UZrH-fueled, NaK-cooled reactor with a steam Rankine conversion system, (2) a UN-fueled gas-cooled reactor with a recuperated Brayton conversion system, and (3) a UN-fueled heatpipe-cooled reactor with a recuperated Brayton conversion system. (Boiling and condensation in the Rankine system is a technical risk at present.) All

  18. Design and Implementation of the Automated Rendezvous Targeting Algorithms for Orion

    Science.gov (United States)

    DSouza, Christopher; Weeks, Michael

    2010-01-01

    The Orion vehicle will be designed to perform several rendezvous missions: rendezvous with the ISS in Low Earth Orbit (LEO), rendezvous with the EDS/Altair in LEO, a contingency rendezvous with the ascent stage of the Altair in Low Lunar Orbit (LLO) and a contingency rendezvous in LLO with the ascent and descent stage in the case of an aborted lunar landing. Therefore, it is not difficult to realize that each of these scenarios imposes different operational, timing, and performance constraints on the GNC system. To this end, a suite of on-board guidance and targeting algorithms have been designed to meet the requirement to perform the rendezvous independent of communications with the ground. This capability is particularly relevant for the lunar missions, some of which may occur on the far side of the moon. This paper will describe these algorithms which are designed to be structured and arranged in such a way so as to be flexible and able to safely perform a wide variety of rendezvous trajectories. The goal of the algorithms is not to merely fly one specific type of canned rendezvous profile. Conversely, it was designed from the start to be general enough such that any type of trajectory profile can be flown.(i.e. a coelliptic profile, a stable orbit rendezvous profile, and a expedited LLO rendezvous profile, etc) all using the same rendezvous suite of algorithms. Each of these profiles makes use of maneuver types which have been designed with dual goals of robustness and performance. They are designed to converge quickly under dispersed conditions and they are designed to perform many of the functions performed on the ground today. The targeting algorithms consist of a phasing maneuver (NC), an altitude adjust maneuver (NH), and plane change maneuver (NPC), a coelliptic maneuver (NSR), a Lambert targeted maneuver, and several multiple-burn targeted maneuvers which combine one of more of these algorithms. The derivation and implementation of each of these

  19. Hubble Servicing Challenges Drive Innovation of Shuttle Rendezvous Techniques

    Science.gov (United States)

    Goodman, John L.; Walker, Stephen R.

    2009-01-01

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

  20. Asteroid Rendezvous Mission Design Using Multiobjective Particle Swarm Optimization

    Directory of Open Access Journals (Sweden)

    Ya-zhong Luo

    2014-01-01

    Full Text Available A new preliminary trajectory design method for asteroid rendezvous mission using multiobjective optimization techniques is proposed. This method can overcome the disadvantages of the widely employed Pork-Chop method. The multiobjective integrated launch window and multi-impulse transfer trajectory design model is formulated, which employes minimum-fuel cost and minimum-time transfer as two objective functions. The multiobjective particle swarm optimization (MOPSO is employed to locate the Pareto solution. The optimization results of two different asteroid mission designs show that the proposed approach can effectively and efficiently demonstrate the relations among the mission characteristic parameters such as launch time, transfer time, propellant cost, and number of maneuvers, which will provide very useful reference for practical asteroid mission design. Compared with the PCP method, the proposed approach is demonstrated to be able to provide much more easily used results, obtain better propellant-optimal solutions, and have much better efficiency. The MOPSO shows a very competitive performance with respect to the NSGA-II and the SPEA-II; besides a proposed boundary constraint optimization strategy is testified to be able to improve its performance.

  1. Video-Guidance Design for the DART Rendezvous Mission

    Science.gov (United States)

    Ruth, Michael; Tracy, Chisholm

    2004-01-01

    NASA's Demonstration of Autonomous Rendezvous Technology (DART) mission will validate a number of different guidance technologies, including state-differenced GPS transfers and close-approach video guidance. The video guidance for DART will employ NASA/Marshall s Advanced Video Guidance Sensor (AVGS). This paper focuses on the terminal phase of the DART mission that includes close-approach maneuvers under AVGS guidance. The closed-loop video guidance design for DART is driven by a number of competing requirements, including a need for maximizing tracking bandwidths while coping with measurement noise and the need to minimize RCS firings. A range of different strategies for attitude control and docking guidance have been considered for the DART mission, and design decisions are driven by a goal of minimizing both the design complexity and the effects of video guidance lags. The DART design employs an indirect docking approach, in which the guidance position targets are defined using relative attitude information. Flight simulation results have proven the effectiveness of the video guidance design.

  2. Pollinators' mating rendezvous and the evolution of floral advertisement.

    Science.gov (United States)

    Fishman, Michael A; Hadany, Lilach

    2013-01-07

    Successful cross-fertilization in plant species that rely on animal pollinators depends not just on the number of pollinator visits, but also on these visits' duration. Furthermore, in non-deceptive pollination, a visit's duration depends on the magnitude of the reward provided to the pollinator. Accordingly, plants that rely on biotic pollination have to partition their investment in cross-fertilization assurance between attracting pollinator visits - advertisement, and rewarding visitors to assure that the visit is of productive duration. Here we analyze these processes by a combination of optimality methods and game theoretical modeling. Our results indicate that the optimality in such allocation of resources depends on the types of reward offered to the pollinators. More precisely, we show that plants that offer both food reward and mating rendezvous to pollinators will evolve to allocate a higher proportion of their cross-fertilization assurance budget to advertisement than plants that offer only food reward. That is, our results indicate that pollinators' mating habits may play a role in floral evolution. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Impact of the Intracoronary Rendezvous technique on coronary angioplasty for chronic total occlusion.

    Science.gov (United States)

    Nihei, Taro; Yamamoto, Yoshito; Kudo, Shun; Hanawa, Kenichiro; Hasebe, Yuhi; Takagi, Yusuke; Minatoya, Yutaka; Sugi, Masafumi; Shimokawa, Hiroaki

    2017-10-01

    The Rendezvous technique, which requires bidirectional wiring, is one of the useful methods for improving the success rate of recanalization for chronic total occlusion (CTO) in the field of peripheral intervention. Recently, advanced new devices for percutaneous coronary intervention have enabled us to perform the Rendezvous technique for peripheral as well as for coronary CTO lesions. We used the Intracoronary Rendezvous technique to perform angioplasty for coronary CTO. "Intracoronary Rendezvous" means that Rendezvous was achieved within the CTO lesion. From March 2009 to November 2015, 189 patients underwent CTO angioplasty at our institute, and we treated 10 patients with the Intracoronary Rendezvous technique. This technique involves crossing the Gaia series guidewire to the contralateral Corsair microcatheter located inside the plaque of CTO lesions. The majority of the CTO sites examined were in the proximal RCA (60 %). Lesion length of the occlusion was relatively long (64.4 ± 12.2 mm). Using the biplane imaging system, we were able to control the Gaia guidewires in a specific direction. Furthermore, if the antegrade and retrograde wires can be advanced into contiguous space inside the CTO lesion, we intentionally entered either wire into the contralateral Corsair microcatheter, followed by successful CTO crossing. CTO recanalization was completed for all patients without controlled antegrade retrograde subintimal tracking (CART) or reverse CART. No major complications occurred during hospitalization. These results indicate that the Rendezvous technique, assisted by new devices and a biplane imaging system, represents one of the primary options to achieve successful coronary CTO recanalization.

  4. Comparative study of rendezvous techniques in post-liver transplant biliary stricture.

    Science.gov (United States)

    Chang, Jae Hyuck; Lee, In Seok; Chun, Ho Jong; Choi, Jong Young; Yoon, Seung Kyoo; Kim, Dong Goo; You, Young Kyoung; Choi, Myung-Gyu; Han, Sok Won

    2012-11-07

    To investigate the usefulness of a new rendezvous technique for placing stents using the Kumpe (KMP) catheter in angulated or twisted biliary strictures. The rendezvous technique was performed in patients with a biliary stricture after living donor liver transplantation (LDLT) who required the exchange of percutaneous transhepatic biliary drainage catheters for inside stents. The rendezvous technique was performed using a guidewire in 19 patients (guidewire group) and using a KMP catheter in another 19 (KMP catheter group). We compared the two groups retrospectively. The baseline characteristics did not differ between the groups. The success rate for placing inside stents was 100% in both groups. A KMP catheter was easier to manipulate than a guidewire. The mean procedure time in the KMP catheter group (1012 s, range: 301-2006 s) was shorter than that in the guidewire group (2037 s, range: 251-6758 s, P = 0.022). The cumulative probabilities corresponding to the procedure time of the two groups were significantly different (P = 0.008). The factors related to procedure time were the rendezvous technique method, the number of inside stents, the operator, and balloon dilation of the stricture (P rendezvous technique method was the only significant factor related to procedure time (P = 0.010). The procedural complications observed included one case of mild acute pancreatitis and one case of acute cholangitis in the guidewire group, and two cases of mild acute pancreatitis in the KMP catheter group. The rendezvous technique involving use of the KMP catheter was a fast and safe method for placing inside stents in patients with LDLT biliary stricture that represents a viable alternative to the guidewire rendezvous technique.

  5. Shared control on lunar spacecraft teleoperation rendezvous operations with large time delay

    Science.gov (United States)

    Ya-kun, Zhang; Hai-yang, Li; Rui-xue, Huang; Jiang-hui, Liu

    2017-08-01

    Teleoperation could be used in space on-orbit serving missions, such as object deorbits, spacecraft approaches, and automatic rendezvous and docking back-up systems. Teleoperation rendezvous and docking in lunar orbit may encounter bottlenecks for the inherent time delay in the communication link and the limited measurement accuracy of sensors. Moreover, human intervention is unsuitable in view of the partial communication coverage problem. To solve these problems, a shared control strategy for teleoperation rendezvous and docking is detailed. The control authority in lunar orbital maneuvers that involves two spacecraft as rendezvous and docking in the final phase was discussed in this paper. The predictive display model based on the relative dynamic equations is established to overcome the influence of the large time delay in communication link. We discuss and attempt to prove via consistent, ground-based simulations the relative merits of fully autonomous control mode (i.e., onboard computer-based), fully manual control (i.e., human-driven at the ground station) and shared control mode. The simulation experiments were conducted on the nine-degrees-of-freedom teleoperation rendezvous and docking simulation platform. Simulation results indicated that the shared control methods can overcome the influence of time delay effects. In addition, the docking success probability of shared control method was enhanced compared with automatic and manual modes.

  6. Robotic Laparoendoscopic Single-site Retroperitioneal Renal Surgery: Initial Investigation of a Purpose-built Single-port Surgical System.

    Science.gov (United States)

    Maurice, Matthew J; Ramirez, Daniel; Kaouk, Jihad H

    2017-04-01

    Robotic single-site retroperitoneal renal surgery has the potential to minimize the morbidity of standard transperitoneal and multiport approaches. Traditionally, technological limitations of non-purpose-built robotic platforms have hindered the application of this approach. To assess the feasibility of retroperitoneal renal surgery using a new purpose-built robotic single-port surgical system. This was a preclinical study using three male cadavers to assess the feasibility of the da Vinci SP1098 surgical system for robotic laparoendoscopic single-site (R-LESS) retroperitoneal renal surgery. We used the SP1098 to perform retroperitoneal R-LESS radical nephrectomy (n=1) and bilateral partial nephrectomy (n=4) on the anterior and posterior surfaces of the kidney. Improvements unique to this system include enhanced optics and intelligent instrument arm control. Access was obtained 2cm anterior and inferior to the tip of the 12th rib using a novel 2.5-cm robotic single-port system that accommodates three double-jointed articulating robotic instruments, an articulating camera, and an assistant port. The primary outcome was the technical feasibility of the procedures, as measured by the need for conversion to standard techniques, intraoperative complications, and operative times. All cases were completed without the need for conversion. There were no intraoperative complications. The operative time was 100min for radical nephrectomy, and the mean operative time was 91.8±18.5min for partial nephrectomy. Limitations include the preclinical model, the small sample size, and the lack of a control group. Single-site retroperitoneal renal surgery is feasible using the latest-generation SP1098 robotic platform. While the potential of the SP1098 appears promising, further study is needed for clinical evaluation of this investigational technology. In an experimental model, we used a new robotic system to successfully perform major surgery on the kidney through a single small

  7. Manned maneuvering unit applications for automated rendezvous and capture

    Science.gov (United States)

    Brehm, Donald L.; Cuseo, John A.; Lenda, Joseph A.; Ray, Lex; Whitsett, C. Edward

    Automated Rendezvous and Capture (AR&C) is an important technology to multiple National Aeronautics and Space Administration (NASA) programs and centers. The recent Johnson Spacecraft Center (JSC) AR&C Quality Function Deployment (QFD) has listed on-orbit demonstration of related technologies as a near term priority. Martin Marietta has been evaluating use of the Manned Maneuvering Unit (MMU) for a low cost near term on-orbit demonstration of AR&C technologies such as control algorithms, sensors, and processors as well as system level performance. The MMU Program began in 1979 as the method of repairing the Space Shuttle (STS) Thermal Protection System (the tiles). The units were not needed for this task, but were successfully employed during three Shuttle flights in 1984: a test flight was flown in in February as proof of concept, in April the MMU participated in the Solar Max Repair Mission, and in November the MMU's returned to space to successfully rescue the two errant satellites, Westar and Palapa. In the intervening years, the MMU simulator and MMU Qualification Test Unit (QTU) have been used for Astronaut training and experimental evaluations. The Extra-Vehicular Activities (EVA) Retriever has used the QTU, in an unmanned form, as a free-flyer on the Johnson Space Center (JSC) Precision Air Bearing Floor (PABF). Currently, the MMU is undergoing recertification for flight. The two flight units were removed from storage in September, 1991 and evaluation tests were performed. The tests demonstrated that the units are in good shape with no discrepancies that would preclude further use. The Return to Flight effort is currently clearing up recertification issues and evaluating the design against the present Shuttle environments.

  8. Interesting rendezvous location in a liver transplantation patient with anastomosis stricture.

    Science.gov (United States)

    Odemis, Bulent; Oztas, Erkin; Yurdakul, Mehmet; Torun, Serkan; Suna, Nuredtin; Kayacetin, Ertugrul

    2014-11-14

    An endoscopic or radiologic percutaneous approach may be an initial minimally invasive method for treating biliary strictures after living donor liver transplantation; however, cannulation of biliary strictures is sometimes difficult due to the presence of a sharp or twisted angle within the stricture or a complete stricture. When an angulated or twisted biliary stricture interrupts passage of a guidewire over the stricture, it is difficult to replace the percutaneous biliary drainage catheter with inside stents by endoscopic retrograde cholangiopancreatography. The rendezvous technique can be used to overcome this difficulty. In addition to the classical rendezvous method, in cases with complete transection of the common bile duct a modified technique involving the insertion of a snare into the subhepatic space has been successfully performed. Herein, we report a modified rendezvous technique in the duodenal bulb as an extraordinary location for a patient with duct-to-duct anastomotic complete stricture after liver transplantation.

  9. Tangent Orbital Rendezvous Using Linear Relative Motion with J2 Perturbations

    Directory of Open Access Journals (Sweden)

    Gang Zhang

    2013-01-01

    Full Text Available The tangent-impulse coplanar orbit rendezvous problem is studied based on the linear relative motion for J2-perturbed elliptic orbits. There are three cases: (1 only the first impulse is tangent; (2 only the second impulse is tangent; (3 both impulses are tangent. For a given initial impulse point, the first two problems can be transformed into finding all roots of a single variable function about the transfer time, which can be done by the secant method. The bitangent rendezvous problem requires the same solution for the first two problems. By considering the initial coasting time, the bitangent rendezvous solution is obtained with a difference function. A numerical example for two coplanar elliptic orbits with J2 perturbations is given to verify the efficiency of these proposed techniques.

  10. Quorum system and random based asynchronous rendezvous protocol for cognitive radio ad hoc networks

    Directory of Open Access Journals (Sweden)

    Sylwia Romaszko

    2013-12-01

    Full Text Available This paper proposes a rendezvous protocol for cognitive radio ad hoc networks, RAC2E-gQS, which utilizes (1 the asynchronous and randomness properties of the RAC2E protocol, and (2 channel mapping protocol, based on a grid Quorum System (gQS, and taking into account channel heterogeneity and asymmetric channel views. We show that the combination of the RAC2E protocol with the grid-quorum based channel mapping can yield a powerful RAC2E-gQS rendezvous protocol for asynchronous operation in a distributed environment assuring a rapid rendezvous between the cognitive radio nodes having available both symmetric and asymmetric channel views. We also propose an enhancement of the protocol, which uses a torus QS for a slot allocation, dealing with the worst case scenario, a large number of channels with opposite ranking lists.

  11. Percutaneous-endoscopic rendezvous procedure for the management of bile duct injuries after cholecystectomy: short- and long-term outcomes

    NARCIS (Netherlands)

    Schreuder, Anne Marthe; Booij, Klaske A. C.; de Reuver, Philip R.; van Delden, Otto M.; van Lienden, Krijn P.; Besselink, Marc G.; Busch, Olivier R.; Gouma, Dirk J.; Rauws, Erik A. J.; van Gulik, Thomas M.

    2018-01-01

    Bile duct injury (BDI) remains a daunting complication of laparoscopic cholecystectomy. In patients with complex BDI, a percutaneous-endoscopic rendezvous procedure may be required to establish bile duct continuity. The aim of this study was to assess short- and long-term outcomes of the rendezvous

  12. Methodology for Developing a Probabilistic Risk Assessment Model of Spacecraft Rendezvous and Dockings

    Science.gov (United States)

    Farnham, Steven J., II; Garza, Joel, Jr.; Castillo, Theresa M.; Lutomski, Michael

    2011-01-01

    In 2007 NASA was preparing to send two new visiting vehicles carrying logistics and propellant to the International Space Station (ISS). These new vehicles were the European Space Agency s (ESA) Automated Transfer Vehicle (ATV), the Jules Verne, and the Japanese Aerospace and Explorations Agency s (JAXA) H-II Transfer Vehicle (HTV). The ISS Program wanted to quantify the increased risk to the ISS from these visiting vehicles. At the time, only the Shuttle, the Soyuz, and the Progress vehicles rendezvoused and docked to the ISS. The increased risk to the ISS was from an increase in vehicle traffic, thereby, increasing the potential catastrophic collision during the rendezvous and the docking or berthing of the spacecraft to the ISS. A universal method of evaluating the risk of rendezvous and docking or berthing was created by the ISS s Risk Team to accommodate the increasing number of rendezvous and docking or berthing operations due to the increasing number of different spacecraft, as well as the future arrival of commercial spacecraft. Before the first docking attempt of ESA's ATV and JAXA's HTV to the ISS, a probabilistic risk model was developed to quantitatively calculate the risk of collision of each spacecraft with the ISS. The 5 rendezvous and docking risk models (Soyuz, Progress, Shuttle, ATV, and HTV) have been used to build and refine the modeling methodology for rendezvous and docking of spacecrafts. This risk modeling methodology will be NASA s basis for evaluating the addition of future ISS visiting spacecrafts hazards, including SpaceX s Dragon, Orbital Science s Cygnus, and NASA s own Orion spacecraft. This paper will describe the methodology used for developing a visiting vehicle risk model.

  13. Robust H ∞ Control for Spacecraft Rendezvous with a Noncooperative Target

    Science.gov (United States)

    Wu, Shu-Nan; Zhou, Wen-Ya; Tan, Shu-Jun; Wu, Guo-Qiang

    2013-01-01

    The robust H ∞ control for spacecraft rendezvous with a noncooperative target is addressed in this paper. The relative motion of chaser and noncooperative target is firstly modeled as the uncertain system, which contains uncertain orbit parameter and mass. Then the H ∞ performance and finite time performance are proposed, and a robust H ∞ controller is developed to drive the chaser to rendezvous with the non-cooperative target in the presence of control input saturation, measurement error, and thrust error. The linear matrix inequality technology is used to derive the sufficient condition of the proposed controller. An illustrative example is finally provided to demonstrate the effectiveness of the controller. PMID:24027446

  14. Observer-Based Robust Control for Spacecraft Rendezvous with Thrust Saturation

    Directory of Open Access Journals (Sweden)

    Neng Wan

    2014-01-01

    Full Text Available This paper proposes an observer-based robust guaranteed cost control method for thrust-limited rendezvous in near-circular orbits. Treating the noncircularity of the target orbit as a parametric uncertainty, a linearized motion model derived from the two-body problem is adopted as the controlled plant. Based on this model, a robust guaranteed cost observer-controller is synthesized with a less conservative saturation control law, and sufficient condition for the existence of this observer-based rendezvous controller is derived. Finally, an illustrative example with immeasurable velocity states is presented to demonstrate the advantages and effectiveness of the control scheme.

  15. Concurrent image-based visual servoing with adaptive zooming for non-cooperative rendezvous maneuvers

    Science.gov (United States)

    Pomares, Jorge; Felicetti, Leonard; Pérez, Javier; Emami, M. Reza

    2018-02-01

    An image-based servo controller for the guidance of a spacecraft during non-cooperative rendezvous is presented in this paper. The controller directly utilizes the visual features from image frames of a target spacecraft for computing both attitude and orbital maneuvers concurrently. The utilization of adaptive optics, such as zooming cameras, is also addressed through developing an invariant-image servo controller. The controller allows for performing rendezvous maneuvers independently from the adjustments of the camera focal length, improving the performance and versatility of maneuvers. The stability of the proposed control scheme is proven analytically in the invariant space, and its viability is explored through numerical simulations.

  16. Percutaneous-endoscopic rendezvous procedure for the management of bile duct injuries after cholecystectomy: short- and long-term outcomes.

    Science.gov (United States)

    Schreuder, Anne Marthe; Booij, Klaske A C; de Reuver, Philip R; van Delden, Otto M; van Lienden, Krijn P; Besselink, Marc G; Busch, Olivier R; Gouma, Dirk J; Rauws, Erik A J; van Gulik, Thomas M

    2018-01-19

     Bile duct injury (BDI) remains a daunting complication of laparoscopic cholecystectomy. In patients with complex BDI, a percutaneous-endoscopic rendezvous procedure may be required to establish bile duct continuity. The aim of this study was to assess short- and long-term outcomes of the rendezvous procedure.  All consecutive patients with BDI referred to our tertiary referral center between 1995 and 2016 were analyzed. A rendezvous procedure was performed when endoscopic or radiologic intervention failed, and when deemed feasible by a dedicated multidisciplinary team including hepatopancreaticobiliary surgeons, gastrointestinal endoscopists, and interventional radiologists. Classification of BDI, technical success of the rendezvous procedure, procedure-related adverse events, and outcomes were assessed.  Among a total of 812 patients, rendezvous was performed in 47 (6 %), 31 (66 %) of whom were diagnosed with complete transection of the bile duct (Amsterdam type D/Strasberg type E injury). The primary success rate of rendezvous was 94 % (44 /47 patients). Overall morbidity was 18 % (10 /55 procedures). No life-threatening adverse events or 90-day mortality occurred. After a median follow-up of 40 months (interquartile range 23 - 54 months), rendezvous was the final successful treatment in 26 /47 patients (55 %). In 14 /47 patients (30 %), rendezvous acted as a bridge to surgery, with hepaticojejunostomy being chosen either primarily or secondarily to treat refractory or relapsing stenosis. In experienced hands, rendezvous was a safe procedure, with a long-term success rate of 55 %. When endoscopic or transhepatic interventions fail to restore bile duct continuity in patients with BDI, rendezvous should be considered, either as definitive treatment or as a bridge to elective surgery. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Ovarian Suspension With Adjustable Sutures: An Easy and Helpful Technique for Facilitating Laparoendoscopic Single-Site Gynecologic Surgery.

    Science.gov (United States)

    Chen, Kuo-Hu; Chen, Li-Ru; Seow, Kok-Min

    2015-01-01

    To describe a method of ovarian suspension with adjustable sutures (OSAS) for facilitating laparoendoscopic single-site gynecologic surgery (LESS) and to investigate the effect of OSAS on LESS. Prospective cohort study (Canadian Task Force classification: II-2). University teaching hospital. One hundred seventy-eight patients with benign 5- to 15-cm cystic ovarian tumors who underwent LESS with OSAS (suspension group, n = 90) and without OSAS (control group, n = 88). For patients who underwent OSAS (suspension group), 1 end of double-head straight needles with a polypropylene suture was inserted into the pelvic cavity through the abdominal skin to penetrate the cyst or ovarian parenchyma and puncture outside the abdominal skin. After cutting off the needles, both sides of the remaining suture were held together by a clamp, without knotting, so that the manipulator could "lift," "loosen," or "fix" the stitches to adjust the tension. The average time to create OSAS was 2.9 min. For the suspension and control groups, the average blood loss was 81.4 and 131.8 mL (p < .001), and the operative time was 42.0 and 61.3 min (p < .001), respectively. There were no significant differences in the incidence of complications (5.6% vs 9.1%; p = .365), but there were significant differences in conversions to standard non-single-site laparoscopy (5.6% vs 15.9%; p = .025) and laparotomy (1.1% vs 6.8%; p = .040). Logistic regression analysis revealed that the ratios of conversion to standard non-single-site laparoscopy (odds ratio [OR], 0.126; 95% confidence interval [CI], 0.311-0.508) and laparotomy (OR, 0.032; 95% CI, 0.002-0.479) were much lower in the suspension group; the risk of complications was comparable (OR, 0.346; 95% CI, 0.085-1.403). OSAS is an easy, safe, and feasible method that offers advantages during LESS. Although routine use of OSAS is not necessary, OSAS can be considered during LESS to facilitate the surgery. Copyright © 2015 AAGL. Published by Elsevier Inc. All

  18. Open and laparo-endoscopic repair of incarcerated abdominal wall hernias by the use of biological and biosynthetic meshes

    Directory of Open Access Journals (Sweden)

    René H Fortelny

    2016-02-01

    Full Text Available Introduction: Although recently published guidelines recommend against the use of synthetic non-absorbable materials in cases of potentially contaminated or contaminated surgical fields due to the increased risk of infection [1, 2], the use of bio-prosthetic meshes for abdominal wall or ventral hernia repair is still controversially discussed in such cases. Bio-prosthetic meshes have been recommended due to less susceptibility for infection and the decreased risk of subsequent mesh explantation. The purpose of this review is to elucidate if there are any indications for the use of biological and biosynthetic meshes in incarcerated abdominal wall hernias based on the recently published literature.Methods: A literature search of the Medline database using the PubMed search engine, using the keywords returned 486 articles up to June 2015. The full text of 486 articles was assessed and 13 relevant papers were identified including 5 retrospective case cohort studies, 2 case controlled studies, 6 case series.Results: The results of Franklin et al [23, 24, 25] included the highest number of biological mesh repairs (Surgisis® by laparoscopic IPOM in infected fields which demonstrated a very low incidence of infection and recurrence (0,7% and 5,2%. Han et al [26] reported in his retrospective study the highest number of treated patients due to incarcerated hernias by open approach using acellular dermal matrix (ADM® with very low rate of infection as well as recurrences (1,6% and 15,9. Both studies achieved acceptable outcome in a follow up of at least 3,5 years compared to the use of synthetic mesh in this high-risk population [3]Conclusion:Currently there is a very limited evidence for the use of biological and biosynthetic meshes in strangulated hernias in either open or laparo-endoscopic repair. Finally, there is an urgent need to start with randomized controlled comparative trials as well as to support registries with data to achieve more

  19. The Rendezvous Technique for Common Bile Duct Stones: A Meta-Analysis.

    Science.gov (United States)

    Huang, Long; Yu, Qing-sheng; Zhang, Qi; Liu, Ju-da; Wang, Zhen

    2015-12-01

    This article aimed to clarify the effectiveness and the efficiency of the rendezvous technique for patients with common bile duct stones. Four databases were searched on associations with rendezvous treatment. Six randomized controlled trials were evaluated for their success rate, stone clearance, morbidity, mortality, conversions, hospital stay, operating time, and hospitalization charges. This meta-analysis suggested no significant difference between the rendezvous group and the sequence group in the success rate and the stone clearance, but showed significant differences in the morbidity [odds ratio (OR)=0.54; 95% confidence intervals (CI), 0.30, 0.96], conversions (OR=0.40; 95% CI, 0.16, 0.97), the length of hospital stay (OR=-1.97; 95% CI, -2.29, -1.66), and the operating time (OR=12.95; 95% CI, 7.66, 18.24). The rendezvous technique is as effective as sequential endoscopic management for patients with common bile duct stones in its success rate and stone clearance, but the former is preferred in terms of morbidity, hospital stay, and hospitalization charges.

  20. Rendezvous procedure for the treatment of bile leaks and injury following segmental hepatectomy.

    Science.gov (United States)

    Nasr, John Y; Hashash, Jana G; Orons, Philip; Marsh, Wallis; Slivka, Adam

    2013-05-01

    Endoscopic retrograde cholangiopancreatography is a minimally invasive procedure used for the evaluation and management of biliary injuries. At times, ERCP fails and percutaneous modalities may be required. Rendezvous procedures are combined endoscopic and percutaneous techniques that have been used to restore anatomic continuity and biliary drainage in cases where retrograde and/or transhepatic access alone has failed either due to anatomic variation or traumatic injury with biloma formation. To assess if the Rendezvous technique plays a role in establishing biliary continuity in patients with a bile leak after segmental hepatectomy. We herby present a series of 3 patients who had complex bile leaks after segmental liver resection and underwent a combined percutaneous and endoscopic Rendezvous procedure to establish biliary continuity. This technique was successful in restoring biliary continuity and avoiding hepaticojejunostomy in 2 of the 3 patients. The Rendezvous technique may play a role in establishing biliary continuity in patients with biliary leak secondary to hepatic surgery. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  1. [Ureteral realignment with the rendezvous procedure in complex ureteral injuries - aspects of technique and our experience].

    Science.gov (United States)

    Brandt, Alexander Sascha; von Rundstedt, F-C; Lazica, D A; Roth, S

    2010-07-01

    The rendezvous procedure for re-establishing ureteral continuity after complex ureteral injuries is introduced and we present our experience with this technique. Aspects of the technique are described in a detailed step-by-step instruction using intraoperative radiographs. We evaluated our patient data from 1998 until 2009 for cases in which the rendezvous procedure was attempted. The rendezvous procedure was used in a total of 11 patients. Realignment was successful in 10 cases (90.9 %) and the initial nephrostomy could be removed. In 3 of 7 cases postoperative removal of the JJ ureteric stent was successful. In 7 patients the final surgical ureter reconstruction was performed after a medium period of 7 months. 5 cases of ureteroneocystostomy and 2 cases of reconstruction of the ureter either with colon or ileum segments were accomplished. In 1 patient a permanent maintenance of the DJ ureteral stent was necessary. Ureteral realignment with the rendezvous procedure enables disposition of the ureteral stent in many cases, exclusively antegrade or retrograde procedures failed. By this means nephrostomy could be spared as a temporary or permanent solution and a better chance of restitutio ad integrum could be realised. Georg Thieme Verlag KG Stuttgart * New York.

  2. Rendezvous and Docking Strategy for Crewed Segment of the Asteroid Redirect Mission

    Science.gov (United States)

    Hinkel, Heather D.; Cryan, Scott P.; D'Souza, Christopher; Dannemiller, David P.; Brazzel, Jack P.; Condon, Gerald L.; Othon, William L.; Williams, Jacob

    2014-01-01

    This paper will describe the overall rendezvous, proximity operations and docking (RPOD) strategy in support of the Asteroid Redirect Crewed Mission (ARCM), as part of the Asteroid Redirect Mission (ARM). The focus of the paper is on the crewed mission phase of ARM, starting with the establishment of Orion in the Distant Retrograde Orbit (DRO) and ending with docking to the Asteroid Redirect Vechicle (ARV). The paper will detail the sequence of maneuvers required to execute the rendezvous and proximity operations mission phases along with the on-board navigation strategies, including the final approach phase. The trajectories to be considered will include target vehicles in a DRO. The paper will also discuss the sensor requirements for rendezvous and docking and the various trade studies associated with the final sensor selection. Building on the sensor requirements and trade studies, the paper will include a candidate sensor concept of operations, which will drive the selection of the sensor suite; concurrently, it will be driven by higher level requirements on the system, such as crew timeline constraints and vehicle consummables. This paper will address how many of the seemingly competing requirements will have to be addressed to create a complete system and system design. The objective is to determine a sensor suite and trajectories that enable Orion to successfully rendezvous and dock with a target vehicle in trans lunar space. Finally, the paper will report on the status of a NASA action to look for synergy within RPOD, across the crewed and robotic asteroid missions.

  3. Optimal planning approaches with multiple impulses for rendezvous based on hybrid genetic algorithm and control method

    Directory of Open Access Journals (Sweden)

    JingRui Zhang

    2015-03-01

    Full Text Available In this article, we focus on safe and effective completion of a rendezvous and docking task by looking at planning approaches and control with fuel-optimal rendezvous for a target spacecraft running on a near-circular reference orbit. A variety of existent practical path constraints are considered, including the constraints of field of view, impulses, and passive safety. A rendezvous approach is calculated by using a hybrid genetic algorithm with those constraints. Furthermore, a control method of trajectory tracking is adopted to overcome the external disturbances. Based on Clohessy–Wiltshire equations, we first construct the mathematical model of optimal planning approaches of multiple impulses with path constraints. Second, we introduce the principle of hybrid genetic algorithm with both stronger global searching ability and local searching ability. We additionally explain the application of this algorithm in the problem of trajectory planning. Then, we give three-impulse simulation examples to acquire an optimal rendezvous trajectory with the path constraints presented in this article. The effectiveness and applicability of the tracking control method are verified with the optimal trajectory above as control objective through the numerical simulation.

  4. Lyapunov design of event-based controllers for the rendez-vous of coupled systems

    NARCIS (Netherlands)

    De Persis, Claudio; Postoyan, Romain

    2014-01-01

    The objective is to present a new type of triggering conditions together with new proof concepts for the event-based coordination of multi-agents. As a first step, we focus on the rendez-vous of two identical systems modeled as double integrators with additional damping in the velocity dynamics. The

  5. Endoskopisk ultralydvejledt rendezvous til intern drænage ved galdevejsobstruktion

    DEFF Research Database (Denmark)

    Knudsen, Marie Høxbro; Vilmann, Peter; Hassan, Hazem

    2015-01-01

    Endoscopic retrograde cholangiography (ERCP) is currently standard treatment for biliary drainage. Endoscopic ultrasound guided rendezvous (EUS-RV) is a novel method to overcome an unsuccessful biliary drainage procedure. Under endoscopic ultrasound guidance a guidewire is passed via a needle from...

  6. Rendezvous terminal phase automatic braking sequencing and targeting. [for space shuttle orbiter

    Science.gov (United States)

    Kachmar, P. M.

    1973-01-01

    The purpose of the rendezvous terminal phase braking program is to provide the means of automatically bringing the primary orbiter within desired station keeping boundaries relative to the target satellite. A detailed discussion is presented on the braking program and its navigation, targeting, and guidance functions.

  7. Comparison of EUS-guided rendezvous and precut papillotomy techniques for biliary access (with videos).

    Science.gov (United States)

    Dhir, Vinay; Bhandari, Suryaprakash; Bapat, Mukta; Maydeo, Amit

    2012-02-01

    Precut papillotomy after failed bile duct cannulation is associated with an increased risk of pancreatitis. EUS-guided rendezvous drainage is a novel alternative technique, but there are no data comparing this approach with precut papillotomy. To evaluate the safety and efficacy of EUS-guided rendezvous drainage of the bile duct and compare its outcome with that of precut papillotomy. Retrospective study. Tertiary care referral center. Consecutive patients with distal bile duct obstruction, in whom selective cannulation of the bile duct at ERCP failed after 5 attempts with a guidewire and sphincterotome, underwent an EUS-guided rendezvous procedure. The outcomes were compared with those in a historical cohort of patients who underwent precut papillotomy. Patients in whom selective cannulation failed underwent EUS-guided rendezvous drainage by use of the short wire technique or precut papillotomy by use of the Erlangen papillotome. At EUS, after the extrahepatic bile duct was punctured with a 19-gauge needle, a hydrophilic angled-tip guidewire 260 cm long was passed in an antegrade manner across the papilla into the duodenum. The echoendoscope was then exchanged for a duodenoscope, which was introduced alongside the EUS-placed guidewire. The transpapillary guidewire was retrieved through its biopsy channel, and accessories were passed over the wire to perform the requisite endotherapy. Comparison of the rates of technical success and complications between patients treated by the EUS-guided rendezvous and those treated by precut papillotomy techniques. Treatment success was defined as completion of the requisite endotherapy in one treatment session. Treatment success was significantly higher for the EUS-guided rendezvous (57/58 patients) than for those undergoing precut papillotomy technique (130/144 patients) (98.3% vs 90.3%; P = .03). There was no significant difference in the rate of procedural complications between the EUS and precut papillotomy techniques (3

  8. Optimal starting conditions for the rendezvous maneuver: Analytical and computational approach

    Science.gov (United States)

    Ciarcia, Marco

    The three-dimensional rendezvous between two spacecraft is considered: a target spacecraft on a circular orbit around the Earth and a chaser spacecraft initially on some elliptical orbit yet to be determined. The chaser spacecraft has variable mass, limited thrust, and its trajectory is governed by three controls, one determining the thrust magnitude and two determining the thrust direction. We seek the time history of the controls in such a way that the propellant mass required to execute the rendezvous maneuver is minimized. Two cases are considered: (i) time-to-rendezvous free and (ii) time-to-rendezvous given, respectively equivalent to (i) free angular travel and (ii) fixed angular travel for the target spacecraft. The above problem has been studied by several authors under the assumption that the initial separation coordinates and the initial separation velocities are given, hence known initial conditions for the chaser spacecraft. In this paper, it is assumed that both the initial separation coordinates and initial separation velocities are free except for the requirement that the initial chaser-to-target distance is given so as to prevent the occurrence of trivial solutions. Two approaches are employed: optimal control formulation (Part A) and mathematical programming formulation (Part B). In Part A, analyses are performed with the multiple-subarc sequential gradient-restoration algorithm for optimal control problems. They show that the fuel-optimal trajectory is zero-bang, namely it is characterized by two subarcs: a long coasting zero-thrust subarc followed by a short powered max-thrust braking subarc. While the thrust direction of the powered subarc is continuously variable for the optimal trajectory, its replacement with a constant (yet optimized) thrust direction produces a very efficient guidance trajectory. Indeed, for all values of the initial distance, the fuel required by the guidance trajectory is within less than one percent of the fuel required

  9. Diagnostic Laparoscopy as Decision Tool for Re-recurrent Inguinal Hernia Treatment Following Open Anterior and Laparo-Endoscopic Posterior Repair

    Directory of Open Access Journals (Sweden)

    Ferdinand Köckerling

    2017-05-01

    Full Text Available IntroductionThe guidelines of the international hernia societies recommend posterior repair in laparo-endoscopic technique for recurrent inguinal hernia after open anterior mesh repair and, conversely, open anterior repair for recurrence after laparo-endoscopic primary repair. Even when these guidelines are followed, already 1 year after repair a re-recurrence rate of 1–2% must be expected, with that rate rising further in the subsequent years. Accordingly, increasingly more patients with re-recurrence after anterior and posterior mesh implantation must be treated, which constitutes a problem that to date has been investigated in only very few studies. Hence, there are no well-founded recommendations. This paper now presents a number of case reports aimed at identifying the role of explorative laparoscopy as decision tool for re-recurrent inguinal hernia treatment.Patients and methodsBased on three case reports the role of explorative laparoscopy as decision tool for re-recurrent inguinal hernia treatment is presented below.ResultsIn all the three cases described explorative laparoscopy played a key role as decision tool when deciding how best to treat re-recurrence after anterior and posterior inguinal hernia repair. In one case severe adhesions after robotic prostatectomy and in another case correct placement of the mesh in the posterior plane, adhesions from the cecum to the groin region and no definitive finding of a re-recurrence resulted in an open repair. In the third case, an insufficient laparoscopic posterior mesh placement made the re-recurrent TAPP procedure relatively easy.ConclusionExplorative laparoscopy is an important decision tool for re-recurrent inguinal hernia treatment to minimize the risks of the procedure for the patients.

  10. The Effect of Air Drag in Optimal Power-Limited Rendezvous Between Coplanar Low-Earth Orbits

    Directory of Open Access Journals (Sweden)

    Gil-Young Maeng

    1998-06-01

    Full Text Available The effect of air drag was researched when a low-earth orbit spacecraft using power-limited thruster rendezvoused another low-earth orbit spacecraft. The air density was assumed to decrease exponentially. The radius of parking orbit was 6655.935 km and that of target orbit was 7321.529 km. From the trajectories of active vehicles, the fuel consumption and the magnitude of thrust acceleration, we could conclude that the effect of air drag had to be considered in fuel optimal rendezvous problem between low-earth orbit spacecrafts. In multiple-revolution rendezvous case, the air drag was more effective.

  11. Laparoendoscopic Single-Site Surgery for the Treatment of Benign Adnexal Disease: A Prospective Trial

    Directory of Open Access Journals (Sweden)

    Anna Fagotti

    2010-01-01

    Full Text Available Background. To validate feasibility, efficacy, and safeness of laparoscopic treatment of benign adnexal diseases through a single transumbilical access (LESS in a prospective series of patients. Methods. A prospective clinical trial including 30 women has been conducted at the Division of Gynecology of Catholic University of Sacred Hearth of Rome. Patients underwent different laparoscopic procedures by LESS utilizing a multiport trocar and conventional straight laparoscopic instrumentation. Intra and perioperative outcome has been reported. Results. Ten mono/bilateral adnexectomies and 20 cystectomies have been performed by LESS approach. Laparoscopic procedures were completed through a single access in 28 cases (93.4%. No major intra- or postoperative complications were observed. Mean hospital stay was 1.3 days. Conclusions. LESS approach is feasible to treat benign adnexal disease with a very low conversion rate and no early or late complications. More clinical data are needed to confirm these advantages compared to standard laparoscopic technique.

  12. Usefulness of combined percutaneous-endoscopic rendezvous techniques after failed therapeutic endoscopic retrograde cholangiography in the era of endoscopic ultrasound guided rendezvous.

    Science.gov (United States)

    Yang, Min Jae; Kim, Jin Hong; Hwang, Jae Chul; Yoo, Byung Moo; Kim, Soon Sun; Lim, Sun Gyo; Won, Je Hwan

    2017-12-01

    The rendezvous approach is a salvage technique after failure of endoscopic retrograde cholangiography (ERC). In certain circumstances, percutaneous-endoscopic rendezvous (PE-RV) is preferred, and endoscopic ultrasound-guided rendezvous (EUS-RV) is difficult to perform. We aimed to evaluate PE-RV outcomes, describe the PE-RV techniques, and identify potential indications for PE-RV over EUS-RV.Retrospective analysis was conducted of a prospectively designed ERC database between January 2005 and December 2016 at a tertiary referral center including cases where PE-RV was used as a salvage procedure after ERC failure.During the study period, PE-RV was performed in 42 cases after failed therapeutic ERC; 15 had a surgically altered enteric anatomy. The technical success rate of PE-RV was 92.9% (39/42), with a therapeutic success rate of 88.1% (37/42). Potential indications for PE-RV over EUS-RV were identified in 23 cases, and either PE-RV or EUS-RV could have effectively been used in 19 cases. Endoscopic bile duct access was successfully achieved with PE-RV in 39 cases with accessible biliary orifice using one of PE-RV cannulation techniques (classic, n = 11; parallel, n = 19; and adjunctive maneuvers, n = 9).PE-RV uses a unique technology and has clinical indications that distinguish it from EUS-RV. Therefore, PE-RV can still be considered a useful salvage technique for the treatment of biliary obstruction after ERC failure.

  13. Guidance and Navigation for Rendezvous and Proximity Operations with a Non-Cooperative Spacecraft at Geosynchronous Orbit

    Science.gov (United States)

    Barbee, Brent William; Carpenter, J. Russell; Heatwole, Scott; Markley, F. Landis; Moreau, Michael; Naasz, Bo J.; VanEepoel, John

    2010-01-01

    The feasibility and benefits of various spacecraft servicing concepts are currently being assessed, and all require that the servicer spacecraft perform rendezvous, proximity, and capture operations with the target spacecraft to be serviced. Many high-value spacecraft, which would be logical targets for servicing from an economic point of view, are located in geosynchronous orbit, a regime in which autonomous rendezvous and capture operations are not commonplace. Furthermore, existing GEO spacecraft were not designed to be serviced. Most do not have cooperative relative navigation sensors or docking features, and some servicing applications, such as de-orbiting of a non-functional spacecraft, entail rendezvous and capture with a spacecraft that may be non-functional or un-controlled. Several of these challenges have been explored via the design of a notional mission in which a nonfunctional satellite in geosynchronous orbit is captured by a servicer spacecraft and boosted into super-synchronous orbit for safe disposal. A strategy for autonomous rendezvous, proximity operations, and capture is developed, and the Orbit Determination Toolbox (ODTBX) is used to perform a relative navigation simulation to assess the feasibility of performing the rendezvous using a combination of angles-only and range measurements. Additionally, a method for designing efficient orbital rendezvous sequences for multiple target spacecraft is utilized to examine the capabilities of a servicer spacecraft to service multiple targets during the course of a single mission.

  14. Robust H(∞) control for spacecraft rendezvous with a noncooperative target.

    Science.gov (United States)

    Wu, Shu-Nan; Zhou, Wen-Ya; Tan, Shu-Jun; Wu, Guo-Qiang

    2013-01-01

    The robust H(∞) control for spacecraft rendezvous with a noncooperative target is addressed in this paper. The relative motion of chaser and noncooperative target is firstly modeled as the uncertain system, which contains uncertain orbit parameter and mass. Then the H(∞) performance and finite time performance are proposed, and a robust H(∞) controller is developed to drive the chaser to rendezvous with the non-cooperative target in the presence of control input saturation, measurement error, and thrust error. The linear matrix inequality technology is used to derive the sufficient condition of the proposed controller. An illustrative example is finally provided to demonstrate the effectiveness of the controller.

  15. Failed common bile duct cannulation during pregnancy: Rescue with endoscopic ultrasound guided rendezvous procedure.

    Science.gov (United States)

    Singla, Vikas; Arora, Anil; Tyagi, Pankaj; Sharma, Praveen; Bansal, Naresh; Kumar, Ashish

    2016-01-01

    Common bile duct (CBD) stones can lead to serious complications and require intervention with either endoscopic retrograde cholangiopancreatography (ERCP) or laparoscopic techniques for urgent relief. On an average 10%-20% of the patients with gall bladder stones can have associated CBD stones. CBD stones during pregnancy can be associated with hazardous complications for both the mother and the fetus. Failed cannulation while performing ERCP during pregnancy is a technically demanding situation, which requires immediate rescue with special techniques. Conventional rescue techniques may not be feasible and can be associated with hazardous consequences. Endoscopic ultrasound (EUS) guided rendezvous technique has now emerged as a safe alternative, and in one of our patients, this technique was successfully attempted. To the best of our knowledge, this is the first case report in the literature on EUS-guided rendezvous procedure during pregnancy.

  16. "Rendezvous technique" for intraluminal vacuum therapy of anastomotic leakage of the jejunum.

    Science.gov (United States)

    Krajinovic, K; Reimer, S; Kudlich, T; Germer, C T; Wiegering, A

    2016-12-01

    Anastomotic leakage (AL) is one of the most common and serious complications following visceral surgery. In recent years, endoluminal vacuum therapy has dramatically changed therapeutic options for AL, but its use has been limited to areas easily accessible by endoscope. We describe the first use of endoluminal vacuum therapy in the small intestine employing a combined surgical and endoscopic "rendezvous technique" in which the surgeon assists the endoscopic placement of an endoluminal vacuum therapy sponge in the jejunum by means of a pullback string. This technique led to a completely closed AL after 27 days and 7 changes of the endosponge. The combined surgical and endoscopic rendezvous technique can be useful in cases of otherwise difficult endosponge placement.

  17. Choledocholithiasis and endo-laparoscopic rendezvous. Analysis of 59 consecutive cases.

    Science.gov (United States)

    Del Rio, Paolo; Dell'Abate, Paolo; Labonia, Domenico; Negri, Marco; Sianesi, Nicoletta; Arcuri, Maria Francesca; Sianesi, Mario

    2011-01-01

    Choledocholithiasis is a real problem of major clinical importance. The incidence of cholelithiasis is 10-20%. We have examined 2907 patients treated with videolaparoscopic cholecystectomy (VLC) between January 2001 and September 2009. 214 cases (7.4%) were affected by choledocolithiasis; among these, 59 consecutive cases were treated by rendezvous, 151 cases by sequential treatment (ERCP-ES before VLC), 3 cases by extraction with Dormia's basket, and 1 case by ERCP-ES after VLC. The complications were one biliary fistula and three hemorrhages (one from the cystic artery, one from the hepatic area and one from trocar's site). The mean hospital stay was 1.38 +/- 0.83 days for the rendezvous group vs 4 53 +/- 0.74 days in the sequential treatment group (prendezvous procedure reduces hospital stay and has a greater compliance (only one treatment). We can use this option in the management of cases where preoperative ERCP-ES has failed.

  18. Radiation effects in the Si-PIN detector on the Near Earth Asteroid Rendezvous mission

    CERN Document Server

    Starr, R; Evans, L G; Floyd, S R; McClanahan, T P; Trombka, J I; Goldsten, J O; Maurer, R H; McNutt, R L; Roth, D R

    1999-01-01

    A Si-PIN photodiode is being used as a solar X-ray monitor on the X-ray/gamma-ray spectrometer experiment which is flying on the Near Earth Asteroid Rendezvous spacecraft. Since its launch in February 1996 this photodiode has experienced several brief failures. These anomalies and other performance characteristics will be described. Efforts to reproduce these failures in ground tests with flight spare equipment will also be discussed.

  19. Image-guided ureteral reconstruction using rendezvous technique for complex ureteric transection after gunshot injuries.

    Science.gov (United States)

    Arabi, Mohammad; Mat'hami, Abdulaziz; Said, Mohammad T; Bulbul, Muhammad; Haddad, Maurice; Al-Kutoubi, Aghiad

    2016-01-01

    Management of complex ureteric transection poses a significant clinical challenge, particularly after gunshot injuries due to marked distortion of anatomy and associated tissue loss. We report two cases of total ureteric transection due to gunshot injury successfully repaired using fluoroscopy-guided rendezvous procedure and double J stent placement. This minimally invasive approach may offer a safe and effective technique to repair complete ureteral transection and obviate the need for complex surgical procedures.

  20. Rendezvous Protocols and Dynamic Frequency Hopping Interference Design for Anti-Jamming Satellite Communication

    Science.gov (United States)

    2013-11-25

    previously considered this proactive approach to combat unintentional, persistent (non- reactive) interference . In this project, we plan on extending our...channel” (or code ) by chance, through public knowledge of the underlying protocol semantics , or by compromising one of the network devices. An alternative...AFRL-RV-PS- AFRL-RV-PS- TR-2013-0142 TR-2013-0142 RENDEZVOUS PROTOCOLS AND DYNAMIC FREQUENCY HOPPING INTERFERENCE DESIGN FOR ANTI-JAMMING

  1. A "rendezvous technique" for treating a pancreatic fistula after distal pancreatectomy.

    Science.gov (United States)

    Imai, Daisuke; Yamashita, Yo-ichi; Ikegami, Toru; Toshima, Takeo; Harimoto, Norifumi; Yoshizumi, Tomoharu; Soejima, Yuji; Shirabe, Ken; Ikeda, Tetsuo; Maehara, Yoshihiko

    2015-01-01

    Pancreatic fistulae are a major complication of distal pancreatectomy (DP). Some cases of severe pancreatic fistula require invasive procedures. There have been some reports concerning the effectiveness of pancreatic duct drainage through an endoscopic transpapillary approach for pancreatic fistulae. We herein present a case of a pancreatic fistula after DP that was successfully treated with percutaneous pancreatic duct drainage, which was performed using a combined percutaneous and endoscopic approach, named the "rendezvous technique". In our case, we performed distal pancreatectomy with celiac artery resection for a locally advanced pancreatic body cancer. On postoperative day (POD) 7, the drain amylase level increased up to 37,460 IU/l. Computed tomography (CT) revealed peripancreatic fluid collections. On POD 10, we placed a catheter in the main pancreatic duct using the rendezvous technique. CT on POD 14 revealed a decrease in the size of the peripancreatic fluid collection, and contrast imaging from the drains on POD 22 revealed almost complete disappearance of the fluid collection. We withdrew the pigtail catheter on POD 27 and the percutaneous pancreatic duct drain on POD 36. This patient was discharged from our hospital on POD 40. We herein report a new approach called the "rendezvous technique" for the management of pancreatic fistulae after DP that can be used instead of a stressful nasopancreatic tube.

  2. Imaging Flash Lidar for Safe Landing on Solar System Bodies and Spacecraft Rendezvous and Docking

    Science.gov (United States)

    Amzajerdian, Farzin; Roback, Vincent E.; Bulyshev, Alexander E.; Brewster, Paul F.; Carrion, William A; Pierrottet, Diego F.; Hines, Glenn D.; Petway, Larry B.; Barnes, Bruce W.; Noe, Anna M.

    2015-01-01

    NASA has been pursuing flash lidar technology for autonomous, safe landing on solar system bodies and for automated rendezvous and docking. During the final stages of the landing from about 1 kilometer to 500 meters above the ground, the flash lidar can generate 3-Dimensional images of the terrain to identify hazardous features such as craters, rocks, and steep slopes. The onboard flight computer can then use the 3-D map of terrain to guide the vehicle to a safe location. As an automated rendezvous and docking sensor, the flash lidar can provide relative range, velocity, and bearing from an approaching spacecraft to another spacecraft or a space station. NASA Langley Research Center has developed and demonstrated a flash lidar sensor system capable of generating 16,000 pixels range images with 7 centimeters precision, at 20 Hertz frame rate, from a maximum slant range of 1800 m from the target area. This paper describes the lidar instrument and presents the results of recent flight tests onboard a rocket-propelled free-flyer vehicle (Morpheus) built by NASA Johnson Space Center. The flights were conducted at a simulated lunar terrain site, consisting of realistic hazard features and designated landing areas, built at NASA Kennedy Space Center specifically for this demonstration test. This paper also provides an overview of the plan for continued advancement of the flash lidar technology aimed at enhancing its performance to meet both landing and automated rendezvous and docking applications.

  3. The Data Transfer Kit: A geometric rendezvous-based tool for multiphysics data transfer

    International Nuclear Information System (INIS)

    Slattery, S. R.; Wilson, P. P. H.; Pawlowski, R. P.

    2013-01-01

    The Data Transfer Kit (DTK) is a software library designed to provide parallel data transfer services for arbitrary physics components based on the concept of geometric rendezvous. The rendezvous algorithm provides a means to geometrically correlate two geometric domains that may be arbitrarily decomposed in a parallel simulation. By repartitioning both domains such that they have the same geometric domain on each parallel process, efficient and load balanced search operations and data transfer can be performed at a desirable algorithmic time complexity with low communication overhead relative to other types of mapping algorithms. With the increased development efforts in multiphysics simulation and other multiple mesh and geometry problems, generating parallel topology maps for transferring fields and other data between geometric domains is a common operation. The algorithms used to generate parallel topology maps based on the concept of geometric rendezvous as implemented in DTK are described with an example using a conjugate heat transfer calculation and thermal coupling with a neutronics code. In addition, we provide the results of initial scaling studies performed on the Jaguar Cray XK6 system at Oak Ridge National Laboratory for a worse-case-scenario problem in terms of algorithmic complexity that shows good scaling on 0(1 x 104) cores for topology map generation and excellent scaling on 0(1 x 105) cores for the data transfer operation with meshes of O(1 x 109) elements. (authors)

  4. A Ground Testbed to Advance US Capability in Autonomous Rendezvous and Docking Project

    Science.gov (United States)

    D'Souza, Chris

    2014-01-01

    This project will advance the Autonomous Rendezvous and Docking (AR&D) GNC system by testing it on hardware, particularly in a flight processor, with a goal of testing it in IPAS with the Waypoint L2 AR&D scenario. The entire Agency supports development of a Commodity for Autonomous Rendezvous and Docking (CARD) as outlined in the Agency-wide Community of Practice whitepaper entitled: "A Strategy for the U.S. to Develop and Maintain a Mainstream Capability for Automated/Autonomous Rendezvous and Docking in Low Earth Orbit and Beyond". The whitepaper establishes that 1) the US is in a continual state of AR&D point-designs and therefore there is no US "off-the-shelf" AR&D capability in existence today, 2) the US has fallen behind our foreign counterparts particularly in the autonomy of AR&D systems, 3) development of an AR&D commodity is a national need that would benefit NASA, our commercial partners, and DoD, and 4) an initial estimate indicates that the development of a standardized AR&D capability could save the US approximately $60M for each AR&D project and cut each project's AR&D flight system implementation time in half.

  5. Trajectory design for a rendezvous mission to Earth's Trojan asteroid 2010 TK7

    Science.gov (United States)

    Lei, Hanlun; Xu, Bo; Zhang, Lei

    2017-12-01

    In this paper a rendezvous mission to the Earth's Trojan asteroid 2010 TK7 is proposed, and preliminary transfer trajectories are designed. Due to the high inclination (∼ 20.9°) of the target asteroid relative to the ecliptic plane, direct transfers usually require large amounts of fuel consumption, which is beyond the capacity of current technology. As gravity assist technique could effectively change the inclination of spacecraft's trajectory, it is adopted to reduce the launch energy and rendezvous velocity maneuver. In practical computation, impulsive and low-thrust, gravity-assisted trajectories are considered. Among all the trajectories computed, the low-thrust gravity-assisted trajectory with Venus-Earth-Venus (V-E-V) swingby sequence performs the best in terms of propellant mass. For a spacecraft with initial mass of 800 kg , propellant mass of the best trajectory is 36.74 kg . Numerical results indicate that both the impulsive and low-thrust, gravity-assisted trajectories corresponding to V-E-V sequence could satisfy mission constraints, and can be applied to practical rendezvous mission.

  6. The Data Transfer Kit: A geometric rendezvous-based tool for multiphysics data transfer

    Energy Technology Data Exchange (ETDEWEB)

    Slattery, S. R.; Wilson, P. P. H. [Department of Engineering Physics, University of Wisconsin - Madison, 1500 Engineering Dr., Madison, WI 53706 (United States); Pawlowski, R. P. [Sandia National Laboratories, P.O. Box 5800, Albuquerque, NM 87185 (United States)

    2013-07-01

    The Data Transfer Kit (DTK) is a software library designed to provide parallel data transfer services for arbitrary physics components based on the concept of geometric rendezvous. The rendezvous algorithm provides a means to geometrically correlate two geometric domains that may be arbitrarily decomposed in a parallel simulation. By repartitioning both domains such that they have the same geometric domain on each parallel process, efficient and load balanced search operations and data transfer can be performed at a desirable algorithmic time complexity with low communication overhead relative to other types of mapping algorithms. With the increased development efforts in multiphysics simulation and other multiple mesh and geometry problems, generating parallel topology maps for transferring fields and other data between geometric domains is a common operation. The algorithms used to generate parallel topology maps based on the concept of geometric rendezvous as implemented in DTK are described with an example using a conjugate heat transfer calculation and thermal coupling with a neutronics code. In addition, we provide the results of initial scaling studies performed on the Jaguar Cray XK6 system at Oak Ridge National Laboratory for a worse-case-scenario problem in terms of algorithmic complexity that shows good scaling on 0(1 x 104) cores for topology map generation and excellent scaling on 0(1 x 105) cores for the data transfer operation with meshes of O(1 x 109) elements. (authors)

  7. Society of Laparoendoscopic Surgeons

    Science.gov (United States)

    ... the Minimally Invasive Surgery and Therapy World. Nezhat’s History of Endoscopy In 2005 pioneering surgeon Dr. Camran Nezhat was awarded a fellowship by The American College of Obstetrics and Gynecology to research and write this important ...

  8. Wyoming's Early Settlement and Ethnic Groups, Unit IV.

    Science.gov (United States)

    Robinson, Terry

    This unit on Wyoming's early settlement and ethnic groups provides concepts, activities, stories, charts, and graphs for elementary school students. Concepts include the attraction Wyoming held for trappers; the major social, economic, and religious event called "The Rendezvous"; the different ethnic and religious groups that presently…

  9. Proximal tibiofibular joint: Rendezvous with a forgotten articulation

    Directory of Open Access Journals (Sweden)

    Amitav Sarma

    2015-01-01

    Full Text Available The proximal tibiofibular joint (PTFJ is a plane type synovial joint. The primary function of the PTFJ is dissipation of torsional stresses applied at the ankle and the lateral tibial bending moments besides a very significant tensile, rather than compressive weight bearing. Though rare, early diagnosis and treatment of the PTFJ dislocation are essential to prevent chronic joint instability and extensive surgical intervention to restore normal PTFJ biomechanics, ankle and knee function, especially in athletes prone to such injuries. PTFJ dislocations often remain undiagnosed in polytrauma scenario with ipsilateral tibial fracture due to the absence of specific signs and symptoms of PTFJ injury. Standard orthopedic textbooks generally describe no specific tests or radiological signs for assessment of the integrity of this joint. The aim of this paper was to review the relevant clinical anatomy, biomechanics and traumatic pathology of PTFJ with its effect on the knee emphasizing the importance of early diagnosis through a high index of suspicion. Dislocation of the joint may have serious implications for the knee joint stability since fibular collateral ligament and posterolateral ligament complex is attached to the upper end of the fibula. Any high energy knee injury with peroneal nerve palsy should immediately raise the suspicion of PTFJ dislocation especially if the mechanism of injury involved knee twisting in flexion beyond 80° and in such cases a comparative radiograph of the contralateral side should be performed. Wider clinical awareness can avoid both embarrassingly extensive surgeries due to diagnostic delays or unnecessary overtreatment due to misinformation on the part of the treating surgeon.

  10. Laparoendoscopic single-site repair of bladder rupture using a home-made single-port device: initial experience of treatment for a traumatic intraperitoneal bladder rupture.

    Science.gov (United States)

    Lee, Joo Yong; Kang, Dong Hyuk; Lee, Seung Wook

    2012-06-01

    We report our initial experience with a laparoendoscopic single-site (LESS) repair of a bladder rupture using a home-made single-port device. A 37-year-old man presented to the emergency department with complaints of voiding difficulty and gross hematuria after blunt trauma. Cystography and computed tomography revealed an intraperitoneal bladder rupture. The patient underwent LESS repair of a bladder rupture using the Alexis wound retractor, which was inserted through the umbilical incision. A home-made single-port device was made by fixing 6½ surgical gloves to the outer rim of the retractor and securing the glove finger to the end of 3 trocars with a tie. Using the flexible laparoscopic instruments and rigid instruments, LESS surgery was performed using a procedure similar to conventional laparoscopic surgery. The patient did not have any voiding problem after removal of the urethral Foley catheter on the 10th postoperative day. To our knowledge, this is the first published report of LESS repair of a traumatic bladder rupture using a home-made single-port device in the literature.

  11. Development of an in vivo visual robot system with a magnetic anchoring mechanism and a lens cleaning mechanism for laparoendoscopic single-site surgery (LESS).

    Science.gov (United States)

    Feng, Haibo; Dong, Dinghui; Ma, Tengfei; Zhuang, Jinlei; Fu, Yili; Lv, Yi; Li, Liyi

    2017-12-01

    Surgical robot systems which can significantly improve surgical procedures have been widely used in laparoendoscopic single-site surgery (LESS). For a relative complex surgical procedure, the development of an in vivo visual robot system for LESS can effectively improve the visualization for surgical robot systems. In this work, an in vivo visual robot system with a new mechanism for LESS was investigated. A finite element method (FEM) analysis was carried out to ensure the safety of the in vivo visual robot during the movement, which was the most important concern for surgical purposes. A master-slave control strategy was adopted, in which the control model was established by off-line experiments. The in vivo visual robot system was verified by using a phantom box. The experiment results show that the robot system can successfully realize the expected functionalities and meet the demands of LESS. The experiment results indicate that the in vivo visual robot with high manipulability has great potential in clinical application. Copyright © 2017 John Wiley & Sons, Ltd.

  12. Comparative Study of 2D and 3D Optical Imaging Systems: Laparoendoscopic Single-Site Surgery in an Ex Vivo Model.

    Science.gov (United States)

    Vilaça, Jaime; Pinto, José Pedro; Fernandes, Sandra; Costa, Patrício; Pinto, Jorge Correia; Leão, Pedro

    2017-12-01

    Usually laparoscopy is performed by means of a 2-dimensional (2D) image system and multiport approach. To overcome the lack of depth perception, new 3-dimensional (3D) systems are arising with the added advantage of providing stereoscopic vision. To further reduce surgery-related trauma, there are new minimally invasive surgical techniques being developed, such as LESS (laparoendoscopic single-site) surgery. The aim of this study was to compare 2D and 3D laparoscopic systems in LESS surgical procedures. All participants were selected from different levels of experience in laparoscopic surgery-10 novices, 7 intermediates, and 10 experts were included. None of the participants had had previous experience in LESS surgery. Participants were chosen randomly to begin their experience with either the 2D or 3D laparoscopic system. The exercise consisted of performing an ex vivo pork cholecystectomy through a SILS port with the assistance of a fixed distance laparoscope. Errors, time, and participants' preference were recorded. Statistical analysis of time and errors between groups was conducted with a Student's t test (using independent samples) and the Mann-Whitney test. In all 3 groups, the average time with the 2D system was significantly reduced after having used the 3D system ( P 3D system. This study suggests that the 3D system may improve the learning curve and that learning from the 3D system is transferable to the 2D environment. Additionally, the majority of participants prefer 3D equipment.

  13. Integrated vision-based GNC for autonomous rendezvous and capture around Mars

    Science.gov (United States)

    Strippoli, L.; Novelli, G.; Gil Fernandez, J.; Colmenarejo, P.; Le Peuvedic, C.; Lanza, P.; Ankersen, F.

    2015-06-01

    Integrated GNC (iGNC) is an activity aimed at designing, developing and validating the GNC for autonomously performing the rendezvous and capture phase of the Mars sample return mission as defined during the Mars sample return Orbiter (MSRO) ESA study. The validation cycle includes testing in an end-to-end simulator, in a real-time avionics-representative test bench and, finally, in a dynamic HW in the loop test bench for assessing the feasibility, performances and figure of merits of the baseline approach defined during the MSRO study, for both nominal and contingency scenarios. The on-board software (OBSW) is tailored to work with the sensors, actuators and orbits baseline proposed in MSRO. The whole rendezvous is based on optical navigation, aided by RF-Doppler during the search and first orbit determination of the orbiting sample. The simulated rendezvous phase includes also the non-linear orbit synchronization, based on a dedicated non-linear guidance algorithm robust to Mars ascent vehicle (MAV) injection accuracy or MAV failures resulting in elliptic target orbits. The search phase is very demanding for the image processing (IP) due to the very high visual magnitude of the target wrt. the stellar background, and the attitude GNC requires very high pointing stability accuracies to fulfil IP constraints. A trade-off of innovative, autonomous navigation filters indicates the unscented Kalman filter (UKF) as the approach that provides the best results in terms of robustness, response to non-linearities and performances compatibly with computational load. At short range, an optimized IP based on a convex hull algorithm has been developed in order to guarantee LoS and range measurements from hundreds of metres to capture.

  14. Combined Surgical and Transhepatic Rendezvous Procedure for Relieving Anastomotic Biliary Obstruction in Children with Liver Transplants.

    Science.gov (United States)

    Crowley, John; Soltys, Kyle; Sindhi, Rakesh; Baskin, Kevin; Yilmaz, Sabri; Close, Orrie; Medsinge, Avinash

    2017-08-01

    Four children (3 boys and 1 girl, age 1.4-9.4 y) presented 2-70 months after liver transplantation (mean 26 months) with high-grade narrowing at the surgical anastomosis that could not be crossed at percutaneous transhepatic cholangiography. Each patient was treated with a combined surgical and interventional radiology "rendezvous" procedure. Biliary drainage catheters were left in place for an average of 6 months after the procedure. At a mean 7.5 months after biliary drainage catheter removal, all children were catheter-free without clinical or biochemical evidence of biliary stricture recurrence. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

  15. Sheath rendezvous method: a novel distal protection technique during endovascular treatment of subclavian artery occlusions.

    Science.gov (United States)

    Haraguchi, Takuya; Urasawa, Kazushi; Nakama, Tatsuya; Nakagawa, Yuya; Tan, Michinao; Koshida, Ryoji; Sato, Katsuhiko

    2016-10-01

    To describe an innovative distal protection technique, "sheath rendezvous method", during endovascular treatment for subclavian arterial occlusions. 4.5F and 6F guiding sheath were inserted from left brachial and common femoral artery, respectively. 0.014″ guidewire retrogradely passed through occlusion and into antegrade sheath to establish a pull-through system. 3.0 mm balloon was used to expand occlusion and anchor to deliver retrograde sheath into antegrade one. Both sheaths locked by balloon dilatation crossed occlusion until antegrade sheath passed over lesion. Balloon expandable stent was delivered within antegrade sheath. Sheath was removed, and stent was implanted. We obtained an excellent outcome without complications.

  16. System and Method for Automated Rendezvous, Docking and Capture of Autonomous Underwater Vehicles

    Science.gov (United States)

    Stone, William C. (Inventor); Clark, Evan (Inventor); Richmond, Kristof (Inventor); Paulus, Jeremy (Inventor); Kapit, Jason (Inventor); Scully, Mark (Inventor); Kimball, Peter (Inventor)

    2018-01-01

    A system for automated rendezvous, docking, and capture of autonomous underwater vehicles at the conclusion of a mission comprising of comprised of a docking rod having lighted, pulsating (in both frequency and light intensity) series of LED light strips thereon, with the LEDs at a known spacing, and the autonomous underwater vehicle specially designed to detect and capture the docking rod and then be lifted structurally by a spherical end strop about which the vehicle can be pivoted and hoisted up (e.g., onto a ship). The method of recovery allows for very routine and reliable automated recovery of an unmanned underwater asset.

  17. Robust control for spacecraft rendezvous system with actuator unsymmetrical saturation: a gain scheduling approach

    Science.gov (United States)

    Wang, Qian; Xue, Anke

    2018-06-01

    This paper has proposed a robust control for the spacecraft rendezvous system by considering the parameter uncertainties and actuator unsymmetrical saturation based on the discrete gain scheduling approach. By changing of variables, we transform the actuator unsymmetrical saturation control problem into a symmetrical one. The main advantage of the proposed method is improving the dynamic performance of the closed-loop system with a region of attraction as large as possible. By the Lyapunov approach and the scheduling technology, the existence conditions for the admissible controller are formulated in the form of linear matrix inequalities. The numerical simulation illustrates the effectiveness of the proposed method.

  18. Endoscopic Sphincterotomy Using the Rendezvous Technique for Choledocholithiasis during Laparoscopic Cholecystectomy: A Case Report.

    Science.gov (United States)

    Tanaka, Takayuki; Haraguchi, Masashi; Tokai, Hirotaka; Ito, Shinichiro; Kitajima, Masachika; Ohno, Tsuyoshi; Onizuka, Shinya; Inoue, Keiji; Motoyoshi, Yasuhide; Kuroki, Tamotsu; Kanemastu, Takashi; Eguchi, Susumu

    2014-05-01

    A 50-year-old male was examined at another hospital for fever, general fatigue and slight abdominal pain. He was treated with antibiotics and observed. However, his symptoms did not lessen, and laboratory tests revealed liver dysfunction, jaundice and an increased inflammatory response. He was then admitted to our hospital and underwent an abdominal computed tomography scan and magnetic resonance cholangiopancreatography (MRCP), which revealed common bile duct (CBD) stones. He was diagnosed with mild acute cholangitis. As the same time, he was admitted to our hospital and an emergency endoscopic retrograde cholangiopancreatography was performed. Vater papilla opening in the third portion of the duodenum and presence of a peripapillary duodenal diverticulum made it difficult to perform cannulation of the CBD. In addition, MRCP revealed that the CBD was extremely narrow (diameter 5 mm). We therefore performed laparoscopic cholecystectomy and endoscopic sphincterotomy using the rendezvous technique for choledocholithiasis simultaneously rather than laparoscopic CBD exploration. After the operation, the patient was discharged with no complications. Although the rendezvous technique has not been very commonly used because several experts in the technique and a large operating room are required, this technique is a very attractive and effective approach for treating choledocholithiasis, for which endoscopic treatment is difficult.

  19. COMPASS Final Report: Near Earth Asteroids Rendezvous and Sample Earth Returns (NEARER)

    Science.gov (United States)

    Oleson, Steven R.; McGuire, Melissa L.

    2009-01-01

    In this study, the Collaborative Modeling for Parametric Assessment of Space Systems (COMPASS) team completed a design for a multi-asteroid (Nereus and 1996 FG3) sample return capable spacecraft for the NASA In-Space Propulsion Office. The objective of the study was to support technology development and assess the relative benefits of different electric propulsion systems on asteroid sample return design. The design uses a single, heritage Orion solar array (SA) (approx.6.5 kW at 1 AU) to power a single NASA Evolutionary Xenon Thruster ((NEXT) a spare NEXT is carried) to propel a lander to two near Earth asteroids. After landing and gathering science samples, the Solar Electric Propulsion (SEP) vehicle spirals back to Earth where it drops off the first sample s return capsule and performs an Earth flyby to assist the craft in rendezvousing with a second asteroid, which is then sampled. The second sample is returned in a similar fashion. The vehicle, dubbed Near Earth Asteroids Rendezvous and Sample Earth Returns (NEARER), easily fits in an Atlas 401 launcher and its cost estimates put the mission in the New Frontier s (NF's) class mission.

  20. The endoscopic ultrasonography-guided rendezvous technique for biliary cannulation: a technical review.

    Science.gov (United States)

    Isayama, Hiroyuki; Nakai, Yousuke; Kawakubo, Kazumichi; Kawakami, Hiroshi; Itoi, Takao; Yamamoto, Natsuyo; Kogure, Hirofumi; Koike, Kazuhiko

    2013-04-01

    Steady progress is being made in endoscopic biliary intervention, especially endoscopic ultrasonography (EUS)-guided procedures. The EUS-guided rendezvous technique (EUS-RV) is a salvage method for failed selective biliary cannulation. The overall success rate of EUS-RV in 247 cases from seven published articles was 74 % and the incidence of complications was 11 %. The main cause of failed rendezvous cannulation was difficulty passing a biliary stricture or papilla due to poor guidewire (GW) manipulation. A recent large study found a 98.3 % success rate and superiority to precutting. This report suggested using a hydrophilic guidewire. Major complications were bleeding (0.8 %), bile leakage (1.2 %), peritonitis (0.4 %), pneumoperitoneum (0.2 %), and pancreatitis (1.6 %). The approach routes for EUS-RV were transgastric, transduodenal short position, and transduodenal long position. The appropriate route for each patient should be used. GW selection for EUS-RV is critical, and a hydrophilic GW might be the most useful. The catheter can be inserted through the papilla alongside or over the wire. Alongside cannulation is convenient, but difficult. The problem with the over-the-wire technique is withdrawal of the GW in the accessory channel. EUS-RV is effective and safe, but is not established. The efficacy should be confirmed in a prospective comparative trial, and the necessary specialist equipment should be developed.

  1. Pancreatic duct drainage using EUS-guided rendezvous technique for stenotic pancreaticojejunostomy.

    Science.gov (United States)

    Takikawa, Tetsuya; Kanno, Atsushi; Masamune, Atsushi; Hamada, Shin; Nakano, Eriko; Miura, Shin; Ariga, Hiroyuki; Unno, Jun; Kume, Kiyoshi; Kikuta, Kazuhiro; Hirota, Morihisa; Yoshida, Hiroshi; Katayose, Yu; Unno, Michiaki; Shimosegawa, Tooru

    2013-08-21

    The patient was a 30-year-old female who had undergone excision of the extrahepatic bile duct and Roux-en-Y hepaticojejunostomy for congenital biliary dilatation at the age of 7. Thereafter, she suffered from recurrent acute pancreatitis due to pancreaticobiliary maljunction and received subtotal stomach-preserving pancreaticoduodenectomy. She developed a pancreatic fistula and an intra-abdominal abscess after the operation. These complications were improved by percutaneous abscess drainage and antibiotic therapy. However, upper abdominal discomfort and the elevation of serum pancreatic enzymes persisted due to stenosis from the pancreaticojejunostomy. Because we could not accomplish dilation of the stenosis by endoscopic retrograde cholangiopancreatography, we tried an endoscopic ultrasonography (EUS) guided rendezvous technique for pancreatic duct drainage. After transgastric puncture of the pancreatic duct using an EUS-fine needle aspiration needle, the guidewire was inserted into the pancreatic duct and finally reached to the jejunum through the stenotic anastomosis. We changed the echoendoscope to an oblique-viewing endoscope, then grasped the guidewire and withdrew it through the scope. The stenosis of the pancreaticojejunostomy was dilated up to 4 mm, and a pancreatic stent was put in place. Though the pancreatic stent was removed after three months, the patient remained symptom-free. Pancreatic duct drainage using an EUS-guided rendezvous technique was useful for the treatment of a stenotic pancreaticojejunostomy after pancreaticoduodenectomy.

  2. Endoscopic Sphincterotomy Using the Rendezvous Technique for Choledocholithiasis during Laparoscopic Cholecystectomy: A Case Report

    Directory of Open Access Journals (Sweden)

    Takayuki Tanaka

    2014-08-01

    Full Text Available A 50-year-old male was examined at another hospital for fever, general fatigue and slight abdominal pain. He was treated with antibiotics and observed. However, his symptoms did not lessen, and laboratory tests revealed liver dysfunction, jaundice and an increased inflammatory response. He was then admitted to our hospital and underwent an abdominal computed tomography scan and magnetic resonance cholangiopancreatography (MRCP, which revealed common bile duct (CBD stones. He was diagnosed with mild acute cholangitis. As the same time, he was admitted to our hospital and an emergency endoscopic retrograde cholangiopancreatography was performed. Vater papilla opening in the third portion of the duodenum and presence of a peripapillary duodenal diverticulum made it difficult to perform cannulation of the CBD. In addition, MRCP revealed that the CBD was extremely narrow (diameter 5 mm. We therefore performed laparoscopic cholecystectomy and endoscopic sphincterotomy using the rendezvous technique for choledocholithiasis simultaneously rather than laparoscopic CBD exploration. After the operation, the patient was discharged with no complications. Although the rendezvous technique has not been very commonly used because several experts in the technique and a large operating room are required, this technique is a very attractive and effective approach for treating choledocholithiasis, for which endoscopic treatment is difficult.

  3. Space Shuttle Guidance, Navigation, and Rendezvous Knowledge Capture Reports. Revision 1

    Science.gov (United States)

    Goodman, John L.

    2011-01-01

    This document is a catalog and readers guide to lessons learned, experience, and technical history reports, as well as compilation volumes prepared by United Space Alliance personnel for the NASA/Johnson Space Center (JSC) Flight Dynamics Division.1 It is intended to make it easier for future generations of engineers to locate knowledge capture documentation from the Shuttle Program. The first chapter covers observations on documentation quality and research challenges encountered during the Space Shuttle and Orion programs. The second chapter covers the knowledge capture approach used to create many of the reports covered in this document. These chapters are intended to provide future flight programs with insight that could be used to formulate knowledge capture and management strategies. The following chapters contain descriptions of each knowledge capture report. The majority of the reports concern the Space Shuttle. Three are included that were written in support of the Orion Program. Most of the reports were written from the years 2001 to 2011. Lessons learned reports concern primarily the shuttle Global Positioning System (GPS) upgrade and the knowledge capture process. Experience reports on navigation and rendezvous provide examples of how challenges were overcome and how best practices were identified and applied. Some reports are of a more technical history nature covering navigation and rendezvous. They provide an overview of mission activities and the evolution of operations concepts and trajectory design. The lessons learned, experience, and history reports would be considered secondary sources by historians and archivists.

  4. An integrated autonomous rendezvous and docking system architecture using Centaur modern avionics

    Science.gov (United States)

    Nelson, Kurt

    1991-01-01

    The avionics system for the Centaur upper stage is in the process of being modernized with the current state-of-the-art in strapdown inertial guidance equipment. This equipment includes an integrated flight control processor with a ring laser gyro based inertial guidance system. This inertial navigation unit (INU) uses two MIL-STD-1750A processors and communicates over the MIL-STD-1553B data bus. Commands are translated into load activation through a Remote Control Unit (RCU) which incorporates the use of solid state relays. Also, a programmable data acquisition system replaces separate multiplexer and signal conditioning units. This modern avionics suite is currently being enhanced through independent research and development programs to provide autonomous rendezvous and docking capability using advanced cruise missile image processing technology and integrated GPS navigational aids. A system concept was developed to combine these technologies in order to achieve a fully autonomous rendezvous, docking, and autoland capability. The current system architecture and the evolution of this architecture using advanced modular avionics concepts being pursued for the National Launch System are discussed.

  5. Inverse simulation system for evaluating handling qualities during rendezvous and docking

    Science.gov (United States)

    Zhou, Wanmeng; Wang, Hua; Thomson, Douglas; Tang, Guojin; Zhang, Fan

    2017-08-01

    The traditional method used for handling qualities assessment of manned space vehicles is too time-consuming to meet the requirements of an increasingly fast design process. In this study, a rendezvous and docking inverse simulation system to assess the handling qualities of spacecraft is proposed using a previously developed model-predictive-control architecture. By considering the fixed discrete force of the thrusters of the system, the inverse model is constructed using the least squares estimation method with a hyper-ellipsoidal restriction, the continuous control outputs of which are subsequently dispersed by pulse width modulation with sensitivity factors introduced. The inputs in every step are deemed constant parameters, and the method could be considered as a general method for solving nominal, redundant, and insufficient inverse problems. The rendezvous and docking inverse simulation is applied to a nine-degrees-of-freedom platform, and a novel handling qualities evaluation scheme is established according to the operation precision and astronauts' workload. Finally, different nominal trajectories are scored by the inverse simulation and an established evaluation scheme. The scores can offer theoretical guidance for astronaut training and more complex operation missions.

  6. Laparo-Endoscopic Single-Site Surgery for Radical and Cytoreductive Nephrectomy, Renal Vein Thrombectomy, and Partial Nephrectomy: A Prospective Pilot Evaluation

    Directory of Open Access Journals (Sweden)

    Ithaar H. Derweesh

    2010-01-01

    Full Text Available Introduction. Laparo-endoscopic single-site surgery (LESS may diminish morbidity of laparoscopic surgery. We prospectively evaluated feasibility and outcomes of LESS-Radical Nephrectomy (LESS-RN and Partial Nephrectomy (LESS-PN. Methods. 10 patients underwent LESS-RN (6 and LESS-PN (4 between 2/2009-5/2009. LESS-RN included 2 with renal vein thrombectomy, one of which was also cytoreductive. Transperitoneal LESS access was obtained by periumbilical incision. Patient/tumor characteristics, oncologic, and quality of life (QoL outcomes were analyzed. Results. 3 Men/7 Women (mean age 58.7 years, median follow-up 9.8 months underwent LESS. 9/10 cases were completed successfully. All had negative margins. Mean operative time was 161 minutes, estimated blood loss was 125 mL, and incision size was 4.4 cm. Median tumor size for LESS-RN and -PN was 5.0 and 1.7 cm (=.045. Median LESS-PN ischemia time was 24 minutes; mean preoperative/postoperative creatinine were 0.7/0.8 mg/dL (=.19. Mean pain score at discharge was 1.3. Mean preoperative, 3-, and 6-month postoperative SF-36 QoL Score was 73.8, 74.4 and 77.1 (=.222. All patients are currently alive. Conclusions. LESS-RN, renal vein thrombectomy, and PN are technically feasible and safe while maintaining adherence to oncologic principles, with excellent QoL preservation and low discharge pain scores. Further study is requisite.

  7. Laparoendoscopic single site (LESS) in vivo suturing using a magnetic anchoring and guidance system (MAGS) camera in a porcine model: impact on ergonomics and workload.

    Science.gov (United States)

    Yin, Gang; Han, Woong Kyu; Faddegon, Stephen; Tan, Yung Khan; Liu, Zhuo-Wei; Olweny, Ephrem O; Scott, Daniel J; Cadeddu, Jeffrey A

    2013-01-01

    To compare the ergonomics and workload of the surgeon during single-site suturing while using the magnetic anchoring and guidance system (MAGS) camera vs a conventional laparoscope. Seven urologic surgeons were enrolled and divided into an expert group (n=2) and a novice group (n=5) according to their laparoendoscopic single-site (LESS) experience. Each surgeon performed 2 conventional LESS and 2 MAGS camera-assisted LESS vesicostomy closures in a porcine model. A Likert scale (scoring 1-5) questionnaire assessing workload, ergonomics, technical difficulty, visualization, and needle handling, as well as a validated National Aeronautics and Space Administration Task Load Index (NASA-TLX) questionnaire were used to evaluate the tasks and workloads. MAGS LESS suturing was universally favored by expert and novice surgeons compared with conventional LESS in workload (3.4 vs 4.2), ergonomics (3.4 vs 4.4), technical challenge (3.3 vs 4.3), visualization (2.4 vs 3.3), and needle handling (3.1 vs 3.9 respectively; PNASA-TLX assessments found MAGS LESS suturing significantly decreased the workload in physical demand (P=.004), temporal demand (P=.017), and effort (P=.006). External instrument clashing was significantly reduced in MAGS LESS suturing (P<.001). The total operative time of MAGS LESS suturing was comparable to that of conventional LESS (P=.89). MAGS camera technology significantly decreased surgeon workload and improved ergonomics. Nevertheless, LESS suturing and knot tying remains a challenging task that requires training, regardless of which camera is used. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. The Decline of Laparoendoscopic Single-Site Surgery: A Survey of the Endourological Society to Identify Shortcomings and Guidance for Future Directions.

    Science.gov (United States)

    Sorokin, Igor; Canvasser, Noah E; Irwin, Brian; Autorino, Riccardo; Liatsikos, Evangelos N; Cadeddu, Jeffrey A; Rane, Abhay

    2017-10-01

    To analyze the most recent temporal trends in the adoption of urologic laparoendoscopic single-site (LESS), to identify the perceived limitations associated with its decline, and to determine factors that might revive the role of LESS in the field of minimally invasive urologic surgery. A 15 question survey was created and sent to members of the Endourological Society in September 2016. Only members who performed LESS procedures in practice were asked to respond. In total, 106 urologists responded to the survey. Most of the respondents were from the United States (35%) and worked in an academic hospital (84.9%). Standard LESS was the most popular approach (78.1%), while 14.3% used robotics, and 7.6% used both. 2009 marked the most popular year to perform the initial (27.6%) and the majority (20%) of LESS procedures. The most common LESS procedure was a radical/simple nephrectomy (51%) followed by pyeloplasty (17.3%). In the past 12 months, 60% of respondents had performed no LESS procedures. Compared to conventional laparoscopy, respondents only believed cosmesis to be better, however, this enthusiasm waned over time. Worsening shifts in enthusiasm for LESS also occurred with patient desire, marketability, cost, safety, and robotic adaptability. The highest rated factor to help LESS regain popularity was a new robotic platform. The decline of LESS is apparent, with few urologists continuing to perform procedures attributed to multiple factors. The availability of a purpose-built robotic platform and better instrumentation might translate into a renewed future interest of LESS.

  9. Q-Learning and p-persistent CSMA based rendezvous protocol for cognitive radio networks operating with shared spectrum activity

    Science.gov (United States)

    Watson, Clifton L.; Biswas, Subir

    2014-06-01

    With an increasing demand for spectrum, dynamic spectrum access (DSA) has been proposed as viable means for providing the flexibility and greater access to spectrum necessary to meet this demand. Within the DSA concept, unlicensed secondary users temporarily "borrow" or access licensed spectrum, while respecting the licensed primary user's rights to that spectrum. As key enablers for DSA, cognitive radios (CRs) are based on software-defined radios which allow them to sense, learn, and adapt to the spectrum environment. These radios can operate independently and rapidly switch channels. Thus, the initial setup and maintenance of cognitive radio networks are dependent upon the ability of CR nodes to find each other, in a process known as rendezvous, and create a link on a common channel for the exchange of data and control information. In this paper, we propose a novel rendezvous protocol, known as QLP, which is based on Q-learning and the p-persistent CSMA protocol. With the QLP protocol, CR nodes learn which channels are best for rendezvous and thus adapt their behavior to visit those channels more frequently. We demonstrate through simulation that the QLP protocol provides a rendevous capability for DSA environments with different dynamics of PU activity, while attempting to achieve the following performance goals: (1) minimize the average time-to-rendezvous, (2) maximize system throughput, (3) minimize primary user interference, and (4) minimize collisions among CR nodes.

  10. Transluminal recanalization of chronic total occlusion of radial artery using rendezvous technique: a case report and literature review.

    Science.gov (United States)

    Arabi, Mohammad; Ahmed, Ishtiaq; Qattan, Nabeel

    2014-01-01

    Although endovascular management of lower extremity peripheral arterial disease (PAD) is well studied, little information exists regarding endovascular treatment of critical upper limb ischemia. We report a case of transluminal recanalization of right radial artery chronic total occlusion (CTO) using rendezvous technique in a patient with critical hand ischemia and dry gangrene of the right index finger.

  11. Endoscopic rendezvous procedure for ureteral iatrogenic detachment: report of a case series with long-term outcomes.

    Science.gov (United States)

    Pastore, Antonio Luigi; Palleschi, Giovanni; Silvestri, Luigi; Leto, Antonino; Autieri, Domenico; Ripoli, Andrea; Maggioni, Cristina; Al Salhi, Yazan; Carbone, Antonio

    2015-04-01

    Injury to the ureter is the most common urologic complication of pelvic surgery, with an incidence that ranges from 1% to 10%. Most cases of ureteral injuries are related to gynecologic procedures. The ureter is particularly vulnerable to detachment or ligation during hysterectomy because of its position from the lateral edge of the cervix. We report a case series of female patients who underwent the ureteral rendezvous procedure for ureteral detachment. Between January 2009 and April 2013, 18 ureteral rendezvous procedures were performed for patients with complete detachment. We assessed the operative and clinical outcomes of these patients over a mean follow-up duration of 26.5 months and describe the three most representative cases. The endoscopic rendezvous technique was performed in all cases to manage ureteral detachment. CT urography at discharge and 6 and 12 months after discharge confirmed the restoration of ureteral integrity without any leakage in 66% (12/18) patients, indicated ureteral stenosis in 22% (4/18) patients, and indicated ureteral leakage in 12% (2/18) patients. The overall long-term success rate for all 18 patients was 78% (14/18) at a mean follow-up of 26.5 months. The endoscopic rendezvous procedure reduces the need for invasive open surgical repair and represents the optimal initial option in patients with iatrogenic ureteral lesions before invasive procedures with higher morbidity are attempted.

  12. Rendezvous technique for recanalization of long-segmental chronic total occlusion above the knee following unsuccessful standard angioplasty.

    Science.gov (United States)

    Cao, Jun; Lu, Hai-Tao; Wei, Li-Ming; Zhao, Jun-Gong; Zhu, Yue-Qi

    2016-04-01

    To assess the technical feasibility and efficacy of the rendezvous technique, a type of subintimal retrograde wiring, for the treatment of long-segmental chronic total occlusions above the knee following unsuccessful standard angioplasty. The rendezvous technique was attempted in eight limbs of eight patients with chronic total occlusions above the knee after standard angioplasty failed. The clinical symptoms and ankle-brachial index were compared before and after the procedure. At follow-up, pain relief, wound healing, limb salvage, and the presence of restenosis of the target vessels were evaluated. The rendezvous technique was performed successfully in seven patients (87.5%) and failed in one patient (12.5%). Foot pain improved in all seven patients who underwent successful treatment, with ankle-brachial indexes improving from 0.23 ± 0.13 before to 0.71 ± 0.09 after the procedure (P rendezvous technique is a feasible and effective treatment for chronic total occlusions above the knee when standard angioplasty fails. © The Author(s) 2015.

  13. Endo-laparoscopic rendezvous approach for pericardia with gastric posterior wall of gastrointestinal stromal tumor: Analysis of 52 consecutive cases

    Directory of Open Access Journals (Sweden)

    Po Ding

    2014-01-01

    Conclusions: Endo-laparoscopic rendezvous approach is considered to represent the next revolution in surgery. The new technique is reliable and effective in clinical application, due to the advantages of accurate and quick localization for pericardial GIST within gastric posterior wall.

  14. Transluminal Recanalization of Chronic Total Occlusion of Radial Artery Using Rendezvous Technique: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Mohammad Arabi

    2014-01-01

    Full Text Available Although endovascular management of lower extremity peripheral arterial disease (PAD is well studied, little information exists regarding endovascular treatment of critical upper limb ischemia. We report a case of transluminal recanalization of right radial artery chronic total occlusion (CTO using rendezvous technique in a patient with critical hand ischemia and dry gangrene of the right index finger.

  15. Usefulness of the 'Rendezvous' Technique in Living Related Right Liver Donors with Postoperative Biliary Leakage from Bile Duct Anastomosis

    International Nuclear Information System (INIS)

    Miraglia, R.; Traina, M.; Maruzzelli, L.; Caruso, S.; Di Pisa, M.; Gruttadauria, S.; Luca, A.; Gridelli, B.

    2008-01-01

    This is a report on two cases of large bile leak following right hepatectomy performed for living related liver transplantation, originating from the stump of the ligated right bile duct, and treated with the placement of large percutaneous biliary catheters through a combined percutaneous transhepatic and endoscopic approach (rendezvous technique).

  16. Autonomous rendezvous and docking operations of unmanned expendable cargo transfer vehicles (e.g. Centaur) with Space Station Freedom

    Science.gov (United States)

    Emmet, Brian R.

    1991-01-01

    This paper describes the results of the feasibility study using Centaur or other CTV's to deliver payloads to the Space Station Freedom (SSF). During this study was examined the requirements upon unmanned cargo transfer stages (including Centaur) for phasing, rendezvous, proximity operations and docking/berthing (capture).

  17. Multi-Sensor Testing for Automated Rendezvous and Docking Sensor Testing at the Flight Robotics Laboratory

    Science.gov (United States)

    Brewster, L.; Johnston, A.; Howard, R.; Mitchell, J.; Cryan, S.

    2007-01-01

    The Exploration Systems Architecture defines missions that require rendezvous, proximity operations, and docking (RPOD) of two spacecraft both in Low Earth Orbit (LEO) and in Low Lunar Orbit (LLO). Uncrewed spacecraft must perform automated and/or autonomous rendezvous, proximity operations and docking operations (commonly known as AR&D). The crewed missions may also perform rendezvous and docking operations and may require different levels of automation and/or autonomy, and must provide the crew with relative navigation information for manual piloting. The capabilities of the RPOD sensors are critical to the success of the Exploration Program. NASA has the responsibility to determine whether the Crew Exploration Vehicle (CEV) contractor proposed relative navigation sensor suite will meet the requirements. The relatively low technology readiness level of AR&D relative navigation sensors has been carried as one of the CEV Project's top risks. The AR&D Sensor Technology Project seeks to reduce the risk by the testing and analysis of selected relative navigation sensor technologies through hardware-in-the-loop testing and simulation. These activities will provide the CEV Project information to assess the relative navigation sensors maturity as well as demonstrate test methods and capabilities. The first year of this project focused on a series of"pathfinder" testing tasks to develop the test plans, test facility requirements, trajectories, math model architecture, simulation platform, and processes that will be used to evaluate the Contractor-proposed sensors. Four candidate sensors were used in the first phase of the testing. The second phase of testing used four sensors simultaneously: two Marshall Space Flight Center (MSFC) Advanced Video Guidance Sensors (AVGS), a laser-based video sensor that uses retroreflectors attached to the target vehicle, and two commercial laser range finders. The multi-sensor testing was conducted at MSFC's Flight Robotics Laboratory (FRL

  18. Multi-Sensor Testing for Automated Rendezvous and Docking Sensor Testing at the Flight Robotics Lab

    Science.gov (United States)

    Brewster, Linda L.; Howard, Richard T.; Johnston, A. S.; Carrington, Connie; Mitchell, Jennifer D.; Cryan, Scott P.

    2008-01-01

    The Exploration Systems Architecture defines missions that require rendezvous, proximity operations, and docking (RPOD) of two spacecraft both in Low Earth Orbit (LEO) and in Low Lunar Orbit (LLO). Uncrewed spacecraft must perform automated and/or autonomous rendezvous, proximity operations and docking operations (commonly known as AR&D). The crewed missions may also perform rendezvous and docking operations and may require different levels of automation and/or autonomy, and must provide the crew with relative navigation information for manual piloting. The capabilities of the RPOD sensors are critical to the success ofthe Exploration Program. NASA has the responsibility to determine whether the Crew Exploration Vehicle (CEV) contractor-proposed relative navigation sensor suite will meet the requirements. The relatively low technology readiness level of AR&D relative navigation sensors has been carried as one of the CEV Project's top risks. The AR&D Sensor Technology Project seeks to reduce the risk by the testing and analysis of selected relative navigation sensor technologies through hardware-in-the-Ioop testing and simulation. These activities will provide the CEV Project information to assess the relative navigation sensors maturity as well as demonstrate test methods and capabilities. The first year of this project focused on a series of "pathfinder" testing tasks to develop the test plans, test facility requirements, trajectories, math model architecture, simulation platform, and processes that will be used to evaluate the Contractor-proposed sensors. Four candidate sensors were used in the first phase of the testing. The second phase of testing used four sensors simultaneously: two Marshall Space Flight Center (MSFC) Advanced Video Guidance Sensors (AVGS), a laser-based video sensor that uses retroreflectors attached to the target vehicle, and two commercial laser range finders. The multi-sensor testing was conducted at MSFC's Flight Robotics Laboratory (FRL

  19. A Summary of the Rendezvous, Proximity Operations, Docking, and Undocking (RPODU) Lessons Learned from the Defense Advanced Research Project Agency (DARPA) Orbital Express (OE) Demonstration System Mission

    Science.gov (United States)

    Dennehy, Cornelius J.; Carpenter, James R.

    2011-01-01

    The Guidance, Navigation, and Control (GN&C) Technical Discipline Team (TDT) sponsored Dr. J. Russell Carpenter, a Navigation and Rendezvous Subject Matter Expert (SME) from NASA's Goddard Space Flight Center (GSFC), to provide support to the Defense Advanced Research Project Agency (DARPA) Orbital Express (OE) rendezvous and docking flight test that was conducted in 2007. When that DARPA OE mission was completed, Mr. Neil Dennehy, NASA Technical Fellow for GN&C, requested Dr. Carpenter document his findings (lessons learned) and recommendations for future rendezvous missions resulting from his OE support experience. This report captures lessons specifically from anomalies that occurred during one of OE's unmated operations.

  20. Determination of Eros Physical Parameters for Near Earth Asteroid Rendezvous Orbit Phase Navigation

    Science.gov (United States)

    Miller, J. K.; Antreasian, P. J.; Georgini, J.; Owen, W. M.; Williams, B. G.; Yeomans, D. K.

    1995-01-01

    Navigation of the orbit phase of the Near Earth steroid Rendezvous (NEAR) mission will re,quire determination of certain physical parameters describing the size, shape, gravity field, attitude and inertial properties of Eros. Prior to launch, little was known about Eros except for its orbit which could be determined with high precision from ground based telescope observations. Radar bounce and light curve data provided a rough estimate of Eros shape and a fairly good estimate of the pole, prime meridian and spin rate. However, the determination of the NEAR spacecraft orbit requires a high precision model of Eros's physical parameters and the ground based data provides only marginal a priori information. Eros is the principal source of perturbations of the spacecraft's trajectory and the principal source of data for determining the orbit. The initial orbit determination strategy is therefore concerned with developing a precise model of Eros. The original plan for Eros orbital operations was to execute a series of rendezvous burns beginning on December 20,1998 and insert into a close Eros orbit in January 1999. As a result of an unplanned termination of the rendezvous burn on December 20, 1998, the NEAR spacecraft continued on its high velocity approach trajectory and passed within 3900 km of Eros on December 23, 1998. The planned rendezvous burn was delayed until January 3, 1999 which resulted in the spacecraft being placed on a trajectory that slowly returns to Eros with a subsequent delay of close Eros orbital operations until February 2001. The flyby of Eros provided a brief glimpse and allowed for a crude estimate of the pole, prime meridian and mass of Eros. More importantly for navigation, orbit determination software was executed in the landmark tracking mode to determine the spacecraft orbit and a preliminary shape and landmark data base has been obtained. The flyby also provided an opportunity to test orbit determination operational procedures that will be

  1. Satellite Servicing's Autonomous Rendezvous and Docking Testbed on the International Space Station

    Science.gov (United States)

    Naasz, Bo J.; Strube, Matthew; Van Eepoel, John; Barbee, Brent W.; Getzandanner, Kenneth M.

    2011-01-01

    The Space Servicing Capabilities Project (SSCP) at NASA's Goddard Space Flight Center (GSFC) has been tasked with developing systems for servicing space assets. Starting in 2009, the SSCP completed a study documenting potential customers and the business case for servicing, as well as defining several notional missions and required technologies. In 2010, SSCP moved to the implementation stage by completing several ground demonstrations and commencing development of two International Space Station (ISS) payloads-the Robotic Refueling Mission (RRM) and the Dextre Pointing Package (DPP)--to mitigate new technology risks for a robotic mission to service existing assets in geosynchronous orbit. This paper introduces the DPP, scheduled to fly in July of 2012 on the third operational SpaceX Dragon mission, and its Autonomous Rendezvous and Docking (AR&D) instruments. The combination of sensors and advanced avionics provide valuable on-orbit demonstrations of essential technologies for servicing existing vehicles, both cooperative and non-cooperative.

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

    Science.gov (United States)

    Nam, Kwangwoo; Choi, Jun-Ho

    2017-05-01

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

  3. Robust adaptive backstepping neural networks control for spacecraft rendezvous and docking with input saturation.

    Science.gov (United States)

    Xia, Kewei; Huo, Wei

    2016-05-01

    This paper presents a robust adaptive neural networks control strategy for spacecraft rendezvous and docking with the coupled position and attitude dynamics under input saturation. Backstepping technique is applied to design a relative attitude controller and a relative position controller, respectively. The dynamics uncertainties are approximated by radial basis function neural networks (RBFNNs). A novel switching controller consists of an adaptive neural networks controller dominating in its active region combined with an extra robust controller to avoid invalidation of the RBFNNs destroying stability of the system outside the neural active region. An auxiliary signal is introduced to compensate the input saturation with anti-windup technique, and a command filter is employed to approximate derivative of the virtual control in the backstepping procedure. Globally uniformly ultimately bounded of the relative states is proved via Lyapunov theory. Simulation example demonstrates effectiveness of the proposed control scheme. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Kwangwoo Nam

    2017-05-01

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

  5. Observer-Based Stabilization of Spacecraft Rendezvous with Variable Sampling and Sensor Nonlinearity

    Directory of Open Access Journals (Sweden)

    Zhuoshi Li

    2013-01-01

    Full Text Available This paper addresses the observer-based control problem of spacecraft rendezvous with nonuniform sampling period. The relative dynamic model is based on the classical Clohessy-Wiltshire equation, and sensor nonlinearity and sampling are considered together in a unified framework. The purpose of this paper is to perform an observer-based controller synthesis by using sampled and saturated output measurements, such that the resulting closed-loop system is exponentially stable. A time-dependent Lyapunov functional is developed which depends on time and the upper bound of the sampling period and also does not grow along the input update times. The controller design problem is solved in terms of the linear matrix inequality method, and the obtained results are less conservative than using the traditional Lyapunov functionals. Finally, a numerical simulation example is built to show the validity of the developed sampled-data control strategy.

  6. Rendezvous with connectivity preservation for multi-robot systems with an unknown leader

    Science.gov (United States)

    Dong, Yi

    2018-02-01

    This paper studies the leader-following rendezvous problem with connectivity preservation for multi-agent systems composed of uncertain multi-robot systems subject to external disturbances and an unknown leader, both of which are generated by a so-called exosystem with parametric uncertainty. By combining internal model design, potential function technique and adaptive control, two distributed control strategies are proposed to maintain the connectivity of the communication network, to achieve the asymptotic tracking of all the followers to the output of the unknown leader system, as well as to reject unknown external disturbances. It is also worth to mention that the uncertain parameters in the multi-robot systems and exosystem are further allowed to belong to unknown and unbounded sets when applying the second fully distributed control law containing a dynamic gain inspired by high-gain adaptive control or self-tuning regulator.

  7. Leak or Fistula After Sleeve Gastrectomy: Treatment with Pigtail Drain by the Rendezvous Technique.

    Science.gov (United States)

    Soufron, Jacques

    2015-10-01

    After a sleeve gastrectomy, a leak or fistula is a serious complication. Laparoscopic drainage, drainage under US or CT scan control, or endoscopic insertion of a stent can be used, but a major re-operation is sometimes unavoidable. Endoscopic drainage with a pigtail catheter could give more success and fewer complications, but the insertion of the drain is not always possible nor does it always provide a perfect drainage. If a laparoscopic second look appears necessary, it is possible to insert a pigtail drain laparoscopically, but under endoscopic control, ensuring a correct positioning of the drain both in the peritoneal cavity and in the gastric tube. This simultaneous "rendezvous" technique could combine in this situation the advantages of purely surgical techniques and of purely endoscopic or image-guided techniques.

  8. Resolving external pancreatic fistulas in patients with disconnected pancreatic duct syndrome: using rendezvous techniques to avoid surgery (with video).

    Science.gov (United States)

    Irani, Shayan; Gluck, Michael; Ross, Andrew; Gan, S Ian; Crane, Robert; Brandabur, John J; Hauptmann, Ellen; Fotoohi, Mehran; Kozarek, Richard A

    2012-09-01

    An external pancreatic fistula (EPF) generally results from an iatrogenic manipulation of a pancreatic fluid collection (PFC), such as walled-off pancreatic necrosis (WOPN). Severe necrotizing pancreatitis can lead to complete duct disruption, causing disconnected pancreatic duct syndrome (DPDS) with viable upstream pancreas draining out of a low-pressure fistula created surgically or by a percutaneous catheter. The EPF can persist for months to years, and distal pancreatectomy, often the only permanent solution, carries a high morbidity and defined mortality. To describe 3 endoscopic and percutaneous rendezvous techniques to completely resolve EPFs in the setting of DPDS. A retrospective review of a prospective database of 15 patients who underwent rendezvous internalization of EPFs. Tertiary-care pancreatic referral center. Fifteen patients between October 2002 and October 2011 with EPFs in the setting of DPDS and resolved WOPN. Three rendezvous techniques that combined endoscopic and percutaneous procedures to internalize EPFs by transgastric, transduodenal, or transpapillary methods. EPF resolution and morbidity. Fifteen patients (12 men) with a median age of 51 years (range 24-65 years) with EPFs and DPDS (cutoff/blowout of pancreatic duct, with inability to demonstrate upstream body/tail of pancreas on pancreatogram) resulting from severe necrotizing pancreatitis underwent 1 of 3 rendezvous procedures to eliminate the EPFs. All patients were either poor surgical candidates or refused surgery. At the time of the rendezvous procedure, WOPN had fully resolved, DPDS was confirmed on pancreatography, and the EPF had persisted for a median of 5 months (range 1-48 months), producing a median output of 200 mL/day (range 50-700 mL/day). The rendezvous technique in 10 patients used the existing percutaneous drainage fistula to puncture into the stomach/duodenum to deliver wires that were captured endoscopically. The transenteric fistula was dilated and two

  9. EUS-guided biliary drainage by using a standardized approach for malignant biliary obstruction: rendezvous versus direct transluminal techniques (with videos).

    Science.gov (United States)

    Khashab, Mouen A; Valeshabad, Ali Kord; Modayil, Rani; Widmer, Jessica; Saxena, Payal; Idrees, Mehak; Iqbal, Shahzad; Kalloo, Anthony N; Stavropoulos, Stavros N

    2013-11-01

    EUS-guided biliary drainage (EGBD) can be performed via direct transluminal or rendezvous techniques. It is unknown how both techniques compare in terms of efficacy and adverse events. To describe outcomes of EGBD performed by using a standardized approach and compare outcomes of rendezvous and transluminal techniques. Retrospective analysis of prospectively collected data. Two tertiary-care centers. Consecutive jaundiced patients with distal malignant biliary obstruction who underwent EGBD after failed ERCP between July 2006 and December 2012 were included. EGBD by using a standardized algorithm. Technical success, clinical success, and adverse events. During the study period, 35 patients underwent EGBD (rendezvous n = 13, transluminal n = 20). Technical success was achieved in 33 patients (94%), and clinical success was attained in 32 of 33 patients (97.0%). The mean postprocedure bilirubin level was 1.38 mg/dL in the rendezvous group and 1.33 mg/dL in the transluminal group (P = .88). Similarly, length of hospital stay was not different between groups (P = .23). There was no significant difference in adverse event rate between rendezvous and transluminal groups (15.4% vs 10%; P = .64). Long-term outcomes were comparable between groups, with 1 stent migration in the rendezvous group at 62 days and 1 stent occlusion in the transluminal group at 42 days after EGBD. Retrospective analysis, small number of patients, and selection bias. EGBD is safe and effective when the described standardized approach is used. Stent occlusion is not common during long-term follow-up. Both rendezvous and direct transluminal techniques seem to be equally effective and safe. The latter approach is a reasonable alternative to rendezvous EGBD. Copyright © 2013. Published by Mosby, Inc.

  10. Combined Radial and Femoral Access Strategy and Radial-Femoral Rendezvous in Patients With Long and Complex Iliac Occlusions.

    Science.gov (United States)

    Hanna, Elias B; Mogabgab, Owen N; Baydoun, Hassan

    2018-01-01

    We present cases of complex, calcified iliac occlusive disease revascularized via a combined radial-femoral access strategy. Through a 6-French, 125-cm transradial guiding catheter, antegrade guidewires and catheters are advanced into the iliac occlusion, while retrograde devices are advanced transfemorally. The transradial and transfemoral channels communicate, allowing the devices to cross the occlusion into the true lumen (radial-femoral antegrade-retrograde rendezvous).

  11. Endoscopic ultrasound rendezvous for bile duct access using a transduodenal approach: cumulative experience at a single center. A case series.

    Science.gov (United States)

    Kim, Y S; Gupta, K; Mallery, S; Li, R; Kinney, T; Freeman, M L

    2010-06-01

    Endoscopic ultrasound (EUS)-assisted biliary access is utilized when conventional endoscopic retrograde cholangiopancreatography (ERCP) fails. We report a 10-year experience utilizing a transduodenal EUS rendezvous via a transpapillary route without dilation of the transduodenal tract, followed by immediate ERCP access. Patients included all EUS-guided rendezvous procedures for biliary access that were performed following ERCP failure. EUS-assisted bile duct puncture was performed via a transduodenal approach and a guide wire was advanced through the papilla without any dilation or bougienage of the tract; ERCP was performed immediately afterwards. EUS-assisted biliary rendezvous was attempted in 15 patients (mean age 66 +/- 18.2 years; malignant = 10, benign = 5). Mean diameter of measured bile ducts was 14.3 +/- 5.17 mm (range 4-23 mm). The reasons for initial ERCP failure were tumor infiltration or edema (n = 9), intradiverticular papilla (n = 2), pre-existing duodenal stent (n = 1), and anatomic anomalies (n = 3). Successful EUS-guided bile duct puncture and wire passage were achieved in all 15 patients (100 %), with drainage being successful in 12 / 15 (80 %). Failures occurred in three patients due to inability to traverse the biliary stricture (n = 2) or dissection of a choledochocele with the guide wire (n = 1); all were subsequently drained via percutaneous methods. Stents placed were metallic in eight patients and plastic in four. Complications consisted of moderate pancreatitis after a difficult ERCP attempt in one patient, and bacteremia after percutaneous biliary drainage in another. There were no instances of perforation, extraluminal air or fluid collections. EUS-assisted biliary drainage utilizing a transduodenal rendezvous approach demonstated a high success rate without any complications directly attributable to the EUS access. Advantages over percutaneous biliary and other methods of EUS biliary access include performance under the same

  12. Endo-laparoscopic rendezvous approach for pericardia with gastric posterior wall of gastrointestinal stromal tumor: analysis of 52 consecutive cases.

    Science.gov (United States)

    Ding, Po; Zhao, Yongjie

    2014-12-01

    Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor in the gastrointestinal tract and most frequently developed in the stomach, and surgical therapy is limited on removal of the tumor lesion. The aim of this study was to investigate the clinical values of endo-laparoscopic rendezvous approach for pericardial GISTs within gastric posterior wall. Surgical outcome and clinical data of 52 patients with pericardial GISTs within gastric posterior wall treated at Tianjin Peoples' Hospital from January 2004 to October 2013 were analyzed. Endo-laparoscopic rendezvous approach was used as an operative procedure for tumor resection ranged from 10 to 50 mm. Endoscopic ultrasound, computed tomography and microscopic findings all certified the gastric spindle type GIST locating in the submucosa to muscle proper. Endo-laparoscopic rendezvous approach was attempted in 52 patients (male/female: 31/21) with median age of 51 years (25-71 years). The median operating time was 80 min (range: 40-120 min) and median intra-operative blood loss was 26 ml (range: 10-50 ml). The median hospital stay was 5 days (range: 4-6 days), while the median tumor size was 25 mm (range: 7-50 mm). All operative margins were clear. There were no recurrences or metastases of all patients in a median follow-up of 24 months (range: 6-36 months). Endo-laparoscopic rendezvous approach is considered to represent the next revolution in surgery. The new technique is reliable and effective in clinical application, due to the advantages of accurate and quick localization for pericardial GIST within gastric posterior wall.

  13. Rendezvous cannulation technique reduces post-ERCP pancreatitis: a prospective nationwide study of 12,718 ERCP procedures.

    Science.gov (United States)

    Swahn, Fredrik; Nilsson, Magnus; Arnelo, Urban; Löhr, Matthias; Persson, Gunnar; Enochsson, Lars

    2013-04-01

    The aim of this study was to investigate if intraoperative rendezvous cannulation reduces the risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) because there is no universal consensus on the optimal treatment of common bile duct stones. We performed a nationwide case-control study, nested within the cohort of ERCP procedures reported to the Swedish Registry for Gallstone Surgery and ERCP (GallRiks), between 2007 and 2009. Data were collected prospectively from a web-based registry of ERCP procedures that includes variables such as patient characteristics, indication, cannulation technique, diagnostic findings, therapeutic measures, and complications. The primary outcome was PEP. The registry included 12,718 ERCP procedures performed on patients without a history of previous ERCP. The risk of PEP when using the rendezvous technique compared with those who were cannulated by conventional means was reduced from 3.6 to 2.2% (odds ratio (OR) 0.5, 95% confidence interval 0.2-0.9, P=0.02). Although a significant reduction there are overall relatively few cases with PEP and the calculated numbers needed to treat to avoid one case of PEP is as high as 71. Other factors associated with increased risk of PEP were young age, prolonged procedure time, and elective ERCP. Rendezvous bile duct cannulation during ERCP reduces the risk of PEP from 3.6 to 2.2% compared with conventional biliary cannulation.

  14. A 10-year study of rendezvous intraoperative endoscopic retrograde cholangiography during cholecystectomy and the risk of post-ERCP pancreatitis.

    Science.gov (United States)

    Noel, Rozh; Enochsson, Lars; Swahn, Fredrik; Löhr, Matthias; Nilsson, Magnus; Permert, Johan; Arnelo, Urban

    2013-07-01

    Rendezvous intraoperative endoscopic retrograde cholangiography (RV-IOERC), also called guidewire-facilitated IOERC, is one of the single-stage options available for managing common bile duct stones (CBDS) during laparoscopic cholecystectomy. The objective of this study is to investigate procedure-related complications in IOERC patients and stone clearance. All patients who underwent IOERC between January 2000 and December 2009 were identified from the local registry of Karolinska University Hospital in Huddinge. Medical charts and ERC reports were studied, and descriptive statistics were obtained. Outcomes were procedure-related complications, especially post-ERCP pancreatitis (PEP), stone clearance, and mortality. 307 patients were identified. In 264 of the patients, the rendezvous cannulation technique was successful (86 %); in the remaining 43 patients, conventional cannulation technique was necessary. In total, PEP occurred in seven patients (2.28 %). One of the PEP patients was in the rendezvous cannulated group (0.37 %), whereas six patients developed PEP in the nonrendezvous group (13.95 %, p < 0.001). The primary stone clearance rate was 88.27 % (271/307). There was no mortality within 90 days in the series. IOERC with RV cannulation technique for management of CBDS during laparoscopic cholecystectomy has a low PEP rate and a high stone clearance rate, making it a safe and feasible method for removing CBDS. However, the technique requires logistics to perform IOERC in the operating theater. The present data suggest that IOERC with RV cannulation is superior to conventional cannulation with respect to risk of PEP.

  15. Navigation Strategies for Primitive Solar System Body Rendezvous and Proximity Operations

    Science.gov (United States)

    Getzandanner, Kenneth M.

    2011-01-01

    A wealth of scientific knowledge regarding the composition and evolution of the solar system can be gained through reconnaissance missions to primitive solar system bodies. This paper presents analysis of a baseline navigation strategy designed to address the unique challenges of primitive body navigation. Linear covariance and Monte Carlo error analysis was performed on a baseline navigation strategy using simulated data from a· design reference mission (DRM). The objective of the DRM is to approach, rendezvous, and maintain a stable orbit about the near-Earth asteroid 4660 Nereus. The outlined navigation strategy and resulting analyses, however, are not necessarily limited to this specific target asteroid as they may he applicable to a diverse range of mission scenarios. The baseline navigation strategy included simulated data from Deep Space Network (DSN) radiometric tracking and optical image processing (OpNav). Results from the linear covariance and Monte Carlo analyses suggest the DRM navigation strategy is sufficient to approach and perform proximity operations in the vicinity of the target asteroid with meter-level accuracy.

  16. Handling Neighbor Discovery and Rendezvous Consistency with Weighted Quorum-Based Approach.

    Science.gov (United States)

    Own, Chung-Ming; Meng, Zhaopeng; Liu, Kehan

    2015-09-03

    Neighbor discovery and the power of sensors play an important role in the formation of Wireless Sensor Networks (WSNs) and mobile networks. Many asynchronous protocols based on wake-up time scheduling have been proposed to enable neighbor discovery among neighboring nodes for the energy saving, especially in the difficulty of clock synchronization. However, existing researches are divided two parts with the neighbor-discovery methods, one is the quorum-based protocols and the other is co-primality based protocols. Their distinction is on the arrangements of time slots, the former uses the quorums in the matrix, the latter adopts the numerical analysis. In our study, we propose the weighted heuristic quorum system (WQS), which is based on the quorum algorithm to eliminate redundant paths of active slots. We demonstrate the specification of our system: fewer active slots are required, the referring rate is balanced, and remaining power is considered particularly when a device maintains rendezvous with discovered neighbors. The evaluation results showed that our proposed method can effectively reschedule the active slots and save the computing time of the network system.

  17. Endoscopic dilation of complete oesophageal obstructions with a combined antegrade-retrograde rendezvous technique.

    Science.gov (United States)

    Bertolini, Reto; Meyenberger, Christa; Putora, Paul Martin; Albrecht, Franziska; Broglie, Martina Anja; Stoeckli, Sandro J; Sulz, Michael Christian

    2016-02-21

    To investigate the combined antegrade-retrograde endoscopic rendezvous technique for complete oesophageal obstruction and the swallowing outcome. This single-centre case series includes consecutive patients who were unable to swallow due to complete oesophageal obstruction and underwent combined antegrade-retrograde endoscopic dilation (CARD) within the last 10 years. The patients' demographic characteristics, clinical parameters, endoscopic therapy, adverse events, and outcomes were obtained retrospectively. Technical success was defined as effective restoration of oesophageal patency. Swallowing success was defined as either percutaneous endoscopic gastrostomy (PEG)-tube independency and/or relevant improvement of oral food intake, as assessed by the functional oral intake scale (FOIS) (≥ level 3). The cohort consisted of six patients [five males; mean age 71 years (range, 54-74)]. All but one patient had undergone radiotherapy for head and neck or oesophageal cancer. Technical success was achieved in five out of six patients. After discharge, repeated dilations were performed in all five patients. During follow-up (median 27 mo, range, 2-115), three patients remained PEG-tube dependent. Three of four patients achieved relevant improvement of swallowing (two patients: FOIS 6, one patient: FOIS 7). One patient developed mediastinal emphysema following CARD, without a need for surgery. The CARD technique is safe and a viable alternative to high-risk blind antegrade dilation in patients with complete proximal oesophageal obstruction. Although only half of the patients remained PEG-tube independent, the majority improved their ability to swallow.

  18. Gunshot Injury of Pelvi-Ureteric Junction: Management by the Rendezvous Technique.

    Science.gov (United States)

    Sekhon, Virender; Suryavanshi, Manav

    2017-01-01

    Background: Gunshot injury of ureter is common, but isolated injury of pelvi-ureteric junction (PUJ) has not been reported. Moreover, its management is evolving from the traditional urinary diversion, stenting followed later by definitive surgical repair to a more upfront minimally invasive endourologic approach. Case Presentation: An adolescent boy presented with gunshot laceration injury of left PUJ with associated small intestinal injury. Radiological investigations confirmed a contained urinary leak. Retrograde stenting was not effective. The same guidewire was retained into the urinoma and an antegrade percutaneous access was obtained. A snare was used to retrieve the guidewire and obtain a through and through access. A ureteropelvic drainage catheter was inserted over this guidewire and secured in the upper ureter, bypassing the region of injury. Three weeks later, the drainage tube was removed and the same tract was used for antegrade stenting. A retrograde pyelogram done 3 months later during stent removal demonstrated no leak. The patient is asymptomatic for urinary symptoms on 6 months of follow-up. Conclusion: Rendezvous technique is a feasible alternative to open repair of gunshot pelvi-ureteric junction injury. Long-term follow-up is awaited.

  19. Coherent Doppler lidar for automated space vehicle rendezvous, stationkeeping and capture

    Science.gov (United States)

    Bilbro, James A.

    1991-01-01

    The inherent spatial resolution of laser radar makes ladar or lidar an attractive candidate for Automated Rendezvous and Capture application. Previous applications were based on incoherent lidar techniques, requiring retro-reflectors on the target vehicle. Technology improvements (reduced size, no cryogenic cooling requirement) have greatly enhanced the construction of coherent lidar systems. Coherent lidar permits the acquisition of non-cooperative targets at ranges that are limited by the detection capability rather than by the signal-to-noise ratio (SNR) requirements. The sensor can provide translational state information (range, velocity, and angle) by direct measurement and, when used with any array detector, also can provide attitude information by Doppler imaging techniques. Identification of the target is accomplished by scanning with a high pulse repetition frequency (dependent on the SNR). The system performance is independent of range and should not be constrained by sun angle. An initial effort to characterize a multi-element detection system has resulted in a system that is expected to work to a minimum range of 1 meter. The system size, weight and power requirements are dependent on the operating range; 10 km range requires a diameter of 3 centimeters with overall size at 3 x 3 x 15 to 30 cm, while 100 km range requires a 30 cm diameter.

  20. Handling Neighbor Discovery and Rendezvous Consistency with Weighted Quorum-Based Approach

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    Chung-Ming Own

    2015-09-01

    Full Text Available Neighbor discovery and the power of sensors play an important role in the formation of Wireless Sensor Networks (WSNs and mobile networks. Many asynchronous protocols based on wake-up time scheduling have been proposed to enable neighbor discovery among neighboring nodes for the energy saving, especially in the difficulty of clock synchronization. However, existing researches are divided two parts with the neighbor-discovery methods, one is the quorum-based protocols and the other is co-primality based protocols. Their distinction is on the arrangements of time slots, the former uses the quorums in the matrix, the latter adopts the numerical analysis. In our study, we propose the weighted heuristic quorum system (WQS, which is based on the quorum algorithm to eliminate redundant paths of active slots. We demonstrate the specification of our system: fewer active slots are required, the referring rate is balanced, and remaining power is considered particularly when a device maintains rendezvous with discovered neighbors. The evaluation results showed that our proposed method can effectively reschedule the active slots and save the computing time of the network system.

  1. Maximizing the Lifetime of Wireless Sensor Networks Using Multiple Sets of Rendezvous

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    Bo Li

    2015-01-01

    Full Text Available In wireless sensor networks (WSNs, there is a “crowded center effect” where the energy of nodes located near a data sink drains much faster than other nodes resulting in a short network lifetime. To mitigate the “crowded center effect,” rendezvous points (RPs are used to gather data from other nodes. In order to prolong the lifetime of WSN further, we propose using multiple sets of RPs in turn to average the energy consumption of the RPs. The problem is how to select the multiple sets of RPs and how long to use each set of RPs. An optimal algorithm and a heuristic algorithm are proposed to address this problem. The optimal algorithm is highly complex and only suitable for small scale WSN. The performance of the proposed algorithms is evaluated through simulations. The simulation results indicate that the heuristic algorithm approaches the optimal one and that using multiple RP sets can significantly prolong network lifetime.

  2. Dynamical analysis of rendezvous and docking with very large space infrastructures in non-Keplerian orbits

    Science.gov (United States)

    Colagrossi, Andrea; Lavagna, Michèle

    2018-03-01

    A space station in the vicinity of the Moon can be exploited as a gateway for future human and robotic exploration of the solar system. The natural location for a space system of this kind is about one of the Earth-Moon libration points. The study addresses the dynamics during rendezvous and docking operations with a very large space infrastructure in an EML2 Halo orbit. The model takes into account the coupling effects between the orbital and the attitude motion in a circular restricted three-body problem environment. The flexibility of the system is included, and the interaction between the modes of the structure and those related with the orbital motion is investigated. A lumped parameter technique is used to represents the flexible dynamics. The parameters of the space station are maintained as generic as possible, in a way to delineate a global scenario of the mission. However, the developed model can be tuned and updated according to the information that will be available in the future, when the whole system will be defined with a higher level of precision.

  3. Basic targeting strategies for rendezvous and flyby missions to the near-Earth asteroids

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    Perozzi, Ettore; Rossi, Alessandro; Valsecchi, Giovanni B.

    2001-01-01

    Missions to asteroids and comets are becoming increasingly feasible both from a technical and a financial point of view. In particular, those directed towards the Near-Earth Asteroids have proven suitable for a low-cost approach, thus attracting the major space agencies as well as private companies. The choice of a suitable target involves both scientific relevance and mission design considerations, being often a difficult task to accomplish due to the limited energy budget at disposal. The aim of this paper is to provide an approach to basic trajectory design which allows to account for both aspects of the problem, taking into account scientific and technical information. A global characterization of the Near-Earth Asteroids population carried out on the basis of their dynamics, physical properties and flight dynamics considerations, allows to identify a group of candidates which satisfy both, the scientific and engineering requirements. The feasibility of rendezvous and flyby missions towards them is then discussed and the possibility of repeated encounters with the same object is investigated, as an intermediate scenario. Within this framework, the capability of present and near future launch and propulsion systems for interplanetary missions is also addressed.

  4. Time and Covariance Threshold Triggered Optimal Uncooperative Rendezvous Using Angles-Only Navigation

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    Yue You

    2017-01-01

    Full Text Available A time and covariance threshold triggered optimal maneuver planning method is proposed for orbital rendezvous using angles-only navigation (AON. In the context of Yamanaka-Ankersen orbital relative motion equations, the square root unscented Kalman filter (SRUKF AON algorithm is developed to compute the relative state estimations from a low-volume/mass, power saving, and low-cost optical/infrared camera’s observations. Multi-impulsive Hill guidance law is employed in closed-loop linear covariance analysis model, based on which the quantitative relative position robustness and relative velocity robustness index are defined. By balancing fuel consumption, relative position robustness, and relative velocity robustness, we developed a time and covariance threshold triggered two-level optimal maneuver planning method, showing how these results correlate to past methods and missions and how they could potentially influence future ones. Numerical simulation proved that it is feasible to control the spacecraft with a two-line element- (TLE- level uncertain, 34.6% of range, initial relative state to a 100 m v-bar relative station keeping point, at where the trajectory dispersion reduces to 3.5% of range, under a 30% data gap per revolution on account of the eclipse. Comparing with the traditional time triggered maneuver planning method, the final relative position accuracy is improved by one order and the relative trajectory robustness and collision probability are obviously improved and reduced, respectively.

  5. Usefulness of the rendezvous technique for biliary stricture after adult right-lobe living-donor liver transplantation with duct-to-duct anastomosis.

    Science.gov (United States)

    Chang, Jae Hyuck; Lee, In Seok; Chun, Ho Jong; Choi, Jong Young; Yoon, Seung Kyoo; Kim, Dong Goo; You, Young Kyoung; Choi, Myung-Gyu; Choi, Kyu-Yong; Chung, In-Sik

    2010-03-01

    Replacement of a percutaneous transhepatic biliary drainage (PTBD) catheter with inside stents using endoscopic retrograde cholangiography is difficult in patients with angulated or twisted biliary anastomotic stricture after living donor liver transplantation (LDLT). We evaluated the usefulness and safety of the rendezvous technique for the management of biliary stricture after LDLT. Twenty patients with PTBD because of biliary stricture after LDLT with duct-to-duct anastomosis underwent the placement of inside stents using the rendezvous technique. Inside stents were successfully placed in the 20 patients using the rendezvous technique. The median procedure time was 29.6 (range, 7.5-71.8) minutes. The number of inside stents placed was one in 12 patients and two in eight patients. One mild acute pancreatitis and one acute cholangitis occurred, which improved within a few days. Inside stent related sludge or stone was identified in 12 patients during follow-up. Thirteen patients achieved stent-free status for a median of 281 (range, 70-1,351) days after removal of the inside stents. The rendezvous technique is a useful and safe method for the replacement of PTBD catheter with inside stent in patients with biliary stricture after LDLT with duct-to-duct anastomosis. The rendezvous technique could be recommended to patients with angulated or twisted strictures.

  6. Comparison of transhepatic and extrahepatic routes for EUS-guided rendezvous procedure for distal CBD obstruction.

    Science.gov (United States)

    Dhir, Vinay; Bhandari, Suryaprakash; Bapat, Mukta; Joshi, Nitin; Vivekanandarajah, Suhirdan; Maydeo, Amit

    2013-04-01

    EUS-guided rendezvous procedure (EUS-RV) can be done by the transhepatic (TH) or the extrahepatic (EH) route. There is no data on the preferred access route when both routes are available. To compare the success, complications, and duration of hospitalization for patients undergoing EUS-RV by the TH or the EH route. Patients with distal common bile duct (CBD) obstruction, who failed selective cannulation, underwent EUS-RV by the TH route through the stomach or the EH route through the duodenum. A total of 35 patients were analysed (17 TH, 18 EH). The mean procedure time was significantly longer for the TH group (34.4 vs. 25.7 min; p = 0.0004). There was no difference in the technical success (94.1 vs. 100%). However, the TH group had a higher incidence of post-procedure pain (44.1 vs. 5.5%; p = 0.017), bile leak (11.7 vs. 0; p = 0.228), and air under diaphragm (11.7 vs. 0; p = 0.228). All bile leaks were small and managed conservatively. Duration of hospitalization was significantly higher for the TH group (2.52 vs. 0.17 days; p = 0.015). EUS-RV has similar success rate by the TH or the EH route. However, the TH route has higher post-procedure pain, longer procedure time, and longer duration of hospitalization. The EH route should be preferred for EUS-RV in patients with distal CBD obstruction when both access routes are technically feasible.

  7. Coherent Doppler lidar for automated space vehicle, rendezvous, station-keeping and capture

    Science.gov (United States)

    Dunkin, James A.

    1991-01-01

    Recent advances in eye-safe, short wavelength solid-state lasers offer real potential for the development of compact, reliable, light-weight, efficient coherent lidar. Laser diode pumping of these devices has been demonstrated, thereby eliminating the need for flash lamp pumping, which has been a major drawback to the use of these lasers in space based applications. Also these lasers now have the frequency stability required to make them useful in coherent lidar, which offers all of the advantages of non-coherent lidar, but with the additional advantage that direct determination of target velocity is possible by measurement of the Doppler shift. By combining the Doppler velocity measurement capability with the inherent high angular resolution and range accuracy of lidar it is possible to construct Doppler images of targets for target motion assessment. A coherent lidar based on a Tm,Ho:YAG 2-micrometer wavelength laser was constructed and successfully field tested on atmospheric targets in 1990. This lidar incorporated an all solid state (laser diode pumped) master oscillator, in conjunction with a flash lamp pumped slave oscillator. Solid-state laser technology is rapidly advancing, and with the advent of high efficiency, high power, semiconductor laser diodes as pump sources, all-solid-state, coherent lidars are a real possibility in the near future. MSFC currently has a feasibility demonstration effort under way which will involve component testing, and preliminary design of an all-solid-state, coherent lidar for automatic rendezvous, and capture. This two year effort, funded by the Director's Discretionary Fund is due for completion in 1992.

  8. Rendezvous with Toutatis from the Moon: The Chang'e-2 mission

    Science.gov (United States)

    Huang, J.; Tang, X.; Meng, L.

    2014-07-01

    Chang'e-2 probe was the second lunar probe of China, with the main objectives to demonstrate some key features of the new lunar soft landing technology, and its applications to future exploration missions. After completing the planned mission successfully, Chang'e-2 flew away from the Moon and entered into the interplanetary space. Later, at a distance of 7 million km from the Earth, Chang'e-2 encountered asteroid (4179) Toutatis with a very close fly-by distance and obtained colorful images with a 3-m resolution. Given some surplus velocity increment as well as the promotion of autonomous flight ability and improvement of control, propulsion, and thermal systems in the initial design, Chang'e-2 had the capabilities necessary for escaping from the Moon. By taking advantage of the unique features of the Lagrangian point, the first close fly-by of asteroid Toutatis was realized despite the tight constraints of propellant allocation, spacecraft-Earth communication, and coordination of execution sequences. Chang'e-2 realized the Toutatis flyby with a km-level distance at closest approach. In the absence of direct measurement method, based on the principle of relative navigation and through the use of the sequence of target images, we calculated the rendezvous parameters such as relative distance and image resolution. With the help of these parameters, some fine and new scientific discoveries about the asteroid were obtained by techniques of optical measurements and image processing. Starting with an innovative design, followed by high-fidelity testing and demonstration, elaborative implementation, and optimal usage of residual propellant, Chang'e-2 has for the first time successfully explored the Moon, L2 point and an asteroid, while achieving the purpose of 'faster, better, cheaper'. What Chang'e-2 has accomplished was far beyond our expectations. *J. Huang is the chief designer (PI) of Chang'e-2 probe, planned Chang'e-2's multi-objective and multitasking exploration

  9. Combined radiologic and endoscopic treatment (using the “rendezvous technique”) of a biliary fistula following left hepatectomy

    Science.gov (United States)

    Gracient, Aurélien; Rebibo, Lionel; Delcenserie, Richard; Yzet, Thierry; Regimbeau, Jean-Marc

    2016-01-01

    Despite the ongoing decrease in the frequency of complications after hepatectomy, biliary fistulas still occur and are associated with high morbidity and mortality rates. Here, we report on an unusual technique for managing biliary fistula following left hepatectomy in a patient in whom the right posterior segmental duct joined the left hepatic duct. The biliary fistula was treated with a combined radiologic and endoscopic procedure based on the “rendezvous technique”. The clinical outcome was good, and reoperation was not required. PMID:27570431

  10. The rendezvous technique involving insertion of a guidewire in a percutaneous transhepatic gallbladder drainage tube for biliary access in a case of difficult biliary cannulation.

    Science.gov (United States)

    Sunada, Fumiko; Morimoto, Naoki; Tsukui, Mamiko; Kurata, Hidekazu

    2017-05-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic method and treatment approach for biliary diseases. However, biliary cannulation can be difficult in some cases. We performed ERCP in a 97-year-old woman with abdominal pain resulting from acute cholangitis caused by choledocholithiasis and observed difficult biliary cannulation. Eventually, the patient was successfully treated with the rendezvous technique. We could not cannulate the biliary duct during ERCP twice. Therefore, we placed a percutaneous transhepatic gallbladder drainage (PTGBD) tube without intrahepatic dilation. The rendezvous technique was performed using the PTGBD tube. The patient did not experience pancreatitis or perforation.

  11. Rendezvous technique treatment for late-onset biliary leakage after major hepatectomy of a living donor: report of a case.

    Science.gov (United States)

    Kimura, Koichi; Ikegami, Toru; Yamashita, Yo-ichi; Saeki, Hiroshi; Oki, Eiji; Yoshizumi, Tomoharu; Uchiyama, Hideaki; Kawanaka, Hirofumi; Soejima, Yuji; Morita, Masaru; Shirabe, Ken; Ikeda, Tetsuo; Maehara, Yoshihiko

    2013-09-01

    Biliary leakage is a major complication after hepatectomy. We report the case of a living-donor liver transplantation (LDLT) donor with a late-onset bile leak from the trifurcation of the hepatic duct who was successfully treated using rendezvous technique. A 52-year-old man underwent extended left hepatectomy for donation and was discharged on postoperative day (PD) 13. However, he was rehospitalized on PD 26 with severe abdominal pain. Physical examination suggested panperitonitis, and abdominocentesis showed bilious ascites. Emergent laparotomy for biliary leakage and peritonitis was performed. There was bilious ascites in the peritoneal cavity. A biliary fistula was recognized at the trifurcation of B8a, B8b, and B5. Intraoperative transhepatic biliary drainage of each bile duct was performed. Endoscopic transpapillary drainage was performed on PD 24. Finally, external drains were removed and complete internal drainage established on PD 70. The bile leak was considered to be the result of injury from electrocautery device. Appropriate making choices of the electrocautery devices enable us to avoid over thermal injury of the liver surface. Rendezvous bidirectional drainage effectively treated late-onset bile leakage from the trifurcation of a hepatic bile duct.

  12. Guidance and Control of Position and Attitude for Rendezvous and Dock/Berthing with a Noncooperative/Target Spacecraft

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    Gilberto Arantes

    2014-01-01

    Full Text Available Noncooperative target spacecrafts are those assets in orbit that cannot convey any information about their states (position, attitude, and velocities or facilitate rendezvous and docking/berthing (RVD/B process. Designing a guidance, navigation, and control (GNC module for the chaser in a RVD/B mission with noncooperative target should be inevitably solved for on-orbit servicing technologies. The proximity operations and the guidance for achieving rendezvous problems are addressed in this paper. The out-of-plane maneuvers of proximity operations are explored with distinct subphases, including a chaser far approach in the target’s orbit to the first hold point and a closer approach to the final berthing location. Accordingly, guidance solutions are chosen for each subphase from the standard Hill based Closhessy-Willtshire (CW solution, elliptical fly-around, and Glideslope algorithms. The control is based on a linear quadratic regulator approach (LQR. At the final berthing location, attitude tracker based on a proportional derivative (PD form is tested to synchronize the chaser and target attitudes. The paper analyzes the performance of both controllers in terms of the tracking ability and the robustness. Finally, it prescribes any restrictions that may be imposed on the guidance during any subphase which can help to improve the controllers tracking ability.

  13. NASA's Automated Rendezvous and Docking/Capture Sensor Development and Its Applicability to the GER

    Science.gov (United States)

    Hinkel, Heather; Cryan, Scott; DSouza, Christopher; Strube, Matthew

    2014-01-01

    This paper will address how a common Automated Rendezvous and Docking/Capture (AR&D/C) sensor suite can support Global Exploration Roadmap (GER) missions, and discuss how the model of common capability development to support multiple missions can enable system capability level partnerships and further GER objectives. NASA has initiated efforts to develop AR&D/C sensors, that are directly applicable to GER. NASA needs AR&D/C sensors for both the robotic and crewed segments of the Asteroid Redirect Mission (ARM). NASA recently conducted a commonality assessment of the concept of operations for the robotic Asteroid Redirect Vehicle (ARV) and the crewed mission segment using the Orion crew vehicle. The commonality assessment also considered several future exploration and science missions requiring an AR&D/C capability. Missions considered were asteroid sample return, satellite servicing, and planetary entry, descent, and landing. This assessment determined that a common sensor suite consisting of one or more visible wavelength cameras, a three-dimensional LIDAR along with long-wavelength infrared cameras for robustness and situational awareness could be used on each mission to eliminate the cost of multiple sensor developments and qualifications. By choosing sensor parameters at build time instead of at design time and, without having to requalify flight hardware, a specific mission can design overlapping bearing, range, relative attitude, and position measurement availability to suit their mission requirements with minimal nonrecurring engineering costs. The resulting common sensor specification provides the union of all performance requirements for each mission and represents an improvement over the current systems used for AR&D/C today. NASA's AR&D/C sensor development path could benefit the International Exploration Coordination Group (ISECG) and support the GER mission scenario by providing a common sensor suite upon which GER objectives could be achieved while

  14. Using Information from Rendezvous Missions for Best-Case Appraisals of Impact Damage to Planet Earth Caused by Natural Objects

    Science.gov (United States)

    Arnold, James O.; Chodas, Paul W.; Ulamec, Stephan; Mathias, Donovan L.; Burkhard, Craig D.

    2017-01-01

    The Asteroid Threat Assessment Project (ATAP), a part of NASAs Planetary Defense Coordination Office (PDCO) has the responsibility to appraise the range of surface damage by potential asteroid impacts on land or water. If a threat is realized, the project will provide appraisals to officials empowered to make decisions about potential mitigation actions. This paper describes a scenario for assessment of surface damage when characterization of an asteroid had been accomplished by a rendezvous mission that would be conducted by the international planetary defense community. It is shown that the combination of data from ground and in-situ measurements on an asteroid provides knowledge that can be used to pin-point its impact location and predict the level of devastation it would cause. The hypothetical asteroid 2017 PDC with a size range of 160 to 290 m in diameter to be discussed at the PDC 2017 is used as an example. In order of importance for appraising potential damage, information required is: (1) where will the surface impact occur? (2) what is the mass, shape and size of the asteroid and what is its entry state (speed and entry angle) at the 100 km atmospheric pierce point? And (3) is the asteroid a monolith or a rubble pile? If it is a rubble pile, what is its structure and heterogeneity from the surface and throughout its interior? Item (1) is of first order importance to determine levels of devastation (loss of life and infrastructure damage) because it varies strongly on the impact location. Items (2) and (3) are used as inputs for ATAPs simulations to define the level of surface hazards: winds, overpressure, thermal exposure; all created by the deposition of energy during the objects atmospheric flight, andor cratering. Topics presented in this paper include: (i) the devastation predicted by 2017 PDCs impact on land based on initial observations using ATAPs risk assessment capability, (ii) how information corresponding to items (1) to (3) could be obtained

  15. Pneumoperitoneum Caused by Air Leakage Through the Percutaneous Puncture Tract as a Complication of Rendezvous Technique: A Case Report

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    Chiao-Hsiung Chuang

    2008-11-01

    Full Text Available The rendezvous technique, combining percutaneous and endoscopic procedures, is a safe and effective method to achieve biliary cannulation if an endoscopic approach fails. The two procedures in this technique can be carried out simultaneously or in stages. A simultaneous approach is reported to be associated with fewer complications, and patients undergoing this approach can recover and be discharged more rapidly. Here, we report a complication of pneumoperitoneum in a patient who underwent percutaneous and endoscopic procedures simultaneously for the removal of a common bile duct stone. It was supposed that prolonged air insufflation during endoscopy forced intestinal air to track into the peritoneal cavity through the bile ducts and the puncture tract. Accordingly, a short wait before removing the percutaneous catheter to deflate the intestinal air will be helpful to avoid such a complication.

  16. Spacecraft Actuator Diagnosis with Principal Component Analysis: Application to the Rendez-Vous Phase of the Mars Sample Return Mission

    Directory of Open Access Journals (Sweden)

    Othman Nasri

    2015-01-01

    Full Text Available This paper presents a fault detection and isolation (FDI approach in order to detect and isolate actuators (thrusters and reaction wheels faults of an autonomous spacecraft involved in the rendez-vous phase of the Mars Sample Return (MSR mission. The principal component analysis (PCA has been adopted to estimate the relationships between the various variables of the process. To ensure the feasibility of the proposed FDI approach, a set of data provided by the industrial “high-fidelity” simulator of the MSR and representing the opening (resp., the rotation rates of the spacecraft thrusters (resp., reaction wheels has been considered. The test results demonstrate that the fault detection and isolation are successfully accomplished.

  17. The impact of trauma on the psyche of the individual using the film Belleville Rendez-vous as an illustrative vehicle.

    Science.gov (United States)

    Waldron, Sharn

    2008-09-01

    Using the film Belleville Rendez-vous as a vehicle for discussion, this paper argues that whilst a traumatic complex may bring about dissociation of the psyche, this is not the only possibility, nor is dissociation necessarily to be seen solely as a difficulty to be overcome. If trauma is experienced within the context of support and validation, the experience of trauma may generate integration not only of the trauma but also of the growth potential that the trauma has previously inhibited.

  18. Relationship between automation trust and operator performance for the novice and expert in spacecraft rendezvous and docking (RVD).

    Science.gov (United States)

    Niu, Jianwei; Geng, He; Zhang, Yijing; Du, Xiaoping

    2018-09-01

    Operator trust in automation is a crucial factor influencing its use and operational performance. However, the relationship between automation trust and performance remains poorly understood and requires further investigation. The objective of this paper is to explore the difference in trust and performance on automation-aided spacecraft rendezvous and docking (RVD) between the novice and the expert and to investigate the relationship between automation trust and performance as well. We employed a two-factor mixed design, with training skill (novice and expert) and automation mode (manual RVD and automation aided RVD) serving as the two factors. Twenty participants, 10 novices and 10 experts, were recruited to conduct six RVD tasks for two automation levels. After the tasks, operator performance was recorded by the desktop hand-held docking training equipment. Operator trust was also measured by a 12-items questionnaire at the beginning and end of each trial. As a result, automation narrowed the performance gap significantly between the novice and the expert, and the automation trust showed a marginally significant difference between the novice and the expert. Furthermore, the result demonstrated that the attitude angle control error of the expert was related to the total trust score, whereas other automation performance indicators were not related to the total score of trust. However, automation performance was related to the dimensions of trust, such as entrust, harmful, and dependable. Copyright © 2018 Elsevier Ltd. All rights reserved.

  19. Endoscopic Ultrasound-guided Rendezvous Technique after Failed Endoscopic Retrograde Cholangiopancreatography: Which Approach Route Is the Best?

    Science.gov (United States)

    Okuno, Nozomi; Hara, Kazuo; Mizuno, Nobumasa; Hijioka, Susumu; Tajika, Masahiro; Tanaka, Tsutomu; Ishihara, Makoto; Hirayama, Yutaka; Onishi, Sachiyo; Niwa, Yasumasa; Yamao, Kenji

    2017-12-01

    Objective The endoscopic ultrasound-guided rendezvous technique (EUS-RV) is a salvage method for failed selective biliary cannulation. Three puncture routes have been reported, with many comparisons between the intra-hepatic and extra-hepatic biliary ducts. We used the trans-esophagus (TE) and trans-jejunum (TJ) routes. In the present study, the utility of EUS-RV for biliary access was evaluated, focusing on the approach routes. Methods and Patients In 39 patients, 42 puncture routes were evaluated in detail. EUS-RV was performed between January 2010 and December 2014. The patients were prospectively enrolled, and their clinical data were retrospectively collected. Results The patients' median age was 71 (range 29-84) years. The indications for endoscopic retrograde cholangiopancreatography (ERCP) were malignant biliary obstruction in 24 patients and benign biliary disease in 15. The technical success rate was 78.6% (33/42) and was similar among approach routes (p=0.377). The overall complication rate was 16.7% (7/42) and was similar among approach routes (p=0.489). However, mediastinal emphysema occurred in 2 TE route EUS-RV patients. No EUS-RV-related deaths occurred. Conclusion EUS-RV proved reliable after failed ERCP. The selection of the appropriate route based on the patient's condition is crucial.

  20. The Space Operations Simulation Center (SOSC) and Closed-Loop Hardware Testing for Orion Rendezvous System Design

    Science.gov (United States)

    Milenkovic, Zoran; DSouza, Christopher; Huish, David; Bendle, John; Kibler, Angela

    2012-01-01

    The exploration goals of Orion / MPCV Project will require a mature Rendezvous, Proximity Operations and Docking (RPOD) capability. Ground testing autonomous docking with a next-generation sensor such as the Vision Navigation Sensor (VNS) is a critical step along the path of ensuring successful execution of autonomous RPOD for Orion. This paper will discuss the testing rationale, the test configuration, the test limitations and the results obtained from tests that have been performed at the Lockheed Martin Space Operations Simulation Center (SOSC) to evaluate and mature the Orion RPOD system. We will show that these tests have greatly increased the confidence in the maturity of the Orion RPOD design, reduced some of the latent risks and in doing so validated the design philosophy of the Orion RPOD system. This paper is organized as follows: first, the objectives of the test are given. Descriptions of the SOSC facility, and the Orion RPOD system and associated components follow. The details of the test configuration of the components in question are presented prior to discussing preliminary results of the tests. The paper concludes with closing comments.

  1. Endoscopic Ultrasound Guided Rendezvous Drainage of Biliary Obstruction Using a New Flexible 19-Gauge Fine Needle Aspiration Needle.

    Science.gov (United States)

    Tang, Zhouwen; Igbinomwanhia, Efehi; Elhanafi, Sherif; Othman, Mohamed O

    2016-01-01

    Background and Aim. A successful endoscopic ultrasound guided rendezvous (EUS-RV) biliary drainage is dependent on accurate puncture of the bile duct and precise guide wire manipulation across the ampulla of Vater. We aim to study the feasibility of using a flexible 19-gauge fine aspiration needle in the performance of EUS-RV biliary drainage. Method. This is a retrospective case series of EUS-RV biliary drainage procedures at a single center. Patients who failed ERCP during the same session for benign or malignant biliary obstruction underwent EUS-RV using a flexible, nitinol covered, 19-gauge needle for biliary access and guide wire manipulation. Result. 24 patients underwent EUS-RV biliary drainage via extrahepatic access while 1 attempt was via intrahepatic access. The technical success rate was 80%, including 83.3% of cases via extrahepatic access. There was no significant difference in success rate of inpatient and outpatient procedures, benign or malignant indications, or type of guide wire used. Adverse events included mild pancreatitis (3 patients) and cholangitis (1 patient). Conclusion. A flexible 19-gauge needle for biliary access can be safe and effective when used to perform EUS-RV biliary drainage. Direct comparison between the nitinol needle and conventional metal needles in the performance of EUS guided biliary drainage is needed.

  2. A novel "hitch-and-ride" deep biliary cannulation method during rendezvous endoscopic ultrasound-guided ERCP technique.

    Science.gov (United States)

    Nakai, Yousuke; Isayama, Hiroyuki; Matsubara, Saburo; Kogure, Hirofumi; Mizuno, Suguru; Hamada, Tsuyoshi; Takahara, Naminatsu; Nakamura, Tomoka; Sato, Tatsuya; Takeda, Tsuyoshi; Hakuta, Ryunosuke; Ishigaki, Kazunaga; Saito, Kei; Tada, Minoru; Koike, Kazuhiko

    2017-10-01

    Background and study aim Endoscopic ultrasound-guided rendezvous (EUS-RV) is increasingly reported as a treatment option after failed endoscopic retrograde cholangiopancreatography. We developed a novel "hitch-and-ride" catheter for biliary cannulation to reduce the risk of guidewire loss during EUS-RV. Patients and methods We retrospectively evaluated safety and technical success of EUS-RV between June 2011 and May 2016. Biliary cannulation during EUS-RV using three methods - over-the-wire, along-the-wire, and hitch-and-ride - were compared. Results A total of 30 EUS-RVs were attempted and the technical success rate was 93.3 %, with two failures (one bile duct puncture and one guidewire insertion). After 28 cases of successful guidewire passage, cannulation was attempted by the over-the-wire (n = 13), along-the-wire (n = 4) or hitch-and-ride (n = 11) method. Only the hitch-and-ride method achieved biliary cannulation without guidewire loss or conversion to the other methods. Time to cannulation was shorter with the hitch-and-ride method (4 minutes) than with over-the-wire and along-the-wire methods (9 and 13 minutes, respectively). The adverse event rate of EUS-RV was 23.3 %. Conclusion A novel hitch-and-ride catheter was feasible for biliary cannulation after EUS-RV. © Georg Thieme Verlag KG Stuttgart · New York.

  3. A New Path-Constrained Rendezvous Planning Approach for Large-Scale Event-Driven Wireless Sensor Networks

    Directory of Open Access Journals (Sweden)

    Ahmadreza Vajdi

    2018-05-01

    Full Text Available We study the problem of employing a mobile-sink into a large-scale Event-Driven Wireless Sensor Networks (EWSNs for the purpose of data harvesting from sensor-nodes. Generally, this employment improves the main weakness of WSNs that is about energy-consumption in battery-driven sensor-nodes. The main motivation of our work is to address challenges which are related to a network’s topology by adopting a mobile-sink that moves in a predefined trajectory in the environment. Since, in this fashion, it is not possible to gather data from sensor-nodes individually, we adopt the approach of defining some of the sensor-nodes as Rendezvous Points (RPs in the network. We argue that RP-planning in this case is a tradeoff between minimizing the number of RPs while decreasing the number of hops for a sensor-node that needs data transformation to the related RP which leads to minimizing average energy consumption in the network. We address the problem by formulating the challenges and expectations as a Mixed Integer Linear Programming (MILP. Henceforth, by proving the NP-hardness of the problem, we propose three effective and distributed heuristics for RP-planning, identifying sojourn locations, and constructing routing trees. Finally, experimental results prove the effectiveness of our approach.

  4. A New Path-Constrained Rendezvous Planning Approach for Large-Scale Event-Driven Wireless Sensor Networks.

    Science.gov (United States)

    Vajdi, Ahmadreza; Zhang, Gongxuan; Zhou, Junlong; Wei, Tongquan; Wang, Yongli; Wang, Tianshu

    2018-05-04

    We study the problem of employing a mobile-sink into a large-scale Event-Driven Wireless Sensor Networks (EWSNs) for the purpose of data harvesting from sensor-nodes. Generally, this employment improves the main weakness of WSNs that is about energy-consumption in battery-driven sensor-nodes. The main motivation of our work is to address challenges which are related to a network’s topology by adopting a mobile-sink that moves in a predefined trajectory in the environment. Since, in this fashion, it is not possible to gather data from sensor-nodes individually, we adopt the approach of defining some of the sensor-nodes as Rendezvous Points (RPs) in the network. We argue that RP-planning in this case is a tradeoff between minimizing the number of RPs while decreasing the number of hops for a sensor-node that needs data transformation to the related RP which leads to minimizing average energy consumption in the network. We address the problem by formulating the challenges and expectations as a Mixed Integer Linear Programming (MILP). Henceforth, by proving the NP-hardness of the problem, we propose three effective and distributed heuristics for RP-planning, identifying sojourn locations, and constructing routing trees. Finally, experimental results prove the effectiveness of our approach.

  5. A New Path-Constrained Rendezvous Planning Approach for Large-Scale Event-Driven Wireless Sensor Networks

    Science.gov (United States)

    Zhang, Gongxuan; Wang, Yongli; Wang, Tianshu

    2018-01-01

    We study the problem of employing a mobile-sink into a large-scale Event-Driven Wireless Sensor Networks (EWSNs) for the purpose of data harvesting from sensor-nodes. Generally, this employment improves the main weakness of WSNs that is about energy-consumption in battery-driven sensor-nodes. The main motivation of our work is to address challenges which are related to a network’s topology by adopting a mobile-sink that moves in a predefined trajectory in the environment. Since, in this fashion, it is not possible to gather data from sensor-nodes individually, we adopt the approach of defining some of the sensor-nodes as Rendezvous Points (RPs) in the network. We argue that RP-planning in this case is a tradeoff between minimizing the number of RPs while decreasing the number of hops for a sensor-node that needs data transformation to the related RP which leads to minimizing average energy consumption in the network. We address the problem by formulating the challenges and expectations as a Mixed Integer Linear Programming (MILP). Henceforth, by proving the NP-hardness of the problem, we propose three effective and distributed heuristics for RP-planning, identifying sojourn locations, and constructing routing trees. Finally, experimental results prove the effectiveness of our approach. PMID:29734718

  6. Omnidirectional angle constraint based dynamic six-degree-of-freedom measurement for spacecraft rendezvous and docking simulation

    Science.gov (United States)

    Shi, Shendong; Yang, Linghui; Lin, Jiarui; Ren, Yongjie; Guo, Siyang; Zhu, Jigui

    2018-04-01

    In this paper we present a novel omnidirectional angle constraint based method for dynamic 6-DOF (six-degree-of-freedom) measurement. A photoelectric scanning measurement network is employed whose photoelectric receivers are fixed on the measured target. They are in a loop distribution and receive signals from rotating transmitters. Each receiver indicates an angle constraint direction. Therefore, omnidirectional angle constraints can be constructed in each rotation cycle. By solving the constrained optimization problem, 6-DOF information can be obtained, which is independent of traditional rigid coordinate system transformation. For the dynamic error caused by the measurement principle, we present an interpolation method for error reduction. Accuracy testing is performed in an 8  ×  8 m measurement area with four transmitters. The experimental results show that the dynamic orientation RMSEs (root-mean-square errors) are reduced from 0.077° to 0.044°, 0.040° to 0.030° and 0.032° to 0.015° in the X, Y, and Z axes, respectively. The dynamic position RMSE is reduced from 0.65 mm to 0.24 mm. This method is applied during the final approach phase in the rendezvous and docking simulation. Experiments under different conditions are performed in a 40  ×  30 m area, and the method is verified to be effective.

  7. Laparoscopic-endoscopic rendezvous versus preoperative endoscopic sphincterotomy in people undergoing laparoscopic cholecystectomy for stones in the gallbladder and bile duct.

    Science.gov (United States)

    Vettoretto, Nereo; Arezzo, Alberto; Famiglietti, Federico; Cirocchi, Roberto; Moja, Lorenzo; Morino, Mario

    2018-04-11

    The management of gallbladder stones (lithiasis) concomitant with bile duct stones is controversial. The more frequent approach is a two-stage procedure, with endoscopic sphincterotomy and stone removal from the bile duct followed by laparoscopic cholecystectomy. The laparoscopic-endoscopic rendezvous combines the two techniques in a single-stage operation. To compare the benefits and harms of endoscopic sphincterotomy and stone removal followed by laparoscopic cholecystectomy (the single-stage rendezvous technique) versus preoperative endoscopic sphincterotomy followed by laparoscopic cholecystectomy (two stages) in people with gallbladder and common bile duct stones. We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, CENTRAL, MEDLINE Ovid, Embase Ovid, Science Citation Index Expanded Web of Science, and two trials registers (February 2017). We included randomised clinical trials that enrolled people with concomitant gallbladder and common bile duct stones, regardless of clinical status or diagnostic work-up, and compared laparoscopic-endoscopic rendezvous versus preoperative endoscopic sphincterotomy procedures in people undergoing laparoscopic cholecystectomy. We excluded other endoscopic or surgical methods of intraoperative clearance of the bile duct, e.g. non-aided intraoperative endoscopic retrograde cholangiopancreatography or laparoscopic choledocholithotomy (surgical incision of the common bile duct for removal of bile duct stones). We used standard methodological procedures recommended by Cochrane. We included five randomised clinical trials with 517 participants (257 underwent a laparoscopic-endoscopic rendezvous technique versus 260 underwent a sequential approach), which fulfilled our inclusion criteria and provided data for analysis. Trial participants were scheduled for laparoscopic cholecystectomy because of suspected cholecysto-choledocholithiasis. Male/female ratio was 0.7; age of men and women ranged from 21 years to 87

  8. 21st century early mission concepts for Mars delivery and earth return

    Science.gov (United States)

    Cruz, Manuel I.; Ilgen, Marc R.

    1990-01-01

    In the 21st century, the early missions to Mars will entail unmanned Rover and Sample Return reconnaissance missions to be followed by manned exploration missions. High performance leverage technologies will be required to reach Mars and return to earth. This paper describes the mission concepts currently identified for these early Mars missions. These concepts include requirements and capabilities for Mars and earth aerocapture, Mars surface operations and ascent, and Mars and earth rendezvous. Although the focus is on the unmanned missions, synergism with the manned missions is also discussed.

  9. A comparison between endoscopic ultrasound-guided rendezvous and percutaneous biliary drainage after failed ERCP for malignant distal biliary obstruction.

    Science.gov (United States)

    Bill, Jason G; Darcy, Michael; Fujii-Lau, Larissa L; Mullady, Daniel K; Gaddam, Srinivas; Murad, Faris M; Early, Dayna S; Edmundowicz, Steven A; Kushnir, Vladimir M

    2016-09-01

    Selective biliary cannulation is unsuccessful in 5 % to 10 % of patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) for malignant distal biliary obstruction (MDBO). Percutaneous biliary drainage (PBD) has been the gold standard, but endoscopic ultrasound guided rendezvous (EUSr) have been increasingly used for biliary decompression in this patient population. Our aim was to compare the initial success rate, long-term efficacy, and safety of PBD and EUSr in relieving MDBO after failed ERC Patients and methods: A retrospective study involving 50 consecutive patients who had an initial failed ERCP for MDBO. Twenty-five patients undergoing EUSr between 2008 - 2014 were compared to 25 patients who underwent PBD immediately prior to the introduction of EUSr at our center (2002 - 2008). Comparisons were made between the two groups with regard to technical success, duration of hospital stay and adverse event rates after biliary decompression. The mean age at presentation was 66.5 (± 12.6 years), 28 patients (54.9 %) were female. The etiology of MDBO was pancreaticobiliary malignancy in 44 (88 %) and metastatic disease in 6 (12 %) cases. Biliary drainage was technically successful by EUSr in 19 (76 %) cases and by PBD in 25 (100 %) (P = 0.002). Median length of hospital stay after initial drainage was 1 day in the EUSr group vs 5 days in PBD group (P = 0.02). Repeat biliary intervention was required for 4 patients in the EUSr group and 15 in the PBD group (P = 0.001). Initial technical success with EUSr was significantly lower than with PBD, however when EUSr was successful, patients had a significantly shorter post-procedure hospital stay and required fewer follow-up biliary interventions. Meeting presentations: Annual Digestive Diseases Week 2015.

  10. Endoscopic Ultrasound-Guided Rendezvous Technique for Failed Biliary Cannulation in Benign and Resectable Malignant Biliary Disorders.

    Science.gov (United States)

    Shiomi, Hideyuki; Yamao, Kentaro; Hoki, Noriyuki; Hisa, Takeshi; Ogura, Takeshi; Minaga, Kosuke; Masuda, Atsuhiro; Matsumoto, Kazuya; Kato, Hironari; Kamada, Hideki; Goto, Daisuke; Imai, Hajime; Takenaka, Mamoru; Noguchi, Chishio; Nishikiori, Hidefumi; Chiba, Yasutaka; Kutsumi, Hiromu; Kitano, Masayuki

    2018-03-01

    Endoscopic ultrasound-guided rendezvous technique (EUS-RV) has emerged as an effective salvage method for unsuccessful biliary cannulation. However, its application for benign and resectable malignant biliary disorders has not been fully evaluated. To assess the efficacy and safety of EUS-RV for benign and resectable malignant biliary disorders. This was a multicenter prospective study from 12 Japanese referral centers. Patients who underwent EUS-RV after failed biliary cannulation for biliary disorder were candidates for this study. Inclusion criteria were unsuccessful biliary cannulation for therapeutic endoscopic retrograde cholangiopancreatography with benign and potentially resectable malignant biliary obstruction. Exclusion criteria included unresectable malignant biliary obstruction, inaccessible papillae due to surgically altered upper gastrointestinal anatomy or duodenal stricture, and previous sphincterotomy and/or biliary stent placement. The primary outcome was the technical success rate of biliary cannulation; procedure time, adverse events, and clinical outcomes were secondary outcomes. Twenty patients were prospectively enrolled. The overall technical success rate and median procedure time were 85% and 33 min, respectively. Guidewire manipulation using a 4-Fr tapered tip catheter contributed to the success in advancing the guidewire into the duodenum. Adverse events were identified in 15% patients, including 2 with biliary peritonitis and 1 mild pancreatitis. EUS-RV did not affect surgical maneuvers or complications associated with surgery, or postoperative course. EUS-RV may be a safe and feasible salvage method for unsuccessful biliary cannulation for benign or resectable malignant biliary disorders. Use of a 4-Fr tapered tip catheter may improve the overall EUS-RV success rate.

  11. EUS-guided rendezvous for difficult biliary cannulation using a standardized algorithm: a multicenter prospective pilot study (with videos).

    Science.gov (United States)

    Iwashita, Takuji; Yasuda, Ichiro; Mukai, Tsuyoshi; Iwata, Keisuke; Ando, Nobuhiro; Doi, Shinpei; Nakashima, Masanori; Uemura, Shinya; Mabuchi, Masatoshi; Shimizu, Masahito

    2016-02-01

    Biliary cannulation is necessary in therapeutic ERCP for biliary disorders. EUS-guided rendezvous (EUS-RV) can salvage failed cannulation. Our aim was to determine the safety and efficacy of EUS-RV by using a standardized algorithm with regard to the endoscope position in a prospective study. EUS-RV was attempted after failed cannulation in 20 patients. In a standardized approach, extrahepatic bile duct (EHBD) cannulation was preferentially attempted from the second portion of the duodenum (D2) followed by additional approaches to the EHBD from the duodenal bulb (D1) or to the intrahepatic bile duct from the stomach, if necessary. A guidewire was placed in an antegrade fashion into the duodenum. After the guidewire was placed, the endoscope was exchanged for a duodenoscope to complete the cannulation. The bile duct was accessed from the D2 in 10 patients, but from the D1 in 5 patients and the stomach in 4 patients because of no dilation or tumor invasion at the distal EHBD. In the remaining patient, biliary puncture was not attempted due to the presence of collateral vessels. The guidewire was successfully manipulated in 80% of patients: 100% (10/10) with the D2 approach and 66.7% (6/9) with other approaches. The overall success rate was 80% (16/20). Failed EUS-RV was salvaged with a percutaneous approach in 2 patients, repeat ERCP in 1 patient, and conservative management in 1 patient. Minor adverse events occurred in 15% of patients (3/20). EUS-RV is a safe and effective salvage method. Using EUS-RV to approach the EHBD from the D2 may improve success rates. Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  12. Technology Development of Automated Rendezvous and Docking/Capture Sensors and Docking Mechanism for the Asteroid Redirect Crewed Mission

    Science.gov (United States)

    Hinkel, Heather; Strube, Matthew; Zipay, John J.; Cryan, Scott

    2016-01-01

    This paper will describe the technology development efforts NASA has underway for Automated Rendezvous and Docking/Capture (AR&D/C) sensors and a docking mechanism and the challenges involved. The paper will additionally address how these technologies will be extended to other missions requiring AR&D/C whether robotic or manned. NASA needs AR&D/C sensors for both the robotic and crewed segments of the Asteroid Redirect Mission (ARM). NASA recently conducted a commonality assessment of the concept of operations for the robotic Asteroid Redirect Vehicle (ARV) and the crewed mission segment using the Orion spacecraft. The commonality assessment also considered several future exploration and science missions requiring an AR&D/C capability. Missions considered were asteroid sample return, satellite servicing, and planetary entry, descent, and landing. This assessment determined that a common sensor suite consisting of one or more visible wavelength cameras, a three-dimensional LIDAR along with long-wavelength infrared cameras for robustness and situational awareness could be used on each mission to eliminate the cost of multiple sensor developments and qualifications. By choosing sensor parameters at build-time instead of at design-time and, without having to requalify flight hardware, a specific mission can design overlapping bearing, range, relative attitude, and position measurement availability to suit their mission requirements with minimal non-recurring engineering costs. The resulting common sensor specification provides the union of all performance requirements for each mission and represents an improvement over the current systems used for AR&D/C today. These sensor specifications are tightly coupled to the docking system capabilities and requirements for final docking conditions. The paper will describe NASA's efforts to develop a standard docking system for use across NASA human spaceflight missions to multiple destinations. It will describe the current

  13. A Review of Tiangong-1/Shenzhou-8 Rendezvous and Docking Mission%天宫一号/神舟八号交会对接任务总体评述

    Institute of Scientific and Technical Information of China (English)

    周建平

    2012-01-01

    The complete success of Tiangong-1/Shenzhou-8 rendezvous and docking mission represents a great breakthrough of China in space rendezvous and docking technology. A basic introduction of Tiangong-land Shenzhou-8 rendezvous and docking mission is presented, with the general evaluation of the mission and its main achievements being put forward.%天宫一号/神舟八号交会对接任务圆满成功,标志着我国空间交会对接技术取得重大突破。本文介绍了天宫一号目标飞行器与神舟八号飞船交会对接飞行任务的基本情况、总体评价及主要成果。

  14. Spontaneous Rupture of Superficial Femoral Artery Repaired with Endovascular Stent-Grafting with use of Rendez-Vous Technique, Followed by Delayed Infection

    International Nuclear Information System (INIS)

    Fanelli, Fabrizio; Cannavale, Alessandro; Gazzetti, Marianna; Fantozzi, Cristiano; Taurino, Maurizio; Speziale, Francesco

    2013-01-01

    This is the case of a 72-year-old man with lower limb ischemia due to spontaneous rupture of nonaneurysmal superficial femoral artery that developed into thigh hematoma. After failure of a Fogarty revascularization, an emergency endovascular procedure was performed to restore the arterial continuity. A rendezvous procedure was performed with a double femoral and popliteal approach and two covered stent-grafts were deployed. Patient’s clinical conditions immediately improved, but 4 months later the stent-grafts were surgically removed for infection and exteriorization. A femoropopliteal bypass was performed. After 1 year follow-up, the patient is in good clinical condition.

  15. Retrieval of a self-expanding metal stent after migration and incorporation in the omental bursa, using a gastroscopic-transgastric laparoscopic rendezvous technique.

    Science.gov (United States)

    Patrzyk, Maciej; Dierzek, Przemyslaw; Glitsch, Anne; Paul, Hartmut; Heidecke, Claus-Dieter

    2015-01-01

    Endoscopic drainage is a widely used treatment for pancreatic pseudocysts. Drainage-related complications may be related directly to the procedure or may occur later as stents migrate or erode into adjacent structures. Migration of a self-expanding metal stent into peritoneal cavity and incorporation in the omental bursa is rare. When endoscopic retrieval fails a combined laparoscopic-endoscopic (rendezvous technique) approach offers an alternative to open surgery. We report a case of successful gastroscopic-transgastric laparoscopic removal of a stent that was dislocated into the omental bursa after a ½ year observation period.

  16. The endoscopic ultrasound-assisted Rendez-Vous technique for treatment of recurrent pancreatitis due to pancreas divisum and ansa pancreatica

    Directory of Open Access Journals (Sweden)

    Sergio López-Durán

    Full Text Available Endoscopic treatment of pancreatic ductal malformations causing recurrent acute pancreatitis, such as pancreas divisum or ansa pancreatica, is mainly based on the sphincterotomy of the minor papilla. However, the technical complexity of conventional endoscopic retrograde cholangiopancreatography (ERCP is increased in patients presenting anatomical variants like these and it may be unsuccessful. We report the case of a pancreas divisum combined with ansa pancreatica and describe the cannulation and sphincterotomy of the minor papilla using an ultrasound-assisted Rendez-Vous technique.

  17. Retrieval of a self-expanding metal stent after migration and incorporation in the omental bursa, using a gastroscopic-transgastric laparoscopic rendezvous technique

    Directory of Open Access Journals (Sweden)

    Maciej Patrzyk

    2015-01-01

    Full Text Available Endoscopic drainage is a widely used treatment for pancreatic pseudocysts. Drainage-related complications may be related directly to the procedure or may occur later as stents migrate or erode into adjacent structures. Migration of a self-expanding metal stent into peritoneal cavity and incorporation in the omental bursa is rare. When endoscopic retrieval fails a combined laparoscopic-endoscopic (rendezvous technique approach offers an alternative to open surgery. We report a case of successful gastroscopic-transgastric laparoscopic removal of a stent that was dislocated into the omental bursa after a ΍ year observation period.

  18. Spontaneous Rupture of Superficial Femoral Artery Repaired with Endovascular Stent-Grafting with use of Rendez-Vous Technique, Followed by Delayed Infection

    Energy Technology Data Exchange (ETDEWEB)

    Fanelli, Fabrizio, E-mail: fabrizio.fanelli@uniroma1.it; Cannavale, Alessandro [University of Rome ' Sapienza,' , Department of Radiological Sciences, Vascular and Interventional Radiology Unit (Italy); Gazzetti, Marianna [Sapienza University of Rome ' Sapienza,' , Department of Surgery Paride Stefanini, Vascular Surgery Division, Policlinico Umberto I (Italy); Fantozzi, Cristiano; Taurino, Maurizio [University of Rome ' Sapienza,' , Department of Vascular Surgery (Italy); Speziale, Francesco [Sapienza University of Rome ' Sapienza,' , Department of Surgery Paride Stefanini, Vascular Surgery Division, Policlinico Umberto I (Italy)

    2013-02-15

    This is the case of a 72-year-old man with lower limb ischemia due to spontaneous rupture of nonaneurysmal superficial femoral artery that developed into thigh hematoma. After failure of a Fogarty revascularization, an emergency endovascular procedure was performed to restore the arterial continuity. A rendezvous procedure was performed with a double femoral and popliteal approach and two covered stent-grafts were deployed. Patient's clinical conditions immediately improved, but 4 months later the stent-grafts were surgically removed for infection and exteriorization. A femoropopliteal bypass was performed. After 1 year follow-up, the patient is in good clinical condition.

  19. Single Balloon Enteroscopy-Assisted ERCP Using Rendezvous Technique for Sharp Angulation of Roux-en-Y Limb in a Patient with Bile Duct Stones

    Science.gov (United States)

    Itoi, Takao; Ishii, Kentaro; Sofuni, Atsushi; Itokawa, Fumihide; Kurihara, Toshio; Tsuchiya, Takayoshi; Tsuji, Shujiro; Umeda, Junko; Moriyasu, Fuminori

    2009-01-01

    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. PMID:20169091

  20. Combined Radial-Pedal Access Strategy and Radial-Pedal Rendezvous in the Revascularization of Complex Total Occlusions of the Superficial Femoral Artery (the "No Femoral Access" Strategy).

    Science.gov (United States)

    Hanna, Elias B; Prout, Davey L

    2016-04-01

    To describe the combined use of radial-pedal access for recanalization of complex superficial femoral artery (SFA) occlusions unsuitable for transfemoral recanalization. Patients are selected for this strategy if they have a long (≥ 10 cm) SFA occlusion with unfavorable aortoiliac anatomy, an absent ostial stump, or severely diseased and calcified distal reconstitution. Left radial artery and distal anterior or posterior tibial artery are accessed with 6-F and 4-F sheaths, respectively. The SFA lesion is crossed retrogradely with a 0.035-inch wire system. If retrograde crossing is not immediately successful, transradial subintimal tracking and radial-pedal subintimal rendezvous are used to allow retrograde reentry. Fifteen patients (mean age 62 ± 5 years; 11 men) have been treated in this fashion, and frequently stented, through the tibiopedal access. Seven patients required radial-pedal rendezvous to facilitate retrograde reentry. Two patients underwent transradial iliac stenting during the same session, and 1 patient underwent transradial kissing angioplasty of the profunda. No major complication occurred in any patient. After the procedure, the pulse across the accessed tibial artery was palpable in all patients. In patients with long and complex SFA occlusion unsuitable for transfemoral recanalization, a radial-pedal strategy can overcome revascularization obstacles. © The Author(s) 2016.

  1. 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.

  2. A new duodenal rendezvous technique for biliary cannulation in patients with T-tube after orthotopic liver transplantation (with video).

    Science.gov (United States)

    Cantù, Paolo; Parzanese, Ilaria; Melada, Ernesto; Rossi, Giorgio; Conte, Dario; Penagini, Roberto

    2016-01-01

    Because a traditional rendezvous (RV) technique implies stretching of the papilla, possibly leading to post-ERCP pancreatitis, an alternative duodenal RV technique was evaluated. The aim was to assess the effectiveness, safety, and amount of time spent performing duodenal RV versus traditional RV cannulation in orthotopic liver transplantation patients with a T-tube. We retrospectively reviewed data from a prospective ERCP database held by our university hospital. Twenty patients with a T-tube who had undergone ERCP for biliary adverse events after orthotopic liver transplantation were included. The successful cannulation rate, the amount of time spent performing cannulation, the post-ERCP pancreatitis rate, and hyperamylasemia 24 hours after the procedure were recorded. Successful cannulation was achieved by the duodenal RV technique in 9 of 10 patients (90%), taking 146 seconds (interquartile range 63-341 seconds) with a short learning curve effect. An unsuccessful duodenal RV procedure occurred because of the angulation of the hydrophilic tip of the guidewire while crossing the papilla, thus preventing cannulation. Successful cannulation was achieved by the traditional RV technique in all cases (N = 11), including the failed duodenal RV technique, taking 374 seconds (interquartile range 320-410 seconds) (P < .05 vs duodenal RV). However, no post-ERCP pancreatitis occurred after using the duodenal RV technique compared with 2 episodes of mild pancreatitis after using the traditional RV technique. Twenty-four hours after the procedure, the median amylasemia level was 84 IU/L (interquartile range 49-105 IU/L) and 265 IU/L (interquartile range 73-2945 IU/L) for the duodenal versus traditional RV techniques, respectively (P = not significant). In patients with a T-tube after liver transplantation, the duodenal RV technique was not associated with post-ERCP pancreatitis, presumably because of the reduction of stress on the major papilla. Cannulation by using the

  3. DARe: Dark Asteroid Rendezvous

    Science.gov (United States)

    Noll, K. S.; McFadden, L. A.; Rhoden, A. R.; Lim, L. F.; Boynton, W. V.; Carter, L. M.; Collins, G.; Englander, J. A.; Goossens, S. A.; Grundy, W. M.; hide

    2015-01-01

    Small bodies record the chemical, physical, and dynamical processes that gave birth to and shaped the solar system. The great variety of small bodies reflects the diversity of both their genesis and their histories. The DARe mission conducts a critical test of how small body populations reflect a history of planetary migration and planetesimal scattering. This understanding is crucial for planning future NASA missions and placing current and past missions into context.

  4. Millennials: Rendezvous with Destiny?

    Science.gov (United States)

    2008-03-05

    lockers” to bedroom spy cams.12 Tragedies such as the Columbine and Virginia Tech shootings are events that have caused the security net to further...uniquely positioned to understand and respond to the “hero trial” of the clash of cultures that culminated in 9-11. They note how high school history...Association of Colleges and Schools , 3624 Market Street, Philadelphia, PA 19104, (215) 662-5606. The Commission on Higher Education is an

  5. Millennials: Rendezvous with Destiny?

    National Research Council Canada - National Science Library

    Fahlbusch, Frederick L

    2008-01-01

    The Millennial Generation (born between 1982 and about 2002) is showing characteristics and tendencies that lead generational theorists to believe that this generation will become America's next "Hero" generation...

  6. In-Flight Operation of the Dawn Ion Propulsion System: Status at One Year from the Vesta Rendezvous

    Science.gov (United States)

    Garner, Charles E.; Rayman, Marc D.

    2010-01-01

    , 2007 and was successfully concluded as planned on October 31, 2008. During this time period the Dawn IPS was operated mostly at full power for approximately 6500 hours, consumed 71.7 kg of xenon and delivered approximately 1.8 km/s of delta V to the spacecraft. The thrusting to Mars was followed by a coasting period of approximately 3.5 months that included a Mars flyby in February of 2009. The Mars flyby provided a gravity assist (MGA) for a plane change and approximately 1 km/s of heliocentric energy increase and is the only part of the mission following launch in which a needed velocity change is not accomplished by the IPS. During the coast period IPS was operated for a trajectory correction maneuver and for engineering tests but was not operated for primary propulsion. Closest approach to Mars occurred as planned on February 17, 2009 and was followed by another coasting period of just under 4 months in duration. During this last coasting phase IPS was operated only for routine maintenance activities and for system engineering tests. Deterministic thrusting for heliocentric transfer to Vesta resumed on June 8, 2009. Since resumption of cruise to Vesta IPS has been operated at throttled power levels, most of the time at full power, and with a duty cycle of approximately 93%, leading to an arrival at Vesta in July of 2011 and arrival at Ceres in February 2015. This paper provides an overview of Dawn's mission objectives and the results of Dawn IPS mission operations through one year from the spacecraft's rendezvous with Vesta.

  7. Spectral analysis and compositing techniques for the Near Earth Asteroid Rendezvous (NEAR Shoemaker), X-ray and Gamma-Ray Spectrometers (XGRS)

    CERN Document Server

    McClanahan, T P; Nittler, L R; Boynton, W V; Bruckner, J; Squyres, S W; Evans, L G; Bhangoo, J S; Clark, P E; Floyd, S R; McCartney, E; Mikheeva, I; Starr, R D

    2001-01-01

    An X-ray and Gamma-Ray Spectrometer (XGRS) is on board the Near Earth Asteroid Rendezvous (NEAR) spacecraft to determine the elemental composition of the surface of the asteroid 433 Eros. The Eros asteroid is highly oblate and irregular in shape. As a result, analysis methodologies are in many ways a divergence from comparable techniques. Complex temporal, spatial and instrument performance relationships must be accounted for during the analysis process. Field of view and asteroid surface geometry measurements must be modeled and then combined with real measurements of solar, spectral and instrument calibration information to derive scientific results. NEAR is currently orbiting 433 Eros and is in the initial phases of its primary data integration and mapping phases. Initial results have been obtained and bulk chemistry assessments have been obtained through specialized background assessment and data reduction techniques.

  8. Identifying indications for percutaneous (PTC) vs. endoscopic ultrasound (EUS)- guided "rendezvous" procedure in biliary obstruction and incomplete endoscopic retrograde cholangiography (ERC).

    Science.gov (United States)

    Albert, J G; Finkelmeier, F; Friedrich-Rust, M; Kronenberger, B; Trojan, J; Zeuzem, S; Sarrazin, C

    2014-10-01

    The variety of rendezvous (RV) procedures has recently been extended by EUS- and PTCD-guided procedures as a complementary means to conventional ERCP. We have identified indication criteria and the potential of biliary PTCD-guided vs. EUS-guided RV. Consecutive patients with bile duct obstruction who underwent RV were included. In all, ERCP alone was unable to achieve treatment success. Indication, technical success, and outcome in PTCD- vs. EUS-guided RV were retrospectively compared to identify criteria that indicate preference of RV technique. Site of obstruction, clinical scenario (stenosis with abscess vs. no abscess) and reason for previous failure of ERC were evaluated. In 32 patients, three different indications for RV procedures were identified: First, a one-step access to assist in failed ERCP (type 1, intra-ductal RV); second, temporary drainage for prolonged treatment of complex biliary disease (type 2, intra-ductal RV), and drainage of cholangio-abscess with re-establishing bile outflow (type 3, intra-abscess RV). Indication of PTCD- vs. EUS-guided rendezvous was competitive in type 1, but exclusive in favor of PTCD in types 2 and 3. The site of biliary obstruction indicated the anatomic location of RV procedures. This classification may help to define inclusion criteria for prospective studies on biliary RV procedures. Choice of therapeutic strategy depends on the anatomic location of the biliary obstruction and the type of the biliary lesion. PTCD-guided RV might improve outcome in cholangio-abscess. © Georg Thieme Verlag KG Stuttgart · New York.

  9. La formation continue des usagers : évaluation qualitative des rendez-vous d'évaluation post-permis pour les conducteurs novices. Thème 11. Rapport final

    OpenAIRE

    CHATENET, F; TORRES, S; GAUTHIER, P; PERVANCHON, M

    2001-01-01

    Rapport final de convention DSCR/INRETS. Le présent rapport fait état de l'évaluation qualitative des rendez-vous d'évaluation (RVE) pour les conducteurs novices, le volet des rendez-vous de perfectionnement (RVP) pour les conducteurs expérimentés sera abordé ultérieurement dans le cadre d'une convention DSCR/INRETS. La première partie développe les problématiques et les objectifs poursuivis par cette étude ainsi que la méthodologie qui a été utilisée. Les trois autres parties présentent les...

  10. Evaluation of a novel, hybrid model (Mumbai EUS II) for stepwise teaching and training in EUS-guided biliary drainage and rendezvous procedures

    Science.gov (United States)

    Dhir, Vinay; Itoi, Takao; Pausawasdi, Nonthalee; Khashab, Mouen A.; Perez-Miranda, Manuel; Sun, Siyu; Park, Do Hyun; Iwashita, Takuji; Teoh, Anthony Y. B.; Maydeo, Amit P.; Ho, Khek Yu

    2017-01-01

    Background and aims  EUS-guided biliary drainage (EUS-BD) and rendezvous (EUS-RV) are acceptable rescue options for patients with failed endoscopic retrograde cholangiopancreatography (ERCP). However, there are limited training opportunities at most centers owing to low case volumes. The existing models do not replicate the difficulties encountered during EUS-BD. We aimed to develop and validate a model for stepwise learning of EUS-BD and EUS-RV, which replicates the actual EUS-BD procedures. Methods  A hybrid model was created utilizing pig esophagus and stomach, with a synthetic duodenum and biliary system. The model was objectively assessed on a grade of 1 – 4 by two experts. Twenty-eight trainees were given initial training with didactic lectures and live procedures. This was followed by hands-on training in EUS-BD and EUS-RV on the hybrid model. Trainees were assessed for objective criteria of technical difficulties. Results  Both the experts graded the model as very good or above for all parameters. All trainees could complete the requisite steps of EUS-BD and EUS-RV in a mean time of 11 minutes (8 – 18 minutes). Thirty-six technical difficulties were noted during the training (wrong scope position, 13; incorrect duct puncture, 12; guidewire related problems, 11). Technical difficulties peaked for EUS-RV, followed by hepaticogastrostomy (HGS) and choledochoduodenostomy (CDS) (20, 9, and 7, P  = 0.001). At 10 days follow-up, nine of 28 trainees had successfully performed three EUS-RV and seven EUS-BD procedures independently. Conclusions  The Mumbai EUS II hybrid model replicates situations encountered during EUS-RV and EUS-BD. Stepwise mentoring improves the chances of success in EUS-RV and EUS-BD procedures. PMID:29250585

  11. Evaluation of a novel, hybrid model (Mumbai EUS II) for stepwise teaching and training in EUS-guided biliary drainage and rendezvous procedures.

    Science.gov (United States)

    Dhir, Vinay; Itoi, Takao; Pausawasdi, Nonthalee; Khashab, Mouen A; Perez-Miranda, Manuel; Sun, Siyu; Park, Do Hyun; Iwashita, Takuji; Teoh, Anthony Y B; Maydeo, Amit P; Ho, Khek Yu

    2017-11-01

     EUS-guided biliary drainage (EUS-BD) and rendezvous (EUS-RV) are acceptable rescue options for patients with failed endoscopic retrograde cholangiopancreatography (ERCP). However, there are limited training opportunities at most centers owing to low case volumes. The existing models do not replicate the difficulties encountered during EUS-BD. We aimed to develop and validate a model for stepwise learning of EUS-BD and EUS-RV, which replicates the actual EUS-BD procedures.  A hybrid model was created utilizing pig esophagus and stomach, with a synthetic duodenum and biliary system. The model was objectively assessed on a grade of 1 - 4 by two experts. Twenty-eight trainees were given initial training with didactic lectures and live procedures. This was followed by hands-on training in EUS-BD and EUS-RV on the hybrid model. Trainees were assessed for objective criteria of technical difficulties.  Both the experts graded the model as very good or above for all parameters. All trainees could complete the requisite steps of EUS-BD and EUS-RV in a mean time of 11 minutes (8 - 18 minutes). Thirty-six technical difficulties were noted during the training (wrong scope position, 13; incorrect duct puncture, 12; guidewire related problems, 11). Technical difficulties peaked for EUS-RV, followed by hepaticogastrostomy (HGS) and choledochoduodenostomy (CDS) (20, 9, and 7, P  = 0.001). At 10 days follow-up, nine of 28 trainees had successfully performed three EUS-RV and seven EUS-BD procedures independently.  The Mumbai EUS II hybrid model replicates situations encountered during EUS-RV and EUS-BD. Stepwise mentoring improves the chances of success in EUS-RV and EUS-BD procedures.

  12. Early discontinuation

    DEFF Research Database (Denmark)

    Hansen, Dorte Gilså; Felde, Lina; Gichangi, Anthony

    2007-01-01

    prevalence and rate of early discontinuation of different drugs consisting of, in this study, lipid-lowering drugs, antihypertensive drugs, antidepressants, antidiabetics and drugs against osteoporosis. Material and methods This was a register study based on prescription data covering a 4-year period...... and consisting of 470,000 citizens. For each practice and group of drug, a 1-year prevalence for 2002 and the rate of early discontinuation among new users in 2002-2003 were estimated. Early discontinuation was defined as no prescriptions during the second half-year following the first prescription....... There was a positive association between the prevalence of prescribing for the specific drugs studied (antidepressants, antidiabetics, drugs against osteoporosis and lipid-lowering drugs) and early discontinuation (r = 0.29 -0.44), but not for anti-hypertensive drugs. The analysis of the association between prevalence...

  13. Early literacy

    DEFF Research Database (Denmark)

    Jensen, Anders Skriver

    2012-01-01

    This paper discusses findings from the Danish contribution to the EASE project, a European research project running from 2008 to 2010 on early literacy in relation to the transition from childcare to school. It explores a holistic, inclusive approach to early literacy that resists a narrow...... and schools. The paper also draws on Gee’s (2001, 2003, 2004, 2008) sociocultural approach to literacy, and Honneth’s (2003, 2006) concept of recognition. Emphasizing participation and recognition as key elements, it claims that stakeholders in early liter- acy must pay attention to how diverse early literacy...... opportunities empower children, especially when these opportunities are employed in a project-based learning environ- ment in which each child is able to contribute to the shared literacy events....

  14. Early Math.

    Science.gov (United States)

    Van Nuys, Ute Elisabeth

    1986-01-01

    Presents reviews of the following mathematics software designed to teach young children counting, number recognition, visual discrimination, matching, addition, and subtraction skills; Stickybear Numbers, Learning with Leeper, Getting Ready to Read and Add, Counting Parade, Early Games for Young Children, Charlie Brown's 1,2,3's, Let's Go Fishing,…

  15. A Proposed Strategy for the U.S. to Develop and Maintain a Mainstream Capability Suite ("Warehouse") for Automated/Autonomous Rendezvous and Docking in Low Earth Orbit and Beyond

    Science.gov (United States)

    Krishnakumar, Kalmanje S.; Stillwater, Ryan A.; Babula, Maria; Moreau, Michael C.; Riedel, J. Ed; Mrozinski, Richard B.; Bradley, Arthur; Bryan, Thomas C.

    2012-01-01

    The ability of space assets to rendezvous and dock/capture/berth is a fundamental enabler for numerous classes of NASA fs missions, and is therefore an essential capability for the future of NASA. Mission classes include: ISS crew rotation, crewed exploration beyond low-Earth-orbit (LEO), on-orbit assembly, ISS cargo supply, crewed satellite servicing, robotic satellite servicing / debris mitigation, robotic sample return, and robotic small body (e.g. near-Earth object, NEO) proximity operations. For a variety of reasons to be described, NASA programs requiring Automated/Autonomous Rendezvous and Docking/Capture/Berthing (AR&D) capabilities are currently spending an order-of-magnitude more than necessary and taking twice as long as necessary to achieve their AR&D capability, "reinventing the wheel" for each program, and have fallen behind all of our foreign counterparts in AR&D technology (especially autonomy) in the process. To ensure future missions' reliability and crew safety (when applicable), to achieve the noted cost and schedule savings by eliminate costs of continually "reinventing the wheel ", the NASA AR&D Community of Practice (CoP) recommends NASA develop an AR&D Warehouse, detailed herein, which does not exist today. The term "warehouse" is used herein to refer to a toolbox or capability suite that has pre-integrated selectable supply-chain hardware and reusable software components that are considered ready-to-fly, low-risk, reliable, versatile, scalable, cost-effective, architecture and destination independent, that can be confidently utilized operationally on human spaceflight and robotic vehicles over a variety of mission classes and design reference missions, especially beyond LEO. The CoP also believes that it is imperative that NASA coordinate and integrate all current and proposed technology development activities into a cohesive cross-Agency strategy to produce and utilize this AR&D warehouse. An initial estimate indicates that if NASA

  16. Early or Premature Menopause

    Science.gov (United States)

    ... email updates Enter email Submit Early or premature menopause Menopause that happens before age 40 is called ... What is the difference between early and premature menopause? Early or premature menopause happens when ovaries stop ...

  17. 首次交会对接任务发射场加注安全保障改进%Improvement of safety assurance conditions during spacecraft propellant injection procedure for China's first rendezvous and docking mission

    Institute of Scientific and Technical Information of China (English)

    罗克; 冯雷

    2011-01-01

    载人航天器加注是航天器研制过程中安全风险最高、危险作业工序最多的环节,必须采取严密的安全防护措施,确保万无一失.通过实践探索积累经验,全面周密的设计论证,对原有加注硬件条件进行改造,工作流程进行优化,从而大幅提高本质安全度,并在首次交会对接任务中加以应用和验证,取得了良好的效果,圆满完成了“天宫一号”、“神舟八号”发射任务的加注工作.%The propellant injection for spacecraft at the launch site is the most dangerous procedure in the whole R&D process, which involves many dangerous operations. Strict protective measures must be taken to avoid any mistakes. Based on the experience of previous practices, and by adequate design and discussion aimed at improving the current hardware conditions, the operation procedures for propellant injection of spacecrafts are optimized with a great enhancement of the intrinsic safety. These approaches have been applied in China's first rendezvous and docking mission, which brings about successful accomplishment of the propellant injection of the Tiangong-Ⅰ and Shenzhou-Ⅷ spacecraft.

  18. Early hospital discharge and early puerperal complications.

    Science.gov (United States)

    Ramírez-Villalobos, Dolores; Hernández-Garduño, Adolfo; Salinas, Aarón; González, Dolores; Walker, Dilys; Rojo-Herrera, Guadalupe; Hernández-Prado, Bernardo

    2009-01-01

    To evaluate the association between time of postpartum discharge and symptoms indicative of complications during the first postpartum week. Women with vaginal delivery at a Mexico City public hospital, without complications before the hospital discharge, were interviewed seven days after delivery. Time of postpartum discharge was classified as early (25 hours). The dependent variable was defined as the occurrence and severity of puerperal complication symptoms. Out of 303 women, 208 (68%) were discharged early. However, women with early discharge and satisfactory prenatal care had lower odds of presenting symptoms in early puerperium than women without early discharge and inadequate prenatal care (OR 0.36; 95% confidence intervals = 0.17-0.76). There was no association between early discharge and symptoms of complications during the first postpartum week; the odds of complications were lower for mothers with early discharge and satisfactory prenatal care.

  19. Early Childhood Systems: Transforming Early Learning

    Science.gov (United States)

    Kagan, Sharon Lynn, Ed.; Kauertz, Kristie, Ed.

    2012-01-01

    In this seminal volume, leading authorities strategize about how to create early childhood systems that transcend politics and economics to serve the needs of all young children. The authors offer different interpretations of the nature of early childhood systems, discuss the elements necessary to support their development, and examine how…

  20. Early discharge following birth

    DEFF Research Database (Denmark)

    Nilsson, Ingrid M. S.; Kronborg, Hanne; Knight, Christopher H.

    2017-01-01

    .26–0.48) and primiparous compared to multiparous had an OR of 0.22 (CI 0.17–0.29) for early discharge. Other predictors for early discharge were: no induction of labour, no epidural painkiller, bleeding less than 500 ml during delivery, higher gestational age, early expected discharge and positive breastfeeding experience...

  1. Optimizing the Earth-LISA 'rendezvous'

    International Nuclear Information System (INIS)

    De Marchi, Fabrizio; Pucacco, Giuseppe; Bassan, Massimo

    2012-01-01

    We present a general survey of heliocentric LISA orbits, hoping that it might help in the exercise of rescoping the mission. We try to semi-analytically optimize the orbital parameters in order to minimize the disturbances coming from the Earth-LISA interaction. In a set of numerical simulations, we include non-autonomous perturbations and provide an estimate of Doppler shift and breathing as a function of the trailing angle. (paper)

  2. A Rendezvous With an Unexpected Diagnosis

    Directory of Open Access Journals (Sweden)

    Helen C. Williams

    2014-01-01

    Full Text Available A personal account of skin cancer explores a caregiver’s emotional encounter with malignant melanoma, following her podiatrist’s initial diagnosis when she presented for an ingrown toenail.

  3. Au rendez-vous allemand (2

    Directory of Open Access Journals (Sweden)

    Agnès Bouvier

    2010-12-01

    Full Text Available La parution en 1857 des Études d’histoire religieuse d’Ernest Renan marque l’entrée en France des conceptions allemandes du mythe appliquées à l’histoire des textes sacrés. Or, cette date est aussi celle de la rencontre intellectuelle entre Renan et Flaubert, rencontre qui se matérialisera deux ans plus tard : au moment où Flaubert entreprend Salammbô, il accède aux travaux philologiques de la « nouvelle école » représentée en France par Renan. La supériorité de l’école allemande tient essentiellement selon Renan à sa capacité de penser le mythe comme un tout « indivis » irréductible à toute interprétation univoque : en dépit de certaines outrances des « rationalistes » et des « mythologues », dont il distingue nettement les deux types d’approche, Renan envisage l’exégèse allemande comme un progrès dont il montre les étapes et qu’il se propose d’achever en développant ce qu’il appelle une critique « sympathique ». Davantage qu’une méthode, il définit une posture critique d’adhésion à l’objet que Flaubert pourra mettre en oeuvre dans son roman.The publication in 1857 of Ernest Renan’s Études d’histoire religieuse signals the introduction in France of German ideas about myths applied to the history of religious texts. Now this date is also that of the intellectual encounter between Renan and Flaubert. Their actual meeting came about two years later. Indeed, while Flaubert was starting Salammbô, he discovered the philological studies of the “New School” represented in France by Renan. According to Renan the superiority of the German School was due to its capacity to comprehend the myth as an undivided whole irreducible to a univocal interpretation. Thus, despite the excesses of the “rationalists” and “mythologs”, whose methods he clearly distinguished, Renan considered the German exegesis a progress. He outlined its stages which he sought to complete by developing what he called a “sympathetic” approach. Rather than a method, Renan defined a critical position of to adherence to the object, an approach which Flaubert applied to his novel.

  4. Au rendez-vous allemand (1

    Directory of Open Access Journals (Sweden)

    Agnès Bouvier

    2010-12-01

    Full Text Available Comment traduire, transporter un monde dans un autre, et y faire croire ? La solution de Flaubert pour Salammbô a été d’investir cette difficulté en se plaçant du côté des discours et récits de l’Antiquité, depuis les Anciens et avec eux, retrouvant la parole de l’autre à partir d’une attitude « sympathique » au savoir recueilli. Cette attitude est conforme aux injonctions contemporaines de la « nouvelle école » critique et historique venue d’Allemagne où la pensée de Herder, relayée par Renan, occupe de ce point de vue une place centrale. L’Histoire de la poésie des Hébreux de Herder, paru en 1783, est traduit en français en 1845. Il s’agit d’un ouvrage fondateur de la critique allemande en ce qu’il aborde le texte sacré dans sa dimension exclusivement textuelle. Son titre même est une invitation à envisager la Bible du point de vue de l’art, c’est-à-dire du côté de ses effets : l’exégèse biblique selon Herder doit passer par le déplacement du lieu critique et le développement chez le lecteur moderne d’une sensibilité esthétique identique à celle du lecteur original.How can you translate or transpose one world into another and make it believable?  Flaubert’s solution for Salammbô was to adopt the point of view of Antiquity.  Going back to Antiquity’s speeches and tales, from and with the Classics and our knowledge of them, he chose a sympathetic stance.  This attitude is in line with contemporary admonitions of the “new” critical and historical school that came from Germany where Herder’s thought, passed on by Renan, had a central role.  Herder’s History of Hebrew Poetry, published in 1783, was translated in 1845.  It is a seminal text of German criticism in that it approaches the sacred text in an exclusively textual dimension.  Even the title of his book is an invitation to consider the Bible from the point of view of art, that is, for its effects.  According to Herder, biblical exegesis must performed by shifting the critical angle to develop in the modern reader an esthetic sensibility similar to that of the original reader.

  5. RENDEZVOUS WITH A PIONEER: PROFESSOR KUPPAMUTHU DHARMALINGAM

    Directory of Open Access Journals (Sweden)

    Subhoshree Ghose

    2015-06-01

    Full Text Available This article enlightens the influential role of a great Indian scientist and teacher, Prof. K Dharmalingam in the field of bacteriophage genetics, microbiology, biotechnology and clinical proteomics. He is a role model to all those young investigators who are extremely impelled to try novel things in Science. His journey originating from yeast mitochondriogenesis to Mycobacterium leprae biomarkers shows how passionate he is to ameliorate his intellectual abilities and endeavor his ideas. Not only a great achiever, he is also a modest human being who always acknowledges his school teachers, PhD mentor as well as graduate students for his immense success in scientific career. He has tried to explore the cross talk between microorganisms, proteins and nucleic acids to understand the molecular machinery inside a cell

  6. Rendez-vous with "InGRID"

    CERN Multimedia

    Laëtitia Pedroso

    2011-01-01

    Pending the elaboration of the master plan which should be implemented in 2013 and the results of a competition for the design of the major public areas between Entrance A and the St. Genis customs (along the Route de Meyrin), CERN and the Canton of Geneva have worked together on the installation of a temporary garden financed by the Canton. The garden will bring a bit of style to the area between Building 33 and the Globe of Science and Innovation.   "InGRID" at night. You may have been wondering what those long arching rods are that have suddenly appeared in front of Building 33. Well, we are pleased to introduce InGRID, the temporary garden that is transforming the old parking area between Building 33 and the Globe into a new pedestrian concourse around the tram stop. This space will serve as a multimodal concourse, a meeting point, a waiting area and a place to chat, reserved for pedestrians, CERN personnel and visitors. “We want to create a user-friendly atmosphe...

  7. Operator learning effects in teleoperated rendezvous & docking

    Science.gov (United States)

    Wilde, M.; Harder, J.; Purschke, R.

    Teleoperation of spacecraft proximity operations and docking requires delicate timing and coordination of spacecraft maneuvers. Experience has shown that human operators show large performance fluctuations in these areas, which are a major factor to be addressed in operator training. In order to allow the quantification of the impact of these human fluctuations on control system performance and the human perception of this performance, a learning curve study was conducted with teleoperated final approach and docking scenarios. Over a period of ten experiment days, three test participants were tasked with repeatedly completing a set of three training scenarios. The scenarios were designed to contain different combinations of the major elements of any final approach and docking situation, and to feature an increasing difficulty level. The individual difficulty levels for the three operators furthermore differed in the level of operator support functions available in their human-machine interfaces. Operator performance in the test scenarios were evaluated in the fields approach success and precision, docking safety, and approach efficiency by a combination of recorded maneuver data and questionnaires. The results show that operator experience and the associated learning curves increase operator performance substantially, regardless of the support system used. The paper also shows that the fluctuations in operator performance and self-perception are substantial between as well as within experiment days, and must be reckoned with in teleoperation system design and mission planning.

  8. Early Transcendental Analysis

    OpenAIRE

    Cowell, Simon; Poulin, Philippe

    2015-01-01

    In Early Transcendentals (The American Mathematical Monthly, Vol. 104, No 7) Steven Weintraub presents a rigorous justifcation of the "early transcendental" calculus textbook approach to the exponential and logarithmic functions. However, he uses tools such as term-by-term differentiation of infinite series. We present a rigorous treatment of the early transcendental approach suitable for a first course in analysis, using mainly the supremum property of the real numbers.

  9. Early Retirement Payoff

    Science.gov (United States)

    Fitzpatrick, Maria D.; Lovenheim, Michael F.

    2014-01-01

    As public budgets have grown tighter over the past decade, states and school districts have sought ways to control the growth of spending. One increasingly common strategy employed to rein in costs is to offer experienced teachers with high salaries financial incentives to retire early. Although early retirement incentive (ERI) programs have been…

  10. Early Modern Philosophical Systems

    NARCIS (Netherlands)

    L. van Bunge (Wiep)

    2014-01-01

    textabstractThe occurrence of an entry on early modern philosophical systems in an encyclopaedia of Neo-Latin studies is fraught with complications, if only on account of the gradual disappearance during the early modern period of Latin as the main vehicle of philosophical communication. What

  11. Early Intervention in Budapest.

    Science.gov (United States)

    Gallai, Maria; Katona, Ferenc; Balogh, Erzsebet; Schultheisz, Judit; Deveny, Anna; Borbely, Sjoukje

    2000-01-01

    This article presents five models of early intervention used in Budapest. Diagnostic and treatment methods used by the Pediatric Institute and the Conductive Education System are described, along with the Deveny Special Manual Technique and Gymnastic Method, the Gezenguz method and techniques used in the Early Developmental Center. (CR)

  12. The early universe

    International Nuclear Information System (INIS)

    Steigman, G.

    1989-01-01

    The author discusses the physics of the early universe: the production and survival of relics from the big bang. The author comments on relic WIMPs as the dark matter in the universe. The remainder of this discussion is devoted to a review of the status of the only predictions from the early evolution of the universe that are accessible to astronomical observation: primordial nucleosynthesis

  13. Early College High Schools

    Science.gov (United States)

    Dessoff, Alan

    2011-01-01

    For at-risk students who stand little chance of going to college, or even finishing high school, a growing number of districts have found a solution: Give them an early start in college while they still are in high school. The early college high school (ECHS) movement that began with funding from the Bill and Melinda Gates Foundation 10 years ago…

  14. Early Option Exercise

    DEFF Research Database (Denmark)

    Heje Pedersen, Lasse; Jensen, Mads Vestergaard

    A classic result by Merton (1973) is that, except just before expiration or dividend payments, one should never exercise a call option and never convert a convertible bond. We show theoretically that this result is overturned when investors face frictions. Early option exercise can be optimal when...... it reduces short-sale costs, transaction costs, or funding costs. We provide consistent empirical evidence, documenting billions of dollars of early exercise for options and convertible bonds using unique data on actual exercise decisions and frictions. Our model can explain as much as 98% of early exercises...

  15. Early Option Exercise

    DEFF Research Database (Denmark)

    Jensen, Mads Vestergaard; Heje Pedersen, Lasse

    2016-01-01

    A classic result by Merton (1973) is that, except just before expiration or dividend payments, one should never exercise a call option and never convert a convertible bond. We show theoretically that this result is overturned when investors face frictions. Early option exercise can be optimal when...... it reduces short-sale costs, transaction costs, or funding costs. We provide consistent empirical evidence, documenting billions of dollars of early exercise for options and convertible bonds using unique data on actual exercise decisions and frictions. Our model can explain as much as 98% of early exercises...

  16. Early detection of psychosis

    DEFF Research Database (Denmark)

    Larsen, Tor Ketil; Melle, Ingrid; Auestad, B.

    2011-01-01

    Background During the last decades we have seen a new focus on early treatment of psychosis. Several reviews have shown that duration of untreated psychosis (DUP) is correlated to better outcome. However, it is still unknown whether early treatment will lead to a better long-term outcome....... This study reports the effects of reducing DUP on 5-year course and outcome. Method During 1997–2000 a total of 281 consecutive patients aged >17 years with first episode non-affective psychosis were recruited, of which 192 participated in the 5-year follow-up. A comprehensive early detection (ED) programme...... and cognitive factors and for global assessment of functioning for social functioning at 5-year follow-up. The ED group also had more contacts with friends. Regression analysis did not find that these differences could be explained by confounders. Conclusions Early treatment had positive effects on clinical...

  17. Early Head Start Evaluation

    Data.gov (United States)

    U.S. Department of Health & Human Services — Longitudinal information from an evaluation where children were randomly assigned to Early Head Start or community services as usual;direct assessments and...

  18. Guideline for Early Interventions

    National Research Council Canada - National Science Library

    Vries, de, Maaike

    2006-01-01

    .... During the last years, the demand for early interventions has been increasing. International literature has shown that the psychosocial effects of disaster and military deployment may last for years...

  19. Early Life Stages

    Science.gov (United States)

    Childhood should be viewed as a sequence of lifestages, from birth through infancy and adolescence. When assessing early life risks, consideration is given to risks resulting from fetal exposure via the pregnant mother, as well as postnatal exposures.

  20. Cancer treatment - early menopause

    Science.gov (United States)

    Premature menopause; Ovarian insufficiency - cancer ... Cancer treatments that can cause early menopause include: Surgery. Having both ovaries removed causes menopause to happen right away. If you are age 50 or younger, your provider may ...

  1. Early intervention in psychosis

    DEFF Research Database (Denmark)

    Csillag, Claudio; Nordentoft, Merete; Mizuno, Masafumi

    2017-01-01

    AIM: Early intervention in psychosis (EIP) is a well-established approach with the intention of early detection and treatment of psychotic disorders. Its clinical and economic benefits are well documented. This paper presents basic aspects of EIP services, discusses challenges to their implementa......AIM: Early intervention in psychosis (EIP) is a well-established approach with the intention of early detection and treatment of psychotic disorders. Its clinical and economic benefits are well documented. This paper presents basic aspects of EIP services, discusses challenges...... benefits alone is not enough to promote implementation, as economic arguments and political and social pressure have shown to be important elements in efforts to achieve implementation. CONCLUSIONS: Users' narratives, close collaboration with community organizations and support from policy-makers and known...

  2. Earth's early biosphere

    Science.gov (United States)

    Des Marais, D. J.

    1998-01-01

    Understanding our own early biosphere is essential to our search for life elsewhere, because life arose on Earth very early and rocky planets shared similar early histories. The biosphere arose before 3.8 Ga ago, was exclusively unicellular and was dominated by hyperthermophiles that utilized chemical sources of energy and employed a range of metabolic pathways for CO2 assimilation. Photosynthesis also arose very early. Oxygenic photosynthesis arose later but still prior to 2.7 Ga. The transition toward the modern global environment was paced by a decline in volcanic and hydrothermal activity. These developments allowed atmospheric O2 levels to increase. The O2 increase created new niches for aerobic life, most notably the more advanced Eukarya that eventually spawned the megascopic fauna and flora of our modern biosphere.

  3. Mercury's Early Geologic History

    Science.gov (United States)

    Denevi, B. W.; Ernst, C. M.; Klima, R. L.; Robinson, M. S.

    2018-05-01

    A combination of geologic mapping, compositional information, and geochemical models are providing a better understanding of Mercury's early geologic history, and allow us to place it in the context of the Moon and the terrestrial planets.

  4. Embracing early literacy indicators

    DEFF Research Database (Denmark)

    Broström, Stig; Hansen, Ole Henrik; Jensen, Anders Skriver

    2010-01-01

    Abstract til paper om early literacy indikatorer. Det paper abstractet er knyttet til var en del af et inviteret, selvorganiseret symposium som afrapporterede EASE-projektet (www.ease-eu.com) på OMEP's 26. verdenskongres.......Abstract til paper om early literacy indikatorer. Det paper abstractet er knyttet til var en del af et inviteret, selvorganiseret symposium som afrapporterede EASE-projektet (www.ease-eu.com) på OMEP's 26. verdenskongres....

  5. Who Gets Early Tracheostomy?

    Science.gov (United States)

    Shaw, Joshua J.

    2015-01-01

    BACKGROUND: Although the benefits of early tracheostomy in patients dependent on ventilators are well established, the reasons for variation in time from intubation to tracheostomy remain unclear. We identified clinical and demographic disparities in time to tracheostomy. METHODS: We performed a level 3 retrospective prognostic study by querying the University HealthSystem Consortium (2007-2010) for adult patients receiving a tracheostomy after initial intubation. Time to tracheostomy was designated early ( 10 days). Cohorts were stratified by time to tracheostomy and compared using univariate tests of association and multivariable adjusted models. RESULTS: A total of 49,191 patients underwent tracheostomy after initial intubation: 42% early (n = 21,029) and 58% late (n = 28,162). On both univariate and multivariable analyses, women, blacks, Hispanics, and patients receiving Medicaid were less likely to receive an early tracheostomy. Patients in the early group also experienced lower rates of mortality (OR, 0.84; 95% CI, 0.79-0.88). CONCLUSIONS: Early tracheostomy was associated with increased survival. Yet, there were still significant disparities in time to tracheostomy according to sex, race, and type of insurance. Application of evidence-based algorithms for tracheostomy may reduce unequal treatment and improve overall mortality rates. Additional research into this apparent bias in referral/rendering of tracheostomy is needed. PMID:26313324

  6. Redefining early gastric cancer.

    Science.gov (United States)

    Barreto, Savio G; Windsor, John A

    2016-01-01

    The problem is that current definitions of early gastric cancer allow the inclusion of regional lymph node metastases. The increasing use of endoscopic submucosal dissection to treat early gastric cancer is a concern because regional lymph nodes are not addressed. The aim of the study was thus to critically evaluate current evidence with regard to tumour-specific factors associated with lymph node metastases in "early gastric cancer" to develop a more precise definition and improve clinical management. A systematic and comprehensive search of major reference databases (MEDLINE, EMBASE, PubMed and the Cochrane Library) was undertaken using a combination of text words "early gastric cancer", "lymph node metastasis", "factors", "endoscopy", "surgery", "lymphadenectomy" "mucosa", "submucosa", "lymphovascular invasion", "differentiated", "undifferentiated" and "ulcer". All available publications that described tumour-related factors associated with lymph node metastases in early gastric cancer were included. The initial search yielded 1494 studies, of which 42 studies were included in the final analysis. Over time, the definition of early gastric cancer has broadened and the indications for endoscopic treatment have widened. The mean frequency of lymph node metastases increased on the basis of depth of infiltration (mucosa 6% vs. submucosa 28%), presence of lymphovascular invasion (absence 9% vs. presence 53%), tumour differentiation (differentiated 13% vs. undifferentiated 34%) and macroscopic type (elevated 13% vs. flat 26%) and tumour diameter (≤2 cm 8% vs. >2 cm 25%). There is a need to re-examine the diagnosis and staging of early gastric cancer to ensure that patients with one or more identifiable risk factor for lymph node metastases are not denied appropriate chemotherapy and surgical resection.

  7. Early Dementia Screening

    Directory of Open Access Journals (Sweden)

    Peter K. Panegyres

    2016-01-01

    Full Text Available As the population of the world increases, there will be larger numbers of people with dementia and an emerging need for prompt diagnosis and treatment. Early dementia screening is the process by which a patient who might be in the prodromal phases of a dementing illness is determined as having, or not having, the hallmarks of a neurodegenerative condition. The concepts of mild cognitive impairment, or mild neurocognitive disorder, are useful in analyzing the patient in the prodromal phase of a dementing disease; however, the transformation to dementia may be as low as 10% per annum. The search for early dementia requires a comprehensive clinical evaluation, cognitive assessment, determination of functional status, corroborative history and imaging (including MRI, FDG-PET and maybe amyloid PET, cerebrospinal fluid (CSF examination assaying Aβ1–42, T-τ and P-τ might also be helpful. Primary care physicians are fundamental in the screening process and are vital in initiating specialist investigation and treatment. Early dementia screening is especially important in an age where there is a search for disease modifying therapies, where there is mounting evidence that treatment, if given early, might influence the natural history—hence the need for cost-effective screening measures for early dementia.

  8. Early cosmology constrained

    Energy Technology Data Exchange (ETDEWEB)

    Verde, Licia; Jimenez, Raul [Institute of Cosmos Sciences, University of Barcelona, IEEC-UB, Martí Franquès, 1, E08028 Barcelona (Spain); Bellini, Emilio [University of Oxford, Denys Wilkinson Building, Keble Road, Oxford, OX1 3RH (United Kingdom); Pigozzo, Cassio [Instituto de Física, Universidade Federal da Bahia, Salvador, BA (Brazil); Heavens, Alan F., E-mail: liciaverde@icc.ub.edu, E-mail: emilio.bellini@physics.ox.ac.uk, E-mail: cpigozzo@ufba.br, E-mail: a.heavens@imperial.ac.uk, E-mail: raul.jimenez@icc.ub.edu [Imperial Centre for Inference and Cosmology (ICIC), Imperial College, Blackett Laboratory, Prince Consort Road, London SW7 2AZ (United Kingdom)

    2017-04-01

    We investigate our knowledge of early universe cosmology by exploring how much additional energy density can be placed in different components beyond those in the ΛCDM model. To do this we use a method to separate early- and late-universe information enclosed in observational data, thus markedly reducing the model-dependency of the conclusions. We find that the 95% credibility regions for extra energy components of the early universe at recombination are: non-accelerating additional fluid density parameter Ω{sub MR} < 0.006 and extra radiation parameterised as extra effective neutrino species 2.3 < N {sub eff} < 3.2 when imposing flatness. Our constraints thus show that even when analyzing the data in this largely model-independent way, the possibility of hiding extra energy components beyond ΛCDM in the early universe is seriously constrained by current observations. We also find that the standard ruler, the sound horizon at radiation drag, can be well determined in a way that does not depend on late-time Universe assumptions, but depends strongly on early-time physics and in particular on additional components that behave like radiation. We find that the standard ruler length determined in this way is r {sub s} = 147.4 ± 0.7 Mpc if the radiation and neutrino components are standard, but the uncertainty increases by an order of magnitude when non-standard dark radiation components are allowed, to r {sub s} = 150 ± 5 Mpc.

  9. Early Islamic Syria

    DEFF Research Database (Denmark)

    Walmsley, Alan

    After more than a century of neglect, a profound revolution is occurring in the way archaeology addresses and interprets developments in the social history of early Islamic Syria-Palestine. This concise book offers an innovative assessment of social and economic developments in Syria-Palestine sh......After more than a century of neglect, a profound revolution is occurring in the way archaeology addresses and interprets developments in the social history of early Islamic Syria-Palestine. This concise book offers an innovative assessment of social and economic developments in Syria......-Palestine shortly before, and in the two centuries after, the Islamic expansion (the later sixth to the early ninth century AD), drawing on a wide range of new evidence from recent archaeological work. Alan Walmsley challenges conventional explanations for social change with the arrival of Islam, arguing...

  10. Early breastfeeding problems

    DEFF Research Database (Denmark)

    Feenstra, Maria Monberg; Kirkeby, Mette Jørgine; Thygesen, Marianne

    2018-01-01

    Objectives Breastfeeding problems are common and associated with early cessation. Stilllength of postpartum hospital stay has been reduced. This leaves new mothers to establish breastfeeding at home with less support from health care professionals. The objective was to explore mothers’ perspectives...... on when breastfeeding problems were the most challenging and prominent early postnatal. The aim was also toidentify possible factors associated with the breastfeeding problems. Methods In a cross-sectional study, a mixed method approach was used to analyse postal survey data from 1437 mothers with full...... term singleton infants. Content analysis was used to analyse mothers’ open text descriptions of their most challenging breastfeeding problem. Multiple logistic regression was used to calculate odds ratios for early breastfeeding problems according to sociodemographic- and psychosocial factors. Results...

  11. Early Intervention in Psychosis

    Science.gov (United States)

    McGorry, Patrick D.

    2015-01-01

    Abstract Early intervention for potentially serious disorder is a fundamental feature of healthcare across the spectrum of physical illness. It has been a major factor in the reductions in morbidity and mortality that have been achieved in some of the non-communicable diseases, notably cancer and cardiovascular disease. Over the past two decades, an international collaborative effort has been mounted to build the evidence and the capacity for early intervention in the psychotic disorders, notably schizophrenia, where for so long deep pessimism had reigned. The origins and rapid development of early intervention in psychosis are described from a personal and Australian perspective. This uniquely evidence-informed, evidence-building and cost-effective reform provides a blueprint and launch pad to radically change the wider landscape of mental health care and dissolve many of the barriers that have constrained progress for so long. PMID:25919380

  12. Early life vaccination

    DEFF Research Database (Denmark)

    Nazerai, Loulieta; Bassi, Maria Rosaria; Uddbäck, Ida Elin Maria

    2016-01-01

    Intracellular pathogens represent a serious threat during early life. Importantly, even though the immune system of newborns may be characterized as developmentally immature, with a propensity to develop Th2 immunity, significant CD8+ T-cell responses may still be elicited in the context of optimal...... the first period of life and provide a pertinent alternative in infant vaccinology. To address this, infant mice were vaccinated with three different adenoviral vectors and the CD8+ T-cell response after early life vaccination was explored. We assessed the frequency, polyfunctionality and in vivo...... cytotoxicity of the elicited memory CD8+ T cells, as well as the potential of these cells to respond to secondary infections and confer protection. We further tested the impact of maternal immunity against our replication-deficient adenoviral vector during early life vaccination. Overall, our results indicate...

  13. Early anaerobic metabolisms

    DEFF Research Database (Denmark)

    Canfield, Donald Eugene; Rosing, Minik T; Bjerrum, Christian

    2006-01-01

    probably driven by the cycling of H2 and Fe2+ through primary production conducted by anoxygenic phototrophs. Interesting and dynamic ecosystems would have also been driven by the microbial cycling of sulphur and nitrogen species, but their activity levels were probably not so great. Despite the diversity......Before the advent of oxygenic photosynthesis, the biosphere was driven by anaerobic metabolisms. We catalogue and quantify the source strengths of the most probable electron donors and electron acceptors that would have been available to fuel early-Earth ecosystems. The most active ecosystems were...... of potential early ecosystems, rates of primary production in the early-Earth anaerobic biosphere were probably well below those rates observed in the marine environment. We shift our attention to the Earth environment at 3.8Gyr ago, where the earliest marine sediments are preserved. We calculate, consistent...

  14. 75 FR 20830 - Early Learning

    Science.gov (United States)

    2010-04-21

    ... DEPARTMENT OF EDUCATION Early Learning AGENCY: Office of the Secretary, Department of Education... meetings and written submissions, is seeking input from State agencies responsible for early learning and... assistance providers, researchers of early learning, stakeholders who work with early learning and...

  15. Cognitive Development in Early Readers.

    Science.gov (United States)

    Briggs, Chari; Elkind, David

    Some studies of early readers are discussed. It is pointed out that study of early readers has relevance for practical and theoretical issues in psychology and education. Of interest in this document are the following questions: (1) Are there any special talents or traits distinguishing early from non-early readers? (2) Do children who read early…

  16. Introduction to "Early psychosis

    DEFF Research Database (Denmark)

    McGorry, Patrick; Nordentoft, Merete; Simonsen, Erik

    2005-01-01

    warrants careful analysis. The Third International Early Psychosis Conference proved to be a watershed and was the largest and most vibrant meeting to that point. This preface aims to set the scene for a selection of contributions, derived from the array of new evidence reported in Copenhagen, and recently...

  17. Early Functional Abilities

    DEFF Research Database (Denmark)

    Lorentzen, Jakob; Poulsen, Ingrid

    2005-01-01

    Early Functional Abilities (EFA), - en skala til evaluering af behandlingsforløb af svært hjerneskadede patienter i forbindelse med tidlig rehabilitering. Formål At monitorere og dokumentere rehabiliteringsforløbet for svært hjerneskadede patienter, hvor funktionsniveauet endnu ikke kan registreres...

  18. Early Islamic Syria

    DEFF Research Database (Denmark)

    Walmsley, Alan George

    This book presents a new interpretation of social and economic developments in Syria-Palestine in the decades before and during the two centuries after the Islamic expansion into the region (roughly the later 6th to the early 9th century AD). Drawing on a wide range of evidence from recent...

  19. Teaching polymorphism early

    DEFF Research Database (Denmark)

    2005-01-01

    Is it possible to teach dynamic polymorphism early? What techniques could facilitate teaching it in Java. This panel will bring together people who have considered this question and attempted to implement it in various ways, some more completely than others. It will also give participants...

  20. Early childhood aggression

    NARCIS (Netherlands)

    Alink, Lenneke Rosalie Agnes

    2006-01-01

    In this thesis the development, stability, and correlates of early childhood aggression were investigated. The normative development was examined in a general population sample using questionnaires completed by the parents of 12-, 24-, and 36-month-old children and again one year later. Results

  1. Characteristics of early psychosis

    NARCIS (Netherlands)

    Schothorst, P.F.; Emck, C.; van Engeland, H.

    2006-01-01

    There is little research on characteristics related to course and prognosis of early-onset psychosis. The present article aims to advance our knowledge of this disorder for the purpose of proper diagnosis and treatment. It focuses on premorbid and prodromal characteristics, treatment history,

  2. Early practice: neurotology.

    Science.gov (United States)

    Breen, Joseph T; Vrabec, Jeffrey T

    2015-04-01

    Besides technical and surgical proficiency, some of the most important skills for a young Neurotologist to refine include communication and critical thinking abilities. This Early Practice article provides perspectives on common challenges and career development from a current Neurotology fellow and his mentor. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Early Building Design

    DEFF Research Database (Denmark)

    Østergård, Torben; Jensen, Rasmus Lund; Maagaard, Steffen

    2017-01-01

    Highlights •Development of a design methodology that can handle the vast design space in early building design. •A global design space is modelled from extensive Monte Carlo simulations. •Sensitivity analysis methods applied to guide decision-makers. •Interactive visualizations help the multi-act...

  4. Early Childhood Trauma

    Science.gov (United States)

    National Child Traumatic Stress Network, 2010

    2010-01-01

    Early childhood trauma generally refers to the traumatic experiences that occur to children aged 0-6. Because infants' and young children's reactions may be different from older children's, and because they may not be able to verbalize their reactions to threatening or dangerous events, many people assume that young age protects children from the…

  5. Early prenatal syphilis

    Directory of Open Access Journals (Sweden)

    Santosh Rathod

    2010-01-01

    Full Text Available Syphilis in pregnancy still remains a challenge despite the availability of adequate diagnostic tests for serological screening and penicillin therapy. We report a case of 2 month old female infant who presented with runny nose, papulosquamous lesions over both palms and soles and perianal erosions since 1 month after birth. Cutaneous examination revealed moist eroded areas in the perianal region and fine scaly lesions over palms and soles. Radiograph of both upper limbs and limbs revealed early periosteal changes in lower end of humerus and lower end of tibia. Diagnosis of early pre-natal syphilis was confirmed by Child′s Serum Rapid Plasma Reagin Antibody test [S.RPR] being positive with 1:64 dilution while that of mother was 1:8.

  6. Early Childhood Caries

    Directory of Open Access Journals (Sweden)

    Yumiko Kawashita

    2011-01-01

    Full Text Available Dental caries is one of the most common childhood diseases, and people continue to be susceptible to it throughout their lives. Although dental caries can be arrested and potentially even reversed in its early stages, it is often not self-limiting and progresses without proper care until the tooth is destroyed. Early childhood caries (ECC is often complicated by inappropriate feeding practices and heavy infection with mutans streptococci. Such children should be targeted with a professional preventive program that includes oral hygiene instructions for mothers or caregivers, along with fluoride and diet counseling. However, these strategies alone are not sufficient to prevent dental caries in high-risk children; prevention of ECC also requires addressing the socioeconomic factors that face many families in which ECC is endemic. The aim of this paper is to systematically review information about ECC and to describe why many children are suffering from dental caries.

  7. Mapping the early Universe

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    From its unique vantage point 900 kilometres above the earth's surface, NASA's Cosmic Background Explorer (COBE) satellite has a privileged view of cosmic background radiation - the remnants of the early (radiation-dominated) Universe which followed the Big Bang some ten Gigayears ago, and possibly some subsequent history. In this way astroparticle physicists get a first peek at the quantum cosmology which moulded the infant Universe

  8. Earthquake Early Warning Systems

    OpenAIRE

    Pei-Yang Lin

    2011-01-01

    Because of Taiwan’s unique geographical environment, earthquake disasters occur frequently in Taiwan. The Central Weather Bureau collated earthquake data from between 1901 and 2006 (Central Weather Bureau, 2007) and found that 97 earthquakes had occurred, of which, 52 resulted in casualties. The 921 Chichi Earthquake had the most profound impact. Because earthquakes have instant destructive power and current scientific technologies cannot provide precise early warnings in advance, earthquake ...

  9. Coaching in Early Mathematics.

    Science.gov (United States)

    Germeroth, Carrie; Sarama, Julie

    2017-01-01

    Falling scores in math have prompted a renewed interest in math instruction at early ages. By their own admission, early childhood educators are generally underprepared and not always comfortable teaching math. Professional development (PD) in early mathematics is widely considered a main way to increase teachers' skills and efficacy (e.g., Guskey, 2000; Hyson & Woods, 2014; Munby, Russell, & Martin, 2001; Piasta, Logan, Pelatti, Capps, & Petrill, 2015; Richardson & Placier, 2001; Sarama, Clements, Wolfe, & Spitler, 2016; Sarama & DiBiase, 2004; Zaslow, 2014). However, it has been documented that stand-alone PD is not as effective in changing practice (e.g., Biancarosa & Bryk, 2011; Garet et al., 2008; Guskey, 2000; Hyson & Woods, 2014; Institute of Medicine and National Research Council, 2015; Joyce & Showers, 2002; Zaslow, 2014). Site-embedded ongoing support in the form of coaching or mentoring has been shown to be critical for successful implementation (Neuman & Cunningham, 2009; Powell, Diamond, Burchinal, & Koehler, 2010). In this chapter, we describe coaching models and abstract characteristics of effective coaching from the research. With this background, we provide an in-depth view of the coaching aspect of two large empirical studies in early mathematics. We introduce the theoretical framework from which the coaching models for these projects were developed and describe the research on which they were based. We then summarize how the planned models were instantiated and challenges to their implementation within each project. In the final section, we summarize what we have learned and described implications and challenges for the field. © 2017 Elsevier Inc. All rights reserved.

  10. Early prevention of obesity

    OpenAIRE

    Claudio Maffeis

    2014-01-01

    Childhood obesity is the metabolic disorder with the highest prevalence in both children and adults. Urgency to treat and prevent childhood obesity is based on the clear evidence that obesity tends to track from childhood to adulthood, is associated to morbidity also in childhood and to long-term mortality. Early life, i.e., intrauterine life and the first two years, is a sensitive window for prevention. Anatomical and functional maturation of the hypothalamic structures devoted to regulating...

  11. Hands of early primates.

    Science.gov (United States)

    Boyer, Doug M; Yapuncich, Gabriel S; Chester, Stephen G B; Bloch, Jonathan I; Godinot, Marc

    2013-12-01

    Questions surrounding the origin and early evolution of primates continue to be the subject of debate. Though anatomy of the skull and inferred dietary shifts are often the focus, detailed studies of postcrania and inferred locomotor capabilities can also provide crucial data that advance understanding of transitions in early primate evolution. In particular, the hand skeleton includes characteristics thought to reflect foraging, locomotion, and posture. Here we review what is known about the early evolution of primate hands from a comparative perspective that incorporates data from the fossil record. Additionally, we provide new comparative data and documentation of skeletal morphology for Paleogene plesiadapiforms, notharctines, cercamoniines, adapines, and omomyiforms. Finally, we discuss implications of these data for understanding locomotor transitions during the origin and early evolutionary history of primates. Known plesiadapiform species cannot be differentiated from extant primates based on either intrinsic hand proportions or hand-to-body size proportions. Nonetheless, the presence of claws and a different metacarpophalangeal [corrected] joint form in plesiadapiforms indicate different grasping mechanics. Notharctines and cercamoniines have intrinsic hand proportions with extremely elongated proximal phalanges and digit rays relative to metacarpals, resembling tarsiers and galagos. But their hand-to-body size proportions are typical of many extant primates (unlike those of tarsiers, and possibly Teilhardina, which have extremely large hands). Non-adapine adapiforms and omomyids exhibit additional carpal features suggesting more limited dorsiflexion, greater ulnar deviation, and a more habitually divergent pollex than observed plesiadapiforms. Together, features differentiating adapiforms and omomyiforms from plesiadapiforms indicate increased reliance on vertical prehensile-clinging and grasp-leaping, possibly in combination with predatory behaviors in

  12. Early Detection Of Cancer

    Directory of Open Access Journals (Sweden)

    V B Bhatnagar

    1987-04-01

    Full Text Available Farly detection of cancer is based upon three fundamental assumptions, firstly that the trea'ment of benign and precancerous lesions reduces the incidence of cancer, secondly, that the treatment of in situ cancers is conducive to total cure and thirdly that early diagnosis and management of invasive cancer ensures be.ter survival. When patient seeks medical advice for vague symptoms, which could however be due to a possible malignant tumour at a particular site, the alert clinician should investigate the patient immediately to exclude cancer. At this stage cancer is usually not significantly advanced. Currently the U. I. C. C. (International Union for Cancer Control} is studying the epidemiology of cancers in various countries The importance of this is two folds : Firstly by focussing attention on a section of population vulnerable to a particular cancer an early detection is facilitated Secondly by changing the causative factors responsible to a particular cancer, the incidence of that cancer can be reduced e. g. reduction in lung cancer following campaigns against ciguette smoking and reductioi in breast cancer after campaigns for advocating breast feeding of infants, lowering fat consumption and encouraging self palpation of breast regularly. Indeed early diagnosis of cancer implies diagnosis of cancer in almost a symptomatic stage It involves motiva’ion of the population towards acquisitio : of knowledge, attitude and practice.. Epidemiologies and clinicians should be able to recognise high risk cases exposed to particular neoplasia and knowledge of alarming symptoms should be pro- pogated for wide publicity through common available media and means. Probable cases should have regular clhrcal examination periodically and relevant investigations including radiological, imaging techniques and Bio-Chemical examination should be undertaken as and when desired Suspicious lesions should be investigated by specific tests including smear cytology

  13. PHOBOS, the Early Years

    Science.gov (United States)

    Stephans, George S. F.; Back, B. B.; Baker, M. D.; Barton, D. S.; Betts, R. R.; Ballintijn, M.; Bickley, A. A.; Bindel, R.; Budzanowski, A.; Busza, W.; Carroll, A.; Decowski, M. P.; Garcia, E.; George, N.; Gulbrandsen, K.; Gushue, S.; Halliwell, C.; Hamblen, J.; Heintzelman, G. A.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Holynski, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Katzy, J.; Khan, N.; Kucewicz, W.; Kulinich, P.; Kuo, C. M.; Lin, W. T.; Manly, S.; McLeod, D.; Michalowski, J.; Mignerey, A. C.; Nouicer, R.; Olszewski, A.; Pak, R.; Park, I. C.; Pernegger, H.; Reed, C.; Remsberg, L. P.; Reuter, M.; Roland, C.; Roland, G.; Rosenberg, L.; Sagerer, J.; Sarin, P.; Sawicki, P.; Skulski, W.; Steadman, S. G.; Steinberg, P.; Stephans, G. S. F.; Stodulski, M.; Sukhanov, A.; Tang, J.-L.; Teng, R.; Trzupek, A.; Vale, C.; van Nieuwenhuizen, G. J.; Verdier, R.; Wadsworth, B.; Wolfs, F. L. H.; Wosiek, B.; Wozniak, K.; Wuosmaa, A. H.; Wyslouch, B.

    2002-06-01

    The PHOBOS detector, one of the two small experiments at RHIC, focuses on measurements of charged particle multiplicity over almost the full phase space and identified particles near mid-rapidity. Results will be presented from the early RHIC gold--gold runs at nucleon--nucleon center of mass energies of 56 and 130 GeV as well as the recently concluded run at the full RHIC energy of 200 GeV.

  14. Mapping the early Universe

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1991-06-15

    From its unique vantage point 900 kilometres above the earth's surface, NASA's Cosmic Background Explorer (COBE) satellite has a privileged view of cosmic background radiation - the remnants of the early (radiation-dominated) Universe which followed the Big Bang some ten Gigayears ago, and possibly some subsequent history. In this way astroparticle physicists get a first peek at the quantum cosmology which moulded the infant Universe.

  15. Early breast cancer

    International Nuclear Information System (INIS)

    Dongen, J.A. van

    1989-01-01

    The therapy of early breast cancer has been changing during the last decennium. It requires a multi-disciplinary approach and in each of these disciplines improvements have been implemented. The result is that treatment schedules can now be adapted to specific subgroups. In this review early breast cancer is defined as operable disease, using the criteria set out by Haagensen. Emphasis is given to describing the new developments in prognostic criteria, since these form the basis for creating subgroups for specific treatment schedules. Distinction is made between the factors relating to growth rate and those relating to metastatic potential. Data on screening promises a beneficial effect of the implementation of screening in national health care programs. Important shifts are seen in treatment schedules; the place of postoperative radiotherapy after classic ablative treatment is being challenged, whereas it plays a major role in the new breast conserving therapy schedules. The data mentioned in the review suggest that a large proportion of 'operable' cases can be treated with breast conservation but details in the technique of breast conserving therapy are still under investigation. They form a major part of the coming prospective studies in breast cancer. Improvements in reconstruction techniques, creating better cosmetic results, make reconstruction more competitive with breast conserving therapy. The use of chemotherapy and endocrine manipulation in early breast cancer has now been clearly confirmed by the overview technique by the Peto-group, thanks to all efforts of individual trialists together. (orig.)

  16. Early intervention as a catalyst for effective early childhood ...

    African Journals Online (AJOL)

    ... of positive attitudes towards children with disabilities in a country like Ghana. ... As Ghana strides towards mainstreaming early childhood education in the quest ... an integrated, inclusive and effective early intervention programme becomes ...

  17. Infusing Early Childhood Mental Health into Early Intervention Services

    Science.gov (United States)

    Grabert, John C.

    2009-01-01

    This article describes the process of enhancing early childhood mental health awareness and skills in non-mental health staff. The author describes a pilot training model, conducted the U.S. Army's Early Intervention Services, that involved: (a) increasing early childhood mental health knowledge through reflective readings, (b) enhancing…

  18. Early Life Exposures and Cancer

    Science.gov (United States)

    Early-life events and exposures have important consequences for cancer development later in life, however, epidemiological studies of early-life factors and cancer development later in life have had significant methodological challenges.

  19. History of early atomic clocks

    International Nuclear Information System (INIS)

    Ramsey, N.F.

    2005-01-01

    This review of the history of early atomic clocks includes early atomic beam magnetic resonance, methods of separated and successive oscillatory fields, microwave absorption, optical pumping and atomic masers. (author)

  20. Early prevention of obesity

    Directory of Open Access Journals (Sweden)

    Claudio Maffeis

    2014-06-01

    Full Text Available Childhood obesity is the metabolic disorder with the highest prevalence in both children and adults. Urgency to treat and prevent childhood obesity is based on the clear evidence that obesity tends to track from childhood to adulthood, is associated to morbidity also in childhood and to long-term mortality. Early life, i.e., intrauterine life and the first two years, is a sensitive window for prevention. Anatomical and functional maturation of the hypothalamic structures devoted to regulating energy intake and expenditure and body size mainly occurs in the first 1,000 days of life. Therefore, factors affecting the foetal exposition to maternal metabolic environment and early postnatal nutrition are crucial in modulating the definition of the metabolic programming processes in the brain. Maternal diseases, mainly malnutrition for defect or excess, obesity and diabetes, placental disorders and dysfunctions, maternal use of alcohol and drugs, smoking, affect long term metabolic programming of the foetus with lifelong consequences. Similarly, early nutrition contributes to complete the long-term metabolic regulating framework initiated in the uterus. Breastfeeding, adequate weaning, attention to portion size and diet composition are potential tools for reducing the obesity risk later in childhood. Longitudinal randomized controlled studies are needed for exploring the efficacy of obesity prevention strategies initiated after conception.Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  1. Crowdsourced earthquake early warning

    Science.gov (United States)

    Minson, Sarah E.; Brooks, Benjamin A.; Glennie, Craig L.; Murray, Jessica R.; Langbein, John O.; Owen, Susan E.; Heaton, Thomas H.; Iannucci, Robert A.; Hauser, Darren L.

    2015-01-01

    Earthquake early warning (EEW) can reduce harm to people and infrastructure from earthquakes and tsunamis, but it has not been implemented in most high earthquake-risk regions because of prohibitive cost. Common consumer devices such as smartphones contain low-cost versions of the sensors used in EEW. Although less accurate than scientific-grade instruments, these sensors are globally ubiquitous. Through controlled tests of consumer devices, simulation of an Mw (moment magnitude) 7 earthquake on California’s Hayward fault, and real data from the Mw 9 Tohoku-oki earthquake, we demonstrate that EEW could be achieved via crowdsourcing.

  2. Why Recruits Separate Early

    Science.gov (United States)

    1991-01-01

    our sample were reportedly unable to adjust to the military environment due to social or emotional immaturity. This problem was especially prevalent...Table 9. Table 9 REASONS FOR EARLY SEPARATION 1. Mental health. Phobias , suicide threats and attempts, emotional immaturity, and personality and...hliurfl’lutf t’ htrtiuug tht .’ plinittol piioL’m.9 evIn’ thfll I b’ r i’lli. vre’.Ilv ifao~ , ýI ll.tv ill it](- rv ’: 111nil tln1 (i~..󈧏 4 P A W4.11

  3. Early modern mathematical instruments.

    Science.gov (United States)

    Bennett, Jim

    2011-12-01

    In considering the appropriate use of the terms "science" and "scientific instrument," tracing the history of "mathematical instruments" in the early modern period is offered as an illuminating alternative to the historian's natural instinct to follow the guiding lights of originality and innovation, even if the trail transgresses contemporary boundaries. The mathematical instrument was a well-defined category, shared across the academic, artisanal, and commercial aspects of instrumentation, and its narrative from the sixteenth to the eighteenth century was largely independent from other classes of device, in a period when a "scientific" instrument was unheard of.

  4. Early solar physics

    CERN Document Server

    Meadows, A J

    1970-01-01

    Early Solar Physics reviews developments in solar physics, particularly the advent of solar spectroscopy and the discovery of relationships between the various layers of the solar atmosphere and between the different forms of solar activity. Topics covered include solar observations during 1843; chemical analysis of the solar atmosphere; the spectrum of a solar prominence; and the solar eclipse of December 12, 1871. Spectroscopic observations of the sun are also presented. This book is comprised of 30 chapters and begins with an overview of ideas about the sun in the mid-nineteenth century, fo

  5. Early and late motherhood

    DEFF Research Database (Denmark)

    Christoffersen, Mogens; Lausten, Mette

    2009-01-01

    The study investigates parental child rearing methods, structural factors relating to the family during adolescence geographic segregation, individual resource deficits and social background of first time late live births among 32 to 37 years old women and compare to teenagers before becoming...... economic and social gradient for first-time teenage mothers. Teenagers who had experienced family separation or who were formerly in out-of-home care in particular had an increased risk of early childbearing. Results showed that teenage mothers were in every respect in a more disadvantaged position than...

  6. Early Reading and Concrete Operations.

    Science.gov (United States)

    Polk, Cindy L. Howes; Goldstein, David

    1980-01-01

    Indicated that early readers are more likely to be advanced in cognitive development than are nonearly-reading peers. After one year of formal reading instruction, early readers maintained their advantage in reading achievement. Measures of concrete operations were found to predict reading achievement for early and nonearly readers. (Author/DB)

  7. Early Childhood Workforce Index, 2016

    Science.gov (United States)

    Whitebook, Marcy; McLean, Caitlin; Austin, Lea J. E.

    2016-01-01

    The State of the Early Childhood Workforce (SECW) Initiative is a groundbreaking multi-year project to shine a steady spotlight on the nation's early childhood workforce. The SECW Initiative is designed to challenge entrenched ideas and policies that maintain an inequitable and inadequate status quo for early educators and for the children and…

  8. Radiation early warning system

    International Nuclear Information System (INIS)

    Schmitzer, C.; Kloesch, W.; Stadtmann, H.

    1993-01-01

    A prototype station for a Radiation Early Warning Network has been designed and set up at the Austrian Research Centre Seibersdorf. This unit was developed to measure all relevant parameters necessary to detect and track radioactive contamination at an early stage. The station consists of the following components: Radiation measuring channel for ambient gamma dose rate. Meteorological measurement channels for air temperature and humidity, wind direction and wind speed, and precipitation. Data processing and storage unit. The system is capable of unattended operation and data acquisition even under adverse environmental conditions. Connection to a central processing platform may be achieved via leased line, dial up over public switched telephone network (PSTN), or radio-frequency transmission. The remote station will continue acquiring and storing data for at least a month, even if the communications link is broken. Multiple stations can be combined to form a network, providing detailed information about radiological and meteorological data at each site. Thus increased ambient radiation levels may be discovered, tracked, and forecasted based on calculations using current and local weather data

  9. Sonority and early words

    DEFF Research Database (Denmark)

    Kjærbæk, Laila; Boeg Thomsen, Ditte; Lambertsen, Claus

    2015-01-01

    Syllables play an important role in children’s early language acquisition, and children appear to rely on clear syllabic structures as a key to word acquisition (Vihman 1996; Oller 2000). However, not all languages present children with equally clear cues to syllabic structure, and since the spec......Syllables play an important role in children’s early language acquisition, and children appear to rely on clear syllabic structures as a key to word acquisition (Vihman 1996; Oller 2000). However, not all languages present children with equally clear cues to syllabic structure, and since...... acquisition therefore presents us with the opportunity to examine how children respond to the task of word learning when the input language offers less clear cues to syllabic structure than usually seen. To investigate the sound structure in Danish children’s lexical development, we need a model of syllable......-29 months. For the two children, the phonetic structure of the first ten words to occur is compared with that of the last ten words to occur before 30 months of age, and with that of ten words in between. Measures related to the sonority envelope, viz. sonority types and in particular sonority rises...

  10. Early-Onset Dementia

    DEFF Research Database (Denmark)

    Konijnenberg, Elles; Fereshtehnejad, Seyed-Mohammad; Kate, Mara Ten

    2017-01-01

    BACKGROUND: Early-onset dementia (EOD) is a rare condition, with an often atypical clinical presentation, and it may therefore be challenging to diagnose. Specialized memory clinics vary in the type of patients seen, diagnostic procedures applied, and the pharmacological treatment given. The aim...... of this study was to investigate quality-of-care indicators in subjects with EOD from 3 tertiary memory clinics in 3 European countries. METHODS: We included 1325 newly diagnosed EOD patients, ages 65 years or younger, between January 1, 2007 and December 31, 2013, from the Danish Dementia Registry...... (Rigshospitalet, Copenhagen), the Swedish Dementia Registry ("SveDem", Karolinska University Hospital, Stockholm), and the Amsterdam Dementia Cohort (VU University Medical Center). RESULTS: The frequency of EOD among all dementia patients was significantly lower in Copenhagen (410, 20%) and Stockholm (284, 21...

  11. Manipulating early pig embryos.

    Science.gov (United States)

    Niemann, H; Reichelt, B

    1993-01-01

    On the basis of established surgical procedures for embryo recovery and transfer, the early pig embryo can be subjected to various manipulations aimed at a long-term preservation of genetic material, the generation of identical multiplets, the early determination of sex or the alteration of the genetic make-up. Most of these procedures are still at an experimental stage and despite recent considerable progress are far from practical application. Normal piglets have been obtained after cryopreservation of pig blastocysts hatched in vitro, whereas all attempts to freeze embryos with intact zona pellucida have been unsuccessful. Pig embryos at the morula and blastocyst stage can be bisected microsurgically and the resulting demi-embryos possess a high developmental potential in vitro, whereas their development in vivo is impaired. Pregnancy rates are similar (80%) but litter size is reduced compared with intact embryos and twinning rate is approximately 2%. Pig blastomeres isolated from embryos up to the 16-cell stage can be grown in culture and result in normal blastocysts. Normal piglets have been born upon transfer of blastocysts derived from isolated eight-cell blastomeres, clearly underlining the totipotency of this developmental stage. Upon nuclear transfer the developmental capacity of reconstituted pig embryos is low and culture. Sex determination can be achieved either by separation of X and Y chromosome bearing spermatozoa by flow cytometry or by analysing the expression of the HY antigen in pig embryos from the eight-cell to morula stage. Microinjection of foreign DNA has been successfully used to alter growth and development of transgenic pigs, and to produce foreign proteins in the mammary gland or in the bloodstream, indicating that pigs can be used as donors for valuable human pharmaceutical proteins. Another promising area of gene transfer is the increase of disease resistance in transgenic lines of pigs. Approximately 30% of pig spermatozoa bind

  12. EARLY ENTRANCE COPRODUCTION PLANT

    Energy Technology Data Exchange (ETDEWEB)

    John S. Abughazaleh; Mushtaq Ahmed; Ashok Anand; John H. Anderson; Charles Benham; Fred D. Brent; Thomas E. Chance; William K. Davis; Raymond F. Drnevich; Larry Hall; Ming He; Stephen A. Lang; David Mintner; Wendy Moore; Jimmy O. Ong; George Potoczniak; Adela G. Sanchez; Charles H. Schrader; Lalit S. Shah; Kalapi D. Sheth; Phil J. Shires; Rae Song

    2001-05-17

    The overall objective of this project is the three-phase development of an Early Entrance Coproduction Plant (EECP) that produces at least one product from at least two of the following three categories: Electric power (or heat); Fuels; and Chemicals. The objective is to have these products produced by technologies capable of using synthesis gas derived from coal and/or some other carbonaceous feedstock, such as petroleum coke. The objective of Phase I was to determine the feasibility and define the concept for the EECP located at a specific site and to develop a Research, Development, and Testing (RD and T) Plan for implementation in Phase II. This objective has now been accomplished. A specific site, Motiva Refinery in Port Arthur, Texas, has been selected as the location best suited for the EECP. The accomplishments of Phase I are discussed in detail in this Phase I Concept Report. A RD and T Plan and a preliminary project financing plan have been developed and are submitted separately from this report.

  13. The Early Experiments

    Science.gov (United States)

    Garvey, Gerald

    2013-04-01

    Stuart Freedman obtained his PhD at Berkley with an experimental thesis providing very strong evidence against theories requiring local hidden variables. He then came to Princeton in 1972 and began collaboration on a search for second-class currents. These measurements are quite difficult as the effects are the order of 1%, demonstrating Freedman's drive to take on hard but important experiments. After carrying out some relatively standard nuclear physics measurements he moved on to Stanford in 1976. There, Freedman was involved in identifying measurements sensitive to the existence of light axions. He also carried out searches for various exotica that might be produced from cosmic rays or the SLAC beam stop. During this time he was collaborating with us at Argonne investigating nuclear parity violation and time-like axial beta decay. In 1982 Freedman came to Argonne where he worked on fundamental issues in neutron beta decay. He also initiated what was to become one of his trademarks, demonstrating that surprising peaks in the e^+-e^- spectrum observed in very heavy ion collisions were spurious. He further launched his first neutrino oscillation experiment. This period of early research was marked by a remarkable diversity of subject matter and approach.

  14. Early diagnosis of leptospirosis

    Directory of Open Access Journals (Sweden)

    Andrea Babic-Erceg

    2014-06-01

    Full Text Available A 25-years old man from Zagreb, Croatia, was admitted to the University Hospital for Infectious Diseases four days after the onset of symptoms such as fever, intense pain in the calves and anuria. The patient owned a rabbit and, before the onset of the disease, repaired some rubber pipes damaged by rodents. At admission, he had a severe clinical picture with fever, hypotension, jaundice, immobility, and pain in leg muscles. Treatment with ceftriaxone was initiated in combination with volume restitution. Renal failure soon ensued. Consequently continuous venovenous hemodiaphiltration therapy was performed. Due to acute respiratory distress syndrome, the patient was mechanically ventilated. The patient’s condition gradually improved and he recovered fully from multi-organ failure. Diagnosis was confirmed by a microscopic agglutination test (MAT covering 15 leptospira serovars and real-time polymerase-chain reaction (PCR. The first serum sample taken on day 6 tested negative for leptospira, while PCR showed positive results for leptospiral DNA. The second serum sample taken on day 13 tested positive for serovar Canicola serogroup Canicola, serovar Patoc, serovar Grippotyphosa serogroup Grippotyphosa and serovar Tarassovi serogroup Tarassovi (titre 4000, 4000, 1000 and 2000, respectively, while PCR was negative. This report highlights the benefits of combining MAT and PCR methods in early diagnosis of leptospirosis.

  15. EARLY ENTRANCE COPRODUCTION PLANT

    International Nuclear Information System (INIS)

    William K. Davis

    2001-01-01

    The overall objective of this project is the three phase development of an Early Entrance Coproduction Plant (EECP) which produces at least one product from at least two of the following three categories: (1) electric power (or heat), (2) fuels, and (3) chemicals. The objective is to have these products produced by technologies capable of using synthesis gas derived from coal and/or other carbonaceous feedstocks. The objective of Phase I is to determine the feasibility and define the concept for the EECP located at a specific site; develop a Research, Development, and Testing (RD and T) Plan for implementation in Phase II; and prepare a Preliminary Project Financing Plan. The objective of Phase II is to implement the work as outlined in the Phase I RD and T Plan to enhance the development and commercial acceptance of coproduction technology that produces high-value products, particularly those that are critical to our domestic fuel and power requirements. The project will resolve critical knowledge and technology gaps on the integration of gasification and downstream processing to coproduce some combination of power, fuels, and chemicals from coal and/or other carbonaceous feedstocks. The objective of Phase III is to develop an engineering design package and a financing plan for an EECP located at a specific site. The project's intended result is to provide the necessary technical, economic, and environmental information needed by industry to move the EECP forward to detailed design, construction, and operation

  16. Is credit for early action credible early action?

    International Nuclear Information System (INIS)

    Rolfe, C.; Michaelowa, A.; Dutschke, M.

    1999-12-01

    Credit for early action as a tool for greenhouse gas emissions reduction is compared with various market instruments as a means of narrowing the gap between projected emissions and those of the Kyoto Protocol. Market instruments work by creating a market price for emissions and use the market to encourage reductions at the lowest price, which is done by placing limits on greenhouse gas emissions and allowing the market to decide where reductions occur, or by imposing a carbon tax or emissions charge. While they can be applied within a sector, they are usually used to encourage reductions throughout the economy or across large sectors. Credit for early action also creates an incentive for emissions reductions throughout the economy or at least across many sectors. Credit for early action tools do not work by either imposing a carbon tax or emissions charge or placing limits on emissions, rather they promise that entities that take action against greenhouse gases prior to the imposition of a carbon tax or emissions limits will receive a credit against future taxes or limits. An overview is provided of the Kyoto Protocol and the rationale for taking early action, and a review is included of the theory and specific proposals for market instruments and credit for early action. A comparative analysis is provided of these approaches by examining their relative efficiency, environmental effectiveness, and impacts on the redistribution of wealth. Credit for early action is viewed as problematic on a number of counts and is seen as an interim strategy for imposition while political support for market instruments develop. The environmental effectiveness of credit for early action is very difficult to predict, and credit for early action programs do not yield the lowest cost emissions reductions. Credit for early action programs will not achieve compliance with the Kyoto Protocol at the lowest cost, and credits for early action will increase the compliance costs for those who

  17. Early tetrapod relationships revisited.

    Science.gov (United States)

    Ruta, Marcello; Coates, Michael I; Quicke, Donald L J

    2003-05-01

    In an attempt to investigate differences between the most widely discussed hypotheses of early tetrapod relationships, we assembled a new data matrix including 90 taxa coded for 319 cranial and postcranial characters. We have incorporated, where possible, original observations of numerous taxa spread throughout the major tetrapod clades. A stem-based (total-group) definition of Tetrapoda is preferred over apomorphy- and node-based (crown-group) definitions. This definition is operational, since it is based on a formal character analysis. A PAUP* search using a recently implemented version of the parsimony ratchet method yields 64 shortest trees. Differences between these trees concern: (1) the internal relationships of aïstopods, the three selected species of which form a trichotomy; (2) the internal relationships of embolomeres, with Archeria crassidisca and Pholiderpeton scut collapsed in a trichotomy with a clade formed by Anthracosaurus russelli and Pholiderpeton attheyi; (3) the internal relationships of derived dissorophoids, with four amphibamid species forming an unresolved node with a clade consisting of micromelerpetontids and branchiosaurids and a clade consisting of albanerpetontids plus basal crown-group lissamphibians; (4) the position of albenerpetontids and Eocaecilia micropoda, which form an unresolved node with a trichotomy subtending Karaurus sharovi, Valdotriton gracilis and Triadobatrachus massinoti; (5) the branching pattern of derived diplocaulid nectrideans, with Batrachiderpeton reticulatum and Diceratosaurus brevirostris collapsed in a trichotomy with a clade formed by Diplocaulus magnicornis and Diploceraspis burkei. The results of the original parsimony run--as well as those retrieved from several other treatments of the data set (e.g. exclusion of postcranial and lower jaw data; character reweighting; reverse weighting)--indicate a deep split of early tetrapods between lissamphibian- and amniote-related taxa. Colosteids, Crassigyrinus

  18. Transumbilical laparoendoscopic single-site donor nephrectomy: Without the use of a single port access device

    Directory of Open Access Journals (Sweden)

    Deepak Dubey

    2011-01-01

    Conclusions : Transumbilical LESS-DN can be cost-effectively performed using conventional laparoscopy instruments and without the need for a single port access device. Warm ischemia times with this technique are comparable with that during conventional multiport laparoscopic donor nephrectomy.

  19. [Choledocholithiasis and pregnancy. Hybrid laparo-endoscopic treatment in one step].

    Science.gov (United States)

    Valadez-Caballero, David; González-Santamaría, Roberto; Soto-Mendoza, Héctor; Alberto Blanco-Figueroa, Jorge; Flores-Pantoja, Juan Manuel

    2014-01-01

    Complications associated with choledocholithiasis are uncommon during pregnancy. However, when it occurs, the morbidity and mortality related for the product and the mother increases, so a proper treatment is imperative in these patients. A 25-year-old pregnant woman on her second trimester. The current condition was started four days prior to the hospital admission with abdominal pain in the right upper quadrant with nausea and vomit.Twenty-four hours later jaundice and dark urine is observed. Physical examination shows scleral jaundice, right upper quadrant abdominal pain without peritoneal irritation. Uterus at umbilicus level without uterine activity. Uterus at umbilicus level without uterine activity. Laboratory tests showed elevated bilirubin and transaminases without leukocytosis; ultrasound reported live intrauterine unique product, with a heart rate of 128 beats per minute, gallbladder with multiple images inside that cast acoustic shadowing, and a 10 mm common bile duct dilated bile duct with dilatation of intrahepatic bile ducts. It was perform laparoscopic cholecystectomy with intraoperative cholangiography and placement of a transcystic jaguar guide for selective cannulation of the common bile duct. Intraoperative endoscopic retrograde cholangiopancreatography was performed with endoscopic stone extraction. The outcome was satisfactory with a hospital discharge at 48 hours. Current evidence has shown that the combined use of laparoscopy and therapeutic endoscopic cholangiography in one step is effective for the treatment of choledocholithiasis, decreasing the risk of complications associated with cannulation of the bile duct.

  20. [The LESS (Laparo-endoscopic Single-Site) procedure in urology. Technical and clinical aspects].

    Science.gov (United States)

    Neri, F; Cindolo, L; Gidaro, S; Schips, L

    2010-01-01

    Minimally invasive urology is rapidly advancing, and single-site laparoscopic surgery is being explored clinically. Such laparoscopic procedures are technically challenging and require an experienced laparoscopic surgeon due to the lack of port placement triangulation and instrument clashing. In the last years several surgeons all over the world have explored the feasibility and safety of LESS using several and different ports, approaches and devices. Hundreds of procedures have been described with overall favorable intraoperative and postoperative outcomes. Our experience consists of more than 30 procedures successfully completed for adrenal, kidney disease and varicocele. To date, LESS could be considered feasible and effective using currently available devices, however it is to be considered as an initial status technique requiring further confirmatory studies and advanced laparoscopic skills.

  1. Learning curve for laparoendoscopic single-site surgery for an experienced laparoscopic surgeon

    Directory of Open Access Journals (Sweden)

    Pao-Ling Torng

    2013-11-01

    Conclusion: LESS is a safe and feasible alternative to conventional laparoscopic surgery for adnexal and uterine diseases. A learning curve is not required for LESS surgery for experienced laparoscopic surgeons.

  2. Early onset sebaceous carcinoma

    Directory of Open Access Journals (Sweden)

    Kaltreider Sara A

    2011-09-01

    Full Text Available Abstract Background Ocular sebaceous carcinoma can masquerade as benign lesions resulting in delay of diagnosis. Early recognition is even more difficult in young patients where the disease rarely occurs. Here, we provide a clinicopathological correlation of ocular sebaceous carcinoma in a young individual lacking history of hereditary cancer or immunosuppression. Findings A detailed histopathological study including p53 DNA sequencing was performed on an aggressive sebaceous carcinoma presenting in a healthy 32 year-old Caucasian woman. She had no history of retinoblastoma, evidence for a hereditary cancer syndrome, or radiation therapy. However, she potentially was at risk for excessive UV light exposure. A detailed review of the literature is also provided. A moderately well differentiated sebaceous carcinoma was established histopathologically arising from the meibomian gland of the upper eyelid. In most areas, the cytoplasm contained small but distinct Oil-red-O positive vacuoles. Direct sequencing of p53 identified a G:C→A:T mutation at a dipyrimidine site. The mutation results in substitution of arginine for the highly conserved glycine at residue 199 located at the p53 dimer-dimer interface. Energy minimization structural modeling predicts that G199R will neutralize negative charges contributed by nearby inter- and intramonomeric glutamate residues. Discussion This study points to the importance of recognizing that sebaceous carcinoma can occur in young patients with no evidence for hereditary cancer risk or radiation therapy. The G199R substitution is anticipated to alter the stability of the p53 tetrameric complex. The role of UV light in the etiology of sebaceous carcinoma deserves further study. Our findings, taken together with those of others, suggest that different environmental factors could lead to the development of sebaceous carcinoma in different patients.

  3. Early determinants of mental health

    NARCIS (Netherlands)

    Räikkönen, Katri; Pesonen, Anu-Katriina; Roseboom, Tessa J.; Eriksson, Johan G.

    2012-01-01

    Environmental adversities in pre- and early postnatal life may have life-long consequences. Based upon a series of epidemiological and clinical studies and natural experiments, this review describes how the early life environment may affect psychological functions and mental disorders later in life.

  4. Early Childhood Education in Taiwan.

    Science.gov (United States)

    Barclay, Lisa K.

    1989-01-01

    Describes early childhood education in Taiwan, focusing on living patterns and child care arrangements, the position of the individual within the family and community, and the application of cultural norms to early childhood education. Compares the behavior of Chinese preschool children to that of American preschool children. (RJC)

  5. Cell Analysis and Early Diagnostics

    NARCIS (Netherlands)

    Subramaniam, Vinod; Jones, Val

    2006-01-01

    In an era of aging populations and rising health-care costs, the shift of medical paradigms towards rapid, accurate, early diagnoses of diseases is inevitable. In addition to further development of ultrasensitive in vitro tests, the focus of attention in both diagnostics and the early drug discovery

  6. Early Childhood Inclusion in Spain

    Science.gov (United States)

    Giné, Climent; Balcells-Balcells, Anna; Cañadas, Margarita; Paniagua, Gema

    2016-01-01

    This article describes early childhood inclusion in educational settings in Spain. First, we address the legislative framework of preschool education in Spain and offer a brief analysis of some relevant issues, including the current situation of early childhood education and inclusion at this stage. Second, current policies and practices relating…

  7. Early diagnosis and early intervention in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Mijna eHadders-Algra

    2014-09-01

    Full Text Available This paper reviews the opportunities and challenges for early diagnosis and early intervention in cerebral palsy (CP. CP describes a group of disorders of the development of movement and posture, causing activity limitation, that are attributed to disturbances that occurred in the fetal or infant brain. Therefore the paper starts with a summary of relevant information from developmental neuroscience. Most lesions underlying CP occur in the second half of gestation, when developmental activity in the brain reaches its summit. Variations in timing of the damage not only result in different lesions, but also in different neuroplastic reactions and different associated neuropathologies. This turns CP into a heterogeneous entity. This may mean that the best early diagnostics and the best intervention methods may differ for various subgroups of children with CP. Next, the paper addresses possibilities for early diagnosis. It discusses the predictive value of neuromotor and neurological exams, neuro-imaging techniques and neurophysiological assessments. Prediction is best when complementary techniques are used in longitudinal series. Possibilities for early prediction of CP differ for infants admitted to neonatal intensive care and other infants. In the former group best prediction is achieved with the combination of neuro-imaging and the assessment of general movements, in the latter group best prediction is based on carefully documented milestones and neurological assessment. The last part reviews early intervention in infants developing CP. Most knowledge on early intervention is based on studies in high risk infants without CP. In these infants early intervention programs promote cognitive development until preschool age; motor development profits less. The few studies on early intervention in infants developing CP suggest that programs that stimulate all aspects of infant development by means of family coaching are most promising. More research is

  8. Early Maternal Time Investment and Early Child Outcomes

    OpenAIRE

    Del Bono, Emilia; Francesconi, Marco; Kelly, Yvonne; Sacker, Amanda

    2014-01-01

    Using large longitudinal survey data from the UK Millennium Cohort Study, this paper estimates the relationship between maternal time inputs and early child development. We find that maternal time is a quantitatively important determinant of skill formation and that its effect declines with child age. There is evidence of long-term effects of early maternal time inputs on later outcomes, especially in the case of cognitive skill development. In the case of non-cognitive development, the evide...

  9. EARLY ENTRANCE COPRODUCTION PLANT

    Energy Technology Data Exchange (ETDEWEB)

    Fred D. Brent; Lalit Shah; Earl Berry; Charles H. Schrader; John Anderson; Ming He; James F. Stevens; Centha A. Davis; Michael Henley; Jerome Mayer; Harry Tsang; Jimell Erwin; Jennifer Adams; Michael Tillman; Chris Taylor; Marjan J. Roos; Robert F. Earhart

    2004-01-27

    The overall objective of this project is the three phase development of an Early Entrance Coproduction Plant (EECP) which uses petroleum coke to produce at least one product from at least two of the following three categories: (1) electric power (or heat), (2) fuels, and (3) chemicals using ChevronTexaco's proprietary gasification technology. The objective of Phase I is to determine the feasibility and define the concept for the EECP located at a specific site; develop a Research, Development, and Testing (RD&T) Plan to mitigate technical risks and barriers; and prepare a Preliminary Project Financing Plan. The objective of Phase II is to implement the work as outlined in the Phase I RD&T Plan to enhance the development and commercial acceptance of coproduction technology. The objective of Phase III is to develop an engineering design package and a financing and testing plan for an EECP located at a specific site. The project's intended result is to provide the necessary technical, economic, and environmental information needed by industry to move the EECP forward to detailed design, construction, and operation. The partners in this project are Texaco Energy Systems LLC or TES (a subsidiary of ChevronTexaco), General Electric (GE), Praxair, and Kellogg Brown & Root (KBR) in addition to the U.S. Department of Energy (DOE). TES is providing gasification technology and Fischer-Tropsch (F-T) technology developed by Rentech, GE is providing combustion turbine technology, Praxair is providing air separation technology, and KBR is providing engineering. Each of the EECP subsystems was assessed for technical risks and barriers. A plan was developed to mitigate the identified risks (Phase II RD&T Plan, October 2000). The potential technical and economic risks to the EECP from Task 2.5 can be mitigated by demonstrating that the end-use products derived from the upgrading of the F-T synthesis total liquid product can meet or exceed current specifications for the

  10. Early vision and visual attention

    Directory of Open Access Journals (Sweden)

    Gvozdenović Vasilije P.

    2003-01-01

    Full Text Available The question whether visual perception is spontaneous, sudden or is running through several phases, mediated by higher cognitive processes, was raised ever since the early work of Gestalt psychologists. In the early 1980s, Treisman proposed the feature integration theory of attention (FIT, based on the findings of neuroscience. Soon after publishing her theory a new scientific approach appeared investigating several visual perception phenomena. The most widely researched were the key constructs of FIT, like types of visual search and the role of the attention. The following review describes the main studies of early vision and visual attention.

  11. FAA Loran early implementation project

    Science.gov (United States)

    1990-03-01

    The Early Implementation Project (EIP), established by FAA Administrator Admiral : Donald C. Engen, was the initial step in the process of Loran integration into the : National Airsace System (NAS). The EIP was designed to give the FAA and the Loran ...

  12. Hypertension presenting early in pregnancy

    OpenAIRE

    Melvin, Audrey; Kinsley, Brendan

    2015-01-01

    Key Clinical Message Paraganglioma in pregnancy is an exceedingly rare and potentially life?threatening diagnosis. It is important that the clinicians consider secondary causes when women present with hypertension in early pregnancy.

  13. Early onset type 2 diabetes

    DEFF Research Database (Denmark)

    Bo, A; Thomsen, R W; Nielsen, J S

    2018-01-01

    was more frequent and meeting physical activity recommendations less likely in persons with early-onset type 2 DM. CONCLUSIONS: We found a clear age-gradient, with increasing prevalence of clinical and behavioural risk factors the younger the onset age of type 2 DM. Younger persons with early-onset type 2......AIM: To examine the association between early onset of type 2 diabetes (DM) and clinical and behavioural risk factors for later diabetes complications. METHODS: We conducted a cross-sectional study of 5115 persons with incident type 2 DM enrolled during 2010-2015 in the Danish Centre for Strategic...... Research in Type 2 Diabetes-cohort. We compared risk factors at time of diagnosis among those diagnosed at ≤45 years (early-onset) with diagnosis age 46-55, 56-65 (average-onset = reference), 66-75, and >75 years (late-onset). Prevalence ratios (PRs) were computed using Poisson regression. RESULTS: Poor...

  14. [Early management of cerebrovascular accidents].

    Science.gov (United States)

    Libot, Jérômie; Guillon, Benoit

    2013-01-01

    A cerebrovascular accident requires urgent diagnosis and treatment.The management of a stroke must be early and adapted in order to improve the overall clinical outcome and lower the risk of mortality.

  15. Early Identification of Reading Difficulties

    DEFF Research Database (Denmark)

    Poulsen, Mads; Nielsen, Anne-Mette Veber; Juul, Holger

    2017-01-01

    Early screening for reading difficulties before the onset of instruction is desirable because it allows intervention that is targeted at prevention rather than remediation of reading difficulties. However, early screening may be too inaccurate to effectively allocate resources to those who need...... them. The present study compared the accuracy of early screening before the onset of formal reading instruction with late screening six months into the first year of instruction. The study followed 164 Danish students from the end of Grade 0 to the end of Grade 2. Early screening included measures...... of phonemic awareness, rapid naming, letter knowledge, paired associate learning, and reading. Late screening included only reading. Results indicated that reading measures improved substantially as predictors over the first six months of Grade 1, to the point where late reading measures alone provided...

  16. Early Retiree Reinsurance Program Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Early Retiree Reinsurance Program (ERRP) was established by section 1102 of the Patient Protection and Affordable Care Act (the Affordable Care Act) enacted on...

  17. EARLY ENTRANCE COPRODUCTION PLANT

    Energy Technology Data Exchange (ETDEWEB)

    Fred D. Brent; Lalit Shah; Earl Berry; Charles H. Schrader; John Anderson; J. Erwin; Matthew G. Banks; Terry L. Ullman

    2004-01-12

    The overall objective of this project is the three phase development of an Early Entrance Coproduction Plant (EECP) which uses petroleum coke to produce at least one product from at least two of the following three categories: (1) electric power (or heat), (2) fuels, and (3) chemicals using ChevronTexaco's proprietary gasification technology. The objective of Phase I is to determine the feasibility and define the concept for the EECP located at a specific site; develop a Research, Development, and Testing (RD&T) Plan to mitigate technical risks and barriers; and prepare a Preliminary Project Financing Plan. The objective of Phase II is to implement the work as outlined in the Phase I RD&T Plan to enhance the development and commercial acceptance of coproduction technology. The objective of Phase III is to develop an engineering design package and a financing and testing plan for an EECP located at a specific site. The project's intended result is to provide the necessary technical, economic, and environmental information needed by industry to move the EECP forward to detailed design, construction, and operation. The partners in this project are Texaco Energy Systems LLC or TES (a subsidiary of ChevronTexaco), General Electric (GE), Praxair, and Kellogg Brown & Root (KBR) in addition to the U.S. Department of Energy (DOE). TES is providing gasification technology and Fischer-Tropsch (F-T) technology developed by Rentech, GE is providing combustion turbine technology, Praxair is providing air separation technology, and KBR is providing engineering. Each of the EECP subsystems was assessed for technical risks and barriers. A plan was developed to mitigate the identified risks (Phase II RD&T Plan, October 2000). Phase II RD&T Task 2.6 identified as potential technical risks to the EECP the fuel/engine performance and emissions of the F-T diesel fuel products. Hydrotreating the neat F-T diesel product reduces potentially reactive olefins, oxygenates, and acids

  18. Early Intervention in Bipolar Disorder.

    Science.gov (United States)

    Vieta, Eduard; Salagre, Estela; Grande, Iria; Carvalho, André F; Fernandes, Brisa S; Berk, Michael; Birmaher, Boris; Tohen, Mauricio; Suppes, Trisha

    2018-05-01

    Bipolar disorder is a recurrent disorder that affects more than 1% of the world population and usually has its onset during youth. Its chronic course is associated with high rates of morbidity and mortality, making bipolar disorder one of the main causes of disability among young and working-age people. The implementation of early intervention strategies may help to change the outcome of the illness and avert potentially irreversible harm to patients with bipolar disorder, as early phases may be more responsive to treatment and may need less aggressive therapies. Early intervention in bipolar disorder is gaining momentum. Current evidence emerging from longitudinal studies indicates that parental early-onset bipolar disorder is the most consistent risk factor for bipolar disorder. Longitudinal studies also indicate that a full-blown manic episode is often preceded by a variety of prodromal symptoms, particularly subsyndromal manic symptoms, therefore supporting the existence of an at-risk state in bipolar disorder that could be targeted through early intervention. There are also identifiable risk factors that influence the course of bipolar disorder, some of them potentially modifiable. Valid biomarkers or diagnosis tools to help clinicians identify individuals at high risk of conversion to bipolar disorder are still lacking, although there are some promising early results. Pending more solid evidence on the best treatment strategy in early phases of bipolar disorder, physicians should carefully weigh the risks and benefits of each intervention. Further studies will provide the evidence needed to finish shaping the concept of early intervention. AJP AT 175 Remembering Our Past As We Envision Our Future April 1925: Interpretations of Manic-Depressive Phases Earl Bond and G.E. Partridge reviewed a number of patients with manic-depressive illness in search of a unifying endo-psychic conflict. They concluded that understanding either phase of illness was "elusive" and

  19. Early vision and visual attention

    OpenAIRE

    Gvozdenović Vasilije P.

    2003-01-01

    The question whether visual perception is spontaneous, sudden or is running through several phases, mediated by higher cognitive processes, was raised ever since the early work of Gestalt psychologists. In the early 1980s, Treisman proposed the feature integration theory of attention (FIT), based on the findings of neuroscience. Soon after publishing her theory a new scientific approach appeared investigating several visual perception phenomena. The most widely researched were the key constru...

  20. Early diagnosis of breast cancer

    International Nuclear Information System (INIS)

    Semiglazov, V.F.

    1989-01-01

    Modern data are presentd on epidemology etiopathogensis and statistics of breast cancer. Home and international clinical and histological classifications is given. Much attention is paid to the methods for early diagnosis of pretumor diseases and breast cancer: clinical roentgenomammography, thrmography and computerized tomomammography. The role of self-examination in cancer early detection has been analyzed. Special attention is paid to system of detection of minimal and unpalpable form of breast cancer, screening of these tumors. 113 refs.; 60 figs.; 6 tabs

  1. Early presentation of primary glioblastoma.

    Science.gov (United States)

    Faguer, R; Tanguy, J-Y; Rousseau, A; Clavreul, A; Menei, P

    2014-08-01

    Clinical and neuroimaging findings of glioblastomas (GBM) at an early stage have rarely been described and those tumors are most probably under-diagnosed. Furthermore, their genetic alterations, to our knowledge, have never been previously reported. We report the clinical as well as neuroimaging findings of four early cases of patients with GBM. In our series, early stage GBM occurred at a mean age of 57 years. All patients had seizures as their first symptom. In all early stages, MRI showed a hyperintense signal on T2-weighted sequences and an enhancement on GdE-T1WI sequences. A hyperintense signal on diffusion sequences with a low ADC value was also found. These early observed occurrences of GBM developed rapidly and presented the MRI characteristics of classic GBM within a few weeks. The GBM size was multiplied by 32 in one month. Immunohistochemical analysis indicated the de novo nature of these tumors, i.e. absence of mutant IDH1 R132H protein expression, which is a diagnostic marker of low-grade diffuse glioma and secondary GBM. A better knowledge of early GBM presentation would allow a more suitable management of the patients and may improve their prognosis. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  2. [Autism: An early neurodevelopmental disorder].

    Science.gov (United States)

    Bonnet-Brilhault, F

    2017-04-01

    With approximately 67 million individuals affected worldwide, autism spectrum disorder (ASD) is the fastest growing neurodevelopmental disorder (United Nations, 2011), with a prevalence estimated to be 1/100. In France ASD affects approximately 600,000 individuals (from childhood to adulthood, half of whom are also mentally retarded), who thus have a major handicap in communication and in adapting to daily life, which leads autism to be recognized as a national public health priority. ASD is a neurodevelopmental disorder that affects several domains (i.e., socio-emotional, language, sensori-motor, executive functioning). These disorders are expressed early in life with an age of onset around 18 months. Despite evidence suggesting a strong genetic link with ASD, the genetic determinant remains unclear. The clinical picture is characterized by impairments in social interaction and communication and the presence of restrictive and repetitive behaviors (DSM-5, ICD-10). However, in addition to these two main dimensions there is significant comorbidity between ASD and other neurodevelopmental disorders such as attention deficit hyperactivity disorder or with genetic and medical conditions. One of the diagnostic features of ASD is its early emergence: symptoms must begin in early childhood for a diagnosis to be given. Due to brain plasticity, early interventions are essential to facilitate clinical improvement. Therefore, general practitioners and pediatricians are on the front line to detect early signs of ASD and to guide both medical explorations and early rehabilitation. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. Early Learner Engagement in the Clinical Workplace

    NARCIS (Netherlands)

    Chen, H.C.

    2015-01-01

    Introduction Recent calls for medical education reform advocate for the integration of knowledge with clinical experience through early clinical immersion. Yet, early learners rarely are invited to participate in workplace activities and early clinical experiences remain largely observational.

  4. Telomere lengthening early in development.

    Science.gov (United States)

    Liu, Lin; Bailey, Susan M; Okuka, Maja; Muñoz, Purificación; Li, Chao; Zhou, Lingjun; Wu, Chao; Czerwiec, Eva; Sandler, Laurel; Seyfang, Andreas; Blasco, Maria A; Keefe, David L

    2007-12-01

    Stem cells and cancer cells maintain telomere length mostly through telomerase. Telomerase activity is high in male germ line and stem cells, but is low or absent in mature oocytes and cleavage stage embryos, and then high again in blastocysts. How early embryos reset telomere length remains poorly understood. Here, we show that oocytes actually have shorter telomeres than somatic cells, but their telomeres lengthen remarkably during early cleavage development. Moreover, parthenogenetically activated oocytes also lengthen their telomeres, thus the capacity to elongate telomeres must reside within oocytes themselves. Notably, telomeres also elongate in the early cleavage embryos of telomerase-null mice, demonstrating that telomerase is unlikely to be responsible for the abrupt lengthening of telomeres in these cells. Coincident with telomere lengthening, extensive telomere sister-chromatid exchange (T-SCE) and colocalization of the DNA recombination proteins Rad50 and TRF1 were observed in early cleavage embryos. Both T-SCE and DNA recombination proteins decrease in blastocyst stage embryos, whereas telomerase activity increases and telomeres elongate only slowly. We suggest that telomeres lengthen during the early cleavage cycles following fertilization through a recombination-based mechanism, and that from the blastocyst stage onwards, telomerase only maintains the telomere length established by this alternative mechanism.

  5. Routine Early Angioplasty after Fibrinolysis

    DEFF Research Database (Denmark)

    Wang, Zhipeng; Liang, Bo; Mei, Qibing

    2009-01-01

    patients in the group that underwent routine early PCI than in the group that received standard treatment received clopidogrel (Ppatients who undergo PCI, as well as in those who do not, is well established,1...... with early beta-blocker therapy is taken into consideration.3 The overall benefit of clopidogrel and beta-blocker therapy could have influenced the outcome in patients who underwent early PCI. These facts leave the conclusion of the TRANSFER-AMI trial still highly uncertain.......To the Editor: Cantor et al. report that there is a significantly reduced rate of ischemic complications among patients with myocardial infarction with ST-segment elevation who are transferred for PCI within 6 hours after fibrinolysis. However, Table 2 of the article shows that significantly more...

  6. Brachytherapy in early prostate cancer--early experience.

    Science.gov (United States)

    Jose, B O; Bailen, J L; Albrink, F H; Steinbock, G S; Cornett, M S; Benson, D C; Schmied, W K; Medley, R N; Spanos, W J; Paris, K J; Koerner, P D; Gatenby, R A; Wilson, D L; Meyer, R

    1999-01-01

    Use of brachytherapy with radioactive seeds in the management of early prostate cancer is commonly used in the United States. The early experience has been reported from the prostate treatment centers in Seattle for the last 10 years. In this manuscript we are reporting our early experience of 150 radioactive seed implantations in early stage prostate cancer using either Iodine 125 or Palladium 103 seeds. The average age of the patient is 66 years and the median Gleason score is 5.4 with a median PSA of 6. A brief description of the evolution of the treatment of prostate cancer as well as the preparation for the seed implantation using the volume study with ultrasound of the prostate, pubic arch study using CT scan of the pelvis and the complete planning using the treatment planning computers are discussed. We also have described the current technique which is used in our experience based on the Seattle guidelines. We plan a follow-up report with the results of the studies with longer follow-up.

  7. Early diagnosis of lung cancer

    International Nuclear Information System (INIS)

    Scherrer, M.

    1982-01-01

    Unanimity does not exist about the utility and organisation of screening procedures for early diagnosis of lung cancer. We describe a low cost structue of screening, requiring only a minimum of compliance from the elderly smoker and ex-smoker. At 4 months interval, radiographs, sputum cytologies and eventual fiberbronchoscopies are realized in all that elderly smokers and ex-smokers which begin to present one of the first early lung cancer signs or symptoms (loss of weight, hemoptoe, thoracic pain and others). (orig.) [de

  8. Shocks in the Early Universe.

    Science.gov (United States)

    Pen, Ue-Li; Turok, Neil

    2016-09-23

    We point out a surprising consequence of the usually assumed initial conditions for cosmological perturbations. Namely, a spectrum of Gaussian, linear, adiabatic, scalar, growing mode perturbations not only creates acoustic oscillations of the kind observed on very large scales today, it also leads to the production of shocks in the radiation fluid of the very early Universe. Shocks cause departures from local thermal equilibrium as well as create vorticity and gravitational waves. For a scale-invariant spectrum and standard model physics, shocks form for temperatures 1  GeVUniverse as early as 10^{-30}  sec after the big bang.

  9. Rendezvous with the World: Missouri Southern State University's Themed Semesters

    Science.gov (United States)

    Stebbins, Chad

    2011-01-01

    Although most universities emphasize study abroad as the primary vehicle to internationalize the campus, in reality only a small percentage of students actually participate in this endeavor. The internationally themed semesters at Missouri Southern State University (MSSU) reach virtually every student, and provide a global perspective and cultural…

  10. China Accomplished Its First Space Rendezvous and Docking

    Institute of Scientific and Technical Information of China (English)

    Chen Xiaoli

    2011-01-01

    At 1:36 am on November 3,China's Shenzhou 8 unmanned spaceship and Tiangong 1 space lab spacecraft accomplished the country's first space docking procedure and coupling in space at more than 343km above Earth's surface,marking a great leap in China's space program.

  11. Self-triggered rendezvous of gossiping second-order agents

    NARCIS (Netherlands)

    De Persis, Claudio; Frasca, Paolo; Hendrickx, Julien M.

    2013-01-01

    A recent paper by some of the authors introduced several self-triggered coordination algorithms for first-order continuous-time systems. The extension of these algorithms to second-order agents is relevant in many practical applications but presents some challenges that are tackled in this

  12. Physics and Medicine: ready for a new rendez-vous

    CERN Multimedia

    Antonella Del Rosso

    2014-01-01

    The second ICTR-PHE conference is on the starting blocks. From 10 to 14 February, physicists, medical doctors and life science experts will meet again in Geneva to discuss how to improve the use of innovative techniques in the fight against cancer.   Over 400 participants from Europe, the US and Asia will gather at the Geneva International Conference Centre to attend the 2014 edition of the joint ICTR (International Conference on Transnational Research in Radiation Oncology) and PHE (Physics for Health in Europe) conference. “For this second conference we will reproduce the successful model tested in 2012 with just a few tweaks, suggested by the participants themselves,” says Manjit Dosanjh, CERN’s Advisor for Life Sciences and Chair of the conference together with radiation oncologist Jacques Bernier from Geneva’s Genolier Clinic. This second conference will feature more oral presentations on the themes proposed by PHE, including detectors, nuclear med...

  13. Rendezvous with IQ: Metacognition in Real-Life Situations

    Science.gov (United States)

    Al-Hilawani, Yasser A.

    2018-01-01

    The purpose of this study was to examine the relationship between metacognition as measured in real-life situations and IQ scores as reflected by performance on the Raven Standard Progressive Matrices Scale. It is also intended in this study to report on whether or not there were significant differences in performance on the metacognitive…

  14. Flash 3D Rendezvous and Docking Sensor, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — 3D Flash Ladar is a breakthrough technology for many emerging and existing 3D vision areas, and sensor improvements will have an impact on nearly all these fields....

  15. An Interdisciplinary Rendezvous between Mathematics, Literature and Literacy

    DEFF Research Database (Denmark)

    Bremholm, Jesper; Thomas Jankvist, Uffe; Rørbech, Helle

    2017-01-01

    ’s aesthetic arguments for the value of pure mathematics (A Mathematician’s Apology from 1940) as the textual basis of a potential interdisciplinary collaboration between the subjects of mathematics and Danish (i.e. Language 1). Through the perspective of literacy, it points out didactic potentials...

  16. Vision Based Navigation Sensors for Spacecraft Rendezvous and Docking

    DEFF Research Database (Denmark)

    Benn, Mathias

    provided new information and insight into gravitational related physics as diverse as dessert growth, ocean circulation, gravity anomaly mapping and precipitation and climate models. Plans and projects for future multi segment missions are plenty, with missions from all major space agencies in progress...

  17. Appointment with Climate 2005; Rendez-vous climat 2005

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    This document takes stock on the situation one year after the Climate Plan decided by the government in July 2004. It provides the allocutions of politicians occurred during the 14 and 15 November 2005 and a synthesis of the main questions and problems discussed during these two days. (A.L.B.)

  18. Simultaneous Localization and Mapping for Satellite Rendezvous and Proximity Operations

    Data.gov (United States)

    National Aeronautics and Space Administration — Simultaneous Localization and Mapping (SLAM) attempts to estimate a vehicle’s position and orientation (localization) and the location of an initially unknown number...

  19. Early-delayed radiation rhombencephalopathy

    International Nuclear Information System (INIS)

    Nightingale, S.; Dawes, P.J.D.K.; Cartlidge, N.E.F.; Newcastle upon Tyne Univ.

    1982-01-01

    A 37-year-old woman developed an early-delayed rhombencephalopathy 7 weeks after completing a course of radiotherapy to a glomus jugulare tumour. The clinical features, comprising nystagmus, skew strabismus, unilateral facial weakness, dysarthria and ataxia, are compared with four previously reported patients with this syndrome. (author)

  20. Early stage fuel cell funding

    International Nuclear Information System (INIS)

    Bergeron, C.

    2004-01-01

    'Full text:' Early stage venture funding requires an in depth understanding of both current and future markets as well as the key technical hurdles that need to be overcome for new technology to commercialize into successful products for mass markets. As the leading fuel cell and hydrogen investor, Chrysalix continuously reviews global trends and new technologies, evaluates them with industry leaders worldwide and tries to match them up with the best possible management teams when selecting its early stage investments. Chrysalix Energy Limited Partnership is an early-stage venture capital firm focusing on fuel cell and related fueling technology companies and is a private equity joint venture between Ballard Power Systems, BASF Venture Capital, The BOC Group, The Boeing Company, Duke Energy, Mitsubishi Corporation and Shell Hydrogen. Operating independently, Chrysalix offers a unique value proposition to its clients throughout the business planning, start-up and operations phases of development. Chrysalix provides early-stage funding to new companies as well as management assistance, technological knowledge, organized networking with industry players and experience in the management of intellectual property. (author)

  1. Early Childhood Intervention in China

    Science.gov (United States)

    Zheng, Yuzhu; Maude, Susan P.; Brotherson, Mary Jane

    2015-01-01

    With rapid economic development and increasing awareness of the importance of early childhood intervention (ECI), China is re-examining its social and educational practices for young children with disabilities. This re-examination may have a significant impact on young children with disabilities in China. It may also set an example for other…

  2. Uganda Early Generation Seed Study

    NARCIS (Netherlands)

    Mastenbroek, A.; Ntare, Bonny

    2016-01-01

    One of the major bottlenecks limiting farmers’ access to good quality seed for food crops in Uganda is the shortage of early generation seed (EGS - breeder and foundation) to produce sufficient quantities of certified and/or quality declared) to satisfy the needs of farmers. A national study was

  3. Early and Late Retirement Exits

    Science.gov (United States)

    Brougham, Ruby R.; Walsh, David A.

    2009-01-01

    The current study proposes that personal need fulfillment (relatedness, generativity, identity, growth, and finances) predicts early and late retirement intentions. The personal needs of 160 full-time older employees were measured by personal goals, job satisfactions, job characteristics, and intrinsic motivation. Results suggest that the personal…

  4. Defeating cancer with early detection

    CERN Document Server

    2003-01-01

    A meeting of scientists and industry experts will hold an open review of the Three Dimension Complete Body Screening System (3D-CBS) on the 1st of July 2003. This new imaging technlogy is potentially powerful and safe enough to offer routine screening of healthy patients for early signs of cancer (1 page).

  5. Boys' Bodies in Early Childhood

    Science.gov (United States)

    Drummond, Murray

    2012-01-01

    This paper is based on qualitative research data from a project investigating early childhood boys' constructions of masculinities in relation to sport, health and the body. The focus group data, with 33 boys, has been collected in each of the boys' first three years at school. It is part of the data that will be collected over eight years with…

  6. Early Childhood Inclusion in Croatia

    Science.gov (United States)

    Ljubešic, Marta; Šimleša, Sanja

    2016-01-01

    This article explains early childhood inclusion in Croatia from its beginnings up to challenges in current policy and practice. The first preschool education for children with disabilities dates back to the 1980s and was provided in special institutions. In the last 10 years, mainstream kindergartens have been enrolling children with disabilities…

  7. Early Childhood Education in Scandinavia.

    Science.gov (United States)

    Austin, Gilbert R.; Dittman, Laura

    This article discusses the move toward greater equality of educational opportunity in Scandinavia with particular emphasis on early childhood education. The increasing demand for preschool education in Denmark, Finland, Norway and Sweden is related to low birth rates together with increased employment of women and the general demand for equality…

  8. Galaxies in the Early Universe

    DEFF Research Database (Denmark)

    Krogager, Jens-Kristian

    Understanding how galaxies evolved from the early Universe through cosmic time is a fundamental part of modern astrophysics. In order to study this evolution it is important to sample the galaxies at various times in a consistent way through time. In regular luminosity selected samples, our...

  9. Glucocorticoids in early rheumatoid arthritis

    NARCIS (Netherlands)

    Everdingen, Amalia A. van

    2002-01-01

    For 50 years, glucocorticoids (GC) are used for symptomatic treatment of rheumatoid arthritis (RA). In the last decade, results from clinical studies of treatment with GC as additional therapy to long-acting antirheumatic drugs in patients with early RA suggested also disease-modifying properties of

  10. Internationalism in Early Adult Education.

    Science.gov (United States)

    Keane, Patrick

    1985-01-01

    Explores the nature and scope of internationalism in early 19th century adult education, using as a context the lyceums and mechanics' institutes of Britain and North America. The contacts involved newspaper and journal accounts, the personal advocacy of former members, written advice from promoters and administrators, and the contributions of…

  11. Management of early pregnancy loss

    NARCIS (Netherlands)

    Graziosi, G. C. M.; Mol, B. W.; Ankum, W. M.; Bruinse, H. W.

    2004-01-01

    Objectives: In order to assess the available evidence on the management of early pregnancy loss, we performed a meta-analysis on the subject. Methods: MEDLINE and EMBASE were searched for randomized studies reporting on the effectiveness of expectant management, misoprostol treatment or curettage.

  12. Physics of the early universe

    International Nuclear Information System (INIS)

    Klinkhamer, F.R.

    1983-01-01

    In this thesis, the author has assembled his papers on elementary particle physics which are of importance for studying cosmology viz. the physics of the early universe. A rather detailed introduction reviewing basic principles and current trends in the relation particle physics/cosmology precedes the papers. (Auth.)

  13. Electromigration early resistance increase measurements

    NARCIS (Netherlands)

    Niehof, J.; Flinn, P.A.; Maloney, T.J.

    1993-01-01

    An early resistance change measurement set-up, using an AC bridge technique, has been developed, and measurements have been performed. Large sample-to-sample variations occur. The characteristic time for the resistance change curve is shorter for resistance increase (under current stress) than for

  14. Early Learning Theories Made Visible

    Science.gov (United States)

    Beloglovsky, Miriam; Daly, Lisa

    2015-01-01

    Go beyond reading about early learning theories and see what they look like in action in modern programs and teacher practices. With classroom vignettes and colorful photographs, this book makes the works of Jean Piaget, Erik Erikson, Lev Vygotsky, Abraham Maslow, John Dewey, Howard Gardner, and Louise Derman-Sparks visible, accessible, and easier…

  15. Early Diagnosis of Breast Cancer.

    Science.gov (United States)

    Wang, Lulu

    2017-07-05

    Early-stage cancer detection could reduce breast cancer death rates significantly in the long-term. The most critical point for best prognosis is to identify early-stage cancer cells. Investigators have studied many breast diagnostic approaches, including mammography, magnetic resonance imaging, ultrasound, computerized tomography, positron emission tomography and biopsy. However, these techniques have some limitations such as being expensive, time consuming and not suitable for young women. Developing a high-sensitive and rapid early-stage breast cancer diagnostic method is urgent. In recent years, investigators have paid their attention in the development of biosensors to detect breast cancer using different biomarkers. Apart from biosensors and biomarkers, microwave imaging techniques have also been intensely studied as a promising diagnostic tool for rapid and cost-effective early-stage breast cancer detection. This paper aims to provide an overview on recent important achievements in breast screening methods (particularly on microwave imaging) and breast biomarkers along with biosensors for rapidly diagnosing breast cancer.

  16. Early Signs of Entrepreneurial Giftedness

    Science.gov (United States)

    Shavinina, Larisa V.

    2008-01-01

    Although successful entrepreneurship is important for the economic prosperity of any society, one should acknowledge that entrepreneurial giftedness is terra incognita from a research viewpoint. This article analyzes early manifestations of entrepreneurial giftedness in the cases of Richard Branson, Michael Dell, and Bill Gates and thus opens a…

  17. FUNdamental Movement in Early Childhood.

    Science.gov (United States)

    Campbell, Linley

    2001-01-01

    Noting that the development of fundamental movement skills is basic to children's motor development, this booklet provides a guide for early childhood educators in planning movement experiences for children between 4 and 8 years. The booklet introduces a wide variety of appropriate practices to promote movement skill acquisition and increased…

  18. IDEA and Early Childhood Inclusion.

    Science.gov (United States)

    Smith, Barbara J.; Rapport, Mary Jane K.

    This paper discusses 1997 amendments to the Individuals with Disabilities Education Act (IDEA) that promote the inclusion of children with disabilities in general early childhood education settings. The evolution of inclusion policy is explored and changes in disability terminology are described. Amended provisions are then explained and include:…

  19. Melanoma early detection and awareness

    DEFF Research Database (Denmark)

    Wainstein, Alberto; Algarra, Salvador Martin; Bastholt, Lars

    2014-01-01

    to increase public awareness and favor early diagnosis. Awareness campaigns, doctor education, and screening of high-risk subjects have all contributed to improve disease outcome in developed countries. The role of primary care physicians is particularly relevant in this regard. Developing countries...

  20. Early Childhood Inclusion in Israel

    Science.gov (United States)

    Al-Yagon, Michal; Aram, Dorit; Margalit, Malka

    2016-01-01

    This article describes conceptual aspects, current policies and practices, and research representing the Israeli perspective regarding early childhood inclusion (ECI) at preschool ages (3-6 years). We review legislative, historical, attitudinal, philosophical, practical, empirical, and cultural issues regarding ECI in Israel. Finally, we focus on…

  1. Reduplication Facilitates Early Word Segmentation

    Science.gov (United States)

    Ota, Mitsuhiko; Skarabela, Barbora

    2018-01-01

    This study explores the possibility that early word segmentation is aided by infants' tendency to segment words with repeated syllables ("reduplication"). Twenty-four nine-month-olds were familiarized with passages containing one novel reduplicated word and one novel non-reduplicated word. Their central fixation times in response to…

  2. Early Childhood Inclusion in Australia

    Science.gov (United States)

    Kemp, Coral R.

    2016-01-01

    From the introduction of early intervention services in Australian in the mid-1970s, the families of children with intellectual and multiple disabilities have been encouraged to enroll their children in local preschools and childcare centers. Children with disabilities have also accessed a range of alternatives to full inclusion, such as reverse…

  3. HPLC: Early and Recent Perspectives.

    Science.gov (United States)

    Karger, Barry L.

    1997-01-01

    Provides a perspective on what it was like in the early days of high-performance liquid chromatography (HPLC) and several of the key developments. Focuses on the advances in HPLC generally, and more specifically for the biological sciences, that were necessary for the method to reach the preeminent stage of today. Contains 20 references. (JRH)

  4. Early Children's Literature and Aging

    Science.gov (United States)

    McGuire, Sandra L.

    2016-01-01

    Increased longevity is a worldwide phenomenon placing emphasis on the need for preparation for life's later years. Today's children will be the older adults of tomorrow. A resource that can help to educate them about aging and prepare them for the long life ahead is early children's literature (Preschool-Primary). This literature can provide…

  5. Vantage point - Early warning flaws.

    Science.gov (United States)

    Swinden, Donna

    2014-08-28

    USING AN EARLY warning score (EWS) system should improve the detection of acutely deteriorating patients. Under such a system, a score is allocated to each of six physiological measurements including respiratory rate and oxygen saturations, which are aggregated to produce an overall score. An aggregated score of seven or higher prompts nursing staff to refer a patient for emergency assessment.

  6. The Integrated Early Childhood Curriculum.

    Science.gov (United States)

    Krogh, Suzanne

    This textbook provides an outline of an integrated curriculum for early childhood education. Part 1 discusses the human element in school: the child and the teacher and child development. Part 2 contains the curriculum itself and covers the subjects of language, mathematics, science, social studies, art, music, and movement. Guidelines provide…

  7. Natural course of early COPD

    Directory of Open Access Journals (Sweden)

    Rhee CK

    2017-02-01

    Full Text Available Chin Kook Rhee,1 Kyungjoo Kim,1 Hyoung Kyu Yoon,2 Jee-Ae Kim,3 Sang Hyun Kim,4 Sang Haak Lee,5 Yong Bum Park,6 Ki-Suck Jung,7 Kwang Ha Yoo,8 Yong Il Hwang7 1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St Mary’s Hospital, 2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, 3Pharmaceutical Policy Evaluation Research Team, Research Institution, 4Big Data Division, Health Insurance Review and Assessment Service, Wonju, 5Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, St Paul’s Hospital, College of Medicine, The Catholic University of Korea, 6Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, 7Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, 8Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Republic of Korea Background and objective: Few studies have examined the natural course of early COPD. The aim of this study was to observe the natural course of early COPD patients. We also aimed to analyze medical utilization and costs for early COPD during a 6-year period. Methods: Patients with early COPD were selected from Korean National Health and Nutrition Examination Survey (KNHANES data. We linked the KNHANES data of patients with early COPD to National Health Insurance data. Results: A total of 2,397 patients were enrolled between 2007 and 2012. The mean forced expiratory volume in 1 second (FEV1 was 78.6%, and the EuroQol five dimensions questionnaire (EQ-5D index value was 0.9. In total, 110 patients utilized health

  8. Famines in Africa: is early warning early enough?

    Directory of Open Access Journals (Sweden)

    Jeeyon Janet Kim

    2012-06-01

    Full Text Available Following the second Sahelian famine in 1984–1985, major investments were made to establish Early Warning Systems. These systems help to ensure that timely warnings and vulnerability information are available to decision makers to anticipate and avert food crises. In the recent crisis in the Horn of Africa, alarming levels of acute malnutrition were documented from March 2010, and by August 2010, an impending food crisis was forecast. Despite these measures, the situation remained unrecognised, and further deteriorated causing malnutrition levels to grow in severity and scope. By the time the United Nations officially declared famine on 20 July 2011, and the humanitarian community sluggishly went into response mode, levels of malnutrition and mortality exceeded catastrophic levels. At this time, an estimated 11 million people were in desperate and immediate need for food. With warnings of food crises in the Sahel, South Sudan, and forecast of the drought returning to the Horn, there is an immediate need to institutionalize change in the health response during humanitarian emergencies. Early warning systems are only effective if they trigger an early response.

  9. Pompe Disease: Early Diagnosis and Early Treatment Make a Difference

    Directory of Open Access Journals (Sweden)

    Yin-Hsiu Chien

    2013-08-01

    Full Text Available Pompe disease (glycogen storage disease type II or acid maltase deficiency is a lysosomal disorder in which acid α-glucosidase (GAA deficiencies lead to intralysosomal accumulation of glycogen in all tissues; most notably in skeletal muscles. Both the patient's age at the onset of Pompe disease symptoms and the rate of deterioration caused by the disease can vary considerably. In classical infant-onset Pompe disease (IOPD, symptoms start very early in life, and death occurs soon afterward if the disease remains untreated. In later-onset Pompe disease, symptoms are slower to appear, and patients often progress to wheelchair confinement and eventual respiratory failure. A diagnosis can be made by screening for GAA in dried blood samples, followed either by GAA assessment in lymphocytes or in fibroblasts or by the genetic analysis of mutations. Treatment by enzyme replacement therapy (ERT with alglucosidase alfa was approved for human use in 2006. In classical IOPD, treatment significantly lengthens survival and improves motor development and cardiac function. The sooner ERT begins, the better are the results. Newborn screening aims to take advantage of different technologies for diagnosing and treating newborns early on and it yields better outcomes. However, newborns diagnosed early and other long-term survivors may encounter fresh problems, making up a new phenotype of IOPD patients. Further modifications of the treatment, such as a decrease in immune responses to ERT, a higher dosage, a better uptake formulation, and gene therapy delivered locally or systemically are being explored.

  10. Abnormal early cleavage events predict early embryo demise: sperm oxidative stress and early abnormal cleavage.

    Science.gov (United States)

    Burruel, Victoria; Klooster, Katie; Barker, Christopher M; Pera, Renee Reijo; Meyers, Stuart

    2014-10-13

    Human embryos resulting from abnormal early cleavage can result in aneuploidy and failure to develop normally to the blastocyst stage. The nature of paternal influence on early embryo development has not been directly demonstrated although many studies have suggested effects from spermatozoal chromatin packaging, DNA damage, centriolar and mitotic spindle integrity, and plasma membrane integrity. The goal of this study was to determine whether early developmental events were affected by oxidative damage to the fertilizing sperm. Survival analysis was used to compare patterns of blastocyst formation based on P2 duration. Kaplan-Meier survival curves demonstrate that relatively few embryos with short (P2 times reached blastocysts, and the two curves diverged beginning on day 4, with nearly all of the embryos with longer P2 times reaching blastocysts by day 6 (p < .01). We determined that duration of the 2nd to 3rd mitoses were sensitive periods in the presence of spermatozoal oxidative stress. Embryos that displayed either too long or too short cytokineses demonstrated an increased failure to reach blastocyst stage and therefore survive for further development. Although paternal-derived gene expression occurs later in development, this study suggests a specific role in early mitosis that is highly influenced by paternal factors.

  11. Do schizophrenia patients age early?

    Science.gov (United States)

    Shivakumar, Venkataram; Kalmady, Sunil V; Venkatasubramanian, Ganesan; Ravi, Vasanthapuram; Gangadhar, Bangalore N

    2014-08-01

    The etiopathogenesis of schizophrenia is poorly understood. Within the proposed "neurodegeneration paradigm", observations have been put forth for "accelerated aging" in this disorder. This proposition is largely based on the neuroscience research that demonstrates progressive changes in brain as well as other systemic abnormalities supportive of faster aging process in patients with this disorder. In this review, we have summarized the literature related to the concept of early aging in schizophrenia. These studies include P300 abnormalities & visual motion discrimination, neuroimaging findings, telomere dynamics as well as neuropathology of related brain regions. We also propose a role of vitamin D, neuroimmunological changes and elevated oxidative stress as well as mitochondrial dysfunction in addition to the above factors with 'vitamin-D deficiency' as the central paradox. Put together, the evidence supporting early aging in schizophrenia is compelling and this requires further systematic studies. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Nanotechnology for Early Cancer Detection

    Directory of Open Access Journals (Sweden)

    Joon Won Park

    2010-01-01

    Full Text Available Vast numbers of studies and developments in the nanotechnology area have been conducted and many nanomaterials have been utilized to detect cancers at early stages. Nanomaterials have unique physical, optical and electrical properties that have proven to be very useful in sensing. Quantum dots, gold nanoparticles, magnetic nanoparticles, carbon nanotubes, gold nanowires and many other materials have been developed over the years, alongside the discovery of a wide range of biomarkers to lower the detection limit of cancer biomarkers. Proteins, antibody fragments, DNA fragments, and RNA fragments are the base of cancer biomarkers and have been used as targets in cancer detection and monitoring. It is highly anticipated that in the near future, we might be able to detect cancer at a very early stage, providing a much higher chance of treatment.

  13. Early intervention services in psychosis

    DEFF Research Database (Denmark)

    Csillag, Claudio; Nordentoft, Merete; Mizuno, Masafumi

    2016-01-01

    AIM: Early intervention (EI) in psychosis is a comprehensive and evidence-based approach aimed at detection and treatment of psychotic symptoms in their early stages. This paper presents core features and noteworthy aspects of the evidence basis and limitations of EI, the importance of programme ....... Wider dissemination of EI services will probably benefit from better integration of potential funders, promotion of joint targets and shared financial or budgetary incentives....... overcome these difficulties. CONCLUSIONS: Funding for mental health in general and for EI services appears low relative to need. One key argument for better funding for EI can be found in its favourable cost-effectiveness, but not all stakeholders beyond mental health administrators are aware of this...

  14. Cosmology and the early universe

    CERN Document Server

    Di Bari, Pasquale

    2018-01-01

    This book discusses cosmology from both an observational and a strong theoretical perspective. The first part focuses on gravitation, notably the expansion of the universe and determination of cosmological parameters, before moving onto the main emphasis of the book, the physics of the early universe, and the connections between cosmological models and particle physics. Readers will gain a comprehensive account of cosmology and the latest observational results, without requiring prior knowledge of relativistic theories, making the text ideal for students.

  15. Early laparotomy after lung transplantation

    DEFF Research Database (Denmark)

    Bredahl, Pia; Zemtsovski, Mikhail; Perch, Michael

    2014-01-01

    BACKGROUND: Gastrointestinal complications after lung transplantation have been reported with incidence rates ranging from 3% to 51%, but the reasons are poorly understood. We aimed to investigate the correlations between pulmonary diseases leading to lung transplantation and early gastrointestinal...... for time on mechanical ventilation. Among pulmonary diseases and demographics of the patients, no other risk factors were identified for laparotomy. CONCLUSIONS: A1AD was the only significant risk factor identified for gastrointestinal complications that required laparotomy within 3 months after lung...

  16. The early days of incineration

    Energy Technology Data Exchange (ETDEWEB)

    Valenti, M.

    1995-05-01

    Landfills reaching capacity, beaches fouled with trash, neighborhood residents protesting waste disposal sites in their backyards, and municipalities forced to recycle. Sound familiar? These issues might have been taken from today`s headlines, but they were also problems facing mechanical engineers a century ago. Conditions such as these were what led engineers to design the first incinerators for reducing the volume of municipal garbage, as well as for producing heat and electricity. The paper discusses these early days.

  17. Interpersonal relationships in early adulthood

    OpenAIRE

    Kočevar, Zala

    2014-01-01

    Interpersonal relationships in early adulthood, in people aged 25 to 30 vary considerably among individuals. Some place emphasis on partnership, and others on relations with friends. Even the relationship with parents and siblings are experienced by young adults in a variety of ways. Some have frequent and regular contact with their parents while some no longer have any relationship with their parents. These are two frequent situations hiding much more in between. Relationships are complex an...

  18. Supporting Families through Early Intervention

    Directory of Open Access Journals (Sweden)

    Roy McConkey

    2003-09-01

    Full Text Available Internationally early intervention programmes for infants and preschoolers with disabilities have proved to be remarkably successful. In many countries, they began with teachers for visually impaired or hearing impaired children visiting the family home to teach parents how they could overcome the child's impairments. The logic of early intervention was inequitable. For example, the sooner children with visual impairments learnt to be independently mobile, then the greater their potential to learn and to kad an ordinary life. In time, this philosophy was extended to children with neurological and developmental delays, such as mental retardation, although success could be variable. In part, many different factors contributed to this variability: the form the interventions took, the extent of family involvement in the intervention and the lack of sensitivity of the measures used to assess a child's progress, to name but three. Perhaps the most extensive and intensive Early intervention schemes have been in the United States with their Head Start programmes. They were aimed at promoting the educational potential of preschoolers from deprived socio - economic backgrounds. Although the first phase of programmes had varying success, those in the second phase yielded impressive results which were mainly attributed to a greater focus on parental participation and links forged with the school system. Recently in developing countries, priority has been given to establishing early intervention as a means of creating new styles of family-based and community-based service in these countries in contrast to the hospital or institutional-services that were a legacy from a previous generation. Although formal evaluations are largely lacking, informal reports have been broadly enthusiastic. In sum, early intervention is no longer a new approach to developmental disabilities. It is an approach of proven effectiveness with children who have different impairments

  19. Early detection of first-episode psychosis

    DEFF Research Database (Denmark)

    Larsen, Tor K; Melle, Ingrid; Auestad, Bjørn

    2006-01-01

    Early intervention is assumed to improve outcome in first-episode psychosis, but this has not been proven.......Early intervention is assumed to improve outcome in first-episode psychosis, but this has not been proven....

  20. Early Identification of Psychosis: A Primer

    OpenAIRE

    Early Psychosis Initiative of British Columbia

    2000-01-01

    This document is an educational resource concerning the early identification of psychosis. Primary topics addressed include: an outline of the importance of early intervention; signs and symptoms of psychosis; and strategies for recognizing psychosis.  

  1. Peering Into an Early Galaxy

    Science.gov (United States)

    Kohler, Susanna

    2018-04-01

    Thirteen billion years ago, early galaxies ionized the gas around them, producing some of the first light that brought our universe out of its dark ages. Now the Atacama Large Millimeter/submillimeter Array (ALMA) has provided one of the first detailed looks into the interior of one of these early, distant galaxies.Sources of LightArtists illustration of the reionization of the universe (time progresses left to right), in which ionized bubbles that form around the first sources of light eventually overlap to form the fully ionized universe we observe today. [Avi Loeb/Scientific American]For the first roughly hundred million years of its existence, our universe expanded in relative darkness there were no sources of light at that time besides the cosmic microwave background. But as mass started to condense to form the first objects, these objects eventually shone as the earliest luminous sources, contributing to the reionization of the universe.To learn about the early production of light in the universe, our best bet is to study in detail the earliest luminous sources stars, galaxies, or quasars that we can hunt down. One ideal target is the galaxy COSMOS Redshift 7, known as CR7 for short.Targeting CR7CR7 is one of the oldest, most distant galaxies known, lying at a redshift of z 6.6. Its discovery in 2015 and subsequent observations of bright, ultraviolet-emitting clumps within it have led to broad speculation about the source of its emission. Does this galaxy host an active nucleus? Or could it perhaps contain the long-theorized first generation of stars, metal-free Population III stars?To determine the nature of CR7 and the other early galaxies that contributed to reionization, we need to explore their gas and dust in detail a daunting task for such distant sources! Conveniently, this is a challenge that is now made possible by ALMAs incredible capabilities. In a new publication led by Jorryt Matthee (Leiden University, the Netherlands), a team of scientists now

  2. THE IMPORTANCE OF INVESTMENTS IN EARLY EDUCATION

    OpenAIRE

    DUMITRESCU Alexandra; CONSTANTINESCU Adrian; TACHE Ileana

    2012-01-01

    The early education is analyzed as being the most profitable investment in education (R. Cuhna). early education supports later learning opportunities. The economic dimension of early education takes into account the fact that the necessary investment for a child to benefit from early education services is rather low when looking at the cost (both economic and social) generated by a child who misses this education level, not necessarily because of the late education start but because of the l...

  3. Early diagnosis of the Spondyloarthropathies

    International Nuclear Information System (INIS)

    Gonzalez Naranjo, Luis Alonso; Londono, John D; Valle, Rafael Raul

    2005-01-01

    Spondyloarthropathies are a cluster of chronic inflammatory diseases that primarily include ankylosing spondylitis, reactive arthritis, psoriatic arthritis; arthritis associated with inflammatory bowel diseases and undifferentiated spondyloarthropathies. The most common subgroups of spondyloarthropathies are ankylosing spondylitis and undifferentiated spondyloarthropathy. The diagnosis of ankylosing spondylitis is mainly based on unequivocal radiographic sacroiliitis of at least grade 2 bilaterally or grade 3 unilaterally. How ever, in the early phase of disease, conventional radiographs are often too insensitive to show sacroiliitis and it usually takes several years for definite radiographic sacroiliitis to evolve. Thus, the diagnosis of ankylosing spondylitis is a commonly delayed by 8 to 11 years after the onset of symptoms. As a result, diagnosing axial spondyloarthropathy in the absence of radiographic sacroiliitis is very difficult to rheumatologists. In the early phase of disease, HLA B27 test and magnetic resonance imaging of sacroiliac joints may be helpful to the early diagnosis. In the presence of chronic low back pain the probability of axial spondyloarthropathy is about 5% and is about 14% if the back pain is inflammatory. The presence of = 3 features of spondyloarthropathy (heel pain, uveitis, dactylitis, positive family history, alternating buttock pain, psoriasis, inflammatory bowel disease, asymmetrical arthritis, positive response to anti-inflammatory drugs) increase the probability of axial spondyloarthropathy to 90%. Both, the positive HLA B27 and magnetic resonance imaging with signs of sacroiliitis increase the probability of spondyloarthropathy, particularly in patients without spondyloarthropathies features or with only 1 or 2 features. Since ankylosing spondylitis in association with psoriasis and inflammatory bowel disease is often HLA B27 negative, this test is of limited value under theses circumstances. Is important to consider that

  4. Observations of Early Optical Afterglows

    OpenAIRE

    Roming, Peter W. A.; Mason, Keith O.

    2006-01-01

    The Swift Ultra-Violet/Optical Telescope (UVOT) has performed extensive follow-up on 71 Swift Burst Alert Telescope triggered gamma-ray bursts (GRBs) in its first ten months of operations. In this paper, we discuss some of the UV and optical properties of UVOT detected afterglows such as XRF 050406, the bright GRB 050525A, the high redshift GRB 050730, the early flaring GRB 050801, and others. We also discuss some of the implications of why 75% of GRB afterglows observed by UVOT in less than ...

  5. Early discharge hospital at home.

    Science.gov (United States)

    Gonçalves-Bradley, Daniela C; Iliffe, Steve; Doll, Helen A; Broad, Joanna; Gladman, John; Langhorne, Peter; Richards, Suzanne H; Shepperd, Sasha

    2017-06-26

    Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit. We searched clinical trials registries. Randomised trials comparing early discharge hospital at home with acute hospital inpatient care for adults. We excluded obstetric, paediatric and mental health hospital at home schemes.   DATA COLLECTION AND ANALYSIS: We followed the standard methodological procedures expected by Cochrane and EPOC. We used the GRADE approach to assess the certainty of the body of evidence for the most important outcomes. We included 32 trials (N = 4746), six of them new for this update, mainly conducted in high-income countries. We judged most of the studies to have a low or unclear risk of bias. The intervention was delivered by hospital outreach services (17 trials), community-based services (11 trials), and was co-ordinated by a hospital-based stroke team or physician in conjunction with community-based services in four trials.Studies recruiting people recovering from strokeEarly discharge hospital at home probably makes little or no difference to mortality at three to six months (risk ratio (RR) 0.92, 95% confidence interval (CI) 0.57 to 1.48, N = 1114, 11 trials, moderate-certainty evidence) and may make little or no difference to the risk of hospital readmission (RR 1.09, 95% CI 0.71 to 1.66, N = 345, 5 trials, low-certainty evidence). Hospital at home may lower the risk of living in institutional setting at six months (RR 0.63, 96% CI

  6. Early detection of congenital syphilis

    Directory of Open Access Journals (Sweden)

    Nagalakshmi Chowdhary

    2014-01-01

    Full Text Available Late congenital syphilis is a very rare clinical entity, and its early diagnosis and treatment is essential. Dental findings often provide valuable evidence for the diagnosis of late congenital syphilis. It occurs due to the transmission of the disease from an infected mother to her fetus through placenta. This long forgotten disease continues to effect pregnant women resulting in perinatal morbidity and mortality. Congenital syphilis is a preventable disease, and its presence reflects a failure of prenatal care delivery system, as well as syphilis control programs. We are reporting a case of late congenital syphilis with only Hutchinson′s teeth.

  7. Early history of military radiology

    International Nuclear Information System (INIS)

    Eisenberg, R.L.

    1991-01-01

    This paper reports that soon after Roentgen's discovery, physicians in the armed services of the major powers grasped the importance of x-ray sin military surgery. By May of 1896, radiographic examinations were being performed on Italian soldiers returning from the ill-fated Ethiopian campaign. Initially, radiographs were used for foreign body localization and the detection of fractures; later, a full range of diagnostic services was offered. The early challenges of obtaining x-ray examinations in the field - fragility of tubes and plates, mobility of machines and patients, and unpredictability of radiation dosage - became the basis for innovations that would fundamentally alter the daily practice of radiology in civilian life

  8. Examining Text Complexity in the Early Grades

    Science.gov (United States)

    Fitzgerald, Jill; Elmore, Jeff; Hiebert, Elfrieda H.; Koons, Heather H.; Bowen, Kimberly; Sanford-Moore, Eleanor E.; Stenner, A. Jackson

    2016-01-01

    The Common Core raises the stature of texts to new heights, creating a hubbub. The fuss is especially messy at the early grades, where children are expected to read more complex texts than in the past. But early-grades teachers have been given little actionable guidance about text complexity. The authors recently examined early-grades texts to…

  9. Ethics dilemmas of early detection of obesity

    DEFF Research Database (Denmark)

    Vallgårda, Signild

    2016-01-01

    Aim: To discuss the ethics dilemmas of the early detection of overweight and obesity. Methods: Analysis of the ethical aspects of early detection. Results: The early detection of overweight and obesity entails a number of ethical dilemmas because it may both be helpful and harmful. It may help...

  10. Early identification and intervention in cerebral palsy

    DEFF Research Database (Denmark)

    Herskind, Anna; Greisen, Gorm; Nielsen, Jens Bo

    2015-01-01

    Infants with possible cerebral palsy (CP) are commonly assumed to benefit from early diagnosis and early intervention, but substantial evidence for this is lacking. There is no consensus in the literature on a definition of 'early', but this review focuses on interventions initiated within...

  11. Early Childhood Inclusion in the United Kingdom

    Science.gov (United States)

    Blackburn, Carolyn

    2016-01-01

    A policy-to-practice paper is presented of early childhood inclusion in England. The article aims to report the benefits of early intervention services and early childhood inclusion for children with special educational needs and disabilities (SEND), document the chronology of policy development, and discuss research evidence about…

  12. Early Learning and Educational Technology Policy Brief

    Science.gov (United States)

    Lee, Joan

    2016-01-01

    Recognizing the growth of technology use in early learning settings, the U.S. Department of Education and U.S. Department of Health and Human Services collaborated in the development of the "Early Learning and Educational Technology Policy Brief" to promote developmentally appropriate use of technology in homes and early learning…

  13. Early infection and prognosis after acute stroke

    DEFF Research Database (Denmark)

    Kammersgaard, L P; Jørgensen, H S; Reith, J

    2001-01-01

    Infection is a frequent complication in the early course of acute stroke and may adversely affect stroke outcome. In the present study, we investigate early infection developing in patients within 3 days of admission to the hospital and its independent relation to recovery and stroke outcome....... In addition, we identify predictors for early infections, infection subtypes, and their relation to initial stroke severity....

  14. Early Smoking, Education, and Labor Market Performance

    NARCIS (Netherlands)

    Palali, Ali

    2015-01-01

    This study investigates the effects of early smoking on educational attainment and labor market performance. The results show that early smoking adversely affects educational attainment and initial labor market performance, but only for males. The effect of early smoking on initial labor market

  15. Early Archaean collapse basins, a habitat for early bacterial life.

    Science.gov (United States)

    Nijman, W.

    For a better definition of the sedimentary environment in which early life may have flourished during the early Archaean, understanding of the basin geometry in terms of shape, depth, and fill is a prerequisite. The basin fill is the easiest to approach, namely from the well exposed, low-grade metamorphic 3.4 - 3.5 Ga rock successions in the greenstone belts of the east Pilbara (Coppin Gap Greenstone Belt and North Pole Dome) in West Australia and of the Barberton Greenstone Belt (Buck Ridge volcano-sedimentary complex) in South Africa. They consist of mafic to ultramafic volcanic rocks, largely pillow basalts, with distinct intercalations of intermediate to felsic intrusive and volcanic rocks and of silicious sediments. The, partly volcaniclastic, silicious sediments of the Buck Ridge and North Pole volcano-sedimentary complexes form a regressive-transgressive sequence. They were deposited close to base level, and experienced occasional emersion. Both North Pole Chert and the chert of the Kittys Gap volcano-sedimentary complex in the Coppin Gap Greenstone Belt preserve the flat-and-channel architecture of a shallow tidal environment. Thickness and facies distribution appear to be genetically linked to systems, i.e. arrays, of syn-depositionally active, extensional faults. Structures at the rear, front and bottoms of these fault arrays, and the fault vergence from the basin margin towards the centre characterize the basins as due to surficial crustal collapse. Observations in the Pilbara craton point to a non-linear plan view and persistence for the basin-defining fault patterns over up to 50 Ma, during which several of these fault arrays became superposed. The faults linked high-crustal level felsic intrusions within the overall mafic rock suite via porphyry pipes, black chert veins and inferred hydrothermal circulations with the overlying felsic lavas, and more importantly, with the cherty sediments. Where such veins surfaced, high-energy breccias, and in the

  16. Early occurring and continuing effects

    International Nuclear Information System (INIS)

    Scott, B.R.; Hahn, F.F.

    1985-01-01

    This chapter deals with health-risk estimates for early and continuing effects of exposure to ionizing radiations that could be associated with light water nuclear power plants accidents. Early and continuing effects considered are nonneoplastic diseases and symptoms that normally occur soon after radiation exposure, but may also occur after years have passed. They are generally associated with relatively high (greater than 1 Gy) doses. For most of the effects considered, there is a practical dose threshold. Organs of primary interest, because of their high sensitivity or the likelihood of receiving a large radiation dose, are bone marrow, gastrointestinal tract, thyroid glands, lungs, skin, gonads, and eyes. In utero exposure of the fetus is also considered. New data and modeling techniques available since publication of the Reactor Safety Study (WASH 1400, 1975) were used along with data cited in the Study to develop improved health-risk models for morbidity and mortality. The new models are applicable to a broader range of accident scenarios, provide a more detailed treatment of dose protraction effects, and include morbidity effects not considered in the Reactor Safety Study. 115 references, 20 figures, 19 tables

  17. Cerebrovascular Diseases and Early Seizure

    Directory of Open Access Journals (Sweden)

    Ayşegül Gündüz

    2006-08-01

    Full Text Available OBJECTIVE: Cerebrovascular disease is one of the important causes of seizures and epilepsy among the advanced age group. Seziures are found to be associated with lesion localization and size in previous studies. METHODS: Here, we aimed to detect prevelance of seizure, relation of seizure and lesion localization, and observed seizure types. RESULTS: Three hundred seventy eight patients with ischemic cerebrovascular disease or intraparenchymal hemorrhage who were followed in Cerrahpasa IVIedical School clinic were studied retrospectively and probability of seizure occurence within 1 month after stroke was evaluated. CONCLUSION: Among 378 patients hospitalized by acute stroke, 339 were diagnosed as ischemic cerebrovascular disease and 39 (10.3% had primary intraparenchymal hematoma. Seizures were observed in 16 patients (4.2%, 2 (%5.1 in intraparenchymal hematoma group and 14 (%4.1 in ischemic cerebrovascular disease. Early seizures were detected in 33% of patients with anterior cerebral artery, in 6.8% of posterior cerebral artery and in 3.3% of middle cerebral artery infarcts and in three patients out of 12 who were known to have epilepsy. Seizure types were secondarily generalised tonic-clonic seizure in nine cases (57%. Among whole group status epilepticus was observed in four patients (1.1%. Conclusion: Early seizure rates are found to be high among patients with anterior cerebral artery infarct and known epilepsy

  18. EGU's Early Career Scientists Network

    Science.gov (United States)

    Roberts Artal, L.; Rietbroek, R.

    2017-12-01

    The EGU encourages early career scientists (ECS) to become involved in interdisciplinary research in the Earth, planetary and space sciences, through sessions, social events and short courses at the annual General Assembly in April and throughout the year. Through division-level representatives, all ECS members can have direct input into matters of the division. A Union-wide representative, who sits on the EGU Council, ensures that ECS are heard at a higher level in the Union too. After a brief introduction as to how the network is organised and structured, this presentation will discuss how EGU ECS activities have been tailored to the needs of ECS members and how those needs have been identified. Reaching and communicating opportunities to ECS remains an ongoing challenge; they will be discussed in this presentation too, as well as some thoughts on how to make them more effective. Finally, the service offered to EGU ECS members would certainly benefit from building links and collaboration with other early career networks in the geosciences. This presentation will outline some of our efforts in that direction and the challenges that remain.

  19. Overview of Play: Its Uses and Importance in Early Intervention/Early Childhood Special Education

    Science.gov (United States)

    Lifter, Karin; Foster-Sanda, Suzanne; Arzamarski, Caley; Briesch, Jacquelyn; McClure, Ellen

    2011-01-01

    Play is a natural activity of early childhood, which has great relevance to the fields of early intervention, early childhood special education, and early childhood education. Within these fields, ongoing tensions persist in how play is described and used. These tensions compromise activities of assessment, intervention, and curriculum development…

  20. Recent Coverage of Early Childhood Education Approaches in Open Access Early Childhood Journals

    Science.gov (United States)

    Keskin, Burhanettin

    2016-01-01

    A content analysis of the coverage of the major approaches to early childhood education in the early childhood research journals, published between 2010 and 2014, that are early childhood research oriented and have free online access were investigated. Among 21 journals in early childhood education, two journals were selected for the content…