WorldWideScience

Sample records for evaluating surgical innovation

  1. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated

  2. Surgical innovations in canine gonadectomy

    OpenAIRE

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated negative consequences (lengthy placement, impaired wound healing around bulky knots, and the effect of unsightly knots on cosmetics). A study in 9 dogs found that celiotomy closure was easily achiev...

  3. No Surgical Innovation Without Evaluation: Evolution and Further Development of the IDEAL Framework and Recommendations.

    Science.gov (United States)

    Hirst, Allison; Philippou, Yiannis; Blazeby, Jane; Campbell, Bruce; Campbell, Marion; Feinberg, Joshua; Rovers, Maroeska; Blencowe, Natalie; Pennell, Christopher; Quinn, Tom; Rogers, Wendy; Cook, Jonathan; Kolias, Angelos G; Agha, Riaz; Dahm, Philipp; Sedrakyan, Art; McCulloch, Peter

    2018-04-24

    To update, clarify, and extend IDEAL concepts and recommendations. New surgical procedures, devices, and other complex interventions need robust evaluation for safety, efficacy, and effectiveness. Unlike new medicines, there is no internationally agreed evaluation pathway for generating and analyzing data throughout the life cycle of surgical innovations. The IDEAL Framework and Recommendations were designed to provide this pathway and they have been used increasingly since their introduction in 2009. Based on a Delphi survey, expert workshop and major discussions during IDEAL conferences held in Oxford (2016) and New York (2017), this article updates and extends the IDEAL Recommendations, identifies areas for future research, and discusses the ethical problems faced by investigators at each IDEAL stage. The IDEAL Framework describes 5 stages of evolution for new surgical therapeutic interventions-Idea, Development, Exploration, Assessment, and Long-term Study. This comprehensive update proposes several modifications. First, a "Pre-IDEAL" stage describing preclinical studies has been added. Second we discuss potential adaptations to expand the scope of IDEAL (originally designed for surgical procedures) to accommodate therapeutic devices, through an IDEAL-D variant. Third, we explicitly recognise the value of comprehensive data collection through registries at all stages in the Framework and fourth, we examine the ethical issues that arise at each stage of IDEAL and underpin the recommendations. The Recommendations for each stage are reviewed, clarified and additional detail added. The intention of this article is to widen the practical use of IDEAL by clarifying the rationale for and practical details of the Recommendations. Additional research based on the experience of implementing these Recommendations is needed to further improve them.

  4. Innovation in pediatric surgical education.

    Science.gov (United States)

    Clifton, Matthew S; Wulkan, Mark L

    2015-06-01

    Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Surgical innovation: the ethical agenda: A systematic review.

    Science.gov (United States)

    Broekman, Marike L; Carrière, Michelle E; Bredenoord, Annelien L

    2016-06-01

    particularly enrich the necessary future discussion on surgical innovation: integration of research and practice and a moral emphasis on "learning activities." Future research should evaluate whether the learning health care system and its adjacent moral framework provides ethical guidance for evidence-based surgery.

  6. Developing Tomorrow’s Innovative Surgical Solutions

    Directory of Open Access Journals (Sweden)

    Philip Breedon

    2009-11-01

    Full Text Available Designers are increasingly becoming aware of the potential use and integration of smart materials and technologies within their designs. One of the critical steps towards building innovative surgical solutions will be to link physicians and product designers utilising the appropriate materials and technologies to provide tangible improvements in patient care and treatment.

  7. High resolution micro-CT scanning as an innovative tool for evaluation of the surgical positioning of cochlear implant electrodes.

    Science.gov (United States)

    Postnov, A; Zarowski, A; De Clerck, N; Vanpoucke, F; Offeciers, F E; Van Dyck, D; Peeters, S

    2006-05-01

    X-ray microtomography (micro-CT) is a new technique allowing for visualization of the internal structure of opaque specimens with a quasi-histological quality. Among multiple potential applications, the use of this technique in otology is very promising. Micro-CT appears to be ideally suited for in vitro visualization of the inner ear tissues as well as for evaluation of the electrode damage and/or surgical insertion trauma during implantation of the cochlear implant electrodes. This technique can greatly aid in design and development of new cochlear implant electrodes and is applicable for temporal bone studies. The main advantage of micro-CT is the practically artefact-free preparation of the samples and the possibility of evaluation of the interesting parameters along the whole insertion depth of the electrode. This paper presents the results of the first application of micro-CT for visualization of the inner ear structures in human temporal bones and for evaluation of the surgical positioning of the cochlear implant electrodes relative to the intracochlear soft tissues.

  8. Evaluation of innovation processes

    Directory of Open Access Journals (Sweden)

    Jakub Tabas

    2012-01-01

    Full Text Available In present, innovations are spoken as an engine of the world economy because the innovations are transforming not only business entities but the whole industries. The innovations have become a necessity for business entities in order to survive on floating challenging markets. This way, innovations are driving force of companies’ performance. The problem which arises here is a question of measurement innovation’s effect on the financial performance of company or selection between two or more possible variants of innovation’s realization. Various authors which are focused on innovations processes are divided into two groups in their attitudes towards the question of influence of innovations on financial performance of companies. One group of the authors present the idea that any reliable measurement is not possible or efficient. The second group of authors present some methods theoretically applicable on this measurement but they base their approaches mostly on the methods of measurement of investments effectiveness or they suggest employment of indicators or ratios which wouldn’t be clearly connected with the outcome of innovation process. The aim of submitted article is to compare different approaches to evaluation of the innovation processes. The authors compare various approaches here and by use of analysis and synthesis, they determine their own method how to measure outcome of innovation process.

  9. Value innovation: an important aspect of global surgical care.

    Science.gov (United States)

    Cotton, Michael; Henry, Jaymie Ang; Hasek, Lauren

    2014-01-06

    Limited resources in low- and middle-income countries (LMICs) drive tremendous innovation in medicine, as well as in other fields. It is not often recognized that several important surgical tools and methods, widely used in high-income countries, have their origins in LMICs. Surgical care around the world stands much to gain from these innovations. In this paper, we provide a short review of some of these successful innovations and their origins that have had an important impact in healthcare delivery worldwide. Examples of LMIC innovations that have been adapted in high-income countries include the Bogotá bag for temporary abdominal wound closure, the orthopaedic external fixator for complex fractures, a hydrocephalus fluid valve for normal pressure hydrocephalus, and intra-ocular lens and manual small incision cataract surgery. LMIC innovations that have had tremendous potential global impact include mosquito net mesh for inguinal hernia repair, and a flutter valve for intercostal drainage of pneumothorax. Surgical innovations from LMICs have been shown to have comparable outcomes at a fraction of the cost of tools used in high-income countries. These innovations have the potential to revolutionize global surgical care. Advocates should actively seek out these innovations, campaign for the financial gains from these innovations to benefit their originators and their countries, and find ways to develop and distribute them locally as well as globally.

  10. Innovative financing for rural surgical patients: Experience in mission hospitals

    Directory of Open Access Journals (Sweden)

    Gnanaraj Jesudian

    2016-01-01

    Full Text Available In rural India most of the surgical patients become impoverished due to surgical treatment pushing several families below poverty line. We describe the various methods that we tried to help these patients pay for the surgical procedures without becoming impoverished. Some of them were successful and many of them were not so successful. The large turnover and innovative methods helped the mission hospitals to serve the poor and the marginalized. Some of these methods might not be relevant in areas other than Northeast India while many could be used in other areas.

  11. Innovation in surgical technology and techniques: Challenges and ethical issues.

    Science.gov (United States)

    Geiger, James D; Hirschl, Ronald B

    2015-06-01

    The pace of medical innovation continues to increase. The deployment of new technologies in surgery creates many ethical challenges including how to determine safety of the technology, what is the timing and process for deployment of a new technology, how are patients informed before undergoing a new technology or technique, how are the outcomes of a new technology evaluated and how are the responsibilities of individual patients and society at large balanced. Ethical considerations relevant to the implementation of ECMO and robotic surgery are explored to further discussion of how we can optimize the delicate balance between innovation and regulation. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. The Business Engineering Surgical Technologies (BEST) teaching method: incubating talents for surgical innovation.

    Science.gov (United States)

    de Ruijter, V; Halvax, P; Dallemagne, B; Swanström, L; Marescaux, J; Perretta, S

    2015-01-01

    Technological innovation in surgical science and healthcare is vital and calls for close collaboration between engineering and surgery. To meet this objective, BEST was designed as a free sustainable innovative teaching method for young professionals, combining surgery, engineering, and business in a multidisciplinary, high-quality, low-cost, and learning-by-doing philosophy. This paper reviews the initial outcomes of the program and discusses lessons learned and future directions of this innovative educational method. BEST educational method is delivered in two parts: the first component consisting of live streaming or pre-recorded online lectures, with an interdisciplinary profile focused on surgery, engineering, and business. The second component is an annual 5-day on-site course, organized at IRCAD-IHU, France. The program includes workshops in engineering, entrepreneurship team projects, and in-depth hands-on experience in laparoscopy, robotic surgery, interventional radiology, and flexible endoscopy with special emphasis on the interdisciplinary aspect of the training. A panel of surgeons, engineers, well-established entrepreneurs, and scientists assessed the team projects for potential patent application. From November 2011 till September 2013, 803 individual and institutional users from 79 different countries attended the online course. In total, 134 young professionals from 32 different countries applied to the onsite course. Sixty participants were selected each year for the onsite course. In addition, five participants were selected for a web-based team. Thirteen provisional patents were filed for the most promising projects. BEST proved to be a global talent incubator connecting students to high-quality education despite institutional and economical boundaries. Viable and innovative ideas arose from this revolutionary approach which is likely to spin-off significant technology transfer and lead the way for future interdisciplinary hybrid surgical

  13. Network analysis of surgical innovation: Measuring value and the virality of diffusion in robotic surgery.

    Directory of Open Access Journals (Sweden)

    George Garas

    Full Text Available Existing surgical innovation frameworks suffer from a unifying limitation, their qualitative nature. A rigorous approach to measuring surgical innovation is needed that extends beyond detecting simply publication, citation, and patent counts and instead uncovers an implementation-based value from the structure of the entire adoption cascades produced over time by diffusion processes. Based on the principles of evidence-based medicine and existing surgical regulatory frameworks, the surgical innovation funnel is described. This illustrates the different stages through which innovation in surgery typically progresses. The aim is to propose a novel and quantitative network-based framework that will permit modeling and visualizing innovation diffusion cascades in surgery and measuring virality and value of innovations.Network analysis of constructed citation networks of all articles concerned with robotic surgery (n = 13,240, Scopus® was performed (1974-2014. The virality of each cascade was measured as was innovation value (measured by the innovation index derived from the evidence-based stage occupied by the corresponding seed article in the surgical innovation funnel. The network-based surgical innovation metrics were also validated against real world big data (National Inpatient Sample-NIS®.Rankings of surgical innovation across specialties by cascade size and structural virality (structural depth and width were found to correlate closely with the ranking by innovation value (Spearman's rank correlation coefficient = 0.758 (p = 0.01, 0.782 (p = 0.008, 0.624 (p = 0.05, respectively which in turn matches the ranking based on real world big data from the NIS® (Spearman's coefficient = 0.673;p = 0.033.Network analysis offers unique new opportunities for understanding, modeling and measuring surgical innovation, and ultimately for assessing and comparing generative value between different specialties. The novel surgical innovation metrics

  14. Network analysis of surgical innovation: Measuring value and the virality of diffusion in robotic surgery.

    Science.gov (United States)

    Garas, George; Cingolani, Isabella; Panzarasa, Pietro; Darzi, Ara; Athanasiou, Thanos

    2017-01-01

    Existing surgical innovation frameworks suffer from a unifying limitation, their qualitative nature. A rigorous approach to measuring surgical innovation is needed that extends beyond detecting simply publication, citation, and patent counts and instead uncovers an implementation-based value from the structure of the entire adoption cascades produced over time by diffusion processes. Based on the principles of evidence-based medicine and existing surgical regulatory frameworks, the surgical innovation funnel is described. This illustrates the different stages through which innovation in surgery typically progresses. The aim is to propose a novel and quantitative network-based framework that will permit modeling and visualizing innovation diffusion cascades in surgery and measuring virality and value of innovations. Network analysis of constructed citation networks of all articles concerned with robotic surgery (n = 13,240, Scopus®) was performed (1974-2014). The virality of each cascade was measured as was innovation value (measured by the innovation index) derived from the evidence-based stage occupied by the corresponding seed article in the surgical innovation funnel. The network-based surgical innovation metrics were also validated against real world big data (National Inpatient Sample-NIS®). Rankings of surgical innovation across specialties by cascade size and structural virality (structural depth and width) were found to correlate closely with the ranking by innovation value (Spearman's rank correlation coefficient = 0.758 (p = 0.01), 0.782 (p = 0.008), 0.624 (p = 0.05), respectively) which in turn matches the ranking based on real world big data from the NIS® (Spearman's coefficient = 0.673;p = 0.033). Network analysis offers unique new opportunities for understanding, modeling and measuring surgical innovation, and ultimately for assessing and comparing generative value between different specialties. The novel surgical innovation metrics developed may

  15. An overview of pre-surgical evaluation

    Directory of Open Access Journals (Sweden)

    Kurupath Radhakrishnan

    2014-01-01

    Full Text Available The success of an epilepsy surgery program depends upon the early identification of potential surgical candidates and selecting from them, ideal candidates for surgery, who are destined to have a post-operative seizure-free outcome without any unacceptable neurological deficits. Since epilepsy surgery centers in resource-poor countries will lack the full range of state-of-the-art technologies usually available in resource-rich countries to perform pre-surgical evaluation, cost-effectively utilization of the locally available investigative facilities to select the surgical candidates becomes challenging. In the present era of rapid electronic communications and telemedicine, it has become possible for epilepsy surgery centers to pool their technological and human resources and to partner with centers nationally and internationally in implementing pre-surgical evaluation strategies.

  16. Innovating for quality and value: Utilizing national quality improvement programs to identify opportunities for responsible surgical innovation.

    Science.gov (United States)

    Woo, Russell K; Skarsgard, Erik D

    2015-06-01

    Innovation in surgical techniques, technology, and care processes are essential for improving the care and outcomes of surgical patients, including children. The time and cost associated with surgical innovation can be significant, and unless it leads to improvements in outcome at equivalent or lower costs, it adds little or no value from the perspective of the patients, and decreases the overall resources available to our already financially constrained healthcare system. The emergence of a safety and quality mandate in surgery, and the development of the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) allow needs-based surgical care innovation which leads to value-based improvement in care. In addition to general and procedure-specific clinical outcomes, surgeons should consider the measurement of quality from the patients' perspective. To this end, the integration of validated Patient Reported Outcome Measures (PROMs) into actionable, benchmarked institutional outcomes reporting has the potential to facilitate quality improvement in process, treatment and technology that optimizes value for our patients and health system. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Technological innovations in surgical approach for thyroid cancer.

    Science.gov (United States)

    Lang, Brian Hung-Hin; Lo, Chung-Yau

    2010-01-01

    Over the last decade, surgeons have witnessed dramatic changes in surgical practice as a result of the introduction of new technological advancement. Some of these changes include refinement of techniques in thyroid cancer surgery. The development of various endoscopic thyroidectomy techniques, the addition of the da Vinci robot, and the use of operative adjuncts in thyroid surgery, such as intraoperative neuromonitoring and quick intraoperative parathyroid hormone, have made thyroid cancer surgery not only safer and better accepted by patients with thyroid cancer but also offer them more surgical treatment options.

  18. Conference Support - Surgery in Extreme Environments - Center for Surgical Innovation

    Science.gov (United States)

    2007-01-01

    technology accelerator. Lunar capability concerns include (1) optimization of safety, habitability, and biomechanics ; (2) clinical infrastructure, limited... remove the tissue from the animals, we would then immerse them, fixating the tissues as well. A couple of interesting things though were strange. We had...cellular surgery, new surgical tools, intelligent prosthesis , tissue engineering, and suspended animation. Each of these concepts has a potential for

  19. The female innovation-generation consumer's evaluation

    African Journals Online (AJOL)

    user

    The female innovation-generation consumer's evaluation of traditional and virtual displays in South. African clothing ..... only affect consumer behaviour by adding value to displayed ..... Promotional Management 19(5):652-632. FIORE, A.M. ...

  20. The future of innovation and training in surgical oncology.

    Science.gov (United States)

    Kim, Michael J; Monson, John R T

    2011-09-01

    This article addresses the current paradigms of surgical oncology training and the directions in which the training process may evolve over the course of the next decade. In doing so, the potential influences upon this evolution are discussed along with potential barriers associated with each of these factors. In particular, the topics include issues of specialty training with regard to new technologies and procedures, involvement of the surgeon as part of the multi-disciplinary team of oncologists, and the very real issue of burnout and career satisfaction associated with the profession of surgical oncology. Changes to the training of tomorrow's cancer surgeons will need to involve each one of these factors in a comprehensive and efficient manner, in order to ensure the continued strength and growth of the field. Copyright © 2010 Elsevier Ltd. All rights reserved.

  1. [Evaluation of technical skills in surgical training].

    Science.gov (United States)

    Kasparian, Andres C; Martinez, A C; JoverClos, R J; Chércoles, R A

    2014-01-01

    technical skills acquisition is considered to be of paramount importance in surgical training. Yet, formal assessment of technical skills is the weakest and less developed area. Currently available resources to evaluate technical skills are largely subjective, and lack of validity and reliability. Direct observation, one of the most frequently used methods, is largely biased by interpersonal subjectivity and personality traits. We propose the creation and use of a new procedure-specific tool for objective assessment of technical skills in surgery to evaluate validity and reliability. laparoscopic cholecystectomy and Lichstenstein's inguinal hernia repair were the chosen procedures. Three groups of comparison were defined according to surgical expertise: initial, intermediate, and experts. Surgeries were videorecorded in real time without identification of the patient or the surgeon. Tapes without any posterior edition were assigned to two expert surgeons in a blind and randomized sequence. A newly proposed procedure-specific rating scale was used for evaluation, as well as Reznick's OSATS global scale. Kruskal-Wallis non-parametric test was used to assess validity. p 0.8 granted reliability. from April 2010 to December 2012 36 laparoscopic cholecystectomies and 31 inguinal hernia repairs were recorded. Significant difference was found among groups of comparison for every item (ptechnical skills in surgery is feasible and useful. The tool we proposed showed construct validity and reliability. Video recording of surgical procedures grants durability over time to an ephemeral phenomenon. The objectivity is based on the explicit statements and quantification of every step to be evaluated, and the blind randomization and anonymous treatment of the sample. Sharing the same quality criteria between evaluators is of paramount importance to reach satisfactory results. The process of evaluation always implies a shortened view of the reality.

  2. Restoring accommodation: surgical technique and preliminary evaluation in rabbits

    Science.gov (United States)

    Tahi, Hassan; Chapon, Pascal F.; Hamaoui, Marie; Lee, William E.; Holden, Brien; Parel, Jean-Marie A.

    1999-06-01

    Purpose. To evaluate an innovative surgical technique for phaco-ersatz, a cataract surgery designed to restore accommodation. Techniques for very small capsulorhexis as well as the refilling procedure were developed. This study evaluates the feasibility and reproducibility of the surgical technique. Methods. The right eye of 8 NZW rabbits (~ 2 Kg) were operated following the ARVO Statements for the Use of Animals in Ophthalmic and Vision Research. The surgery is begun by making a small peripheral capsulorhexis of about 1 mm using. The lens content is then removed. The lens is then refilled with a novel in situ polymerizable gel and the corneal incision is closed using one 10/0 Nylon interrupted stitch. Results. The capsulorhexis technique was succesfully performed and reproducible in all animals. The average size of the capsulorhexis opening was 1. 2 mm (+/-0.14). Lens material removal and refilling of the capsular bag with an in situ polymerizable material was also performed in each trial study. Conclusion. This surgical technique seemed feasible and reproducible.

  3. Innovative Surgical Management of the Synovial Chondromatosis of Temporo-Mandibular Joints: Highly Conservative Surgical Technique.

    Science.gov (United States)

    Ionna, Franco; Amantea, Massimiliano; Mastrangelo, Filiberto; Ballini, Andrea; Maglione, Maria Grazia; Aversa, Corrado; De Cecio, Rossella; Russo, Daniela; Marrelli, Massimo; Tatullo, Marco

    2016-07-01

    Synovial chondromatosis (SC) is an uncommon disease characterized by a benign nodular cartilaginous proliferation arising from the joint synovium, bursae, or tendon sheaths. Although the temporomandibular joint is rarely affected by neoplastic lesions, SC is the most common neoplastic lesion of this joint. The treatment of this disease consists in the extraoral surgery with a wide removal of the lesion; in this study, the authors described a more conservative intraoral surgical approach. Patient with SC of temporomandibular joint typically refer a limitation in the mouth opening, together with a persistent not physiological mandibular protrusion and an appearance of a neoformation located at the right preauricular region: the authors reported 1 scholar patient. After biopsy of the neoformation, confirming the synovial chondromatosis, the patient underwent thus to the surgical excision of the tumor, via authors' conservative transoral approach, to facilitate the enucleation of the neoformation. The mass fully involved the pterygo-maxillary fossa with involvement of the parotid lodge and of the right TMJ: this multifocal extension suggested for a trans-oral surgical procedure, in the light of the suspicion of a possible malignant nature of the neoplasm. Our intraoral conservative approach to surgery is aimed to reduce the presence of unaesthetic scars in preauricular and facial regions, with surgical results undoubtedly comparable to the traditional surgical techniques much more aggressive. Our technique could be a valid, alternative, and safe approach to treat this rare and complex kind of oncological disease.

  4. TEXACO GASIFICATION PROCESS - INNOVATIVE TECHNOLOGY EVALUATION REPORT

    Science.gov (United States)

    This report summarizes the evaluation of the Texaco Gasification Process (TGP) conducted under the U.S. Environmental Protection Agency (EPA) Superfund Innovative Technology Evaluation (SITE) Program. The Texaco Gasification Process was developed by Texaco Inc. The TGP is a comm...

  5. MINERGY CORPORATION GLASS FURNACE TECHNOLOGY EVALUATION: INNOVATION TECHNOLOGY EVALUATION REPORT

    Science.gov (United States)

    This report presents performance and economic data for a U.S. Environmental Protection Agency (EPA) Superfund Innovative Technology Evaluation (SITE) Program demonstration of the Minergy Corporation (Minergy) Glass Furnace Technology (GFT). The demonstration evaluated the techno...

  6. Evaluation of the Community Cataract Surgical Services of a ...

    African Journals Online (AJOL)

    Evaluation of the Community Cataract Surgical Services of a University Teaching Hospital Using Cataract Surgical Coverage in Nigeria. ... Ethiopian Journal of Health Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search ...

  7. Cephalometric evaluation of surgical mandibular advancement

    Directory of Open Access Journals (Sweden)

    Eloísa Marcantônio Boeck

    2010-06-01

    Full Text Available The treatment of Class II adult individuals with mandibular deficiency has been the combination of orthodontic treatment and orthognathic surgery. Therefore, a study was conducted in which cephalometric analysis was used to evaluate the influence of dentoalveolar decompensation in Class II patients submitted to orthodontic and surgical treatment for mandibular advancement, by bilateral osteotomy of the mandibular ramus. A sample of 15 leukoderma adult female patients were selected and three cephalometric radiographs of each patient, taken before the orthodontic treatment, before surgery and after at least 6 months postoperatively, were analyzed in a total of 45 roentgenograms. The tracings were made by the manual method and the points were digitalized using software. The results showed that values of SNB increased from 75.6 to 78.6°. The measures BNP and PGNP were reduced from -12.7 to -7.7 mm and -12.7 to -6.6 mm, respectively. For ANB there was a reduction of 3.23° (from 8.1° to 4.9°. Likewise, the values of AOBO were diminished by 6.3 mm (from 7.6 to 1.3 mm, and in the values of OJ there was a reduction of 5.7 mm (from 9 to 3.3 mm. It was concluded that the pre-surgical orthodontic treatment promoted minimal and variable dental and skeletal changes in the final result. The surgical treatment caused significant skeletal changes, especially in the measurements related to the mandible (SNB, BNP, PGNP and SNPM or indirectly to it (ANB, AOBO and OJ.

  8. Cephalometric evaluation of surgical mandibular advancement.

    Science.gov (United States)

    Boeck, Eloísa Marcantônio; Kuramae, Mayury; Lunardi, Nádia; Santos-Pinto, Ary dos; Mazzonetto, Renato

    2010-01-01

    The treatment of Class II adult individuals with mandibular deficiency has been the combination of orthodontic treatment and orthognathic surgery. Therefore, a study was conducted in which cephalometric analysis was used to evaluate the influence of dentoalveolar decompensation in Class II patients submitted to orthodontic and surgical treatment for mandibular advancement, by bilateral osteotomy of the mandibular ramus. A sample of 15 leukoderma adult female patients were selected and three cephalometric radiographs of each patient, taken before the orthodontic treatment, before surgery and after at least 6 months postoperatively, were analyzed in a total of 45 roentgenograms. The tracings were made by the manual method and the points were digitalized using software. The results showed that values of SNB increased from 75.6 to 78.6 degrees. The measures BNP and PGNP were reduced from -12.7 to -7.7 mm and -12.7 to -6.6 mm, respectively. For ANB there was a reduction of 3.23 degrees (from 8.1 degrees to 4.9 degrees). Likewise, the values of AOBO were diminished by 6.3 mm (from 7.6 to 1.3 mm), and in the values of OJ there was a reduction of 5.7 mm (from 9 to 3.3 mm). It was concluded that the pre-surgical orthodontic treatment promoted minimal and variable dental and skeletal changes in the final result. The surgical treatment caused significant skeletal changes, especially in the measurements related to the mandible (SNB, BNP, PGNP and SNPM) or indirectly to it (ANB, AOBO and OJ).

  9. Evaluation matters: lessons learned on the evaluation of surgical teaching.

    Science.gov (United States)

    Woods, Nicole N

    2011-01-01

    The traditional system of academic promotion and tenure can make it difficult to reward those who excel at surgical teaching. A successful faculty evaluation process can provide the objective measures of teaching performance needed for performance appraisals and promotion decisions. Over the course of two decades, an extensive faculty evaluation process has been developed in the Department of Surgery at the University of Toronto. This paper presents some of the non-psychometric characteristics of that system. Faculty awareness of the evaluation process, the consistency of its application, trainee anonymity and the materiality of the results are described key factors of a faculty evaluation system that meets the assessment needs of individual teachers and raises the profile of teaching in surgical departments. Copyright © 2010 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  10. New technologies and surgical innovation: five years of a local health technology assessment program in a surgical department.

    Science.gov (United States)

    Poulin, Paule; Austen, Lea; Kortbeek, John B; Lafrenière, René

    2012-06-01

    There is pressure for surgical departments to introduce new and innovative health technologies in an evidence-based manner while ensuring that they are safe and effective and can be managed with available resources. A local health technology assessment (HTA) program was developed to systematically integrate research evidence with local operational management information and to make recommendations for subsequent decision by the departmental executive committee about whether and under what conditions the technology will be used. The authors present a retrospective analysis of the outcomes of this program as used by the Department of Surgery & Surgical Services in the Calgary Health Region over a 5-year period from December 2005 to December 2010. Of the 68 technologies requested, 15 applications were incomplete and dropped, 12 were approved, 3 were approved for a single case on an urgent/emergent basis, 21 were approved for "clinical audit" for a restricted number of cases with outcomes review, 14 were approved for research use only, and 3 were referred to additional review bodies. Subsequent outcome reports resulted in at least 5 technologies being dropped for failure to perform. Decisions based on local HTA program recommendations were rarely "yes" or "no." Rather, many technologies were given restricted approval with full approval contingent on satisfying certain conditions such as clinical outcomes review, training protocol development, or funding. Thus, innovation could be supported while ensuring safety and effectiveness. This local HTA program can be adapted to a variety of settings and can help bridge the gap between evidence and practice.

  11. Financial Evaluation Techniques, Institutions and Innovation

    DEFF Research Database (Denmark)

    Howells, John

    2003-01-01

    This paper reviews the relationship between financial evaluation and control techniques and innovative activity in a range of technological contexts. The relationship is broadly conceived to include both the financial techniques developed and deployed within the firm and theevaluative behaviour...... of financial institutions external to the firm such as venture capital and industrial investment banking. With innovative and investment opportunities tending to vary over time within an industry, it becomes apparent that there can be no permanent solution to the common problem of how to trade off financial...

  12. An innovative surgical technique for treating penile incarceration injury caused by heavy metallic ring

    Directory of Open Access Journals (Sweden)

    S J Baruah

    2009-01-01

    Full Text Available Penile incarceration injury by heavy metallic ring is a rare genital injury. A man may place metal object for erotic or autoerotic purposes, for masturbation or increasing erection, and due to psychiatric disturbances are some of the reasons for a penile incarceration injury. The incarcerating injury results in reduced blood flow distal to the injury, leading to edema, ischemia, and sometimes gangrene. These injuries are divided into five grades and their treatment options are divided into four groups. Surgical techniques are reserved for the advanced grades (Grades IV and V. We describe an innovative surgical technique, which can be adopted in Grades II and III injuries.

  13. Biomedical engineering principles of modern cochlear implants and recent surgical innovations.

    Science.gov (United States)

    Eshraghi, Adrien A; Gupta, Chhavi; Ozdamar, Ozcan; Balkany, Thomas J; Truy, Eric; Nazarian, Ronen

    2012-11-01

    This review covers the most recent clinical and surgical advances made in the development and application of cochlear implants (CIs). In recent years, dramatic progress has been made in both clinical and basic science aspect of cochlear implantation. Today's modern CI uses multi-channel electrodes with highly miniaturized powerful digital processing chips. This review article describes the function of various components of the modern multi-channel CIs. A selection of the most recent clinical and surgical innovations is presented. This includes the preliminary results with electro-acoustic stimulation or hybrid devices and ongoing basic science research that is focused on the preservation of residual hearing post-implantation. The result of an original device that uses a binaural stimulation mode with a single implanted receiver/stimulator is also presented. The benefit and surgical design of a temporalis pocket technique for the implant's receiver stimulator is discussed. Advances in biomedical engineering and surgical innovations that lead to an increasingly favorable clinical outcome and to an expansion of the indication of CI surgery are presented and discussed. Copyright © 2012 Wiley Periodicals, Inc.

  14. Surgical evaluation of acute abdomen in pregnancy

    International Nuclear Information System (INIS)

    Kovarova, P.

    2013-01-01

    Acute abdomen in pregnancy is a disease with a low incidence. The purpose of this work was therefore to create a review of current recommended practice in diagnostics and surgical solution. I also mention surgically relevant physiological and pathological changes specific to pregnancy, differential diagnostics of acute abdomen in pregnancy and impact of the disease and its treatment on the fetus. (author)

  15. Fuzzy AHP Analysis on Enterprises’ Independent Innovation Capability Evaluation

    Science.gov (United States)

    Zhu, Yu; Lei, Huai-ying

    Independent innovation has become a key factor in the rapid and healthy development of the enterprises. Therefore, an effective and reasonable comprehensive evaluation on the independent innovation capability of the businesses is especially important. This paper applies fuzzy AHP in the evaluation of the independent innovation capability of the businesses, and validates the rationality and feasibility of the evaluation methods and the indicators.

  16. Evaluation of surgical gloves for radiation protection

    International Nuclear Information System (INIS)

    Antolin, E.; Rot, M.J.; Ordonez, J.; Arranz, L.; Sastre, J.M.; Ferrer, N.; Andres, J.C. de

    2006-01-01

    Full text of publication follows: Accumulated doses in hands during interventionist cardiology and radiological procedures can reach high values, and even go beyond legal limits for exposed professionals after years of work, unless they use specific radiation protection methods. An important protection mean for hands is the use of surgical gloves that attenuate the radiation while maintaining the tactile sensitivity demanded by physicians.There is a wide variety of commercialized gloves for radiation protection, with different advantages and disadvantages for various uses. In this paper nine different models of gloves have been evaluated for testing its attenuation capacity for several voltages, the maintenance of tactile sensitivity, its resistance to elongation, and the apparition of pores after successive sterilizing processes. It is very important that they do not lose its initial characteristics after processes of sterilization in order to optimize the product effective cost. The attenuation values have been measured under the voltages of 60, 70, 80 and 90 KVp obtaining very different values at each voltage with different gloves. The values measured range between 34 % before any supplementary sterilization with one model of glove (for 90 KVp), and 57 % after four sterilization processes with another glove (for 60 KVp). Some gloves lose its attenuation capacity after successive sterilizations, having not been found an y significant relation with their composition. The tactile sensitivity, a decisive factor for its users, decreases as its attenuation capacity increases, and remains mostly constant after being sterilized. The tests performed allow to conclude a set of fi nal results that can facilitate the choice of the most suitable gloves according to the practical applications (the priorities being the radiation protection and the tactile sensitivity)

  17. Adaptation and innovation: a grounded theory study of procedural variation in the academic surgical workplace.

    Science.gov (United States)

    Apramian, Tavis; Watling, Christopher; Lingard, Lorelei; Cristancho, Sayra

    2015-10-01

    Surgical research struggles to describe the relationship between procedural variations in daily practice and traditional conceptualizations of evidence. The problem has resisted simple solutions, in part, because we lack a solid understanding of how surgeons conceptualize and interact around variation, adaptation, innovation, and evidence in daily practice. This grounded theory study aims to describe the social processes that influence how procedural variation is conceptualized in the surgical workplace. Using the constructivist grounded theory methodology, semi-structured interviews with surgeons (n = 19) from four North American academic centres were collected and analysed. Purposive sampling targeted surgeons with experiential knowledge of the role of variations in the workplace. Theoretical sampling was conducted until a theoretical framework representing key processes was conceptually saturated. Surgical procedural variation was influenced by three key processes. Seeking improvement was shaped by having unsolved procedural problems, adapting in the moment, and pursuing personal opportunities. Orienting self and others to variations consisted of sharing stories of variations with others, taking stock of how a variation promoted personal interests, and placing trust in peers. Acting under cultural and material conditions was characterized by being wary, positioning personal image, showing the logic of a variation, and making use of academic resources to do so. Our findings include social processes that influence how adaptations are incubated in surgical practice and mature into innovations. This study offers a language for conceptualizing the sociocultural influences on procedural variations in surgery. Interventions to change how surgeons interact with variations on a day-to-day basis should consider these social processes in their design. © 2015 John Wiley & Sons, Ltd.

  18. The model of evaluation of innovative potential of enterprise

    Directory of Open Access Journals (Sweden)

    Ганна Ігорівна Заднєпровська

    2015-06-01

    Full Text Available The basic components of the enterprise’s innovative potential evaluation process are investigated. It is offered the conceptual model of evaluation of the innovative potential that includes: subjects, objects, purpose, provision of information, principles, methods, criteria, indicators. It is noted that the innovative capacity characterizes the transition from the current to the strategic level of innovation potential and, thus, characterizes the composition of objects from position of user

  19. Surgical Nondestructive Evaluation (SuNDE)

    Science.gov (United States)

    2011-07-01

    on a moveable pedestal) demonstrated during the program visit to CMU.......................................................45 APPENDIX LIST OF... bridge inspection, and tank inspection. The CMU research group has constructed a variety of highly articulated snake robots, which can exploit their...visit to CMU. The locomoting or free crawling snake (on the left) is observed climbing a pole. The surgical type snake on a moveable pedestal (on the

  20. Development of a tool for evaluating multimedia for surgical education.

    Science.gov (United States)

    Coughlan, Jane; Morar, Sonali S

    2008-09-01

    Educational multimedia has been designed to provide surgical trainees with expert operative information outside of the operating theater. The effectiveness of multimedia (e.g., CD-ROMs) for learning has been a common research topic since the 1990s. To date, however, little discussion has taken place on the mechanisms to evaluate the quality of multimedia-driven teaching. This may be because of a lack of research into the development of appropriate tools for evaluating multimedia, especially for surgical education. This paper reports on a small-scale pilot and exploratory study (n = 12) that developed a tool for surgical multimedia evaluation. The validity of the developed tool was established through adaptation of an existing tool, which was reviewed using experts in surgery, usability, and education. The reliability of the developed tool was tested with surgical trainees who used it to assess a multimedia CD-ROM created for teaching basic surgical skills. The findings contribute to an understanding of surgical trainees' experience of using educational multimedia, in terms of characteristics of the learning material for interface design and content and the process of developing evaluation tools, in terms of inclusion of appropriate assessment criteria. The increasing use of multimedia in medical education necessitates the development of standardized tools for determining the quality of teaching and learning. Little research exists into the development of such tools and so the present work stimulates discussion on how to evaluate surgical training.

  1. Evaluation of an antimicrobial surgical glove to inactivate live human immunodeficiency virus following simulated glove puncture.

    Science.gov (United States)

    Edmiston, Charles E; Zhou, S Steve; Hoerner, Pierre; Krikorian, Raffi; Krepel, Candace J; Lewis, Brian D; Brown, Kellie R; Rossi, Peter J; Graham, Mary Beth; Seabrook, Gary R

    2013-02-01

    Percutaneous injuries associated with cutting instruments, needles, and other sharps (eg, metallic meshes, bone fragments, etc) occur commonly during surgical procedures, exposing members of surgical teams to the risk for contamination by blood-borne pathogens. This study evaluated the efficacy of an innovative integrated antimicrobial glove to reduce transmission of the human immunodeficiency virus (HIV) following a simulated surgical-glove puncture injury. A pneumatically activated puncturing apparatus was used in a surgical-glove perforation model to evaluate the passage of live HIV-1 virus transferred via a contaminated blood-laden needle, using a reference (standard double-layer glove) and an antimicrobial benzalkonium chloride (BKC) surgical glove. The study used 2 experimental designs. In method A, 10 replicates were used in 2 cycles to compare the mean viral load following passage through standard and antimicrobial gloves. In method B, 10 replicates were pooled into 3 aliquots and were used to assess viral passage though standard and antimicrobial test gloves. In both methods, viral viability was assessed by observing the cytopathic effects in human lymphocytic C8166 T-cell tissue culture. Concurrent viral and cell culture viability controls were run in parallel with the experiment's studies. All controls involving tissue culture and viral viability were performed according to study design. Mean HIV viral loads (log(10)TCID(50)) were significantly reduced (P reduction (log reduction and percent viral reduction) of the HIV virus ranged from 1.96 to 2.4 and from 98.9% to 99.6%, respectively, following simulated surgical-glove perforation. Sharps injuries in the operating room pose a significant occupational risk for surgical practitioners. The findings of this study suggest that an innovative antimicrobial glove was effective at significantly (P < .01) reducing the risk for blood-borne virus transfer in a model of simulated glove perforation. Copyright

  2. The Hidden Story of Innovation: Charity Hospital, Angola Prison, and the Challenging of Surgical Dogma.

    Science.gov (United States)

    Greiffenstein, Patrick; Hastings, Paul R

    2017-02-01

    The late 1960s was a period of significant upheaval of social, cultural, and scientific norms. The generally accepted notion of mandatory laparotomy for all penetrating abdominal injuries was among those norms being called into question across the country and many advocated expectant management of selected patients presenting with this type of injury. Leaders of the surgical community published opinions on either side of the argument. The house staff at Charity Hospital during this period was among the busiest in the nation in treating these injuries, many of them inmates of the Louisiana State Penitentiary who used self-inflicted stab wounds to the abdomen as a means of temporary respite from the inhumane conditions in the prison. Inspired, in part, by the overabundance of negative laparotomies among this group, F. Carter Nance went on to systematically challenge the standard of care. This effort constitutes one of the major forces for change of the surgical dogma of mandatory laparotomy for all abdominal stab wounds. It is the first major study to show conclusively that delayed laparotomy for perforated viscous was not significantly detrimental and posed less of a risk than unnecessary laparotomy. The circumstances surrounding this initiative constitute a powerful and heretofore unknown chapter in the history of surgical innovation.

  3. A novel surgical correction and innovative splint for swan neck deformity in hypermobility syndrome

    Directory of Open Access Journals (Sweden)

    Karthik Vishwanathan

    2018-01-01

    Full Text Available Splinting is a great domain of occupational therapy profession. Making a splint for the patient would depend on the need or requirement of the problems and deformities. Swan neck deformity is an uncommon condition, and it can be seen in rheumatoid arthritis, cerebral palsy, and after trauma. Conservative treatment of the swan neck deformity is available by different static splints only. There are very few reports of surgical correction of swan-neck deformity in benign hypermobility syndrome. This case report describes the result of novel surgical intervention and an innovative hand splint in a 20-year-old female with a history of cardiovascular stroke with no residual neurological deficit. She presented with correctable swan neck deformity and failed to improve with static ring splints to correct the deformity. She underwent volar plate plication of the proximal interphalangeal joint of the left ring finger along with hemitenodesis of ulnar slip of flexor digitorum superficialis (FDS tendon whereby, the ulnar slip of FDS was passed through a small surgically created rent in A2 pulley and sutured back to itself. Postoperatively, the patient was referred to occupational therapy for splinting with the instruction that the splint would work sometimes for as static and some time as dynamic for positional and correction of the finger. After occupational therapy intervention and splinting, the patient had a full correction of the swan-neck deformity with near full flexion of the operated finger and can work independently.

  4. [Evaluation of surgical treatment of keratoacanthoma].

    Science.gov (United States)

    Bogdanowski, T; Rubisz-Brzezińska, J; Macura-Gina, M; Skrzypek-Wawrzyniak, K

    1990-01-01

    From 1973 to 1988 in the Dermatological Surgery Unit of the 1st Department of Dermatology of the Silesian School of Medicine in Katowice 82 patients were treated surgically for keratoacanthoma. In 76 patients the defect was closed by simple bringing closer the edges or by local plastic surgery, in 6 patients it was covered with free full-thickness skin grafts. The preparations of the excised tumors from various places were examined histologically. In three cases the texture of carcinoma spinocellulare was found in the base of the tumor. In 98% of the patients the wounds healed by first intention.

  5. Radiation enteritis. Evaluation of surgical cases

    Energy Technology Data Exchange (ETDEWEB)

    Sato, M.; Sano, M.; Minakuchi, N.; Narisawa, T.; Takahashi, T. (Akita Univ. (Japan))

    1981-09-01

    Radiation enteritis with severe complications including intestinal bleeding, fistula, and stenosis were treated surgically in 9 cases. These 9 cases included 7 cases of cancer of the uterine cervix and 2 single cases of seminoma and melanoma. The patients received /sup 60/Co or Linac x-ray external irradiation with or without intracavitary irradiation by a radium needle. Radiation injury began with melena, vaginorectal fistula, and intestinal obstruction 3 to 18 months after irradiation. One patient with melena underwent colostomy and survived 2 years. One of the three patients with vaginorectal fistula who had colostomy survived 1.5 years. In intestinal obstruction, one patients had bypass operation and three patients had resection of the intestine and the other had both. Leakage was noted in one patient, but the others had favorable prognosis.

  6. Modelling and evaluation of surgical performance using hidden Markov models.

    Science.gov (United States)

    Megali, Giuseppe; Sinigaglia, Stefano; Tonet, Oliver; Dario, Paolo

    2006-10-01

    Minimally invasive surgery has become very widespread in the last ten years. Since surgeons experience difficulties in learning and mastering minimally invasive techniques, the development of training methods is of great importance. While the introduction of virtual reality-based simulators has introduced a new paradigm in surgical training, skill evaluation methods are far from being objective. This paper proposes a method for defining a model of surgical expertise and an objective metric to evaluate performance in laparoscopic surgery. Our approach is based on the processing of kinematic data describing movements of surgical instruments. We use hidden Markov model theory to define an expert model that describes expert surgical gesture. The model is trained on kinematic data related to exercises performed on a surgical simulator by experienced surgeons. Subsequently, we use this expert model as a reference model in the definition of an objective metric to evaluate performance of surgeons with different abilities. Preliminary results show that, using different topologies for the expert model, the method can be efficiently used both for the discrimination between experienced and novice surgeons, and for the quantitative assessment of surgical ability.

  7. Anisotropic evaluation of synthetic surgical meshes.

    Science.gov (United States)

    Saberski, E R; Orenstein, S B; Novitsky, Y W

    2011-02-01

    The material properties of meshes used in hernia repair contribute to the overall mechanical behavior of the repair. The anisotropic potential of synthetic meshes, representing a difference in material properties (e.g., elasticity) in different material axes, is not well defined to date. Haphazard orientation of anisotropic mesh material can contribute to inconsistent surgical outcomes. We aimed to characterize and compare anisotropic properties of commonly used synthetic meshes. Six different polypropylene (Trelex(®), ProLite™, Ultrapro™), polyester (Parietex™), and PTFE-based (Dualmesh(®), Infinit) synthetic meshes were selected. Longitudinal and transverse axes were defined for each mesh, and samples were cut in each axis orientation. Samples underwent uniaxial tensile testing, from which the elastic modulus (E) in each axis was determined. The degree of anisotropy (λ) was calculated as a logarithmic expression of the ratio between the elastic modulus in each axis. Five of six meshes displayed significant anisotropic behavior. Ultrapro™ and Infinit exhibited approximately 12- and 20-fold differences between perpendicular axes, respectively. Trelex(®), ProLite™, and Parietex™ were 2.3-2.4 times. Dualmesh(®) was the least anisotropic mesh, without marked difference between the axes. Anisotropy of synthetic meshes has been underappreciated. In this study, we found striking differences between elastic properties of perpendicular axes for most commonly used synthetic meshes. Indiscriminate orientation of anisotropic mesh may adversely affect hernia repairs. Proper labeling of all implants by manufacturers should be mandatory. Understanding the specific anisotropic behavior of synthetic meshes should allow surgeons to employ rational implant orientation to maximize outcomes of hernia repair.

  8. Innovation Policy Evaluation – Challenges and Roads Ahead

    DEFF Research Database (Denmark)

    Christensen, Jesper Lindgaard

    2012-01-01

    Prior Work A vital development of innovation policies as well as innovation theories over the past couple of decades is the increased focus upon collaboration and networking between actors. It is, however, difficult to evaluate such activities with traditional evaluation metrics. The literature o...

  9. Cross-platform digital assessment forms for evaluating surgical skills

    DEFF Research Database (Denmark)

    Andersen, Steven Arild Wuyts

    2015-01-01

    developed for the rating of surgical skills. The database platform used in this study was reasonably priced, intuitive for the user, and flexible. The forms have been provided online as free downloads that may serve as the basis for further development or as inspiration for future efforts. In conclusion......A variety of structured assessment tools for use in surgical training have been reported, but extant assessment tools often employ paper-based rating forms. Digital assessment forms for evaluating surgical skills could potentially offer advantages over paper-based forms, especially in complex...... assessment situations. In this paper, we report on the development of cross-platform digital assessment forms for use with multiple raters in order to facilitate the automatic processing of surgical skills assessments that include structured ratings. The FileMaker 13 platform was used to create a database...

  10. Evaluation of two surveillance methods for surgical site infection

    Directory of Open Access Journals (Sweden)

    M. Haji Abdolbaghi

    2006-08-01

    Full Text Available Background: Surgical wound infection surveillance is an important facet of hospital infection control processes. There are several surveillance methods for surgical site infections. The objective of this study is to evaluate the accuracy of two different surgical site infection surveillance methods. Methods: In this prospective cross sectional study 3020 undergoing surgey in general surgical wards of Imam Khomeini hospital were included. Surveillance methods consisted of review of medical records for postoperative fever and review of nursing daily note for prescription of antibiotics postoperatively and during patient’s discharge. Review of patient’s history and daily records and interview with patient’s surgeon and the head-nurse of the ward considered as a gold standard for surveillance. Results: The postoperative antibiotic consumption especially when considering its duration is a proper method for surgical wound infection surveillance. Accomplishments of a prospective study with postdischarge follow up until 30 days after surgery is recommended. Conclusion: The result of this study showed that postoperative antibiotic surveillance method specially with consideration of the antibiotic usage duration is a proper method for surgical site infection surveillance in general surgery wards. Accomplishments of a prospective study with post discharge follow up until 30 days after surgery is recommended.

  11. Development of stereo endoscope system with its innovative master interface for continuous surgical operation.

    Science.gov (United States)

    Kim, Myungjoon; Lee, Chiwon; Hong, Nhayoung; Kim, Yoon Jae; Kim, Sungwan

    2017-06-24

    Although robotic laparoscopic surgery has various benefits when compared with conventional open surgery and minimally invasive surgery, it also has issues to overcome and one of the issues is the discontinuous surgical flow that occurs whenever control is swapped between the endoscope system and the operating robot arm system. This can lead to problems such as collision between surgical instruments, injury to patients, and increased operation time. To achieve continuous surgical operation, a wireless controllable stereo endoscope system is proposed which enables the simultaneous control of the operating robot arm system and the endoscope system. The proposed system consists of two improved novel master interfaces (iNMIs), a four-degrees of freedom (4-DOFs) endoscope control system (ECS), and a simple three-dimensional (3D) endoscope. In order to simultaneously control the proposed system and patient side manipulators of da Vinci research kit (dVRK), the iNMIs are installed to the master tool manipulators of dVRK system. The 4-DOFs ECS consists of four servo motors and employs a two-parallel link structure to provide translational and fulcrum point motion to the simple 3D endoscope. The images acquired by the endoscope undergo stereo calibration and rectification to provide a clear 3D vision to the surgeon as available in clinically used da Vinci surgical robot systems. Tests designed to verify the accuracy, data transfer time, and power consumption of the iNMIs were performed. The workspace was calculated to estimate clinical applicability and a modified peg transfer task was conducted with three novice volunteers. The iNMIs operated for 317 min and moved in accordance with the surgeon's desire with a mean latency of 5 ms. The workspace was calculated to be 20378.3 cm 3 , which exceeds the reference workspace of 549.5 cm 3 . The novice volunteers were able to successfully execute the modified peg transfer task designed to evaluate the proposed system's overall

  12. Evaluation of teleoperated surgical robots in an enclosed undersea environment.

    Science.gov (United States)

    Doarn, Charles R; Anvari, Mehran; Low, Thomas; Broderick, Timothy J

    2009-05-01

    The ability to support surgical care in an extreme environment is a significant issue for both military medicine and space medicine. Telemanipulation systems, those that can be remotely operated from a distant site, have been used extensively by the National Aeronautics and Space Administration (NASA) for a number of years. These systems, often called telerobots, have successfully been applied to surgical interventions. A further extension is to operate these robotic systems over data communication networks where robotic slave and master are separated by a great distance. NASA utilizes the National Oceanographic and Atmospheric Administration (NOAA) Aquarius underwater habitat as an analog environment for research and technology evaluation missions, known as NASA Extreme Environment Mission Operations (NEEMO). Three NEEMO missions have provided an opportunity to evaluate teleoperated surgical robotics by astronauts and surgeons. Three robotic systems were deployed to the habitat for evaluation during NEEMO 7, 9, and 12. These systems were linked via a telecommunications link to various sites for remote manipulation. Researchers in the habitat conducted a variety of tests to evaluate performance and applicability in extreme environments. Over three different NEEMO missions, components of the Automated Endoscopic System for Optimal Positioning (AESOP), the M7 Surgical System, and the RAVEN were deployed and evaluated. A number of factors were evaluated, including communication latency and semiautonomous functions. The M7 was modified to permit a remote surgeon the ability to insert a needle into simulated tissue with ultrasound guidance, resulting in the world's first semi-autonomous supervisory-controlled medical task. The deployment and operation of teleoperated surgical systems and semi-autonomous, supervisory-controlled tasks were successfully conducted.

  13. Innovation in Pediatric Surgical Education for General Surgery Residents: A Mobile Web Resource.

    Science.gov (United States)

    Rouch, Joshua D; Wagner, Justin P; Scott, Andrew; Sullins, Veronica F; Chen, David C; DeUgarte, Daniel A; Shew, Stephen B; Tillou, Areti; Dunn, James C Y; Lee, Steven L

    2015-01-01

    General surgery residents lack a standardized educational experience in pediatric surgery. We hypothesized that the development of a mobile educational interface would provide general surgery residents broader access to pediatric surgical education materials. We created an educational mobile website for general surgery residents rotating on pediatric surgery, which included a curriculum, multimedia resources, the Operative Performance Rating Scale (OPRS), and Twitter functionality. Residents were instructed to consult the curriculum. Residents and faculty posted media using the Twitter hashtag, #UCLAPedSurg, and following each surgical procedure reviewed performance via the OPRS. Site visits, Twitter posts, and OPRS submissions were quantified from September 2013 to July 2014. The pediatric surgery mobile website received 257 hits; 108 to the homepage, 107 to multimedia, 28 to the syllabus, and 19 to the OPRS. All eligible residents accessed the content. The Twitter hashtag, #UCLAPedSurg, was assigned to 20 posts; the overall audience reach was 85 individuals. Participants in the mobile OPRS included 11 general surgery residents and 4 pediatric surgery faculty. Pediatric surgical education resources and operative performance evaluations are effectively administered to general surgery residents via a structured mobile platform. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  14. The female innovation-generation consumer's evaluation

    African Journals Online (AJOL)

    user

    to date is the millennial consumer segment ... consumers (Eastman et al, 2014; Pérez-Luño et al, 2011), due to their love of technology and the virtual world. Consumers of the innovation- generation were born between 1980 and 2000 and currently fall in the age ... The constantly changing media habits of consumers ...

  15. Evaluation of Sensor Configurations for Robotic Surgical Instruments

    Directory of Open Access Journals (Sweden)

    Jesús M. Gómez-de-Gabriel

    2015-10-01

    Full Text Available Designing surgical instruments for robotic-assisted minimally-invasive surgery (RAMIS is challenging due to constraints on the number and type of sensors imposed by considerations such as space or the need for sterilization. A new method for evaluating the usability of virtual teleoperated surgical instruments based on virtual sensors is presented. This method uses virtual prototyping of the surgical instrument with a dual physical interaction, which allows testing of different sensor configurations in a real environment. Moreover, the proposed approach has been applied to the evaluation of prototypes of a two-finger grasper for lump detection by remote pinching. In this example, the usability of a set of five different sensor configurations, with a different number of force sensors, is evaluated in terms of quantitative and qualitative measures in clinical experiments with 23 volunteers. As a result, the smallest number of force sensors needed in the surgical instrument that ensures the usability of the device can be determined. The details of the experimental setup are also included.

  16. Evaluation of Sensor Configurations for Robotic Surgical Instruments.

    Science.gov (United States)

    Gómez-de-Gabriel, Jesús M; Harwin, William

    2015-10-27

    Designing surgical instruments for robotic-assisted minimally-invasive surgery (RAMIS) is challenging due to constraints on the number and type of sensors imposed by considerations such as space or the need for sterilization. A new method for evaluating the usability of virtual teleoperated surgical instruments based on virtual sensors is presented. This method uses virtual prototyping of the surgical instrument with a dual physical interaction, which allows testing of different sensor configurations in a real environment. Moreover, the proposed approach has been applied to the evaluation of prototypes of a two-finger grasper for lump detection by remote pinching. In this example, the usability of a set of five different sensor configurations, with a different number of force sensors, is evaluated in terms of quantitative and qualitative measures in clinical experiments with 23 volunteers. As a result, the smallest number of force sensors needed in the surgical instrument that ensures the usability of the device can be determined. The details of the experimental setup are also included.

  17. Evaluation of Sensor Configurations for Robotic Surgical Instruments

    Science.gov (United States)

    Gómez-de-Gabriel, Jesús M.; Harwin, William

    2015-01-01

    Designing surgical instruments for robotic-assisted minimally-invasive surgery (RAMIS) is challenging due to constraints on the number and type of sensors imposed by considerations such as space or the need for sterilization. A new method for evaluating the usability of virtual teleoperated surgical instruments based on virtual sensors is presented. This method uses virtual prototyping of the surgical instrument with a dual physical interaction, which allows testing of different sensor configurations in a real environment. Moreover, the proposed approach has been applied to the evaluation of prototypes of a two-finger grasper for lump detection by remote pinching. In this example, the usability of a set of five different sensor configurations, with a different number of force sensors, is evaluated in terms of quantitative and qualitative measures in clinical experiments with 23 volunteers. As a result, the smallest number of force sensors needed in the surgical instrument that ensures the usability of the device can be determined. The details of the experimental setup are also included. PMID:26516863

  18. An innovative model for achieving breast-feeding success in infants with complex surgical anomalies.

    Science.gov (United States)

    Edwards, Taryn M; Spatz, Diane L

    2010-01-01

    This manuscript describes an innovative nurse-driven continuous quality improvement project. Infants born with congenital surgical anomalies face significant challenges within the newborn period and human milk/breast-feeding may not be viewed as a priority. In many hospitals, nurses refer families to lactation consultants for all breast-feeding assistance and support. The Transition to Breast Pathway was developed on the basis of the evidence-based standards and protocols at The Children's Hospital of Philadelphia. The pathway consists of (1) initiation of pumping and maintenance of milk supply, (2) mouth care with human milk, (3) skin-to-skin care, (4) nonnutritive sucking at the breast, (5) transitioning to at breast feeds. A sample of 80 infants were enrolled in this project. Major results of the project are as follows: (1) mother's average milk supply was approximately 603 mL/d, (2) 71% (57/80) of the infants received mouth care with human milk, (3) 48% (38/80) mother/infant dyads performed skin-to-skin care, (4) 60% (35/58) of mother/infant dyads performed nonnutritive sucking at the breast, (5) 100% (58/58) of mother-infant dyads transitioned to breast prior to discharge. This continuous quality improvement project demonstrates that nurses can and should lead the process of transitioning infants to at breast feeds.

  19. Cross-platform digital assessment forms for evaluating surgical skills

    Directory of Open Access Journals (Sweden)

    Steven Arild Wuyts Andersen

    2015-04-01

    Full Text Available A variety of structured assessment tools for use in surgical training have been reported, but extant assessment tools often employ paper-based rating forms. Digital assessment forms for evaluating surgical skills could potentially offer advantages over paper-based forms, especially in complex assessment situations. In this paper, we report on the development of cross-platform digital assessment forms for use with multiple raters in order to facilitate the automatic processing of surgical skills assessments that include structured ratings. The FileMaker 13 platform was used to create a database containing the digital assessment forms, because this software has cross-platform functionality on both desktop computers and handheld devices. The database is hosted online, and the rating forms can therefore also be accessed through most modern web browsers. Cross-platform digital assessment forms were developed for the rating of surgical skills. The database platform used in this study was reasonably priced, intuitive for the user, and flexible. The forms have been provided online as free downloads that may serve as the basis for further development or as inspiration for future efforts. In conclusion, digital assessment forms can be used for the structured rating of surgical skills and have the potential to be especially useful in complex assessment situations with multiple raters, repeated assessments in various times and locations, and situations requiring substantial subsequent data processing or complex score calculations.

  20. An Evaluation of the Role of Simulation Training for Teaching Surgical Skills in Sub-Saharan Africa.

    Science.gov (United States)

    Campain, Nicholas J; Kailavasan, Mithun; Chalwe, Mumba; Gobeze, Aberra A; Teferi, Getaneh; Lane, Robert; Biyani, Chandra Shekhar

    2018-04-01

    An estimated 5 billion people worldwide lack access to any surgical care, whilst surgical conditions account for 11-30% of the global burden of disease. Maximizing the effectiveness of surgical training is imperative to improve access to safe and essential surgical care on a global scale. Innovative methods of surgical training have been used in sub-Saharan Africa to attempt to improve the efficiency of training healthcare workers in surgery. Simulation training may have an important role in up-scaling and improving the efficiency of surgical training and has been widely used in SSA. Though not intended to be a systematic review, the role of simulation for teaching surgical skills in Sub-Saharan Africa was reviewed to assess the evidence for use and outcomes. A systematic search strategy was used to retrieve relevant studies from electronic databases PubMed, Ovid, Medline for pertinent articles published until August 2016. Studies that reported the use of simulation-based training for surgery in Africa were included. In all, 19 articles were included. A variety of innovative surgical training methods using simulation techniques were identified. Few studies reported any outcome data. Compared to the volume of surgical training initiatives that are known to take place in SSA, there is very limited good quality published evidence for the use of simulation training in this context. Simulation training presents an excellent modality to enhance and improve both volume and access to high quality surgical skills training, alongside other learning domains. There is a desperate need to meticulously evaluate the appropriateness and effectiveness of simulation training in SSA, where simulation training could have a large potential beneficial impact. Training programs should attempt to assess and report learner outcomes.

  1. GENERAL ENVIRONMENTAL CORPORATION; CURE ELECTROCOAGULATION TECHNOLOGY: INNOVATIVE TECHNOLOGY EVALUATION REPORT

    Science.gov (United States)

    The CURE electrocoagulation technology was demonstrated under the Superfund Innovative Technology Evaluation (SITE) program at the U.S. Department of Energy (DOE) Rocky Flats Environmental Technology Site (RFETS), where water from the solar evaporation ponds (SEPs) was contaminat...

  2. Evaluating Innovations in Home Care for Performance Accountability.

    Science.gov (United States)

    Collister, Barbara; Gutscher, Abram; Ambrogiano, Jana

    2016-01-01

    Concerns about rising costs and the sustainability of our healthcare system have led to a drive for innovative solutions and accountability for performance. Integrated Home Care, Calgary Zone, Alberta Health Services went beyond traditional accountability measures to use evaluation methodology to measure the progress of complex innovations to its organization structure and service delivery model. This paper focuses on the first two phases of a three-phase evaluation. The results of the first two phases generated learning about innovation adoption and sustainability, and performance accountability at the program-level of a large publicly funded healthcare organization.

  3. Evaluation of Cosmetic Results of Surgical Wound Closure in Dogs

    Directory of Open Access Journals (Sweden)

    Rachel Williams

    2018-02-01

    Full Text Available Objective: To evaluate the correlation between wound cosmesis and pet owner satisfaction, to determine the agreement among vet surgeons, and pet owners evaluating a surgical wound with a visual assessment score (VAS, and to determine the agreement between the VAS, a semi-quantitative score of wound inflammation, and wound width.Background: Perception of post-surgical cosmesis by human patients has been found to influence their satisfaction and perceived adequacy of vet surgeons. Due to the trend of owners anthropomorphising pets, this logic can be extended to veterinary patients. Also, there is a lack of consistent, reliable methods to evaluate cosmesis have been developed, creating the need for a scoring system that is accurate and reproducible.Evidentiary value: This was a prospective cohort study with one hundred and seven patients. This study may not change day-to-day practices, but it will bring to light for practitioners the discordance between pet owners and vet surgeons concerning attractiveness of an incision as well as overall satisfaction with a procedure.Methods: Photographs of surgical wounds were taken immediately, 2 weeks, and 8 weeks after surgery in dogs. Owners were asked to evaluate satisfaction with the procedure and attractiveness of the incision using the VAS. Photos were evaluated for cosmetic outcome by pet owner and vet surgeon evaluators with different scoring systems. The reliability of the scoring systems was evaluated using intraclass correlations and kappa statistics as appropriate.Results:  Owners’ evaluation of cosmetic outcome correlated with their overall satisfaction. (r2=0.37, where r2 is the coefficient of determination, and can be used to determine what proportion of variance in one variable is predictable from the other variableThere was generally poor reliability of the subjective scoring between both vet surgeons and pet owners, and the less subjective scoring systems.Conclusion: The cosmetic outcome

  4. Characteristics of uveitic glaucoma and evaluation of its surgical treatment

    Directory of Open Access Journals (Sweden)

    Shimizu A

    2014-11-01

    Full Text Available Ai Shimizu, Kazuichi Maruyama, Yu Yokoyama, Satoru Tsuda, Morin Ryu, Toru Nakazawa Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan Purpose: To investigate the characteristics of uveitic glaucoma (UG and evaluate surgical treatments.Methods: This study examined a retrospective, nonrandomized comparative interventional case series of 105 UG patients (141 eyes followed between April 1, 2001 and July 30, 2014 at the outpatient clinic of Tohoku University Hospital. The study group included 47 patients (47 eyes who underwent glaucoma surgery: trabeculectomy, trabeculotomy, and trabectome surgery. The analysis used Kaplan–Meier life tables, with surgical failure defined as intraocular pressure ≧21 mmHg or the need for additional glaucoma surgery.Results: UG patients represented 9.73% of our database of glaucoma patients. The mean follow-up period was 40.32±32.53 months. Seventy-one patients had granulomatous uveitis (67.62% and 34 had nongranulomatous uveitis (32.38%. The causes of uveitis included sarcoidosis (n=25, Behçet’s disease (n=11, Vogt–Koyanagi–Harada disease (n=9, Posner–Schlossman syndrome (n=12, herpes simplex virus infectious uveitis (n=7, acute anterior uveitis (n=5, intermediate uveitis (n=4, scleritis (n=4, inflammatory bowel disease (n=4, varicella zoster virus uveitis (n=2, and others (n=6. An additional 16 patients were diagnosed with idiopathic UG. Surgical success rates were 82.86% for trabeculectomy, 62.50% for trabeculotomy, and 75.00% for trabectome. Significant risk factors for surgical failure included male sex (P=0.02, age less than 45 years (P=0.0009, nongranulomatous uveitis (P=0.04, and postoperative inflammation (P=0.01.Conclusion: Young male patients with nongranulomatous uveitis had a significant risk of surgical failure. Moreover, prolonged postoperative inflammation created a susceptibility to surgical failure, indicating the importance of postoperative

  5. Enhancing surgical innovation through a specialized medical school pathway of excellence in innovation and entrepreneurship: Lessons learned and opportunities for the future.

    Science.gov (United States)

    Cohen, Mark S

    2017-11-01

    The mission of an academic medical center and academic departments of surgery focuses on teaching, scholarship/research, and expertise of clinical care. The standard 4-year medical school curriculum and general surgery residency training are well balanced to expose trainees to these missions in varying degrees, yet the advancement of medicine as a field is predicated on the creation, development, and successful implementation of medical innovations. Surgeons, by virtue of their clinical training, are immersed in medical technology and are continually required to use this technology effectively in combination with their own technical skills and judgment to provide optimal patient care. As such, they routinely face the challenges of current technology and the need for innovation and improvement, leading many to become natural inventors. Having a good idea or innovation to improve patient care, however, is just the starting point of the complex process of implementing that idea in the clinic. Unfortunately, the vast majority of surgeons and medical students have no formal educational training on the innovation process regarding how good ideas can be developed successfully for clinical and commercial implementation. Added to this lack of formal education are the limited resources and time constraints that surgeons, residents, and medical students face in acquiring the educational skill set to adeptly navigate this innovation and entrepreneurial landscape. To address these challenges, the University of Michigan recently created the first pathway of excellence for medical students to focus their passions and interests in medical innovation and entrepreneurship. This program has been transformative for building a new culture of young, motivated medical innovators, many of whom have dedicated their talents already to addressing several key problems in surgical patient care. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Use of Eye Tracking as an Innovative Instructional Method in Surgical Human Anatomy.

    Science.gov (United States)

    Sánchez-Ferrer, María Luísa; Grima-Murcia, María Dolores; Sánchez-Ferrer, Francisco; Hernández-Peñalver, Ana Isabel; Fernández-Jover, Eduardo; Sánchez Del Campo, Francisco

    Tobii glasses can record corneal infrared light reflection to track pupil position and to map gaze focusing in the video recording. Eye tracking has been proposed for use in training and coaching as a visually guided control interface. The aim of our study was to test the potential use of these glasses in various situations: explanations of anatomical structures on tablet-type electronic devices, explanations of anatomical models and dissected cadavers, and during the prosection thereof. An additional aim of the study was to test the use of the glasses during laparoscopies performed on Thiel-embalmed cadavers (that allows pneumoinsufflation and exact reproduction of the laparoscopic surgical technique). The device was also tried out in actual surgery (both laparoscopy and open surgery). We performed a pilot study using the Tobii glasses. Dissection room at our School of Medicine and in the operating room at our Hospital. To evaluate usefulness, a survey was designed for use among students, instructors, and practicing physicians. The results were satisfactory, with the usefulness of this tool supported by more than 80% positive responses to most questions. There was no inconvenience for surgeons and that patient safety was ensured in the real laparoscopy. To our knowledge, this is the first publication to demonstrate the usefulness of eye tracking in practical instruction of human anatomy, as well as in teaching clinical anatomy and surgical techniques in the dissection and operating rooms. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. Implications of Frugal Innovations on Sustainable Development: Evaluating Water and Energy Innovations

    Directory of Open Access Journals (Sweden)

    Jarkko Levänen

    2015-12-01

    Full Text Available Frugal innovations are often associated with sustainable development. These connections, however, are based on anecdotal assumptions rather than empirical evidence. This article evaluates the sustainability of four frugal innovations from water and energy sectors. For the purposes of the evaluation, a set of indicators was developed. Indicators are drawn from sustainable development goals by the United Nations and they encompass central dimensions of sustainability: ecological, social and economic. In this article, frugal innovations are compared to solutions that are currently used in similar low-income contexts. Studied frugal innovations were found more sustainable in terms of energy production and water purification capacity than the existing solutions. In terms of social sustainability, larger differences between innovations were found. For example, business models of frugal energy solutions focus on capacity building and the inclusion of marginalized low-income people, whereas business models of water purification solutions focus on more traditional corporate social responsibility activities, such as marketing awareness campaigns and cooperation with non-governmental organizations. Three major sustainability challenges for frugal innovators were identified: (1 the proper integration of material efficiency into product or service systems; (2 the patient promotion of inclusive employment; and (3 the promotion of inclusive and sustainable local industrialization. The article concludes that despite indisputable similarities between frugality and sustainability, it is problematic to equate the two conceptually.

  8. Sonographic evaluation of surgical repair of uterine cesarean scar defects.

    Science.gov (United States)

    Pomorski, Michal; Fuchs, Tomasz; Rosner-Tenerowicz, Anna; Zimmer, Mariusz

    2017-10-01

    The aim of the study was to assess the clinical outcomes of surgical repair of uterine cesarean scar defects with sonography (US). Seven nonpregnant women with history of cesarean section and a large uterine scar defect were enrolled. The surgical repair was performed by minilaparotomy. The US assessment of the uterine scar was performed using a standardized approach at baseline, then at a first visit 2-3 days following the surgical intervention (V1) and at a follow-up visit 3 months later (V2). Residual myometrial thickness (RMT), width, and depth of the scar defect were measured. The mean RMT increased significantly from 1.9 mm at baseline to 8.8 mm at V1 and 8.0 mm at V2. No intraoperative complications were observed. Postmenstrual spotting and abdominal pain reported preoperatively resolved after the operation. A surgical repair procedure for an incompletely healed uterine cesarean scar is effective in increasing RMT thickness, decreasing the depth of the scar, and reducing symptoms related to the cesarean section scar defect. Further studies on post-repair pregnancy outcomes are required to evaluate whether the procedure affects the rate of cesarean scar pregnancy, morbidly adherent placenta, and/or uterine scar dehiscence and rupture. The repair of a cesarean scar defect is recommended only for symptomatic women. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:455-460, 2017. © 2017 Wiley Periodicals, Inc.

  9. Evaluating the Knowledge Assets of Innovative Companies

    Directory of Open Access Journals (Sweden)

    Maen Al-Hawari

    2002-11-01

    Full Text Available Knowledge has long been recognised as a valuable resource for organisational growth and sustained competitive advantage, especially for organisations competing in an uncertain environment (Miller & Shamsie 1987. In the current post-industrial society, knowledge is recognised as a primary source of a company’s wealth. However knowledge assets are much more difficult to identify and measure than are the physical assets with which we are much more familiar. (Boisot 1998 As a company’s innovative capacity may be dependent upon its ability to take advantage of its knowledge assets, it is important to be able to identify and measure those assets. While large companies can afford extensive knowledge management projects, there is a acute need for a method by which managers in smaller organisations can easily and reliably locate, quantify and compare their knowledge assets in order to maximise their potential for innovation. The paper will begin with an overview of current thinking on the topic of Knowledge Management (KM. It will then introduce the three functions of the knowledge life cycle (Bhatt 2000, Tan 2000, the four modes of conversion between tacit and explicit knowledge (Nonaka 1995 and the five knowledge enablers (Von Krogh 2000. The research, reported here, aims to identify, from the literature, a set of knowledge elements that will give a balanced view of knowledge assets across the four modes and five enablers. An integrated model, which is the result of research to date by the authors, will then be defined. This model combines the functions of the knowledge life cycle and Nonaka’s knowledge creation spiral with the notion of I-Space, which has been used to classify information across three dimensions, to form a new model of K-Space, which can be used to classify the knowledge elements. The paper will present this model and discuss the appropriateness of a set of knowledge elements as a means of measuring the knowledge asset of an

  10. Innovation Incubator: Whisker Labs Technical Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Sparn, Bethany F. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Frank, Stephen M. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Earle, Lieko [National Renewable Energy Lab. (NREL), Golden, CO (United States); Scheib, Jennifer G. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2017-08-01

    The Wells Fargo Innovation Incubator (IN2) is a program to foster and accelerate startup companies with commercial building energy-efficiency and demand management technologies. The program is funded by the Wells Fargo Foundation and co-administered by the National Renewable Energy Laboratory (NREL). Whisker Labs, an Oakland, California-based company, was one of four awardees in the first IN2 cohort and was invited to participate in the program because of its novel electrical power sensing technology for circuit breakers. The stick-on Whisker meters install directly on the front face of the circuit breakers in an electrical panel using adhesive, eliminating the need to open the panel and install current transducers (CTs) on the circuit wiring.

  11. Evaluation of surgical skill of uvulopalato pharyngo plasty (UPPP)

    International Nuclear Information System (INIS)

    Takashima, Masayuki; Oda, Makoto; Itoi, Aya; Tomoda, Kouichi

    2006-01-01

    We evaluated the surgical skill of uvulopalato pharyngo plasty (UPPP) done in 35 cases in our hospital and discussed its efficacy. Our method of UPPP has three characteristics. First, a mattress suture was applied in the tonsillar bed. As a result there was no failure of the suture. Second, we made a raw surface at a little upper part of the root of the uvula and applied the mattress suture to it. This suture has efficacy of soft palate upword to the oral side. Third, no continuous suture has advantage to present scar formation. We also examined the dynamic MRI for obstructive site and images were divided some morphological obstructive pattern, and assess about efficacy of improvement rate of AHI. The efficacy was over 80% in tonsillar type. But there was 31% efficacy not only soft palate but also tongue rotation type. We concluded that the important factor to have good result of UPPP are surgical skill and adequate indication. (author)

  12. Innovation

    Science.gov (United States)

    EPA frames innovation as critical to the protection of human health and the environment through initiatives such as sustainable practices, innovative research, prize competitions, innovation awards, partnerships, and community activities.

  13. Evaluation of Augmented Reality Feedback in Surgical Training Environment.

    Science.gov (United States)

    Zahiri, Mohsen; Nelson, Carl A; Oleynikov, Dmitry; Siu, Ka-Chun

    2018-02-01

    Providing computer-based laparoscopic surgical training has several advantages that enhance the training process. Self-evaluation and real-time performance feedback are 2 of these advantages, which avoid dependency of trainees on expert feedback. The goal of this study was to investigate the use of a visual time indicator as real-time feedback correlated with the laparoscopic surgical training. Twenty novices participated in this study working with (and without) different presentations of time indicators. They performed a standard peg transfer task, and their completion times and muscle activity were recorded and compared. Also of interest was whether the use of this type of feedback induced any side effect in terms of motivation or muscle fatigue. Of the 20 participants, 15 (75%) preferred using a time indicator in the training process rather than having no feedback. However, time to task completion showed no significant difference in performance with the time indicator; furthermore, no significant differences in muscle activity or muscle fatigue were detected with/without time feedback. The absence of significant difference between task performance with/without time feedback shows that using visual real-time feedback can be included in surgical training based on user preference. Trainees may benefit from this type of feedback in the form of increased motivation. The extent to which this can influence training frequency leading to performance improvement is a question for further study.

  14. Evaluation of surgical treatment for cerebral amyloid angiopathy

    International Nuclear Information System (INIS)

    Ohta, Masaru; Takeshita, Iwao; Samoto, Ken

    2007-01-01

    Treatment of cerebral hemorrhage in the elderly is often difficult and a growing concern due to Japan's aging population. We retrospectively evaluated radiological images of intracerebral hemorrhages associated with cerebral amyloid angiopathy (CAA) and surgical efficacy for performance status of patients. From January 2000 to December 2005, 240 patients with intracerebral hemorrhage and 49 patients with cerebral subcortical hemorrhage were reported. Of these, 41 cases fulfilled the Boston criteria for CAA. Diagnosis by autopsy was 0, surgical biopsy histopathology 9, multiple hemorrhagic lesions 8 and single lesion in 24 patients. Involved lobes were frontal: 6, temporal: 1, fronto-parietal: 3, temporo-parietal: 8, parietal: 12, parieto-occipital: 6 and occipital: 5. CAA-related subcortical hemorrhages were commonly distributed in 2 lobes, with the parietal lobe the most commonly affected area. Radiological characteristics of CAA-related subcortical hemorrhages were irregular borders: 30/41 (73%) intraventricular ruptures: 15/41 (37%), and subarachnoid hemorrhage and/or acute subdural hematoma: 37/41 (90%). Surgery was indicated if consciousness level (Japan Coma Scale) was greater than II-20 and hematoma volume greater than 40 ml. Craniotomy was performed on 18 patients with modified Rankin Scale (mRS) with 60% improving postoperatively and the remainder maintaining the same mRS as before surgery. Two patients underwent emergency craniotomy due to a rapidly growing hematoma producing a comatose state. Of the 18 surgical cases, 1 had further bleeding in a different area postoperatively at 3 months. Of the 23 nonsurgical cases, 4 had further bleeding after conservative treatment at 1.5 to 3.5 months with 1 case affected on 3 separate occasions. Surgical removal of hematomas caused by CAA is safe and unlikely to accelerate the rate of further bleeding, but rather contribute to improvement of mRS in selected patients. (author)

  15. 2016 CAPS ethics session/Ein debate: 1. Regionalization of pediatric surgical care 2. Ethical introduction of surgical innovation 3. Addressing stress in a surgical practice: resiliency, well-being, and burnout.

    Science.gov (United States)

    Bagwell, Charles E; Chiu, Priscilla; Fecteau, Annie; Gow, Kenneth W; Mueller, Claudia M; Price, David; Zigman, Andrew F

    2017-05-01

    The following is the conference proceeding of the Second Ein Debate from the 48th Annual Meeting of the Canadian Association of Paediatric Surgeons held in Vancouver, BC, from September 22 to 24, 2016. The three main topics for debate, as prepared by the members of the CAPS Ethics Committee, are: 1. Regionalization of care: pros and cons, 2. Innovation in clinical care: ethical considerations, and 3. Surgeon well-being: caring for the caregiver. The authors of this paper, as participants in the debate, were assigned their positions at random. Therefore, the opinions they express within this summary might not reflect their own viewpoints. In the first discussion, arguments for and against the regionalization of pediatric surgical care are discussed, primarily in the context of a case of BA. In the pro argument, the evidence and lessons learned from different European countries are explored as well as different models to provide the best BA care outside of large teaching centers. In the counterargument, the author explains how regionalization of care could be detrimental for the patient, the family, the regional center, and for the health care system in general. In the debate on surgical innovation the authors define surgical innovation. They review the pertinent ethical principles, explore a model for its implementation, and the role of the institution at which the innovation is proposed. In the third section, surgeon well-being is examined, and recent literature on surgeon resiliency and burnout both at the attending and resident level is reviewed. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Automated robot-assisted surgical skill evaluation: Predictive analytics approach.

    Science.gov (United States)

    Fard, Mahtab J; Ameri, Sattar; Darin Ellis, R; Chinnam, Ratna B; Pandya, Abhilash K; Klein, Michael D

    2018-02-01

    Surgical skill assessment has predominantly been a subjective task. Recently, technological advances such as robot-assisted surgery have created great opportunities for objective surgical evaluation. In this paper, we introduce a predictive framework for objective skill assessment based on movement trajectory data. Our aim is to build a classification framework to automatically evaluate the performance of surgeons with different levels of expertise. Eight global movement features are extracted from movement trajectory data captured by a da Vinci robot for surgeons with two levels of expertise - novice and expert. Three classification methods - k-nearest neighbours, logistic regression and support vector machines - are applied. The result shows that the proposed framework can classify surgeons' expertise as novice or expert with an accuracy of 82.3% for knot tying and 89.9% for a suturing task. This study demonstrates and evaluates the ability of machine learning methods to automatically classify expert and novice surgeons using global movement features. Copyright © 2017 John Wiley & Sons, Ltd.

  17. Innovative strategies for nursing education program evaluation.

    Science.gov (United States)

    Story, Lachel; Butts, Janie B; Bishop, Sandra B; Green, Lisa; Johnson, Kathy; Mattison, Haley

    2010-06-01

    Nursing programs are mandated by accreditation bodies to report data significant to program quality and outcomes. The history at one school of nursing in the southern United States revealed the program evaluation committee experienced roadblocks in retrieving such information. Creative approaches were adopted to overcome some of the barriers to program evaluation, including the use of more technological-based approaches to engage alumni who embrace this technology as a way of life. Among the many advantages of these approaches were convenience, ease of administration and analysis, cost effectiveness, and more meaningful data. The advantages far outweighed the few disadvantages incurred, with the most prominent being potential sampling bias. Copyright 2010, SLACK Incorporated.

  18. Innovative technology transfer of nondestructive evaluation research

    Science.gov (United States)

    Brian Brashaw; Robert J. Ross; Xiping Wang

    2008-01-01

    Technology transfer is often an afterthought for many nondestructive evaluation (NDE) researchers. Effective technology transfer should be considered during the planning and execution of research projects. This paper outlines strategies for using technology transfer in NDE research and presents a wide variety of technology transfer methods used by a cooperative...

  19. Surgical approach to TIR3 cytology class A prospective evaluation.

    Science.gov (United States)

    D'Alessandro, Nicola; Fasano, Giovanni Michele; Gilio, Francesco; Iside, Giovanni; Izzo, Maria Lucia; Loffredo, Andrea; Pinto, Margherita; Tramontano, Salvatore; Tramutola, Giuseppe; Citro, Giuseppe

    2014-01-01

    Fine-needle aspiration (FNA) has proven to be a safe and reliable method of investigation of thyroid lesions. Referencing to European classification, the associated risk of malignancy for TIR3, category reserved for aspirates that contain architectural and/or nuclear atypia, is variable in such studies. Aims of study were evaluating safety of surgical approach, assessing perioperative parameters surgically related, and estimating neoplastic rate for TIR3 group. A prospective evaluation of all TIR3 submitted to thyroidectomy was conducted by assessing histopatohologic results between January 2005 and December 2012, considering two categories, positive (neoplastic) and negative (not neoplastic) group. Intraoperative and complication rate was analyzed on TIR3 population. A total of 1514 total thyroidectomy was performed from 2005 to 2012: a total of 148 cases was considered on TIR3 group. Positive cases amounted to 64 (43.2%), 29 of which were carcinoma (19.6% of total population) and 35 of which were adenoma, while negative cases amounted to 84 (56.8%). Sensitivity and specificity of TIR3 as neoplastic screening was 43.2% and 82.1%. A total of 32 linfectomies was performed (21.6% of group). Positive group presented a significant lower mean age than negative group (42.1 vs 56.2 years) TIR3 group represents a various category, with probably different malignancy risk. Our results and neoplasms rate confirmed that surgical option should be gold standard, in order to define atypical pattern and reduce delayed diagnoses. Choice of a second FNA or a imaging monitoring should be adopted for specific condition. Fine-needle aspiration, Thyroidectomy, TIR3, Thyroid cancer.

  20. Evaluating a Passive Social Media Citizensourcing Innovation

    OpenAIRE

    Loukis , Euripidis; Charalabidis , Yannis; Androutsopoulou , Aggeliki

    2015-01-01

    Part 4: Application Areas and Evaluation; International audience; Governments initially used social media mainly in order to disseminate information to the public about their activities, services, policies and plans. Then they started using social media also in order to collect from citizens useful information, knowledge, opinions and ideas concerning the problems and needs of modern societies and more recently in order to apply crowdsourcing ideas in the public sector context and promote ‘ci...

  1. R-IDEAL: A Framework for Systematic Clinical Evaluation of Technical Innovations in Radiation Oncology.

    Science.gov (United States)

    Verkooijen, Helena M; Kerkmeijer, Linda G W; Fuller, Clifton D; Huddart, Robbert; Faivre-Finn, Corinne; Verheij, Marcel; Mook, Stella; Sahgal, Arjun; Hall, Emma; Schultz, Chris

    2017-01-01

    The pace of innovation in radiation oncology is high and the window of opportunity for evaluation narrow. Financial incentives, industry pressure, and patients' demand for high-tech treatments have led to widespread implementation of innovations before, or even without, robust evidence of improved outcomes has been generated. The standard phase I-IV framework for drug evaluation is not the most efficient and desirable framework for assessment of technological innovations. In order to provide a standard assessment methodology for clinical evaluation of innovations in radiotherapy, we adapted the surgical IDEAL framework to fit the radiation oncology setting. Like surgery, clinical evaluation of innovations in radiation oncology is complicated by continuous technical development, team and operator dependence, and differences in quality control. Contrary to surgery, radiotherapy innovations may be used in various ways, e.g., at different tumor sites and with different aims, such as radiation volume reduction and dose escalation. Also, the effect of radiation treatment can be modeled, allowing better prediction of potential benefits and improved patient selection. Key distinctive features of R-IDEAL include the important role of predicate and modeling studies (Stage 0), randomization at an early stage in the development of the technology, and long-term follow-up for late toxicity. We implemented R-IDEAL for clinical evaluation of a recent innovation in radiation oncology, the MRI-guided linear accelerator (MR-Linac). MR-Linac combines a radiotherapy linear accelerator with a 1.5-T MRI, aiming for improved targeting, dose escalation, and margin reduction, and is expected to increase the use of hypofractionation, improve tumor control, leading to higher cure rates and less toxicity. An international consortium, with participants from seven large cancer institutes from Europe and North America, has adopted the R-IDEAL framework to work toward coordinated, evidence

  2. Learning towards system innovation: Evaluating a systemic instrument

    NARCIS (Netherlands)

    Mierlo, B. van; Leeuwis, C.; Smits, R.; Klein Woolthuis, R.J.A.

    2010-01-01

    In this paper we develop an analytical framework for studying learning processes in the context of efforts to bring about system innovation by building new networks of actors who are willing to work on a change towards sustainable development. We then use it to evaluate two specific intervention

  3. Developmental evaluation applying complexity concepts to enhance innovation and use

    CERN Document Server

    Patton, Michael Quinn

    2011-01-01

    Developmental evaluation (DE) offers a powerful approach to monitoring and supporting social innovations by working in partnership with program decision makers. In this book, eminent authority Michael Quinn Patton shows how to conduct evaluations within a DE framework. Patton draws on insights about complex dynamic systems, uncertainty, nonlinearity, and emergence. He illustrates how DE can be used for a range of purposes: ongoing program development, adapting effective principles of practice to local contexts, generating innovations and taking them to scale, and facilitating rapid response in crisis situations. Students and practicing evaluators will appreciate the book's extensive case examples and stories, cartoons, clear writing style, "closer look" sidebars, and summary tables. Provided is essential guidance for making evaluations useful, practical, and credible in support of social change.

  4. Innovation

    DEFF Research Database (Denmark)

    Nielsen, Janni; Yaganeh, Suzanne; Bloch Rasmussen, Leif

    2013-01-01

    This paper contributes to a theoretical discussion of creation of innovation with participants in, or outside, organisations. We address the creation of innovation with a complex theoretical understanding drawing on the Scandinavian and the Participatory Design tradition introducing two approaches...... to the processes of innovation. We ask if innovation can be initiated and enhanced looking at two collaborative approaches; participatory innovation (PIN) and cooperative innovation (COIN). We invite to dialogue and reflections on PIN’s conflict and creative frictions on one side and COIN’s complexity......, complementarity in diversity and the didactic scaffolding of the innovation process on the other side. Our contribution focuses on the methods and practices for facilitation of co-creating activities between different groups leading to cooperation, and innovation in thinking....

  5. Ergonomic design and evaluation of new surgical scissors.

    Science.gov (United States)

    Shimomura, Yoshihiro; Shirakawa, Hironori; Sekine, Masashi; Katsuura, Tetsuo; Igarashi, Tatsuo

    2015-01-01

    The purpose of this study is to design a new surgical scissors handle and determine its effectiveness with various usability indices. A new scissors handle was designed that retains the professional grip but has the shapes of the eye rings modified to fit the thumb and ring finger and finger rests for the index and little finger. The newly designed scissors and traditional scissors were compared by electromyography, subjective evaluation and task performance in experiments using cutting and peeling tasks. The newly designed scissors reduced muscle load in both hand during cutting by the closing action, and reduced the muscle load in the left hand during peeling by the opening action through active use of the right hand. In evaluation by surgeons, task performance improved in addition to the decrease in muscle load. The newly designed scissors used in this study demonstrated high usability. A new scissors handle was designed that has the eye rings modified to fit the thumb and ring finger. The newly designed scissors reduced muscle load and enabled active use of the right hand. In evaluation by surgeons, task performance improved in addition to the decrease in muscle load.

  6. Evaluating research for disruptive innovation in the space sector

    Science.gov (United States)

    Summerer, L.

    2012-12-01

    Many governmental space activities need to be planned with a time horizon that extends beyond the comfort zone of reliable technology development assessments and predictions. In an environment of accelerating technological change, a methodological approach to addressing non-core technology trends and potentially disruptive, game-changing developments not yet linked to the space sector is increasingly important to complement efforts in core technology R&D planning. Various models and organisational setups aimed at fulfilling this purpose are in existence. These include, with varying levels of relevance to space, the National Aeronautics and Space Administration (NASA) Institute for Advanced Concepts (NIAC, operational form 1998 to 2007 and recently re-established), the Defence Advanced Research Projects Agency of the US Department of Defence, the Massachusetts Institute of Technology (MIT) Medialab, the early versions of Starlab, the Lockheed Skunk Works and the European Space Agency's Advanced Concepts Team. Some of these organisations have been reviewed and assessed individually, though systematic comparison of their methods, approaches and results have not been published. This may be due in part to the relatively sparse scientific literature on organisational parameters for enabling disruptive innovation as well as to the lack of commonly agreed indicators for the evaluation of their performance. Furthermore, innovation support systems in the space sector are organised differently than in traditional, open competitive markets, which serve as the basis for most scholarly literature on the organisation of innovation. The present paper is intended to advance and stimulate discussion on the organisation of disruptive innovation mechanisms specifically for the space sector. It uses the examples of the NASA Institute for Advanced Concepts and the ESA Advanced Concepts Team, analyses their respective approaches and compares their results, leading to the proposal of

  7. 4D CT and lung cancer surgical resectability: a technical innovation

    International Nuclear Information System (INIS)

    Troupis, John M.; Pasricha, Sundeep S.; Narayanan, Harish; Rybicki, Frank J.

    2014-01-01

    A 74-year-old man presents with a left upper lobe lung adenocarcinoma, which demonstrated a wide base intimately with the aortic arch. We utilised 4D CT technique with a wide field of view CT unit to preoperatively determine likely surgical resectability. We propose that 4D CT may be of use in further investigating lung cancer with likely invasion of adjacent structures.

  8. Step-based cognitive virtual surgery simulation: an innovative approach to surgical education.

    Science.gov (United States)

    Oliker, Aaron; Napier, Zachary; Deluccia, Nicolette; Qualter, John; Sculli, Frank; Smith, Brandon; Stern, Carrie; Flores, Roberto; Hazen, Alexes; McCarthy, Joseph

    2012-01-01

    BioDigital Systems, LLC in collaboration with New York University Langone Medical Center Department of Reconstructive Plastic Surgery has created a complex, real-time, step-based simulation platform for plastic surgery education. These simulators combine live surgical footage, interactive 3D visualization, text labels, and voiceover as well as a high-yield, expert-approved testing mode to create a comprehensive virtual educational environment for the plastic surgery resident or physician.

  9. Evaluation of adherence to measures for the prevention of surgical site infections by the surgical team

    Directory of Open Access Journals (Sweden)

    Adriana Cristina de Oliveira

    2015-10-01

    Full Text Available AbstractOBJECTIVEEvaluate pre- and intraoperative practices adopted by medical and nursing teams for the prevention of surgical infections.METHODA prospective study carried out in the period of April to May 2013, in a surgical center of a university hospital in Belo Horizonte, Minas Gerais.RESULTS18 surgeries were followed and 214 surgical gloves were analyzed, of which 23 (10.7% had postoperative glove perforation detected, with 52.2% being perceived by users. Hair removal was performed on 27.7% of patients in the operating room, with the use of blades in 80% of the cases. Antibiotic prophylaxis was administered to 81.8% of patients up to 60 minutes prior to surgical incision. An average of nine professionals were present during surgery and the surgery room door remained open in 94.4% of the procedures.CONCLUSIONPartial adhesion to the recommended measures was identified, reaffirming a need for greater attention to these critical steps/actions in order to prevent surgical site infection.

  10. Evidence-Based Evaluation of Practice and Innovation in Physical Therapy Using the IDEAL-Physio Framework.

    Science.gov (United States)

    Beard, David; Hamilton, David; Davies, Loretta; Cook, Jonathan; Hirst, Allison; McCulloch, Peter; Paez, Arsenio

    2018-02-01

    The IDEAL framework is an established method for initial and ongoing evaluations of innovation and practice for complex health care interventions. First derived for surgical sciences and embedded at a global level for evaluating surgery/surgical devices, the IDEAL framework is based on the principle that innovation and evaluation in clinical practice can, and should, evolve together in an ordered manner: from conception to development and then to validation by appropriate clinical studies and, finally, longer-term follow-up. This framework is highly suited to other complex, nonpharmacological interventions, such as physical therapist interventions. This perspective outlines the application of IDEAL to physical therapy in the new IDEAL-Physio framework. The IDEAL-Physio framework comprises 5 stages. In stage 1, the idea phase, formal data collection should begin. Stage 2a is the phase for iterative improvement and adjustment with thorough data recording. Stage 2b involves the onset of formal evaluation using systematically collected group or cohort data. Stage 3 is the phase for formal comparative assessment of treatment, usually involving randomized studies. Stage 4 involves long-term follow-up. The IDEAL-Physio framework is recommended as a method for guiding and evaluating both innovation and practice in physical therapy, with the overall goal of providing better evidence-based care. © 2017 American Physical Therapy Association.

  11. Innovative approach using interprofessional simulation to educate surgical residents in technical and nontechnical skills in high-risk clinical scenarios.

    Science.gov (United States)

    Nicksa, Grace A; Anderson, Cristan; Fidler, Richard; Stewart, Lygia

    2015-03-01

    The Accreditation Council for Graduate Medical Education core competencies stress nontechnical skills that can be difficult to evaluate and teach to surgical residents. During emergencies, surgeons work in interprofessional teams and are required to perform certain procedures. To obtain proficiency in these skills, residents must be trained. To educate surgical residents in leadership, teamwork, effective communication, and infrequently performed emergency surgical procedures with the use of interprofessional simulations. SimMan 3GS was used to simulate high-risk clinical scenarios (15-20 minutes), followed by debriefings with real-time feedback (30 minutes). A modified Oxford Non-Technical Skills scale (score range, 1-4) was used to assess surgical resident performance during the first half of the academic year (July-December 2012) and the second half of the academic year (January-June 2013). Anonymous online surveys were used to solicit participant feedback. Simulations were conducted in the operating room, intensive care unit, emergency department, ward, and simulation center. A total of 43 surgical residents (postgraduate years [PGYs] 1 and 2) participated in interdisciplinary clinical scenarios, with other health care professionals (nursing, anesthesia, critical care, medicine, respiratory therapy, and pharmacy; mean number of nonsurgical participants/session: 4, range 0-9). Thirty seven surgical residents responded to the survey. Simulation of high-risk clinical scenarios: postoperative pulmonary embolus, pneumothorax, myocardial infarction, gastrointestinal bleeding, anaphylaxis with a difficult airway, and pulseless electrical activity arrest. Evaluation of resident skills: communication, leadership, teamwork, problem solving, situation awareness, and confidence in performing emergency procedures (eg, cricothyroidotomy). A total of 31 of 35 (89%) of the residents responding found the sessions useful. Additionally, 28 of 33 (85%) reported improved confidence

  12. Social capital, agricultural innovation and the evaluation of agricultural development initiatives

    NARCIS (Netherlands)

    Rijn, van F.C.

    2014-01-01

    In this thesis, I show that social capital has an important role in the evaluation of development initiatives targeting agricultural innovation. Social capital and agricultural innovation are naturally linked from an innovation system perspective in which innovations result from the integration

  13. Evaluation of an innovative late-life depression training program.

    Science.gov (United States)

    Smith, Marianne; Stolder, Mary Ellen; Liu, Megan Fang

    2014-01-01

    This paper describes evaluation findings associated with an innovative, CD-based, self-directed training program that was designed to improve general practice nurses' abilities to identify and care for older adults with depression. A voluntary sample of nurses completed an evaluation that focused on participants' perceptions of changes in their knowledge and skills and usefulness of the program. Quantitative items received high ratings, and narrative responses to open-ended questions were largely positive. Many opportunities exist for psychiatric nurses to facilitate, support, and extend training principles to promote late-life depression recognition and treatment. © 2013 Wiley Periodicals, Inc.

  14. Introduction into the NHS of magnetic sphincter augmentation: an innovative surgical therapy for reflux - results and challenges.

    Science.gov (United States)

    Prakash, D; Campbell, B; Wajed, S

    2018-04-01

    Introduction Gastro-oesophageal reflux disease (GORD) is a common, chronic debilitating condition. Surgical management traditionally involves fundoplication. Magnetic sphincter augmentation (MSA) is a new definitive treatment. We describe our experience of introducing this innovative therapy into NHS practice and report the early clinical outcomes. Methods MSA was introduced into NHS practice following successful acceptance of a cost-effective business plan and close observation of National Institute for Health and Care Excellence (NICE) recommendations for new procedures, including a carefully planned prospective data collection over a two-year follow-up period. Results Forty-seven patients underwent MSA over the 40-month period. Reflux health-related quality of life (GERD-HRQL) was significantly improved after the procedure and maintained at one- and two-year (P business plan and compliance with NICE recommendations.

  15. Evaluation of the radiation levels in different surgical procedures

    International Nuclear Information System (INIS)

    Silva Santos, M.C.P. da; Almeida, A. de; Belluci, A.D.; Ghilardi Neto, T.

    1989-01-01

    The exposure of a medical team to radiation during surgical procedures evidently depends on the duration and difficulties of the particular procedure. We have made a dosimetric study of the average equivalent doses received by the surgical teams during 10 different surgical procedures over a period of one month. Our results demonstrate that the levels of ionizing radiation that the members of the teams receive typically do not surpass the limits stipulated for the following surgical procedures: nefrolithotomy, percutaneous ureterolithomy, ureteroscoy connected with removal of stones in the inferior third of the ureter, osteosynthesis of the tibial plateau together with a articular toalet and minireconstruction of the knee. For compound surgical procedures, for example, osteosynthesis of a femur fracture together with biopsy of an exposed femur or percutaneous nefrolithotomy (complex cases), the dose limits have been surpassed owing to the additional fluoroscopy needed in those p rocedures. (author) [pt

  16. Methodology evaluation of innovative projects under risk and uncertainty

    Directory of Open Access Journals (Sweden)

    2012-09-01

    Full Text Available This article deals with problems connected with the assessment of innovative projects in the context of risk and uncertainty, topical issues of evaluation of innovative projects at the present stage of development of the Russian economy. By the example of the solution of the "crossing the river" is considering the possibility of using hierarchical models to address it. In what follows, and compares the priorities of different groups of factors are given by calculating the overall costs and benefits. The paper provides a rationale for combined use of four aspects: the beneficial aspects of the decision (the benefits and opportunities and negative (costs and risks that may lead to the decision in question.

  17. Innovators.

    Science.gov (United States)

    NEA Today, 2001

    2001-01-01

    Describes various innovations that have been developed to enhance education. These innovations include: helping educators help at-risk students succeed; promoting high school journalism; ensuring quality online learning experiences; developing a student performing group that uses theater to address social issues; and having students design their…

  18. Innovations in macroscopic evaluation of pancreatic specimens and radiologic correlation

    Directory of Open Access Journals (Sweden)

    Charikleia Triantopoulou

    2016-01-01

    Full Text Available The purpose of this study was to evaluate the feasibility of a novel dissection technique of surgical specimens in different cases of pancreatic tumors and provide a radiologic pathologic correlation. In our hospital, that is a referral center for pancreatic diseases, the macroscopic evaluation of the pancreatectomy specimens is performed by the pathologists using the axial slicing technique (instead of the traditional procedure with longitudinal opening of the main pancreatic and/or common bile duct and slicing along the plane defined by both ducts. The specimen is sliced in an axial plane that is perpendicular to the longitudinal axis of the descending duodenum. The procedure results in a large number of thin slices (3–4 mm. This plane is identical to that of CT or MRI and correlation between pathology and imaging is straightforward. We studied 70 cases of suspected different solid and cystic pancreatic tumors and we correlated the tumor size and location, the structure—consistency (areas of necrosis—hemorrhage—fibrosis—inflammation, the degree of vessels’ infiltration, the size of pancreatic and common bile duct and the distance from resection margins. Missed findings by imaging or pitfalls were recorded and we tried to explain all discrepancies between radiology evaluation and the histopathological findings. Radiologic-pathologic correlation is extremely important, adding crucial information on imaging limitations and enabling quality assessment of surgical specimens. The deep knowledge of different pancreatic tumors’ consistency and way of extension helps to improve radiologists’ diagnostic accuracy and minimize the radiological-surgical mismatching, preventing patients from unnecessary surgery.

  19. Evaluation of surgical treatment in mandibular condyle fractures.

    Science.gov (United States)

    Vesnaver, Aleš; Ahčan, Uroš; Rozman, Janez

    2012-12-01

    In the past, fractures of the mandibular condylar process were, as a rule, treated conservatively. At the Department of Maxillofacial and Oral Surgery of the University Medical Centre Ljubljana, Slovenia, our doctrine was changed in 2002 on the basis of preliminary results and reports in the literature, and these fractures were started to be treated surgically by open reduction and internal fixation with miniplates and screws, which led to good results and a shorter rehabilitation period. The goal of this study was to determine the safety and efficiency of surgical treatment, as well as to compare long-term results of surgical and conservative treatment, as objectively as possible. Two groups of patients, which had all sustained a unilateral, extra-articular mandibular condyle fracture, were compared. In the test group, there were 42 surgically treated patients, and in the control group, 20 conservatively treated patients. Clinical parameters and X-ray images were assessed in both groups and compared by the two tailed Student t test, and in case of attributive variables by the χ(2) test. Within the surgically treated group, postoperative and intraoperative complications were noted: temporary facial nerve palsy, development of a parotid salivary fistula, disturbance of auricle sensibility due to injury of the greater auricular nerve, miniplate fracture, as well as intraoperative bleeding, postoperative haematoma formation, infection, reoperation due to fragment malposition and other complications. Postoperative scars were also assessed. Statistically significant differences between the surgically and conservatively treated patients were found when comparing clinical parameters as well as X-ray images, the results being better in the surgically treated group. Complications of surgical treatment were also noted, the most important among them temporary paresis of facial nerve branches, which occurred in 10 patients (24%). Plate fractures occurred in five patients (12

  20. Innovation

    African Journals Online (AJOL)

    In recent years ULA has emphasized advocacy, and contributed to progress towards new legislation (freedom of information, copyright, the ... East African Community e-government strategy) of importance to the library and ... Innovation Vol.

  1. Health technology assessment. Evaluation of biomedical innovative technologies.

    Science.gov (United States)

    Turchetti, Giuseppe; Spadoni, Enza; Geisler, Eliezer Elie

    2010-01-01

    This article describes health technology assessment (HTA) as an evaluation tool that applies systematic methods of inquiry to the generation and use of health technologies and new products. The focus of this article is on the contributions of HTA to the management of the new product development effort in the biomedical organization. Critical success factors (CSFs) are listed, and their role in assessing success is defined and explained. One of the conclusions of this article is that HTA is a powerful tool for managers in the biomedical sector, allowing them to better manage their innovation effort in their continuing struggle for competitiveness and survival.

  2. EVALUATION CRITERIA OF INNOVATIVE SOCIAL INVESTMENT PROJECTS IN HEALTH CARE

    Directory of Open Access Journals (Sweden)

    Vadim Aleksandrovich Lomazov

    2013-11-01

    Full Text Available Purpose: analysis of key indicators and creation of evaluation criteria of innovative socio-economic investment projects in healthcare, implemented on the basis of public-private partnerships.Methodology: there has been performed comprehensive assessment of specialized socio-economic projects in health sector taking into consideration interests of participants in the project (public and private, main aspects (medical, social, economic, scientific and innovative, and assessment components (presumable effectiveness or risk during implementation of the project. The degree of relative importance of the factors considered in each level, and the levels themselves are determined by experts with the help of paired comparisons method. The values of the project indicators are estimated against nonuniform grading scale, both the results of direct measurements and expert information being used.Results: There has been suggested an approach and a procedure for evaluating projects based on the allocation of interests, issues and evaluation components of the project as sub-criteria levels of the hierarchy analysis method; there has been developed research prototype of information analysis system for assessment of projects on the basis of the proposed approach.DOI: http://dx.doi.org/10.12731/2218-7405-2013-8-48

  3. Big Data and Machine Learning in Plastic Surgery: A New Frontier in Surgical Innovation.

    Science.gov (United States)

    Kanevsky, Jonathan; Corban, Jason; Gaster, Richard; Kanevsky, Ari; Lin, Samuel; Gilardino, Mirko

    2016-05-01

    Medical decision-making is increasingly based on quantifiable data. From the moment patients come into contact with the health care system, their entire medical history is recorded electronically. Whether a patient is in the operating room or on the hospital ward, technological advancement has facilitated the expedient and reliable measurement of clinically relevant health metrics, all in an effort to guide care and ensure the best possible clinical outcomes. However, as the volume and complexity of biomedical data grow, it becomes challenging to effectively process "big data" using conventional techniques. Physicians and scientists must be prepared to look beyond classic methods of data processing to extract clinically relevant information. The purpose of this article is to introduce the modern plastic surgeon to machine learning and computational interpretation of large data sets. What is machine learning? Machine learning, a subfield of artificial intelligence, can address clinically relevant problems in several domains of plastic surgery, including burn surgery; microsurgery; and craniofacial, peripheral nerve, and aesthetic surgery. This article provides a brief introduction to current research and suggests future projects that will allow plastic surgeons to explore this new frontier of surgical science.

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

    Science.gov (United States)

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

    2013-02-01

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

  5. User evaluation of an innovative digital reading room.

    Science.gov (United States)

    Hugine, Akilah; Guerlain, Stephanie; Hedge, Alan

    2012-06-01

    Reading room design can have a major impact on radiologists' health, productivity, and accuracy in reading. Several factors must be taken into account in order to optimize the work environment for radiologists. Further, with the advancement in imaging technology, clinicians now have the ability to view and see digital exams without having to interact with radiologists. However, it is important to design components that encourage and enhance interactions between clinicians and radiologists to increase patient safety, and to combine physician and radiologist expertise. The present study evaluates alternative workstations in a real-world testbed space, using qualitative data (users' perspectives) to measure satisfaction with the lighting, ergonomics, furniture, collaborative spaces, and radiologist workstations. In addition, we consider the impact of the added collaboration components of the future reading room design, by utilizing user evaluation surveys to devise baseline satisfaction data regarding the innovative reading room environment.

  6. Evaluation of 30 patients with gynecomastia surgically treated

    Directory of Open Access Journals (Sweden)

    Nurettin Yiyit

    2013-10-01

    Conclusions; Surgery is the most effective  treatment of gynecomastia. The most suitable surgical tecnique should be selected according to the skin redundancy. The target always must be breast reduction by the tecnique to provide the best symmetry and leave at least scar.

  7. 3D Printed Surgical Instruments Evaluated by a Simulated Crew of a Mars Mission.

    Science.gov (United States)

    Wong, Julielynn Y; Pfahnl, Andreas C

    2016-09-01

    The first space-based fused deposition modeling (FDM) 3D printer became operational in 2014. This study evaluated whether Mars simulation crewmembers of the Hawai'i Space Exploration Analog and Simulation (HI-SEAS) II mission with no prior surgical experience could utilize acrylonitrile butadiene styrene (ABS) thermoplastic surgical instruments FDM 3D printed on Earth to complete simulated surgical tasks. This study sought to examine the feasibility of using 3D printed surgical tools when the primary crew medical officer is incapacitated and the back-up crew medical officer must conduct a surgical procedure during a simulated extended space mission. During a 4 mo duration ground-based analog mission, five simulation crewmembers with no prior surgical experience completed 16 timed sets of simulated prepping, draping, incising, and suturing tasks to evaluate the relative speed of using four ABS thermoplastic instruments printed on Earth compared to conventional instruments. All four simulated surgical tasks were successfully performed using 3D printed instruments by Mars simulation crewmembers with no prior surgical experience. There was no substantial difference in time to completion of simulated tasks with control vs. 3D printed sponge stick, towel clamp, scalpel handle, and toothed forceps. These limited findings support further investigation into the creation of an onboard digital catalog of validated 3D printable surgical instrument design files to support autonomous, crew-administered healthcare on Mars missions. Future work could include addressing sterility, biocompatibility, and having astronaut crew medical officers test a wider range of surgical instruments printed in microgravity during actual surgical procedures. Wong JY, Pfahnl AC. 3D printed surgical instruments evaluated by a simulated crew of a Mars mission. Aerosp Med Hum Perform. 2016; 87(9):806-810.

  8. Innovation

    African Journals Online (AJOL)

    The purpose of Innovation journal of appropriate librarianship and information work in Southern Africa is to publish material on libraries, information supply and other related matters in South and Southern Africa. Vol 45 (2012). DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription or Fee Access ...

  9. Innovation

    DEFF Research Database (Denmark)

    Torfing, Jacob; Ricard, Lykke Margot

    2017-01-01

    Innovation i krydsfeltet mellem forskellige styringsparadigmer i offentlige organisationer. New Public Governance gør det muligt at skabe offentlig værdi på nye måder. Men NPG er ingen trylledrik, der fra den ene dag til den anden skaber balance mellem borgernes store forventninger og en trængt ø...

  10. Innovations in macroscopic evaluation of pancreatic specimens and radiologic correlation

    International Nuclear Information System (INIS)

    Triantopoulou, Charikleia; Papaparaskeva, Kleo; Agalianos, Christos; Dervenis, Christos

    2016-01-01

    •The axial slicing technique offers many advantages in accurate estimation of tumors extend and staging.•Cross-sectional axial imaging is the best technique for accurate radiologic-pathologic correlation.•Correlation may explain any discrepancies between radiological and histopathological findings.•Pathology correlation may offer a better understanding of the missed findings by imaging or pitfalls The axial slicing technique offers many advantages in accurate estimation of tumors extend and staging. Cross-sectional axial imaging is the best technique for accurate radiologic-pathologic correlation. Correlation may explain any discrepancies between radiological and histopathological findings. Pathology correlation may offer a better understanding of the missed findings by imaging or pitfalls The purpose of this study was to evaluate the feasibility of a novel dissection technique of surgical specimens in different cases of pancreatic tumors and provide a radiologic pathologic correlation. In our hospital, that is a referral center for pancreatic diseases, the macroscopic evaluation of the pancreatectomy specimens is performed by the pathologists using the axial slicing technique (instead of the traditional procedure with longitudinal opening of the main pancreatic and/or common bile duct and slicing along the plane defined by both ducts). The specimen is sliced in an axial plane that is perpendicular to the longitudinal axis of the descending duodenum. The procedure results in a large number of thin slices (3–4 mm). This plane is identical to that of CT or MRI and correlation between pathology and imaging is straightforward. We studied 70 cases of suspected different solid and cystic pancreatic tumors and we correlated the tumor size and location, the structure—consistency (areas of necrosis—hemorrhage—fibrosis—inflammation), the degree of vessels’ infiltration, the size of pancreatic and common bile duct and the distance from resection margins

  11. Innovative Design and Performance Evaluation of Bionic Imprinting Toothed Wheel.

    Science.gov (United States)

    Zhang, Zhihong; Wang, Xiaoyang; Tong, Jin; Stephen, Carr

    2018-01-01

    A highly efficient soil-burrowing dung beetle possesses an intricate outer contour curve on its foreleg end-tooth. This study was carried out based on evidence that this special outer contour curve has the potential of reducing soil penetration resistance and could enhance soil-burrowing efficiency. A toothed wheel is a typical agricultural implement for soil imprinting, to increase its working efficiency; the approach of the bionic geometrical structure was utilized to optimize the innovative shape of imprinting toothed wheel. Characteristics in the dung beetle's foreleg end-tooth were extracted and studied by the edge detection technique. Then, this special outer contour curve was modeled by a nine-order polynomial function and used for the innovative design of imprinting the tooth's cutting edge. Both the conventional and bionic teeth were manufactured, and traction tests in a soil bin were conducted. Taking required draft force and volume of imprinted microbasin as the evaluating indexes, operating efficiency and quality of different toothed wheels were compared and investigated. Results indicate that compared with the conventional toothed wheel, a bionic toothed wheel possesses a better forward resistance reduction property against soil and, meanwhile, can enhance the quality of soil imprinting by increasing the volume of the created micro-basin.

  12. METHODOLOGY TO EVALUATE THE INNOVATIVE ACTIVITY OF THE MEAT INDUSTRY

    Directory of Open Access Journals (Sweden)

    D. N. Bakaev

    2014-01-01

    Full Text Available The article considers the methods of estimation of innovative activity of the enterprise. Revealed advantages and disadvantages of the proposed techniques in various publications, devoted to the innovative development. Analysis of the works of domestic and foreign authors showed that the existing methods do not provide an adequate assessment of innovative activity of the enterprise. Asked to enter the integral indicator of innovative activity, which is the criterion of the dynamism of innovative activity of the enterprise, as measured by the speed and volume creation, promotion and use of innovations in economic activity of the enterprise. The proposed system of estimation of innovative activity of the enterprise is based on the following indicators: the ratio of personnel development, the growth rate of financial assets directed on conducting innovative activity of the enterprise, the coefficient for mastering new technologies, the growth rate of intellectual property. The assessment matrix integral indicator of innovative activity of the enterprise reflects the relationship of the indicators of innovative potential and innovative activity and includes a group of indicators, which allows the estimation of innovative activity of enterprises in various spheres of business: technological, organizational, marketing. The main advantages of the developed technique of estimation of level of innovative development of the enterprises of the meat industry is: an assessment of the level in dynamics; complex research of a level of innovation development; the possibility of comparison of actual values with the values of the indicators, assessments United experts. A feature of the proposed method is not only able to measure the level of innovation development in General, but diagnosis of individual factors. This allows you to determine which factors-the Torah must be activated to display the meat industry to a higher level of innovation development.

  13. Evaluating Eco-Innovation of OECD Countries with Data Envelopment Analysis

    Science.gov (United States)

    Mavi, Reza Kiani; Standing, Craig

    2016-01-01

    Government regulations require businesses to improve their processes and products/services in a green and sustainable manner. For being environmentally friendly, businesses should invest more on eco-innovation practices. Firms eco-innovate to promote eco-efficiency and sustainability. This paper evaluates the eco-innovation performance of…

  14. Using Innovative Technologies for Manufacturing and Evaluating Rocket Engine Hardware

    Science.gov (United States)

    Betts, Erin M.; Hardin, Andy

    2011-01-01

    Many of the manufacturing and evaluation techniques that are currently used for rocket engine component production are traditional methods that have been proven through years of experience and historical precedence. As we enter into a new space age where new launch vehicles are being designed and propulsion systems are being improved upon, it is sometimes necessary to adopt new and innovative techniques for manufacturing and evaluating hardware. With a heavy emphasis on cost reduction and improvements in manufacturing time, manufacturing techniques such as Direct Metal Laser Sintering (DMLS) and white light scanning are being adopted and evaluated for their use on J-2X, with hopes of employing both technologies on a wide variety of future projects. DMLS has the potential to significantly reduce the processing time and cost of engine hardware, while achieving desirable material properties by using a layered powdered metal manufacturing process in order to produce complex part geometries. The white light technique is a non-invasive method that can be used to inspect for geometric feature alignment. Both the DMLS manufacturing method and the white light scanning technique have proven to be viable options for manufacturing and evaluating rocket engine hardware, and further development and use of these techniques is recommended.

  15. The surgical manegement of metastases to humerus-clinical evaluation.

    Science.gov (United States)

    Chrobok, Adam; Spindel, Jerzy; Miszczyk, Leszek; Koczy, Bogdan; Pilecki, Bogdan; Jarosz, Adam; Mrozek, Tomasz

    2003-06-30

    Background. The humerus is a common localisation of cancer metastases. The restoration of anatomical order and tumor resection within humerus is important for patients quality of everyday life and for their pain relief. The surgical treatment is one of the most important part of the whole oncological ways of tratment. The study objective was a clinical assesment of tumor resection and reconstruction within humerus according to matastasis localisation and the choice of surgical technique. Material and methods. In the years 1999-2002 19 patients underwent surgery due to pathological fracture or/and cancer metastasis within humerus. The shaft localisation of the tumor was found in 8 cases and in 11 patients the metastatic foci were found in proximnal diaphysis. In patients with proximal diaphysis localisation of the tumor the partial resection with subsequent joint exchange procedure was made. The humeral shaft metastatic cancer changes were treated by the segmental resection with subsequent surgical cement filling or auto/allogenical bone grafting combined with intramedullary nail or AO/ASIF plate stabilisation. The average follow-up period was 8,5 months. Results. In patients after resection with shoulder joint alloplasty according to the Enneking test a very good result was found in 7 and very good in 4 cases. In patients with femoral shaft metastatic tumor locaslisation, 6 good and 2 fair results were found. In 1 patient after 2 months rehabilitation a reoperation was needed due to the mechanical destabilisation. The best results were found in patients after intramedullary nailing.An acute soft tissue inflamation requiering surgical treatment was found in 1 patient after shoulder joint replacement. Conclusions. After clinical analysis of the material we highly recomend the partial humeral bone resection with subsequent shoulder alloplasty in patients with proximal humeral diaphysis metastatic localisation. In cases with shaft localisation a better results were

  16. [Evaluation of several immunologic indices in suppurative surgical infections].

    Science.gov (United States)

    Barashkov, V G; Shemerovskaia, T G; Iusupov, Iu N; Vinogradov, O T

    1984-02-01

    The clinical course of the disease was correlated with the indices characterizing the activity of different components of the immune system in 47 patients with a purulent surgical infection. The investigation has shown the clinical value of immunological tests studied to be not identical. The determination of the concentration of the circulating immune complexes and the migration activity of macrophages is proposed for the prognostic assessment of the course of the disease.

  17. Intraocular robotic interventional surgical system (IRISS): Mechanical design, evaluation, and master-slave manipulation.

    Science.gov (United States)

    Wilson, Jason T; Gerber, Matthew J; Prince, Stephen W; Chen, Cheng-Wei; Schwartz, Steven D; Hubschman, Jean-Pierre; Tsao, Tsu-Chin

    2018-02-01

    Since the advent of robotic-assisted surgery, the value of using robotic systems to assist in surgical procedures has been repeatedly demonstrated. However, existing technologies are unable to perform complete, multi-step procedures from start to finish. Many intraocular surgical steps continue to be manually performed. An intraocular robotic interventional surgical system (IRISS) capable of performing various intraocular surgical procedures was designed, fabricated, and evaluated. Methods were developed to evaluate the performance of the remote centers of motion (RCMs) using a stereo-camera setup and to assess the accuracy and precision of positioning the tool tip using an optical coherence tomography (OCT) system. The IRISS can simultaneously manipulate multiple surgical instruments, change between mounted tools using an onboard tool-change mechanism, and visualize the otherwise invisible RCMs to facilitate alignment of the RCM to the surgical incision. The accuracy of positioning the tool tip was measured to be 0.205±0.003 mm. The IRISS was evaluated by trained surgeons in a remote surgical theatre using post-mortem pig eyes and shown to be effective in completing many key steps in a variety of intraocular surgical procedures as well as being capable of performing an entire cataract extraction from start to finish. The IRISS represents a necessary step towards fully automated intraocular surgery and demonstrated accurate and precise master-slave manipulation for cataract removal and-through visual feedback-retinal vein cannulation. Copyright © 2017 John Wiley & Sons, Ltd.

  18. Innovation

    OpenAIRE

    2012-01-01

    Présenté par FutuRIS, plate-forme prospective sur la recherche, l’innovation et la société animée par l’Association Nationale de la Recherche et de la Technologie, ce volume livre un panorama du système français de recherche et d’innovation dans son environnement européen. Sont abordés dans une première partie les champs décisionnels concernés, les politiques nationales menées en matière de R&D, les relations entre enseignement supérieur et recherche et l’Espace européen de la recherche à l’h...

  19. INNOVATION

    DEFF Research Database (Denmark)

    Helms, Niels Henrik

    2012-01-01

    Kravet om innovation og kreativitet er på flere måder en stor og en ny udfordring for voksenuddannelserne. Det udfordrer det didaktiske dilemma, det at vi skal gøres til kompetente og frie mennesker gennem pædagogiske handlinger, som netop pålægger os en ufrihed. – Men hvor denne ufrihed tidligere...... kunne begrundes med, at skolen eller uddannelsen vidste bedre, så er det ikke længere tilfældet. Skolen skal sørge for, at vi lærer noget – og ikke noget andet. Men det kan ikke længere med bestemthed afgøres, hvad det er vi skal lære i skolen, fordi det nye, det kreative og ikke mindst innovative...

  20. "Two-step" technique with OsiriXTM to evaluate feasibility of C2 pedicle for surgical fixation

    Directory of Open Access Journals (Sweden)

    Luis Miguel Sousa Marques

    2016-01-01

    Full Text Available Background: Surgical treatment of craniovertebral junction pathology has evolved considerably in recent decades with the implementation of short atlanto-axial fixation techniques, notwhithstanding increasing neurovascular risks. Also, there is strong evidence that fixation of C2 anatomical pedicle has the best biomechanical profile of the entire cervical spine. However, it is often difficult and misleading, to evaluate anatomical bony and vascular anomalies using the three orthogonal planes (axial, coronal, and sagittal of CT. Objectives: The authors describe an innovative and simple technique to evaluate the feasibility of C2 pedicle for surgical screw fixation using preoperative planning with the free DICOM (Digital Imaging and Communications in Medicine software OsiriX TM . Materials and Methods: The authors report the applicatin of this novel technique in 5 cases (3 traumatic, 1 Os Odontoideum, and 1 complex congenital malformation collected from our general case series of the Department in the last 5 years. Results: In this "proof of concept" study, the pre-operative analysis with the "two-step" tecnique was detrimental for choosing the surgical tecnique. Detailed post-operative analysis confirmed correct position of C2 screws without cortical breach. There were no complications or mortality reported. Conclusion: This "two-step" technique is an easy and reliable way to determine the feasibility of C2 pedicle for surgical fixation. The detailed tridimensional radiological preoperative evaluation of craniovertebral junction anatomy is critical to the sucess and safety of this surgeries, and can avoid, to certain degree, expensive intra-operative tridimensional imaging facilities.

  1. Surgical team turnover and operative time: An evaluation of operating room efficiency during pulmonary resection.

    Science.gov (United States)

    Azzi, Alain Joe; Shah, Karan; Seely, Andrew; Villeneuve, James Patrick; Sundaresan, Sudhir R; Shamji, Farid M; Maziak, Donna E; Gilbert, Sebastien

    2016-05-01

    Health care resources are costly and should be used judiciously and efficiently. Predicting the duration of surgical procedures is key to optimizing operating room resources. Our objective was to identify factors influencing operative time, particularly surgical team turnover. We performed a single-institution, retrospective review of lobectomy operations. Univariate and multivariate analyses were performed to evaluate the impact of different factors on surgical time (skin-to-skin) and total procedure time. Staff turnover within the nursing component of the surgical team was defined as the number of instances any nurse had to leave the operating room over the total number of nurses involved in the operation. A total of 235 lobectomies were performed by 5 surgeons, most commonly for lung cancer (95%). On multivariate analysis, percent forced expiratory volume in 1 second, surgical approach, and lesion size had a significant effect on surgical time. Nursing turnover was associated with a significant increase in surgical time (53.7 minutes; 95% confidence interval, 6.4-101; P = .026) and total procedure time (83.2 minutes; 95% confidence interval, 30.1-136.2; P = .002). Active management of surgical team turnover may be an opportunity to improve operating room efficiency when the surgical team is engaged in a major pulmonary resection. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  2. A prospective study on an innovative online forum for peer reviewing of surgical science.

    Directory of Open Access Journals (Sweden)

    Martin Almquist

    Full Text Available Peer review is important to the scientific process. However, the present system has been criticised and accused of bias, lack of transparency, failure to detect significant breakthrough and error. At the British Journal of Surgery (BJS, after surveying authors' and reviewers' opinions on peer review, we piloted an open online forum with the aim of improving the peer review process.In December 2014, a web-based survey assessing attitudes towards open online review was sent to reviewers with a BJS account in Scholar One. From April to June 2015, authors were invited to allow their manuscripts to undergo online peer review in addition to the standard peer review process. The quality of each review was evaluated by editors and editorial assistants using a validated instrument based on a Likert scale.The survey was sent to 6635 reviewers. In all, 1454 (21.9% responded. Support for online peer review was strong, with only 10% stating that they would not subject their manuscripts to online peer review. The most prevalent concern was about intellectual property, being highlighted in 118 of 284 comments (41.5%. Out of 265 eligible manuscripts, 110 were included in the online peer review trial. Around 7000 potential reviewers were invited to review each manuscript. In all, 44 of 110 manuscripts (40% received 100 reviews from 59 reviewers, alongside 115 conventional reviews. The quality of the open forum reviews was lower than for conventional reviews (2.13 (± 0.75 versus 2.84 (± 0.71, P<0.001.Open online peer review is feasible in this setting, but it attracts few reviews, of lower quality than conventional peer reviews.

  3. A prospective study on an innovative online forum for peer reviewing of surgical science.

    Science.gov (United States)

    Almquist, Martin; von Allmen, Regula S; Carradice, Dan; Oosterling, Steven J; McFarlane, Kirsty; Wijnhoven, Bas

    2017-01-01

    Peer review is important to the scientific process. However, the present system has been criticised and accused of bias, lack of transparency, failure to detect significant breakthrough and error. At the British Journal of Surgery (BJS), after surveying authors' and reviewers' opinions on peer review, we piloted an open online forum with the aim of improving the peer review process. In December 2014, a web-based survey assessing attitudes towards open online review was sent to reviewers with a BJS account in Scholar One. From April to June 2015, authors were invited to allow their manuscripts to undergo online peer review in addition to the standard peer review process. The quality of each review was evaluated by editors and editorial assistants using a validated instrument based on a Likert scale. The survey was sent to 6635 reviewers. In all, 1454 (21.9%) responded. Support for online peer review was strong, with only 10% stating that they would not subject their manuscripts to online peer review. The most prevalent concern was about intellectual property, being highlighted in 118 of 284 comments (41.5%). Out of 265 eligible manuscripts, 110 were included in the online peer review trial. Around 7000 potential reviewers were invited to review each manuscript. In all, 44 of 110 manuscripts (40%) received 100 reviews from 59 reviewers, alongside 115 conventional reviews. The quality of the open forum reviews was lower than for conventional reviews (2.13 (± 0.75) versus 2.84 (± 0.71), Ponline peer review is feasible in this setting, but it attracts few reviews, of lower quality than conventional peer reviews.

  4. Improved patient specific seizure detection during pre-surgical evaluation.

    LENUS (Irish Health Repository)

    Chua, Eric C-P

    2011-04-01

    There is considerable interest in improved off-line automated seizure detection methods that will decrease the workload of EEG monitoring units. Subject-specific approaches have been demonstrated to perform better than subject-independent ones. However, for pre-surgical diagnostics, the traditional method of obtaining a priori data to train subject-specific classifiers is not practical. We present an alternative method that works by adapting the threshold of a subject-independent to a specific subject based on feedback from the user.

  5. Evaluation of post-surgical relapse after mandibular setback surgery with minimal orthodontic preparation.

    Science.gov (United States)

    Lee, Nam-Ki; Kim, Young-Kyun; Yun, Pil-Young; Kim, Jong-Wan

    2013-01-01

    The aim of this study was to evaluate of the patterns of post-surgical relapse after mandibular setback surgery with minimal orthodontic preparation (MS-MO). The subjects consisted of 15 patients with minimal pre-surgical orthodontic preparation (1.37 ± 1.69 months). Lateral cephalograms were taken in pre-surgical (T0), post-surgical 1 month (T1) and immediately after debonding (T2) stages. To evaluate the surgical changes (T1-T0) and the relapse (T2-T1), the linear and angular measurements were analyzed using paired t-test. Pearson's correlation coefficients of the horizontal and vertical relapses of Pog and Me to other measurements were calculated. Pog or Me in T1 were displaced rotationally on Ar-Pog or Ar-Me lines in T2 to evaluate the remaining surgical relapse except the rotational relapse from total relapse. The mandible relapsed anteriorly 3.53 mm (Pog) and 4.00 mm (Me) and superiorly 2.72 mm (Pog) and 2.44 mm (Me). FH to Ar-Pog and FH to Ar-Me decreased by about 2°. Pure surgical relapses at Pog and Me, except rotational relapses, were about 0.5 mm anteriorly and inferiorly 0.8 mm. The vertical relapse might induce mandibular rotation with the horizontal relapse. For an accurate prediction after MS-MO, the rotational relapse might be considered. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  6. [Evaluation of the results of surgical treatment of granuloma teleangiectodes].

    Science.gov (United States)

    Bogdanowski, T; Rubisz-Brzezińska, J; Macura-Gina, M; Misiewicz, D

    1990-01-01

    In the clinic of dermatological surgery, I Department of Dermatology Silesian Medical Academy in Katowice 328 patients were treated surgically for granuloma teleangiectodes in the years 1973-1988. Two methods were used: excision of the lesion and curettage with electrocoagulation of the base of the lesion. After excision the wound was closed by approximation of its margins or local plastic procedure (285 cases) and by covering it with a free full-thickness skin graft (3 cases). Curettage and electrocoagulation was used in 43 cases, mainly due to the location of the lesion (in 90% on fingers). After granuloma excision no recurrences were observed, while after curettage and electrocoagulation recurrences developed in 20% of cases.

  7. Cognitive learning during surgical residency. A model for curriculum evaluation.

    Science.gov (United States)

    Rhodes, R S; Wile, M Z; Persons, M L; Shuck, J M

    1987-02-01

    The program summary of the American Board of Surgery In-Service Training Exam (ABSITE) can be used to quantitate cognitive learning during a surgical residency and to identify areas of curricular weakness in a residency program. Knowledge on each question is categorized as high (known) or low (unknown) depending on the percentage of residents who answered correctly. Knowledge of Level 1 (entry) residents is then compared with Level 5 (exit) residents. Each ABSITE question can thus be categorized on entry versus exit as known-known, unknown-unknown, unknown-known, and known-unknown. Only about half of unknown knowledge on entry appears to become known on exit. Very little knowledge known on entry becomes unknown on exit. Weaknesses in specific subject areas can be readily identified by ranking questions according to the number of exiting residents who answer incorrectly. Use of this technique to quantitate cognitive learning in a residency program may allow objective assessment of changes in curriculum.

  8. Luxury and innovation: Towards an evaluative framework | Riley ...

    African Journals Online (AJOL)

    ... luxury to argue that it is has been, and continues to be, a driver of innovation in the tourism and hospitality industries. In examining the relationship between creativity and innovation, the paper identifies four paradoxes which, it argues, are embedded in the decision-making processes that create new objects and services.

  9. SURVIVAL OF CONTINUOUS AMBULATORY PERITONEAL DIALYSIS CATHETERS: AN EVALUATION OF SURGICAL AND NON-SURGICAL FACTORS (SINGLE CENTER STUDY

    Directory of Open Access Journals (Sweden)

    A. Keshvari

    2006-06-01

    Full Text Available Peritoneal dialysis is an established form of renal replacement therapy used in many patients with end-stage renal disease. The key to a successful chronic peritoneal dialysis is a permanent and safe access to the peritoneal cavity. This study was conducted in order to evaluate the catheter survival and its related factors in Imam Khomeini Hospital. A total of 80 catheters were inserted into 69 patients (52 men and 28 women with end-stage chronic renal failure during a period of 84 months. Retrospectively the correlation between catheter survival (overall and event free with demographic factors (sex and age, surgical factors (surgeons and surgical methods, nephrologic factors (the causes of peritoneal dialysis selection and the history of hemodialysis and peritonitis factors (the history and number of peritonitis has been evaluated. The mean age of the patients was 48.35 years (16 to 79 years. The overall survival of catheters or the probability of having a functioning catheter after one, two and three years was 53%, 41%, 22%, respectively. The event free survival of the catheter or the probability of having a functioning catheter without any problems after one year was 14%. It has been found out that among all factors in this study only history of hemodialysis had statistically significant effect on the overall survival of continuous ambulatory peritoneal dialysis catheter (P = 0.04. It seems that the overall survival of catheters is better when CAPD is started before any other attempts for hemodialysis.

  10. Evaluation of the effect of cognitive therapy on perioperative anxiety and depression among Nigerian surgical patients.

    Science.gov (United States)

    Osinowo, H O; Olley, B O; Adejumo, A O

    2003-12-01

    Surgical paients have been known to benefit immensely from psychological interventions. This study set out to assess the pre and postoperative anxiety levels and depression and the effect of cognitive therapy among Nigerian surgical patients. The effects of gender and educational status on perioperative anxiety and depression were also evaluated. The study utilized a controlled outcome design to evaluate the efficacy of self-instructional training (SIT) and rational emotive therapy (RET) in surgical patients. Preoperative anxiety and depression scores were used as co-variants. Thirty-three (33) elective surgical patients were sampled randomly, divided into 3 groups of eleven (11) patients each. Eight (8) subjects underwent gynaecological procedures while the remaining 25 subjects had general surgical procedures. The mean age was 32.72 +/- 15.83 years (range = 17-16 years.) The major instruments used in the study were the State Anxiety Subscale of the Speilberger State Trait Anxiety Inventory (STAI) and Hospital Anxiety and Depression Inventory. SIT had the potential to reduce anxiety level among subjects postoperatively (t = 2.06; df = 10; p < 0.05). The use of RET reduced depression among surgical patients (t = 1.23; df = 10; p < 0.05). It was concluded that surgical patients manifest varying degrees of anxiety preoperatively and postoperatively. Patient's pre and postoperative anxiety and depression can be reduced by the introduction of SIT and RET.

  11. IMPROVED METHODS FOR EVALUATING THE EFFECTIVENESS OF INNOVATION DEVELOPMENT IN RUSSIAN CORPORATIONS

    Directory of Open Access Journals (Sweden)

    E. L. Dorzhieva

    2016-01-01

    Full Text Available Objectives. Innovative activity is a key factor in the effective development and growth of competitiveness in the Russian economy. An important role in this process is played by industrial corporations. Against this background, there is an increased need for improving the effectiveness of methods for evaluating the innovation development of Russian corporations. Methods. Formal logic as well as system analysis methods were used in the research, allowing us to consider the corporation as a system that includes a variety of innovational directions (elements. Results. The article discusses various approaches to the determination of the basic definitions of innovation; a classification of innovation is proposed. The attributes of innovative activity of industrial corporations are distinguished together with an outline of the possible causes of various innovative corporate activities; components of the system of indicators of innovation activity are isolated: financial; consumer; process; development and training; risk management. The need for the indices of the innovation activity of the risk component to be included in the composition of the system is substantiated. It is shown how the objectives for each area of innovation may be achieved in tandem with a methodological approach that allows continuous monitoring of the implementation of innovative development strategies. An algorithm for evaluating the implementation of innovative strategies contributing to the development of industrial corporations is presented. Conclusion. Theoretical and methodological development can be used not only to navigate the variety of innovations but also to determine and establish the relationship and interdependence between the various innovations as well as carry out analysis, assessment and forecasting for the effective development of innovative activity of Russian corporations. 

  12. An evaluation of Irish general surgical research publications from 2000 to 2009.

    LENUS (Irish Health Repository)

    Robertson, I J

    2010-12-01

    Maintaining a high standard of research, and being competitive in the funding application process requires a coordinated and focused research strategy. The first step in the formulation of such a strategy is the identification of those centres, and specifically those areas of study, in which Irish surgical research has previously performed strongly. The aim of this paper was to evaluate all surgical research produced in the Republic of Ireland in the first ten years of the new millennium.

  13. Novel surgical performance evaluation approximates Standardized Incidence Ratio with high accuracy at simple means.

    Science.gov (United States)

    Gabbay, Itay E; Gabbay, Uri

    2013-01-01

    Excess adverse events may be attributable to poor surgical performance but also to case-mix, which is controlled through the Standardized Incidence Ratio (SIR). SIR calculations can be complicated, resource consuming, and unfeasible in some settings. This article suggests a novel method for SIR approximation. In order to evaluate a potential SIR surrogate measure we predefined acceptance criteria. We developed a new measure - Approximate Risk Index (ARI). "Number Needed for Event" (NNE) is the theoretical number of patients needed "to produce" one adverse event. ARI is defined as the quotient of the group of patients needed for no observed events Ge by total patients treated Ga. Our evaluation compared 2500 surgical units and over 3 million heterogeneous risk surgical patients that were induced through a computerized simulation. Surgical unit's data were computed for SIR and ARI to evaluate compliance with the predefined criteria. Approximation was evaluated by correlation analysis and performance prediction capability by Receiver Operating Characteristics (ROC) analysis. ARI strongly correlates with SIR (r(2) = 0.87, p 0.9) 87% sensitivity and 91% specificity. ARI provides good approximation of SIR and excellent prediction capability. ARI is simple and cost-effective as it requires thorough risk evaluation of only the adverse events patients. ARI can provide a crucial screening and performance evaluation quality control tool. The ARI method may suit other clinical and epidemiological settings where relatively small fraction of the entire population is affected. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  14. Public participation in the evaluation of innovative environmental cleanup technology

    International Nuclear Information System (INIS)

    Peterson, T.; McCabe, G.; Serie, P.; Niesen, K.

    1994-08-01

    Technologies for remediation of contamination are urgently needed to clean up US Department of Energy (DOE) sites across the country. DOE is managing a national program to develop, demonstrate, and deploy new technologies with promise to expedite this cleanup. The Integrated Demonstration for Cleanup of Volatile Organic Compounds at Arid Sites (VOC-Arid ID) is one such effort. Time and resources, however, are too limited to be invested in methods of remediation that will never be deployed because they have not been rigorously evaluated or because they face the withering opposition of stakeholders. Therefore the VOC-Arid ID is assessing technology both in terms of its technical effectiveness and its stakeholder acceptability. Only if a technology performs as required and is acceptable to regulators, users of technology, and the public will the VOC-Arid ID recommend its use. What distinguishes public involvement in the VOC-Arid ID is the direct influence stakeholders have on the design of technology demonstrations by working directly with technology developers. Stakeholders participated in defining the criteria with which innovative environmental cleanup technology is being evaluated. The integrated demonstration is committed to providing stakeholders with the information they've indicated they need to reach reasoned judgments about the use of specific cleanup technologies. A guiding principle of the VOC-Arid ID is that stakeholder participation improves the technologies being developed, enhances the acceptance of the technologies, and will lead to the broad and timely deployment of appropriate and effective methods of environmental remediation. The VOC-Arid ID has involved stakeholders from the host demonstration site, Hanford, Washington, and from other and sites where the ID technologies may be deployed

  15. Total football in innovation policy. Discussion paper on the evaluation of innovation policy; Totaalvoetbal in het innovatiebeleid. Discussiedocument evaluatie innovatiebeleid

    Energy Technology Data Exchange (ETDEWEB)

    Schoots, K.; Daniels, B.W.; Rivera Tinoco, R.A. [ECN Beleidsstudies, Petten (Netherlands)

    2010-10-15

    By distinguishing phases within a technology development trajectory, this report describes the factors for a well functioning innovation system and an evaluation framework for the effectiveness of innovation policy. The focus lies with energy technologies. The followed methodology connects mechanisms for creating the factors and boundary conditions for a sound innovation climate with the types of policy instruments that are required to reduce the uncertainties and barriers for actors in the different technology development phases. [Dutch] Dit rapport schetst aan de hand van de fasen binnen een technologieontwikkelingtraject en de factoren voor een goed functionerend innovatiesysteem een beoordelingskader voor de effectiviteit van innovatiebeleid, met een focus op energietechnieken. De gevolgde methodiek verbindt de mechanismen voor het creeren van de bouwstenen en randvoorwaarden voor een goed innovatieklimaat met de typen instrumenten die nodig zijn om de onzekerheden en barrieres voor de actoren in de verschillende technologieontwikkelingsfasen te verlagen.

  16. IN SITU STEAM ENHANCED RECOVERY PROCESS - HUGHES ENVIRONMENTAL SYSTEMS, INC. - INNOVATIVE TECHNOLOGY EVALUATION REPORT

    Science.gov (United States)

    This Innovative Technology Evaluation report summarizes the findings of an evaluation of the in situ Steam Enhanced Recovery Process (SERP) operated by Hughes Environmental Systems, Inc. at the Rainbow Disposal facility in Huntington Beach, California. he technology demonstration...

  17. SANDIA NATIONAL LABORATORIES IN SITU ELECTROKINETIC EXTRACTION TECHNOLOGY; INNOVATIVE TECHNOLOGY EVALUATION REPORT

    Science.gov (United States)

    As a part of the Superfund Innovative Technology Evaluation (SITE) Program, the U.S. Environmental Protection Agency evaluated the In-Situ Electrokinetic Extraction (ISEE) system at Sandia National Laboratories, Albuquerque, New Mexico.The SITE demonstration results show ...

  18. Innovation

    African Journals Online (AJOL)

    Natal, South Africa are presented in this article. Of particular interest is how the combination of adult and early literacy activities has encouraged reading in families. The evaluative process involved individual qualitative interviews, material review ...

  19. CRITERIA FOR EVALUATING INNOVATION ACTIVITY AND CHALLENGES IN DEFINING IT

    Directory of Open Access Journals (Sweden)

    A. T. Volkov

    2017-01-01

    Full Text Available The article presents polemically the peculiarities of using the indicators of innovation activity for evaluating the state and outcomes of the organization’s operation, including Higher Learning Institutions in the areas of development and learning new types of techniques and technology. There is considered a possible structure of a system of balanced innovation activity indicators. There is substantiated a necessity to change statistical reporting on the innovation activity.

  20. EVALUATION OF TWO SURGICAL TREATMENTS OF PRIMARY VESICOURETERAL REFLUX AMONG CHILDREN: A 15 YEARS EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Memeti Shaban

    2016-07-01

    Full Text Available Aim: aim of the study was to evaluate the efficiency of two different surgical treatments of vesicoureteral reflux (VUR on succesfull rate and patient outcome. Methods: Retrospective study on children with primary VUR and their surgical treatment from 1999 to 2014 in the University Clinic for Pediatric Surgery in Skopje. A total of 76 children (114 ureters with VUR ranging from second to fifth grade were treated surgically, 44 patients (67 ureters with an open surgical technique and 32 patients (47 ureters with endoscopic treatment ”STING” procedure. The following parameters were analyzed: duration of the intervention, duration of the hospitalization, the need for antibiotics and analgesic therapy and the need for blood and blood derivatives transfusion. The result of the surgical treatment was also validated. A good result was considered when reduction of VUR by 2 degrees with the endoscopic method or by 3 degrees in the open surgical technique was noticed. Results: Using open surgical technique, patients were hospitalized for an average of 9 days (range from 5 to 13 days. All children received double antibiotic therapy. The need for analgesics lasted for 3 to 4 days. 90% of treated children needed blood and/or blood derivatives transfusion. Success rate with this method was 93.8%. Endoscopic procedure was performed as a one-day surgical procedure. The average duration was 15 minutes. Single, prophylactic dose of antibiotic was ordinated. There was no need for blood and/or blood derivatives transfusion. The overall success of the treatment was about 70%. Conclusion: Open surgical procedure is used for more complicated cases, VUR grade IV-V or by previously failed. Endoscopic, “STING” procedure was commonly used for patients with VUR grade greater than 2, after previously failed conservative treatment, febrile urinary infection despite antibiotic prophylaxis and/or emergence of new scarring in the renal parenchyma. Patient assessment and

  1. Evaluation of surgical resident staff knowledge of cancer pain ...

    African Journals Online (AJOL)

    Objective: Inadequate knowledge and expertise are major contributing factors to poor pain management in the cancer patient. This study was carried out to evaluate the effect of formal teaching on pain management on the current practice of the resident surgeons at the University College Hospital (UCH). Ibadan. Method: ...

  2. The Evaluation of Innovation in the IT Service Sector: Methodological and Empirical Aspects

    Directory of Open Access Journals (Sweden)

    Eglė Kazlauskienė

    2013-08-01

    Full Text Available Purpose — Nowadays services are comprehended as the key factor for economic activity, growth and employment. Developed economies are service-dominated though little is known about the innovation details in the service sector and this study field has been neglected for a while. The innovation in service sector activities needs to be thoroughly evaluated because innovation is an interconnected process and cannot be defined using one or few indicators. IT services are an integral part of contemporary life, particularly for business. It can be introduced and implemented in all fields, especially when the world is becoming more multidimensional. Innovation performance in the IT sector has been under-researched, despite the fact that IT service sector plays the innovation disseminator role in other sectors by appliance of IT products. Design/methodology/approach — Based on scientific literature and methodological aspects analyses, an empirical research methodology was designed and the qualitative research on innovation in information technology service sector was accomplished. Findings — The article presents methodological aspects of innovation evaluation in service sector and empirical aspects on innovation implementation and development in the IT service companies in Lithuania. Research limitations/implications — For more comprehensive understanding of innovation in service sector, especially in IT services, the theory of service innovation is necessary. Deeper understanding and perspectives on how innovation benefits the information technology sector should be revealed in further researches and the multi-country analysis is needed. Practical implications — The finding of the paper can be used to improve the development of innovation in information technology service companies and create a model for more exhaustive multi-country empirical researches. Originality/value — The impact of innovation and its development in information

  3. Carbon capture and sequestration (CCS) technological innovation system in China: Structure, function evaluation and policy implication

    International Nuclear Information System (INIS)

    Lai Xianjin; Ye Zhonghua; Xu Zhengzhong; Husar Holmes, Maja; Henry Lambright, W.

    2012-01-01

    Carbon capture and sequestration (CCS) can be an important technology option for China in addressing global climate change and developing clean energy technologies. Promoted by international climate conventions and supported by government research and development programs, an increasing number of CCS pilot and demonstration projects have been launched in China. In this study, we analyze the structure of China’s CCS effort from a technological innovation system (TIS) perspective. Within this system, key socio-political components, including institutions, actor-networks, and technology development, are examined to evaluate the state of the innovation system. The study assessed the perceived capacity of seven functional areas of the CCS innovation system through a survey of key CCS actors and stakeholders. The findings suggest that China’s CCS innovation system has a strong functional capacity for knowledge and technology development. It is significantly weaker in the innovative functions of knowledge diffusion, market formation, facilitating entrepreneurs and new entrants into the CCS market. Based on the evaluation of China’s technological innovation system to develop CCS, the article articulates specific public policies to formulate a more robust innovation system to traverse the “valley of death” from research and development to commercial deployment and accelerate energy innovation in China. - Highlights: ► We analyze and evaluate China’s CCS innovation system from TIS perspective. ► Strong and systematic CCS innovation system structure has come into being in China. ► The system has acquired high knowledge development and accumulation. ► Weak innovation functions are identified: market creation, guidance, etc. ► Public policies are needed to improve the innovation system performance.

  4. Innovation management and performance evaluation: structured process of literature review

    Directory of Open Access Journals (Sweden)

    Julieta Scheidt Dienstmann

    2014-03-01

    Full Text Available This article aims to provide a process for the construction of knowledge demanded by researchers at the initial stage of their work on innovation management. To meet this need, the process adopted was the ProKnow-C (Knowledge Development Process - Constructivist, which proposes the construction of researchers knowledge considering their perceptions on the subject, and the recognition of scientific articles analyzed. The knowledge generated in the researcher means, for this article, knowing what are the main journals, articles, authors and keywords associated with 15 articles with scientific recognition and aligned with the perception of the researcher on innovation management, with focus on results. Through this application, the process ProKnow-C is presented demonstrating how it can be used by researchers to meet their initial demands of building knowledge about innovation management and aims to instill future works  based on structured processes for selecting a theoretical framework in this field of knowledge.

  5. R-IDEAL : A Framework for Systematic Clinical Evaluation of Technical Innovations in Radiation Oncology

    NARCIS (Netherlands)

    Verkooijen, Helena M; Kerkmeijer, LGW; Fuller, Clifton D; Huddart, Robbert; Faivre-Finn, Corinne; Verheij, Marcel; Mook, Stella; Sahgal, Arjun; Hall, Emma; Schultz, Chris

    2017-01-01

    The pace of innovation in radiation oncology is high and the window of opportunity for evaluation narrow. Financial incentives, industry pressure, and patients' demand for high-tech treatments have led to widespread implementation of innovations before, or even without, robust evidence of improved

  6. Wind Technology: A Framework for the Evaluation of Innovations¿ Impacts on the Diffusion Potential

    NARCIS (Netherlands)

    Dinica, V.

    2010-01-01

    This paper proposes a framework based on which innovations in wind power technologies can be evaluated from the standpoint of their contribution to diffusion expansion. The framework helps build up a missing link between the technical literature on innovations and policy-oriented contributions

  7. Evaluation of field trials of innovative practices in science education

    OpenAIRE

    Gerloff-Gasser, C; Büchel, K

    2012-01-01

    Science and technology (S&T) education is vital to increase the science literacy in modern societies and to stimulate more young people to opt for careers in S&T. Because there are considerable differences in S&T education among and sometimes within countries, it is promising to adopt an adaptive strategy to its innovation that allows a fit to the specific conditions of each of the countries. In this report, we present first results of field trials with innovative practices in S&T educatio...

  8. Impact of measurement and evaluation on innovation level

    DEFF Research Database (Denmark)

    Jakobsen, Henning Sejer; Gertsen, Frank; Goduscheit, René Chester

    This article explores the situation in which an innovation project fails to achieve its full potential because the goal is lowered during the process. When the gap between measured/perceived progress and goals/aspirations of an innovation project becomes too large, the goals will be lowered...... and opportunities will be lost. The hypothetical explanation suggested here, is that the progress is often perceived to be linear whereas the actual progress is often exponential and that this makes the gap between actual achievement and expected progress much larger. The hypothesis is explored by means of a single...

  9. Perioperative Evaluation of Pregnant Surgical Patients: A Review

    Directory of Open Access Journals (Sweden)

    Manu Gupta

    2016-06-01

    Full Text Available Pregnant Females require special perioperative consideration as females react differently to treatment from physiologic and behavioural standpoints. Thus a standard perioperative assessment plays a crucial role for successful accomplishment of intraoperative and postoperative phase as well as to resist complications due to pregnancy. Each physiologic system is affected in such a way that may or may not have clinical significance for the surgeons. Thus affect of Pregnancy on cardiovascular, respiratory, gastrointestinal, renal and endocrinal system have been reviewed. Moreover to decrease the hazards to the developing child, impact of surgery/treatment on the fetus has also been discussed. It was concluded that the goal of the perioperative evaluation of pregnant females is to identify its physiological effects on various systems and provide for the best efficacious perioperative treatment algorithm that shall minimize the patient morbidity.

  10. MR evaluation of postmenopausal ovarian size. Comparison with surgical specimen

    International Nuclear Information System (INIS)

    Joja, Ikuo; Ishida, Kana; Matsushita, Toshi; Mimura, Seiichi; Yamaguchi, Takuya; Akagi, Noriaki; Miyagi, Yasunari; Hara, Takeshi; Kanazawa, Susumu

    2008-01-01

    We investigated ovarian size after menopause using magnetic resonance (MR) imaging and gross specimens obtained from patients with uterine cancer after menopause in whom normal ovaries were confirmed at the time of surgery. The relationships between size of ovarian long axis and age, the number of years since menopause, and age at menopause were statistically evaluated for 130 ovaries observed in short-axis T 2 -weighted MR images of the uterine corpus and in 147 ovarian gross specimens. No significant relationships were found between size of ovarian long axis and these 3 factors. When the sizes of the ovaries in MR images were compared with those in gross specimens, the latter were larger, with a statistically significant difference. Similarly, when the sizes of the ovaries observed or not observed in MR images were compared in gross specimens, the former were larger, with a statistically significant difference. These results indicate that the size of the ovarian long axis observed in MR images does not accurately reflect the true size of the long axis, but ovarian size strongly affects visualization of the ovaries in MR images after menopause. In addition, these results indicate that there are no significant relationships between ovarian size after menopause and age, the number of years since menopause, or age at menopause. (author)

  11. HIGH VOLTAGE ENVIRONMENTAL APPLICATIONS, INC.ELECTRON BEAM TECHNOLOGY - INNOVATIVE TECHNOLOGY EVALUATION REPORT

    Science.gov (United States)

    This report evaluates a high-voltage electron beam (E-beam) technology's ability to destroy volatile organic compounds (VOCs) and other contaminants present in liquid wastes. Specifically, this report discusses performance and economic data from a Superfund Innovative Technology...

  12. Innovative Startup-Projects: Experience, Evaluation, Implementation Contradictions

    Directory of Open Access Journals (Sweden)

    Inshakov Maksim Olegovich

    2015-09-01

    Full Text Available Innovative companies in the conditions of global post-crisis economic recovery and increased economic activity become again a promising area for investments of large investment and venture capital funds, venture divisions of large transnational corporations, business angels and other private investors. This is confirmed by the data on the increase in the volume of venture capital market in the US and Europe and on a significant increase in the cost of the leading foreign and Russian start-up companies which are rated as of 2014 in the present article. The comparative analysis of the leading Russian and foreign start-ups showed the prevalence of companies engaged in the field of IT-Internet-Mobile and focused on the provision of various kinds of innovative services to consumers among the foreign participants of the rating. Among Russian startups-winners the companies of technological orientation (biological, medical, and “clean” technologies dominate. They reflect the increasing importance of start-ups in the innovative development of the Russian economy. Participation in such competitions and ratings is a favorable factor of promoting start-ups, increasing awareness of potential investors and consumers of start-up products. The importance of start-ups formation and the development of effective regional and national innovation systems update the studies related to the identification of the fundamental contradictions in the activities of Russian start-ups and to the development of recommendations for their resolution. The article identifies the key issues of economic, organizational, informational and marketing character causing the collapse of start-up projects in the Russian economy in modern conditions.

  13. Imaging in the Evaluation of Endoscopic or Surgical Treatment for Achalasia

    OpenAIRE

    Diego Palladino; Andrea Mardighian; Marilina D’Amora; Luca Roberto; Francesco Lassandro; Claudia Rossi; Gianluca Gatta; Mariano Scaglione; Guglielmi Giuseppe

    2016-01-01

    Purpose. Aim of the study is to evaluate the efficacy of the endoscopic (pneumatic dilation) versus surgical (Heller myotomy) treatment in patients affected by esophageal achalasia using barium X-ray examination of the digestive tract performed before and after the treatment. Materials and Methods. 19 patients (10 males and 9 females) were enrolled in this study; each patient underwent a barium X-ray examination to evaluate the esophageal diameter and the height of the barium column before a...

  14. Surgeon-tool force/torque signatures--evaluation of surgical skills in minimally invasive surgery.

    Science.gov (United States)

    Rosen, J; MacFarlane, M; Richards, C; Hannaford, B; Sinanan, M

    1999-01-01

    The best method of training for laparoscopic surgical skills is controversial. Some advocate observation in the operating room, while others promote animal and simulated models or a combination of surgical related tasks. The mode of proficiency evaluation common to all of these methods has been subjective evaluation by a skilled surgeon. In order to define an objective means of evaluating performance, an instrumented laparoscopic grasper was developed measuring the force/torque at the surgeon hand/tool interface. The measured database demonstrated substantial differences between experienced and novice surgeon groups. Analyzing forces and torques combined with the state transition during surgical procedures allows an objective measurement of skill in MIS. Teaching the novice surgeon to limit excessive loads and improve movement efficiency during surgical procedures can potentially result in less injury to soft tissues and less wasted time during laparoscopic surgery. Moreover the force/torque database measured in this study may be used for developing realistic virtual reality simulators and optimization of medical robots performance.

  15. EVALUATION OF THE IMPACT OF INNOVATIVE PROJECTS ON THE COMPETITIVENESS OF AGRICULTURAL HOLDINGS IN SLOVAK REPUBLIC

    Directory of Open Access Journals (Sweden)

    Ľubica RUMANOVSKÁ

    2013-01-01

    Full Text Available The scientific paper evaluates the impact of innovative projects on the competitiveness of agricultural holdings in SR. Evaluation of the impact of innovative projects on competitiveness of agricultural holdings was realized on the selected holdings in Nitra and Trnava region. For the evaluation was used RCR coefficient. With the use of RCR coefficient could be confirmed the scientific hypothesis - The innovative projects realized through Program for rural development SR 2007-2013 have positive impact on competitiveness of agricultural holdings. The possibilities for EU financial support for innovative projects in SR represent important source for introduction of new innovative technologies into production process and in future they can significantly contribute to the growth of competitiveness of agricultural subjects. Therefore, to increase competitiveness of agricultural holdings it is important to focus on modernization of machinery and buildings, use of natural sources for energy production, but also to increase the education and the flow of information between rural inhabitants, mainly farmers. In competitive area of EU agricultural sector it is necessary that agricultural holdings will innovate, not only to create independent flow of innovative products and knowledge, but also to increase its value on internal market. Agricultural holdings –receivers of financial support – have expressed the opinion that financial support realized through PRD SR 2007-2013 had definitely allowed them to implement new processes and products.

  16. William Watson Cheyne (1852-1932): a life in medicine and his innovative surgical treatment of congenital hydrocephalus.

    Science.gov (United States)

    Watson, Caroline C; Griessenauer, Christoph J; Loukas, Marios; Blount, Jeffrey P; Tubbs, R Shane

    2013-11-01

    William Watson Cheyne lived and trained during a period of great advances in medical knowledge and surgical techniques. Despite his various contributions to the fields of bacteriology and surgery, little is known about his career or his life apart from his affiliations with Joseph Lister. This article aims to identify Cheyne as a pioneer in the treatment of congenital hydrocephalus and sheds light on the man who existed in Lister's shadow for most of his life. Cheyne's technique for surgical intervention of hydrocephalus was a great turning point and contributes to the current treatment strategy utilized today for hydrocephalus.

  17. [What and how to evaluate clinical-surgical competence. The resident and staff surgeon perspective].

    Science.gov (United States)

    Cervantes-Sánchez, Carlos Roberto; Chávez-Vizcarra, Paola; Barragán-Ávila, María Cristina; Parra-Acosta, Haydee; Herrera-Mendoza, Renzo Eduardo

    2016-01-01

    Evaluation is a means for significant and rigorous improvement of the educational process. Therefore, competence evaluation should allow assessing the complex activity of medical care, as well as improving the training process. This is the case in the evaluation process of clinical-surgical competences. A cross-sectional study was designed to measure knowledge about the evaluation of clinical-surgical competences for the General Surgery residency program at the Faculty of Medicine, Universidad Autónoma de Chihuahua (UACH). A 55-item questionnaire divided into six sections was used (perception, planning, practice, function, instruments and strategies, and overall evaluation), with a six level Likert scale, performing a descriptive, correlation and comparative analysis, with a significance level of 0.001. In both groups perception of evaluation was considered as a further qualification. As regards tools, the best known was the written examination. As regards function, evaluation was considered as a further administrative requirement. In the correlation analysis, evaluation was perceived as qualification and was significantly associated with measurement, assessment and accreditation. In the comparative analysis between residents and staff surgeons, a significant difference was found as regards the perception of the evaluation as a measurement of knowledge (Student t test: p=0.04). The results provide information about the concept we have about the evaluation of clinical-surgical competences, considering it as a measure of learning achievement for a socially required certification. There is confusion as regards the perception of evaluation, its function, goals and scopes as benefit for those evaluated. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  18. An Evaluation of Preparedness, Delivery and Impact of Surgical and Anesthesia Care in Madagascar: A Framework for a National Surgical Plan.

    Science.gov (United States)

    Bruno, Emily; White, Michelle C; Baxter, Linden S; Ravelojaona, Vaonandianina Agnès; Rakotoarison, Hasiniaina Narindria; Andriamanjato, Hery Harimanitra; Close, Kristin L; Herbert, Alison; Raykar, Nakul; Saluja, Saurabh; Shrime, Mark G

    2017-05-01

    The Lancet Commission on Global Surgery (LCoGS) described the lack of access to safe, affordable, timely surgical, and anesthesia care. It proposed a series of 6 indicators to measure surgery, accompanied by time-bound targets and a template for national surgical planning. To date, no sub-Saharan African country has completed and published a nationwide evaluation of its surgical system within this framework. Mercy Ships, in partnership with Harvard Medical School and the Madagascar Ministry of Health, collected data on the 6 indicators from 22 referral hospitals in 16 out of 22 regions of Madagascar. Data collection was by semi-structured interviews with ministerial, medical, laboratory, pharmacy, and administrative representatives in each region. Microsimulation modeling was used to calculate values for financial indicators. In Madagascar, 29% of the population can access a surgical facility within 2 h. Surgical workforce density is 0.78 providers per 100,000 and annual surgical volume is 135-191 procedures per 100,000 with a perioperative mortality rate of 2.5-3.3%. Patients requiring surgery have a 77.4-86.3 and 78.8-95.1% risk of incurring impoverishing and catastrophic expenditure, respectively. Of the six LCoGS indicator targets, Madagascar meets one, the reporting of perioperative mortality rate. Compared to the LCoGS targets, Madagascar has deficits in surgical access, workforce, volume, and the ability to offer financial risk protection to surgical patients. Its perioperative mortality rate, however, appears better than in comparable countries. The government is committed to improvement, and key stakeholder meetings to create a national surgical plan have begun.

  19. Evaluation of surgical staging prior to combined modality therapy for esophageal cancer

    International Nuclear Information System (INIS)

    Suntharalingam, M.; Vines, E.; Echo, D. van; Greenwald, B.; Krasna, M.

    1996-01-01

    OBJECTIVE: Historically, patients with esophageal cancer have had a poor outcome despite aggressive treatment approaches. Recently chemo/RT followed by surgical resection has shown a significant improvement in survival in this patient population. The success of this aggressive approach has been predicated on accurate definition of disease extent and appropriate patient selection. We have performed pre-treatment surgical staging (thoracoscopy and laparoscopy) on 38 pts. referred for management of their localized esophageal cancer. The purpose of this report is to compare the results of clinical (CT, MRI, EGD, EUS) vs. surgical staging. The data gathered prospectively will also be used to identify potential predictors for disease-free survival. METHODS: Thirty-eight pts. were treated with combined modality therapy prior to a planned surgical resection. Patients received 50.4 Gy in 1.8 Gy fractions in conjunction with 5 FU (1 Gm/m2) and Cisplatin (100 mg/m2) on days 1 and 28. Patients were evaluated 4 to 6 wks. after completion of therapy for consideration of Ivor-Lewis esophagectomy. Of the original 38 pts., 4 are awaiting surgery, 3 died prior to resection, 2 pts. progressed through chemo/RT, and 1 refused. To date, 28 pts. are available for analysis with a median follow up of 21.5 months. This group included 16 pts. with squamous cell and 12 with adenocarcinoma. RESULTS: Twenty-five of the 28 pts. taken to surgery have undergone pre treatment surgical staging (2 refused, 1 medically unfit). Evaluation of tumor status revealed noninvasive staging to be accurate 56% of the time. Five pts. were converted from T 2 to T 3 , 1 from T 3 to T 4 and 3 T 4 tumors were found to be T 3 . Using the surgical findings at time of staging, 6 pts. were found to have T 2 tumors, 16 had T 3 tumors, and 3 had T 4 tumors. Clinical lymph node status was confirmed in 15 patients (60%). Six went from N+ to N 0 and 4 pts. thought to be N 0 were N+. Eight patients had evidence of positive

  20. Dig into Learning: A Program Evaluation of an Agricultural Literacy Innovation

    Science.gov (United States)

    Edwards, Erica Brown

    2016-01-01

    This study is a mixed-methods program evaluation of an agricultural literacy innovation in a local school district in rural eastern North Carolina. This evaluation describes the use of a theory-based framework, the Concerns-Based Adoption Model (CBAM), in accordance with Stufflebeam's Context, Input, Process, Product (CIPP) model by evaluating the…

  1. Use of Performance Measures to Evaluate, Document Competence and Deterioration of Advanced Surgical Skills Exposure for Trauma (ASSET) Surgical Skills

    Science.gov (United States)

    2015-03-01

    Sharon Henry1, Stacy Shackelford4. 1Shock Trauma Anesthesiology Research, University of Maryland Baltimore; 2The Alfred Hospital and Swinburne...Bethesda USA, The Alfred Hospital and Swinburne University, Melbourne, Australia • 6) THE ASSETS OF ASSET: IMPROVING SURGICAL PERFROMANCE...ACTIVITY 820 CHANDLER STREET FORT DETRICK MD 21702-5014 January 15, 2015 SUBJECT: BA 150077- "Refreshing Combat Surgical Skills for Vascular Control

  2. Evaluation of obstetricians' surgical decision making in the management of uterine rupture.

    Science.gov (United States)

    Eze, Justus Ndulue; Anozie, Okechukwu Bonaventure; Lawani, Osaheni Lucky; Ndukwe, Emmanuel Okechukwu; Agwu, Uzoma Maryrose; Obuna, Johnson Akuma

    2017-06-08

    Uterine rupture is an obstetric calamity with surgery as its management mainstay. Uterine repair without tubal ligation leaves a uterus that is more prone to repeat rupture while uterine repair with bilateral tubal ligation (BTL) or (sub)total hysterectomy predispose survivors to psychosocial problems like marital disharmony. This study aims to evaluate obstetricians' perspectives on surgical decision making in managing uterine rupture. A questionnaire-based cross-sectional study of obstetricians at the 46th annual scientific conference of Society of Gynaecology and Obstetrics of Nigeria in 2012. Data was analysed by descriptive and inferential statistics. Seventy-nine out of 110 obstetricians (71.8%) responded to the survey, of which 42 (53.2%) were consultants, 60 (75.9%) practised in government hospitals and 67 (84.8%) in urban hospitals, and all respondents managed women with uterine rupture. Previous cesarean scars and injudicious use of oxytocic are the commonest predisposing causes, and uterine rupture carries very high incidences of maternal and perinatal mortality and morbidity. Uterine repair only was commonly performed by 38 (48.1%) and uterine repair with BTL or (sub) total hysterectomy by 41 (51.9%) respondents. Surgical management is guided mainly by patients' conditions and obstetricians' surgical skills. Obstetricians' distribution in Nigeria leaves rural settings starved of specialist for obstetric emergencies. Caesarean scars are now a rising cause of ruptures. The surgical management of uterine rupture and obstetricians' surgical preferences vary and are case scenario-dependent. Equitable redistribution of obstetricians and deployment of medical doctors to secondary hospitals in rural settings will make obstetric care more readily available and may reduce the prevalence and improve the outcome of uterine rupture. Obstetrician's surgical decision-making should be guided by the prevailing case scenario and the ultimate aim should be to avert

  3. WHO Safety Surgical Checklist implementation evaluation in public hospitals in the Brazilian Federal District

    Directory of Open Access Journals (Sweden)

    Heiko T. Santana

    2016-09-01

    Full Text Available Summary: The World Health Organization (WHO created the WHO Surgical Safety Checklist to prevent adverse events in operating rooms. The aim of this study was to analyze WHO checklist implementation in three operating rooms of public hospitals in the Brazilian Federal District. A prospective cross-sectional study was performed with pre- (Period I and post (Period II-checklist intervention evaluations. A total of 1141 patients and 1052 patients were studied in Periods I and II for a total of 2193 patients. Period I took place from December 2012 to March 2013, and Period II took place from April 2013 to August 2014. Regarding the pre-operatory items, most surgeries were classified as clean-contaminated in both phases, and team attire improved from 19.2% to 71.0% in Period II. Regarding checklist adherence in Period II, “Patient identification” significantly improved in the stage “Before induction of anesthesia”. “Allergy verification”, “Airway obstruction verification”, and “Risk of blood loss assessment” had low adherence in all three hospitals. The items in the stage “Before surgical incision” showed greater than 90.0% adherence with the exception of “Anticipated critical events: Anesthesia team review” (86.7% and “Essential imaging display” (80.0%. Low adherence was noted in “Instrument counts” and “Equipment problems” in the stage “Before patient leaves operating room”. Complications and deaths were low in both periods. Despite the variability in checklist item compliance in the surveyed hospitals, WHO checklist implementation as an intervention tool showed good adherence to the majority of the items on the list. Nevertheless, motivation to use the instrument by the surgical team with the intent of improving surgical patient safety continues to be crucial. Keywords: Surgical checklist, Adverse events, Patient safety, Surgical team, Infection control

  4. Evaluation of the US Department of Energy Weatherization Innovation Pilot Program (2010-2014)

    Energy Technology Data Exchange (ETDEWEB)

    Tonn, Bruce Edward [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Rose, Erin M. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hawkins, Beth A. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2017-05-01

    This report contains results from analysis conducted on each of the Weatherization Innovation Pilot Program (WIPP) grants awarded to 16 organizations by the US Department of Energy (DOE) in 2010. The purpose of WIPP was to explore the potential adoptability or replicability of innovative processes or technologies for the enhancement of DOE’s Weatherization Assistance Program (WAP). DOE initiated the WIPP grant to accelerate effective innovations in home energy efficiency and other WAP mission-related goals for income-qualifying households of low socioeconomic status. This study was performed alongside a broader, national evaluation of WAP conducted by Oak Ridge National Laboratory (ORNL) for DOE.

  5. Evaluating Robotic Surgical Skills Performance Under Distractive Environment Using Objective and Subjective Measures.

    Science.gov (United States)

    Suh, Irene H; LaGrange, Chad A; Oleynikov, Dmitry; Siu, Ka-Chun

    2016-02-01

    Distractions are recognized as a significant factor affecting performance in safety critical domains. Although operating rooms are generally full of distractions, the effect of distractions on robot-assisted surgical (RAS) performance is unclear. Our aim was to investigate the effect of distractions on RAS performance using both objective and subjective measures. Fifteen participants performed a knot-tying task using the da Vinci Surgical System and were exposed to 3 distractions: (1) passive distraction entailed listening to noise with a constant heart rate, (2) active distraction included listening to noise and acknowledging a change of random heart rate from 60 to 120 bpm, and (3) interactive distraction consisted of answering math questions. The objective kinematics of the surgical instrument tips were used to evaluate performance. Electromyography (EMG) of the forearm and hand muscles of the participants were collected. The median EMG frequency (EMG(fmed)) and the EMG envelope (EMG(env)) were analyzed. NASA Task Load Index and Fundamentals of Laparoscopic Surgery score were used to evaluate the subjective performance. One-way repeated analysis of variance was applied to examine the effects of distraction on skills performance. Spearman's correlations were conducted to compare objective and subjective measures. Significant distraction effect was found for all objective kinematics measures (P < .05). There were significant distraction effects for EMG measures (EMG(env), P < .004; EMG(fmed), P = .031). Significant distraction effects were also found for subjective measurements. Distraction impairs surgical skills performance and increases muscle work. Understanding how the surgeons cope with distractions is important in developing surgical education. © The Author(s) 2015.

  6. Evaluation of primary and secondary stability of titanium implants using different surgical techniques.

    Science.gov (United States)

    Tabassum, Afsheen; Meijer, Gert J; Walboomers, X Frank; Jansen, John A

    2014-04-01

    To investigate the influence of different surgical techniques on the primary and secondary implant stability using trabecular bone of goats as an implantation model. In the iliac crest of eight goats, 48 cylindrical-screw-type implants with a diameter of 4.2 mm (Dyna(®) ; Bergen op Zoom, the Netherlands) were installed, using three different surgical techniques: (i) 5% undersized, using a final drill diameter of 4 mm; (ii) 15% undersized, using a final drill diameter of 3.6 mm; and (iii) 25% undersized, using a final drill diameter of 3.2 mm. Peak insertion torque values were measured by a Digital(®) (MARK-10 Corporation, New York, NY, USA) torque gauge instrument during placement. At 3 weeks after implantation, removal torque was measured. Histomorphometrically, the peri-implant bone volume was measured in three zones; the inner zone (0-500 μm), the middle zone (500-1000 μm) and the outer zone (1000-1500 μm). Evaluation of the obtained data demonstrated no statistically significant difference between different surgical techniques regarding removal torque values. With respect to the percentage peri-implant bone volume (%BV), also no significant difference could be observed between all three applied surgical techniques for both the inner, middle and outer zone. However, irrespective of the surgical technique, it was noticed that the %BV was significantly higher for the inner zone as compared to middle and outer zone (P < 0.05) around the implant. At 3 weeks after implant installation, independent of the used undersized surgical technique, the %BV in the inner zone (0-500 μm) peri-implant area was improved due to both condensation of the surrounding bone as also the translocation of host bone particles along the implant surface. Surprisingly, no mechanical beneficial effect of the 25% undersized surgical technique could be observed as compared to the 5% or 15% undersized surgical technique to improve primary or secondary implant stability. © 2013

  7. Innovation in urban agriculture: Evaluation data of a participatory approach (ROIR).

    Science.gov (United States)

    Zoll, Felix; Specht, Kathrin; Siebert, Rosemarie

    2016-06-01

    The data in this article represent an evaluation of a participatory process called Regional Open Innovation Roadmapping (ROIR). The approach aims at the promotion of regional development. In this case, it was carried out to develop a specific innovation in the field of 'Zero-acreage farming' (ZFarming), which is a building-related subtype of urban agriculture. For the evaluation of the process, an online survey was sent to the 58 participants of the ROIR on March 4, 2014. The survey ended on April 8, 2014, and a response rate of 53.54% resulted in a sample size of 31 respondents. The survey was divided into seven different blocks. We analyzed the ROIR process׳s contribution to knowledge generation, the establishment of networks among the participants, the implementation of new projects related to ZFarming, and the increase of acceptance of ZFarming and the selected ZFarming innovation. Furthermore, other remarks, and personal information were collected. Hence, the objective of the survey was to assess whether ROIR is a useful tool to promote the aforementioned innovation drivers, and thereby, the selected innovation, which was developed throughout the process. The data were used in the research article "Application and evaluation of a participatory "open innovation" approach (ROIR): the case of introducing zero-acreage farming in Berlin" (Specht et al., 2016) [1].

  8. Postoperative evaluation of surgical procedures in congenital heart disease with MR imaging

    International Nuclear Information System (INIS)

    Seelos, K.C.; Kersting-Sommerhoff, B.; Higgins, C.B.

    1989-01-01

    This paper reports on a study in which electrocardiographically gated spin-echo MR imaging was used to evaluate 23 patients with congenital heart disease who had undergone Waterston (n = 3), Potts (n = 2), Senning (n = 3), Fontan (n = 3), Rastelli (n = 4), Damus (n = 1) and Jatene (n = 7) procedures. Surgical shunts, conduits, or baffles were identified correctly in all patients. Patency, atresia and hypoplasia of central pulmonary arteries (PAs) as well as postoperative complications (focal stenosis of PAs, thrombosed pseudoaneurysm, intramural abscess) were diagnosed. MR findings were corroborated with angiography, echocardiography, and surgery. Narrowing of the right ventricular outflow tract and focal compression of the proximal PAs were recognized as specific complications of the Jatene procedure. MR imaging appears to be effective for the postoperative evaluation of surgical procedures used for congenital heart disease

  9. Pathologic evaluation of the cervical spine following surgical and chiropractic interventions.

    Science.gov (United States)

    Matshes, Evan W; Joseph, Jeffrey

    2012-01-01

    When patients die after chiropractic or surgical interventions of the cervical spine, pathologists tasked with the autopsy are frequently overwhelmed by the complicated anatomy, laborious dissections, complex operative procedures and surgical hardware, and the necessity to differentiate artifacts from trauma and disease. However, abundant data can be obtained from careful evaluation of the cervical spine in situ; extensive postmortem diagnostic imaging procedures; detailed dissections of the removed, formalin-fixed and decalcified spine; and histology. This study presents a regimented, stepwise approach to the evaluation of the cervical spine in these difficult cases, promotes uniform assessment, facilitates diagnoses, and supports the accumulation of otherwise hard-to-come-by reference material that can be of value in future cases. The resultant detailed autopsy findings may prove useful in the medico-legal death investigation process. Autopsy findings may also be of great value to health care providers involved in quality assurance processes. © 2011 American Academy of Forensic Sciences.

  10. Accuracy Evaluation of a Stereolithographic Surgical Template for Dental Implant Insertion Using 3D Superimposition Protocol

    Directory of Open Access Journals (Sweden)

    Corina Marilena Cristache

    2017-01-01

    Full Text Available The aim of this study was to evaluate the accuracy of a stereolithographic template, with sleeve structure incorporated into the design, for computer-guided dental implant insertion in partially edentulous patients. Materials and Methods. Sixty-five implants were placed in twenty-five consecutive patients with a stereolithographic surgical template. After surgery, digital impression was taken and 3D inaccuracy of implants position at entry point, apex, and angle deviation was measured using an inspection tool software. Mann–Whitney U test was used to compare accuracy between maxillary and mandibular surgical guides. A p value < .05 was considered significant. Results. Mean (and standard deviation of 3D error at the entry point was 0.798 mm (±0.52, at the implant apex it was 1.17 mm (±0.63, and mean angular deviation was 2.34 (±0.85. A statistically significant reduced 3D error was observed at entry point p=.037, at implant apex p=.008, and also in angular deviation p=.030 in mandible when comparing to maxilla. Conclusions. The surgical template used has proved high accuracy for implant insertion. Within the limitations of the present study, the protocol for comparing a digital file (treatment plan with postinsertion digital impression may be considered a useful procedure for assessing surgical template accuracy, avoiding radiation exposure, during postoperative CBCT scanning.

  11. Evaluation of management and surgical outcomes in pregnancies complicated by acute cholecystitis.

    Science.gov (United States)

    El-Messidi, Amira; Alsarraj, Ghazi; Czuzoj-Shulman, Nicholas; Mishkin, Daniel S; Abenhaim, Haim Arie

    2018-01-25

    To evaluate the management of pregnancies complicated by acute cholecystitis (AC) and determine whether pregnant women are more likely to have medical and surgical complications. We carried out a population-based matched cohort study using the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample from 2003 to 2011. Pregnant women with AC were age matched to non-pregnant women with AC on a 1:5 ratio. Management and outcomes were compared using descriptive analysis and conditional logistic regression. There were 11,835 pregnant women admitted with AC who were age matched to 59,175 non-pregnant women. As compared to non-pregnant women, women with AC were more commonly managed conservatively, odds ratio (OR) 6.1 (5.8-6.4). As compared to non-pregnant women, pregnant women with AC more commonly developed sepsis [OR 1.4 (1.0-1.9)], developed venous thromboembolism [OR 8.7 (4.3-17.8)] and had bowel obstruction [OR 1.3 (1.1-1.6)]. Among pregnant women with AC, surgical management was associated with a small but significant increased risk of septic shock and bile leak. AC, in the context of pregnancy, is associated with an increased risk of adverse outcomes. Although the literature favors early surgical intervention, pregnancies with AC appear to be more commonly managed conservatively with overall comparable outcomes to surgically managed AC. Conservative management may have a role in select pregnant women with AC.

  12. A framework for the monitoring and evaluation of international surgical initiatives in low- and middle-income countries.

    Science.gov (United States)

    Ibrahim, George M; Cadotte, David W; Bernstein, Mark

    2015-01-01

    An estimated two billion people worldwide lack adequate access to surgical care. To address this humanitarian emergency, an increasing number of international surgical partnerships are emerging between developed and low- and middle-income countries (LMICs). At present, there are no clear indicators that may be used to assess the effectiveness of such initiatives. We conducted an international qualitative study of 31 surgeons from developed and LMICs involved in international partnerships across a variety of subspecialties. Thematic analysis and grounded theory were applied in order to develop a practical framework that may be applied to monitor and evaluate global surgical initiatives. Several themes emerged from the study: (i) there is a large unmet need to establish and maintain prospective databases in LMICs to inform the monitoring and evaluation of international surgical partnerships; (ii) assessment of initiatives must occur longitudinally over the span of several years; (ii) the domains of assessment are contextual and encompass cultural, institutional and regional factors; and (iv) evaluation strategies should explore broader impact within the community and country. Based on thematic analysis within the domains of inputs, outputs and outcomes, a framework for the monitoring and evaluation of international surgical initiatives, the Framework for the Assessment of InteRNational Surgical Success (FAIRNeSS) is proposed. In response to the increasing number of surgical partnerships between developed and LMICs, we propose a framework to monitor and evaluate international surgical initiatives.

  13. COMPOST-FREE BIOREACTOR TREATMENT OF ACID ROCK DRAINAGE LEVIATHAN MINE, CALIFORNIA INNOVATIVE TECHNOLOGY EVALUATION REPORT

    Science.gov (United States)

    As part of the Superfund Innovative Technology Evaluation (SITE) program, an evaluation of the compost-free bioreactor treatment of acid rock drainage (ARD) from the Aspen Seep was conducted at the Leviathan Mine Superfund site located in a remote, high altitude area of Alpine Co...

  14. Opportunities to Personalize Teacher Learning: Innovative Approaches to Bridge Evaluation and Professional Development for Continuous Improvement

    Science.gov (United States)

    Kassner, Laura

    2014-01-01

    The purpose of this report was to consider ways to integrating teacher evaluation and professional development--specifically, to explore innovative ways to harness feedback from teacher evaluations for the creation of personalized professional learning for teachers. This study was commissioned by the planning council members of the Metropolitan…

  15. Facilitating Evaluations of Innovative, Competence-Based Assessments: Creating Understanding and Involving Multiple Stakeholders

    Science.gov (United States)

    Gulikers, Judith T. M.; Baartman, Liesbeth K. J.; Biemans, Harm J. A.

    2010-01-01

    Schools are held more responsible for evaluating, quality assuring and improving their student assessments. Teachers' lack of understanding of new, competence-based assessments as well as the lack of key stakeholders' involvement, hamper effective and efficient self-evaluations by teachers of innovative, competence-based assessments (CBAs). While…

  16. The use of an essay examination in evaluating medical students during the surgical clerkship.

    Science.gov (United States)

    Smart, Blair J; Rinewalt, Daniel; Daly, Shaun C; Janssen, Imke; Luu, Minh B; Myers, Jonathan A

    2016-01-01

    Third-year medical students are graded according to subjective performance evaluations and standardized tests written by the National Board of Medical Examiners (NBME). Many "poor" standardized test takers believe the heavily weighted NBME does not evaluate their true fund of knowledge and would prefer a more open-ended forum to display their individualized learning experiences. Our study examined the use of an essay examination as part of the surgical clerkship evaluation. We retrospectively examined the final surgical clerkship grades of 781 consecutive medical students enrolled in a large urban academic medical center from 2005 to 2011. We examined final grades with and without the inclusion of the essay examination for all students using a paired t test and then sought any relationship between the essay and NBME using Pearson correlations. Final average with and without the essay examination was 72.2% vs 71.3% (P essay examination increasing average scores by .4, 1.8, and 2.5 for those receiving high pass, pass, and fail, respectively. The essay decreased the average score for those earning an honors by .4. Essay scores were found to overall positively correlate with the NBME (r = .32, P essay examination as part of the third-year surgical core clerkship final did increase the final grade a modest degree, especially for those with lower scores who may identify themselves as "poor" standardized test takers. A more open-ended forum may allow these students an opportunity to overcome this deficiency and reveal their true fund of surgical knowledge. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Post-Occupancy Evaluation of a Mental Healthcare Facility Based on Staff Perceptions of Design Innovations.

    Science.gov (United States)

    Kalantari, Saleh; Snell, Robin

    2017-07-01

    This study was a post-occupancy evaluation (POE) to examine the effectiveness of three specific design innovations in a mental healthcare facility. In addition to collecting data about the impact of these specific designs, the study provides a model for the broader implementation of POE approaches in the mental healthcare context. POEs in general healthcare settings have been shown to lead to better work environments and better outcomes for patients. Despite growing evidence of the value provided by POE studies, the industry has been somewhat slow to adopt their regular use, in part due to unfamiliarity with the POE process. This is particularly true in mental healthcare contexts, where POE studies remain virtually nonexistent. In-depth interviews and a widely distributed, anonymous survey were used to collect hospital staff perceptions and feedback regarding the impact of specific design features. The hospital staff were quite enthusiastic about two of the design innovations studied here (a new wayfinding strategy and the use of vibrant colors in specific areas of the facility). The third innovation, open-style communication centers, elicited more mixed evaluations. The results include extensive hypothesis testing about the effects of each innovation as well as narrative discussions of their pros and cons. The study generated new knowledge about three specific mental healthcare design innovations and provides a model for the practical implementation of a POE approach in mental healthcare contexts. The results are particularly relevant for designers who are considering innovative strategies in future mental healthcare facilities.

  18. Innovation and invention in Finland. Strategies for networking. An international evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Zegveld, W.; McCarthy, S.; Lemola, T.

    1998-12-31

    The objective of the evaluation was to come up with recommendations on how the Finnish systems for promoting independent inventions and their commercialisation could be most appropriately developed. In practice, the evaluation was expected to address at least the following aspects of the promotion: The role of the public sector; The role of the private sector (inventors, financiers, companies); The evaluation of the Finnish Foundation for Inventions (FFI); The strengths and weaknesses of the present system for promoting inventions and their commercialisation. In effect, the evaluation proved to be the evaluation of a subsystem integrated within the overall Finnish National System of Innovation with its many players from the public and private sectors. An effort was made to evaluate the relationship between the different actors in this system and closer cooperation is recommended in many areas. Interviews were held with 130 individuals from 70 organisations. The evaluators address the following nine issues: (1) Improving the balance between r and d and the promotion of inventiveness/innovation; (2) Increased coherence between the different organisations; (3) The responsibility of inventors and research organisations in inventive activities and the role of support organisations; (4) A gradual shift towards private services; (5) The development of the role of FFI; (6) Improving the competence in the area of intellectual property rights; (7) Financial incentives for inventors; (8) Increasing the awareness on invention and innovation; (9) The requirement to broaden the concept of inventiveness and innovation. (orig.)

  19. Innovation and invention in Finland. Strategies for networking. An international evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Zegveld, W; McCarthy, S; Lemola, T

    1999-12-31

    The objective of the evaluation was to come up with recommendations on how the Finnish systems for promoting independent inventions and their commercialisation could be most appropriately developed. In practice, the evaluation was expected to address at least the following aspects of the promotion: The role of the public sector; The role of the private sector (inventors, financiers, companies); The evaluation of the Finnish Foundation for Inventions (FFI); The strengths and weaknesses of the present system for promoting inventions and their commercialisation. In effect, the evaluation proved to be the evaluation of a subsystem integrated within the overall Finnish National System of Innovation with its many players from the public and private sectors. An effort was made to evaluate the relationship between the different actors in this system and closer cooperation is recommended in many areas. Interviews were held with 130 individuals from 70 organisations. The evaluators address the following nine issues: (1) Improving the balance between r and d and the promotion of inventiveness/innovation; (2) Increased coherence between the different organisations; (3) The responsibility of inventors and research organisations in inventive activities and the role of support organisations; (4) A gradual shift towards private services; (5) The development of the role of FFI; (6) Improving the competence in the area of intellectual property rights; (7) Financial incentives for inventors; (8) Increasing the awareness on invention and innovation; (9) The requirement to broaden the concept of inventiveness and innovation. (orig.)

  20. Imaging in the Evaluation of Endoscopic or Surgical Treatment for Achalasia

    Directory of Open Access Journals (Sweden)

    Diego Palladino

    2016-01-01

    Full Text Available Purpose. Aim of the study is to evaluate the efficacy of the endoscopic (pneumatic dilation versus surgical (Heller myotomy treatment in patients affected by esophageal achalasia using barium X-ray examination of the digestive tract performed before and after the treatment. Materials and Methods. 19 patients (10 males and 9 females were enrolled in this study; each patient underwent a barium X-ray examination to evaluate the esophageal diameter and the height of the barium column before and after endoscopic or surgical treatment. Results. The mean variation of oesophageal diameter before and after treatment is −2.1 mm for surgery and 1.74 mm for pneumatic dilation (OR 0.167, CI 95% 0.02–1.419, and P: 0.10. The variations of all variables, with the exception of the oesophageal diameter variation, are strongly related to the treatment performed. Conclusions. The barium X-ray study of the digestive tract, performed before and after different treatment approaches, demonstrates that the surgical treatment has to be considered as the treatment of choice of achalasia, reserving endoscopic treatment to patients with high operative risk and refusing surgery.

  1. Evaluation of the International Consensus Guidelines for the Surgical Resection of Intraductal Papillary Mucinous Neoplasms.

    Science.gov (United States)

    Tsukagoshi, Mariko; Araki, Kenichiro; Saito, Fumiyoshi; Kubo, Norio; Watanabe, Akira; Igarashi, Takamichi; Ishii, Norihiro; Yamanaka, Takahiro; Shirabe, Ken; Kuwano, Hiroyuki

    2018-04-01

    International consensus guidelines for intraductal papillary mucinous neoplasms (IPMNs) were revised in 2012. We aimed to evaluate the clinical utility of each predictor in the 2006 and 2012 guidelines and validate the diagnostic value and surgical indications. Forty-two patients with surgically resected IPMNs were included. Each predictor was applied to evaluate its diagnostic value. The 2012 guidelines had greater accuracy for invasive carcinoma than the 2006 guidelines (64.3 vs. 31.0%). Moreover, the accuracy for high-grade dysplasia was also increased (48.6 vs. 77.1%). When the main pancreatic duct (MPD) size ≥8 mm was substituted for MPD size ≥10 mm in the 2012 guidelines, the accuracy for high-grade dysplasia was 80.0%. The 2012 guidelines exhibited increased diagnostic accuracy for invasive IPMN. It is important to consider surgical resection prior to invasive carcinoma, and high-risk stigmata might be a useful diagnostic criterion. Furthermore, MPD size ≥8 mm may be predictive of high-grade dysplasia.

  2. Cooperation networks and innovation: A complex system perspective to the analysis and evaluation of a EU regional innovation policy programme

    OpenAIRE

    Russo, Margherita; Rossi, Federica

    2008-01-01

    Recent developments in innovation theory and policy have led policymakers to assign particular importance to supporting networks of cooperation among heterogeneous economic actors, especially in production systems composed of small and medium enterprises. Such innovative policies call for parallel innovations in policy analysis, monitoring and assessment. Our analysis of a policy experiment aimed at supporting innovation networks in the Italian region of Tuscany intends to address some issues...

  3. Surgical resident technical skill self-evaluation: increased precision with training progression.

    Science.gov (United States)

    Quick, Jacob A; Kudav, Vishal; Doty, Jennifer; Crane, Megan; Bukoski, Alex D; Bennett, Bethany J; Barnes, Stephen L

    2017-10-01

    Surgical resident ability to accurately evaluate one's own skill level is an important part of educational growth. We aimed to determine if differences exist between self and observer technical skill evaluation of surgical residents performing a single procedure. We prospectively enrolled 14 categorical general surgery residents (six post-graduate year [PGY] 1-2, three PGY 3, and five PGY 4-5). Over a 6-month period, following each laparoscopic cholecystectomy, residents and seven faculty each completed the Objective Structured Assessment of Technical Skills (OSATS). Spearman's coefficient was calculated for three groups: senior (PGY 4-5), PGY3, and junior (PGY 1-2). Rho (ρ) values greater than 0.8 were considered well correlated. Of the 125 paired assessments (resident-faculty each evaluating the same case), 58 were completed for senior residents, 54 for PGY3 residents, and 13 for junior residents. Using the mean from all OSATS categories, trainee self-evaluations correlated well to faculty (senior ρ 0.97, PGY3 ρ 0.9, junior ρ 0.9). When specific OSATS categories were analyzed, junior residents exhibited poor correlation in categories of respect for tissue (ρ -0.5), instrument handling (ρ 0.71), operative flow (ρ 0.41), use of assistants (ρ 0.05), procedural knowledge (ρ 0.32), and overall comfort with the procedure (ρ 0.73). PGY3 residents lacked correlation in two OSATS categories, operative flow (ρ 0.7) and procedural knowledge (ρ 0.2). Senior resident self-evaluations exhibited strong correlations to observers in all areas. Surgical residents improve technical skill self-awareness with progressive training. Less-experienced trainees have a tendency to over-or-underestimate technical skill. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Skull base meningioma. Surgical and adjuvant treatment with clinical and PET evaluation

    International Nuclear Information System (INIS)

    Gudjonsson, O.

    2001-01-01

    The treatment strategy for skull base meningiomas remains a controversial issue. Because of the proximity of these tumours to critical neurovascular structures, the risk for vascular damage and new cranial neuropathies postoperatively is significant. To avoid unacceptable neurological deficits the surgical treatment strategy includes different surgical approaches and a subtotal removal of these tumours in some cases. However, because the rate of recurrence and progression is significant in these patients, a demand for adjuvant treatment and better prognostic methods is called for so that treatment and follow-up can be tailored to each patient. Accordingly, we have chosen to evaluate general outcome and facial nerve function after translabyrinthine and transcochlear approaches for cerebellopontine angle (CPA) meningiomas. Furthermore, we have evaluated two adjuvant treatments, namely, irradiation by high-energy proton beams and medical treatment with interferon-alpha as well as evaluation of the treatment effect with 11 C-L-methionine PET. In addition, we have evaluated a new PET tracer ( 76 Br-BrdU) for 'in vivo' determination of the growth potential of intracranial tumours. Conclusion: The translabyrinthine and transcochlear approaches are apparently safe surgical procedures in the treatment of CPA meningiomas. Proton beam therapy is technically feasible as suggested by the fact that only minimal side effects were observed. Moreover, none of the meningiomas treated have shown progression during a 36-month follow-up. Our results indicate that IFN-alpha can be an effective oncostatic treatment for certain patients with meningiomas. The 11 C-L-methionine PET method might be used as a complement to CT or MRI in the evaluation of the effect of proton beam and IFN-alpha treatment in meningiomas. The present attempt failed to demonstrate that the PET tracer 76 Br-BrdU could be used for the non-invasive characterisation of growth potential in brain, tumours

  5. Skull base meningioma. Surgical and adjuvant treatment with clinical and PET evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Gudjonsson, O

    2001-05-01

    The treatment strategy for skull base meningiomas remains a controversial issue. Because of the proximity of these tumours to critical neurovascular structures, the risk for vascular damage and new cranial neuropathies postoperatively is significant. To avoid unacceptable neurological deficits the surgical treatment strategy includes different surgical approaches and a subtotal removal of these tumours in some cases. However, because the rate of recurrence and progression is significant in these patients, a demand for adjuvant treatment and better prognostic methods is called for so that treatment and follow-up can be tailored to each patient. Accordingly, we have chosen to evaluate general outcome and facial nerve function after translabyrinthine and transcochlear approaches for cerebellopontine angle (CPA) meningiomas. Furthermore, we have evaluated two adjuvant treatments, namely, irradiation by high-energy proton beams and medical treatment with interferon-alpha as well as evaluation of the treatment effect with {sup 11}C-L-methionine PET. In addition, we have evaluated a new PET tracer ({sup 76}Br-BrdU) for 'in vivo' determination of the growth potential of intracranial tumours. Conclusion: The translabyrinthine and transcochlear approaches are apparently safe surgical procedures in the treatment of CPA meningiomas. Proton beam therapy is technically feasible as suggested by the fact that only minimal side effects were observed. Moreover, none of the meningiomas treated have shown progression during a 36-month follow-up. Our results indicate that IFN-alpha can be an effective oncostatic treatment for certain patients with meningiomas. The {sup 11}C-L-methionine PET method might be used as a complement to CT or MRI in the evaluation of the effect of proton beam and IFN-alpha treatment in meningiomas. The present attempt failed to demonstrate that the PET tracer {sup 76}Br-BrdU could be used for the non-invasive characterisation of growth potential in

  6. Anomalous Aortic Origin of Coronary Arteries in the Young: Echocardiographic Evaluation With Surgical Correlation.

    Science.gov (United States)

    Lorber, Richard; Srivastava, Shubhika; Wilder, Travis J; McIntyre, Susan; DeCampli, William M; Williams, William G; Frommelt, Peter C; Parness, Ira A; Blackstone, Eugene H; Jacobs, Marshall L; Mertens, Luc; Brothers, Julie A; Herlong, J René

    2015-11-01

    This study sought to compare findings from institutional echocardiographic reports with imaging core laboratory (ICL) review of corresponding echocardiographic images and operative reports in 159 patients with anomalous aortic origin of a coronary artery (AAOCA). The study also sought to develop a "best practice" protocol for imaging and interpreting images in establishing the diagnosis of AAOCA. AAOCA is associated with sudden death in the young. Underlying anatomic risk factors that can cause ischemia-related events include coronary arterial ostial stenosis, intramural course of the proximal coronary within the aortic wall, interarterial course, and potential compression between the great arteries. Consistent protocols for diagnosing and evaluating these features are lacking, potentially precluding the ability to risk stratify patients based on evidence and plan surgical strategy. For a prescribed set of anatomic AAOCA features, percentages of missing data in institutional echocardiographic reports were calculated. For each feature, agreement among institutional echocardiographic reports, ICL review of images, and surgical reports was evaluated using the weighted kappa statistic. An echocardiographic imaging protocol was developed heuristically to reduce differences between institutional reports and ICL review. A total of 13%, 33%, and 62% of echocardiograms were missing images enabling diagnosis of intra-arterial course, proximal intramural course, and high ostial takeoff, respectively. There was poor agreement between institutional reports and ICL review for diagnosis of origin of coronary artery, interarterial course, intramural course, and acute angle takeoff (kappa = 0.74, 0.11, -0.03, 0.13, respectively). Surgical findings were also significantly different from those of reports, and to a lesser extent ICL reviews. The resulting protocol contains technical recommendations for imaging each of these features. Poor agreement between institutional reports and

  7. Description and evaluation of a bench porcine model for teaching surgical residents vascular anastomosis skills

    Directory of Open Access Journals (Sweden)

    Jauch Karl-Walter

    2010-07-01

    Full Text Available Abstract Background Numerous models, of variable quality, exist to impart the complex skills required to perform vascular anastomosis. These models differ with regard to the kinds of materials used, as well as their sizes, the time needed for their preparation, their availability, and the associated costs. The present study describes a bench model that uses formalin-fixed porcine aorta, and its evaluation by young surgical residents during a recent skills course. Findings The aortic segments used were a by-product of slaughtering. They were fixed and stored after harvesting for eventual use. Ten young surgical residents participated, and each performed one end-to-side vascular anastomosis. The evaluation was a questionnaire maintaining anonymity of the participant containing questions addressing particular aspects of the model and the experiences of the trainee, along with their ratings concerning the need for a training course to learn vascular anastomosis techniques. The scoring on the survey was done using a global 6-point rating scale (Likert Scale. In addition, we ranked the present model by reviewing the current literature for models that address vascular anastomosis skills. The trainees who participated were within their first two years of training (1.25 ± 0.46. A strong agreement in terms of the necessity of training for vascular anastomosis techniques was evident among the participating trainees (5.90 ± 0.32, who had only few prior manual experiences (total number 1.50 ± 0.53. The query revealed a strong agreement that porcine aorta is a suitable model that fits the needs for training vascular anastomosis skills (5.70 ± 0.48. Only a few bench models designed to teach surgical residents vascular anastomosis techniques were available in the literature. Conclusions The preparatory and financial resources needed to perform anastomosis skills training using porcine aorta are few. The presented bench model appears to be appropriate for

  8. Innovation in urban agriculture: Evaluation data of a participatory approach (ROIR

    Directory of Open Access Journals (Sweden)

    Felix Zoll

    2016-06-01

    Full Text Available The data in this article represent an evaluation of a participatory process called Regional Open Innovation Roadmapping (ROIR. The approach aims at the promotion of regional development. In this case, it was carried out to develop a specific innovation in the field of ‘Zero-acreage farming’ (ZFarming, which is a building-related subtype of urban agriculture. For the evaluation of the process, an online survey was sent to the 58 participants of the ROIR on March 4, 2014. The survey ended on April 8, 2014, and a response rate of 53.54% resulted in a sample size of 31 respondents. The survey was divided into seven different blocks. We analyzed the ROIR process׳s contribution to knowledge generation, the establishment of networks among the participants, the implementation of new projects related to ZFarming, and the increase of acceptance of ZFarming and the selected ZFarming innovation. Furthermore, other remarks, and personal information were collected. Hence, the objective of the survey was to assess whether ROIR is a useful tool to promote the aforementioned innovation drivers, and thereby, the selected innovation, which was developed throughout the process. The data were used in the research article “Application and evaluation of a participatory “open innovation” approach (ROIR: the case of introducing zero-acreage farming in Berlin” (Specht et al., 2016 [1].

  9. The study of surgical image quality evaluation system by subjective quality factor method

    Science.gov (United States)

    Zhang, Jian J.; Xuan, Jason R.; Yang, Xirong; Yu, Honggang; Koullick, Edouard

    2016-03-01

    GreenLightTM procedure is an effective and economical way of treatment of benign prostate hyperplasia (BPH); there are almost a million of patients treated with GreenLightTM worldwide. During the surgical procedure, the surgeon or physician will rely on the monitoring video system to survey and confirm the surgical progress. There are a few obstructions that could greatly affect the image quality of the monitoring video, like laser glare by the tissue and body fluid, air bubbles and debris generated by tissue evaporation, and bleeding, just to name a few. In order to improve the physician's visual experience of a laser surgical procedure, the system performance parameter related to image quality needs to be well defined. However, since image quality is the integrated set of perceptions of the overall degree of excellence of an image, or in other words, image quality is the perceptually weighted combination of significant attributes (contrast, graininess …) of an image when considered in its marketplace or application, there is no standard definition on overall image or video quality especially for the no-reference case (without a standard chart as reference). In this study, Subjective Quality Factor (SQF) and acutance are used for no-reference image quality evaluation. Basic image quality parameters, like sharpness, color accuracy, size of obstruction and transmission of obstruction, are used as subparameter to define the rating scale for image quality evaluation or comparison. Sample image groups were evaluated by human observers according to the rating scale. Surveys of physician groups were also conducted with lab generated sample videos. The study shows that human subjective perception is a trustworthy way of image quality evaluation. More systematic investigation on the relationship between video quality and image quality of each frame will be conducted as a future study.

  10. EVALUATION OF OUTCOME OF VARIOUS SURGICAL PROCEDURES FOR UPPER EYELID PTOSIS

    Directory of Open Access Journals (Sweden)

    Nagaraju

    2015-02-01

    Full Text Available INTRODUCTION: There are various procedures available for ptosis correction. Successful outcome not only depends on correct technique but also choosing appropriate procedure for each patient. Selection of procedure is based on available levator function and also other factors like etiology, severity, Bell’s phenomenon etc. If such varied procedure s are performed in a group of patients based on standard criteria and results are evaluated systematically we can determine what works best for a given patient . AIM : Evaluation of outcome of various surgical procedures for upper eyelid ptosis . METHODOLOGY : 25 eyelids of 20 patients who presented to a tertiary centre in south India with complaint of drooping of upper lid were considered. All subjects underwent complete ocular examination corrected visual acuity and detailed ptosis evaluation with particular emphasis on measurement of levator muscle function, MRD1 (margin reflex distance - 1, palpebral fissure width in different gazes and margin crease distance. The effect of various factors like MRD1, MCD, levator function were assessed, the amount of correction required and appropriate surgical procedure was chosen. Surgical procedure of Levator resection, frontalis sling operation, anterior levator aponeurosis advancement, o r other ptosis correction procedures under appropriate anaesthesia were performed. Post - operative evaluation in terms of visual acuity, MRD, Interpalpebral fissure height, lid symmetry, lagophthalmos and complications (if any was done. RESULTS : Levator muscle resection was done in 28% of eyelids, frontal sling surgery in 60% of eyelids, Levator muscle plication in 8% eyelids and levator muscle disinsertion with frontal sling surgery in 4% eyes. Undercorrection was seen in about 44% of eyelids in varying degrees. 56% of the eyes had optimal correction. Symmetric correction was achieved in 76% of eyelids. CONCLUSION: The influence of various preoperative factors on the

  11. Evaluating Surgical Residents' Patient-Centered Communication Skills: Practical Alternatives to the "Apprenticeship Model".

    Science.gov (United States)

    Newcomb, Anna; Trickey, Amber W; Lita, Elena; Dort, Jonathan

    2017-10-06

    The Accreditation Council for Graduate Medical Education (ACGME) requires residency programs to assess communication skills and provide feedback to residents. We aimed to develop a feasible data collection process that generates objective clinical performance information to guide training activities, inform ACGME milestone evaluations, and validate assessment instruments. Residents care for patients in the surgical clinic and in the hospital, and participate in a communication curriculum providing practice with standardized patients (SPs). We measured perception of resident communication using the 14-item Communication Assessment Tool (CAT), collecting data from patients at the surgery clinic and surgical wards in the hospital, and from SP encounters during simulated training scenarios. We developed a handout of CAT example behaviors to guide patients completing the communication assessment. Independent academic medical center. General surgery residents. The primary outcome is the percentage of total items patients rated "excellent;" we collected data on 24 of 25 residents. Outpatient evaluations resulted in significantly higher scores (mean 84.5% vs. 68.6%, p communication assessments in their concurrent patient population (p = 0.017), and (2) receiving CAT example instructions was associated with a lower percentage of excellent ratings by 9.3% (p = 0.047). Our data collection process provides a model for obtaining meaningful information about resident communication proficiency. CAT evaluations of surgical residents by the inpatient population had not previously been described in the literature; our results provide important insight into relationships between the evaluations provided by inpatients, clinic patients, and SPs in simulation. Our example behaviors guide shows promise for addressing a common concern, minimizing ceiling effects when measuring physician-patient communication. Copyright © 2017 Association of Program Directors in Surgery. Published by

  12. Evaluation of surgical outcome in advanced age patients with developmental hip dysplasia.

    Science.gov (United States)

    Çiçekli, Özgür; Doğan, Metin

    2018-04-01

    This study aimed at determining the efficacy of the surgical treatment conducted on children with delayed presentation developmental dysplasia of the hip (DDH). The objective was to provide a good comparison of functional and radiographic outcomes and to determine various surgical treatment options. In this study, we evaluated the results of 38 hips of 27 patients aged 4 years onset which had been operated due to DDH. Radiographic outcomes were evaluated by using acetabular index, CE angle, Tonnis and the Severin classification system. Clinical evaluation was made by using IOWA hip scores. Degenerative changes were evaluated according to Boyer and avascular necrosis according to Kalamchi-MacEwen criteria. The mean age of the patients at the operation time was 10 years 3 months (range: 4 years 3 months-30 years). While the mean acetabular index was 37.97 preoperatively, in the last follow-up it was 19.92. Thirty-six hips (94%) had an excellent and good outcomes, and two hips (%6) had a fair outcome with respect to the Severin criteria. The mean hip score with respect to IOWA was 93.736 (range: 75-98) and the rate of excellent and good outcomes was 98%. For the treatment of patients with DDH of late onset, a one-staged operative procedure is recommended. This method is applied successfully and enables us to achieve good clinical and radiographic results. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  13. Giving tranexamic acid to reduce surgical bleeding in sub-Saharan Africa: an economic evaluation

    Directory of Open Access Journals (Sweden)

    Perel Pablo

    2010-02-01

    Full Text Available Abstract Background The identification of safe and effective alternatives to blood transfusion is a public health priority. In sub-Saharan Africa, blood shortage is a cause of mortality and morbidity. Blood transfusion can also transmit viral infections. Giving tranexamic acid (TXA to bleeding surgical patients has been shown to reduce both the number of blood transfusions and the volume of blood transfused. The objective of this study is to investigate whether routinely administering TXA to bleeding elective surgical patients is cost effective by both averting deaths occurring from the shortage of blood, and by preventing infections from blood transfusions. Methods A decision tree was constructed to evaluate the cost-effectiveness of providing TXA compared with no TXA in patients with surgical bleeding in four African countries with different human immunodeficiency virus (HIV prevalence and blood donation rates (Kenya, South Africa, Tanzania and Botswana. The principal outcome measures were cost per life saved and cost per infection averted (HIV, Hepatitis B, Hepatitis C averted in 2007 International dollars ($. The probability of receiving a blood transfusion with and without TXA and the risk of blood borne viral infection were estimated. The impact of uncertainty in model parameters was explored using one-way deterministic sensitivity analyses. Probabilistic sensitivity analysis was performed using Monte Carlo simulation. Results The incremental cost per life saved is $87 for Kenya and $93 for Tanzania. In Botswana and South Africa, TXA administration is not life saving but is highly cost saving since fewer units of blood are transfused. Further, in Botswana the administration of TXA averts one case of HIV and four cases of Hepatitis B (HBV per 1,000 surgical patients. In South Africa, one case of HBV is averted per 1,000 surgical patients. Probabilistic sensitivity analyses confirmed the robustness of the model. Conclusion An economic

  14. Clinical evaluation of preoperative arterial infusion chemotherapy and surgical operation for colorectal carcinoma

    International Nuclear Information System (INIS)

    Yuan Jianhua; Zhao Zhongsheng; Deng Gaoli; Hu Tingyang; Yu Wenqiang; Chen Fanghong; Luo Zuyan; Ru Guoqing; Dong Quanjin; Tu Shiliang

    2003-01-01

    Objective: To investigate the clinical values of preoperative arterial infusion chemotherapy and surgical operation for colorectal carcinoma. Methods: 66 patients with colorectal carcinoma were subjected to percutaneous femoral artery catheterization by Seldinger's technique with infusion of anti-cancer drugs. The resection was performed 5-30 days after the arterial infusion (mean 12 days). In 50 surgical specimens of the 66 cases, histological findings were evaluated including the density and distribution of the apoptosis cells under the observation by DNA nick end labelling technique. Of which 22 specimens before arterial infusion chemotherapy (got from biopsy of preoperation) and 25 normal mucosa (got from normal surgical specimens) were used as controls. Results: The total histological response rate was 100% with grade I in 20 cases, grade II in 21 cases, grade III in 9 cases. The densities of the apoptosis cells were 31.47 ± 5.58 before arterial infusion chemotherapy, 76.69 ± 17.12 after arterial infusion chemotherapy and 8.01 ± 3.39 in normal mucosa. The density of the apoptosis cells after arterial infusion chemotherapy was significantly higher than that before arterial infusion chemotherapy (P 2 =4.696, P>0.30). There were no significant differences in the apoptosis of adenocarcinoma during different pathological stages (F=0.001376, P>0.05). Conclusions: Peroperative transcatheter arterial infusion chemotherapy resulting in apoptosis of adenocarcinoma, can raise the radical operation rate, and prolong survival rate for colorectal carcinoma patients

  15. Usefulness of color and pulsed Doppler's in the evaluation of surgical portosystemic shunts in pediatric patients

    International Nuclear Information System (INIS)

    Berrocal, T.; Prieto, C.; Cortes, P.; Rodriguez, R.; Pastor, I.

    2003-01-01

    Portosystemic shunts are performed to relieve symptomatic portal hypertension symptomatic or removal pressure in hepatic vascularisation in patients with Budd-Chiari's syndrome. Most surgical portosystemic shunts can be suitably studied by means of ultrasound scan complemented by color and pulsed Dopplers, proved one understands the hemodynamics of the surgical procedures involved. This article demonstrates the usefulness and limitations of the ultrasound scan Duplex Doppler in the evaluation of portosystemic shunts performed on pediatric patients. Pulsed Doppler provides information regarding the nature and direction of blood flow. Color doppler is capable of directly revealing the shunt and, in most cases, permits the anastomosis to be located. The types of shunts that appear include proximal and distal spleno-renal, portocaval and mesocaval. Types of vascular connections are illustrated,s well as expected post-surgical blood flow direction in affected vessels. The ultrasound scanning technique is discussed, as well as the criteria for determining vascular permeability. Also highlighted are the advantages, limitations and diagnostic difficulties associated with the different forms of Doppler. (Author) 17 refs

  16. Multicenter surgical experience evaluation on the Mid-Scala electrode and insertion tools.

    Science.gov (United States)

    Gazibegovic, Dzemal; Bero, Eva M

    2017-02-01

    The HiFocus Mid-Scala electrode is intended to improve hearing for individuals with severe-to-profound hearing loss by providing extended electrical coverage of the cochlea while minimizing trauma related to insertion. The electrode is appropriate for use with a wide range of surgical techniques, including either a cochleostomy or round window insertion, and the use of either a free-hand or tool-assisted approach. The objective of this survey was to evaluate how the HiFocus Mid-Scala electrode and insertion tools was used across a population of cochlear implant recipients of differing ages, audiologic profiles, and anatomical characteristics. The intent was to understand the type and frequency of surgical techniques applicable with the electrode, and to provide guidelines for clinical practice. Two questionnaires were completed by surgeons at implant centres located in the United States, Europe, and Asia. Before any surgeries were conducted, surgeons completed a questionnaire that assessed their overall cochlear implant surgical practice and preferences. Following each HiFocus Mid-Scala electrode insertion, surgeons completed a questionnaire that summarized their experience during that surgical procedure. Questionnaires were completed by 32 surgeons from 16 centres for a total of 143 surgeries (112 adults, 31 children). Most surgeons (62 %) preferred to insert the electrode via the round window or an extended round window compared with a cochleostomy (16 %), whereas the remaining 22 % indicated that they made an insertion choice based on presenting anatomy. Sixty-nine percent preferred a free-hand approach over using insertion tools. In 32 procedures, surgeons elected to deviate from an intended round window insertion to either an extended round window or cochleostomy approach.

  17. Evaluating healthcare resource utilization and outcomes for surgical hip dislocation and hip arthroscopy for femoroacetabular impingement.

    Science.gov (United States)

    de Sa, Darren; Horner, Nolan S; MacDonald, Austin; Simunovic, Nicole; Slobogean, Gerard; Philippon, Marc J; Belzile, Etienne L; Karlsson, Jon; Ayeni, Olufemi R

    2016-12-01

    Surgical hip dislocation (SHD) and hip arthroscopy are surgical methods used to correct deformity associated with femoroacetabular impingement (FAI). Though both of these approaches appear to benefit patients, no studies exist comparing healthcare resource utilization of the two surgical approaches. This systematic review examines the literature and the records of two surgeons to evaluate the resource utilization associated with treating symptomatic FAI via these two methods. EMBASE, MEDLINE and PubMed were searched for relevant articles. The articles were systematically screened, and data was abstracted in duplicate. To further supplement resource utilization data, a retrospective chart review of two surgeon's patient data (one using SHD and another using an arthroscopic approach) was completed. Experts in pharmacy, physiotherapy, radiology, anaesthesia, physiatry and the local hospital finance department were also consulted. There were 52 studies included with a total of 460 patients (535 hips) and 3886 patients (4147 hips) who underwent SHD and arthroscopic surgery for FAI, respectively. Regardless of approach, most patients treated for symptomatic FAI improved across various outcomes measures with low complication rates. Surgical time across all approaches was similar, averaging 118 ± 2 min. On a per patient basis, hip arthroscopy ($10,976) uses approximately 41 % of the resources of SHD ($24,379). There were no significant differences in outcomes for FAI treated with SHD or arthroscopy. However, with regard to healthcare resource utilization based on the OHIP healthcare system, hip arthroscopy uses substantially less resources than SHD within the first post-operative year. Systematic Review of Level IV Studies, Level IV.

  18. An evaluation of stereoacuity (3D vision) in practising surgeons across a range of surgical specialities.

    Science.gov (United States)

    Biddle, Mairiosa; Hamid, Sana; Ali, Nadeem

    2014-02-01

    Judging depth is important in surgery. Although there are several cues that permit depth perception, stereoacuity has been singled out as a possible predictor of surgical ability. However, it is not clear whether high-grade stereoacuity is necessary for a career in surgery. To help answer this, we aimed to evaluate stereoacuities in practising surgeons across a range of surgical specialities. We recorded stereoacuity values on 66 surgeons working at a London teaching hospital using three standard stereotests: Titmus, TNO and Frisby. There were 36 Trainees and 30 Consultants, covering 12 surgical specialities. Median stereoacuities (with range) for the whole group were: 40 s arc on Titmus (40-800), 30 s arc on TNO (15-480) and 20 s arc on Frisby (20-600). Four surgeons had no recordable stereoacuity on TNO, and one was also unrecordable on Titmus. Three of these four were Consultants. Depending on the test used, high-grade stereopsis was found in 74%-83% of surgeons while reduced stereopsis was found in 2%-14% of surgeons. While we found that most surgeons in current NHS practice have high-grade stereoacuity, there are also surgeons with reduced stereopsis and some with no stereopsis. The findings do not therefore support the assertion that high-grade stereopsis is a universal requirement for a career in surgery. It would be difficult to justify setting a stereoacuity criterion for entrance into a surgical training programme. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  19. Value of volume measurements in evaluating abdominal aortic aneurysms growth rate and need for surgical treatment

    Energy Technology Data Exchange (ETDEWEB)

    Kontopodis, Nikolaos, E-mail: kontopodisn@yahoo.gr [Department of Vascular Surgery, University of Crete Medical School, Heraklion (Greece); Metaxa, Eleni, E-mail: emmetaxa@gmail.com [Institute of Applied and Computational Mathematics, Foundation for Research and Technology-Hellas, Heraklion, Crete (Greece); Papaharilaou, Yannis, E-mail: yannisp@iacm.forth.gr [Institute of Applied and Computational Mathematics, Foundation for Research and Technology-Hellas, Heraklion, Crete (Greece); Georgakarakos, Efstratios, E-mail: efstratiosgeorg@gmail.com [Vascular Surgery Department, “Demokritus” University of Thrace Medical School, Alexandroupolis (Greece); Tsetis, Dimitris, E-mail: tsetis@med.uoc.gr [Interventional Radiology Unit, Department of Radiology, University of Crete Medical School, Heraklion, Crete (Greece); Ioannou, Christos V., E-mail: ioannou@med.uoc.gr [Department of Vascular Surgery, University of Crete Medical School, Heraklion (Greece)

    2014-07-15

    Purpose: To examine whether indices other than the traditionally used abdominal aortic aneurysm (AAA) maximum diameter, such as AAA volume, intraluminal thrombus (ILT) thickness and ILT volume, may be superior to evaluate aneurismal enlargement. Materials and methods: Thirty-four small AAAs (initially presenting a maximum diameter <5.5 cm which is the threshold for surgical repair) with an initial and a follow-up CT were examined. Median increase and percentile annual change of these variables was calculated. Correlation between growth rates as determined by the new indices under evaluation and those of maximum diameter were assessed. AAAs were divided according to outcome (surveillance vs. elective repair after follow-up which is based on the maximum diameter criterion) and according to growth rate (high vs. low) based on four indices. Contingency between groups of high/low growth rate regarding each of the four indices on one hand and those regarding need for surgical repair on the other was assessed. Results: A strong correlation between growth rates of maximum diameter and those of AAA and ILT volumes could be established. Evaluation of contingency between groups of outcome and those of growth rate revealed significant associations only for AAA and ILT volumes. Subsequently AAAs with a rapid volumetric increase over time had a likelihood ratio of 10 to be operated compared to those with a slower enlargement. Regarding increase of maximum diameter, likelihood ratio between AAAs with rapid and those with slow expansion was only 3. Conclusion: Growth rate of aneurysms regarding 3Dimensional indices of AAA and ILT volumes is significantly associated with the need for surgical intervention while the same does not hold for growth rates determined by 2Dimensional indices of maximum diameter and ILT thickness.

  20. Value of volume measurements in evaluating abdominal aortic aneurysms growth rate and need for surgical treatment

    International Nuclear Information System (INIS)

    Kontopodis, Nikolaos; Metaxa, Eleni; Papaharilaou, Yannis; Georgakarakos, Efstratios; Tsetis, Dimitris; Ioannou, Christos V.

    2014-01-01

    Purpose: To examine whether indices other than the traditionally used abdominal aortic aneurysm (AAA) maximum diameter, such as AAA volume, intraluminal thrombus (ILT) thickness and ILT volume, may be superior to evaluate aneurismal enlargement. Materials and methods: Thirty-four small AAAs (initially presenting a maximum diameter <5.5 cm which is the threshold for surgical repair) with an initial and a follow-up CT were examined. Median increase and percentile annual change of these variables was calculated. Correlation between growth rates as determined by the new indices under evaluation and those of maximum diameter were assessed. AAAs were divided according to outcome (surveillance vs. elective repair after follow-up which is based on the maximum diameter criterion) and according to growth rate (high vs. low) based on four indices. Contingency between groups of high/low growth rate regarding each of the four indices on one hand and those regarding need for surgical repair on the other was assessed. Results: A strong correlation between growth rates of maximum diameter and those of AAA and ILT volumes could be established. Evaluation of contingency between groups of outcome and those of growth rate revealed significant associations only for AAA and ILT volumes. Subsequently AAAs with a rapid volumetric increase over time had a likelihood ratio of 10 to be operated compared to those with a slower enlargement. Regarding increase of maximum diameter, likelihood ratio between AAAs with rapid and those with slow expansion was only 3. Conclusion: Growth rate of aneurysms regarding 3Dimensional indices of AAA and ILT volumes is significantly associated with the need for surgical intervention while the same does not hold for growth rates determined by 2Dimensional indices of maximum diameter and ILT thickness

  1. An Innovative Procedure for the Rolling Noise Evaluation

    Directory of Open Access Journals (Sweden)

    Viscardi Massimo

    2016-01-01

    Full Text Available Noise is often generated by pressure changes in the air induced by mechanical vibrations. The study of these phenomena is known as structural acoustics or, in a more fashionable way, virboacoustics. Vibroacoustics is the study of the mechanical waves in structures and how they interact with, and radiate into, adjacent media. In railway the most important noise source, based on fluid and structure interaction is the rolling noise. The aim of the paper is the development and implementation of a numerical method for the rail decay rate and combined roughness calculation according to the FprCEN/TR 16891:2015 and a subsequent evaluation of the excess noise level in accordance with the ISO/FDIS 3095: 2013. The tool, as a final results, will make possible the evaluation of the rail parameters without the involvement of long and expensive test campaign based on classical roughness measurement methods and will permit the compensation of the roughness induced excess noise level for a comparative comprehension of the acoustic experimental data.

  2. Strategic Management and Innovation: A Checklist for Readiness Evaluation of AACSB Standards

    Science.gov (United States)

    Kundu, Goutam Kumar; Bairi, Jayachandra

    2016-01-01

    Purpose: The purpose of this paper is to introduce the concept of a checklist, focusing on the detailed analysis of the requirement of the Association to Advance Collegiate Schools of Business (AACSB) standards related to strategic management and innovation area, for evaluation of implementation readiness in a business school setting.…

  3. Developmental Evaluation Framework for Innovation and Learning Networks: Integration of the Structure, Process and Outcomes

    Science.gov (United States)

    Ramstad, Elise

    2009-01-01

    Purpose: During the past decade new types of broader networks that aim to achieve widespread effects in the working life have emerged. These are typically based on an interactive innovation approach, where knowledge is created jointly together with diverse players. At the moment, the challenge is how to evaluate these complex networks and learning…

  4. Using Developmental Evaluation as a Design Thinking Tool for Curriculum Innovation in Professional Higher Education

    Science.gov (United States)

    Leonard, Simon N.; Fitzgerald, Robert N.; Riordan, Geoffrey

    2016-01-01

    This paper argues for the use of "developmental" evaluation as a design-based research tool for sustainable curriculum innovation in professional higher education. Professional education is multi-faceted and complex with diverse views from researchers, professional practitioners, employers and the world of politics leaving little…

  5. Pylorus-preserving Whipple pancreaticoduodenectomy: Postoperative evaluation of a new surgical technique

    International Nuclear Information System (INIS)

    Trerotola, S.O.; Jones, B.; Crist, D.J.; Cameron, J.L.

    1988-01-01

    The pylorus-preserving Whipple pancreaticoduodenectomy is becoming an increasingly popular alternative to the standard Whipple operation in the surgical treatment of diseases of the periampullary region. Contrast radiography plays an important role in the postoperative evaluation of patients undergoing this operation. Although most radiologists are familiar with the postoperative anatomy and complications associated with the standard Whipple operation, the newer technique involves different postoperative anatomy and different complications and requires a different approach to examination. The procedure presents several new diagnostic pitfalls. These variables are presented from a described series of 50 patients undergoing this procedure for periampullary neoplasm or chronic pancreatitis

  6. Clinical characteristics, risk factors and pre-surgical evaluation of post-infectious epilepsy.

    Science.gov (United States)

    Sellner, J; Trinka, E

    2013-03-01

    Epilepsy is a frequent complication of central nervous system (CNS) infections. Post-infectious epilepsy is commonly refractory to medical treatment and plays a pivotal role for the poor long-term outcome of CNS infections. To provide an overview of clinical characteristics and risk factors of seizures associated with CNS infections. In addition, to summarize the state of the art of anticonvulsive treatment and the pre-surgical evaluation process in refractory cases. A comprehensive literature search for articles published between January 1970 and December 2011 was carried out. The occurrence of seizures during the acute course of meningitis, encephalitis and brain abscess is the main risk factor for the development of post-infectious epilepsy. There is a shortage of trials evaluating the efficacy of prophylactic and symptomatic treatment during the course of acute infection. Moreover, there are no randomized-controlled trials studying anticonvulsive drugs and their combinations for the management of post-infectious epilepsy. In a selected group of patients, however, medically refractory focal epilepsy is potentially curable by surgery. Further studies are required to improve the pathogenetic understanding of post-infectious epilepsy in order to develop preventive measures as well as to evaluate additional medical and surgical treatment strategies for the patients currently not considered for surgery. © 2012 The Author(s) European Journal of Neurology © 2012 EFNS.

  7. Environment and innovation. An evaluation of EU strategies and policies; Umwelt und Innovation. Eine Evaluation von EU-Strategien und Politiken

    Energy Technology Data Exchange (ETDEWEB)

    Hertin, Julia; Jacob, Klaus; Kahlenborn, Walter

    2008-03-15

    This study outlines the methodology and results of the research project: ''Umwelt, Innovation und Beschaeftigung in einem europaeischen Kontext: Europaeische Strategien als ein Motor fuer oekeffiziente Technologien und Wettbewerbsfaehigkeit'', funded by the BMU and UBA and carried out jointly by the Forschungsstelle fuer Umweltpolitik of Freie Universitaet Berlin and Adelphi Consult. The project was carried out with the intention to evaluate inhowfar current EU policies follow and implement goals that can be classified as ''ecological industrial policy''. In the definition of the BMU, this concept means a political strategy which enhances eco-efficient innovations beyond the traditional approaches of environmental and R + D policy. A strategy of this type is to influence the innovation behaviour and also influence the marketing conditions for generic technologies. As the strategy intends to effect both a reduction of the ecological burden and an enhancement of the economic and competitive standing, it can recur to a two-fold foundation. The current investigation attempted to identify political measures at EU level that are suited for enhancing fast development and propagation of eco-efficient technologies. (orig.)

  8. Evaluating the impact of farm scale innovation at catchment scale

    Science.gov (United States)

    van Breda, Phelia; De Clercq, Willem; Vlok, Pieter; Querner, Erik

    2014-05-01

    Hydrological modelling lends itself to other disciplines very well, normally as a process based system that acts as a catalogue of events taking place. These hydrological models are spatial-temporal in their design and are generally well suited for what-if situations in other disciplines. Scaling should therefore be a function of the purpose of the modelling. Process is always linked with scale or support but the temporal resolution can affect the results if the spatial scale is not suitable. The use of hydrological response units tends to lump area around physical features but disregards farm boundaries. Farm boundaries are often the more crucial uppermost resolution needed to gain more value from hydrological modelling. In the Letaba Catchment of South Africa, we find a generous portion of landuses, different models of ownership, different farming systems ranging from large commercial farms to small subsistence farming. All of these have the same basic right to water but water distribution in the catchment is somewhat of a problem. Since water quantity is also a problem, the water supply systems need to take into account that valuable production areas not be left without water. Clearly hydrological modelling should therefore be sensitive to specific landuse. As a measure of productivity, a system of small farmer production evaluation was designed. This activity presents a dynamic system outside hydrological modelling that is generally not being considered inside hydrological modelling but depends on hydrological modelling. For sustainable development, a number of important concepts needed to be aligned with activities in this region, and the regulatory actions also need to be adhered to. This study aimed at aligning the activities in a region to the vision and objectives of the regulatory authorities. South Africa's system of socio-economic development planning is complex and mostly ineffective. There are many regulatory authorities involved, often with unclear

  9. Innovative procedure for computer-assisted genioplasty: three-dimensional cephalometry, rapid-prototyping model and surgical splint.

    Science.gov (United States)

    Olszewski, R; Tranduy, K; Reychler, H

    2010-07-01

    The authors present a new procedure of computer-assisted genioplasty. They determined the anterior, posterior and inferior limits of the chin in relation to the skull and face with the newly developed and validated three-dimensional cephalometric planar analysis (ACRO 3D). Virtual planning of the osteotomy lines was carried out with Mimics (Materialize) software. The authors built a three-dimensional rapid-prototyping multi-position model of the chin area from a medical low-dose CT scan. The transfer of virtual information to the operating room consisted of two elements. First, the titanium plates on the 3D RP model were pre-bent. Second, a surgical guide for the transfer of the osteotomy lines and the positions of the screws to the operating room was manufactured. The authors present the first case of the use of this model on a patient. The postoperative results are promising, and the technique is fast and easy-to-use. More patients are needed for a definitive clinical validation of this procedure. Copyright 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. PRE-MARKET CLINICAL EVALUATIONS OF INNOVATIVE HIGH-RISK MEDICAL DEVICES IN EUROPE

    DEFF Research Database (Denmark)

    Hulstaert, F.; Neyt, M.; Vinck, I.

    2012-01-01

    data are available? We studied the premarket clinical evaluation of innovative high-risk medical devices in Europe compared with the US, and with medicines, where appropriate. Methods: The literature and regulatory documents were checked. Representatives from industry, Competent Authorities, Notified...... of premarket trials in Europe and number of patients exposed, but failed as this information is not made public. Furthermore, the Helsinki Declaration is not followed with respect to the registration and publication of premarket trials. Conclusions: For innovative high-risk devices, new EU legislation should...

  11. PHIRE (Public Health Innovation and Research in Europe): methods, structures and evaluation.

    Science.gov (United States)

    Barnhoorn, Floris; McCarthy, Mark; Devillé, Walter; Alexanderson, Kristina; Voss, Margaretha; Conceição, Claudia

    2013-11-01

    Public Health Innovation and Research in Europe (PHIRE), building on previous European collaborative projects, was developed to assess national uptake and impacts of European public health innovations, to describe national public health research programmes, strategies and structures and to develop participation of researchers through the organizational structures of the European Public Health Association (EUPHA). This article describes the methods used. PHIRE was led by EUPHA with seven partner organisations over 30 months. It was conceived to engage the organisation of EUPHA--working through its thematic Sections, and through its national public health associations--and assess innovation and research across 30 European countries. Public health research was defined broadly as health research at population and organisational level. There were seven Work Packages (three covering coordination and four for technical aspects) led by partners and coordinated through management meetings. Seven EUPHA Sections identified eight innovations within the projects funded by the Public Health Programme of the European Commission Directorate for Health and Consumers. Country informants, identified through EUPHA thematic Sections, reported on national uptake of the innovations in eight public health projects supported by the European Union Public Health Programme. Four PHIRE partners, each taking a regional sector of Europe, worked with the public health associations and other informants to describe public health research programmes, calls and systems. A classification was created for the national public health research programmes and calls in 2010. The internal and external evaluations were supportive. PHIRE described public health innovations and research across Europe through national experts. More work is needed to conceptualize and define public health 'innovations' and to develop theories and methods for the assessment of their uptake and impacts at country and cross

  12. In vitro histological evaluation of the surgical margins made by different laser wavelengths in tongue tissues

    Science.gov (United States)

    Azevedo, Ana-Salvaterra; Ferreira, Fernando; Delgado, Maria-Leonor; Garcês, Fernanda; Carreira, Sofia; Martins, Marco; Suarez-Quintanilla, Juan

    2016-01-01

    Background Lasers have become standard tools for the surgical treatment of oral lesions. The purpose of this study is to determine the surgical margins and histologically evaluate the tissue thermal effects induced by different types of surgical instruments. Material and Methods Cuts were made in pork tongues’ mucosa with different lasers (Er:YAG at 2W with and without air / water spray and at 4W with and without air / water spray; CO2 at 3.5W and 7W in pulsed mode and at 7W in continuous mode; the diode laser at 3.5W and boost 3.5W in pulsed mode; Nd:YAG at 6W, 40Hz and electroscalpel at 5W and conventional scalpel as control. Macroscopic and microscopic morphological changes were evaluated. Results The results of this study showed that the surgical instruments that caused greater tissue damage extension were: the Nd:YAG laser (670.68μm), the diode 3.5W and boost PW (626.82μm), the CO2 7W CW (571.18μm), the CO2 at 7W PW (485.45μm), the diode 3.5W PW (456.15μm), the electroscalpel (409.57μm) and lastly the CO2 laser 3.5W PW (306.19μm) and Er:YAG (74.66μm) laser, regardless of power, mode or air / water spray used. An association between the Tissue Damage Extension and the Degree of Carbonization (r = 0.789; P = 0.01), and an association between the Tissue Damage Extension and Regularity of the Incision were found (r = -, 299; P = 0.01). Conclusions The results of this study suggest that lasers can be used in soft tissues biopsies of the oral cavity, enabling a correct histopathological analysis, as long as the biological effects of each laser type are considered. The Er:YAG laser revealed its potential for biopsies of the oral mucosa ensuring a successful histological evaluation and the CO2 laser at 3,5W in pulsed mode presented itself as the best choice for surgeries with hemostasis. Key words:CO2 laser, diode laser, Er:YAG laser, laser surgery, Nd:YAG laser, oral mucosa, thermal effect. PMID:27703606

  13. Economic evaluations of comprehensive geriatric assessment in surgical patients: a systematic review.

    Science.gov (United States)

    Eamer, Gilgamesh; Saravana-Bawan, Bianka; van der Westhuizen, Brenden; Chambers, Thane; Ohinmaa, Arto; Khadaroo, Rachel G

    2017-10-01

    Seniors presenting with surgical disease face increased risk of postoperative morbidity and mortality and have increased treatment costs. Comprehensive Geriatric Assessment (CGA) is proposed to reduce morbidity, mortality, and the cost after surgery. A systematic review of CGA in emergency surgical patients was conducted. The primary outcome was cost-effectiveness; secondary outcomes were length of stay, return of function, and mortality. Inclusion and exclusion criteria were predefined. Systematic searches of MEDLINE, Embase, Cochrane, and National Health Service Economic Evaluation Database were performed. Text screening, bias assessment, and data extraction were performed by two authors. There were 560 articles identified; abstract review excluded 499 articles and full-text review excluded 53 articles. Eight studies were included; one nonorthopedic trauma and seven orthopedic trauma studies. Bias assessment revealed moderate to high risk of bias for all studies. Economic evaluation assessment identified two high-quality studies and six moderate or low quality studies. Pooled analysis from four studies assessed loss of function; loss of function decreased in the experimental arm (odds ratio 0.92, 95% confidence interval [CI]: 0.88-0.97). Pooled results for length of stay from five studies found a significant decrease (mean difference: -1.17, 95% CI: -1.63 to -0.71) after excluding the nonorthopedic trauma study. Pooled mortality was significantly decreased in seven studies (risk ratio: 0.78, 95% CI: 0.67-0.90). All studies decreased cost and improved health outcomes in a cost-effective manner. CGA improved return of function and mortality with reduced cost or improved utility. Our review suggests that CGA is economically dominant and the most cost-effective care model for orthogeriatric patients. Further research should examine other surgical fields. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Evaluation capacity assessment of the transport sector in South Africa: An innovative approach

    Directory of Open Access Journals (Sweden)

    Basia D. Bless

    2017-05-01

    Conclusion: In this regard, the framework is recommended as an innovative tool to assist evaluation practitioners and scholars to better understand evaluation capacity constraints within a broader context that involves logistical, technical, contextual, social and political dimensions. It also offers an important insight on how these components interfaced to shape the organisational value system that impacts the use of evidence in the transport sector in South Africa.

  15. An Innovative Metric to Evaluate Satellite Precipitation's Spatial Distribution

    Science.gov (United States)

    Liu, H.; Chu, W.; Gao, X.; Sorooshian, S.

    2011-12-01

    Thanks to its capability to cover the mountains, where ground measurement instruments cannot reach, satellites provide a good means of estimating precipitation over mountainous regions. In regions with complex terrains, accurate information on high-resolution spatial distribution of precipitation is critical for many important issues, such as flood/landslide warning, reservoir operation, water system planning, etc. Therefore, in order to be useful in many practical applications, satellite precipitation products should possess high quality in characterizing spatial distribution. However, most existing validation metrics, which are based on point/grid comparison using simple statistics, cannot effectively measure satellite's skill of capturing the spatial patterns of precipitation fields. This deficiency results from the fact that point/grid-wised comparison does not take into account of the spatial coherence of precipitation fields. Furth more, another weakness of many metrics is that they can barely provide information on why satellite products perform well or poor. Motivated by our recent findings of the consistent spatial patterns of the precipitation field over the western U.S., we developed a new metric utilizing EOF analysis and Shannon entropy. The metric can be derived through two steps: 1) capture the dominant spatial patterns of precipitation fields from both satellite products and reference data through EOF analysis, and 2) compute the similarities between the corresponding dominant patterns using mutual information measurement defined with Shannon entropy. Instead of individual point/grid, the new metric treat the entire precipitation field simultaneously, naturally taking advantage of spatial dependence. Since the dominant spatial patterns are shaped by physical processes, the new metric can shed light on why satellite product can or cannot capture the spatial patterns. For demonstration, a experiment was carried out to evaluate a satellite

  16. The Future of the Space Age or how to Evaluate Innovative Ideas

    Science.gov (United States)

    Vollerthun, A.; Fricke, E.

    2002-05-01

    Based on an initiative of the German Aerospace Industry Association to foster a more transparent and structured funding of German commercial-oriented space projects a three-phased approach is suggested in this paper, to stepwise improve and evaluate proposed concepts for space-related innovations. The objective of this concept was to develop a transparent, structured, and reproducible process to select the right innovative project in terms of political, economical, and technical objectives for funding by e.g. a governmental agency. A stepwise process and related methods, that cover technical as well as economical aspects (and related sensitivities) are proposed. Based on the special needs and requirements of space industry the proposals are compared to a set of predefined top level objectives/requirements. Using an initial trades analysis with the criteria company, technology, product, and market, an initial business case is analyzed. The alternative innovative concepts are in the third process step subject to a very detailed analysis. The full economical and technical scale of the projects is evaluated and metrics for e.g. the 'Return on Investment' or 'Break Even Point' are determined, to compare the various innovations. Risks related to time, cost, and quality are considered, when performing sensitivity analysis by varying the most important factors of the project. Before discussing critical aspects of the proposed process, space-related examples will be presented to show how the process could be applied, and how different concepts should be evaluated.

  17. THE PRACTICE OF EVALUATING THE ECONOMIC EFFICIENCY OF THE INNOVATIVE PROJECT

    Directory of Open Access Journals (Sweden)

    I. A. Vorobiev

    2013-01-01

    Full Text Available At the present stage of development of the society of scientific and technical activities is the most important factor in the intensification of production and the growth of its economic performance. It is therefore important now gets to determine the effectiveness of research and development activities, improving the measurement methods of economic evaluation of innovative projects and innovation. For informed decision-making requires a deep study and objective assessment of the real situation. This is due to changes in economic relations between the producers and consumers of scientific and technical products. Earlier in this activity involved only state scientific institution and the enterprise, then now they are gradually joining financial institutions, commercial and non-profit organizations. The adoption of innovative solutions should be preceded by thorough and comprehensive analysis of the economic feasibility of the innovative project. In this paper we propose to consider how business is costing innovative projects and determine their effectiveness for the enterprise business hotel.

  18. A comparative evaluation: Oral leukoplakia surgical management using diode laser, CO2 laser, and cryosurgery.

    Science.gov (United States)

    Natekar, Madhukar; Raghuveer, Hosahallli-Puttaiah; Rayapati, Dilip-Kumar; Shobha, Eshwara-Singh; Prashanth, Nagesh-Tavane; Rangan, Vinod; Panicker, Archana G

    2017-06-01

    The comparatively evaluate the three surgical treatment modalities namely cryosurgery, diode and CO2 laser surgery in terms of healing outcomes on the day of surgery, first and second week post operatively and recurrence at the end of 18 months was assessed. Thirty selected patients were divided randomly into three groups. Each group comprising of ten patients were subjected to one of the three modalities of treatment namely cryosurgery, diode laser or CO2 laser surgery for ablation of OL. Obtained data was analyzed using mainly using Chi-square and Anova tests. Study showed statistical significant differences (p > 0.05) for evaluation parameters like pain, edema and scar. The parameters like infection, recurrence, bleeding showed no statistical significance. Pain was significantly higher in CO2 laser surgery group as compared with diode laser group. There was no recurrence observed at the end of the 6 months follow up period in all the three study groups. Observations from the study highlights that all three surgical modalities used in this study were effective for treatment of OL, and the overall summation of the results of the study showed that laser therapy (CO2 and Diode) seems to offer better clinically significant results than cryotherapy. Key words: Oral premalignant lesion, leukoplakia, cryosurgery, CO2 laser surgery, diode laser surgery.

  19. Evaluation and analysis of barriers to the innovation activity in the economy of the region

    Directory of Open Access Journals (Sweden)

    D. A. Tomasova

    2017-01-01

    Full Text Available Prospects for the development of the Russian innovative economy largely depend on the successful overcoming of negative factors impeding the effective interaction of institutions in the field of education, science, business, credit and fi nancial sphere regarding the creation, transfer and commercialization of innovations. Deep evaluation of innovative problems needs dynamic analysis of main processes in the spheres accompanying the innovation activity, which determines the topicality of this article. The aim of research consists in elaborating a dynamic approach to complex estimation of problems and barriers to the innovative development of Russia, including their structure and change. In order to do that, this article reviews the main barriers to the development of innovation activity in the region, builds a detailed classifi cation of parameters of innovative economic environment, and analyses their dynamics. The algorithm of innovation barriers assessment is based on economic statistics methods and fuzzy sets theory. This algorithm is determined on the basis of linguistic variables according to the matrix principle and linguistic identifi cation of economic objects. The estimation is based on a dynamic approach, that is, each analyzed indicator represents a rate of growth of one or another factor associated with the level of barriers to the innovation activity and therefore reflects the degree of reduction or strengthening in such barrier for the period under review. The minimax normalization allows providing comparability of all indicators under review. Macroeconomic data and indices of Russian enterprises operation, presented in statistical collections were used as the input data for analysis and estimation. As a result, we evaluated the level of overcoming barriers to innovative development during the past three years on the basis of analyzing research human potential, of development of innovative infrastructure

  20. Several Methods for Evaluating the Investment Attractiveness of Small Innovation Enterprises

    Directory of Open Access Journals (Sweden)

    Ignatova Iuliia V.

    2017-04-01

    Full Text Available An important factor of impact on the development and living abilities of small and medium-sized innovation enterprises, including startups, is the opportunity to evaluate their investment attractiveness. The main reason for the «failure» of such enterprises is the lack of instrumentarium to forecast the potential number of their customers, and therefore their financial results. The article suggests the number of projected customers as an indicator for evaluation of the investment attractiveness of small innovation enterprises. The authors propose to use a number of mathematical models on the basis of the instrumentarium of descriptive statistics and simulation modeling. The proposed models are built on the basis of the hypothesis of normality of the distribution law of random amounts of income clients and allow forecasting with high accuracy in relation to the day of week, and therefore evaluating the investment risks for potential investors.

  1. Can intravenous conscious sedation with midazolam be effective at facilitating surgical dentistry in adolescent orthodontic patients? A service evaluation.

    Science.gov (United States)

    Stamp, A J; Dorman, M L; Vernazza, C R; Deeming, G; Reid, C; Wilson, K E; Girdler, N M

    2017-01-27

    Background Surgical dentistry during orthodontic care often occurs in adolescence and may involve surgical removal or exposure of teeth. The invasive nature of treatment, combined with dental anxiety, means care can often be provided under general anaesthesia (GA). Best-practice guidelines however endorse conscious sedation as an alternative, where appropriate. Although a limited number of studies have shown safe and effective use of intravenous conscious sedation (IVCS) with midazolam in this cohort, robust evidence to support routine use is lacking. Aim To assess whether IVCS with midazolam can effectively facilitate surgical dentistry in adolescent orthodontic patients in primary care.Method A retrospective service evaluation was undertaken reviewing clinical records of adolescents (aged 12-15 years) undergoing surgical exposure and/or surgical removal of teeth under IVCS with midazolam.Results A total of 174 adolescents (mean age 14.2 years) attended for treatment between 2009 and 2015. Of these adolescents, 98.9% (N = 172) allowed cannulation, with all surgical dentistry completed during a single visit. Midazolam dose ranged from 2-7 mg with 79.1% of patients having good or excellent cooperation and three minor adverse events occurring.Conclusion This service evaluation shows IVCS with midazolam can effectively facilitate surgical orthodontics in carefully selected adolescents. There is however a distinct need to further explore potential for this technique to provide a viable alternative to GA.

  2. The evaluation and surgical management of cyclodialysis clefts that have failed to respond to conservative management

    Science.gov (United States)

    Ioannidis, Alexander S; Bunce, Catey; Barton, Keith

    2014-01-01

    Purpose To investigate factors that may influence successful correction of hypotony in a consecutive series of patients with cyclodialysis clefts repaired surgically over a 10-year period. Design Retrospective interventional case series. Methods Interventional case series of consecutive patients with cyclodialysis clefts and hypotony treated surgically after failure of conservative treatment. Results Eighteen patients (18 eyes) of mean (SD) age 48.3 (15.8) years at the time of surgery were included (16 male, 2 female). All were diagnosed using gonioscopy, usually assisted with intracameral viscoelastic injection. Imaging used in three cases was not found to be sufficiently precise to plan surgical intervention, without prior gonioscopic cleft visualisation. The intraocular pressure (IOP) was restored in nine cases (50%) after one procedure with a postoperative IOP (mean±SD) of 13.6±4.5 mm Hg (6/11 who had cyclopexy as a first procedure and 3/6 who had cryopexy). 2–3 procedures were required in the remaining nine patients. There was a trend towards the use of cyclopexy for larger clefts and cryopexy for smaller clefts (NS). We observed a trend for a lower likelihood of successful closure of larger clefts after one intervention. Two eyes that had cyclopexy required later IOP-lowering surgery to achieve IOP control. Conclusions Most clefts were closed with one procedure. A trend towards larger cleft size as a preoperative risk factor for failure to achieve closure with one procedure was observed. In this series, imaging was not found to be sufficiently precise to replace viscoelastic-assisted gonioscopy in the diagnosis and evaluation of cyclodialysis clefts. PMID:24457370

  3. Healing of surgical castration wounds: a description and an evaluation of flunixin.

    Science.gov (United States)

    Mintline, E M; Varga, A; Banuelos, J; Walker, K A; Hoar, B; Drake, Daniel; Weary, D M; Coetzee, J F; Stock, M L; Tucker, C B

    2014-12-01

    Previous studies have shown that surgical castration wounds take between 10 and 61 d to heal. The objectives of this work were to describe healing, inflammation, lying behavior, and serum concentration of substance P after surgical castration in beef calves and to evaluate the effect of a possible intervention, a single injection of flunixin meglumine (1.1 mg/kg IV, a NSAID), on the healing process. Calves (mean±SE: 25±2.0 d of age; 54±1.4 kg BW) were surgically castrated with or without an injection of flunixin immediately before the procedure (n=24/treatment). Healing was measured with a 5-point scale (1=fresh wound, 5=no visible incision or inflammation) as well as weight gain, scrotal size, and scrotal surface temperature, on d 1, 2, 3, 7, 14, 21, 28, 35, 49, and 63 after castration. Serum concentration of substance P was recorded on all d, including d 0, but not d 63. Lying behavior was recorded with loggers from 2 d before to 29 d after castration. Inflammation, as measured by scrotal size, peaked on d 2 and 3 after the procedure (e.g., 51±1.0 mm on d 2 versus 28±1.3 mm before castration) and then declined with time (Pcastration (41±1.2 pg/mL), possibly because the sample was collected after the lidocaine ring block was administered, which was likely painful, and because of separation from the dam and restraint. Values began to drop by d 3 (34±1.2 pg/mL) and leveled out by d 21 (30±1.2 pg/mL; Pcastration caused inflammation in the days that followed, and the wounds required a minimum of 4 wk to heal. Provision of an NSAID had no effect on these outcomes.

  4. Evaluation of different surgical techniques in the management of subluxated cataractous lens.

    Science.gov (United States)

    Aldakaf, A; Bakir, H; Almogahed, A; Carstocea, Benone

    2007-01-01

    To compare and evaluate the outcome of different surgical techniques in the management of subluxated cataractous lens. This retrospective study included 18 eyes of 18 patients with subluxated cataracts of varying etiology. Their preoperative examination maintain included: best corrected visual acuity (BCVA), thorough anterior segment examination, by slit -lamp especially for the degree and extent of subluxation and cataract, cornea, iris and the pupil for other abnormalities or other traumatic signs, presence or absence of vitreous in the anterior chamber, IOP and finally fundus examination. The patients were then divided into 3 groups each comprising 6 patients. The first group underwent ECCE with sulcus implantation PMMA IOL , the second and third groups underwent phacoemulsification with bag implanted Acrylic IOL but the third group underwent special techniques and precautions during surgery. Postoperatively, all patients were examined for BCVA, IOP, IOL positioning, pupil, fundus examination. Thirteen patients were males and five were females. The etiology of subluxation was traumatic in ten males and two female. The ages of the patients were between 11 and 62 years old the post operative follow up period ranged between 7 and 16 months. No major intraoperative complications were noted. In the 1st group 2 patients underwent AC automated vitrectomy, 3 in the 2nd group, 1 in the 3rd group. Three patients needed scleral fixation suture . Thirteen patients had well centered IOL and 4 had slight decentration not necessitating further intervention and one in the 2nd group had clinically significant decentration where IOL explanation, widening of the wound and re implantation of a wide 6.5mm optic PMMA IOL was done in the second post operative daily. Subluxated cataracts need special precautions in the chosen surgical technique to maintain a reasonable safety level intraoperatively and an acceptable surgical.

  5. Experimental evaluation of photocrosslinkable chitosan as a biologic adhesive with surgical applications.

    Science.gov (United States)

    Ono, K; Ishihara, M; Ozeki, Y; Deguchi, H; Sato, M; Saito, Y; Yura, H; Sato, M; Kikuchi, M; Kurita, A; Maehara, T

    2001-11-01

    In various surgical cases, effective tissue adhesives are required for both hemostasis (eg, intraoperative bleeding) and air sealing (eg, thoracic surgery). We have designed a chitosan molecule (Az-CH-LA) that can be photocrosslinked by ultraviolet (UV) light irradiation, thereby forming a hydrogel. The purpose of this work was to evaluate the effectiveness and safety of the photocrosslinkable chitosan hydrogel as an adhesive with surgical applications. The sealing ability of the chitosan hydrogel, determined as a bursting pressure, was assessed with removed thoracic aorta, trachea, and lung of farm pigs and in a rabbit model. The carotid artery and lung of rabbits were punctured with a needle, and the chitosan hydrogel was applied to, respectively, stop the bleeding and the air leakage. In vivo chitosan degradability and biologic responses were histologically assessed in animal models. The bursting pressure of chitosan hydrogel (30 mg/mL) and fibrin glue, respectively, was 225 +/- 25 mm Hg (mean +/- SD) and 80 +/- 20 mm Hg in the thoracic aorta; 77 +/- 29 mm Hg and 48 +/- 21 mm Hg in the trachea; and in the lung, 51 +/- 11 mm Hg (chitosan hydrogel), 62 +/- 4 mm Hg (fibrin glue, rubbing method), and 12 +/- 2 mm Hg (fibrin glue, layer method). The sealing ability of the chitosan hydrogel was stronger than that of fibrin glue. All rabbits with a carotid artery (n = 8) or lung (n = 8) that was punctured with a needle and then sealed with chitosan hydrogel survived the 1-month observation period without any bleeding or air leakage from the puncture sites. Histologic examinations demonstrated that 30 days after application, a fraction of the chitosan hydrogel was phagocytosed by macrophages, had partially degraded, and had induced the formation of fibrous tissues around the hydrogel. A newly developed photocrosslinkable chitosan has demonstrated strong sealing ability and a great potential for use as an adhesive in surgical operations.

  6. Innovative parameters obtained for digital analysis of microscopic images to evaluate in vitro hemorheological action of anesthetics

    Science.gov (United States)

    Alet, Analía. I.; Basso, Sabrina; Delannoy, Marcela; Alet, Nicolás. A.; D'Arrigo, Mabel; Castellini, Horacio V.; Riquelme, Bibiana D.

    2015-06-01

    Drugs used during anesthesia could enhance microvascular flow disturbance, not only for their systemic cardiovascular actions but also by a direct effect on the microcirculation and in particular on hemorheology. This is particularly important in high-risk surgical patients such as those with vascular disease (diabetes, hypertension, etc.). Therefore, in this work we propose a set of innovative parameters obtained by digital analysis of microscopic images to study the in vitro hemorheological effect of propofol and vecuronium on red blood cell from type 2 diabetic patients compared to healthy donors. Obtained innovative parameters allow quantifying alterations in erythrocyte aggregation, which can increase the in vivo risk of microcapillary obstruction.

  7. Evaluating Additionality of an Innovation Subsidy Program Targeted at SMEs: An Exploratory Study

    Directory of Open Access Journals (Sweden)

    Sonja Radas

    2013-04-01

    Full Text Available This paper explores the effectiveness of a recently introduced innovation subsidy program targeted at SMEs in Croatia. Three aspects of program additionality were evaluated: input, output and behavioral aspects. Both qualitative and survey research was employed, and four case studies with selected recipient companies were conducted. This study is a response to the policy-makers’ need for early program assessment. It attempts to show that even with early evaluation and small population of recipients it is possible to gain insight into program effectiveness. The analysis suggests that the effects of programs targeted at innovative SMEs might need to be evaluated differently than general subsidies. This is especially evident in the evaluation of input additionality. The analysis indicates that SMEs which started with a higher R&D capability tend to increase R&D intensity while participating in the program. The program raised R&D and innovation capability of the participating SMEs, but commercialization of project results remains a concern.

  8. Design and Performance Evaluation of Real-time Endovascular Interventional Surgical Robotic System with High Accuracy.

    Science.gov (United States)

    Wang, Kundong; Chen, Bing; Lu, Qingsheng; Li, Hongbing; Liu, Manhua; Shen, Yu; Xu, Zhuoyan

    2018-05-15

    Endovascular interventional surgery (EIS) is performed under a high radiation environment at the sacrifice of surgeons' health. This paper introduces a novel endovascular interventional surgical robot that aims to reduce radiation to surgeons and physical stress imposed by lead aprons during fluoroscopic X-ray guided catheter intervention. The unique mechanical structure allowed the surgeon to manipulate the axial and radial motion of the catheter and guide wire. Four catheter manipulators (to manipulate the catheter and guide wire), and a control console which consists of four joysticks, several buttons and two twist switches (to control the catheter manipulators) were presented. The entire robotic system was established on a master-slave control structure through CAN (Controller Area Network) bus communication, meanwhile, the slave side of this robotic system showed highly accurate control over velocity and displacement with PID controlling method. The robotic system was tested and passed in vitro and animal experiments. Through functionality evaluation, the manipulators were able to complete interventional surgical motion both independently and cooperatively. The robotic surgery was performed successfully in an adult female pig and demonstrated the feasibility of superior mesenteric and common iliac artery stent implantation. The entire robotic system met the clinical requirements of EIS. The results show that the system has the ability to imitate the movements of surgeons and to accomplish the axial and radial motions with consistency and high-accuracy. Copyright © 2018 John Wiley & Sons, Ltd.

  9. Achilles Tendon Open Surgical Treatment With Platelet-Rich Fibrin Matrix Augmentation: Biomechanical Evaluation.

    Science.gov (United States)

    Alviti, Federica; Gurzì, Michele; Santilli, Valter; Paoloni, Marco; Padua, Roberto; Bernetti, Andrea; Bernardi, Marco; Mangone, Massimiliano

    The relationship between surgical technique and ankle biomechanical properties after surgery for acute rupture of the Achilles tendon (ATR) has not yet been fully investigated. Platelet-rich fibrin (PRF) matrices seem to play a central role in the complex processes of tendon healing. Our aim was to analyze the biomechanical characteristics, stiffness, and mechanical work of the ankle during walking in patients who had undergone surgery after ATR with and without PRF augmentation. We performed a retrospective review of all consecutive patients who had been treated with surgical repair after ATR. Of the 20 male subjects enrolled, 9 (45%) had undergone conventional open repair of the Achilles tendon using the Krackow technique (no-PRF) and 11 (55%) had undergone surgery with PRF augmentation. An additional 8 healthy subjects were included as a control group. A gait analysis evaluation was performed at 6 months after surgery. The percentage of the stance time of the operated leg, double-support time of the healthy leg, and net work of the ankle during the gait cycle showed statistically significant differences between the no-PRF and the healthy group (p < .005). No differences were found between the PRF and healthy groups. Treatment with suture and PRF augmentation could result in significant functional improvements in term of efficiency of motion. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Innovations in robotic surgery.

    Science.gov (United States)

    Gettman, Matthew; Rivera, Marcelino

    2016-05-01

    Developments in robotic surgery have continued to advance care throughout the field of urology. The purpose of this review is to evaluate innovations in robotic surgery over the past 18 months. The release of the da Vinci Xi system heralded an improvement on the Si system with improved docking, the ability to further manipulate robotic arms without clashing, and an autofocus universal endoscope. Robotic simulation continues to evolve with improvements in simulation training design to include augmented reality in robotic surgical education. Robotic-assisted laparoendoscopic single-site surgery continues to evolve with improvements on technique that allow for tackling previously complex pathologic surgical anatomy including urologic oncology and reconstruction. Last, innovations of new surgical platforms with robotic systems to improve surgeon ergonomics and efficiency in ureteral and renal surgery are being applied in the clinical setting. Urologic surgery continues to be at the forefront of the revolution of robotic surgery with advancements in not only existing technology but also creation of entirely novel surgical systems.

  11. Ex-ante evaluation of biotechnology innovations: the case of folate biofortified rice in China.

    Science.gov (United States)

    De Steur, Hans; Blancquaert, Dieter; Gellynck, Xavier; Lambert, Willy; Van Der Straeten, Dominique

    2012-12-01

    In order to valorize novel biotechnology innovations, there is a need to evaluate ex-ante their market potential. A case in point is biofortification, i.e. the enhancement of the micronutrient content of staple crops through conventional or genetic breeding techniques. In a recent article in Nature Biotechnology, for example, De Steur et al. (2010) demonstrated the large potential consumer health benefits of folate biofortified rice as a means to reduce folate deficiency and Neural-Tube Defects. By focusing on a Chinese high-risk region of Neural-Tube Defects, the current study defines the potential cost-effectiveness of this genetically modified crop where the need to improve folate intake levels is highest. Building on the Disability-Adjusted Life Years (DALY) approach, both the potential health impacts and costs of its implementation are measured and benchmarked against similar innovations. The results show that this transgenic crop could be a highly cost-effective product innovation (US$ 120.34 - US$ 40.1 per DALY saved) to alleviate the large health burden of folate deficiency and reduce the prevalence of neural-tube birth defects. When compared with other biofortified crops and target regions, folate biofortified rice in China has a relatively high health impact and moderate cost-effectiveness. This research further supports the need for, and importance of ex-ante evaluation studies in order to adequately market and, thus, valorize biotechnology innovations. Although the cost-effectiveness analysis enables to illustrate the market potential of innovative agricultural biotechnology research, further research is required to address policy issues on transgenic biofortification, such as biosafety regulatory requirements.

  12. A MULTI-OBJECTIVE APPROACH TO THE EVALUATION OF INNOVATIVE POTENTIAL OF THE TOURISM INDUSTRY ORGANIZATIONS

    Directory of Open Access Journals (Sweden)

    Tat’yana Pavlovna Levchenko

    2018-02-01

    Full Text Available Speaking about innovation in the tourism industry and hotel business, in particular, it usually means events of a systemic nature, with quality novelty, aimed at achieving positive changes, stable functioning and dynamic development. Along with general economic factors that determine the uneven demand for services of hospitality, it is explained by the sharp increase in dependence of their tourism and recreational opportunities from innovative potential (IP, capability of adapting to challenging competitive environment. The article considers a multi-objective approach to the study of the innovative potential of the tourism industry organizations. Its essence lies in the fact that the choice of the structural elements from the point of view of their value and importance (in any combination cannot be established a priori, without sufficient objective analysis on some of the more important criteria for achieving the goals. A diagnostic analysis and evaluation of the innovation potential of several hotel organizations from the standpoint of a multi-purpose approach is performed.

  13. Evaluating the enhancement and improvement of China's technology and financial services platform innovation strategy.

    Science.gov (United States)

    Wu, Ching-Sung; Hu, Kuang-Hua; Chen, Fu-Hsiang

    2016-01-01

    The development of high-tech industry has been prosperous around the world in past decades, while technology and finance have already become the most significant issues in the information era. While high-tech firms are a major force behind a country's economic development, it requires a lot of money for the development process, as well as the financing difficulties for its potential problems, thus, how to evaluate and establish appropriate technology and financial services platforms innovation strategy has become one of the most critical and difficult issues. Moreover, how the chosen intertwined financial environment can be optimized in order that high-tech firms financing problems can be decided has seldom been addressed. Thus, this research aims to establish a technology and financial services platform innovation strategy improvement model, as based on the hybrid MADM model, which addresses the main causal factors and amended priorities in order to strengthen ongoing planning. A DEMATEL technique, as based on Analytic Network Process, as well as modified VIKOR, will be proposed for selecting and re-configuring the aspired technology and financial services platform. An empirical study, as based on China's technology and financial services platform innovation strategy, will be provided for verifying the effectiveness of this proposed methodology. Based on expert interviews, technology and financial services platforms innovation strategy improvement should be made in the following order: credit guarantee platform ( C )_credit rating platform ( B )_investment and finance platform ( A ).

  14. Evaluation of a pre-surgical functional MRI workflow: From data acquisition to reporting.

    Science.gov (United States)

    Pernet, Cyril R; Gorgolewski, Krzysztof J; Job, Dominic; Rodriguez, David; Storkey, Amos; Whittle, Ian; Wardlaw, Joanna

    2016-02-01

    Present and assess clinical protocols and associated automated workflow for pre-surgical functional magnetic resonance imaging in brain tumor patients. Protocols were validated using a single-subject reliability approach based on 10 healthy control subjects. Results from the automated workflow were evaluated in 9 patients with brain tumors, comparing fMRI results to direct electrical stimulation (DES) of the cortex. Using a new approach to compute single-subject fMRI reliability in controls, we show that not all tasks are suitable in the clinical context, even if they show meaningful results at the group level. Comparison of the fMRI results from patients to DES showed good correspondence between techniques (odds ratio 36). Providing that validated and reliable fMRI protocols are used, fMRI can accurately delineate eloquent areas, thus providing an aid to medical decision regarding brain tumor surgery. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  15. Medical surgical nurses describe missed nursing care tasks-Evaluating our work environment.

    Science.gov (United States)

    Winsett, Rebecca P; Rottet, Kendra; Schmitt, Abby; Wathen, Ellen; Wilson, Debra

    2016-11-01

    The purpose of the study was to explore the nurse work environment by evaluating the self-report of missed nursing care and the reasons for the missed care. A convenience sample of medical surgical nurses from four hospitals was invited to complete the survey for this descriptive study. The sample included 168 nurses. The MISSCARE survey assessed the frequency and reason of 24 routine nursing care elements. The most frequently reported missed care was ambulation as ordered, medications given within a 30 minute window, and mouth care. Moderate or significant reasons reported for the missed care were: unexpected rise in volume/acuity, heavy admissions/discharges, inadequate assistants, inadequate staff, meds not available when needed, and urgent situations. Identifying missed nursing care and reasons for missed care provides an opportunity for exploring strategies to reduce interruptions, develop unit cohesiveness, improve the nurse work environment, and ultimately leading to improved patient outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Real-time monitoring for detection of retained surgical sponges and team motion in the surgical operation room using radio-frequency-identification (RFID) technology: a preclinical evaluation.

    Science.gov (United States)

    Kranzfelder, Michael; Zywitza, Dorit; Jell, Thomas; Schneider, Armin; Gillen, Sonja; Friess, Helmut; Feussner, Hubertus

    2012-06-15

    Technical progress in the surgical operating room (OR) increases constantly, facilitating the development of intelligent OR systems functioning as "safety backup" in the background of surgery. Precondition is comprehensive data retrieval to identify imminent risky situations and inaugurate adequate security mechanisms. Radio-frequency-identification (RFID) technology may have the potential to meet these demands. We set up a pilot study investigating feasibility and appliance reliability of a stationary RFID system for real-time surgical sponge monitoring (passive tagged sponges, position monitoring: mayo-stand/abdominal situs/waste bucket) and OR team tracking (active transponders, position monitoring: right/left side of OR table). In vitro: 20/20 sponges (100%) were detected on the mayo-stand and within the OR-phantom, however, real-time detection accuracy declined to 7/20 (33%) when the tags were moved simultaneously. All retained sponges were detected correctly. In vivo (animal): 7-10/10 sterilized sponges (70%-100%) were detected correctly within the abdominal cavity. OR-team: detection accuracy within the OR (surveillance antenna) and on both sides of the OR table (sector antenna) was 100%. Mean detection time for position change (left to right side and contrariwise) was 30-60 s. No transponder failure was noted. This is the first combined RFID system that has been developed for stationary use in the surgical OR. Preclinical evaluation revealed a reliable sponge tracking and correct detection of retained textiles (passive RFID) but also demonstrated feasibility of comprehensive data acquisition of team motion (active RFID). However, detection accuracy needs to be further improved before implementation into the surgical OR. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Evaluation of the Prevalence of Different Treatment Failure Modes after Crown Lengthening Surgical Procedures

    Directory of Open Access Journals (Sweden)

    Amirreza Babaloo

    2016-07-01

    Full Text Available Introduction: Preservation of the health of periodontium is very important for the long-term success of restored teeth and a balance should always be created between the patients’ esthetic requirements and the periodontal health. Failures of crown lengthening procedures are classified into early and late failures. The aim of this study was to evaluate the prevalence of early failures of crown leathering surgical procedures. Materials and methods: In this descriptive/cross-sectional study, 96 patients were selected from those referring to the Department of Periodontitis, Tabriz Faculty of Dentistry, who required crown lengthening procedures. The particulars of these patients were recorded in special forms and the reasons for the failure of surgical procedures were separately determined at 2- and 6-week intervals. In addition, the frequencies of the reasons for failures were determined in percentages and absolute frequencies. Data were analyzed with descriptive statistics (frequencies and percentages using SPSS 21. Statistical significance was set at P<0.05. Results: Evaluation of patients 6 weeks after surgery showed a failure rate of 14.5% for crown lengthening procedures in patients referring to the Department of Periodontics, Tabriz Faculty of Dentistry. The most common reasons for such early failures in the 6th week, in descending order, were a lack of sufficient keratinized gingiva around in tooth in question, fracture of the tooth structure after surgery, inadequate surgery (not creating a proper distance between the healthy margin and the crest and the coronal returning of the gingival tissue on the tooth. A lack of sufficient keratinized gingiva around the tooth was the most frequent reason for the early failure of crown lengthening procedure at both study intervals. Conclusion: It can be concluded from the results of the present study that during the 6th postoperative week the crown lengthening procedures exhibited a 14.5% failure rate

  18. SU-F-T-03: Radiobiological Evaluation of a Directional Brachytherapy Device Surgically Implanted Following EBRT

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    Rivard, MJ [Tufts University School of Medicine, Boston, MA (United States); Emrich, JG; Poli, J [Drexel University College of Medicine, Philadelphia, PA (United States)

    2016-06-15

    Purpose: Preceding surgical implantation following external-beam radiotherapy (EBRT) delivery, a radiobiological evaluation was performed for a new LDR Pd-103 directional brachytherapy device (CivaSheet). As this was the first case with the device used in combination with EBRT, there was concern to determine the appropriate prescription dose. Methods: The radiobiological model of Dale (1985, 1989) was used for a permanent LDR implant including radioactive decay. The biological effective dose (BED) was converted to the equivalent dose in 2 Gy fractions (EQD2) for comparison with EBRT prescription expectations. Given IMRT delivery of 50.4 Gy, an LDR brachytherapy dose of approximately 15–20 Gy EQD2 was desired. To be specific to the treatment site (leiomyosarcoma T2bN0M0, grade 2 with R1 surgical margin), the radiobiological model required several radiobiological parameters with values taken from the literature. A sensitivity analysis was performed to determine their relative importance on the calculated BED and subsequent EQD2. The Pd-103 decay constant (λ=0.0017 h{sup −1}) was also used. DVHs were prepared for pre- and post-surgical geometries to glean the possible and realized implant geometric configuration. DVHs prepared in VariSeed9 were converted to BEDVHs and subsequently EQD2 values for each volume-element. Results: For a physical dose of 28 Gy to a 0.5 cm depth, BED=21.7 Gy and EQD2=17.6 Gy, which was near the center of the desired EQD2 range. Tumor bed (CTV=4 cm{sup 3}) coverage was 99.2% with 48 sources implanted. In order of decreasing importance from the sensitivity analysis, the radiobiological parameters were α=0.25 Gy{sup −1}, T{sub POT}=23 days, α/β=8.6 Gy, and T=1.5 h. Percentage variations in these values produced EQD2 variations of 40%, 20%, 18%, and 1%, respectively. Conclusion: This radiobiological evaluation indicated that prescription dose may be determined for comparison with the desired EQD2, and that radiobiologicalparameter

  19. A Patient-Assessed Morbidity to Evaluate Outcome in Surgically Treated Vestibular Schwannomas.

    Science.gov (United States)

    Al-Shudifat, Abdul Rahman; Kahlon, Babar; Höglund, Peter; Lindberg, Sven; Magnusson, Måns; Siesjo, Peter

    2016-10-01

    Outcome after treatment of vestibular schwannomas can be evaluated by health providers as mortality, recurrence, performance, and morbidity. Because mortality and recurrence are rare events, evaluation has to focus on performance and morbidity. The latter has mostly been reported by health providers. In the present study, we validate 2 new scales for patient-assessed performance and morbidity in comparison with different outcome tools, such as quality of life (QOL) (European Quality of Life-5 dimensions [EQ-5D]), facial nerve score, and work capacity. There were 167 total patients in a retrospective (n = 90) and prospective (n = 50) cohort of surgically treated vestibular schwannomas. A new patient-assessed morbidity score (paMS), a patient-assessed Karnofsky score (paKPS), the patient-assessed QOL (EQ-5D) score, work capacity, and the House-Brackmann facial nerve score were used as outcome measures. Analysis of paMS components and their relation to other outcomes was done as uni- and multivariate analysis. All outcome instruments, except EQ-5D and paKPS, showed a significant decrease postoperatively. Only the facial nerve score (House-Brackmann facial nerve score) differed significantly between the retrospective and prospective cohorts. Out of the 16 components of the paMS, hearing dysfunction, tear dysfunction, balance dysfunction, and eye irritation were most often reported. Both paMS and EQ-5D correlated significantly with work capacity. Standard QOL and performance instruments may not be sufficiently sensitive or specific to measure outcome at the cohort level after surgical treatment of vestibular schwannomas. A morbidity score may yield more detailed information on symptoms that can be relevant for rehabilitation and occupational training after surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Evaluation of the Effect of Surgical Crown Lengthening on Periodontal Parameters

    Directory of Open Access Journals (Sweden)

    Farzane Vaziri

    2015-09-01

    Full Text Available Background: Surgical crown lengthening is needed for teeth with subgingival caries, fractured teeth, insufficient crown length, and deep subgingival margin of failed restorations. Since there is no agreement on the effects of crown lengthening surgery on gingival parameters, the purpose of this study was to evaluate periodontal parameters in patients who needed crown lengthening surgery. Methods: Twenty patients who had healthy periodontium and needed surgical crown lengthening were included in this study. After professional dental cleaning, gingival parameters including gingival index (GI, probing depth (PD, bone level (BL, and transsulcular probing (TSP were recorded in interproximal and keratinized gingiva (KG in mid buccal portion. The patients were evaluated one and three months after the surgery. Results: After one and three months of the surgery, the amount of PD reduced from 2.32 mm to 1.25 mm and 1.17 mm, respectively (P=0.001. The mean of BL reduction was 0.88 mm after one month (P=0.001, but there was no reduction between 1 month and 3 months. Amounts of KG at baseline andone month later were 4.2 mm and 2.9 mm, respectively (P=0.001, and remained at the same level up to three months. TSP significantly reduced (from 3.67 mm at baseline to 2.62 mm after 1 month, and to 2.27 mm after 3 months (P=0.001, P=0.005. Conclusion: The present  study suggests that in the presence of good oral hygiene, except BW (biological width, other parameters including PD, BL, KG, and TSP had significant changes after crown lengthening surgery in the period of 1 month and 3 months (P

  1. The Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE): Construct and Content Validation Using a Modified Delphi Method.

    Science.gov (United States)

    Paquette-Warren, Jann; Tyler, Marie; Fournie, Meghan; Harris, Stewart B

    2017-06-01

    In order to scale-up successful innovations, more evidence is needed to evaluate programs that attempt to address the rising prevalence of diabetes and the associated burdens on patients and the healthcare system. This study aimed to assess the construct and content validity of the Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE), a tool developed to guide the evaluation, design and implementation with built-in knowledge translation principles. A modified Delphi method, including 3 individual rounds (questionnaire with 7-point agreement/importance Likert scales and/or open-ended questions) and 1 group round (open discussion) were conducted. Twelve experts in diabetes, research, knowledge translation, evaluation and policy from Canada (Ontario, Quebec and British Columbia) and Australia participated. Quantitative consensus criteria were an interquartile range of ≤1. Qualitative data were analyzed thematically and confirmed by participants. An importance scale was used to determine a priority multi-level indicator set. Items rated very or extremely important by 80% or more of the experts were reviewed in the final group round to build the final set. Participants reached consensus on the content and construct validity of DEFINE, including its title, overall goal, 5-step evaluation approach, medical and nonmedical determinants of health schematics, full list of indicators and associated measurement tools, priority multi-level indicator set and next steps in DEFINE's development. Validated by experts, DEFINE has the right theoretic components to evaluate comprehensively diabetes prevention and management programs and to support acquisition of evidence that could influence the knowledge translation of innovations to reduce the burden of diabetes. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  2. In Vitro Evaluation of Evacuated Blood Collection Tubes as a Closed-Suction Surgical Drain Reservoir.

    Science.gov (United States)

    Heiser, Brian; Okrasinski, E B; Murray, Rebecca; McCord, Kelly

    The initial negative pressures of evacuated blood collection tubes (EBCT) and their in vitro performance as a rigid closed-suction surgical drain (CSSD) reservoir has not been evaluated in the scientific literature despite being described in both human and veterinary texts and journals. The initial negative pressures of EBCT sized 3, 6, 10, and 15 mL were measured and the stability of the system monitored. The pressure-to-volume curve as either air or water was added and maximal filling volumes were measured. Evacuated blood collection tubes beyond the manufacture's expiration date were evaluated for initial negative pressures and maximal filling volumes. Initial negative pressure ranged from -214 mm Hg to -528 mm Hg for EBCT within the manufacturer's expiration date. Different pressure-to-volume curves were found for air versus water. Optimal negative pressures of CSSD are debated in the literature. Drain purpose and type of exudates are factors that should be considered when deciding which EBCT size to implement. Evacuated blood collection tubes have a range of negative pressures and pressure-to-volume curves similar to previously evaluated CSSD rigid reservoirs. Proper drain management and using EBCT within labeled expiration date are important to ensure that expected negative pressures are generated.

  3. Toward a Framework for Resource Efficiency Evaluation in Industry: Recommendations for Research and Innovation Projects

    Directory of Open Access Journals (Sweden)

    Sophie Sfez

    2017-01-01

    Full Text Available The world is facing a tremendous resource supply challenge. One strategy of regions and nations to address this issue is to encourage research and innovation through funding programs. Most of the time, these programs require that research and innovation projects quantify potential increases in resource efficiency achieved by the projects. However, no consensus exists on how to calculate resource efficiency; therefore, a wide range of approaches is followed. As a result, resource efficiency results are not comparable between projects, and because no rules or guidelines exist to help project developers, the approach followed is not always appropriate. This paper aims to discuss the existing approaches and methods used to evaluate resource efficiency. In this context, resource efficiency is defined as the ratio between the benefits obtained from resources and the impact or amount of resources used. The most challenging step is the determination of this ratio’s denominator because a wide range of methods to quantify resource consumption exist and are being used. They can be classified as gate-to-gate or life cycle based methods and can be subdivided into accounting methods and impact assessment methods. Each method considers different aspects of resources; thus, no single method aims to answer the same research questions. Therefore, project developers must make a well informed choice about which method to use. This paper provides recommendations to support this choice, as well as the overall evaluation and the valorization of the resource efficiency ratio in the framework of research and innovation programs.

  4. Evaluation of the Market introduction Energy Innovations (MEI) subsidy scheme; Evaluatie van de MEI-regeling

    Energy Technology Data Exchange (ETDEWEB)

    Wetzels, W.; Smekens, K.; Lako, P. [ECN Beleidsstudies, Petten (Netherlands); Warmenhoven, H. [De Gemeynt, Klarenbeek (Netherlands)

    2012-11-15

    This report contains the outcomes of an evaluation study of the Market introduction Energy Innovations (MEI) subsidy scheme. This scheme is targeted to the horticultural sector and aims to stimulate and accelerate the early market introduction of innovative energy systems in greenhouses. The subsidy scheme was initiated in 2007 and has provided subsidies twice a year since then. Based on project and data analysis, stakeholder interviews and a workshop, the evaluation concludes that the MEI scheme has made a positive contribution to the innovation process in the sector, but that the scheme could have been implemented more efficiently [Dutch] De regeling Marktintroductie energie-innovaties (MEI) is in 2007 ingesteld door het toenmalige Ministerie van Landbouw, Natuur en Voedselkwaliteit. Het doel van de MEI-regeling is het stimuleren en versnellen van de vroege marktintroductie van innovatieve energiesystemen in de glastuinbouw. ECN en De Gemeynt hebben een evaluatie uitgevoerd van de MEI-regeling. De centrale conclusie is dat de regeling een positieve bijdrage heeft geleverd aan het innovatieproces in de glastuinbouwsector.

  5. Study of amended reports to evaluate and improve surgical pathology processes.

    Science.gov (United States)

    Meier, Frederick A; Varney, Ruan C; Zarbo, Richard J

    2011-09-01

    : Amended surgical pathology reports record defects in the process of transforming tissue specimens into diagnostic information. : Systematic study of amended reports tests 2 hypotheses: (a) that tracking amendment frequencies and the distribution of amendment types reveals relevant aspects of quality in surgical pathology's daily transformation of specimens into diagnoses and (b) that such tracking measures the effect, or lack of effect, of efforts to improve surgical pathology processes. : We applied a binary definition of altered reports as either amendments or addenda and a taxonomy of defects that caused amendments as misidentifications, specimen defects, misinterpretations, and report defects. During the introduction of a LEAN process improvement approach-the Henry Ford Productions System-we followed trends in amendment rates and defect fractions to (a) evaluate specific interventions, (b) sort case-by-case root causes of misidentifications, specimen defects, and misinterpretations, and (c) audit the ongoing accuracy of the classification of changed reports. LEAN is the management and production system of the Toyota Motor Corporation that promotes continuous improvement; it considers wasted resources expended for purposes other than creating value for end customers and targets such expenditures for elimination. : Introduction of real-time editing of amendments saw annual amendment rates increase from 4.8/1000 to 10.1/1000 and then decrease in an incremental manner to 5.6/1000 as Henry Ford Productions System-specific interventions were introduced. Before introduction of HFPS interventions, about a fifth of the amendments were due to misidentifications, a 10th were due to specimen defects, a quarter due to misinterpretation, and almost half were due to report defects. During the period of the initial application of HFPS, the fraction of amendments due to misidentifications decreased as those due to report defects increased, in a statistically linked manner. As

  6. Evolution of surgical skills training

    Science.gov (United States)

    Roberts, Kurt E; Bell, Robert L; Duffy, Andrew J

    2006-01-01

    Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients. Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated “tissue” in a box trainer. More advanced, virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations. The Accreditation Council of Graduate Medical Education’s (ACGME) has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and to credential surgeons as technically competent. Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery. An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training, ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients. PMID:16718842

  7. Review and evaluation of innovative technologies for measuring diet in nutritional epidemiology.

    Science.gov (United States)

    Illner, A-K; Freisling, H; Boeing, H; Huybrechts, I; Crispim, S P; Slimani, N

    2012-08-01

    The use of innovative technologies is deemed to improve dietary assessment in various research settings. However, their relative merits in nutritional epidemiological studies, which require accurate quantitative estimates of the usual intake at individual level, still need to be evaluated. To report on the inventory of available innovative technologies for dietary assessment and to critically evaluate their strengths and weaknesses as compared with the conventional methodologies (i.e. Food Frequency Questionnaires, food records, 24-hour dietary recalls) used in epidemiological studies. A list of currently available technologies was identified from English-language journals, using PubMed and Web of Science. The search criteria were principally based on the date of publication (between 1995 and 2011) and pre-defined search keywords. Six main groups of innovative technologies were identified ('Personal Digital Assistant-', 'Mobile-phone-', 'Interactive computer-', 'Web-', 'Camera- and tape-recorder-' and 'Scan- and sensor-based' technologies). Compared with the conventional food records, Personal Digital Assistant and mobile phone devices seem to improve the recording through the possibility for 'real-time' recording at eating events, but their validity to estimate individual dietary intakes was low to moderate. In 24-hour dietary recalls, there is still limited knowledge regarding the accuracy of fully automated approaches; and methodological problems, such as the inaccuracy in self-reported portion sizes might be more critical than in interview-based applications. In contrast, measurement errors in innovative web-based and in conventional paper-based Food Frequency Questionnaires are most likely similar, suggesting that the underlying methodology is unchanged by the technology. Most of the new technologies in dietary assessment were seen to have overlapping methodological features with the conventional methods predominantly used for nutritional epidemiology. Their

  8. Public health policy decisions on medical innovations: what role can early economic evaluation play?

    Science.gov (United States)

    Hartz, Susanne; John, Jürgen

    2009-02-01

    Our contribution aims to explore the different ways in which early economic data can inform public health policy decisions on new medical technologies. A literature research was conducted to detect methodological contributions covering the health policy perspective. Early economic data on new technologies can support public health policy decisions in several ways. Embedded in horizon scanning and HTA activities, it adds to monitoring and assessment of innovations. It can play a role in the control of technology diffusion by informing coverage and reimbursement decisions as well as the direct public promotion of healthcare technologies, leading to increased efficiency. Major problems include the uncertainty related to economic data at early stages as well as the timing of the evaluation of an innovation. Decision-makers can benefit from the information supplied by early economic data, but the actual use in practice is difficult to determine. Further empirical evidence should be gathered, while the use could be promoted by further standardization.

  9. МЕTHODOLOGICAL APPROACHES TO EVALUATION OF OPERATION OF INNOVATION INFRASTRUCTURE ENTITIES

    Directory of Open Access Journals (Sweden)

    E. V. Korolyova

    2010-01-01

    Full Text Available Innovation infrastructure entities (IIEs have become a new social institution which regulates relations between all stakeholders involved in the technology R&D and introduction process and decrease transaction costs on information dissemination and decision-making. While making IIE efficiency evaluation it is necessary to take into account the following: from one side, an influence of the given entity on the activity of scientific and educational institutions, innovative enterprises, investors, and, from the other side, IIE is to be considered as an institution that influences on  social and economic and political processes in the country and correspondingly is subjected to reverse influence of some institutions and economic system as a whole.

  10. Brain spect in the pre-surgical evaluation of epileptic patients preliminary results

    Directory of Open Access Journals (Sweden)

    Carlos A. Buchpiguel

    1992-03-01

    Full Text Available Pre-surgical evaluation of epileptic patients consists of neurological examination, intensive electroencephalographic (EEG monitoring and anatomical studies (CT and MRI. Functional methods such as PET and SPECT imaging are now used more frequently. We have studied pre-operatively 15 adult epileptic patients (8 female, 7 male using a rotational scintillation camera interfaced to a dedicated computer. The tomographic images were obtained 15 minutes after intravenous injection of 99mTc_HMPAO. All had MRI scanning and intensive EEG monitoring which generally included seizure recording. Five patients had progressive lesions (3 meningiomas, 2 astrocytomas. In 10 patients, neuroradiological studies did not show the presence of progressive lesions (2 normal scans and 8 cases with inactive lesions. Two patients with meningioma showed hypoperfusion at the lesion site while the third patient had a marked hyperperfusion which might correlate with the clinical diagnosis of epilepsia partialis continua. In the astrocytoma patients SPECT scans showed hypoperfusion at the lesion site. Data obtained from the 10 patients without progressive CNS lesions showed: (a in 4, SPECT findings correlated well with the anatomical findings; (b in 5 instances, SPECT was able to disclose additional functional deficits; (c in one case, there was no SPECT correlate of a discrete anatomical lesion. In 5 of these cases with no progressive lesions (n=10 SPECT findings were useful as a complementary tool in determining the clinical or surgical management of these patients. Despite the small number and hete-rogenicity of the present sample, SPECT seems to be an useful tool as part of the clinical workup of epileptic patients who are candidates for epilepsy surgery.

  11. Surgical evaluation of magnetic resonance imaging findings in piriformis muscle syndrome

    International Nuclear Information System (INIS)

    Pecina, Hrvoje Ivan; Boric, Igor; Smoljanovic, Tomislav; Pecina, Marko; Duvancic, Davor

    2008-01-01

    The objective of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) in the diagnosis of the piriformis muscle syndrome (PMS). In ten patients, seven female and three male, with a long history of clinical symptoms of the PMS, an MRI was performed as the last preoperative diagnostic tool. All patients were imaged using 2T MR system (Elscint, Haifa, Israel). Axial and coronal spin-echo, fast spin-echo (FSE), and fat-suppressed FSE-weighted images were made through the pelvic region with 3-mm section thickness and a 0.5-mm gap to show the whole piriformis muscle and the course of sciatic nerve on its way out of the pelvis. A routine examination also included axial fast spin-echo T2, three-dimensional gradient echo. In seven cases, an MRI abnormality for the PMS was found. In two women, the MRI demonstrated a bigastric appearance of the piriformis muscle with a tendinous portion between the muscle heads and the course of the common peroneal nerve through the muscle between the tendinous portions of the muscle. In one female patient, the common peroneal nerve passed through the hypertrophied piriformis muscle. In four patients, the MRI showed a hypertrophied aspect of the piriformis muscle and an anteriorly displaced sciatic nerve. All MRI findings were confirmed surgically. In three patients, no apparent abnormalities could be observed, but after a surgical treatment, i.e., a tenotomy of the piriformis muscle and neurolysis of the sciatic nerve, all symptoms disappeared. In piriformis muscle syndrome, MRI may demonstrate signal abnormalities of the sciatic nerve as well as its relationship with the normal and abnormal piriformis muscle. (orig.)

  12. [Effects of malnutrition on infective morbidity in the surgical treatment of portal hypertension (prospective evaluation)].

    Science.gov (United States)

    Herrera, M F; Hoyos, C; Prado, E; Orozco, H

    1991-01-01

    With the aim of investigating the preoperative frequency of undernutrition and its impact on the infectious morbidity in patients without malignant disease, we studied prospectively 41 patients operated because of portal hypertension between 1987 and 1989 at the Instituto Nacional de la Nutrición. All patients were evaluated through anthropometric analysis and biochemical markers one week before the surgical procedure. A standard scheme of antibiotic profilaxis was used during surgery and the preoperative complications were registered up to discharge from the hospital. Undernutrition was considered when the serum albumin was less than 3 mg/dL or the total lymphocyte count was under 900, associated with a 10% weight loss in six months and reduction of one or more anthropometric parameters below the 30th percentile of the normal value. The group consisted of 17 males and 24 females with a mean age of 48 +/- 14 years old. 35 were Child A, four Child B and two Child C. Ten patients had a distal splenorenal shunt, seven esophageal devascularization and 24 gastric desvascularization with splenectomy. Twenty eight patients were well nourished and 13 undernourished. The two groups were comparable in all parameters except for the nutritional status. In the first group seven patients developed 10 complications and in the undernourished group eight patients had 14 complications (p less than 0.05 chi 2). There was no significant difference in the mortality rate. Infections occurred more frequently in: urinary tract, surgical wound, lung and pleura, and esophageal fistulae was an additional complication. The univariate analysis of the anthropometric parameters did not show significant differences between both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Innovation contests to promote sexual health in china: a qualitative evaluation

    Directory of Open Access Journals (Sweden)

    Wei Zhang

    2017-01-01

    Full Text Available Abstract Background Innovation contests call on non-experts to help solve problems. While these contests have been used extensively in the private sector to increase engagement between organizations and clients, there is little data on the role of innovation contests to promote health campaigns. We implemented an innovation contest in China to increase sexual health awareness among youth and evaluated community engagement in the contest. Methods The sexual health image contest consisted of an open call for sexual health images, contest promotion activities, judging of entries, and celebrating contributions. Contest promotion activities included in-person and social media feedback, classroom didactics, and community-driven activities. We conducted 19 semi-structured interviews with a purposive sample to ensure a range of participant scores, experts and non-expert participants, submitters and non-submitters. Transcripts of each interview were coded with Atlas.ti and evaluated by three reviewers. Results We identified stages of community engagement in the contest which contributed to public health impact. Community engagement progressed across a continuum from passive, moderate, active, and finally strong engagement. Engagement was a dynamic process that appeared to have little relationship with formally submitting an image to the contest. Among non-expert participants, contest engagement increased knowledge, healthy attitudes, and empowered participants to share ideas about safe sex with others outside of the contest. Among experts who helped organize the contest, the process of implementing the contest fostered multi-sectoral collaboration and re-oriented public health leadership towards more patient-centered public health campaigns. Conclusion The results of this study suggest that innovation contests may be a useful tool for public health promotion by enhancing community engagement and re-orienting health campaigns to make them more patient-centered.

  14. Innovation contests to promote sexual health in China: a qualitative evaluation.

    Science.gov (United States)

    Zhang, Wei; Schaffer, David; Tso, Lai Sze; Tang, Songyuan; Tang, Weiming; Huang, Shujie; Yang, Bin; Tucker, Joseph D

    2017-01-14

    Innovation contests call on non-experts to help solve problems. While these contests have been used extensively in the private sector to increase engagement between organizations and clients, there is little data on the role of innovation contests to promote health campaigns. We implemented an innovation contest in China to increase sexual health awareness among youth and evaluated community engagement in the contest. The sexual health image contest consisted of an open call for sexual health images, contest promotion activities, judging of entries, and celebrating contributions. Contest promotion activities included in-person and social media feedback, classroom didactics, and community-driven activities. We conducted 19 semi-structured interviews with a purposive sample to ensure a range of participant scores, experts and non-expert participants, submitters and non-submitters. Transcripts of each interview were coded with Atlas.ti and evaluated by three reviewers. We identified stages of community engagement in the contest which contributed to public health impact. Community engagement progressed across a continuum from passive, moderate, active, and finally strong engagement. Engagement was a dynamic process that appeared to have little relationship with formally submitting an image to the contest. Among non-expert participants, contest engagement increased knowledge, healthy attitudes, and empowered participants to share ideas about safe sex with others outside of the contest. Among experts who helped organize the contest, the process of implementing the contest fostered multi-sectoral collaboration and re-oriented public health leadership towards more patient-centered public health campaigns. The results of this study suggest that innovation contests may be a useful tool for public health promotion by enhancing community engagement and re-orienting health campaigns to make them more patient-centered.

  15. Evaluating the optimal timing of surgical antimicrobial prophylaxis: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Mujagic, Edin; Zwimpfer, Tibor; Marti, Walter R; Zwahlen, Marcel; Hoffmann, Henry; Kindler, Christoph; Fux, Christoph; Misteli, Heidi; Iselin, Lukas; Lugli, Andrea Kopp; Nebiker, Christian A; von Holzen, Urs; Vinzens, Fabrizio; von Strauss, Marco; Reck, Stefan; Kraljević, Marko; Widmer, Andreas F; Oertli, Daniel; Rosenthal, Rachel; Weber, Walter P

    2014-05-24

    Surgical site infections are the most common hospital-acquired infections among surgical patients. The administration of surgical antimicrobial prophylaxis reduces the risk of surgical site infections . The optimal timing of this procedure is still a matter of debate. While most studies suggest that it should be given as close to the incision time as possible, others conclude that this may be too late for optimal prevention of surgical site infections. A large observational study suggests that surgical antimicrobial prophylaxis should be administered 74 to 30 minutes before surgery. The aim of this article is to report the design and protocol of a randomized controlled trial investigating the optimal timing of surgical antimicrobial prophylaxis. In this bi-center randomized controlled trial conducted at two tertiary referral centers in Switzerland, we plan to include 5,000 patients undergoing general, oncologic, vascular and orthopedic trauma procedures. Patients are randomized in a 1:1 ratio into two groups: one receiving surgical antimicrobial prophylaxis in the anesthesia room (75 to 30 minutes before incision) and the other receiving surgical antimicrobial prophylaxis in the operating room (less than 30 minutes before incision). We expect a significantly lower rate of surgical site infections with surgical antimicrobial prophylaxis administered more than 30 minutes before the scheduled incision. The primary outcome is the occurrence of surgical site infections during a 30-day follow-up period (one year with an implant in place). When assuming a 5% surgical site infection risk with administration of surgical antimicrobial prophylaxis in the operating room, the planned sample size has an 80% power to detect a relative risk reduction for surgical site infections of 33% when administering surgical antimicrobial prophylaxis in the anesthesia room (with a two-sided type I error of 5%). We expect the study to be completed within three years. The results of this

  16. Retrospective evaluation of surgical intervention following chemo- and radiotherapy of maxillary sinus cancers

    Energy Technology Data Exchange (ETDEWEB)

    Kudo, Keigo; Satoh, Yumi; Endo, Mitsuhiro; Segawa, Kiyoshi; Fukuta, Yoshiyasu; Yokota, Mitsumasa; Fujioka, Yukio (Iwate Medical Univ., Morioka (Japan). School of Dentistry)

    1992-03-01

    During the past 15 years, 30 patients with squamous cell carcinomas of the maxillary sinus were treated by modified partial maxillectomy following chemo- and radiotherapy, taking care to preserve facial contour and function as far as possible. Follow-up evaluation showed that local recurrences, and regional lymph node and distant metastases were more frequent in T4 patients than in T3 patients. Evaluation of the histopathological effects of preoperative chemo- and radiotherapy at the time of surgery showed that T4 patients tended to have a poorer response to the treatment than T3 patients. Analysis according to the direction of primary tumor extension showed that the incidence of local recurrence was higher in the superolateral type, whereas that of regional lymph node metastasis was higher in the medial type. The cumulative 5-year survival was high (72.2%) in Stage III patients and low (22.5%) in Stage IV patients. The overall rate was 55.4%. The treatment produced relatively good outcomes in T3 patients but poor outcomes in T4 patients. These findings indicate that T4 carcinoma of the maxillary sinus must be managed initially by a combination of irradiation and multi-chemotherapeutic drugs, and then treated by more extensive surgical resection. (author).

  17. Retrospective evaluation of surgical intervention following chemo- and radiotherapy of maxillary sinus cancers

    International Nuclear Information System (INIS)

    Kudo, Keigo; Satoh, Yumi; Endo, Mitsuhiro; Segawa, Kiyoshi; Fukuta, Yoshiyasu; Yokota, Mitsumasa; Fujioka, Yukio

    1992-01-01

    During the past 15 years, 30 patients with squamous cell carcinomas of the maxillary sinus were treated by modified partial maxillectomy following chemo- and radiotherapy, taking care to preserve facial contour and function as far as possible. Follow-up evaluation showed that local recurrences, and regional lymph node and distant metastases were more frequent in T4 patients than in T3 patients. Evaluation of the histopathological effects of preoperative chemo- and radiotherapy at the time of surgery showed that T4 patients tended to have a poorer response to the treatment than T3 patients. Analysis according to the direction of primary tumor extension showed that the incidence of local recurrence was higher in the superolateral type, whereas that of regional lymph node metastasis was higher in the medial type. The cumulative 5-year survival was high (72.2%) in Stage III patients and low (22.5%) in Stage IV patients. The overall rate was 55.4%. The treatment produced relatively good outcomes in T3 patients but poor outcomes in T4 patients. These findings indicate that T4 carcinoma of the maxillary sinus must be managed initially by a combination of irradiation and multi-chemotherapeutic drugs, and then treated by more extensive surgical resection. (author)

  18. A prospective, controlled clinical evaluation of surgical stabilization of severe rib fractures.

    Science.gov (United States)

    Pieracci, Fredric M; Lin, Yihan; Rodil, Maria; Synder, Madelyne; Herbert, Benoit; Tran, Dong Kha; Stoval, Robert T; Johnson, Jeffrey L; Biffl, Walter L; Barnett, Carlton C; Cothren-Burlew, Clay; Fox, Charles; Jurkovich, Gregory J; Moore, Ernest E

    2016-02-01

    Previous studies of surgical stabilization of rib fractures (SSRF) have been limited by small sample sizes, retrospective methodology, and inclusion of only patients with flail chest. We performed a prospective, controlled evaluation of SSRF as compared with optimal medical management for severe rib fracture patterns among critically ill trauma patients. We hypothesized that SSRF improves acute outcomes. We conducted a 2-year clinical evaluation of patients with any of the following rib fracture patterns: flail chest, three or more fractures with bicortical displacement, 30% or greater hemithorax volume loss, and either severe pain or respiratory failure despite optimal medical management. In the year 2013, all patients were managed nonoperatively. In the year 2014, all patients were managed operatively. Outcomes included respiratory failure, tracheostomy, pneumonia, ventilator days, tracheostomy, length of stay, daily maximum incentive spirometer volume, narcotic requirements, and mortality. Univariate and multivariable analyses were performed. Seventy patients were included, 35 in each group. For the operative group, time from injury to surgery was 2.4 day, operative time was 1.5 hours, and the ratio of ribs fixed to ribs fractured was 0.6. The operative group had a significantly higher RibScore (4 vs. 3, respectively, p fracture patterns. Therapeutic study, level II.

  19. Particulate bioglass in the regeneration of alveolar bone in dogs: clinical, surgical and radiographic evaluations

    Directory of Open Access Journals (Sweden)

    Alexandre Couto Tsiomis

    2011-04-01

    Full Text Available Bone loss, either by trauma or other diseases, generates an increasing need for substitutes of this tissue. This study evaluated Bioglass as a bone substitute in the regeneration of the alveolar bone in mandibles of dogs by clinical, surgical and radiological analysis. Twenty-eight adult dogs were randomly separated into two equal groups. In each animal, a bone defect was created on the vestibular surface of the alveolar bone between the roots of the fourth right premolar tooth. In the treated group, the defect was immediately filled with bioglass, while in the control, it remained unfilled. Clinical evaluations were performed daily for a week, as well as x-rays immediately after surgery and at 8, 14, 21, 42, 60, 90 and 120 days post-operative. Most animals in both groups showed no signs of inflammation and wound healing was similar. Radiographic examination revealed a gradual increase of radiopacity in the region of the defect in the control group. In the treated group, initial radiopacity was higher than that of adjacent bone, decreasing until 21 days after surgery. Then it gradually increased until 120 days after surgery, when the defect became undetectable. The results showed that Bioglass integrates into bone tissue, is biocompatible and reduced the period for complete bone regeneration.

  20. Evaluation of the Nasal Surgical Questionnaire for Monitoring Results of Septoplasty

    Directory of Open Access Journals (Sweden)

    Rolf Haye

    2015-01-01

    Full Text Available Monitoring the results of surgery is important. The otorhinolaryngology department of our hospital currently uses preoperative and postoperative versions of the Nasal Surgical Questionnaire (NSQ for continuous evaluation of nasal septoplasty. In this study, 55 patients undergoing septoplasty answered the preoperative version twice to assess the NSQ’s test-retest precision, and 75 patients answered the preoperative questionnaire before and the postoperative one 6 months after surgery to evaluate the NSQ’s ability to detect change in symptoms following surgery. Both the pre- and postoperative versions of the NSQ use separate visual analogue scales (VAS to assess nasal obstruction during the day, at night, and during exercise. Other nasal symptoms are graded as secondary outcomes using 4-point Likert scales. The mean VAS scores for the two preoperative obstruction ratings were not significantly different. The scores were significantly higher than in a normal population. There were also significant differences between preoperative and postoperative ratings. The mean pre- and postoperative scores at night for those who reported complete improvement were 66.1 and 8.4, substantial improvement 74.5 and 24.2, and no improvement 83.3 and 76.4. The NSQ reliably assesses nasal symptoms in patients and may be useful for both short and long term prospective studies of septoplasty.

  1. Vocal Fold Hyperplastic Lesions: an Evaluation of Surgical Outcome with Videolaryngostroboscopy

    Directory of Open Access Journals (Sweden)

    Melek Kezban Gürbüz

    2013-06-01

    Full Text Available Background: Vocal fold hyperplastic lesions are premalignant lesions that can be treated effectively by removal of the lesions surgically. Aims: The aim of this study was to discuss the success of surgery in patients with vocal fold hyperplastic lesions in terms of preserving vibratory function by comparing the preoperative and postoperative videolaryngostroboscopy findings. Study Design: The medical charts and videolaryngostroboscopic recordings of patients diagnosed with hyperplastic lesions on the vocal folds were reviewed retrospectively. Methods: Twenty seven patients with unilateral lesions who underwent type1 subepithelial cordectomy were enrolled in the study. The videolaryngostroboscopic recordings were evaluated by three raters who were not the operating surgeon and who were blinded to the histology of patients. To evaluate the videolaryngostroboscopic findings, a form, which is a modification of criteria described by Hirano and Bless, was used. Preoperative and 6th month postoperative videolaryngostroboscopic recordings were compared with each other and with recordings of the control group, which included 50 healthy volunteers. Results: All videolaryngostroboscopic findings, except false cord vibration, were significantly improved after surgery. Conclusion: The principle of vocal fold surgery in patients with benign lesions is to preserve the vibratory tissue. This principle also applies to patients with hyperplastic lesions that are premalignant. The hydrodissection technique may be beneficial for this purpose.

  2. Prospective evaluation of surgical management of sliding hiatal hernia and gastroesophageal reflux in dogs.

    Science.gov (United States)

    Mayhew, Philipp D; Marks, Stanley L; Pollard, Rachel; Culp, William T N; Kass, Philip H

    2017-11-01

    To evaluate response to surgical management of sliding hiatal hernia (SHH) and gastroesophageal reflux (GER) in dogs using standardized clinical scoring, videofluoroscopic swallow studies, and impedance planimetry. Prospective clinical trial. A total of 17 client-owned dogs. Dogs were included if they had clinical signs and videofluoroscopic evidence of SHH and/or GER. Owners were asked to complete a standardized canine dysphagia assessment tool (CDAT) preoperatively and postoperatively. Conscious videofluoroscopic swallowing studies and impedance planimetry (IP) were used to evaluate esophageal function and lower esophageal sphincter location and geometry preoperatively and in a subsection of dogs postoperatively. Preoperatively, 13/17 dogs included in the study had a history of regurgitation, and 4/17 had radiographic evidence of aspiration pneumonia. Postprandial regurgitation improved in 8/10 dogs with preoperative regurgitation, and for which completed preoperative and postoperative CDAT questionnaires were available (P hernia severity score improved postoperatively (P = .046) in dogs with preoperative and postoperative videofluoroscopic swallowing studies (n = 12). However, hernia frequency score (P = .2) and IP parameters did not differ significantly between time points. Clinical signs of SHH generally improved with surgery but did not consistently resolve. Videofluoroscopic studies provide evidence that GER and SHH can persist postoperatively in some patients. Based on IP findings, clinical improvement may be attributed to a mechanism independent of lower esophageal sphincter attenuation. © 2017 The American College of Veterinary Surgeons.

  3. HISTORY AND ACCOMPLISHMENTS OF THE US EPA'S SUPERFUND INNOVATIVE TECHNOLOGY EVALUATION (SITE) MONITORING AND MEASUREMENT (MMT) PROGRAM

    Science.gov (United States)

    This manuscript presents the history and evolution of the U.S. Environmental Protection Agency's (EPA) Superfund Innovative Technology Evaluation (SITE) Monitoring and Measurement Technology (MMT) Program. This includes a discussion of how the fundamental concepts of a performanc...

  4. Evaluation of the Effect of Diagnostic Molecular Testing on the Surgical Decision-Making Process for Patients With Thyroid Nodules.

    Science.gov (United States)

    Noureldine, Salem I; Najafian, Alireza; Aragon Han, Patricia; Olson, Matthew T; Genther, Dane J; Schneider, Eric B; Prescott, Jason D; Agrawal, Nishant; Mathur, Aarti; Zeiger, Martha A; Tufano, Ralph P

    2016-07-01

    Diagnostic molecular testing is used in the workup of thyroid nodules. While these tests appear to be promising in more definitively assigning a risk of malignancy, their effect on surgical decision making has yet to be demonstrated. To investigate the effect of diagnostic molecular profiling of thyroid nodules on the surgical decision-making process. A surgical management algorithm was developed and published after peer review that incorporated individual Bethesda System for Reporting Thyroid Cytopathology classifications with clinical, laboratory, and radiological results. This algorithm was created to formalize the decision-making process selected herein in managing patients with thyroid nodules. Between April 1, 2014, and March 31, 2015, a prospective study of patients who had undergone diagnostic molecular testing of a thyroid nodule before being seen for surgical consultation was performed. The recommended management undertaken by the surgeon was then prospectively compared with the corresponding one in the algorithm. Patients with thyroid nodules who did not undergo molecular testing and were seen for surgical consultation during the same period served as a control group. All pertinent treatment options were presented to each patient, and any deviation from the algorithm was recorded prospectively. To evaluate the appropriateness of any change (deviation) in management, the surgical histopathology diagnosis was correlated with the surgery performed. The study cohort comprised 140 patients who underwent molecular testing. Their mean (SD) age was 50.3 (14.6) years, and 75.0% (105 of 140) were female. Over a 1-year period, 20.3% (140 of 688) had undergone diagnostic molecular testing before surgical consultation, and 79.7% (548 of 688) had not undergone molecular testing. The surgical management deviated from the treatment algorithm in 12.9% (18 of 140) with molecular testing and in 10.2% (56 of 548) without molecular testing (P = .37). In the group with

  5. An approach for evaluating the integrity of fuel applied in Innovative Nuclear Energy Systems

    International Nuclear Information System (INIS)

    Nakae, Nobuo; Ozawa, Takayuki; Ohta, Hirokazu; Ogata, Takanari; Sekimoto, Hiroshi

    2014-01-01

    One of the important issues in the study of Innovative Nuclear Energy Systems is evaluating the integrity of fuel applied in Innovative Nuclear Energy Systems. An approach for evaluating the integrity of the fuel is discussed here based on the procedure currently used in the integrity evaluation of fast reactor fuel. The fuel failure modes determining fuel life time were reviewed and fuel integrity was analyzed and compared with the failure criteria. Metal and nitride fuels with austenitic and ferritic stainless steel (SS) cladding tubes were examined in this study. For the purpose of representative irradiation behavior analyses of the fuel for Innovative Nuclear Energy Systems, the correlations of the cladding characteristics were modeled based on well-known characteristics of austenitic modified 316 SS (PNC316), ferritic–martensitic steel (PNC–FMS) and oxide dispersion strengthened steel (PNC–ODS). The analysis showed that the fuel lifetime is limited by channel fracture which is a nonductile type (brittle) failure associated with a high level of irradiation-induced swelling in the case of austenitic steel cladding. In case of ferritic steel, on the other hand, the fuel lifetime is controlled by cladding creep rupture. The lifetime evaluated here is limited to 200 GW d/t, which is lower than the target burnup value of 500 GW d/t. One of the possible measures to extend the lifetime may be reducing the fuel smeared density and ventilating fission gas in the plenum for metal fuel and by reducing the maximum cladding temperature from 650 to 600 °C for both metal and nitride fuel

  6. An approach for evaluating the integrity of fuel applied in Innovative Nuclear Energy Systems

    Energy Technology Data Exchange (ETDEWEB)

    Nakae, Nobuo, E-mail: nakae-nobuo@jnes.go.jp [Center for Research into Innovative Nuclear Energy System, Tokyo Institute of Technology, 2-12-1-N1-19, Ookayama, Meguro-ku, Tokyo 152-8550 (Japan); Ozawa, Takayuki [Advanced Nuclear System Research and Development Directorate, Japan Atomic Energy Agency, 4-33, Muramatsu, Tokai-mura, Ibaraki-ken 319-1194 (Japan); Ohta, Hirokazu; Ogata, Takanari [Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry, 2-11-1, Iwado Kita, Komae-shi, Tokyo 201-8511 (Japan); Sekimoto, Hiroshi [Center for Research into Innovative Nuclear Energy System, Tokyo Institute of Technology, 2-12-1-N1-19, Ookayama, Meguro-ku, Tokyo 152-8550 (Japan)

    2014-03-15

    One of the important issues in the study of Innovative Nuclear Energy Systems is evaluating the integrity of fuel applied in Innovative Nuclear Energy Systems. An approach for evaluating the integrity of the fuel is discussed here based on the procedure currently used in the integrity evaluation of fast reactor fuel. The fuel failure modes determining fuel life time were reviewed and fuel integrity was analyzed and compared with the failure criteria. Metal and nitride fuels with austenitic and ferritic stainless steel (SS) cladding tubes were examined in this study. For the purpose of representative irradiation behavior analyses of the fuel for Innovative Nuclear Energy Systems, the correlations of the cladding characteristics were modeled based on well-known characteristics of austenitic modified 316 SS (PNC316), ferritic–martensitic steel (PNC–FMS) and oxide dispersion strengthened steel (PNC–ODS). The analysis showed that the fuel lifetime is limited by channel fracture which is a nonductile type (brittle) failure associated with a high level of irradiation-induced swelling in the case of austenitic steel cladding. In case of ferritic steel, on the other hand, the fuel lifetime is controlled by cladding creep rupture. The lifetime evaluated here is limited to 200 GW d/t, which is lower than the target burnup value of 500 GW d/t. One of the possible measures to extend the lifetime may be reducing the fuel smeared density and ventilating fission gas in the plenum for metal fuel and by reducing the maximum cladding temperature from 650 to 600 °C for both metal and nitride fuel.

  7. The Value of Fidelity of Implementation Criteria to Evaluate School-Based Science Curriculum Innovations

    Science.gov (United States)

    Lee, Yew-Jin; Chue, Shien

    2013-10-01

    School-based curriculum innovations, including those in science education, are usually not adequately evaluated, if at all. Furthermore, current procedures and instruments for programme evaluations are often unable to support evidence-based decision-making. We suggest that adopting fidelity of implementation (FOI) criteria from healthcare research can both characterize and narrow the separation between programme intent and actual implementation, which is a mandatory stage of evaluation before determining overall programme value. We demonstrate how such a process could be applied by science educators using data from a secondary school in Singapore that had devised a new curriculum to promote interest, investigative processes, and knowledge in science. Results showed that there were ambivalent student responses to this programme, while there were high levels of science process skill instruction and close alignment with the intended lesson design. The implementation of this programme appeared to have a satisfactory overall level of FOI, but we also detected tensions between programme intent and everyday classroom teaching. If we want to advance science education, then our argument is that applying FOI criteria is necessary when evaluating all curricular innovations, not just those that originate from schools.

  8. Methodological considerations in evaluating a proliferation resistance of innovative nuclear energy systems

    International Nuclear Information System (INIS)

    Kikuchi, Masahiro; Takaki, Naoyuki; Murajiri, Masahiro; Nakagome, Yoshihiro; Tokiwai, Moriyasu

    2004-01-01

    Over 25 years ago, INFCE studied the evaluation methodology of proliferation resistance. Recently, INPRO and GEN-IV coordinated by the IAEA and the USDOE respectively seek an appropriate innovative fuel cycle system for next generation that is furnished safer, sustainable, economical and reliable features. The evaluation methodology of the proliferation resistance is also assigned as an essential part of both studies. The IAEA established and has been strictly implementing the verification measures with accurate material accountancy system from the early of the 1970s in order to detect diversion of plutonium that is individually separated from irradiated nuclear material and recycled as MOX fuel. This paper firstly identifies the impedibility of intrinsic features of innovative fuel cycles and the safeguardability of selected nonproliferation measures as two individual essential parameters for evaluation of a proliferation resistance capability. As a next step, this paper also shows methodological considerations in evaluating the proliferation resistance levels as a multiple model of several clusters that are identified the ability of each parameter. (author)

  9. Expert evaluation of innovation projects of mining enterprises on the basis of methods of system analysis and fuzzy logics

    Directory of Open Access Journals (Sweden)

    Pimonov Alexander

    2017-01-01

    Full Text Available This paper presents the multipurpose approach to evaluation of research and innovation projects based on the method of analysis of hierarchies and fuzzy logics for the mining industry. The approach, implemented as part of a decision support system, can reduce the degree of subjectivity during examinations by taking into account both quantitative and qualitative characteristics of the compared innovative alternatives; it does not depend on specific conditions of examination and allows engagement of experts of various fields of knowledge. The system includes the mechanism of coordination of several experts’ views. Using of fuzzy logics allows evaluating the qualitative characteristics of innovations in the form of formalized logical conclusions.

  10. Urethral obstruction after anti-incontinence surgery in women: evaluation, methodology, and surgical results.

    Science.gov (United States)

    Austin, P; Spyropoulos, E; Lotenfoe, R; Helal, M; Hoffman, M; Lockhart, J L

    1996-06-01

    To evaluate a group of women with voiding dysfunction and a low maximum flow rate (MFR) (less than or equal to 12 mL/s) after surgery for stress urinary incontinence (SUI); to establish diagnostic parameters indicating obstruction in an attempt to determine treatment selection; and to evaluate preliminary surgical results. Eighteen women who underwent anti-incontinence surgery for SUI were diagnosed as having infravesical obstruction (IO). Thirteen women (group A [72%]) presented with clinically predominant symptoms of urgency, frequency, intermittency, and a variable vesical residual volume (RV), and five (group B [28%]) had as their most significant symptoms a high vesical RV and urinary tract infection that had been managed with intermittent catheterization (IC). The diagnosis of IO, suspected after clinical history, was established after physical examination and cystoscopic, cystographic and urodynamic investigations. Bladder instability was demonstrated in 6 group A patients (46%) and 1 group B patient (20%) (P = NS). Mean MFRs were 8.07 and 7.2 mL/s, respectively, in both groups (P = NS). Mean maximal voiding pressures (MVPs) were 20.23 and 5 cm H20, and mean RVs were 57.46 and 174 mL, respectively; both differences were statistically very significant (P <0.01 and P <0.001, respectively). High to normal MVPs occurred in 2 patients overall (11%). Bladder neck overcorrection, midurethral distortion, and postsurgical cystocele were demonstrated in both groups in 11 (85%), 0, and 2 (15%) patients in group A and 3 (60%), 2 (40%), and 3 (60%) patients in group B, respectively (P = NS). Patients in group A were treated surgically with cystourethrolysis and a repeated, less obstructive anti-incontinence operation. In group B 2 women (40%) had a similar surgical procedure; 1 (20%) underwent isolated urethrolysis; and 2 (40%) are currently maintained with IC. Among these 18 patients with voiding dysfunction after anti-incontinence surgery, a primary diagnosis of IO was

  11. 1992 update of US EPA's Superfund Innovative Technology Evaluation (SITE) Emerging Technology Program

    International Nuclear Information System (INIS)

    Lewis, N.M.; Barkley, N.P.; Williams, T.

    1992-01-01

    The Superfund Innovative Technology Evaluation (SITE) Emerging Technology Program (ETP) has financially supported further development of bench- and pilot-scale testing and evaluation of innovative technologies for use at hazardous waste sites for five years. The ETP was established under the Superfund Amendments and Reauthorization Act (SARA) of 1986. The ETP complies with the goal of the SITE Program to promote, accelerate and make commercially available the development of alternative/innovative treatment technologies for use at Superfund sites. Technologies are submitted to the ETP through yearly solicitations for Preproposals. Applicants are asked to submit a detailed project proposal and a cooperative agreement application that requires Developer/EPA cost sharing. EPA co-funds selected Developers for one to two years. Second-year funding requires documentation of significant progress during the first year. Facilities, equipment, data collection, performance and development are monitored throughout the project. The US Department of Energy (DOE) and the US Air Force (USAF) are participants in the ETP. DOE has co-funded ETP projects since 1990 and the USAF since 1991. A goal of the ETP is to move developed technologies to the field-demonstration stage. A developer may be considered for participation in the SITE Demonstration Program if performance in the ETP indicates the technology is field-ready for evaluation. Six technology categories: biological, chemical, materials handling, physical, solidification/stabilization and thermal, are presently in the ETP. Technologies of primary interest to EPA are those that can treat complex mixtures of hazardous organic and inorganic contaminants and provide improved solids handling and/or pretreatment. An account of the background and progress of the ETP's first five years is presented in this paper. Technologies currently in the ETP are noted, and developers and EPA Project Managers, are listed. 4 refs., 11 figs., 6 tabs

  12. Learning Evaluation: blending quality improvement and implementation research methods to study healthcare innovations.

    Science.gov (United States)

    Balasubramanian, Bijal A; Cohen, Deborah J; Davis, Melinda M; Gunn, Rose; Dickinson, L Miriam; Miller, William L; Crabtree, Benjamin F; Stange, Kurt C

    2015-03-10

    In healthcare change interventions, on-the-ground learning about the implementation process is often lost because of a primary focus on outcome improvements. This paper describes the Learning Evaluation, a methodological approach that blends quality improvement and implementation research methods to study healthcare innovations. Learning Evaluation is an approach to multi-organization assessment. Qualitative and quantitative data are collected to conduct real-time assessment of implementation processes while also assessing changes in context, facilitating quality improvement using run charts and audit and feedback, and generating transportable lessons. Five principles are the foundation of this approach: (1) gather data to describe changes made by healthcare organizations and how changes are implemented; (2) collect process and outcome data relevant to healthcare organizations and to the research team; (3) assess multi-level contextual factors that affect implementation, process, outcome, and transportability; (4) assist healthcare organizations in using data for continuous quality improvement; and (5) operationalize common measurement strategies to generate transportable results. Learning Evaluation principles are applied across organizations by the following: (1) establishing a detailed understanding of the baseline implementation plan; (2) identifying target populations and tracking relevant process measures; (3) collecting and analyzing real-time quantitative and qualitative data on important contextual factors; (4) synthesizing data and emerging findings and sharing with stakeholders on an ongoing basis; and (5) harmonizing and fostering learning from process and outcome data. Application to a multi-site program focused on primary care and behavioral health integration shows the feasibility and utility of Learning Evaluation for generating real-time insights into evolving implementation processes. Learning Evaluation generates systematic and rigorous cross

  13. Strategical integration and prior evaluation of science and innovation projects in Ecuadorians sports organizations.

    Directory of Open Access Journals (Sweden)

    Gloria Barroso Rodríguez

    2015-09-01

    Full Text Available This work shows the design of a procedure for evaluating the strategical integration of science and innovation projects level in the physical and sport sphere, and its validation through expert criteria for application to Ecuadorian sports organizations. As a result, it was possible to demonstrate the validity of the procedure designed, so it will be possible to be used to facilitate decision-making in relation to the execution of such projects considering, as a value judgment, the level of their essential components integration for the achievement of objectives aligned to the strategic priorities of the Ecuadorians sports organizations.  

  14. Development and evaluation of a simulator-based laparoscopic training program for surgical novices.

    Science.gov (United States)

    Nugent, Emmeline; Shirilla, Nicole; Hafeez, Adnan; O'Riordain, Diarmuid S; Traynor, Oscar; Harrison, Anthony M; Neary, Paul

    2013-01-01

    The use of simulation to train novice surgeons in laparoscopic skills is becoming increasingly popular. To maximize benefit from simulation, training needs to be delivered and assessed in a structured manner. This study aimed to define performance goals, demonstrate construct validity of the training program, and evaluate whether novice surgeons could reach the preset performance goals. Nine expert laparoscopic surgeons established performance goals for three basic modules of an augmented-reality laparoscopic simulator. The three laparoscopic modules were used by 40 novice surgeons and 40 surgical trainees (postgraduate years [PGYs] 1-4). The performance outcomes were analyzed across the different groups (novice, PGYs 1 and 2, PGYs 3 and 4, expert) to determine construct validity. Then 26 recruited novices trained on the three modules with the aim of reaching the performance goals. The results demonstrated a significant difference in performance between all levels of experience for time (p < 0.001), motion analysis (p < 0.001), and error score (p < 0.001), thus demonstrating construct validity. All 26 novice surgeons significantly improved in performance with repetition for the metrics of time (p < 0.001) and motion analysis (p < 0.001). For two of the modules, the proficiency goals were reached in fewer than 10 trials by 80% of the study participants. Basic skills in laparoscopic surgery can be learned and improved using proficiency-based simulation training. It is possible for novice surgeons to achieve predefined performance goals in a reasonable time frame.

  15. Diagnostic evaluation and aggressive surgical approach in bleeding pseudoaneurysms associated with pancreatic pseudocysts

    International Nuclear Information System (INIS)

    Pitkaeranta, P.; Haapiainen, R.; Kivisaari, L.; Schroeder, T.

    1991-01-01

    Hemorrhage is an uncommon but serious complication of pancreatic pseudocysts. When gastrointestinal bleeding or intra-abdominal hemorrhage is associated with a pancreatic pseudocysts and the usual sources of bleeding are not detected by endoscopy, the rupture of a pseudoaneurysm inside the pseudocyst should be suspected. The article present 13 cases, 11 associated with chronic and 2 with late complications after acute necrotizing pancreatitis. On the basis of sonographic findings, bleeding site was suspected in 8 of 11 patients. Computed tomography (CT) was performed on 10, and bleeding was suspected in 8. The pseudoaneurysm itself was detected by CT in one and by ultrasonography in none. Visceral angiography was performed on five patients, and the pseudoaneurysm was evident in all. External drainage with arterial ligation was done as a primary operation in five patients; four of them later underwent pancreatic resection because of rebleeding. In eight cases pancreatic resection was the initial operation; none of these patients continued to bleed or needed reoperation because of the same pseudoaneurysm. There were no intraoperative deaths, but one patient died postoperatively. Aggressive diagnostic evaluation and surgical approach are associated with a reduction in mortality and morbidity in this serious complication of pancreatic pseudocysts. 28 refs., 2 figs., 1 tab

  16. Evaluating the Impact of Radio Frequency Identification Retained Surgical Instruments Tracking on Patient Safety: Literature Review.

    Science.gov (United States)

    Schnock, Kumiko O; Biggs, Bonnie; Fladger, Anne; Bates, David W; Rozenblum, Ronen

    2017-02-22

    Retained surgical instruments (RSI) are one of the most serious preventable complications in operating room settings, potentially leading to profound adverse effects for patients, as well as costly legal and financial consequences for hospitals. Safety measures to eliminate RSIs have been widely adopted in the United States and abroad, but despite widespread efforts, medical errors with RSI have not been eliminated. Through a systematic review of recent studies, we aimed to identify the impact of radio frequency identification (RFID) technology on reducing RSI errors and improving patient safety. A literature search on the effects of RFID technology on RSI error reduction was conducted in PubMed and CINAHL (2000-2016). Relevant articles were selected and reviewed by 4 researchers. After the literature search, 385 articles were identified and the full texts of the 88 articles were assessed for eligibility. Of these, 5 articles were included to evaluate the benefits and drawbacks of using RFID for preventing RSI-related errors. The use of RFID resulted in rapid detection of RSI through body tissue with high accuracy rates, reducing risk of counting errors and improving workflow. Based on the existing literature, RFID technology seems to have the potential to substantially improve patient safety by reducing RSI errors, although the body of evidence is currently limited. Better designed research studies are needed to get a clear understanding of this domain and to find new opportunities to use this technology and improve patient safety.

  17. Lubrication Theory Model to Evaluate Surgical Alterations in Flow Mechanics of the Lower Esophageal Sphincter

    Science.gov (United States)

    Ghosh, Sudip K.; Brasseur, James G.; Zaki, Tamer; Kahrilas, Peter J.

    2003-11-01

    Surgery is commonly used to rebuild a weak lower esophageal sphincter (LES) and reduce reflux. Because the driving pressure (DP) is proportional to muscle tension generated in the esophagus, we developed models using lubrication theory to evaluate the consequences of surgery on muscle force required to open the LES and drive the flow. The models relate time changes in DP to lumen geometry and trans-LES flow with a manometric catheter. Inertial effects were included and found negligible. Two models, direct (opening specified) and indirect (opening predicted), were combined with manometric pressure and imaging data from normal and post-surgery LES. A very high sensitivity was predicted between the details of the DP and LES opening. The indirect model accurately captured LES opening and predicted a 3-phase emptying process, with phases I and III requiring rapid generation of muscle tone to open the LES and empty the esophagus. Data showed that phases I and III are adversely altered by surgery causing incomplete emptying. Parametric model studies indicated that changes to the surgical procedure can positively alter LES flow mechanics and improve clinical outcomes.

  18. Innovative nuclear thermal propulsion technology evaluation: Results of the NASA/DOE Task Team study

    International Nuclear Information System (INIS)

    Howe, S.; Borowski, S.; Helms, I.; Diaz, N.; Anghaie, S.; Latham, T.

    1991-01-01

    In response to findings from two NASA/DOE nuclear propulsion workshops held in the summer of 1990, six task teams were formed to continue evaluation of various nuclear propulsion concepts. The Task Team on Nuclear Thermal Propulsion (NTP) created the Innovative Concepts Subpanel to evaluate thermal propulsion concepts which did not utilize solid fuel. The Subpanel endeavored to evaluate each of the concepts on a ''level technological playing field,'' and to identify critical technologies, issues, and early proof-of-concept experiments. The concepts included the liquid core fission, the gas core fission, the fission foil reactors, explosively driven systems, fusion, and antimatter. The results of the studies by the panel will be provided. 13 refs., 6 figs., 2 tabs

  19. Semer: a simple calculational tool for the economic evaluations of reactor systems and associated innovations

    Energy Technology Data Exchange (ETDEWEB)

    Nisan, S. [CEA Cadarache, Nuclear Reactor Directorate, DRN, Dept. of Reactor Studies, DER, Reactor and Innovative Systems Service, SERSI, 13 - Saint Paul lez Durance (France); Rouyer, J.L. [Electricite de France (EDF), Pole Industrie, Div. Ingenierie et Services, 93 - Saint-Denis (France)

    2001-07-01

    This paper summarises part of our on-going investigations on the economic evaluations of various nuclear and fossil energy systems and related innovations. These investigations are principally concerned with the development of the code system SEMER and its validation. SEMER has been developed to furnish top management and project leaders a simple tool for cost evaluations enabling a choice between competitive technological options. The cost evaluation models, actually integrated in the SEMER system, already cover a very wide range of electricity producing systems and, where relevant, their associated fuel cycles: The ''global models'', allowing rapid but relatively approximate overall cost estimations (about 15 % error). These include: Almost all the electricity producing systems using fossil energies (Oil, Coal, Gas, including gas turbines with combined cycles); Nuclear reactor systems including all the French PWRs, HTRs, Compact PWRs, and PWRs for nuclear propulsion systems. (author)

  20. Semer: a simple calculational tool for the economic evaluations of reactor systems and associated innovations

    International Nuclear Information System (INIS)

    Nisan, S.; Rouyer, J.L.

    2001-01-01

    This paper summarises part of our on-going investigations on the economic evaluations of various nuclear and fossil energy systems and related innovations. These investigations are principally concerned with the development of the code system SEMER and its validation. SEMER has been developed to furnish top management and project leaders a simple tool for cost evaluations enabling a choice between competitive technological options. The cost evaluation models, actually integrated in the SEMER system, already cover a very wide range of electricity producing systems and, where relevant, their associated fuel cycles: The ''global models'', allowing rapid but relatively approximate overall cost estimations (about 15 % error). These include: Almost all the electricity producing systems using fossil energies (Oil, Coal, Gas, including gas turbines with combined cycles); Nuclear reactor systems including all the French PWRs, HTRs, Compact PWRs, and PWRs for nuclear propulsion systems. (author)

  1. A Mobile Framework for Competence Evaluation: Innovation Assessment Using Mobile Information Systems

    Directory of Open Access Journals (Sweden)

    Marcos Ruano Mayoral

    2007-09-01

    Full Text Available The environment surrounding organizations is characterized by an increasing necessity of competent personnel but with finite competence level. From the scope of the management of those human resources, one of the most crucial aspects is to be able to measure the competence level of each professional as quickly and precisely as possible. This paper introduces a tool, based on HR-XML standard, to feed competence evaluation with data or evidences that help to fit performance evaluations to the actual performance of the employees. Mobility capabilities in performance evaluation, particularly in the innovation field, involve an inventive contribution to current Competence Management Systems that, due to their lack of flexibility, hinder the full development of the capability to include evidences wherever they may take place, whether it is at work, at client’s office or in a recruitment interview.

  2. Halogenated Anesthetics Determination in Urine by SPME/GC/MS and Urine Levels Relationship Evaluation with Surgical Theatres Contamination

    Directory of Open Access Journals (Sweden)

    Serena Indelicato

    2014-01-01

    Full Text Available In this work, a new sensitive analytical method has been developed and evaluated for the determination of the most commonly used gaseous anesthetics, desflurane, sevoflurane, and this latter’s hepatic metabolite hexafluoroisopropanol (HFIP in the urine. In addition, an evaluation of anesthetics exposition on the urine levels of a small population of surgical operators has been performed and results are briefly discussed.

  3. Carpal valgus in llamas and alpacas: Retrospective evaluation of patient characteristics, radiographic features and outcomes following surgical treatment

    Science.gov (United States)

    Hunter, Barbara; Duesterdieck-Zellmer, Katja F.; Huber, Michael J.; Parker, Jill E.; Semevolos, Stacy A.

    2014-01-01

    This study evaluated outcomes of surgical treatment for carpal valgus in New World camelids and correlated successful outcome (absence of carpal valgus determined by a veterinarian) with patient characteristics and radiographic features. Univariable and multivariable analyses of retrospective case data in 19 camelids (33 limbs) treated for carpal valgus between 1987 and 2010 revealed that procedures incorporating a distal radial transphyseal bridge were more likely (P = 0.03) to result in success after a single surgical procedure. A greater degree of angulation (> 19°, P = 0.02) and younger age at surgery (< 4 months, P = 0.03) were associated with unsuccessful outcome. Overall, 74% of limbs straightened, 15% overcorrected, and 11% had persistent valgus following surgical intervention. To straighten, 22% of limbs required multiple procedures, not including implant removal. According to owners, valgus returned following implant removal in 4 limbs that had straightened after surgery. PMID:25477542

  4. Cephalometric evaluation of the predictability of bimaxillary surgical-orthodontic treatment outcomes in long face pattern patients: a retrospective study

    Directory of Open Access Journals (Sweden)

    Carla Maria Melleiro Gimenez

    2013-10-01

    Full Text Available OBJECTIVE: The aim of this study was to compare by means of McNamara as well as Legan and Burstone's cephalometric analyses, both manual and digitized (by Dentofacial Planner Plus and Dolphin Image software prediction tracings to post-surgical results. METHODS: Pre and post-surgical teleradiographs (6 months of 25 long face patients subjected to combined orthognathic surgery were selected. Manual and computerized prediction tracings of each patient were performed and cephalometrically compared to post-surgical outcomes. This protocol was repeated in order to evaluate the method error and statistical evaluation was conducted by means of analysis of variance and Tukey's test. RESULTS: A higher frequency of cephalometric variables, which were not statistically different from the actual post-surgical results for the manual method, was observed. It was followed by DFPlus and Dolphin software; in which similar cephalometric values for most variables were observed. CONCLUSION: It was concluded that the manual method seemed more reliable, although the predictability of the evaluated methods (computerized and manual proved to be reasonably satisfactory and similar.

  5. [Evaluating an effectiveness of surgical treatment of gastroesophageal reflux disease combined with hiatal hernia].

    Science.gov (United States)

    Mozharovskiy, V V; Tsyganov, A A; Mozharovskiy, K V; Tarasov, A A

    To assess an effectiveness of surgical treatment of gastroesophageal reflux disease (GERD) combined with hiatal hernia (HH). The trial included 96 patients with GERD and HH who were divided into 2 groups. The principal difference between groups was the use of surgery in the main group and therapeutic treatment in the comparison group. The effectiveness of surgical treatment is superior to therapeutic treatment of GERD by more than 2.5 times. HH combined with GERD is an indication for surgical treatment. Fundoplication cuff should not lead to angular and rotational esophageal deformation. Nissen procedure in Donahue modification (Short Floppy Nissen) simulates optimally the geometry of esophago-gastric junction and His angle.

  6. Decision Dissonance: Evaluating an Approach to Measuring the Quality of Surgical Decision Making

    Science.gov (United States)

    Fowler, Floyd J.; Gallagher, Patricia M.; Drake, Keith M.; Sepucha, Karen R.

    2013-01-01

    Background Good decision making has been increasingly cited as a core component of good medical care, and shared decision making is one means of achieving high decision quality. If it is to be a standard, good measures and protocols are needed for assessing the quality of decisions. Consistency with patient goals and concerns is one defining characteristic of a good decision. A new method for evaluating decision quality for major surgical decisions was examined, and a methodology for collecting the needed data was developed. Methods For a national probability sample of fee-for-service Medicare beneficiaries who had a coronary artery bypass graft (CABG), a lumpectomy or a mastectomy for breast cancer, or surgery for prostate cancer during the last half of 2008, a mail survey of selected patients was carried out about one year after the procedures. Patients’ goals and concerns, knowledge, key aspects of interactions with clinicians, and feelings about the decisions were assessed. A Decision Dissonance Score was created that measured the extent to which patient ratings of goals ran counter to the treatment received. The construct and predictive validity of the Decision Dissonance Score was then assessed. Results When data were averaged across all four procedures, patients with more knowledge and those who reported more involvement reported significantly lower Decision Dissonance Scores. Patients with lower Decision Dissonance Scores also reported more confidence in their decisions and feeling more positively about how the treatment turned out, and they were more likely to say that they would make the same decision again. Conclusions Surveying discharged surgery patients is a feasible way to evaluate decision making, and Decision Dissonance appears to be a promising approach to validly measuring decision quality. PMID:23516764

  7. Comparative evaluation of diode laser ablation and surgical stripping technique for gingival depigmentation: A clinical and immunohistochemical study.

    Science.gov (United States)

    Bakutra, Gaurav; Shankarapillai, Rajesh; Mathur, Lalit; Manohar, Balaji

    2017-01-01

    There are various treatment modalities to remove the black patches of melanin pigmentation. The aim of the study is to clinically compare the diode laser ablation and surgical stripping technique for gingival depigmentation and to evaluate their effect on the histological changes in melanocyte activity. A total of 40 sites of 20 patients with bilateral melanin hyperpigmentation were treated with the surgical stripping and diode laser ablation technique. Change in Hedin index score, change in area of pigmentation using image analyzing software, pain perception, patient preference of treatment were recorded. All 40 sites were selected for immunohistochemical analysis using HMB-45 immunohistochemical marker. At 12 months post-operative visit, in all sites, repigmentation was observed with different grades of Hedin index. Paired t -test, analysis of variance, and Chi-square tests were used for statistical analysis. Repigmentation in surgical stripping is significantly lesser compared to laser ablation. Lesser numbers of melanocytes were found on immunohistological examination at 12 months postoperatively. Comparison for patient preference and pain indices give statistically significant values for diode laser techniques. Gingival hyperpigmentation is effectively managed by diode laser ablation technique and surgical stripping method. In this study, surgical stripping technique found to be better compared to diode laser ablation.

  8. Surgical competence.

    Science.gov (United States)

    Patil, Nivritti G; Cheng, Stephen W K; Wong, John

    2003-08-01

    Recent high-profile cases have heightened the need for a formal structure to monitor achievement and maintenance of surgical competence. Logbooks, morbidity and mortality meetings, videos and direct observation of operations using a checklist, motion analysis devices, and virtual reality simulators are effective tools for teaching and evaluating surgical skills. As the operating theater is also a place for training, there must be protocols and guidelines, including mandatory standards for supervision, to ensure that patient care is not compromised. Patients appreciate frank communication and honesty from surgeons regarding their expertise and level of competence. To ensure that surgical competence is maintained and keeps pace with technologic advances, professional registration bodies have been promoting programs for recertification. They evaluate performance in practice, professional standing, and commitment to ongoing education.

  9. Evaluating the Collaborative Ecosystem for an Innovation-Driven Economy: A Systems Analysis and Case Study of Science Parks

    Directory of Open Access Journals (Sweden)

    Min-Ren Yan

    2018-03-01

    Full Text Available National policies for science parks and innovation have been identified as one of the major driving forces for the innovation-driven economy, especially for publicly funded science parks. To investigate this collaborative ecosystem (government-academia-industry for growth and sustainable development, this paper proposes a nation-wide economic impact analysis of science parks and innovation policy based on historical data drawn from one of the globally recognized high-technology industrial clusters in Taiwan. Systems thinking with causal loop analysis are adopted to improve our understanding of the collaborative ecosystem with science park policies. First, from a holistic viewpoint, the role of government in a science parks and innovation ecosystem is reviewed. A systems analysis of an innovation-driven economy with a science park policy is presented as a strategy map for policy implementers. Second, the added economic value and employment of the benchmarked science parks is evaluated from a long range perspective. Third, the concepts of government-academia-industry collaboration and policies to innovation ecosystem are introduced while addressing the measures and performance of innovation and applied R&D in the science parks. We conclude with a discussion of lessons learned and the policy implications of science park development and an innovation ecosystem.

  10. The Role of Radio Frequency Detection System Embedded Surgical Sponges in Preventing Retained Surgical Sponges: A Prospective Evaluation in Patients Undergoing Emergency Surgery.

    Science.gov (United States)

    Inaba, Kenji; Okoye, Obi; Aksoy, Hande; Skiada, Dimitra; Ault, Glenn; Sener, Stephen; Lam, Lydia; Benjamin, Elizabeth; Demetriades, Demetrios

    2016-10-01

    To prospectively evaluate the ability of radio frequency detection (RFD) system-embedded sponges to mitigate the incidence of retained surgical sponges (RSS) after emergency surgery. Emergency surgery patients are at high risk for retained foreign bodies. All emergent trauma and nontrauma cavitary operations over a 5-year period (January 2010-December 2014) were prospectively enrolled. For damage-control procedures, only the definitive closure was included. RFD sponges were used exclusively throughout the study period. Before closure, the sponge and instrument count was followed by RFD scanning and x-ray evaluation for retained sponges. RSS and near-misses averted using the RFD system were analyzed. In all, 2051 patients [median (range)], aged 41 (1-101) years, 72.2% male, 46.8% trauma patients, underwent 2148 operations (1824 laparotomy, 100 thoracotomy, 30 sternotomy, and 97 combined). RFD detected retained sponges in 11 (0.5%) patients (81.8%laparotomy, 18.2% sternotomy) before cavitary closure. All postclosure x-rays were negative. No retained sponges were missed by the RFD system. Body mass index was 29 (23-43), estimated blood loss 1.0 L (0-23), and operating room time 160 minutes (71-869). Procedures started after 18:00 to 06:00 hours in 45.5% of the patients. The sponge count was incorrect in 36.4%, not performed due to time constraints in 45.5%, and correct in 18.2%. The additional cost of using RFD-embedded disposables was $0.17 for a 4X18 laparotomy sponge and $0.46 for a 10 pack of 12ply, 4X8. Emergent surgical procedures are high-risk for retained sponges, even when sponge counts are performed and found to be correct. Implementation of a RFD system was effective in preventing this complication and should be considered for emergent operations in an effort to improve patient safety.

  11. Development and validation of surgical training tool: cystectomy assessment and surgical evaluation (CASE) for robot-assisted radical cystectomy for men.

    Science.gov (United States)

    Hussein, Ahmed A; Sexton, Kevin J; May, Paul R; Meng, Maxwell V; Hosseini, Abolfazl; Eun, Daniel D; Daneshmand, Siamak; Bochner, Bernard H; Peabody, James O; Abaza, Ronney; Skinner, Eila C; Hautmann, Richard E; Guru, Khurshid A

    2018-04-13

    We aimed to develop a structured scoring tool: cystectomy assessment and surgical evaluation (CASE) that objectively measures and quantifies performance during robot-assisted radical cystectomy (RARC) for men. A multinational 10-surgeon expert panel collaborated towards development and validation of CASE. The critical steps of RARC in men were deconstructed into nine key domains, each assessed by five anchors. Content validation was done utilizing the Delphi methodology. Each anchor was assessed in terms of context, score concordance, and clarity. The content validity index (CVI) was calculated for each aspect. A CVI ≥ 0.75 represented consensus, and this statement was removed from the next round. This process was repeated until consensus was achieved for all statements. CASE was used to assess de-identified videos of RARC to determine reliability and construct validity. Linearly weighted percent agreement was used to assess inter-rater reliability (IRR). A logit model for odds ratio (OR) was used to assess construct validation. The expert panel reached consensus on CASE after four rounds. The final eight domains of the CASE included: pelvic lymph node dissection, development of the peri-ureteral space, lateral pelvic space, anterior rectal space, control of the vascular pedicle, anterior vesical space, control of the dorsal venous complex, and apical dissection. IRR > 0.6 was achieved for all eight domains. Experts outperformed trainees across all domains. We developed and validated a reliable structured, procedure-specific tool for objective evaluation of surgical performance during RARC. CASE may help differentiate novice from expert performances.

  12. Surgical decompression in endocrine orbitopathy. Visual evoked potential evaluation and effect on the optic nerve.

    Science.gov (United States)

    Clauser, Luigi C; Tieghi, Riccardo; Galie', Manlio; Franco, Filippo; Carinci, Francesco

    2012-10-01

    Endocrine orbitopathy (EO) represents the most frequent and important extrathyroidal stigma of Graves disease. This chronic autoimmune condition involves the orbital contents, including extraocular muscles, periorbital connective-fatty tissue and lacrimal gland. The increase of fat tissue and the enlargement of extraocular muscles within the bony confines of the orbit leads to proptosis, and in the most severe cases optic neuropathy, caused by compression and stretching of the optic nerve. The congestion and the pressure of the enlarged muscles, constrict the nerve and can lead to reduced sight or loss of vision with the so called "orbital apex syndrome". Generally surgical treatment of EO, based on fat and/or orbital wall expansion, is possible and effective in improving exophthalmos and diplopia. Since there are limited reports focussing on optic neuropathy recovery after fat and/or orbital walls decompression the Authors decided to perform a retrospective analysis on a series of patients affected by EO. The study population was composed of 10 patients affected by EO and presenting to the Unit of Cranio Maxillofacial Surgery, Center for Craniofacial Deformities & Orbital Surgery St. Anna Hospital and University, Ferrara, Italy, for evaluation and treatment. A complete Visual Evoked Potentials (VEP) evaluation was performed. There were seven women and three men with a median age of 55 years. Optic nerve VEP amplitude and latency were recorded as normal or pathological. Abnormal results were scored as moderate, mild and severe. Differences in VEP pre and post-operatively were recorded as present or absent (i.e. VEP Delta). Pearson chi square test was applied. There were 20 operated orbits. The first VEP evaluation was performed 3.2 months before surgery and post-operative VEP control was done after a mean of 18.7 months. Fat decompression was performed in all cases and eight patients had also bony decompression. VEP amplitude and latency were affected in 10 and 15

  13. Evaluation of distributed practice schedules on retention of a newly acquired surgical skill: a randomized trial.

    Science.gov (United States)

    Mitchell, Erica L; Lee, Dae Y; Sevdalis, Nick; Partsafas, Aaron W; Landry, Gregory J; Liem, Timothy K; Moneta, Gregory L

    2011-01-01

    practice influences new skill acquisition. The aim of this study was to prospectively investigate the impact of practice distribution (weekly vs monthly) on complex motor skill (end-side vascular anastomosis) acquisition and 4-month retention. twenty-four surgical interns were randomly assigned to weekly training for 4 weeks or monthly training for 4 months, with equal total training times. Performance was assessed before training, immediately after training, after the completion of distributed training, and 4 months later. there was no statistical difference in surgical skill acquisition and retention between the weekly and monthly scheduled groups, as measured by procedural checklist scores, global rating scores of operative performance, final product analysis, and overall performance or assessment of operative "competence." distributed practice results in improvement and retention of a newly acquired surgical skill independent of weekly or monthly practice schedules. Flexibility in a surgical skills laboratory curriculum is possible without adversely affecting training. 2011 Elsevier Inc. All rights reserved.

  14. Development and Evaluation of a Novel Pan-Specialty Virtual Reality Surgical Simulator for Smartphones.

    Science.gov (United States)

    Nehme, Jean; Bahsoun, Ali N; Chow, Andre

    2016-01-01

    Touch Surgery is a novel simulator that allows cognitive task simulation and rehearsal of surgical procedures. Touch Surgery is designed for Apple and Android smartphones and tablets. This allows a global community of surgical professionals to review the steps of a procedure and test their competence. Content on Touch Surgery is developed with expert surgeons in the field from world leading institutions. Here we describe the development of Touch Surgery, its adoption by the global training community.

  15. Evaluation of Spinacia oleracea L. leaves mucilage as an innovative suspending agent

    Directory of Open Access Journals (Sweden)

    Amit Kumar Nayak

    2010-01-01

    Full Text Available The present study was undertaken to evaluate the mucilage isolated from Spinacia oleracea L. leaves, commonly named spinach (family: Amaranthaceae as an innovative suspending agent. Zinc oxide suspensions (20% w/v were prepared using the mucilage of S. oleracea L. leaves as a suspending agent, and it was evaluated for its stability by using parameters like, sedimentation profile, degree of flocculation, and redispersibility. The effect of the tested mucilage on the suspension was compared with various commonly used suspending agents, such as, tragacanth, bentonite, and sodium carboxymethyl cellulose (NaCMC at concentrations of 0.5, 1.0, and 2.0% w/v. The results obtained indicated that the mucilage of S. oleracea L. leaves could be used as a suspending agent, and the performance was found to be superior to both tragacanth and bentonite.

  16. Evaluation of Spinacia oleracea L. leaves mucilage as an innovative suspending agent

    Science.gov (United States)

    Nayak, Amit Kumar; Pal, Dilipkumar; Pany, Dipti Ranjan; Mohanty, Biswaranjan

    2010-01-01

    The present study was undertaken to evaluate the mucilage isolated from Spinacia oleracea L. leaves, commonly named spinach (family: Amaranthaceae) as an innovative suspending agent. Zinc oxide suspensions (20% w/v) were prepared using the mucilage of S. oleracea L. leaves as a suspending agent, and it was evaluated for its stability by using parameters like, sedimentation profile, degree of flocculation, and redispersibility. The effect of the tested mucilage on the suspension was compared with various commonly used suspending agents, such as, tragacanth, bentonite, and sodium carboxymethyl cellulose (NaCMC) at concentrations of 0.5, 1.0, and 2.0% w/v. The results obtained indicated that the mucilage of S. oleracea L. leaves could be used as a suspending agent, and the performance was found to be superior to both tragacanth and bentonite. PMID:22247868

  17. Managing Innovation.

    Science.gov (United States)

    White, Ronald V.

    The management of innovation in instruction in English as a second language can benefit from the experience and techniques of management in the world of commerce as well as from theories and procedures in education. A systematic approach to the management of innovation emphasizes the importance of clearly defined objectives, evaluation that…

  18. Evaluation of transcranial surgical decompression of the optic canal as a treatment option for traumatic optic neuropathy.

    Science.gov (United States)

    He, Zhenhua; Li, Qiang; Yuan, Jingmin; Zhang, Xinding; Gao, Ruiping; Han, Yanming; Yang, Wenzhen; Shi, Xuefeng; Lan, Zhengbo

    2015-07-01

    Traumatic optic neuropathy (TON) is a serious complication of head trauma, with the incidence rate ranging from 0.5% to 5%. The two treatment options widely practiced for TON are: (i) high-dose corticosteroid therapy and (ii) surgical decompression. However, till date, there is no consensus on the treatment protocol. This study aimed to evaluate the therapeutic efficacy of transcranial decompression of optic canal in TON patients. A total of 39 patients with visual loss resulting from TON between January 2005 and June 2013 were retrospectively reviewed for preoperative vision, preoperative image, visual evoked potential (VEP), surgical approach, postoperative visual acuity, complications, and follow-up results. All these patients underwent transcranial decompression of optic canal. During the three-month follow-up period, among the 39 patients, 21 showed an improvement in their eyesight, 6 recovered to standard logarithmic visual acuity chart "visible," 10 could count fingers, 2 could see hand movement, and 3 regained light sensation. Visual evoked potential could be used as an important preoperative and prognostic evaluation parameter for TON patients. Once TON was diagnosed, surgery is a promising therapeutic option, especially when a VEP wave is detected, irrespective of the HRCT scan findings. Operative time between trauma and operation is not necessary reference to assess the therapeutic effect of surgical decompression. The poor results of this procedure may be related to the severity of optic nerve injury. The patient's age is an important factor affecting the surgical outcomes. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Real-time three-dimensional transesophageal echocardiography in valve disease: comparison with surgical findings and evaluation of prosthetic valves.

    Science.gov (United States)

    Sugeng, Lissa; Shernan, Stanton K; Weinert, Lynn; Shook, Doug; Raman, Jai; Jeevanandam, Valluvan; DuPont, Frank; Fox, John; Mor-Avi, Victor; Lang, Roberto M

    2008-12-01

    Recently, a novel real-time 3-dimensional (3D) matrix-array transesophageal echocardiographic (3D-MTEE) probe was found to be highly effective in the evaluation of native mitral valves (MVs) and other intracardiac structures, including the interatrial septum and left atrial appendage. However, the ability to visualize prosthetic valves using this transducer has not been evaluated. Moreover, the diagnostic accuracy of this new technology has never been validated against surgical findings. This study was designed to (1) assess the quality of 3D-MTEE images of prosthetic valves and (2) determine the potential value of 3D-MTEE imaging in the preoperative assessment of valvular pathology by comparing images with surgical findings. Eighty-seven patients undergoing clinically indicated transesophageal echocardiography were studied. In 40 patients, 3D-MTEE images of prosthetic MVs, aortic valves (AVs), and tricuspid valves (TVs) were scored for the quality of visualization. For both MVs and AVs, mechanical and bioprosthetic valves, the rings and leaflets were scored individually. In 47 additional patients, intraoperative 3D-MTEE diagnoses of MV pathology obtained before initiating cardiopulmonary bypass were compared with surgical findings. For the visualization of prosthetic MVs and annuloplasty rings, quality was superior compared with AV and TV prostheses. In addition, 3D-MTEE imaging had 96% agreement with surgical findings. Three-dimensional matrix-array transesophageal echocardiographic imaging provides superb imaging and accurate presurgical evaluation of native MV pathology and prostheses. However, the current technology is less accurate for the clinical assessment of AVs and TVs. Fast acquisition and immediate online display will make this the modality of choice for MV surgical planning and postsurgical follow-up.

  20. What and How Are We Evaluating? Meta-Evaluation Study of the NASA Innovations in Climate Education (NICE) Portfolio

    Science.gov (United States)

    Martin, A. M.; Barnes, M. H.; Chambers, L. H.; Pippin, M. R.

    2013-12-01

    As part of NASA's Minority University Research and Education Program (MUREP), the NASA Innovations in Climate Education (NICE) project at Langley Research Center has funded 71 climate education initiatives since 2008. The funded initiatives span across the nation and contribute to the development of a climate-literate public and the preparation of a climate-related STEM workforce through research experiences, professional development opportunities, development of data access and modeling tools, and educational opportunities in both K-12 and higher education. Each of the funded projects proposes and carries out its own evaluation plan, in collaboration with external or internal evaluation experts. Using this portfolio as an exemplar case, NICE has undertaken a systematic meta-evaluation of these plans, focused primarily on evaluation questions, approaches, and methods. This meta-evaluation study seeks to understand the range of evaluations represented in the NICE portfolio, including descriptive information (what evaluations, questions, designs, approaches, and methods are applied?) and questions of value (do these evaluations meet the needs of projects and their staff, and of NASA/NICE?). In the current climate, as federal funders of climate change and STEM education projects seek to better understand and incorporate evaluation into their decisions, evaluators and project leaders are also seeking to build robust understanding of program effectiveness. Meta-evaluations like this provide some baseline understanding of the current status quo and the kinds of evaluations carried out within such funding portfolios. These explorations are needed to understand the common ground between evaluative best practices, limited resources, and agencies' desires, capacity, and requirements. When NASA asks for evaluation of funded projects, what happens? Which questions are asked and answered, using which tools? To what extent do the evaluations meet the needs of projects and

  1. Evaluating the Role and Contribution of Innovation to Health and Wealth in the UK: A Review of Innovation, Health and Wealth: Phase 1 Final Report.

    Science.gov (United States)

    Bienkowska-Gibbs, Teresa; Exley, Josephine; Saunders, Catherine L; Marjanovic, Sonja; Chataway, Joanna; MacLure, Calum; McDonald, Ruth; Ling, Tom

    2016-06-20

    The Department of Health's Innovation, Health and Wealth (IHW) strategy aimed to introduce a more strategic approach to the spread of innovation across the NHS. This study represents the first phase of a three-year evaluation and aims to map progress towards the IHW strategy and its component actions. This evaluation used a combination of quantitative and qualitative methods: document review, key informant interviews and stakeholder survey. This study also forms the basis for selecting case studies for phase two of the evaluation. Our findings from the interviews and survey suggest broad stakeholder support for the overarching ambitions of the IHW strategy. However, we found variable progress towards the overarching objectives of the eight IHW themes and an ambiguous relationship between many of the themes' objectives and their actions. It was difficult to assess progress on IHW's actions as commitment to the actions, implementation guidance and expected outcomes of the actions were not clearly articulated. The Academic Health Science Networks (AHSNs) and the Small Business Research Initiative (SBRI) were reported to be working well, which may be attributed to their clear structures of accountability and earmarked budgets. However, survey respondents and interviewees raised concerns that budgetary pressures may limit the impact of both AHSNs and the SBRI. The main challenges identified for ongoing action were the resources available for their implementation (e.g. Medtech Briefings), lack of awareness of the initiative (e.g. the NICE Implementation Collaborative) and the design of the actions (e.g. the Innovation Scorecard, web portal and High Impact Innovations).

  2. Biomechanical evaluation of the X-Stop device for surgical treatment of lumbar spinal stenosis.

    Science.gov (United States)

    Wan, Zongmiao; Wang, Shaobai; Kozánek, Michal; Passias, Peter G; Mansfield, Frederick L; Wood, Kirkham B; Li, Guoan

    2012-10-01

    Controlled experimental study. To evaluate the kinematical effects of X-Stop device on the spinal process at the operated and the adjacent segments before and after X-Stop surgeries during various weight-bearing postures in elderly patients with lumbar spine stenosis. The mechanism of interspinous process (ISP) devices is to directly distract the ISP of the implanted level to indirectly decompress the intervertebra foramen and spinal canal. Few studies have investigated the changes of ISP gap caused by X-Stop implantation using magnetic resonance imaging or radiography, but the effect of X-Stop surgery on the kinematics of spinous processes during functional activities is still unclear. Eight patients were tested before and, on average, 7 months after surgical implantation of the X-Stop devices using a combined computed tomography/magnetic resonance imaging and dual fluoroscopic imaging system during weight-bearing standing, flexion-extension, left-right bending, and left-right twisting positions of the torso. The shortest distances of the ISPs at the operated and the adjacent levels were measured using iterative closest point method and was dissected into vertical (gap) and horizontal (lateral translation) components. At the operated levels, the shortest vertical ISP distances (gap) significantly (P0.05) in right twist, left bend, and right bend after the X-Stop implantation. The lateral translations were not significantly affected. At both cephalad and caudad adjacent levels, the ISP distances (vertical and horizontal) were not significantly affected during all postures after X-Stop implantation. The findings of this study indicate that implantation of the X-Stop devices can effectively distract the ISP space at the diseased level without causing apparent kinematic changes at the adjacent segments during the studied postures.

  3. Teaching surgical exposures to undergraduate medical students: an integration concept for anatomical and surgical education.

    Science.gov (United States)

    Hammer, Niels; Hepp, Pierre; Löffler, Sabine; Schleifenbaum, Stefan; Steinke, Hanno; Klima, Stefan

    2015-06-01

    Decreasing numbers of students are interested in starting a surgical career, posing substantial challenges to patient care in the next years. The anatomy course is one of the key subjects in medical training, especially in surgical disciplines. Innovative teaching concepts that integrate surgically relevant anatomy and manual dexterity might help boost student interest in surgery. A preclinical workshop entitled "Surgical exposures" was developed. A team of anatomists and surgeons introduced the surgical exposures, demonstrating the procedures on Thiel-fixed body donors. Following this introduction, students practiced the exposures in an operating room-like manner. A six-point Likert scale was used to evaluate the workshop and to compare it to the first-year dissection course. The overall evaluation result for the surgical exposures was excellent, proving to be a significantly better result when compared to the first-year dissection course. The students were more satisfied with the teaching time invested by the peers and regarded the workshop as clinically highly relevant. Furthermore, they felt that questions were addressed better and that the overall atmosphere was better than in the gross anatomy course. Subject to criticism was the course size and practicing time in both cases. The surgical exposures workshop provides preclinical students with clinically relevant anatomy and manual dexterity. It may positively influence the decision to follow a surgical career. This course, however, requires extensive teaching resources. The given concept may help implement practical medical skills in the preclinical curriculum, strengthening the professional identity of surgeons and anatomists.

  4. Surgical Assisting

    Science.gov (United States)

    ... instruction, including: Microbiology Pathophysiology Pharmacology Anatomy and physiology Medical terminology Curriculum . Course content includes: Advanced surgical anatomy Surgical microbiology Surgical pharmacology Anesthesia methods and agents Bioscience Ethical ...

  5. Impact of an Innovative Classroom-Based Lecture Series on Residents’ Evaluations of an Anesthesiology Rotation

    Directory of Open Access Journals (Sweden)

    Pedro Tanaka

    2016-01-01

    Full Text Available Introduction. Millennial resident learners may benefit from innovative instructional methods. The goal of this study is to assess the impact of a new daily, 15 minutes on one anesthesia keyword, lecture series given by faculty member each weekday on resident postrotation evaluation scores. Methods. A quasi-experimental study design was implemented with the residents’ rotation evaluations for the 24-month period ending by 7/30/2013 before the new lecture series was implemented which was compared to the 14-month period after the lecture series began on 8/1/2013. The primary endpoint was “overall teaching quality of this rotation.” We also collected survey data from residents at clinical rotations at two other different institutions during the same two evaluation periods that did not have the education intervention. Results. One hundred and thirty-one residents were eligible to participate in the study. Completed surveys ranged from 77 to 87% for the eight-question evaluation instrument. On a 5-point Likert-type scale the mean score on “overall teaching quality of this rotation” increased significantly from 3.9 (SD 0.8 to 4.2 (SD 0.7 after addition of the lecture series, whereas the scores decreased slightly at the comparison sites. Conclusion. Rotation evaluation scores for overall teaching quality improved with implementation of a new structured slide daily lectures series.

  6. Pre-market clinical evaluations of innovative high-risk medical devices in Europe.

    Science.gov (United States)

    Hulstaert, Frank; Neyt, Mattias; Vinck, Imgard; Stordeur, Sabine; Huić, Mirjana; Sauerland, Stefan; Kuijpers, Marja R; Abrishami, Payam; Vondeling, Hindrik; Flamion, Bruno; Garattini, Silvio; Pavlovic, Mira; van Brabandt, Hans

    2012-07-01

    High-quality clinical evidence is most often lacking when novel high-risk devices enter the European market. At the same time, a randomized controlled trial (RCT) is often initiated as a requirement for obtaining market access in the US. Should coverage in Europe be postponed until RCT data are available? We studied the premarket clinical evaluation of innovative high-risk medical devices in Europe compared with the US, and with medicines, where appropriate. The literature and regulatory documents were checked. Representatives from industry, Competent Authorities, Notified Bodies, Ethics Committees, and HTA agencies were consulted. We also discuss patient safety and the transparency of information. In contrast to the US, there is no requirement in Europe to demonstrate the clinical efficacy of high-risk devices in the premarket phase. Patients in Europe can thus have earlier access to a potentially lifesaving device, but at the risk of insufficiently documented efficacy and safety. Variations in the stringency of clinical reviews, both at the level of Notified Bodies and Competent Authorities, do not guarantee patient safety. We tried to document the design of premarket trials in Europe and number of patients exposed, but failed as this information is not made public. Furthermore, the Helsinki Declaration is not followed with respect to the registration and publication of premarket trials. For innovative high-risk devices, new EU legislation should require the premarket demonstration of clinical efficacy and safety, using an RCT if possible, and a transparent clinical review, preferably centralized.

  7. An Innovative Method for Evaluating Strategic Goals in a Public Agency: Conservation Leadership in the U.S. Forest Service

    Science.gov (United States)

    David N. Bengston; David P. Fan

    1999-01-01

    This article presents an innovative methodology for evaluating strategic planning goals in a public agency. Computer-coded content analysis was used to evaluate attitudes expressed in about 28,000 on-line news media stories about the U.S. Department of Agriculture Forest Service and its strategic goal of conservation leadership. Three dimensions of conservation...

  8. DEMONSTRATION OF AQUAFIX AND SAPS PASSIVE MINE WATER TREATMENT TECHNOLOGIES AT SUMMITVILLE MINE SITE, INNOVATIVE TECHNOLOGY EVALUATION REPORT

    Science.gov (United States)

    As part of the Superfund Innovative Technology Evaluation (SITE) Program, the U.S. Environmental Protection Agency evaluated two passive water treatment (PWT) technologies for metals removal from acid mine drainage (AMD) at the Summitville Mine Superfund Site in southern Colorado...

  9. 76 FR 80901 - National Medal of Technology and Innovation Nomination Evaluation Committee

    Science.gov (United States)

    2011-12-27

    ... Nation's highest honor for technological innovation, awarded annually by the President of the United... utilizing technological innovation and/or be familiar with the education, training, employment and... Management/Computing/IT/Manufacturing Innovation; Technological Manpower/Workforce Training/Education. Under...

  10. SurF: an innovative framework in biosecurity and animal health surveillance evaluation.

    Science.gov (United States)

    Muellner, Petra; Watts, Jonathan; Bingham, Paul; Bullians, Mark; Gould, Brendan; Pande, Anjali; Riding, Tim; Stevens, Paul; Vink, Daan; Stärk, Katharina Dc

    2018-05-16

    Surveillance for biosecurity hazards is being conducted by the New Zealand Competent Authority, the Ministry for Primary Industries (MPI) to support New Zealand's biosecurity system. Surveillance evaluation should be an integral part of the surveillance life cycle, as it provides a means to identify and correct problems and to sustain and enhance the existing strengths of a surveillance system. The surveillance evaluation Framework (SurF) presented here was developed to provide a generic framework within which the MPI biosecurity surveillance portfolio, and all of its components, can be consistently assessed. SurF is an innovative, cross-sectoral effort that aims to provide a common umbrella for surveillance evaluation in the animal, plant, environment and aquatic sectors. It supports the conduct of the following four distinct components of an evaluation project: (i) motivation for the evaluation, (ii) scope of the evaluation, (iii) evaluation design and implementation and (iv) reporting and communication of evaluation outputs. Case studies, prepared by MPI subject matter experts, are included in the framework to guide users in their assessment. Three case studies were used in the development of SurF in order to assure practical utility and to confirm usability of SurF across all included sectors. It is anticipated that the structured approach and information provided by SurF will not only be of benefit to MPI but also to other New Zealand stakeholders. Although SurF was developed for internal use by MPI, it could be applied to any surveillance system in New Zealand or elsewhere. © 2018 2018 The Authors. Transboundary and Emerging Diseases Published by Blackwell Verlag GmbH.

  11. Evaluating the effects of increasing surgical volume on emergency department patient access.

    Science.gov (United States)

    Levin, S; Dittus, R; Aronsky, D; Weinger, M; France, D

    2011-02-01

    To determine how increases in surgical patient volume will affect emergency department (ED) access to inpatient cardiac services. To compare how strategies to increase cardiology inpatient throughput can either accommodate increases in surgical volume or improve ED patient access. A stochastic discrete event simulation was created to model patient flow through a cardiology inpatient system within a US, urban, academic hospital. The simulation used survival analysis to examine the relationship between anticipated increases in surgical volume and ED patient boarding time (ie, time interval from cardiology admission request to inpatient bed placement). ED patients boarded for a telemetry and cardiovascular intensive care unit (CVICU) bed had a mean boarding time of 5.3 (median 3.1, interquartile range 1.5-6.9) h and 2.7 (median 1.7, interquartile range 0.8-3.0) h, respectively. Each 10% incremental increase in surgical volume resulted in a 37 and 33 min increase in mean boarding time to the telemetry unit and CVICU, respectively. Strategies to increase cardiology inpatient throughput by increasing capacity and decreasing length of stay for specific inpatients was compared. Increasing cardiology capacity by one telemetry and CVICU bed or decreasing length of stay by 1 h resulted in a 7-9 min decrease in average boarding time or an 11-19% increase in surgical patient volume accommodation. Simulating competition dynamics for hospital admissions provides prospective planning (ie, decision making) information and demonstrates how interventions to increase inpatient throughput will have a much greater effect on higher priority surgical admissions compared with ED admissions.

  12. Comparative evaluation of skin cancer therapy with impulse laser radiation and surgical methods

    International Nuclear Information System (INIS)

    Moskalik, K.G.; Kozlov, A.P.

    1980-01-01

    Altogether 324 patients with skin basilomas, 559 with recurrent basiloma and 38 with squamous-cell carcinoma of the skin were treated by means of impulse neodymium laser radiation. A follow-up period was up to 7 years. It was shown that impulse laser radiation is a highly effective means of treating skin cancer, having a number of advantages over the radiation and surgical methods. Laser radiation is also highly effective in the treatment of basiloma relapses. If relapses accounted for by the development of a radioresistant tumour occur at the sites where surgical eXcision yields an unstatisfactory cosmetic effect, laser therapy should be considered a method of choice

  13. Collaborative Evaluation and Market Research Converge: An Innovative Model Agricultural Development Program Evaluation in Southern Sudan

    Science.gov (United States)

    O'Sullivan, John M.; O'Sullivan, Rita

    2012-01-01

    In June and July 2006 a team of outside experts arrived in Yei, Southern Sudan through an AID project to provide support to a local agricultural development project. The team brought evaluation, agricultural marketing and financial management expertise to the in-country partners looking at steps to rebuild the economy of the war ravaged region. A…

  14. Innovative Hyperspectral Imaging-Based Techniques for Quality Evaluation of Fruits and Vegetables: A Review

    Directory of Open Access Journals (Sweden)

    Yuzhen Lu

    2017-02-01

    Full Text Available New, non-destructive sensing techniques for fast and more effective quality assessment of fruits and vegetables are needed to meet the ever-increasing consumer demand for better, more consistent and safer food products. Over the past 15 years, hyperspectral imaging has emerged as a new generation of sensing technology for non-destructive food quality and safety evaluation, because it integrates the major features of imaging and spectroscopy, thus enabling the acquisition of both spectral and spatial information from an object simultaneously. This paper first provides a brief overview of hyperspectral imaging configurations and common sensing modes used for food quality and safety evaluation. The paper is, however, focused on the three innovative hyperspectral imaging-based techniques or sensing platforms, i.e., spectral scattering, integrated reflectance and transmittance, and spatially-resolved spectroscopy, which have been developed in our laboratory for property and quality evaluation of fruits, vegetables and other food products. The basic principle and instrumentation of each technique are described, followed by the mathematical methods for processing and extracting critical information from the acquired data. Applications of these techniques for property and quality evaluation of fruits and vegetables are then presented. Finally, concluding remarks are given on future research needs to move forward these hyperspectral imaging techniques.

  15. The Center For Medicare And Medicaid Innovation's blueprint for rapid-cycle evaluation of new care and payment models.

    Science.gov (United States)

    Shrank, William

    2013-04-01

    The Affordable Care Act established the Center for Medicare and Medicaid Innovation to test innovative payment and service delivery models. The goal is to reduce program expenditures while preserving or improving the quality of care provided to beneficiaries of Medicare, Medicaid, and the Children's Health Insurance Program. Central to the success of the Innovation Center is a new, rapid-cycle approach to evaluation. This article describes that approach--setting forth how the Rapid Cycle Evaluation Group aims to deliver frequent feedback to providers in support of continuous quality improvement, while rigorously evaluating the outcomes of each model tested. This article also describes the relationship between the group's work and that of the Office of the Actuary at the Centers for Medicare and Medicaid Services, which plays a central role in the assessment of new models.

  16. Lessons learned from the tokamak Advanced Reactor Innovation and Evaluation Study (ARIES)

    International Nuclear Information System (INIS)

    Krakowski, R.A.; Bathke, C.G.; Miller, R.L.; Werley, K.A.

    1994-01-01

    Lessons from the four-year ARIES (Advanced Reactor Innovation and Evaluation Study) investigation of a number of commercial magnetic-fusion-energy (MFE) power-plant embodiments of the tokamak are summarized. These lessons apply to physics, engineering and technology, and environmental, safety, and health (ES ampersand H) characteristics of projected tokamak power plants. Summarized herein are the composite conclusions and lessons developed in the course of four conceptual tokamak power-plant designs. A general conclusion from this extensive investigation of the commercial potential of tokamak power plants is the need for combined, symbiotic advances in both physics, engineering, and materials before economic competitiveness with developing advanced energy sources can be realized. Advances in materials are also needed for the exploitation of environmental advantages otherwise inherent in fusion power

  17. Lessons learned from the Tokamak Advanced Reactor Innovation and Evaluation Study (ARIES)

    International Nuclear Information System (INIS)

    Krakowski, R.A.; Bathke, C.G.; Miller, R.L.; Werley, K.A.

    1994-01-01

    Lessons from the four-year ARIES (Advanced Reactor Innovation and Evaluation Study) investigation of a number of commercial magnetic-fusion-energy (MFE) power-plant embodiments of the tokamak are summarized. These lessons apply to physics, engineering and technology, and environmental, safety and health (ES ampersand H) characteristics of projected tokamak power plants. A general conclusion from this extensive investigation of the commercial potential of tokamak power plants is the need for combined, symbiotic advances relative to present understanding in physics, engineering, and materials before economic competitiveness with developing advanced energy sources can be realized. Advanced tokamak plasmas configured in the second-stability regime that achieve both high β and bootstrap fractions near unity through strong profile control offer high promise in this regard

  18. Abortion - surgical

    Science.gov (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  19. Introducing a complex health innovation--primary health care reforms in Estonia (multimethods evaluation).

    Science.gov (United States)

    Atun, Rifat Ali; Menabde, Nata; Saluvere, Katrin; Jesse, Maris; Habicht, Jarno

    2006-11-01

    All post-Soviet countries are trying to reform their primary health care (PHC) systems. The success to date has been uneven. We evaluated PHC reforms in Estonia, using multimethods evaluation: comprising retrospective analysis of routine health service data from Estonian Health Insurance Fund and health-related surveys; documentary analysis of policy reports, laws and regulations; key informant interviews. We analysed changes in organisational structure, regulations, financing and service provision in Estonian PHC system as well as key informant perceptions on factors influencing introduction of reforms. Estonia has successfully implemented and scaled-up multifaceted PHC reforms, including new organisational structures, user choice of family physicians (FPs), new payment methods, specialist training for family medicine, service contracts for FPs, broadened scope of services and evidence-based guidelines. These changes have been institutionalised. PHC effectiveness has been enhanced, as evidenced by improved management of key chronic conditions by FPs in PHC setting and reduced hospital admissions for these conditions. Introduction of PHC reforms - a complex innovation - was enhanced by strong leadership, good co-ordination between policy and operational level, practical approach to implementation emphasizing simplicity of interventions to be easily understood by potential adopters, an encircling strategy to roll-out which avoided direct confrontations with narrow specialists and opposing stakeholders in capital Tallinn, careful change-management strategy to avoid health reforms being politicized too early in the process, and early investment in training to establish a critical mass of health professionals to enable rapid operationalisation of policies. Most importantly, a multifaceted and coordinated approach to reform - with changes in laws; organisational restructuring; modifications to financing and provider payment systems; creation of incentives to enhance

  20. Evaluating the value and impact of the Victorian Audit of Surgical Mortality.

    Science.gov (United States)

    Retegan, Claudia; Russell, Colin; Harris, Darren; Andrianopoulos, Nick; Beiles, C Barry

    2013-10-01

    Since the Victorian Audit of Surgical Mortality (VASM) commenced in 2007, 95% of Victorian Fellows have agreed to participate and have provided data on the deaths of patients receiving surgical care. All public, and the majority of private, hospitals involved in the delivery of surgical services in Victoria have been submitting data on deaths associated with surgery. De-identified reports on this data are distributed in regular annual reports and case note review booklets. Although informal feedback on the perceived value of the audit was encouraging, a formal review of all aspects of the audit was felt necessary. An independent formal review of VASM governance, documentation, datasets and data analysis was performed, in addition to a survey of 257 individuals (surgeons and other stakeholders) on the perceived impact of VASM. The review confirmed increasing participation and acceptance by surgeons since the inception of the project. Governance mechanisms were found to be effective and acknowledged by stakeholders and collaborators. Robust participation rates have been achieved, and stakeholders were generally satisfied with the quality of feedback. Suggestions for improvement were provided by some surgeons and hospitals. External review of VASM processes and procedures confirmed that the audit was operating effectively, with robust quality control and achieving the trust of stakeholders. The educational value of the audit to the surgical community was acknowledged and areas for future improvement have been identified. © 2013 Royal Australasian College of Surgeons.

  1. Evaluation of primary and secondary stability of titanium implants using different surgical techniques

    NARCIS (Netherlands)

    Tabassum, A.; Meijer, G.J.; Walboomers, X.F.; Jansen, J.A.

    2014-01-01

    OBJECTIVE: To investigate the influence of different surgical techniques on the primary and secondary implant stability using trabecular bone of goats as an implantation model. MATERIAL AND METHODS: In the iliac crest of eight goats, 48 cylindrical-screw-type implants with a diameter of 4.2 mm

  2. The laparoscopic surgical skills programme : Preliminary evaluation of grade I Level 1 courses by trainees

    NARCIS (Netherlands)

    Buzink, S.N.; Soltes, M.; Radonak, J.; Fingerhutt, A.; Hanna, G.; Jakimowicz, J.J.

    2012-01-01

    Introduction: New training models are needed to maintain safety and quality of surgical performance. A simulated setting using virtual reality, synthetic, and/or organic models should precede traditional supervised training in the operating room. Aim: The aim of the paper is to describe the

  3. Surgical strategy for giant pituitary adenoma based on evaluation of fine feeding system and angioarchitecture

    Directory of Open Access Journals (Sweden)

    Yoshikazu Ogawa, M.D., Ph.D.

    2017-06-01

    Conclusion: Major blood supply was different from the normal supply to the anterior pituitary gland and did not necessarily correspond to tumor shape and extension. Surgical strategy should be established based on the tumor feeding systems and hemodynamics in giant pituitary adenomas.

  4. Evaluating Disparities in Inpatient Surgical Cancer Care Among American Indian/Alaska Native Patients

    Science.gov (United States)

    Simianu, Vlad V.; Morris, Arden M.; Varghese, Thomas K.; Porter, Michael P.; Henderson, Jeffrey A.; Buchwald, Dedra S.; Flum, David R.; Javid, Sara H.

    2016-01-01

    Background American Indian/Alaska Native (AI/AN) patients with cancer have the lowest survival rates of all racial and ethnic groups, possibly because they are less likely to receive “best practice” surgical care than patients of other races. Methods Prospective cohort study comparing adherence to generic and cancer-specific guidelines on processes of surgical care between AI/AN and non-Hispanic white (NHW) patients in Washington State (2010–2014). Results 156 AI/AN and 6,030 NHW patients underwent operations for 10 different cancers, and had similar mean adherence to generic surgical guidelines (91.5% vs 91.9%, p=0.57). AI/AN patients with breast cancer less frequently received preoperative diagnostic core-needle biopsy (81% versus 94%, p=0.004). AI/AN patients also less frequently received care adherent to prostate cancer-specific guidelines (74% versus 92%,p=0.001). Conclusions While AI/ANs undergoing cancer operations in Washington receive similar overall best practice surgical cancer care to NHW patients, there remain important, modifiable disparities that may contribute to their lower survival. PMID:26846176

  5. Evaluation of 28 years of surgical treatment of children and young adults with familial adenomatous polyposis

    NARCIS (Netherlands)

    Booij, Klaske A. C.; Mathus-Vliegen, Elisabeth M. H.; Taminiau, Jan A. J. M.; ten Kate, Fibo J. W.; Slors, J. Frederick M.; Tabbers, Merit M.; Aronson, Daniel C.

    2010-01-01

    Background: In this retrospective study, 28 years of surgical treatment of children and young adults with familial adenomatous polyposis (FAP) was analyzed. Methods: Forty-three patients were operated on before the age of 26 years. Endoscopic aspects, operative data, and complications were analyzed,

  6. Evaluation of 28 years of surgical treatment of children and young adults with familial adenomatous polyposis.

    NARCIS (Netherlands)

    Booij, K.A.; Mathus-Vliegen, E.M.H.; Taminiau, J.A.; Kate, F.J. ten; Slors, J.F.M.; Tabbers, M.M.; Aronson, D.C.

    2010-01-01

    BACKGROUND: In this retrospective study, 28 years of surgical treatment of children and young adults with familial adenomatous polyposis (FAP) was analyzed. METHODS: Forty-three patients were operated on before the age of 26 years. Endoscopic aspects, operative data, and complications were analyzed,

  7. On the evaluation of social innovations and social enterprises: Recognizing and integrating two solitudes in the empirical knowledge base.

    Science.gov (United States)

    Szijarto, Barbara; Milley, Peter; Svensson, Kate; Cousins, J Bradley

    2018-02-01

    Social innovation (SI) is billed as a new way to address complex social problems. Interest in SI has intensified rapidly in the last decade, making it an important area of practice for evaluators, but a difficult one to navigate. Learning from developments in SI and evaluation approaches applied in SI contexts is challenging because of 'fuzzy' concepts and silos of activity and knowledge within SI communities. This study presents findings from a systematic review and integration of 41 empirical studies on evaluation in SI contexts. We identify two isolated conversations: one about 'social enterprises' (SEs) and the other about non-SE 'social innovations'. These conversations diverge in key areas, including engagement with evaluation scholarship, and in the reported purposes, approaches and use of evaluation. We identified striking differences with respect to degree of interest in collaborative approaches and facilitation of evaluation use. The findings speak to trends and debates in our field, for example how evaluation might reconcile divergent information needs in multilevel, cross-sectoral collaborations and respond to fluidity and change in innovative settings. Implications for practitioners and commissioners of evaluation include how evaluation is used in different contexts and the voice of evaluators (and the evaluation profession) in these conversations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. The Method of Relative Evaluations in the Analysis of the Innovation and Scientific-Technical Activity in the National Innovation System

    Directory of Open Access Journals (Sweden)

    Melnyk Alexander G.

    2017-04-01

    Full Text Available The article suggests the methodical approach to calculation of the system of analytical indicators for complex analysis of the innovation and scientific-technical activity by defining indexes such as: implementarity of technologies; institutional fullness of the national innovation system (NIS; high technology grade of the industry branches and sectors of the NIS. Fundamentals on the interpretation of these indicators in determining the status of institutional and technological structures, as well as the investment ability of technologies in the NIS, have been formulated. An evaluation of status of the innovation and scientific-technical activity in the industry and in the sector of scientific organizations of Ukraine was carried out on the example of practical application of the methodical approach to the analysis of statistical data. A simulation of the calculation index of implementarity of technologies in terms of the hypothesis of a 10 x magnification of the number of patents for inventions was completed. The author’s own interpretation of values of the calculated indicators has been proposed.

  9. Cluster randomized trial to evaluate the impact of team training on surgical outcomes.

    Science.gov (United States)

    Duclos, A; Peix, J L; Piriou, V; Occelli, P; Denis, A; Bourdy, S; Carty, M J; Gawande, A A; Debouck, F; Vacca, C; Lifante, J C; Colin, C

    2016-12-01

    The application of safety principles from the aviation industry to the operating room has offered hope in reducing surgical complications. This study aimed to assess the impact on major surgical complications of adding an aviation-based team training programme after checklist implementation. A prospective parallel-group cluster trial was undertaken between September 2011 and March 2013. Operating room teams from 31 hospitals were assigned randomly to participate in a team training programme focused on major concepts of crew resource management and checklist utilization. The primary outcome measure was the occurrence of any major adverse event, including death, during the hospital stay within the first 30 days after surgery. Using a difference-in-difference approach, the ratio of the odds ratios (ROR) was estimated to compare changes in surgical outcomes between intervention and control hospitals. Some 22 779 patients were enrolled, including 5934 before and 16 845 after team training implementation. The risk of major adverse events fell from 8·8 to 5·5 per cent in 16 intervention hospitals (adjusted odds ratio 0·57, 95 per cent c.i. 0·48 to 0·68; P trends revealed significant improvements among ten institutions, equally distributed across intervention and control hospitals. Surgical outcomes improved substantially, with no difference between trial arms. Successful implementation of an aviation-based team training programme appears to require modification and adaptation of its principles in the context of the the surgical milieu. Registration number: NCT01384474 (http://www.clinicaltrials.gov). © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

  10. Evaluation of robotic-assisted platysmaplasty procedures in a cadaveric model using the da Vinci Surgical System.

    Science.gov (United States)

    Taghizadeh, Farhan; Reiley, Carol; Mohr, Catherine; Paul, Malcolm

    2014-03-01

    We are evaluating the technical feasibility of robotic-assisted laparoscopic vertical-intermediate platysmaplasty in conjunction with an open rhytidectomy. In a cadaveric study, the da Vinci Surgical System was used to access certain angles in the lower neck that are difficult for traditional short incision, short flap procedures. Ergonomics, approach, and technical challenges were noted. To date, there are no published reports of robotic-assisted neck lifts, motivating us to assess its potential in this field of plastic surgery. Standard open technique short flap rhytidectomies with concurrent experimental robotic-assisted platysmaplasties (neck lifts) were performed on six cadavers with the da Vinci Si Surgical System(®) (Intuitive Surgical, Sunnyvale, CA, USA). The surgical procedures were performed on a diverse cadaver population from June 2011 to January 2012. The procedures included (1) submental incision and laser-assisted liposuction, (2) open rhytidectomy, and (3) robotic-assisted platysmaplasty using knot-free sutures. A variety of sutures and fat extraction techniques, coupled with 0° and 30° three-dimensional endoscopes, were utilized to optimize visualization of the platysma. An unaltered da Vinci Si Surgical System with currently available instruments was easily adaptable to neck lift surgery. Mid-neck platysma exposure was excellent, tissue handling was delicate and precise, and suturing was easily performed. Robotic-assisted surgery has the potential to improve outcomes in neck lifts by offering the ability to manipulate instruments with increased freedom of movement, scaled motion, tremor reduction, and stereoscopic three-dimensional visualization in the deep neck. Future clinical studies on live human patients can better assess subject and surgeon benefits arising from the use of the da Vinci system for neck lifts. Evidence obtained from multiple time series with or without the intervention, such as case studies. Dramatic results in

  11. Case study of evaluations that go beyond clinical outcomes to assess quality improvement diabetes programmes using the Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE).

    Science.gov (United States)

    Paquette-Warren, Jann; Harris, Stewart B; Naqshbandi Hayward, Mariam; Tompkins, Jordan W

    2016-10-01

    Investments in efforts to reduce the burden of diabetes on patients and health care are critical; however, more evaluation is needed to provide evidence that informs and supports future policies and programmes. The newly developed Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE) incorporates the theoretical concepts needed to facilitate the capture of critical information to guide investments, policy and programmatic decision making. The aim of the study is to assess the applicability and value of DEFINE in comprehensive real-world evaluation. Using a critical and positivist approach, this intrinsic and collective case study retrospectively examines two naturalistic evaluations to demonstrate how DEFINE could be used when conducting real-world comprehensive evaluations in health care settings. The variability between the cases and the evaluation designs are described and aligned to the DEFINE goals, steps and sub-steps. The majority of the theoretical steps of DEFINE were exemplified in both cases, although limited for knowledge translation efforts. Application of DEFINE to evaluate diverse programmes that target various chronic diseases is needed to further test the inclusivity and built-in flexibility of DEFINE and its role in encouraging more comprehensive knowledge translation. This case study shows how DEFINE could be used to structure or guide comprehensive evaluations of programmes and initiatives implemented in health care settings and support scale-up of successful innovations. Future use of the framework will continue to strengthen its value in guiding programme evaluation and informing health policy to reduce the burden of diabetes and other chronic diseases. © 2016 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  12. MEG time-frequency analyses for pre- and post-surgical evaluation of patients with epileptic rhythmic fast activity.

    Science.gov (United States)

    Sueda, Keitaro; Takeuchi, Fumiya; Shiraishi, Hideaki; Nakane, Shingo; Asahina, Naoko; Kohsaka, Shinobu; Nakama, Hideyuki; Otsuki, Taisuke; Sawamura, Yutaka; Saitoh, Shinji

    2010-02-01

    To evaluate the effectiveness of surgery for epilepsy, we analyzed rhythmic fast activity by magnetoencephalography (MEG) before and after surgery using time-frequency analysis. To assess reliability, the results obtained by pre-surgical MEG and intraoperative electrocorticography were compared. Four children with symptomatic localization-related epilepsy caused by circumscribed cortical lesion were examined in the present study using 204-channel helmet-shaped MEG with a sampling rate of 600Hz. One patient had dysembryoplastic neuroepithelial tumor (DNT) and three patients had focal cortical dysplasia (FCD). Aberrant areas were superimposed, to reconstruct 3D MRI images, and illustrated as moving images. In three patients, short-time Fourier transform (STFT) analyses of MEG showed rhythmic activities just above the lesion with FCD and in the vicinity of DNT. In one patient with FCD in the medial temporal lobe, rhythmic activity appeared in the ipsilateral frontal lobe and temporal lateral aspect. These findings correlate well with the results obtained by intraoperative electrocorticography. After the surgery, three patients were relieved of their seizures, and the area of rhythmic MEG activity disappeared or become smaller. One patient had residual rhythmic MEG activity, and she suffered from seizure relapse. Time-frequency analyses using STFT successfully depicted MEG rhythmic fast activity, and would provide valuable information for pre- and post-surgical evaluations to define surgical strategies for patients with epilepsy.

  13. Surgical approach and optic coherence tomographic evaluation of optic disc anomaly in association with serous macular detachment.

    Science.gov (United States)

    Güven, Dilek; Balcıoğlu, Nihal; Türker, Cağrı; Baydar, Yasemin; Sendül, Yekta

    2013-12-01

    Serous macular detachment (SMD) may accompany optic disc pit (ODP) and cause visual loss if untreated. We want to present different therapeutic approaches and interesting optical coherence tomography (OCT) findings in three consecutive cases. In this case series, two patients with SMD and one patient with partial macular detachment and inferior retinal detachment accompanying ODP were evaluated before and after surgical intervention clinically and by spectral-domain OCT. The patients were 44 (case 1), 22 (case 2) and 24 (case 3) years old. Pars plana vitrectomy (PPV) + silicone oil + laser, PPV + sulfur hexafluoride gas (SF6) + laser and pneumatic retinopexy were applied, respectively. The patients were followed for 18, 15 and 14 months. Preoperative best-corrected visual acuities (BCVAs) were 5/100, 7/10 and counting fingers at 1 m. Vision improved in all cases with resolution of subretinal fluid. Final BCVAs were 3/10, 10/10 and 1/10, respectively. OCT images revealed optic disc anomaly details and changes after surgical intervention, photoreceptor outer segment alterations at the detached area and macular surface changes. Surgical intervention should be tailored individually in cases with SMD. OCT is efficient for in vivo evaluation of this pathological condition and anatomical outcomes of surgery.

  14. Modeling and evaluation of hand-eye coordination of surgical robotic system on task performance.

    Science.gov (United States)

    Gao, Yuanqian; Wang, Shuxin; Li, Jianmin; Li, Aimin; Liu, Hongbin; Xing, Yuan

    2017-12-01

    Robotic-assisted minimally invasive surgery changes the direct hand and eye coordination in traditional surgery to indirect instrument and camera coordination, which affects the ergonomics, operation performance, and safety. A camera, two instruments, and a target, as the descriptors, are used to construct the workspace correspondence and geometrical relationships in a surgical operation. A parametric model with a set of parameters is proposed to describe the hand-eye coordination of the surgical robot. From the results, optimal values and acceptable ranges of these parameters are identified from two tasks. A 90° viewing angle had the longest completion time; 60° instrument elevation angle and 0° deflection angle had better performance; there is no significant difference among manipulation angles and observing distances on task performance. This hand-eye coordination model provides evidence for robotic design, surgeon training, and robotic initialization to achieve dexterous and safe manipulation in surgery. Copyright © 2017 John Wiley & Sons, Ltd.

  15. THE PROBLEMS IN THE EVALUATION THE RISKS ON INVESTMENTS OF INNOVATION PROCESS OF REPUBLIC OF MOLDOVA

    Directory of Open Access Journals (Sweden)

    Anatol Rotaru

    2012-12-01

    Full Text Available An innovative activity in the economy is the most important element of economic growth. This article is dedicated to research of the role of investment risk and implements innovations. It is well known that the interdependence between risk and profit, but there is a strong interrelationship between the risk of investment and innovative development of the country. In this article, the most important features of innovation for economic growth, as well as the direction of its investment, both from the government and from foreign investors and the private individuals are discussed. Based on this purpose have been characterized elements of investment risk has been made an investment risk analysis, innovation process and performance indicators. In that article presents a vision of innovation and investment activity in Moldova.

  16. Load evaluation of the da Vinci surgical system for transoral robotic surgery.

    Science.gov (United States)

    Fujiwara, Kazunori; Fukuhara, Takahiro; Niimi, Koji; Sato, Takahiro; Kitano, Hiroya

    2015-12-01

    Transoral robotic surgery, performed with the da Vinci surgical system (da Vinci), is a surgical approach for benign and malignant lesions of the oral cavity and laryngopharynx. It provides several unique advantages, which include a 3-dimensional magnified view and ability to see and work around curves or angles. However, the current da Vinci surgical system does not provide haptic feedback. This is problematic because the potential risks specific to the transoral use of the da Vinci include tooth injury, mucosal laceration, ocular injury and mandibular fracture. To assess the potential for intraoperative injuries, we measured the load of the endoscope and the instrument of the da Vinci Si surgical system. We pressed the endoscope and instrument of the da Vinci Si against Load cell six times each and measured the dynamic load and the time-to-maximum load. We also struck the da Vinci Si endoscope and instrument against the Load cell six times each and measured the impact load. The maximum dynamic load was 7.27 ± 1.31 kg for the endoscope and 1.90 ± 0.72 for the instrument. The corresponding time-to-maximum loads were 1.72 ± 0.22 and 1.29 ± 0.34 s, but the impact loads were significantly lower than the dynamic load. It remains possible that a major load is exerted on adjacent structures by continuous contact with the endoscope and instrument of da Vinci Si. However, there is a minor delay in reaching the maximum load. Careful monitoring by an on-site assistant may, therefore, help prevent contiguous injury.

  17. Gross Instability After Hip Arthroscopy: An Analysis of Case Reports Evaluating Surgical and Patient Factors.

    Science.gov (United States)

    Yeung, Marco; Memon, Muzammil; Simunovic, Nicole; Belzile, Etienne; Philippon, Marc J; Ayeni, Olufemi R

    2016-06-01

    Gross hip instability is a rare complication after hip arthroscopy, and there is limited literature surrounding this topic. This systematic review investigates cases of gross hip instability after arthroscopy and discusses the risk factors associated with this complication. A systematic search was performed in duplicate for studies investigating gross hip instability after hip arthroscopy up to October 2015. Study parameters including sample size, mechanism and type of dislocation, surgical procedure details, patient characteristics, postoperative rehabilitation protocol, and level of evidence were analyzed. The systematic review identified 9 case reports investigating gross hip instability after hip arthroscopy (10 patients). Anterior dislocation occurred in 66.7% of patients, and most injuries occurred with a low-energy mechanism. Common surgical factors cited included unrepaired capsulotomy (77.8%) and iliopsoas release (33.3%), whereas patient factors included female gender (77.8%), acetabular dysplasia (22.2%), and general ligamentous laxity (11.1%). Postoperative restrictions and protocols were variable and inconsistently reported, and their relation to post-arthroscopy instability was difficult to ascertain. This systematic review discussed various patient, surgical, and postoperative risk factors of gross hip instability after arthroscopy. Patient characteristics such as female gender, hip dysplasia, and ligamentous laxity may be risk factors for post-arthroscopy dislocation. Similarly, surgical risk factors for iatrogenic hip instability may include unrepaired capsulotomies and iliopsoas debridement, although the role of capsular closure in iatrogenic instability is not clear. The influences of postoperative restrictions and protocols on dislocation are also unclear in the current literature. Surgeons should be cognizant of these risk factors when performing hip arthroscopy and be mindful that these factors appear to occur in combination. Level IV

  18. Patient-specific surgical simulation.

    Science.gov (United States)

    Soler, Luc; Marescaux, Jacques

    2008-02-01

    Technological innovations of the twentieth century have provided medicine and surgery with new tools for education and therapy definition. Thus, by combining Medical Imaging and Virtual Reality, patient-specific applications providing preoperative surgical simulation have become possible.

  19. Evaluation of innovative operation concept for flat sheet MBR filtration system.

    Science.gov (United States)

    Weinrich, L; Grélot, A

    2008-01-01

    One of the most limiting factors for the extension and acceptance of MBR filtration systems for municipal and industrial wastewater is the impact of membrane fouling on maintenance, operation and cleaning efforts. One field of action in the European Research Project "AMEDEUS" is the development and testing of MBR module concepts with innovative fouling-prevention technology from three European module manufacturers. This article deals with the performances of the flat-sheet modules by A3 Water Solutions GmbH in double-deck configuration evaluated over 10 months in Anjou Recherche under typical biological operation conditions for MBR systems (MLSS = 10 g/l; SRT = 25 days). By using a double-deck configuration, it is possible to operate with a net flux of 25.5 l/m2.h at 20 degrees C, a membrane air flow rate of 0.21 Nm3/h.m2 of membrane to achieve a stable permeability of around 500-600 l/m2.h.bar. Additionally, it was observed that it is possible to recover the membrane performance after biofouling during operation without intensive cleaning and to maintain stable permeability during peak flows. The evaluated concepts for equipping and operating MBR systems will be applied to several full-scale plants constructed by A3 Water Solutions GmbH.

  20. Evaluation of innovative arsenic treatment technologies :the arsenic water technology partnership vendors forums summary report.

    Energy Technology Data Exchange (ETDEWEB)

    Everett, Randy L.; Siegel, Malcolm Dean; McConnell, Paul E.; Kirby, Carolyn (Comforce Technical Services, Inc.)

    2006-09-01

    The lowering of the drinking water standard (MCL) for arsenic from 50 {micro}g/L to 10 {micro}g/L in January 2006 could lead to significant increases in the cost of water for many rural systems throughout the United States. The Arsenic Water Technology Partnership (AWTP), a collaborative effort of Sandia National Laboratories, the Awwa Research Foundation (AwwaRF) and WERC: A Consortium for Environmental Education and Technology Development, was formed to address this problem by developing and testing novel treatment technologies that could potentially reduce the costs of arsenic treatment. As a member of the AWTP, Sandia National Laboratories evaluated cutting-edge commercial products in three annual Arsenic Treatment Technology Vendors Forums held during the annual New Mexico Environmental Health Conferences (NMEHC) in 2003, 2004 and 2005. The Forums were comprised of two parts. At the first session, open to all conference attendees, commercial developers of innovative treatment technologies gave 15-minute talks that described project histories demonstrating the effectiveness of their products. During the second part, these same technologies were evaluated and ranked in closed sessions by independent technical experts for possible use in pilot-scale field demonstrations being conducted by Sandia National Laboratories. The results of the evaluations including numerical rankings of the products, links to company websites and copies of presentations made by the representatives of the companies are posted on the project website at http://www.sandia.gov/water/arsenic.htm. This report summarizes the contents of the website by providing brief descriptions of the technologies represented at the Forums and the results of the evaluations.

  1. Technology-Enhanced Physics Programme for Community-Based Science Learning: Innovative Design and Programme Evaluation in a Theme Park

    Science.gov (United States)

    Tho, Siew Wei; Chan, Ka Wing; Yeung, Yau Yuen

    2015-01-01

    In this study, a new physics education programme is specifically developed for a famous theme park in Hong Kong to provide community-based science learning to her visitors, involving her three newly constructed rides. We make innovative use of digital technologies in this programme and incorporate a rigorous evaluation of the learning…

  2. Pilot study: evaluation of the use of the convergent interview technique in understanding the perception of surgical design and simulation.

    Science.gov (United States)

    Logan, Heather; Wolfaardt, Johan; Boulanger, Pierre; Hodgetts, Bill; Seikaly, Hadi

    2013-06-19

    It is important to understand the perceived value of surgical design and simulation (SDS) amongst surgeons, as this will influence its implementation in clinical settings. The purpose of the present study was to examine the application of the convergent interview technique in the field of surgical design and simulation and evaluate whether the technique would uncover new perceptions of virtual surgical planning (VSP) and medical models not discovered by other qualitative case-based techniques. Five surgeons were asked to participate in the study. Each participant was interviewed following the convergent interview technique. After each interview, the interviewer interpreted the information by seeking agreements and disagreements among the interviewees in order to understand the key concepts in the field of SDS. Fifteen important issues were extracted from the convergent interviews. In general, the convergent interview was an effective technique in collecting information about the perception of clinicians. The study identified three areas where the technique could be improved upon for future studies in the SDS field.

  3. Evaluation of implementation of the strategy of the economy innovation-oriented development in Russian regions

    Directory of Open Access Journals (Sweden)

    Yuliya Semenovna Toktamysheva

    2015-06-01

    Full Text Available Objective to develop methods for analyzing and determining the level of socioeconomic development of the Russian Federation subjects towards innovations. Methods dialectical and systemic approaches to the consideration of economic phenomena and facts processing and synthesis of information using statistical and graphical methods of analysis. Results it was determined that the transition to intensive economic growth as a vital in the longterm strategy for accelerated economic development is not implemented in all regions of Russia. There are disparities in the level of innovation activity and investment performance. Scientific novelty the method used for estimating the efficiency of implementing and realization of the potential of innovationoriented development in the Russian Federation regions was the method of ranking based on information on the key indicators labour productivity capital productivity sustainability of the regional economy production of innovative goods works and services expenditure on research and development investment in technological innovation in the region. Practical value financing and implementation of innovative projects industrial production and technical innovation special economic zones technology parks etc. proved their efficient impact on the growth and performance of the entire regionrsquos economy. The highest positions in the ranking of innovative development are occupied by the regions with high innovative attractivity and welldeveloped energy and raw materials industry. nbsp

  4. Promoting Entrepreneurship in a Tribal Context: Evaluation of the First Innovations Course Sequence

    Science.gov (United States)

    Walters, Fonda

    2012-01-01

    In the First Innovations Initiative at Arizona State University students are exposed to the culture of innovation and the entrepreneurial process through two courses situated intentionally within an American Indian sustainability context. In this action research dissertation, a summer field practicum was designed and implemented to complement the…

  5. Cutting through the Hype: Evaluating the Innovative Potential of New Educational Technologies through Business Model Analysis

    Science.gov (United States)

    Kalman, Yoram M.

    2016-01-01

    In an era when novel educational technologies are constantly introduced to the marketplace, often accompanied by hyperbolic claims that these ground-breaking innovations will transform the educational landscape, decision makers in educational institutions need a methodological approach for examining the innovative potential of new educational…

  6. Evaluation of the Influence of the Macro-environment on the Social Innovation Activity of Enterprises

    Directory of Open Access Journals (Sweden)

    Satalkina Liliya

    2018-02-01

    Full Text Available Background: Nowadays the emphasis on social components in the general mainstream of innovation activity is one of the strongest grounds for the successful functioning and development of enterprises. In several countries, social innovation activity is becoming a product of business in general, with associated expectations regarding profit.

  7. Knowledge evaluation : A new aim for knowledge management to enhance sustainable innovation

    NARCIS (Netherlands)

    Peters, K.; Maruster, L.; Jorna, R.J.J.M.; Remenyi, D

    2007-01-01

    Sustainability is a topic that presently forces organizations to strive for innovation. Sustainable innovation relates to organizational measures to gain more sustainable outcomes and processes from a social and ecological point of view (People, Planet 8 Profit, i.e. the three Ps, Elkington 1997).

  8. The fast neutrons reactors, the sodium, the fuel cycle: evaluation of the knowledge, innovation potential and forecast

    International Nuclear Information System (INIS)

    Moreau, J.

    2002-01-01

    This document presents the study, the design and the construction of fast neutrons reactors, cooled with sodium. From this evaluation, it details the innovation possibilities of this sector in the sustainable development context of the nuclear energy. Chapter one presents the physical and physico-chemical properties of the sodium. Chapter two analyzes the properties of the fast cores and the sodium advantages. Chapter three analyzes the great contribution of the EFR project. Chapter four takes stock on the innovation possibilities. And before the conclusion, chapter five shows that the fast neutrons reactors allow the electric power production in agreement with a sustainable development. (A.L.B.)

  9. Does Wearable Medical Technology With Video Recording Capability Add Value to On-Call Surgical Evaluations?

    Science.gov (United States)

    Gupta, Sameer; Boehme, Jacqueline; Manser, Kelly; Dewar, Jannine; Miller, Amie; Siddiqui, Gina; Schwaitzberg, Steven D

    2016-10-01

    Background Google Glass has been used in a variety of medical settings with promising results. We explored the use and potential value of an asynchronous, near-real time protocol-which avoids transmission issues associated with real-time applications-for recording, uploading, and viewing of high-definition (HD) visual media in the emergency department (ED) to facilitate remote surgical consults. Study Design First-responder physician assistants captured pertinent aspects of the physical examination and diagnostic imaging using Google Glass' HD video or high-resolution photographs. This visual media were then securely uploaded to the study website. The surgical consultation then proceeded over the phone in the usual fashion and a clinical decision was made. The surgeon then accessed the study website to review the uploaded video. This was followed by a questionnaire regarding how the additional data impacted the consultation. Results The management plan changed in 24% (11) of cases after surgeons viewed the video. Five of these plans involved decision making regarding operative intervention. Although surgeons were generally confident in their initial management plan, confidence scores increased further in 44% (20) of cases. In addition, we surveyed 276 ED patients on their opinions regarding concerning the practice of health care providers wearing and using recording devices in the ED. The survey results revealed that the majority of patients are amenable to the addition of wearable technology with video functionality to their care. Conclusions This study demonstrates the potential value of a medically dedicated, hands-free, HD recording device with internet connectivity in facilitating remote surgical consultation. © The Author(s) 2016.

  10. Evaluation of chemical castration with calcium chloride versus surgical castration in donkeys: testosterone as an endpoint marker.

    Science.gov (United States)

    Ibrahim, Ahmed; Ali, Magda M; Abou-Khalil, Nasser S; Ali, Marwa F

    2016-03-08

    For the last few years, researchers have been interested in developing a method for chemical sterilization which may be a better alternative to surgical castration. An ideal chemical sterilant would be one that effectively arrests spermatogenesis and androgenesis as well as libido with absence of toxic or other side effects. Calcium chloride in various solutions and concentrations has been tested in many animal species, but few studies have been evaluated it in equines as a chemical sterilant. So, the objective of this study was to evaluate the clinical efficacy of chemical castration with 20% calcium chloride dissolved in absolute ethanol in comparison with surgical castration in donkeys based on the changes in the serum testosterone level and the histopathological changes in treated testes. Twelve clinically healthy adult male donkeys were used in this study. Donkeys were divided randomly and equally into two groups: a surgical (S) group (n = 6) and a chemical (C) group (n = 6). Animals in the (S) group were subjected to surgical castration while those in the (C) group received a single bilateral intratesticular injection of 20% calcium chloride dissolved in absolute ethanol (20 ml/testis). Animals were kept under clinical observation for 60 days. Changes in animals' behavior and gross changes in external genitalia were monitored daily. Serum concentrations of testosterone were measured prior to treatment and at 15, 30, 45 and 60 days post-treatment. Testicles in the (C) group were examined histopathologically at the end of the experiment. Chemical castration with intratesticular calcium chloride vs. surgical castration failed to reduce serum concentrations of testosterone throughout the whole duration of the study; however it induced orchitis that was evident by focal necrotic areas in seminiferous tubules, cellular infiltration of neutrophils, proliferative intertubular fibrosis with a compensatory proliferation of Leydig cells. Donkeys tolerated the

  11. Clinical evaluation and surgical decision making for patients with lumbar discogenic pain and facet syndrome

    International Nuclear Information System (INIS)

    Tessitore, Enrico; Molliqaj, Granit; Schatlo, Bawarjan; Schaller, Karl

    2015-01-01

    In industrialized countries, more than two thirds of the population suffers from low back pain (LBP) in their lifetime. LBP associated with lumbar disc herniation, stenosis, and instability is a well-known and documented entity. On the other hand, the lumbar discogenic pain and facet syndrome are difficult to be clearly identified, and they are not always detectable by imaging. This article describes the causes of these painful syndromes, which are typically without radicular component, explains the modern diagnostic procedures, and provides guidelines for surgical decision making

  12. Clinical evaluation and surgical decision making for patients with lumbar discogenic pain and facet syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Tessitore, Enrico, E-mail: enrico.tessitore@hcuge.ch [Neurosurgical Unit, Geneva University Hospitals, Faculty of Medicine, University of Geneva (Switzerland); Molliqaj, Granit, E-mail: granitmolliqaj@gmail.com [Neurosurgical Unit, Geneva University Hospitals, Faculty of Medicine, University of Geneva (Switzerland); Schatlo, Bawarjan, E-mail: schatlo@gmail.com [Department of Neurosurgery, Georg-August University, University of Medicine Gottingen, 37075 Gottingen (Germany); Schaller, Karl, E-mail: karl.schaller@hcuge.ch [Neurosurgical Unit, Geneva University Hospitals, Faculty of Medicine, University of Geneva (Switzerland)

    2015-05-15

    In industrialized countries, more than two thirds of the population suffers from low back pain (LBP) in their lifetime. LBP associated with lumbar disc herniation, stenosis, and instability is a well-known and documented entity. On the other hand, the lumbar discogenic pain and facet syndrome are difficult to be clearly identified, and they are not always detectable by imaging. This article describes the causes of these painful syndromes, which are typically without radicular component, explains the modern diagnostic procedures, and provides guidelines for surgical decision making.

  13. TRANSITION TO INNOVATIVE ECONOMICS ON THE BASIS OF «ROAD CARD»: EXAMINATION, EVALUATION, PROSPECTS

    Directory of Open Access Journals (Sweden)

    A. O. Baklanov

    2011-01-01

    Full Text Available The innovative economics model is examined in its interaction with the environment that includes such components as science, society, state, education, business and market as well as safety and court systems. Three main RF economics innovative and active development strategies are suggested and discussed: «resource-export», «resource-science» and «resource-innovation» strategies. Preference is given to the resourceinnovation strategy characteristic with multiple effect resulting from innovations used to update domestic technologies and to restructure the processing and manufacturing industries. An instrument called «Road map» is developed as a set and succession of measures required for Russia to transit to innovative economy.

  14. A hybrid MCDM framework combined with DEMATEL-based ANP to evaluate enterprise technological innovation capabilities assessment

    Directory of Open Access Journals (Sweden)

    Meng-Jong Kuan

    2014-08-01

    Full Text Available The efficient evaluation of technological innovation capabilities of enterprises is an important factor to enhance competitiveness. This paper aims to assess and to rank technological innovation evaluation criteria in order to provide a practical insight of systematic analysis by gathering the qualified experts’ opinions combined with three methods of multi-criteria decision making approach. A framework is proposed and uses a novel hybrid multiple criteria decision-making (MCDM model to address the dependence relationships of criteria with the aid of the Decision-Making Trial and Evaluation Laboratory (DEMATEL, analytical network process (ANP and VIKOR (VlseKriterijumska Optimizacija I Kompromisno Resenje. The study reports that the interaction between criteria is essential and influences technological innovation capabilities; furthermore, this ranking development of technological innovation capabilities assessment is also one of key management tools for managements of other related high- tech enterprises. Managers can then judge the need to improve and determine which criteria provide the most effective direction towards improvement.

  15. EPA [Environmental Protection Agency] SITE [Superfund Innovative Technology Evaluation] program seeks technology proposals

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    EPA will issue an RFP to initiate the SITE-005 solicitation for demonstration of technologies under the Superfund Innovative Technology Evaluation (SITE) Program. This portion of the SITE program offers a mechanism for conducting a joint technology demonstration between EPA and the private sector. The goal of the demonstration program is to provide an opportunity for developers to demonstrate the performance of their technologies on actual hazardous wastes at Superfund sites, and to provide accurate and reliable data on that performance. Technologies selected must be of commercial scale and provide solutions to problems encountered at Superfund Sites. Primary emphasis in the RFP is on technologies that address: treatment of mixed, low level radioactive wastes in soils and groundwater; treatment of soils and sludges contaminated with organics and/or inorganics, materials handling as a preliminary step to treatment or further processing, treatment trains designed to handle specific wastes, are in situ technologies, especially those processes providing alternatives to conventional groundwater pump and treat techniques

  16. Identifying Opportunities for Virtual Reality Simulation in Surgical Education: A Review of the Proceedings from the Innovation, Design, and Emerging Alliances in Surgery (IDEAS) Conference: VR Surgery

    Science.gov (United States)

    Olasky, Jaisa; Sankaranarayanan, Ganesh; Seymour, Neal E.; Magee, J. Harvey; Enquobahrie, Andinet; Lin, Ming C.; Aggarwal, Rajesh; Brunt, L. Michael; Schwaitzberg, Steven D.; Cao, Caroline G. L.; De, Suvranu; Jones, Daniel B.

    2015-01-01

    Objectives To conduct a review of the state of virtual reality (VR) simulation technology, to identify areas of surgical education that have the greatest potential to benefit from it, and to identify challenges to implementation. Background Data Simulation is an increasingly important part of surgical training. VR is a developing platform for using simulation to teach technical skills, behavioral skills, and entire procedures to trainees and practicing surgeons worldwide. Questions exist regarding the science behind the technology and most effective usage of VR simulation. A symposium was held to address these issues. Methods Engineers, educators, and surgeons held a conference in November 2013 both to review the background science behind simulation technology and to create guidelines for its use in teaching and credentialing trainees and surgeons in practice. Results Several technologic challenges were identified that must be overcome in order for VR simulation to be useful in surgery. Specific areas of student, resident, and practicing surgeon training and testing that would likely benefit from VR were identified: technical skills, team training and decision-making skills, and patient safety, such as in use of electrosurgical equipment. Conclusions VR simulation has the potential to become an essential piece of surgical education curriculum but depends heavily on the establishment of an agreed upon set of goals. Researchers and clinicians must collaborate to allocate funding toward projects that help achieve these goals. The recommendations outlined here should guide further study and implementation of VR simulation. PMID:25925424

  17. Identifying Opportunities for Virtual Reality Simulation in Surgical Education: A Review of the Proceedings from the Innovation, Design, and Emerging Alliances in Surgery (IDEAS) Conference: VR Surgery.

    Science.gov (United States)

    Olasky, Jaisa; Sankaranarayanan, Ganesh; Seymour, Neal E; Magee, J Harvey; Enquobahrie, Andinet; Lin, Ming C; Aggarwal, Rajesh; Brunt, L Michael; Schwaitzberg, Steven D; Cao, Caroline G L; De, Suvranu; Jones, Daniel B

    2015-10-01

    To conduct a review of the state of virtual reality (VR) simulation technology, to identify areas of surgical education that have the greatest potential to benefit from it, and to identify challenges to implementation. Simulation is an increasingly important part of surgical training. VR is a developing platform for using simulation to teach technical skills, behavioral skills, and entire procedures to trainees and practicing surgeons worldwide. Questions exist regarding the science behind the technology and most effective usage of VR simulation. A symposium was held to address these issues. Engineers, educators, and surgeons held a conference in November 2013 both to review the background science behind simulation technology and to create guidelines for its use in teaching and credentialing trainees and surgeons in practice. Several technologic challenges were identified that must be overcome in order for VR simulation to be useful in surgery. Specific areas of student, resident, and practicing surgeon training and testing that would likely benefit from VR were identified: technical skills, team training and decision-making skills, and patient safety, such as in use of electrosurgical equipment. VR simulation has the potential to become an essential piece of surgical education curriculum but depends heavily on the establishment of an agreed upon set of goals. Researchers and clinicians must collaborate to allocate funding toward projects that help achieve these goals. The recommendations outlined here should guide further study and implementation of VR simulation. © The Author(s) 2015.

  18. ABWR3. Passive double confinement and SA population dose evaluation for the innovative ABWR

    International Nuclear Information System (INIS)

    Matsumoto, Keiji; Hosomi, Kenji; Sato, Takashi

    2015-01-01

    iB1350 stands for an innovative, intelligent and inexpensive BWR 1350. It is the first Generation III.7 reactor after the Fukushima Daiichi accident. The iB1350 uses the Mark W containment and the in-containment filtered venting system (IFVS). The Mark W containment is made of reinforced concrete and has double cylinder FP barriers. There are also IC/PCCS pools, a fuel pool and a dryer separator (DS) pool on the top slab of the containment. These pools work as water seal for FP leakage through the top slab. Most FP such as CsI are scrubbed in the pools. The containment head is also submerged in the reactor well pool. The pool water works as shielding for radiation from the reactor core during normal operation and water seal for FP scrubbing dining a severe accident. The base mat concrete is covered with the S/P and the core catcher that is also submerged with corium flooding water during an accident. Therefore, the Mark W containment has passive double confinement barriers for FP. Moreover, the IFVS works as in-containment filtered venting system that scrubs FP from the wet well (WW) and the dry well (DW). The filtered venting tank is arranged in the outer well (OW) of the Mark W containment. Even noble gases and organic iodine going through the filtered venting system are still confined inside the containment and never released directly to the environment. The IFVS uses the innovative passive containment cooling system (iPCCS) as the pre-stage heat removal system. The iPCCS has a normal open suction line from the WW. Therefore, FP are scrubbed in the S/P at first and then vented into the filtered venting tank. After the DW suction line of the iPCCS is opened all the steam is cooled and condensed in the heat exchanger. Most FP are trapped in the condensate and returned into the WW through the condensate return line of the iPCCS. Therefore, the Mark W containment has excellent FP double confinement barriers and the in-containment filtered venting system that enable

  19. Economic evaluation of innovative storage technologies in energy systems with a high share of renewable energies

    International Nuclear Information System (INIS)

    Kondziella, Hendrik

    2017-01-01

    This work addresses the question of whether the ongoing transformation to a low-carbon energy system in Germany will also create market opportunities for innovative market participants, in particular for storage operators. The economic effects that occur in energy systems with high levels of variable renewable energy (vEE) can be measured by their integration costs. Scientific research into the additional storage and flexibility needs of such an energy system often addresses imbalances in the system balance sheet. The respective methods are, however, based on different assumptions and framework conditions, so that the results can only be compared with one another to a limited extent. The hourly fluctuating wholesale price on the electricity exchange is an important indicator to signal the need for flexibility. Many analyzes use historical or predicted pricing time series to evaluate storage options. However, while the feedback of the operation of an energy storage on the market prices is left out. Therefore, a method is developed in this work to estimate the impact of an increasing market volume of storage and other flexibility options on spot market prices. The influence of storage use on electricity demand and spot market prices in 2020 and 2030 is examined. The scenarios to be defined for the electricity market are model-based and evaluated. To answer the question, techno-economic models, e.g. The MICOES power market model for power plant deployment planning, the DeSiflex model for smoothing residual load through integrated flexibility options and the Arturflex model for estimating arbitrage gains through the use of flexibility options on the spot market. [de

  20. Performance Evaluation of An Innovative-Vapor- Compression-Desalination System

    Directory of Open Access Journals (Sweden)

    Mirna R. Lubis

    2012-04-01

    Full Text Available Two dominant desalination methods are reverse osmosis (RO and multi-stage flash (MSF. RO requires large capital investment and maintenance, whereas MSF is too energy-intensive. Innovative system of vapor compression desalination is proposed in this study. Comprehensive mathematics model for evaporator is also described. From literature study, it is indicated that very high overall-heat-transfer coefficient for evaporator can be obtained at specific condition by using dropwise condensation in the steam side, and pool boiling in the liquid side. Smooth titanium surface is selected in order to increase dropwise condensation, and resist corrosion. To maximize energy efficiency, a cogeneration scheme of a combined cycle consisting of gas turbine, boiler heat recovery, and steam turbine that drivescompressor is used. The resource for combined cycle is relatively too high for the compressor requirement. Excess power can be used to generate electricity for internal and/or externalconsumptions, and sold to open market. Four evaporator stages are used. Evaporator is fed by seawater, with assumption of 3.5% salt contents. Boiling brine (7% salt is boiled in low pressure side of the heat exchanger, and condensed vapor is condensed in high pressure side of the heat exchanger. Condensed steam flows at velocity of 1.52 m/s, so that it maximize the heat transfer coefficient. This unit is designed in order to produce 10 million gallon/day, and assumed it is financed with 5%, 30 years of passive obligation. Three cases are evaluated in order to determine recommended condition to obtain the lowest fixed capital investment. Based on the evaluation, it is possible to establish four-stage unit of mechanical vapor compression distillation with capital $31,723,885.

  1. Preapplication safety evaluation report for the Power Reactor Innovative Small Module (PRISM) liquid-metal reactor

    International Nuclear Information System (INIS)

    Donoghue, J.E.; Donohew, J.N.; Golub, G.R.; Kenneally, R.M.; Moore, P.B.; Sands, S.P.; Throm, E.D.; Wetzel, B.A.

    1994-02-01

    This preapplication safety evaluation report (PSER) presents the results of the preapplication desip review for die Power Reactor Innovative Small Module (PRISM) liquid-mew (sodium)-cooled reactor, Nuclear Regulatory Commission (NRC) Project No. 674. The PRISM conceptual desip was submitted by the US Department of Energy in accordance with the NRC's ''Statement of Policy for the Regulation of Advanced Nuclear Power Plants'' (51 Federal Register 24643). This policy provides for the early Commission review and interaction with designers and licensees. The PRISM reactor desip is a small, modular, pool-type, liquid-mew (sodium)-cooled reactor. The standard plant design consists of dim identical power blocks with a total electrical output rating of 1395 MWe- Each power block comprises three reactor modules, each with a thermal rating of 471 MWt. Each module is located in its own below-grade silo and is co to its own intermediate heat transport system and steam generator system. The reactors utilize a metallic-type fuel, a ternary alloy of U-Pu-Zr. The design includes passive reactor shutdown and passive decay heat removal features. The PSER is the NRC's preliminary evaluation of the safety features in the PRISM design, including the projected research and development programs required to support the design and the proposed testing needs. Because the NRC review was based on a conceptual design, the PSER did not result in an approval of the design. Instead it identified certain key safety issues, provided some guidance on applicable licensing criteria, assessed the adequacy of the preapplicant's research and development programs, and concluded that no obvious impediments to licensing the PRISM design had been identified

  2. Evaluation of the professional process portfolio: an innovative tool to help develop and demonstrate leadership competency.

    Science.gov (United States)

    Hastings, Elisabeth S; Chacko, Mariam R; Acosta, Amy B; Hergenroeder, Albert C; Wiemann, Constance M

    2015-02-01

    The professional process portfolio (PPP) was adopted by the Maternal Child and Health Bureau (MCHB) as an 'innovation' in best practice for all Leadership in Education and Adolescent Health (LEAH) Training Programs; however it had not been formally evaluated. Thus the objective was to evaluate the utility of the PPP for graduates of the LEAH training program in terms of (1) how alumni have used, adapted, and applied it since completing fellowship, (2) what fellows learned or gained through completing it, and (3) how it can be improved for continued use in training programs. Graduates from six disciplines were asked via telephone or email to participate in a survey regarding their experience with the PPP. Descriptive statistics were generated for demographic characteristics and closed-choice questions. Responses to open-ended questions were analyzed by a team of faculty using framework analysis. Sixty-one graduates completed surveys. The majority (85%) found the PPP useful and utilized it post-graduation for multiple purposes in professional development: interviewing, training, and referencing previous work. Graduates recommended that the PPP be improved by making it electronic, discipline-specific, and providing earlier and more frequent instruction from faculty on expectations of creating it. Four themes emerged from the qualitative data analysis: accomplishment, experiential learning, skills and accountability, and a best practice of learning. The PPP was an effective personal learning tool for the majority of graduates and enhanced graduates' experiences. We highlight the ways that the PPP may facilitate the development of learning experiences associated with MCH leadership competence.

  3. Comprehensive evaluation of occupational radiation exposure to intraoperative and perioperative personnel from 18F-FDG radioguided surgical procedures

    International Nuclear Information System (INIS)

    Povoski, Stephen P.; Martin, Edward W.; Sarikaya, Ismet; Hall, Nathan C.; Knopp, Michael V.; White, William C.; Marsh, Steven G.; Hinkle, George H.

    2008-01-01

    The purpose of the current study was to comprehensively evaluate occupational radiation exposure to all intraoperative and perioperative personnel involved in radioguided surgical procedures utilizing 18 F-fluorodeoxyglucose ( 18 F-FDG). Radiation exposure to surgeon, anesthetist, scrub technologist, circulating nurse, preoperative nurse, and postoperative nurse, using aluminum oxide dosimeters read by optically stimulated luminescence technology, was evaluated during ten actual radioguided surgical procedures involving administration of 18 F-FDG. Mean patient dosage of 18 F-FDG was 699 ± 181 MBq (range 451-984). Mean time from 18 F-FDG injection to initial exposure of personnel to the patient was shortest for the preoperative nurse (75 ± 63 min, range 0-182) followed by the circulating nurse, anesthetist, scrub technologist, surgeon, and postoperative nurse. Mean total time of exposure of the personnel to the patient was longest for the anesthetist (250 ± 128 min, range 69-492) followed by the circulating nurse, scrub technologist, surgeon, postoperative nurse, and preoperative nurse. Largest deep dose equivalent per case was received by the surgeon (164 ± 135 μSv, range 10-580) followed by the anesthetist, scrub technologist, postoperative nurse, circulating nurse, and preoperative nurse. Largest deep dose equivalent per hour of exposure was received by the preoperative nurse (83 ± 134 μSv/h, range 0-400) followed by the surgeon, anesthetist, postoperative nurse, scrub technologist, and circulating nurse. On a per case basis, occupational radiation exposure to intraoperative and perioperative personnel involved in 18 F-FDG radioguided surgical procedures is relatively small. Development of guidelines for monitoring occupational radiation exposure in 18 F-FDG cases will provide reassurance and afford a safe work environment for such personnel. (orig.)

  4. Delayed Presentation of Traumatic Diaphragmatic Hernia: The Evaluation of Surgical Treatment Results

    Directory of Open Access Journals (Sweden)

    Ali Sadrizadeh

    2015-06-01

    Full Text Available Introduction: Diaphragmatic hernia could be caused by congenital disorders, blunt trauma or penetrating injuries. The diagnosis of traumatic diaphragmatic hernia is normally neglected during the first presentation leading to late complications and considerably increased mortality and morbidity among the patients. Materials and Methods: In this retrospective, descriptive study, we reviewed the medical records of patients presented with traumatic diaphragmatic hernia who had undergone surgical operations between 1982-2015 in Ghaem Hospital and Omid Hospital affiliated to Mashhad University of Medical Sciences, Iran. The studied variables included age, gender, clinical symptoms, location of hernia, involved organs, type of imaging modalities, surgical techniques, length of hospital stay, mortality rate and surgical complications. Results: In this study, 38 patients were diagnosed with traumatic diaphragmatic hernia consisting of 28 men and 10 women. In total, 79% and 21% of the patients suffered from penetrating trauma and blunt trauma, respectively. In addition, left-sided, right-sided and bilateral hernias were present in 33%, 4% and 1% of the patients, respectively. The most frequently herniated organ was the stomach, and the most common clinical symptoms were abdominal pain (84% and dyspnea (53%. Initially, chest radiographs were performed on all the patients, and thoracotomy was performed to repair diaphragmatic tears in all the cases (100%. In this study, 3 patients had previously undergone Hartmann’s operation for gangrenous herniated colon, and devolvulation of gastric volvulus had also been performed on 3 patients. The main post-operative complications were reported to be pneumonia and respiratory insufficiency (2 cases, and the mean length of hospital stay was 6 days (5-8 days which was longer (1-2 months in patients with gangrenous bowel (3 patients. Furthermore, no mortality was reported during the course of hospitalization in these

  5. A broadly applicable surgical teaching method: evaluation of a stepwise introduction to cataract surgery.

    Science.gov (United States)

    Kloek, Carolyn E; Borboli-Gerogiannis, Sheila; Chang, Kenneth; Kuperwaser, Mark; Newman, Lori R; Lane, Anne Marie; Loewenstein, John I

    2014-01-01

    Although cataract surgery is one of the most commonly performed surgeries in the country, it is a microsurgical procedure that is difficult to learn and to teach. This study aims to assess the effectiveness of a new method for introducing postgraduate year (PGY)-3 ophthalmology residents to cataract surgery. Hospital-based ophthalmology residency program. Retrospective cohort study. PGY-3 and PGY-4 residents of the Harvard Medical School Ophthalmology Residency from graduating years 2010 to 2012. In July 2009, a new method of teaching PGY-3 ophthalmology residents cataract surgery was introduced, which was termed "the stepwise introduction to cataract surgery." This curriculum aimed to train residents to perform steps of cataract surgery by deliberately practicing each of the steps of surgery under a structured curriculum with faculty feedback. Assessment methods included surveys administered to the PGY-4 residents who graduated before the implementation of these measures (n = 7), the residents who participated in the first and second years of the new curriculum (n = 16), faculty who teach PGY-4 residents cataract surgery (n = 8), and review of resident Accreditation Council for Graduate Medical Education surgical logs. Resident survey response rate was 100%. Residents who participated in the new curriculum performed more of each step of cataract surgery in the operating room, spent more time practicing each step of cataract surgery on a cataract surgery simulator during the PGY-3 year, and performed more primary cataract surgeries during the PGY-3 year than those who did not. Faculty survey response rate was 63%. Faculty noted an increase in resident preparedness following implementation of the new curriculum. There was no statistical difference between the precurriculum and postcurriculum groups in the percentage turnover of cataracts for the first 2 cataract surgery rotations of the PGY-4 year of training. The introduction of cataract surgery to PGY-3 residents

  6. Platform Innovations and System Integration for Unmanned Air, Land and Sea Vehicles Symposium. Technical Evaluation Report

    National Research Council Canada - National Science Library

    Decuypere, Roland; Selegan, David

    2007-01-01

    ...) of the Research and Technology Organization (RTO) of NATO organized a joint symposium on Platform Innovations and System Integration for Unmanned Air, Land and Sea Vehicles which met from 14-18 May 2007 in Florence Italy...

  7. Evaluation of Open Innovation in B2B from a Company Culture Perspective

    Directory of Open Access Journals (Sweden)

    Nikolaos Katsikis

    2016-10-01

    Full Text Available This article is written for innovation managers, business developers or employees in similar positions in a company selling in a B2B environment. Decision criteria are presented which will help to find the right open innovation tool for the desired goals and also for the given company culture. Aiming to increase business successfully by involving externals cannot be seen independently of the attitude and openness of an organization as a whole to this approach.

  8. Journal of Surgical Technique and Case Report: Editorial Policies

    African Journals Online (AJOL)

    Focus and Scope. The aim of Journal of Surgical Technique and Case Report is to advance surgical knowledge and practice by promoting the reporting of innovative and reproducible surgical techniques and illustrative surgical cases on various surgical disciplines. The journal encourages authoritative synthesis of current ...

  9. Surgical adverse outcomes and patients' evaluation of quality of care: inherent risk or reduced quality of care?

    Science.gov (United States)

    Marang-van de Mheen, Perla J; van Duijn-Bakker, Nanny; Kievit, Job

    2007-12-01

    Previous research has shown that sicker patients are less satisfied with their healthcare, but specific effects of adverse health outcomes have not been investigated. The present study aimed to assess whether patients who experience adverse outcomes, in hospital or after discharge, differ in their evaluation of quality of care compared with patients without adverse outcomes. In hospital adverse outcomes were prospectively recorded by surgeons and surgical residents as part of routine care. Four weeks after discharge, patients were interviewed by telephone about the occurrence of post-discharge adverse outcomes, and their overall evaluation of quality of hospital care and specific suggestions for improvements in the healthcare provided. Of 2145 surgical patients admitted to the Leiden University Medical Center in 2003, 1876 (88%) agreed to be interviewed. Overall evaluation was less favourable by patients who experienced post-discharge adverse outcomes only (average 19% lower). These patients were also more often dissatisfied (OR 2.02, 95% CI 1.24 to 3.31) than patients without adverse outcomes, and they more often suggested that improvements were needed in medical care (OR 2.07, 1.45 to 2.95) and that patients were discharged too early (OR 3.26, 1.72 to 6.20). The effect of in hospital adverse outcomes alone was not statistically significant. Patients with both in hospital and post-discharge adverse outcomes also found the quality of care to be lower (on average 33% lower) than patients without adverse outcomes. Post-discharge adverse outcomes negatively influence patients' overall evaluation of quality of care and are perceived as being discharged too early, suggesting that patients need better information at discharge.

  10. Innovation & evaluation of tangible direct manipulation digital drawing pens for children.

    Science.gov (United States)

    Lee, Tai-Hua; Wu, Fong-Gong; Chen, Huei-Tsz

    2017-04-01

    Focusing on the theme of direct manipulation, in this study, we proposed a new and innovative tangible user interface (TUI) design concept for a manipulative digital drawing pen. Based on interviews with focus groups brainstorming and experts and the results of a field survey, we selected the most suitable tangible user interface for children between 4 and 7 years of age. Using the new tangible user interface, children could choose between the brush tools after touching and feeling the various patterns. The thickness of the brush could be adjusted by changing the tilt angle. In a subsequent experimental process we compared the differences in performance and subjective user satisfaction. A total of sixteen children, aged 4-7 years participated in the experiment. Two operating system experiments (the new designed tangible digital drawing pen and traditional visual interface-icon-clicking digital drawing pens) were performed at random and in turns. We assessed their manipulation performance, accuracy, brush stroke richness and subjective evaluations. During the experimental process we found that operating functions using the direct manipulation method, and adding shapes and semantic models to explain the purpose of each function, enabled the children to perform stroke switches relatively smoothly. By using direct manipulation digital pens, the children could improve their stroke-switching performance for digital drawing. Additionally, by using various patterns to represent different brushes or tools, the children were able to make selections using their sense of touch, thereby reducing the time required to move along the drawing pens and select icons (The significant differences (p = 0.000, p drawing thick lines using the crayon function of the two (new and old) drawing pens (new 5.8750 drawing operations enhanced the drawing results, thereby increasing the children's enjoyment of drawing with tangible digital drawing pens. Copyright © 2016 Elsevier Ltd. All

  11. Transcatheter aortic valve implantation for failing surgical aortic bioprosthetic valve: from concept to clinical application and evaluation (part 2).

    Science.gov (United States)

    Piazza, Nicolo; Bleiziffer, Sabine; Brockmann, Gernot; Hendrick, Ruge; Deutsch, Marcus-André; Opitz, Anke; Mazzitelli, Domenico; Tassani-Prell, Peter; Schreiber, Christian; Lange, Rüdiger

    2011-07-01

    This study sought to review the acute procedural outcomes of patients who underwent transcatheter aortic valve (TAV)-in-surgical aortic valve (SAV) implantation at the German Heart Center, Munich, and to summarize the existing literature on TAV-in-SAV implantation (n = 47). There are several case reports and small case series describing transcatheter aortic valve implantation for a failing surgical aortic valve bioprosthesis (TAV-in-SAV implantation). From January 2007 to March 2011, 20 out of 556 patients underwent a TAV-in-SAV implantation at the German Heart Center Munich. Baseline characteristics and clinical outcome data were prospectively entered into a dedicated database. The mean patient age was 75 ± 13 years, and the mean logistic European System for Cardiac Operative Risk Evaluation and Society of Thoracic Surgeons' Risk Model scores were 27 ± 13% and 7 ± 4%, respectively. Of the 20 patients, 14 had stented and 6 had stentless surgical bioprostheses. Most cases (12 of 20) were performed via the transapical route using a 23-mm Edwards Sapien prosthesis (Edwards Lifesciences, Irvine, California). Successful implantation of a TAV in a SAV with the patient leaving the catheterization laboratory alive was achieved in 18 of 20 patients. The mean transaortic valve gradient was 20.0 ± 7.5 mm Hg. None-to-trivial, mild, and mild-to-moderate paravalvular aortic regurgitation was observed in 10, 6, and 2 patients, respectively. We experienced 1 intraprocedural death following pre-implant balloon aortic valvuloplasty ("stone heart") and 2 further in-hospital deaths due to myocardial infarction. TAV-in-SAV implantation is a safe and feasible treatment for high-risk patients with failing aortic bioprosthetic valves and should be considered as part of the armamentarium in the treatment of aortic bioprosthetic valve failure. Copyright © 2011 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. Evaluation of the results from arthroscopic surgical treatment of rotator cuff injuries in patients aged 65 years and over

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2015-06-01

    Full Text Available OBJECTIVES: To evaluate the results from arthroscopic surgical treatment of rotator cuff injuries in patients aged 65 years and over.METHODS: Between 1998 and 2009, 168 patients underwent operations. Five cases were excluded. The remaining 163 patients were stratified according to their age group: 65-69 years (49.1%, 70-74 (26.4% and 75 years and over (24.5%. Their mean age was 71 years (range: 65-83. There were 63 male patients (38.7%. The mean length of time with pain, from the onset of symptoms to the surgery, was 23 months (range: 2 days to 240 months. Sixty-two patients (38% reported histories of trauma and 26 (16% reported that their pain worsened through exertion.RESULTS: From the UCLA criteria, 80.4% of the results were excellent, 16% good, 1.8% fair and 1.8% poor. Complications occurred in 11%. The final clinical result did not show any correlation with age progression, injury size or tendons affected. However, there was a significant association (p < 0.001 between the presence of trauma and larger injuries. The length of time between the onset of symptoms and the surgical procedure had a significant relationship (p < 0.027 with the postoperative results: the longer this time was, the worse the results were.CONCLUSION: Arthroscopic treatment of rotator cuff injuries in patients aged 65 years and over presented excellent and good results in 96.4% of the cases, according to the UCLA assessment, with a low complication rate. Advanced age did not show any influence on the postoperative clinical evolution, but the earlier the surgical treatment was instituted, the better the results were.

  13. Weighing the value of memory loss in the surgical evaluation of left temporal lobe epilepsy: a decision analysis.

    Science.gov (United States)

    Akama-Garren, Elliot H; Bianchi, Matt T; Leveroni, Catherine; Cole, Andrew J; Cash, Sydney S; Westover, M Brandon

    2014-11-01

    Anterior temporal lobectomy is curative for many patients with disabling medically refractory temporal lobe epilepsy, but carries an inherent risk of disabling verbal memory loss. Although accurate prediction of iatrogenic memory loss is becoming increasingly possible, it remains unclear how much weight such predictions should have in surgical decision making. Here we aim to create a framework that facilitates a systematic and integrated assessment of the relative risks and benefits of surgery versus medical management for patients with left temporal lobe epilepsy. We constructed a Markov decision model to evaluate the probabilistic outcomes and associated health utilities associated with choosing to undergo a left anterior temporal lobectomy versus continuing with medical management for patients with medically refractory left temporal lobe epilepsy. Three base-cases were considered, representing a spectrum of surgical candidates encountered in practice, with varying degrees of epilepsy-related disability and potential for decreased quality of life in response to post-surgical verbal memory deficits. For patients with moderately severe seizures and moderate risk of verbal memory loss, medical management was the preferred decision, with increased quality-adjusted life expectancy. However, the preferred choice was sensitive to clinically meaningful changes in several parameters, including quality of life impact of verbal memory decline, quality of life with seizures, mortality rate with medical management, probability of remission following surgery, and probability of remission with medical management. Our decision model suggests that for patients with left temporal lobe epilepsy, quantitative assessment of risk and benefit should guide recommendation of therapy. In particular, risk for and potential impact of verbal memory decline should be carefully weighed against the degree of disability conferred by continued seizures on a patient-by-patient basis. Wiley

  14. Evaluation of safe surgical treatment of peritonsillar abscess using computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Ishii, Kasumi; Aramaki, Hajime; Arai, Yasuko; Uchimura, Kanako; Okabe, Kunihiko; Nishida, Motoko; Yoda, Keiko [Tokyo Women' s Medical Coll. (Japan). Daini Hospital

    2002-03-01

    With the development of new antimicrobial agents, the incidence of peritonsillar abscess (PTA) is on the decline. PTA is still often encountered in general practice, however, where it requires immediate diagnosis and treatment. Because the internal carotid artery runs medially to the medial parapharyngeal space, damage to nearby vascular or other structures is a surgical risk of PTA. We used contrast computed tomography (CT) from PTA patients to investigate the anatomical relationship between the abscess and parapharyngeal space, and to determine safe surgical sites. We observed 31 patients with PTA, 19 men and 12 women, between February 1997 and April 1999, all examined by contrast CT and undergoing drainage or incision. The average age was 30.7 years (range: 12-54 years). The abscess was on the right side in 20 cases and on the left side in 11. We determined the sites of the abscess and carotid artery, internal jugular vein, and surrounding soft tissue density area including nerves in the parapharyngeal space based on the angle and distance from recognizable anatomical structures in CT scans. The anterior margin of the parapharyngeal space was 29{+-}5 mm posterior from the upper posterior alveolar margin. The medial margin of that space was at 15{+-}2 deg laterally from the midline of the incisors, and 24{+-}4 mm laterally from the midline sagittal plane. The internal carotid artery was located medially to the parapharyngeal space, running on the sagittal plane containing the upper posterior alveolar margin. The distance from the anterior margin of the parapharyngeal space to the posterior wall of the PTA was 9{+-}4 mm, and the distance to the anterior wall of the abscess (including the pharyngeal mucosa) was 31{+-}5 cm. The relationship between the upper posterior alveolar margin and midline sagittal plane was useful for determining the site of the parapharyngeal space. Because the internal carotid artery is located on the same sagittal plane as the upper

  15. Evaluation of safe surgical treatment of peritonsillar abscess using computed tomography

    International Nuclear Information System (INIS)

    Ishii, Kasumi; Aramaki, Hajime; Arai, Yasuko; Uchimura, Kanako; Okabe, Kunihiko; Nishida, Motoko; Yoda, Keiko

    2002-01-01

    With the development of new antimicrobial agents, the incidence of peritonsillar abscess (PTA) is on the decline. PTA is still often encountered in general practice, however, where it requires immediate diagnosis and treatment. Because the internal carotid artery runs medially to the medial parapharyngeal space, damage to nearby vascular or other structures is a surgical risk of PTA. We used contrast computed tomography (CT) from PTA patients to investigate the anatomical relationship between the abscess and parapharyngeal space, and to determine safe surgical sites. We observed 31 patients with PTA, 19 men and 12 women, between February 1997 and April 1999, all examined by contrast CT and undergoing drainage or incision. The average age was 30.7 years (range: 12-54 years). The abscess was on the right side in 20 cases and on the left side in 11. We determined the sites of the abscess and carotid artery, internal jugular vein, and surrounding soft tissue density area including nerves in the parapharyngeal space based on the angle and distance from recognizable anatomical structures in CT scans. The anterior margin of the parapharyngeal space was 29±5 mm posterior from the upper posterior alveolar margin. The medial margin of that space was at 15±2 deg laterally from the midline of the incisors, and 24±4 mm laterally from the midline sagittal plane. The internal carotid artery was located medially to the parapharyngeal space, running on the sagittal plane containing the upper posterior alveolar margin. The distance from the anterior margin of the parapharyngeal space to the posterior wall of the PTA was 9±4 mm, and the distance to the anterior wall of the abscess (including the pharyngeal mucosa) was 31±5 cm. The relationship between the upper posterior alveolar margin and midline sagittal plane was useful for determining the site of the parapharyngeal space. Because the internal carotid artery is located on the same sagittal plane as the upper posterior

  16. Surgical lighting

    NARCIS (Netherlands)

    Knulst, A.J.

    2017-01-01

    The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,

  17. Brain SPECT in the pre-surgical evaluation of epileptic patients

    International Nuclear Information System (INIS)

    Buchpiguel, C.A.; Cukiert, A.; Hironaka, F.H.; Cerri, G.G.; Magalhaes, A.E.A.; Marino Junior, R.

    1992-01-01

    Fifteen adult epileptic patients were studied pre-operatively using a rotational scintillation camera interfaced to a dedicated computer. The tomographic images were obtained 15 minutes after intravenous injection of 99 m Tc-HMPAO. All had MRI scanning and intensive EEG monitoring which generally included seizure recording. Five patients had progressive lesions (3 meningiomas, 2 astrocytomas). In 10 patients, neuroradiological studies did not show the presence of progressive lesions (2 normal scans and 8 cases with inactive lesions). Two patients with meningioma showed hypoperfusion at the lesion site while the third patient had a marked hypoperfusion which might correlate with the clinical diagnosis of epilepsia partialis continua. In the astrocytoma patients SPECT scans showed hypoperfusion at the lesion site. Data obtained from the 10 patients without progressive CNS lesions showed: in 4, SPECT findings correlated well with the anatomical findings; in 5 instances, SPECT was able to disclose additional functional deficits; in one case, there was no SPECT correlate of a discrete anatomical lesion. In 5 of these cases with no progressive lesions (n=10) SPECT findings were useful as a complementary tool in determining the clinical or surgical management of these patients. Despite the small number and heterogeneity of the present sample, SPECT seems to be an useful tool as part of the clinical workup of epileptic who are candidates for epilepsy surgery. (author)

  18. Doppler ultrasound and magnetic resonance for evaluation of patients treated surgically for aortic coarctation

    International Nuclear Information System (INIS)

    Canteli, B.; Saez, F.; Garcia, F.; Cabrera, A.; Galdeano, J.M.; Rodriguez, O.

    1994-01-01

    Doppler ultrasound and magnetic resonance were performed in a series of 39 patients who had been treated surgically for aortic coarctation. The purpose was to assess the different Doppler gradients, comparing the findings with morphological data disclosed by magnetic resonance. The aortic caliber in the operative field was pathological in 7 patients (ratio between the caliber at the level of the lesion and that of descending aorta of less than 0.7). When the patients were considered as a group. Doppler ultrasound did not show satisfactory sensitivity (29%-43%), specificity (74%) or positive predictive value (17%-23%). Only the negative predictive value (85%-88%) presented more favorable results. When the Subgroup of patients without associated cardiac abnormalities or collateral circulation was studied alone, the following results were found: sensitivity, 100%; specificity, 81%-90%, positive predictive value, 33%-50%, negative predictive value, 100%, similar to those reported in the literature. Thus, we consider that Doppler ultrasound is a harmless and low cost diagnostic method that is highly suitable for follow-up of these patients, within certain limits. Magnetic resonance is the method of choice for the noninvasive assessment of aortic morphology. (Author)

  19. Evaluation of a Progressive Mobility Protocol in Postoperative Cardiothoracic Surgical Patients.

    Science.gov (United States)

    Floyd, Shawn; Craig, Sarah W; Topley, Darla; Tullmann, Dorothy

    2016-01-01

    Cardiothoracic surgical patients are at high risk for complications related to immobility, such as increased intensive care and hospital length of stay, intensive care unit readmission, pressure ulcer development, and deep vein thrombosis/pulmonary embolus. A progressive mobility protocol was started in the thoracic cardiovascular intensive care unit in a rural academic medical center. The purpose of the progressive mobility protocol was to increase mobilization of postoperative patients and decrease complications related to immobility in this unique patient population. A matched-pairs design was used to compare a randomly selected sample of the preintervention group (n = 30) to a matched postintervention group (n = 30). The analysis compared outcomes including intensive care unit and hospital length of stay, intensive care unit readmission occurrence, pressure ulcer prevalence, and deep vein thrombosis/pulmonary embolism prevalence between the 2 groups. Although this comparison does not achieve statistical significance (P mobility. This study has implications for nursing, hospital administration, and therapy services with regard to staffing and cost savings related to fewer complications of immobility. Future studies with a larger sample size and other populations are warranted.

  20. A mathematical function to evaluate surgical complexity of cleft lip and palate.

    Science.gov (United States)

    Ortiz-Posadas, M R; Vega-Alvarado, L; Toni, B

    2009-06-01

    The objective of this work is to show the modeling of a similarity function adapted to the medical environment using the logical-combinatorial approach of pattern recognition theory, and its application comparing the condition of patients with congenital malformations in the lip and/or palate, which are called cleft-primary palate and/or cleft-secondary palate, respectively. The similarity function is defined by the comparison criteria determined for each variable, taking into account their type (qualitative or quantitative), their domain and their initial space representation. In all, we defined 18 variables, with their domains and six different comparison criteria (fuzzy and absolute difference type). The model includes, further, the importance of every variable as well as a weight which reflects the surgical complexity of the cleft. Likewise, the usefulness of this function is shown by calculating the similarity among three patients. This work was developed jointly with the Cleft Palate Team at the Reconstructive Surgery Service of the Pediatric Hospital of Tacubaya, which belongs to the Health Institute of the Federal District in Mexico City.

  1. Cost evaluation of the enslaved to breathing radiotherapy as part of support program to innovative and expensive therapies

    International Nuclear Information System (INIS)

    Remonnay, R.; Morelle, M.; Carrere, M.O.; Giraud, P.

    2009-01-01

    This study had for objective to evaluate the consequences of the implementation of the enslaved breathing on the cost of production of radiotherapy, relatively to the conformal radiotherapy without enslaved breathing (witness group) in the bronchopulmonary cancers and the breast cancers. The tariff aspect was studied. The estimation of the complete cost of the treatment enlighten the inadequacy of the pricing for innovation. (N.C.)

  2. RISK VIP: Evaluation of Flood Risk on the French Railway Network Using an Innovative GIS Approach

    Directory of Open Access Journals (Sweden)

    Cheetham Mark

    2016-01-01

    Full Text Available Flooding can have significant direct and indirect negative effects on a railway network affecting both infrastructure and rail operations. Such impacts include the delaying or cancelling of train services, damage to railway structures or the implementation of costly maintenance and monitoring programs to ensure the safety and performance of the railway system. Identifying sections of railway line at risk from flooding allows appropriate actions to be targeted at specific areas and contributes to an effective asset management plan. Flooding of railway infrastructure can have numerous sources including surface water run-off, insufficient capacity of hydraulic structures or the inundation of embankments located in floodplains. Consequences of flooding include the destabilisation of structures (surface erosion of embankments or the undermining of bridge foundations, differential settlement of structures and damage to the track structure. This paper details an innovative approach developed at the SNCF using a Geographic Information System (GIS model to identify zones of the railway network at risk of different types of flooding. The GIS model RiskVIP has been constructed through the assessment of three distinct components of risk: “Vulnerability” (assessment of the susceptibility of the railway infrastructure to flood conditions, Intensity’ (capacity of a catchment to generate a flood flow, Probability’ (probability of a rainfall event.Through the application of decision trees, the component ‘Intensity’ has been characterised in the model by the physical properties of the catchment intercepted by the railway line (surface area of the catchment, slope and land cover characteristics and “Vulnerability” by the infrastructure itself (type, geometry and the presence of hydraulic structures. In order to evaluate its efficiency at identifying sites at risk of flooding, the model has been tested in the region of Languedoc-Roussillon in France

  3. Fifty Years of Innovation in Plastic Surgery

    Directory of Open Access Journals (Sweden)

    Richard M Kwasnicki

    2016-03-01

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

  4. Synergetic Basis of Innovation Marketing

    OpenAIRE

    Melnyk, L; Dehtyarova, I

    2012-01-01

    Issues of synergetic effects of innovation marketing are considered in the article. It shows sources of synergetic effects of innovation marketing, types of synergism, synergetic effects of marketing innovations, as well as evaluation methods.

  5. Journal of Surgical Technique and Case Report

    African Journals Online (AJOL)

    The aim of Journal of Surgical Technique and Case Report is to advance surgical knowledge and practice by promoting the reporting of innovative and reproducible surgical techniques ... Anterior palatal island advancement flap for bone graft coverage: technical note · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  6. The evaluation of competitiveness and innovation factors in order to increase market share

    Directory of Open Access Journals (Sweden)

    Vukajlović Đurđica

    2016-01-01

    Full Text Available Doing business in modern days is characterized by a large number of suppliers of products and / or services that can meet our needs in the same or similar manner. For this reason, each organization has to constantly monitor the competitiveness of the market, to innovate in order to maintain the existing place on the market or possibly reach new markets. The purpose of conducted research was to assess the factors which are important for achieving a competitive advantage, increasing innovative activities and to identify factors which are crucial for the entry and penetration into new markets, as well as to determine the correlation of these factors with different characteristics of organization (size, level and duration of business. The results have shown that marketing is recognized as the most important factor for achieving a competitive advantage. Innovative activities are usually of imitative character, while consumers and their needs and requirements are largely ignored.

  7. Numerical evaluation of an innovative cup layout for open volumetric solar air receivers

    Science.gov (United States)

    Cagnoli, Mattia; Savoldi, Laura; Zanino, Roberto; Zaversky, Fritz

    2016-05-01

    This paper proposes an innovative volumetric solar absorber design to be used in high-temperature air receivers of solar power tower plants. The innovative absorber, a so-called CPC-stacked-plate configuration, applies the well-known principle of a compound parabolic concentrator (CPC) for the first time in a volumetric solar receiver, heating air to high temperatures. The proposed absorber configuration is analyzed numerically, applying first the open-source ray-tracing software Tonatiuh in order to obtain the solar flux distribution on the absorber's surfaces. Next, a Computational Fluid Dynamic (CFD) analysis of a representative single channel of the innovative receiver is performed, using the commercial CFD software ANSYS Fluent. The solution of the conjugate heat transfer problem shows that the behavior of the new absorber concept is promising, however further optimization of the geometry will be necessary in order to exceed the performance of the classical absorber designs.

  8. Pain management: evaluating the effectiveness of an educational programme for surgical nursing staff.

    Science.gov (United States)

    Lin, Pi-Chu; Chiang, Hsiao-Wen; Chiang, Ting-Ting; Chen, Chyang-Shiong

    2008-08-01

    The purpose of this study was to assess the effectiveness of a pain management education programme in improving the nurses' knowledge about, attitude towards and application of relaxation therapy. Pain of surgical patients has long been an existing problem of health care. Nursing staff need to be educated continuously to develop the professional ability of pain management. A quasi-study design with pre- and posttest and post- and posttest was used. Subjects were chosen from a medical centre in Taipei by convenience sampling. The total sample size of 81 was segregated into a study group of 42 and control group of 39 participants. The study group attended a seven-session pain management programme totalling 15 hours. The control group received no pain management training. Scaled measurements were taken on pain management knowledge and attitude and relaxation therapy practice. (1) Scores for pain management knowledge differed significantly between the two groups (F = 40.636, p = 0.001). (2) Attitudes towards pain management differed between the two groups (F = 8.328, p = 0.005) and remained stable over time (F = 1.603, p = 0.205). (3) Relaxation therapy practice differed significantly between the two groups, with the study group better than the control group (F = 4.006, p = 0.049). (4) Relaxation therapy was applied to nearly all (97.5%) of the patients cared for by study group nurses. All of the instructed patients performed this technique one to three times per day postsurgery. Continuing education can improve nurses' knowledge about, attitude towards and behaviour of pain management. Results of this study could be used to guide the development and implementation of continuing education programmes for nursing staff to enhance patients' care knowledge and skills.

  9. Randomized clinical trial to evaluate mental practice in enhancing advanced laparoscopic surgical performance.

    Science.gov (United States)

    Louridas, M; Bonrath, E M; Sinclair, D A; Dedy, N J; Grantcharov, T P

    2015-01-01

    Mental practice, the cognitive rehearsal of a task without physical movement, is known to enhance performance in sports and music. Investigation of this technique in surgery has been limited to basic operations. The purpose of this study was to develop mental practice scripts, and to assess their effect on advanced laparoscopic skills and surgeon stress levels in a crisis scenario. Twenty senior surgical trainees were randomized to either conventional training or mental practice groups, the latter being trained by an expert performance psychologist. Participants' skills were assessed while performing a porcine laparoscopic jejunojejunostomy as part of a crisis scenario in a simulated operating room, using the Objective Structured Assessment of Technical Skill (OSATS) and bariatric OSATS (BOSATS) instruments. Objective and subjective stress parameters were measured, as well as non-technical skills using the Non-Technical Skills for Surgeons rating tool. An improvement in OSATS (P = 0.003) and BOSATS (P = 0.003) scores was seen in the mental practice group compared with the conventional training group. Seven of ten trainees improved their technical performance during the crisis scenario, whereas four of the ten conventionally trained participants deteriorated. Mental imagery ability improved significantly following mental practice training (P = 0.011), but not in the conventional group (P = 0.083). No differences in objective or subjective stress levels or non-technical skills were evident. Mental practice improves technical performance for advanced laparoscopic tasks in the simulated operating room, and allows trainees to maintain or improve their performance despite added stress. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  10. [Deep alkali burns: Evaluation of a two-step surgical strategy].

    Science.gov (United States)

    Devinck, F; Deveaux, C; Bennis, Y; Deken-Delannoy, V; Jeanne, M; Martinot-Duquennoy, V; Guerreschi, P; Pasquesoone, L

    2018-04-10

    Chemical burns are rare but often lead to deep cutaneous lesions. Alkali agents have a deep and long lasting penetrating power, causing burns that evolve over several days. The local treatment for these patients is excision of the wound and split thickness skin graft. Early excision and immediate skin grafting of alkali burns are more likely to be complicated by graft failure and delayed wound healing. We propose a two-step method that delays skin grafting until two-three days after burn wound excision. Our population included 25 controls and 16 cases. Men were predominant with a mean age of 41.9 years. In 78% of cases, burns were located on the lower limbs. The mean delay between the burn and excision was 16.5 days. In cases, the skin graft was performed at a mean of 11.3 days after the initial excision. We did not unveil any significant difference between both groups for the total skin surface affected, topography of the burns and the causal agent. Wound healing was significantly shorter in cases vs controls (37.5 days vs 50.3 days; P<0.025). Furthermore, we observed a decreased number of graft failures in cases vs controls (13.3% vs 46.7%; P=0.059). Our study shows the relevance of a two-step surgical strategy in patients with alkali chemical burns. Early excision followed by interval skin grafting is associated with quicker wound healing and decreased rate of graft failure. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  11. Group Innovation Ability of Agricultural Technological Innovation Strategic Alliance

    Institute of Scientific and Technical Information of China (English)

    Chishun; MA; Jintian; YU

    2013-01-01

    Agricultural technological innovation strategic alliance, as an important form of strategic alliance, has steadily strengthened the collaborative management among organizations and raised competitive power with the backing of improved group innovation ability. This article studies innovation ability from individual innovation ability to the group innovation ability. Firstly, basic connotation of group innovation ability is to be concluded through the comparison of individual and group innovation ability. Secondly, evaluation index system is to be established based on the influencing factors of the group innovation ability of agricultural technological innovation strategic alliance and evaluation is based on three dimensions, namely organization technological innovation ability, alliance collaborative innovation ability as well as innovation environment. Furthermore, basic methods for promoting the group innovation ability of alliance are to be proposed.

  12. A tribute to Dr Willem J. Kolff: innovative inventor, physician, scientist, bioengineer, mentor, and significant contributor to modern cardiovascular surgical and anesthetic practice.

    Science.gov (United States)

    Stanley, Theodore H

    2013-06-01

    Dr Willem J. Kolff was surely one of the greatest inventors/physicians/scientists/bioengineers of the last few hundred years. He was knighted (Commander of the Order of Oranje-Nassau) in 1970 by Queen Juliana of the Netherlands. In 1990, Life magazine published a list of its own 100 most important figures of the 20th century. Kolff stood in 99th place as the Father of Artificial Organs. Dr Kolff forged a path of innovative thinking and creativity that has had a huge impact on the quality of human life. His contributions to the development of the artificial kidney and dialysis, the heart-lung machine, the membrane oxygenator, potassium arrest of the heart, the AH, mechanical cardiac assistance, and other artificial organs, and his support and mentoring of hundreds to thousands of anesthesiologists, surgeons, and bioengineers throughout the world, have had a significant impact on anesthesiology and the medical community.

  13. Explore-create-share study: An evaluation of teachers as curriculum innovators in engineering education

    Science.gov (United States)

    Berry, Ayora

    included twenty-six teachers and data was collected pre-, mid-, and post-program using teacher surveys and a curriculum analysis instrument. The second study evaluated teachers' perceptions of the ECS model as a curriculum authoring tool and the quality of the curriculum units they developed. The study included sixty-two participants and data was collected post-program using teacher surveys and a curriculum analysis instrument. The third study evaluated teachers' experiences implementing ECS units in the classroom with a focus on identifying the benefits, challenges and solutions associated with project-based engineering in the classroom. The study included thirty-one participants and data was collected using an open-ended survey instrument after teachers completed implementation of the ECS curriculum unit. Results of these three studies indicate that teachers can be prepared to integrate engineering in the classroom using a CDB professional development model. Teachers reported an increase in engineering content knowledge, improved their self-efficacy in curriculum planning, and developed high quality instructional units that were aligned to engineering design practices and STEM educational standards. The ECS instructional model was acknowledged as a valuable tool for developing and implementing engineering education in the classroom. Teachers reported that ECS curriculum design aligned with their teaching goals, provided a framework to integrate engineering with other subject-area concepts, and incorporated innovative teaching strategies. After implementing ECS units in the classroom, teachers reported that the ECS model engaged students in engineering design challenges that were situated in a real world context and required the application of interdisciplinary content knowledge and skills. Teachers also reported a number of challenges related to scheduling, content alignment, and access to resources. In the face of these obstacles, teachers presented a number of

  14. Optimization and validation of an existing, surgical and robust dry eye rat model for the evaluation of therapeutic compounds.

    Science.gov (United States)

    Joossen, Cedric; Lanckacker, Ellen; Zakaria, Nadia; Koppen, Carina; Joossens, Jurgen; Cools, Nathalie; De Meester, Ingrid; Lambeir, Anne-Marie; Delputte, Peter; Maes, Louis; Cos, Paul

    2016-05-01

    The aim of this research was to optimize and validate an animal model for dry eye, adopting clinically relevant evaluation parameters. Dry eye was induced in female Wistar rats by surgical removal of the exorbital lacrimal gland. The clinical manifestations of dry eye were evaluated by tear volume measurements, corneal fluorescein staining, cytokine measurements in tear fluid, MMP-9 mRNA expression and CD3(+) cell infiltration in the conjunctiva. The animal model was validated by treatment with Restasis(®) (4 weeks) and commercial dexamethasone eye drops (2 weeks). Removal of the exorbital lacrimal gland resulted in 50% decrease in tear volume and a gradual increase in corneal fluorescein staining. Elevated levels of TNF-α and IL-1α have been registered in tear fluid together with an increase in CD3(+) cells in the palpebral conjunctiva when compared to control animals. Additionally, an increase in MMP-9 mRNA expression was recorded in conjunctival tissue. Reference treatment with Restasis(®) and dexamethasone eye drops had a positive effect on all evaluation parameters, except on tear volume. This rat dry eye model was validated extensively and judged appropriate for the evaluation of novel compounds and therapeutic preparations for dry eye disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Epidemiologic evaluation ABCC and Nagasaki University School of Medicine autopsies and ABCC surgical specimens: Nagasaki 1950-59

    Energy Technology Data Exchange (ETDEWEB)

    Samther, T G; Hrubec, Zdenek; Brown, W J; Thomas, G D

    1962-08-22

    This epidemiologic evaluation covered autopsies performed at ABCC Nagasaki and at the Nagasaki University School of Medicine, as well as surgical pathology specimens examined at ABCC Nagasaki during 1950-59. The material was related to the ABCC Master Sample population. Bias was demonstrated with respect to symptom status, exposure, age, death certificate diagnosis, male occupations, and history of previous medical examinations at ABCC. In addition the ABCC autopsy series was found to be biased with regard to sex. Comparison with data from Hiroshima indicated similar bias which is possibly more pronounced in Hiroshima. On the basis of these findings, it was concluded that at this time the material is not suitable for broad epidemiologic studies of clinically manifest disease. The material, however, does lend itself to a number of studies of clinically occult disease and other problems which were discussed. 19 references, 32 tables.

  16. [Evaluation of traditional German undergraduate surgical training. An analysis at Heidelberg University].

    Science.gov (United States)

    Schürer, S; Schellberg, D; Schmidt, J; Kallinowski, F; Mehrabi, A; Herfarth, Ch; Büchler, M W; Kadmon, M

    2006-04-01

    The medical faculty of Heidelberg University implemented a new problem-based clinical curriculum (Heidelberg Curriculum Medicinale, or Heicumed) in 2001. The present study analyses the evaluation data of two student cohorts prior to the introduction of Heicumed. Its aim was to specify problems of the traditional training and to draw conclusions for implementation of a new curriculum. The evaluation instrument was the Heidelberg Inventory for the Evaluation of Teaching (HILVE-I). The data were analysed calculating differences in the means between defined groups, with the 13 primary scales of the HILVE I-instrument as dependent variables. Teaching method and subject had no systematic influence on evaluation results. Thus, didactic lecture in orthopedic surgery achieved better results than small group tutorials, while the data on vascular and general surgery showed opposite results. Major factors for success were continuity and didactic training of lecturers and tutors. This is convincingly reflected by the results of the lecture course "Differential diagnosis in general surgery". The good evaluation data on small group tutorials resulted largely from the "participation" and "discussion" scales, which represent interactivity in learning. The results of the present study suggest the importance of two major pedagogic ideas: continuity and didactic training of lecturers and tutors. These principles were widely implemented in Heicumed and have contributed to the success of the new curriculum.

  17. Pre-surgical evaluation of the cerebral tumor in the left language related areas by functional MRI

    International Nuclear Information System (INIS)

    Zou Zhitong; Ma Lin; Weng Xuchu

    2010-01-01

    Objective: To evaluate the application of combination of BOLD-fMRI and diffusion tensor tractography (DTT) in pre-operative evaluation of cerebral tumors located at the left language related areas. Methods: A non-vocal button pressing semantic judging paradigm was developed and validated in 10 right-handed volunteers at 3 T. After validation, this protocol combined with DTI were applied to 15 patients with left cerebral tumor prior to surgical resection, and 3 of them had aphasia. fMRI data analysis was on subject-specific basis by one-sampled t-test. The distance from the tumor to Broca area and pre-central 'hand-knot' area were measured separately. Functional language laterality index (LI) was calculated by taking out Broca area and Wernicke area. Three dimensional architecture of frontal lobe white matter fibers, especially arcuate fasciculus, were visualized using diffusion tensor tractography on Volume-one software. The images demonstrating relationship among tumor, language activation areas and white matter fibers were reviewed by neurosurgeons as part of pre-operative planning. One year after the operation, patients were followed up with MRI and language function test. Results: The non-vocal semantic judging paradigm successfully detect Broca area, Wernicke area and pre-central 'hand-knot' area. In 12 of 15 patients, the relationship of Broca area and pre-central motor area to the left brain tumor in language related areas was identified, which make the pre-operative neurosurgical plan applicable to minimize the disruption of language and motor. 8 patients had the left language dominant hemisphere, 3 patients with the right language dominant hemisphere and 1 patient with bilateral dominance. The other 3 patients' fMRI data were corrupted by patients' motion. Diffusion tensor images were corrupted by motion in 1 patient but demonstrated the impact of tumor on left accouter fasciculus in 14 patients. Diffusion tensor tractography showed disruption of left

  18. WE-AB-BRA-06: 4DCT-Ventilation: A Novel Imaging Modality for Thoracic Surgical Evaluation

    International Nuclear Information System (INIS)

    Vinogradskiy, Y; Jackson, M; Schubert, L; Jones, B; Mitchell, J; Kavanagh, B; Miften, M; Castillo, R; Castillo, E; Guerrero, T

    2016-01-01

    Purpose: The current standard-of-care imaging used to evaluate lung cancer patients for surgical resection is nuclear-medicine ventilation. Surgeons use nuclear-medicine images along with pulmonary function tests (PFT) to calculate percent predicted postoperative (%PPO) PFT values by estimating the amount of functioning lung that would be lost with surgery. 4DCT-ventilation is an emerging imaging modality developed in radiation oncology that uses 4DCT data to calculate lung ventilation maps. We perform the first retrospective study to assess the use of 4DCT-ventilation for pre-operative surgical evaluation. The purpose of this work was to compare %PPO-PFT values calculated with 4DCT-ventilation and nuclear-medicine imaging. Methods: 16 lung cancer patients retrospectively reviewed had undergone 4DCTs, nuclear-medicine imaging, and had Forced Expiratory Volume in 1 second (FEV1) acquired as part of a standard PFT. For each patient, 4DCT data sets, spatial registration, and a density-change based model were used to compute 4DCT-ventilation maps. Both 4DCT and nuclear-medicine images were used to calculate %PPO-FEV1 using %PPO-FEV1=pre-operative FEV1*(1-fraction of total ventilation of resected lung). Fraction of ventilation resected was calculated assuming lobectomy and pneumonectomy. The %PPO-FEV1 values were compared between the 4DCT-ventilation-based calculations and the nuclear-medicine-based calculations using correlation coefficients and average differences. Results: The correlation between %PPO-FEV1 values calculated with 4DCT-ventilation and nuclear-medicine were 0.81 (p<0.01) and 0.99 (p<0.01) for pneumonectomy and lobectomy respectively. The average difference between the 4DCT-ventilation based and the nuclear-medicine-based %PPO-FEV1 values were small, 4.1±8.5% and 2.9±3.0% for pneumonectomy and lobectomy respectively. Conclusion: The high correlation results provide a strong rationale for a clinical trial translating 4DCT-ventilation to the surgical

  19. Manual small incision cataract surgery under topical anesthesia with intracameral lignocaine: Study on pain evaluation and surgical outcome

    Directory of Open Access Journals (Sweden)

    Gupta Sanjiv

    2009-01-01

    Full Text Available The authors here describe manual small incision cataract surgery (MSICS by using topical anesthesia with intracameral 0.5% lignocaine, which eliminates the hazards of local anesthesia, cuts down cost and time taken for the administration of local anesthesia. Aims: To evaluate the patients′ and surgeons′ experience in MSICS using topical anesthesia with intracameral lignocaine in terms of pain, surgical complications, and outcome. Settings and Design: Prospective interventional case series. Materials and Methods: Ninety-six patients of senile cataract were operated by MSICS under topical anesthesia with intracameral lignocaine using "fish hook technique." The patients and the single operating surgeon were given a questionnaire to evaluate their experience in terms of pain, surgical experience, and complications. Statistical Analysis Used: Statistical analysis software "Analyseit." Results: There were 96 patients enrolled in the study. The mean pain score was 0.7 (SD ± 0.97, range 0-5, median 0.0, and mode 0.0. Fifty-one patients (53% had pain score of zero, that is, no pain. Ninety-one patients (~95% had a score of less than 3, that is, mild pain to none. All the surgeries were complication-free except one and the surgeon′s experience was favorable in terms of patient′s cooperation, anterior chamber stability, difficulty, and complications. The ocular movements were not affected, and hence, the eye patch could be removed immediately following the surgery. Conclusions: MSICS can be performed under topical anesthesia with intracameral lignocaine, which makes the surgery patient friendly, without compromising the outcome.

  20. Usefulness of Computed Tomography in pre-surgical evaluation of maxillo-facial pathology with rapid prototyping and surgical pre-planning by virtual reality

    International Nuclear Information System (INIS)

    Toso, Francesco; Zuiani, Chiara; Vergendo, Maurizio; Bazzocchi, Massimo; Salvo, Iolanda; Robiony, Massimo; Politi, Massimo

    2005-01-01

    Purpose. To validate a protocol for creating virtual models to be used in the construction of solid prototypes useful for the planning-simulation of maxillo-facial surgery, in particular for very complex anatomical and pathologic problems. To optimize communications between the radiology, engineering and surgical laboratories. Methods and materials. We studied 16 patients with different clinical problems of the maxillo-facial district. Exams were performed with multidetector computed tomography (MDCT) and single slice computed tomography (SDCT) with axial scans and collimation of 0.5-2 mm, and reconstruction interval of 1 mm. Subsequently we performed 2D multiplanar reconstructions and 3D volume-rendering reconstructions. We exported the DICOM images to the engineering laboratory, to recognize and isolate the bony structures by software. With these data the solid prototypes were generated using stereolitography. To date, surgery has been preformed on 12 patients after simulation of the procedure on the stereolitography model. Results. The solid prototypes constructed in the difficult cases were sufficiently detailed despite problems related to the artefacts generated by dental fillings and prostheses. In the remaining cases the MPR/3D images were sufficiently detailed for surgical planning. The surgical results were excellent in all patients who underwent surgery, and the surgeons were satisfied with the improvement in quality and the reduction in time required for the procedure. Conclusions. MDCT enables rapid prototyping using solid replication, which was very helpful in maxillofacial surgery, despite problems related to artifacts due to dental fillings and prosthesis within the acquisition field; solutions for this problem are work in progress. The protocol used for communication between the different laboratories was valid and reproducible [it

  1. Multicentre prospective evaluation of implant-assisted mandibular removable partial dentures: surgical and prosthodontic outcomes.

    Science.gov (United States)

    Payne, Alan G T; Tawse-Smith, Andrew; Wismeijer, Daniel; De Silva, Rohana K; Ma, Sunyoung

    2017-01-01

    To determine implant survival and prosthodontic maintenance of implant-assisted mandibular removable partial dentures in a multicentre prospective study up to 10 years. Forty-eight participants with mandibular distal extension partial dentures were selected. A control group of 12 New Zealand participants had new conventional mandibular partial dentures made. Three test groups of 36 participants in New Zealand (n = 12), the Netherlands (n = 12) and Colombia (n = 12) had bilateral distal implants placed. Surgical and prosthodontic outcomes were documented with only healing caps placed (Stage 1) and with an attachment system (Stage 2). No implants failed after 3 years. Four late implant failures in three participants occurred in New Zealand (two unilateral implant failures after 5 and 8 years and two bilateral implant failures in the same participant after 6 and 10 years); two unilateral late implant failures occurred in the Netherlands and no late failures in Colombia. Implant survival rate was 92% by 10 years. Resonance frequency measurements were taken at surgery implant stability quotient (ISQ) 62.44 ± 7.46; range 40 - 79), baseline (ISQ 63.22 ± 6.17; range 50 - 74) and after 3 years (ISQ 66.38 ± 6.77; range 55 - 83). In New Zealand and Colombia, measured crestal bone levels were 2.03 ± 0.71 mm and 2.20 ± 0.81 mm, respectively, at baseline and 3 years. For Stage I, principal prosthodontic maintenance issues were loose healing caps among 10 New Zealand participants, four Colombian participants and one Netherlands participant. For Stage 2, matrix activation and overdenture puncture fractures resulted in 41 events (25 participants) in New Zealand over 10 years, whilst over 3 years, there were 14 events in nine Colombian participants and six events in five Netherlands participants. This clinical multicentre research complements previous case reports, case series, retrospective and prospective studies on the notion of implant

  2. Spiral CT angiography and surgical correlations in the evaluation of intracranial aneurysms

    International Nuclear Information System (INIS)

    Preda, L.; Di Maggio, E.M.; La Fianza, A.; Dore, R.; Fulle, I.; Solcia, M.; Campani, R.; Gaetani, P.; Rodriguez y Baena, R.; Cecchini, A.; Infuso, L.

    1998-01-01

    We investigated the accuracy of spiral computed tomography angiography (CTA) in the detection and study of intracranial aneurysms by comparing CTA with selective angiograms and surgical findings. Twenty-six patients (9 men and 17 women; mean age 53.1 ± 1.8 years) with suspected intracranial aneurysms were submitted to CTA (1- to 2-mm slices, pitch 1:1, 24 s, RI = 1) after a conventional CT examination showing subarachnoid hemorrhage (SAH) in 19 cases and during neuroradiological investigations performed for other reasons in 7 cases. One hundred twenty to 150 ml iodate contrast agent (0.3-0.4 gI/ml) were injected intravenously at 5 ml/s rate and with 12- to 25-s delay calculated with a preliminary test bolus. Three-dimensional shaded surface display (3D SSD) and maximum intensity projection (MIP) reconstructions were obtained from axial images. Then, within 48 h, all patients were submitted to digital subtraction angiography (DSA), with separate assessment of CTA and DSA findings. Twenty-two aneurysms shown by CTA were confirmed at DSA and surgery (true positives), whereas the vascular lesion was not confirmed at DSA in 2 cases (false positives). The presence of intracranial aneurysms was excluded at both CTA and subsequent DSA in 7 cases (true negatives) and there were no false negatives; sensitivity was 100 %, specificity 77.8 %, and diagnostic accuracy 93.5 %. Computed tomography angiography aneurysm location was confirmed at surgery in all cases, with very high accuracy in assessing the presence of an aneurysm neck (100 %). Computed tomography angiography accurately depicted the aneurysm shape in 20 of 22 cases, but failed to depict its multilobed nature in 2 cases. The mean aneurysm diameter calculated at CTA was 0.99 ± 0.12 cm vs 1.09 ± 0.11 cm at surgery (p < 0.01). The present results suggest that the high sensitivity of CTA, if confirmed by further studies, might help in avoiding having to resort to arteriography after negative CTA in SAH patients. (orig.)

  3. Evaluation of an innovative radiographic technique - parallel profile radiography - to determine the dimensions of dentogingival unit

    Directory of Open Access Journals (Sweden)

    Sushama R Galgali

    2011-01-01

    Full Text Available Background: Maintenance of gingival health is a key factor for longevity of the teeth as well as of restorations. The physiologic dentogingival unit (DGU, which is composed of the epithelial and connective tissue attachments of the gingiva, functions as a barrier against microbial entry into the periodontium. Invasion of this space triggers inflammation and causes periodontal destruction. Despite the clinical relevance of the determination of the length and width of the DGU, there is no standardized technique. The length of the DGU can be either determined by histologic preparations or by transgingival probing. Although width can also be assessed by transgingival probing or with an ultrasound device, they are either invasive or expensive Aims: This study sought to evaluate an innovative radiographic exploration technique - parallel profile radiography - for measuring the dimensions of the DGU on the labial surfaces of anterior teeth. Materials and Methods: Two radiographs were made using the long-cone parallel technique in ten individuals, one in frontal projection, while the second radiograph was a parallel profile radiograph obtained from a lateral position. The length and width of the DGU was measured using computer software. Transgingival probing (trans-sulcular was done for these same patients and length of the DGU was measured. The values obtained by the two methods were compared. Pearson product correlation coefficient was calculated to examine the agreement between the values obtained by PPRx and transgingival probing. Results: The mean biologic width by the parallel profile radiography (PPRx technique was 1.72 mm (range 0.94-2.11 mm, while the mean thickness of the gingiva was 1.38 mm (range 0.92-1.77 mm. The mean biologic width by trans-gingival probing was 1.6 mm (range 0.8-2.2mm. Pearson product correlation coefficient (r for the above values was 0.914; thus, a high degree of agreement exists between the PPRx and TGP techniques

  4. Design Research as a Mechanism for Consultants to Facilitate and Evaluate Educational Innovations

    Science.gov (United States)

    Castillo, Jose M.; Dorman, Clark; Gaunt, Brian; Hardcastle, Beth; Justice, Kelly; March, Amanda L.

    2016-01-01

    Schools across the nation are implementing innovative practices; however, questions remain regarding how to facilitate quality implementation. Research designs that emphasize high degrees of control over independent variables result in findings with internal validity, but that may not generalize to complex, dynamic educational systems. The purpose…

  5. Evaluation of Cueing Innovation for Pressure Ulcer Prevention Using Staff Focus Groups.

    Science.gov (United States)

    Yap, Tracey L; Kennerly, Susan; Corazzini, Kirsten; Porter, Kristie; Toles, Mark; Anderson, Ruth A

    2014-07-25

    The purpose of the manuscript is to describe long-term care (LTC) staff perceptions of a music cueing intervention designed to improve staff integration of pressure ulcer (PrU) prevention guidelines regarding consistent and regular movement of LTC residents a minimum of every two hours. The Diffusion of Innovation (DOI) model guided staff interviews about their perceptions of the intervention's characteristics, outcomes, and sustainability. This was a qualitative, observational study of staff perceptions of the PrU prevention intervention conducted in Midwestern U.S. LTC facilities (N = 45 staff members). One focus group was held in each of eight intervention facilities using a semi-structured interview protocol. Transcripts were analyzed using thematic content analysis, and summaries for each category were compared across groups. The a priori codes (observability, trialability, compatibility, relative advantage and complexity) described the innovation characteristics, and the sixth code, sustainability, was identified in the data. Within each code, two themes emerged as a positive or negative response regarding characteristics of the innovation. Moreover, within the sustainability code, a third theme emerged that was labeled "brainstormed ideas", focusing on strategies for improving the innovation. Cueing LTC staff using music offers a sustainable potential to improve PrU prevention practices, to increase resident movement, which can subsequently lead to a reduction in PrUs.

  6. The use of innovation and practice profiles in the evaluation of curriculum implementation

    NARCIS (Netherlands)

    van den Akker, Jan; Voogt, Joke

    1994-01-01

    Most generic curriculum reform efforts have to deal with a gap between the innovative aspirations of the initial designers and the daily reality of the intended audience of teachers. That tension is not alarming in itself. One might even say that without it no compelling reason for starting

  7. [Hospital-based health technology assessment in France: how to proceed to evaluate innovative medical devices?].

    Science.gov (United States)

    Martelli, N; van den Brink, H; Denies, F; Dervaux, B; Germe, A F; Prognon, P; Pineau, J

    2014-01-01

    Innovative medical devices offer solutions to medical problems and greatly improve patients' outcomes. Like National Health Technology Assessment (HTA) agencies, hospitals face numerous requests for innovative and costly medical devices. To help local decision-makers, different approaches of hospital-based HTA (HB-HTA) have been adopted worldwide. The objective of the present paper is to explore HB-HTA models for adopting innovative medical devices in France and elsewhere. Four different models have been conceptualized: "ambassador" model, "mini-HTA" model, "HTA unit" model and "internal committee". Apparently, "HTA unit" and "internal committee" (or a mixture of both models) are the prevailing HB-HTA models in France. Nevertheless, some weaknesses of these models have been pointed out in previous works. Only few examples involving hospital pharmacists have been found abroad, except in France and in Italy. Finally, the harmonization of the assessment of innovative medical devices in France needs a better understanding of HB-HTA practices. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  8. Dynamic Tensions: Early Reflections from MDRC's Evaluation of the Innovative Professional Development Challenge

    Science.gov (United States)

    MDRC, 2015

    2015-01-01

    In the Innovative Professional Development (iPD) Challenge, the Bill & Melinda Gates Foundation has invested in helping school districts and networks redesign their instructional support systems to better support educators in increasing student success. This Issue Focus, the second in a series, presents early reflections from MDRC's evaluation…

  9. Evaluation of Cueing Innovation for Pressure Ulcer Prevention Using Staff Focus Groups

    Directory of Open Access Journals (Sweden)

    Tracey L. Yap

    2014-07-01

    Full Text Available The purpose of the manuscript is to describe long-term care (LTC staff perceptions of a music cueing intervention designed to improve staff integration of pressure ulcer (PrU prevention guidelines regarding consistent and regular movement of LTC residents a minimum of every two hours. The Diffusion of Innovation (DOI model guided staff interviews about their perceptions of the intervention’s characteristics, outcomes, and sustainability. Methods: This was a qualitative, observational study of staff perceptions of the PrU prevention intervention conducted in Midwestern U.S. LTC facilities (N = 45 staff members. One focus group was held in each of eight intervention facilities using a semi-structured interview protocol. Transcripts were analyzed using thematic content analysis, and summaries for each category were compared across groups. Results: The a priori codes (observability, trialability, compatibility, relative advantage and complexity described the innovation characteristics, and the sixth code, sustainability, was identified in the data. Within each code, two themes emerged as a positive or negative response regarding characteristics of the innovation. Moreover, within the sustainability code, a third theme emerged that was labeled “brainstormed ideas”, focusing on strategies for improving the innovation. Implications: Cueing LTC staff using music offers a sustainable potential to improve PrU prevention practices, to increase resident movement, which can subsequently lead to a reduction in PrUs.

  10. Unlocking the “black box” of practice improvement strategies to implement surgical safety checklists: a process evaluation

    Directory of Open Access Journals (Sweden)

    Gillespie BM

    2017-04-01

    Full Text Available Brigid M Gillespie,1–3 Kyra Hamilton,4 Dianne Ball,5 Joanne Lavin,6 Therese Gardiner,6 Teresa K Withers,7 Andrea P Marshall1–3 1School of Nursing & Midwifery, Griffith University, Gold Coast, 2Gold Coast University Hospital and Health Service, Southport, 3Nursing & Midwifery Education & Research Unit (NMERU, National Centre of Research Excellence in Nursing, Menzies Health Institute of Queensland, Griffith University, Gold Coast, 4School of Applied Psychology, Griffith University, Mt Gravatt, 5Communio Pty Ltd, Sydney, 6Nursing & Midwifery Education & Research Unit, 7Surgical and Procedural Services, Gold Coast University Hospital and Health Service, Southport, Australia Background: Compliance with surgical safety checklists (SSCs has been associated with improvements in clinical processes such as antibiotic use, correct site marking, and overall safety processes. Yet, proper execution has been difficult to achieve.Objectives: The objective of this study was to undertake a process evaluation of four knowledge translation (KT strategies used to implement the Pass the Baton (PTB intervention which was designed to improve utilization of the SSC. Methods: As part of the process evaluation, a logic model was generated to explain which KT strategies worked well (or less well in the operating rooms of a tertiary referral hospital in Queensland, Australia. The KT strategies implemented included change champions/opinion leaders, education, audit and feedback, and reminders. In evaluating the implementation of these strategies, this study considered context, intervention and underpinning assumptions, implementation, and mechanism of impact. Observational and interview data were collected to assess implementation of the KT strategies relative to fidelity, feasibility, and acceptability. Results: Findings from 35 structured observations and 15 interviews with 96 intervention participants suggest that all of the KT strategies were consistently

  11. Pain assessement and management in surgical cancer patients: pilot and evaluation of a continuing education program.

    NARCIS (Netherlands)

    Francke, A.L.; Huijer-Abu Saad, H.; Grypdonck, M.

    1995-01-01

    In a pilot study, a continuing education program on pain assessment and management was implemented and evaluated. Questionnaires were completed by the nurse participants at the beginning, the end, and 2 months after the end of the pilot program. After the pilot program, participants reported having

  12. SCIENTIFIC AND INNOVATIVE APPROACH TO PROBLEM PERTAINING TO EVALUATION AND MONITORING OF ENVIRONMENT QUALITY IN REPUBLIC OF BELARUS

    Directory of Open Access Journals (Sweden)

    I. V. Voytov

    2009-01-01

    Full Text Available The paper proposes a scientific and innovative approach to solution of an important problem in the field of rational nature management and ecology which presupposes realization of evaluation, analysis and monitoring of environment  quality  (EQ in Belarus.  This  approach is based on methods and  facilities  of  administrative-command  and  partially  automatic-control  management.   The  main components of the innovative approach are an automatic  system for  evaluation and monitoring of EQ including estimation and formation of nature-resource potential within 11 cadaster and other data base, general principles on evaluation and monitoring of EQ, structural and algorithmic schemes for evaluation of ecological state of administrative territories, calculation of generalized indices of nature-territorial complexes and solution of nature protection problems in respect of EQ monitoring. A system of equation calculation for the analysis and evaluation of technogenic load on main nature components of the environment (free air, water objects, soil cover, realization of monitoring function in respect of EQ and ecological state of local and urban territories, nature resources  and enterprises, pollution and state of some recipients and also data resources for execution of analytical calculations and functions directed on monitoring quality of nature components of the environment is advanced in the paper.

  13. Protocol for the ProFHER (PROximal Fracture of the Humerus: Evaluation by Randomisation trial: a pragmatic multi-centre randomised controlled trial of surgical versus non-surgical treatment for proximal fracture of the humerus in adults

    Directory of Open Access Journals (Sweden)

    Maffulli Nicola

    2009-11-01

    Full Text Available Abstract Background Proximal humeral fractures, which occur mainly in older adults, account for approximately 4 to 5% of all fractures. Approximately 40% of these fractures are displaced fractures involving the surgical neck. Management of this group of fractures is often challenging and the outcome is frequently unsatisfactory. In particular it is not clear whether surgery gives better outcomes than non-surgical management. Currently there is much variation in the use of surgery and a lack of good quality evidence to inform this decision. Methods/Design We aim to undertake a pragmatic UK-based multi-centre randomised controlled trial evaluating the effectiveness and cost-effectiveness of surgical versus standard non-surgical treatment for adults with an acute closed displaced fracture of the proximal humerus with involvement of the surgical neck. The choice of surgical intervention is left to the surgeon, who must use techniques that they are fully experienced with. This will avoid 'learning curve' problems. We will promote good standards of non-surgical care, similarly insisting on care-provider competence, and emphasize the need for comparable provision of rehabilitation for both groups of patients. We aim to recruit 250 patients from a minimum of 18 NHS trauma centres throughout the UK. These patients will be followed-up for 2 years. The primary outcome is the Oxford Shoulder Score, which will be collected via questionnaires completed by the trial participants at 6, 12 and 24 months. This is a 12-item condition-specific questionnaire providing a total score based on the person's subjective assessment of pain and activities of daily living impairment. We will also collect data for other outcomes, including general health measures and complications, and for an economic evaluation. Additionally, we plan a systematic collection of reasons for non-inclusion of eligible patients who were not recruited into the trial, and their baseline

  14. MR imaging and MR cholangiopancreatography in the preoperative evaluation of hilar cholangiocarcinoma: correlation with surgical and pathologic findings

    Energy Technology Data Exchange (ETDEWEB)

    Masselli, Gabriele; Gualdi, Gianfranco [Umberto I Hospital-La Sapienza University Rome, Department of Radiology, Rome (Italy); Manfredi, Riccardo [University of Verona, Department of Radiology, Verona (Italy); Vecchioli, Amorino [A. Gemelli Hospital-University of Sacred Heart, Department of Radiology, Rome (Italy)

    2008-10-15

    The primary aim was to evaluate delayed contrast-enhanced MRI in depicting perineural spread of hilar cholangiocarcinoma (CCC) and consequently to determine the capability of MRI/MRCP for staging CCC. Fifteen patients that underwent MRI/MRCP and surgical treatment were retrospectively included. Two radiologists evaluated MR images to assess delayed periductal enhancement, extent of bile duct stenosis, liver parenchymal and vascular involvement and presence of liver atrophy. An agreement between delayed enhancement of the bile duct walls and perineural neoplastic spread showed a very good correlation factor (0.93). The overall accuracy in detecting biliary neoplastic invasion was higher for delayed T1-weighted images (93.3%) than for the MRCP images (80%), and T1-delayed image increased the MR accuracy in assessing the neoplastic resectability (p < 0.05). MRI correctly predicted vascular involvement in 73% and liver involvement in 80% of the cases. The number of overall correctly assessed patients with regard to resectability was 11 true positive, 1 false positive and 3 true negative. The combination of MRI/MRCP is a reliable diagnostic method for staging hilar cholangiocarcinomas. Delayed periductal enhancement is accurate in the evaluation of neoplastic perineural spread, and it can improve diagnostic accuracy to identify resectable and unresectable tumours. (orig.)

  15. In vivo Molecular Evaluation of Guinea Pig Skin Incisions Healing after Surgical Suture and Laser Tissue Welding Using Raman Spectroscopy

    Science.gov (United States)

    Alimova, A.; Chakraverty, R.; Muthukattil, R.; Elder, S.; Katz, A.; Sriramoju, V.; Lipper, Stanley; Alfano, R. R.

    2009-01-01

    The healing process in guinea pig skin following surgical incisions was evaluated at the molecular level, in vivo, by the use of Raman spectroscopy. After the incisions were closed either by suturing or by laser tissue welding (LTW), differences in the respective Raman spectra were identified. The study determined that the ratio of the Raman peaks of the amide III (1247 cm−1) band to a peak at 1326 cm−1 (the superposition of elastin and keratin bands) can be used to evaluate the progression of wound healing. Conformational changes in the amide I band (1633 cm−1 to 1682 cm−1) and spectrum changes in the range of 1450 cm−1 to 1520 cm−1 were observed in LTW and sutured skin. The stages of the healing process of the guinea pig skin following LTW and suturing were evaluated by Raman spectroscopy, using histopathology as the gold standard. LTW skin demonstrated better healing than sutured skin, exhibiting minimal hyperkeratosis, minimal collagen deposition, near-normal surface contour, and minimal loss of dermal appendages. A wavelet decomposition-reconstruction baseline correction algorithm was employed to remove the fluorescence wing from the Raman spectra. PMID:19581109

  16. Uses of Magnetic Resonance in Post-Surgical Evaluation of Patients with Tetralogy of Fallot

    International Nuclear Information System (INIS)

    Abad, Pedro; Delgado Jorge Andres; Llano Serna, Juan Fernando

    2008-01-01

    The number of patients with tetralogy of Fallot who survive complete reparative surgery is increasing. For this reason the late complications of this procedure, such as pulmonary regurgitation, right ventricular dysfunction, arrhythmias, pulmonary artery stenosis or pseudo aneurysms outflow tract, are becoming more common in clinical practice. Magnetic resonance imaging is the method of choice for the global evaluation of these patients because the ability to evaluate the morphology, quantifying right ventricular function and characterization of the anatomy and function of the pulmonary valve. The knowledge of the embriopathology and the anatomy of this congenital heart disease, and the different interventions, palliative or corrective and the complications are essential for the proper interpretation of the images and making therapeutic decisions.

  17. A Novel Proforma for Clinical and Radiographic Evaluation of Impacted Third Molars Prior to Surgical Removal

    Directory of Open Access Journals (Sweden)

    Dhuvad Jigar M

    2017-02-01

    Full Text Available Background: Dental surgeons and resident doctors of oral surgery who encounter the complex situation during the third molar removal, such as those in unexpected areas, often have limited resources to provide a structured care. Therefore, there is always a need for simple, easy to memorize, situate into practice, comprehensive and cost-effective “Proforma of third molar evaluation” required. Objective: The purpose of this paper was to facilitate the residents of oral and maxillofacial surgery and the dentists throughout their preliminary phase, by organizing the comprehensive proforma for evaluating upper and lower wisdom tooth impactions, access and anticipate the difficulty, judge intraoperative tribulations they might encounter and hence, prepare an appropriate treatment plan. Materials and methods: The available literature relevant to oral and maxillofacial surgery in online database of the United States National Library of Medicine: PubMed (http://www. ncbi.nlm.nih.gov/pubmed/ was investigated. The inclusion criterion was to review the published clinical papers, abstracts, and evidence based reviews on “Preoperative Evaluation of Impacted Third Molar”. Results: Thirty-six articles found with the search term “Preoperative Evaluation of Impacted Third Molar” in the literature were searched. Thirteen articles met the inclusion criteria for the study. The relevant data extracted and discussed. Conclusion: The advantages of the proforma uses were reported for inpatient care with correct diagnosis, treatment, follow up and prevention of the any superfluous complications further and improved the quality of patient care.

  18. Surgical smoke.

    Science.gov (United States)

    Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

    2009-10-01

    Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.

  19. Building an immune-mediated coagulopathy consensus: early recognition and evaluation to enhance post-surgical patient safety

    Directory of Open Access Journals (Sweden)

    Voils Stacy A

    2009-05-01

    Full Text Available Abstract Topical hemostats, fibrin sealants, and surgical adhesives are regularly used in a variety of surgical procedures involving multiple disciplines. Generally, these adjuncts to surgical hemostasis are valuable means for improving wound visualization, reducing blood loss or adding tissue adherence; however, some of these agents are responsible for under-recognized adverse reactions and outcomes. Bovine thrombin, for example, is a topical hemostat with a long history of clinical application that is widely used alone or in combination with other hemostatic agents. Hematologists and coagulation experts are aware that these agents can lead to development of an immune-mediated coagulopathy (IMC. A paucity of data on the incidence of IMC contributes to under-recognition and leaves many surgeons unaware that this clinical entity, originating from normal immune responses to foreign antigen exposure, requires enhanced post-operative vigilance and judicious clinical judgment to achieve best outcomes. Postoperative bleeding may result from issues such as loosened ties or clips or the occurrence of a coagulopathy due to hemodilution, vitamin K deficiency, disseminated intravascular coagulation (DIC or post-transfusion, post-shock coagulopathic states. Other causes, such as liver disease, may be ruled out by a careful patient history and common pre-operative liver function tests. Less common are coagulopathies secondary to pathologic immune responses. Such coagulopathies include those that may result from inherent patient problems such as patients with an immune dysfunction related to systemic lupus erythrematosus (SLE or lymphoma that can invoke antibodies against native coagulation factors. Medical interventions may also provoke antibody formation in the form of self-directed anti-coagulation factor antibodies, that result in problematic bleeding; it is these iatrogenic post-operative coagulopathies, including those associated with bovine thrombin

  20. Evaluation of median nerve T2 signal changes in patients with surgically treated carpal tunnel syndrome.

    Science.gov (United States)

    Samanci, Yavuz; Karagöz, Yeşim; Yaman, Mehmet; Atçı, İbrahim Burak; Emre, Ufuk; Kılıçkesmez, Nuri Özgür; Çelik, Suat Erol

    2016-11-01

    To determine the accuracy of median nerve T2 evaluation and its relation with Boston Questionnaire (BQ) and nerve conduction studies (NCSs) in pre-operative and post-operative carpal tunnel syndrome (CTS) patients in comparison with healthy volunteers. Twenty-three CTS patients and 24 healthy volunteers underwent NCSs, median nerve T2 evaluation and self-administered BQ. Pre-operative and 1st year post-operative median nerve T2 values and cross-sectional areas (CSAs) were compared both within pre-operative and post-operative CTS groups, and with healthy volunteers. The relationship between MRI findings and BQ and NCSs was analyzed. The ROC curve analysis was used for determining the accuracy. The comparison of pre-operative and post-operative T2 values and CSAs revealed statistically significant improvements in the post-operative patient group (pT2 values at all levels and BQ values, and positive and negative correlations were also found regarding T2 values and NCS findings in CTS patients. The receiver operating characteristic curve analysis for defined cut-off levels of median nerve T2 values in hands with severe CTS yielded excellent accuracy at all levels. However, this accuracy could not be demonstrated in hands with mild CTS. This study is the first to analyze T2 values in both pre-operative and post-operative CTS patients. The presence of increased T2 values in CTS patients compared to controls and excellent accuracy in hands with severe CTS indicates T2 signal changes related to CTS pathophysiology and possible utilization of T2 signal evaluation in hands with severe CTS. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Comparative evaluation of structural and functional changes in pancreas after endoscopic and surgical management of pancreatic necrosis.

    Science.gov (United States)

    Rana, Surinder Singh; Bhasin, Deepak Kumar; Rao, Chalapathi; Sharma, Ravi; Gupta, Rajesh

    2014-01-01

    Patients with acute necrotizing pancreatitis may develop pancreatic insufficiency and this is commonly seen in patients who have undergone surgery for pancreatic necrosis. Owing to the paucity of relative data, we retrospectively evaluated the structural and functional changes in the pancreas after endoscopic and surgical management of pancreatic necrosis. The records of patients who underwent endoscopic transmural drainage of walled off pancreatic necrosis (WOPN) over the last 3 years and who completed at least 6 months of follow up were analyzed. Structural and functional changes in these patients were compared with 25 historical surgical controls (operated in 2005-2006). Twenty six patients (21 M; mean age 35.4±8.1 years) who underwent endoscopic drainage for WOPN were followed up for 22.3±8.6 months. During the follow up, five (19.2%) patients developed diabetes with 3 patients requiring insulin and 1 patient with steatorrhea requiring pancreatic enzyme supplementation. The pancreatic fluid collection (PFC) recurred in 1 patient whose stents spontaneously migrated out. On follow up, in the surgery group, 2 (8%) patients developed steatorrhea and 11 (44%) developed diabetes. Five (20%) of these patients had recurrence of PFC. On comparison of follow up results of endoscopic drainage with surgery, recurrence rates as well as frequency of endocrine and exocrine insufficiency was lower in the endoscopic group but difference was not significant. Structural and functional impairment of pancreas is seen less frequently in patients with pancreatic necrosis treated endoscopically compared to patients undergoing surgery, although the difference was insignificant. Further studies with large sample size are needed to confirm these initial results.

  2. Evaluation of 4 mm implants in mandibular edentulous patients with reduced bone height. Surgical preliminary results

    Directory of Open Access Journals (Sweden)

    J.L. Calvo-Guirado

    2014-06-01

    Full Text Available Aim: Growing evidence has suggested the utility of short dental implants for oral reconstructive procedures in clinical situations of limited vertical bone height. The aim of this short comunication was to evaluate the clinical use of implants < 10 mm in length and to determine short implant-supported prosthesis success in the atrophic jaw. Materials and methods: Six women and three men were recruited for the treatment of edentulous mandibles. A total of 6 implants were inserted in each patient: two anterior implants of conventional lenght and four posterior 4 mm Titanium Zirconium (TiZr implants. The insertion torque and bone denisty were evaluated. Results: The mean insertion torque for the 4 mm implants was lower than for conventional ones, without any statistical difference. Moreover, most of the patients (88% showed a D2 bone type. Conclusion: The provision of short implant-supported prostheses in patients with atrophic alveolar ridges appears to be a successful treatment option in the short term; however, more scientific evidence is needed for the long term.

  3. Magnetic resonance imaging for stress incontinence: evaluation of patients before and after surgical correction

    Energy Technology Data Exchange (ETDEWEB)

    Perk, Hakki E-mail: hakkiperk@yahoo.com; Oral, Baha; Yesildag, Ahmet; Serel, T. Ahmet; Oezsoy, Mesut; Turgut, Tayfun

    2002-10-01

    Objective: The purpose of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) in the pre and postoperative assessment of stress urinary incontinence. Methods: Fifteen female patients with clinical evidence of stress urinary incontinence were included in this prospective study. All the patients underwent MRI in the supine position both preoperatively and postoperatively. For imaging, we used a 1.0 T magnet, T2-weighted images were obtained in the midline sagittal plane with patients at rest. Images were evaluated for anatomical stress urinary incontinence alterations, such as the increased distance between the pubococcygeal line and the bladder base and the posterior urethro-vesical angle and the urethral inclination angle changes. Wilcoxon signed rank test allowed comparisons of pre and postoperative results. Results: Compared with postoperative measurements, the bladder base was lowered significantly by an average of 9.4{+-}4.0 mm (P<0.01), posterior urethro-vesical angle was significantly increased by an average of 127.8{+-}11.4 deg. (P<0.01), and the urethral inclination angle was significantly increased by an average of 54.9{+-}10.1 deg. (P<0.01) preoperatively. Conclusion: Our results suggest that MRI can play a major role in the preoperative and postoperative assessment of stress urinary incontinence. It can reliably detect anatomical urinary incontinence alterations. MRI should be considered in failed surgery, complex prolapse, and in differentiating genuine stress incontinence resulting from malposition of the bladder neck from stress incontinence due to intrinsic urethral damage.

  4. An evaluation of the relationship between innovative culture and employee turnover in organisations in Gauteng

    OpenAIRE

    2015-01-01

    M.Ing. The purpose of the research was to determine the relationship, between the innovative culture and employee retention within the organisation. High labour turnover impacts on organisational performance and survival. Despite an organisation’s level of development, many organisations face employee retention challenges. Therefore devising strategies to improve employee retention has become a priority for most organisations. The problem of high labour turnover was also observed during a ...

  5. Public support to firm level innovation: an evaluation of the FONTEC Program

    Directory of Open Access Journals (Sweden)

    Alessandro Maffioli

    2012-07-01

    Full Text Available Os governos latino-americanos recorrem frequentemente aos Fundos de Desenvolvimento Tecnológico (FDT para apoiar financeiramente as atividades inovadoras das empresas. Neste estudo analisamos a eficácia do um FDT chileno, o programa FONTEC. Constatamos que os subsídios do FONTEC provocaram um aumento dos investimentos inovadores das empresas em ativos intangíveis (principalmente P&D, além de melhorarem as articulações entre atores no sistema de inovação. Entretanto, embora não tenhamos detectado indícios de crowding out (inibição, tampouco encontramos quaisquer evidências de aumento do financiamento privado da inovação devido aos subsídios (crowding in. Em termos de adicionalidade de resultados (output additionality, o FONTEC de fato aumentou a geração de emprego e a produtividade das empresas beneficiárias. As conclusões quanto a habilidades foram mais mistas, mas isso pode ter sido afetado pela baixa qualidade da variável habilidades na enquete.Latin American Governments have frequently adopted Technology Development Funds (TDF to provide financial support for innovation activities of firms. In this paper, we analyzed the effectiveness of a Chilean TDF, the FONTEC program. We found that FONTEC’s subsidies increased firm innovation investments in intangible assets (in particular R&D and they also improved the linkages among actors in the innovation system. However, although we did not find any evidence of crowding-out effects, neither did we find any evidence of the leveraging of private financing for innovation (crowding-in. In terms of output additionality, FONTEC did significantly increase the employment and productivity of beneficiary firms. The findings with regards to skills are more mixed, but this could be affected by the poor quality of the skills variable in the survey.

  6. INNOVATIVE METHODS TO EVALUATE THE RELIABILITY OF INFORMATION CONSOLIDATED FINANCIAL STATEMENTS

    Directory of Open Access Journals (Sweden)

    Irina P. Kurochkina

    2014-01-01

    Full Text Available The article explores the possibility of using foreign innovative methods to assess the reliabilityof information consolidated fi nancial statements of Russian companies. Recommendations aremade under their adaptation and applicationinto commercial organizations. Banish methodindicators are implemented in one of the world’s largest vertically integrated steel and miningcompanies. Audit firms are proposed to usemethods of assessing the reliability of information in the practical application of ISA.

  7. Do soft skills predict surgical performance?: a single-center randomized controlled trial evaluating predictors of skill acquisition in virtual reality laparoscopy.

    Science.gov (United States)

    Maschuw, K; Schlosser, K; Kupietz, E; Slater, E P; Weyers, P; Hassan, I

    2011-03-01

    Virtual reality (VR) training in minimal invasive surgery (MIS) is feasible in surgical residency and beneficial for the performance of MIS by surgical trainees. Research on stress-coping of surgical trainees indicates the additional impact of soft skills on VR performance in the surgical curriculum. The aim of this study was to evaluate the impact of structured VR training and soft skills on VR performance of trainees. The study was designed as a single-center randomized controlled trial. Fifty first-year surgical residents with limited experience in MIS ("camera navigation" in laparoscopic cholecystectomy only) were randomized for either 3 months of VR training or no training. Basic VR performance and defined soft skills (self-efficacy, stress-coping, and motivation) were assessed prior to randomization using basic modules of the VR simulator LapSim(®) and standardized psychological questionnaires. Three months after randomization VR performance was reassessed. Outcome measurement was based on the results derived from the most complex of the basic VR modules ("diathermy cutting") as the primary end point. A correlation analysis of the VR end-point performance and the psychological scores was done in both groups. Structured VR training enhanced VR performance of surgical trainees. An additional correlation to high motivational states (P 0.05). Low self-efficacy and negative stress-coping strategies seem to predict poor VR performance. However, structured training along with high motivational states is likely to balance out this impairment.

  8. Innovative-Simplified Nuclear Power Plant Efficiency Evaluation with High-Efficiency Steam Injector System

    International Nuclear Information System (INIS)

    Shoji, Goto; Shuichi, Ohmori; Michitsugu, Mori

    2006-01-01

    It is possible to establish simplified system with reduced space and total equipment weight using high-efficiency Steam Injectors (SI) instead of low-pressure feedwater heaters in Nuclear Power Plant (NPP). The SI works as a heat exchanger through direct contact between feedwater from condensers and extracted steam from turbines. It can get higher pressure than supplied steam pressure. The maintenance and reliability are still higher than the feedwater ones because SI has no movable parts. This paper describes the analysis of the heat balance, plant efficiency and the operation of this Innovative-Simplified NPP with high-efficiency SI. The plant efficiency and operation are compared with the electric power of 1100 MWe-class BWR system and the Innovative-Simplified BWR system with SI. The SI model is adapted into the heat balance simulator with a simplified model. The results show that plant efficiencies of the Innovated-Simplified BWR system are almost equal to original BWR ones. The present research is one of the projects that are carried out by Tokyo Electric Power Company, Toshiba Corporation, and six Universities in Japan, funded from the Institute of Applied Energy (IAE) of Japan as the national public research-funded program. (authors)

  9. Technical innovation and management

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Yang Cheol

    1982-08-15

    This book gives explanations of the conception of technical innovation, development plan in Korea, connection between technology and a growth factor in national income, problem of technical innovation in developing country, analysis on cooperation between a developed country and a developing country, evaluation and strategy of technical development in Korea, technical innovation of industry, management of technical industry, analysis of special condition in Korea.

  10. Technical innovation and management

    International Nuclear Information System (INIS)

    Yoon, Yang Cheol

    1982-08-01

    This book gives explanations of the conception of technical innovation, development plan in Korea, connection between technology and a growth factor in national income, problem of technical innovation in developing country, analysis on cooperation between a developed country and a developing country, evaluation and strategy of technical development in Korea, technical innovation of industry, management of technical industry, analysis of special condition in Korea.

  11. Evaluation of Students' Perceptions Towards An Innovative Teaching-Learning Method During Pharmacology Revision Classes: Autobiography of Drugs.

    Science.gov (United States)

    Joshi, Anuradha; Ganjiwale, Jaishree

    2015-07-01

    Various studies in medical education have shown that active learning strategies should be incorporated into the teaching-learning process to make learning more effective, efficient and meaningful. The aim of this study was to evaluate student's perceptions on an innovative revision method conducted in Pharmacology i.e. in form of Autobiography of Drugs. The main objective of study was to help students revise the core topics in Pharmacology in an interesting way. Questionnaire based survey on a newer method of pharmacology revision in two batches of second year MBBS students of a tertiary care teaching medical college. Various sessions on Autobiography of Drugs were conducted amongst two batches of second year MBBS students, during their Pharmacology revision classes. Student's perceptions were documented with the help of a five point likert scale through a questionnaire regarding quality, content and usefulness of this method. Descriptive analysis. Students of both the batches appreciated the innovative method taken up for revision. The median scores in most of the domains in both batches were four out of five, indicative of good response. Feedback from open-ended questions also revealed that the innovative module on "Autobiography of Drugs" was taken as a positive learning experience by students. Autobiography of drugs has been used to help students recall topics that they have learnt through other teachings methods. Autobiography sessions in Pharmacology during revision slots, can be one of the interesting ways in helping students revise and recall topics which have already been taught in theory classes.

  12. The usefulness of computed tomography in the diagnosis and evaluation of surgical indication of acute appendicitis

    International Nuclear Information System (INIS)

    Kondo, Hiroshi; Shimizu, Ryoichi; Ozasa, Hiroaki; Eto, Ryuichi

    2009-01-01

    We evaluated the usefulness of computed tomography (CT) in diagnosing and management acute appendicitis. We studied 133 patients diagnosed with acute appendicitis confirmed by plain CT between March 2004 and November 2008. Sixty-nine of these patients underwent appendectomy, 64 were treated conservatively. Recurrence of acute appendicitis was recognized in 13 out of 64 patients treated conservatively, and appendectomy was done in 8. On the CT findings of 77 patients who underwent appendectomy, appendicoliths were shown in 50 patients. In 64 patients treated conservatively, 14 patients had images of calcified appendicoliths. Eight out of 14 patients with appendicoliths had small calcifications, which were not obstructive in inner lumen of appendix. Inflammatory signs (increased white blood cell (WBC) and C reactive protein (CRP), and fever) with positive signs on CT, including calcifications, periappendicular infiltration, free fluid etc., are useful in confirming the clinical diagnosis and directing treatment (operative versus conservative) of patient. (author)

  13. Comparative evaluation of stress levels before, during, and after periodontal surgical procedures with and without nitrous oxide-oxygen inhalation sedation

    Directory of Open Access Journals (Sweden)

    Gurkirat Sandhu

    2017-01-01

    Full Text Available Context: Periodontal surgical procedures produce varying degree of stress in all patients. Nitrous oxide-oxygen inhalation sedation is very effective for adult patients with mild-to-moderate anxiety due to dental procedures and needle phobia. Aim: The present study was designed to perform periodontal surgical procedures under nitrous oxide-oxygen inhalation sedation and assess whether this technique actually reduces stress physiologically, in comparison to local anesthesia alone (LA during lengthy periodontal surgical procedures. Settings and Design: This was a randomized, split-mouth, cross-over study. Materials and Methods: A total of 16 patients were selected for this randomized, split-mouth, cross-over study. One surgical session (SS was performed under local anesthesia aided by nitrous oxide-oxygen inhalation sedation, and the other SS was performed on the contralateral quadrant under LA. For each session, blood samples to measure and evaluate serum cortisol levels were obtained, and vital parameters including blood pressure, heart rate, respiratory rate, and arterial blood oxygen saturation were monitored before, during, and after periodontal surgical procedures. Statistical Analysis Used: Paired t-test and repeated measure ANOVA. Results: The findings of the present study revealed a statistically significant decrease in serum cortisol levels, blood pressure and pulse rate and a statistically significant increase in respiratory rate and arterial blood oxygen saturation during periodontal surgical procedures under nitrous oxide inhalation sedation. Conclusion: Nitrous oxide-oxygen inhalation sedation for periodontal surgical procedures is capable of reducing stress physiologically, in comparison to LA during lengthy periodontal surgical procedures.

  14. Consumer-based technology for distribution of surgical videos for objective evaluation.

    Science.gov (United States)

    Gonzalez, Ray; Martinez, Jose M; Lo Menzo, Emanuele; Iglesias, Alberto R; Ro, Charles Y; Madan, Atul K

    2012-08-01

    The Global Operative Assessment of Laparoscopic Skill (GOALS) is one validated metric utilized to grade laparoscopic skills and has been utilized to score recorded operative videos. To facilitate easier viewing of these recorded videos, we are developing novel techniques to enable surgeons to view these videos. The objective of this study is to determine the feasibility of utilizing widespread current consumer-based technology to assist in distributing appropriate videos for objective evaluation. Videos from residents were recorded via a direct connection from the camera processor via an S-video output via a cable into a hub to connect to a standard laptop computer via a universal serial bus (USB) port. A standard consumer-based video editing program was utilized to capture the video and record in appropriate format. We utilized mp4 format, and depending on the size of the file, the videos were scaled down (compressed), their format changed (using a standard video editing program), or sliced into multiple videos. Standard available consumer-based programs were utilized to convert the video into a more appropriate format for handheld personal digital assistants. In addition, the videos were uploaded to a social networking website and video sharing websites. Recorded cases of laparoscopic cholecystectomy in a porcine model were utilized. Compression was required for all formats. All formats were accessed from home computers, work computers, and iPhones without difficulty. Qualitative analyses by four surgeons demonstrated appropriate quality to grade for these formats. Our preliminary results show promise that, utilizing consumer-based technology, videos can be easily distributed to surgeons to grade via GOALS via various methods. Easy accessibility may help make evaluation of resident videos less complicated and cumbersome.

  15. A CLINICAL STUDY ON SURGICAL MANAGEMENT OF TIBIAL PLATEAU FRACTURES - FUNCTIONAL AND RADIOLOGICAL EVALUATION

    Directory of Open Access Journals (Sweden)

    Bhavani

    2015-10-01

    Full Text Available BACKGROUND: Tremendous advance in mechanization and fastness of travel have been accompanied by steep increase in number and severity of fractures and those of tibial plateau are no exception. Knee being one of the major weight bearing joints of the body, fractures around it will be of paramount importance. AIM OF STUDY: This study is to analyze the functional outcome of CRIF or ORIF with or without bone grafting in tibial plateau fractures in adults. MATERIALS AND METHODS: 30 cases of tibial plateau fractures treated by various modalities were studied from 1 - 8 - 2012 to 31 - 1 - 2014 at our institution and followed for a minimum of 6 months. Fractures were evaluated using Modified Rasmussen’s Clinical, Radiological grading system. RESULTS : The selected patients were evaluated thoroughly and after the relevant investigations, were taken for surgery. The fractures were classified as per the SCHATZKER’S types and operated accordingly with CRIF with Percutaneous cannulated cancellous screws, ORIF with buttress plate/LCP with or without bone grafting. Immobilization of fractures continued for 3 weeks by POP slab. Early range of motion was then started. Weight bearing up to 6 - 8 weeks was not allowed. The full weight bearing deferred until 12 weeks or complete fracture union . The knee range of motion was excellent to very good, gait and weight bearing after complete union was satisfactory, knee stiffness in 3 cases , wound dehiscence and infection in 1 case and non - union in none of our cases was noted. CONCLUSION: Functional outcome is better in operatively treated tibial plateau fractures in adults, because it gives excellent anatomical reduction and rigid fixation to restore articular congruity and early motion thereby preventing knee stiffness.

  16. Added value of cardiac computed tomography for evaluation of mechanical aortic valve: Emphasis on evaluation of pannus with surgical findings as standard reference.

    Science.gov (United States)

    Suh, Young Joo; Lee, Sak; Im, Dong Jin; Chang, Suyon; Hong, Yoo Jin; Lee, Hye-Jeong; Hur, Jin; Choi, Byoung Wook; Chang, Byung-Chul; Shim, Chi Young; Hong, Geu-Ru; Kim, Young Jin

    2016-07-01

    The added value of cardiac computed tomography (CT) with transesophageal echocardiography (TEE) for evaluating mechanical aortic valve (AV) dysfunction has not yet been investigated. The purposes of this study were to investigate the added value of cardiac CT for evaluation of mechanical AVs and diagnoses of pannus compared to TEE, with surgical findings of redo-aortic valve replacement (AVR) used as a standard reference. 25 patients who underwent redo-AVR due to mechanical AV dysfunction and cardiac CT before redo-AVR were included. The presence of pannus, encroachment ratio by pannus, and limitation of motion (LOM) were evaluated on CT. The diagnostic performance of pannus detection was compared using TEE, CT, and CT+TEE, with surgical findings as a standard reference. The added value of CT for diagnosing the cause of mechanical AV dysfunction was assessed compared to TTE+TEE. In two patients, CT analysis was not feasible due to severe metallic artifacts. On CT, pannus and LOM were found in 100% (23/23) and 60.9% (14/23). TEE identified pannus in 48.0% of patients (12/25). CT, TEE, and CT+TEE correctly identified pannus with sensitivity of 92.0%, 48.0%, and 92.0%, respectively (P=0.002 for CT vs. TEE). In 11 of 13 cases (84.6%) with inconclusive or negative TEE results for pannus, CT detected the pannus. Among 13 inconclusive cases of TTE+TEE for the cause of mechanical AV dysfunction, CT suggested 6 prosthetic valve obstruction (PVO) by pannus, 4 low-flow low-gradient PVO, and one LOM without significant PVO. Cardiac CT showed added diagnostic value with TEE in the detection of pannus as the cause of mechanical AV dysfunction. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Innovative learning for innovation

    NARCIS (Netherlands)

    Dr.Ir. Hay Geraedts

    2010-01-01

    Introduction Innovation is crucial for companies who have to react to constantly changing markets. Several national and European research institutes stress the importance of developing innovation for small and medium size enterprises (SMEs). This was a trigger to design a minor on strategic

  18. Bureaucracy and Innovation Revisited

    DEFF Research Database (Denmark)

    Hartmann, Mia Koss; Koss Hartmann, Rasmus

    , but by problematizing the relationship directly. Inspired by prior ethnographic studies of coercive bureaucracies and theories of secrecy and hiding behavior, we propose that coercive bureaucracies do not necessarily impede innovation, but rather create the appearance of doing so. Coercive bureaucracies create......, supplemented by innovation histories, surveys and expert evaluations. This argument implies that future research examines more deeply the organizational processes and practices by which innovation might occur even in coercive bureaucracies. Further, it encourages innovation research methods that rely less...

  19. Evaluation of the efficacy of deep brain stimulation in the surgical treatment of cervical dystonia.

    Science.gov (United States)

    Calheiros-Trigo, Francisca; Linhares, Paulo

    2014-01-01

    Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is a promising therapeutic option for patients with medically refractory dystonia. We present the results after 1 year of DBS of the GPi in 4 patients with cervical dystonia. Four patients with medically refractory cervical dystonia who underwent stereotactic pallidal DBS surgery between June 2010 and November 2011 were included in this retrospective study. Preoperative and postoperative evaluations at 3, 6 and 12 months after surgery were performed using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). The 4 patients experienced a sustained improvement, with a mean TWSTRS reduction of 74.25%, at 12 months follow-up. Disability improved by 80.5% (mean) at 1 year follow-up. No stimulation-related side effects were reported. Pallidal DBS is a valid and effective second-line treatment for patients with cervical focal dystonia. Our results support its use in patients with an insufficient response to medical treatment. Copyright © 2013 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  20. Is obesity associated with healing after non-surgical periodontal therapy? A local vs. systemic evaluation.

    Science.gov (United States)

    Duzagac, E; Cifcibasi, E; Erdem, M G; Karabey, V; Kasali, K; Badur, S; Cintan, S

    2016-10-01

    We aimed to detect the role of obesity on the healing response to periodontal therapy in terms of serum lipids, C-reactive protein (CRP) and both serum and gingival crevicular fluid adipocytokines. Thirty patients with periodontitis with (CPO) (n = 15) and without (n = 15) obesity and 15 healthy controls were included. Serum high-density lipoprotein, low-density lipoprotein, triglyceride, CRP levels and levels of adiponectin, interleukin (IL)-6, tumor necrosis factor (TNF)-α and IL-10 were evaluated before and 3 mo after initial periodontal therapy. Clinical periodontal measurements were also recorded at baseline and 3 mo. Periodontal parameters improved significantly in both periodontitis groups with or without obesity (p 0.05) and change in numbers of sites with probing depth ≥ 4 mm. High-density lipoprotein significantly increased in both groups (p > 0.05). CRP decreased significantly solely in the normal weight group. IL-6, IL-10 and TNF-α levels in gingival crevicular fluid improved significantly based on therapy in both groups (p periodontitis without obesity. Patients with CPO respond to periodontal therapy as well as the non-obese controls. This similar response is accompanied with consistent adipokine levels in gingival crevicular fluid. However, obesity affects the CRP and serum adipocytokine levels in response to therapy. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. A Potential Solution to Minimally Invasive Device for Oral Surgery: Evaluation of Surgical Outcomes in Rat

    Directory of Open Access Journals (Sweden)

    Keng-Liang Ou

    2015-01-01

    Full Text Available The objective of the present research was to investigate the thermal injury in the brain after minimally invasive electrosurgery using instruments with copper-doped diamond-like carbon (DLC-Cu surface coating. The surface morphologies of DLC-Cu thin films were characterized using scanning electron microscopy and atomic force microscopy. Three-dimensional brain models were reconstructed using magnetic resonance imaging to simulate the electrosurgical operation. In adult rats, a monopolar electrosurgical instrument coated with the DLC-Cu thin film was used to generate lesions in the brain. Animals were sacrificed for evaluations on postoperative days 0, 2, 7, and 28. Data indicated that the temperature decreased significantly when minimally invasive electrosurgical instruments with nanostructure DLC-Cu thin films were used and continued to decrease with increasing film thickness. On the other hand, the DLC-Cu-treated device created a relatively small thermal injury area and lateral thermal effect in the brain tissues. These results indicated that the DLC-Cu thin film minimized excessive thermal injury and uniformly distributed the temperature in the brain. Taken together, our study results suggest that the DLC-Cu film on copper electrode substrates is an effective means for improving the performance of electrosurgical instruments.

  2. Proposal for evaluating the quality of reports of surgical interventions in the treatment of trigeminal neuralgia: the Surgical Trigeminal Neuralgia Score.

    Science.gov (United States)

    Akram, Harith; Mirza, Bilal; Kitchen, Neil; Zakrzewska, Joanna M

    2013-09-01

    The aim of this study was to design a checklist with a scoring system for reporting on studies of surgical interventions for trigeminal neuralgia (TN) and to validate it by a review of the recent literature. A checklist with a scoring system, the Surgical Trigeminal Neuralgia Score (STNS), was devised partially based on the validated STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) criteria and customized for TN after a literature review and then applied to a series of articles. These articles were identified using a prespecified MEDLINE and Embase search covering the period from 2008 to 2010. Of the 584 articles found, 59 were studies of interventional procedures for TN that fulfilled the inclusion criteria and 56 could be obtained in full. The STNS was then applied independently by 3 of the authors. The maximum STNS came to 30, and was reliable and reproducible when used by the 3 authors who performed the scoring. The range of scores was 6-23.5, with a mean of 14 for all the journals. The impact factor scores of the journals in which the papers were published ranged from 0 to 4.8. Twenty-four of the studies were published in the Journal of Neurosurgery or in Neurosurgery. Studies published in neurosurgical journals ranked higher on the STNS scale than those published in nonneurosurgical journals. There was no statistically significant correlation between STNS and impact factors. Stereotactic radiosurgery (n = 25) and microvascular decompression (n = 15) were the most commonly reported procedures. The diagnostic criteria were stated in 35% of the studies, and 4 studies reported subtypes of TN. An increasing number of studies (46%) used the recommended Kaplan-Meier methodology for pain survival outcomes. The follow-up period was unclear in 8 studies, and 26 reported follow-ups of more than 5 years. Complications were reported fairly consistently but the temporal course was not always indicated. Direct interview, telephone conversation

  3. Comparative evaluation of gingival depigmentation by tetrafluroethane cryosurgery and surgical scalpel technique. A randomized clinical study

    Directory of Open Access Journals (Sweden)

    Suraj D Narayankar

    2017-01-01

    Full Text Available Introduction: Importance of good smile cannot be underestimated in enhancement of beauty, self-confidence and personality of a person. Health and appearance of gingiva is an essential part of attractive smile. Gingival pigmentation gives rise to unesthetic smile line. In present world, with increasing awareness to esthetic, people have become highly concerned about black gums. Various treatment modalities like abrasion, scrapping, scalpel technique, cryosurgery, electrosurgery and laser are available for treatment of gingival pigmentation. The present study was conducted with an objective of comparing efficacy of gingival depigmentation by cryosurgery and scalpel technique. Method: A Randomized control split mouth study was conducted for 25 patients with gingival pigmentation. Gingival pigmentation Index (GPI for pigmentation and Visual Analoug Scale (VAS for pain was evaluated for both test (Cryosurgery and control sites (Scalpel technique at baseline, 1month, 3months and 6 months. Results: GPI score was 3 and 2 for 21/25 and 4/25 control sites and was 22/25 and 3/25 test sites respectively at baseline. Both the groups showed significant reduction in GPI score i.e., 0 at 1 and 3 months interval after treatment. GPI score increased to 1 for 5/25 sites treated with scalpel technique and 2/25 sites treated with cryosurgery at 6 months interval (P=0.0691. This indicates recurrence rate for pigmentation is higher after scalpel treatment. VAS Score was 3 for 10/25 sites treated with scalpel and was 2 for 12/25 sites treated with cryosurgery (P<0.001. Conclusion: It can be concluded that cryosurgery can be effectively and efficiently used for depigmentation by keeping patients acceptance and comfort in mind and also the long term results and ease of use when compared to scalpel technique.

  4. Evaluating Mind Fitness Training and Its Potential Effects on Surgical Residents’ Well-Being: A Mixed Methods Pilot Study.

    Science.gov (United States)

    Lases, S S; Lombarts, M J M H; Slootweg, Irene A; Arah, Onyebuchi A; Pierik, E G J M; Heineman, Erik

    2016-01-01

    Residents’ well-being is essential for both the individual physician and the quality of patient care they deliver. Therefore, it is important to maintain or possibly enhance residents’ well-being. We investigated (i) the influence of mind fitness training (MFT) on quality of care-related well-being characteristics: work engagement, empathy, work satisfaction and stress perception and explored (ii) residents’ perceptions of MFT. A multicenter study was conducted in eight Dutch teaching hospitals, from September 2012 to February 2014, using mixed methods—that is, quantitative and qualitative approaches to data collection and analysis. Eighty-nine surgical residents were invited to participate in pre- and post-intervention questionnaire surveys. Twenty-two residents participated in MFT and were additionally invited to evaluate the training by post-intervention interviews including open questions. At baseline 22 (100%) residents in intervention group and 47 (70.2%) residents in control group, and postintervention 20 (90.9 %) residents in intervention group and 41 (66.1%) residents in control group completed the questionnaires. In intervention-group, residents’ specialty satisfaction increased by 0.23 point on 5-point Likert scale (95% CI 0.23–0.24, P < 0.001) while stress scores decreased by -0.94 point on 10-point scale (95% CI -1.77 to -0.12, P = 0.026). No substantial changes were observed in control group. Participation in MFT was positively associated with residents’ empathy (b = 7.22; 95% CI 4.33–10.11; P < 0.001) and specialty satisfaction scores (b = 0.42; 95% CI 0.18–0.65; P = 0.001). Residents positively evaluated MFT with median scores of 6.80 for training design and 7.21 for outcome (10-point scale). Residents perceived improvement in focusing skills and reported being more aware of their own state of mind and feeling calmer and more in control. Mind fitness training could improve residents’ empathy, specialty satisfaction, stress

  5. Measuring New Product Portfolio Innovativeness: How Differences in Scale Width and Evaluator Perspectives Affect its Relationship with Performance

    DEFF Research Database (Denmark)

    Schultz, Carsten; Salomo, Søren; Talke, Katrin

    2013-01-01

    Portfolio innovativeness is a central variable in innovation management. However, the impact of portfolio innovativeness on new product development (NPD) performance is unclear, which may partly be due to the construct’s multifaceted nature. Different facets may reflect different degrees of innov...

  6. Evaluation of Big Data and Innovation Interaction in Increase Supply Chain Competencies

    Directory of Open Access Journals (Sweden)

    Zumrut Ecevit Sati

    2017-12-01

    Full Text Available In business today, it means a great deal to uncover meaningful relationships, patterns and trends from the huge stacks of data that are often now available. The explosion in data diversity and volume coming from enterprise content and application data, data from social media, sensor data and also data including streams from third parties is significantly changing the ways and methods of interaction for both companies and their customers. This pressure is felt considerably more in the management of innovation through trying to develop the capability to integrate the supply chain to match the correct methods with the right information. This situation has directed companies into using “big data” in managing both their structured and unstructured data. Big data, which is information, held on a vast scale, can reveal significant potential in its transparency and convenience. To bring about a balanced approach to the use of internal and external information, supporting improved capabilities to better predict future competence, and provide that all important “big picture” through business analytics can improve the vision of businesses through the provision of more in-depth information about how to best access their customers. Improved communication and information links between partners of the supply chain may create major sources of information by bringing together both internal and external resources for customers, partners, stakeholders and suppliers in managing innovation. In this study, it is aimed to provide an extensive literature review on the interaction of innovation and big data in order to increase supply chain competencies and to study the problem, obstacles and driving forces for such interactions, and to consider projections for the future through the application of technology-based methods.

  7. Surgical treatment options following chemotherapy plus cetuximab or bevacizumab in metastatic colorectal cancer-central evaluation of FIRE-3.

    Science.gov (United States)

    Modest, D P; Denecke, T; Pratschke, J; Ricard, I; Lang, H; Bemelmans, M; Becker, T; Rentsch, M; Seehofer, D; Bruns, C J; Gebauer, B; Modest, H I; Held, S; Folprecht, G; Heinemann, V; Neumann, U P

    2018-01-01

    The FIRE-3 trial investigated combination chemotherapy plus either cetuximab or bevacizumab in patients with untreated metastatic colorectal cancer (mCRC) not scheduled for upfront surgery. We aimed to determine the number of patients who present with potentially resectable disease during systemic first-line therapy and to compare the findings with study reports concerning resections and outcome. This evaluation of 448 patients was performed as central review blinded for treatment, other reviewers' evaluations and conducted interventions. Resectability was defined if at least 50% of the reviewers recommended surgical-based intervention. Overall survival was assessed by Kaplan-Meier method. Resectability increased from 22% (97/448) at baseline before treatment to 53% (238/448) at best response (P < 0.001), compared with an actual secondary resection rate for metastases of 16% (72/448). At baseline (23% versus 20%) and best response (53% versus 53%), potential resectability of metastases in this molecular unselected population was similar in cetuximab-treated patients versus bevacizumab-treated patients and not limited to patients with one-organ disease. The actual resection rate of metastases was significantly associated with treatment setting (P = 0.02; university hospital versus hospital/practice). Overall survival was 51.3 months (95% confidence interval [CI] 35.9-66.7) in patients with resectable disease who received surgery, 30.8 months (95% CI 26.6-34.9) in patients with resectable disease without surgery and 18.6 months (95% CI 15.8-21.3) in patients with unresectable disease (P < 0.001). Our findings illustrate the potential for conversion to resectability in mCRC, certain reluctance towards metastatic resections in clinical practice and the need for pre-planned and continuous evaluation for metastatic resection in high-volume centres. CLINICALTRIALS. NCT00433927. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Identifying gaps in the surgical training curriculum in Rwanda through evaluation of operative activity at a teaching hospital.

    Science.gov (United States)

    Rickard, Jennifer L; Ntakiyiruta, Georges; Chu, Kathryn M

    2015-01-01

    To define the operations performed by surgical residents at a tertiary referral hospital in Rwanda to help guide development of the residency program. Cross-sectional study of all patients operated by surgical residents from October 2012 to September 2013. University Teaching Hospital of Kigali (Centre Hospitalier Universitaire de Kigali [CHUK]), a public, tertiary referral hospital in Kigali, Rwanda. All patient data were entered into the operative database by surgical residents at CHUK. A total of 2833 cases were entered into the surgical database. Of them, 53 cases were excluded from further analysis because no surgical resident was listed as the primary or assistant surgeon, leaving 2780 cases for analysis. There were 2780 operations involving surgical residents. Of them, 51% of procedures were classified under general surgery, 38% orthopedics, 7% neurosurgery, and 4% urology. Emergency operations accounted for 64% of the procedures, with 56% of those being general surgery and 35% orthopedic. Further, 50% of all operations were trauma, with 71% of those orthopedic and 21% general surgery. Surgical faculty were involved in 45% of operations as either the primary or the assistant surgeons, while the remainder of operations did not involve surgical faculty. Residents were primary surgeons in 68% of procedures and assistant surgeons in 84% of procedures. The operative experience of surgery residents at CHUK primarily involves emergency and trauma procedures. Although this likely reflects the demographics of surgical care within Rwanda, more focus should be placed on elective procedures to ensure that surgical residents are broadly trained. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  9. Evaluation of clinical skills for first-year surgical residents using orientation programme and objective structured clinical evaluation as a tool of assessment

    Directory of Open Access Journals (Sweden)

    Pandya J

    2010-01-01

    Full Text Available Background: Postgraduate specialities require a combination of knowledge and clinical skills. The internship year is less structured. Clinical and practical skills that are picked up during training are not well regulated and the impact is not assessed. In this study, we assessed knowledge and skills using objective structured clinical examination (OSCE. Aim: To evaluate the clinical skills of new first-year surgical residents using orientation programme and OSCE as a tool for assessment. Settings and Design: Observational study. Materials and Methods: Twenty new first-year surgical residents (10 each in 2008 and 2009 participated in a detailed structured orientation programme conducted over a period of 7 days. Clinically important topics and skills expected at this level (e.g., suturing, wound care etc. were covered. The programme was preceded by an OSCE to test pre-programme knowledge (the "pre-test". The questions were validated by senior department staff. A post-programme OSCE (the "post-test" helped to evaluate the change in clinical skill level brought about by the orientation programme. Statistical Analysis: Wilcoxson matched-pairs signed-ranks test. Results: Passing performance was achieved by all participants in both pre- and post-tests. Following the orientation programme, significant improvement was seen in tasks testing the psychomotor and cognitive domains. (P = 0.0001 and P = 0.0401, respectively. Overall reliability of the OSCE was found to be 0.7026 (Cronbach′s coefficient alpha. Conclusions: This study highlighted the lacunae in current internship training, especially for skill-based tasks. There is a need for universal inclusion of structured orientation programmes in the training of first-year residents. OSCE is a reliable, valid and effective method for the assessment of clinical skills.

  10. Evolving Educational Techniques in Surgical Training.

    Science.gov (United States)

    Evans, Charity H; Schenarts, Kimberly D

    2016-02-01

    Training competent and professional surgeons efficiently and effectively requires innovation and modernization of educational methods. Today's medical learner is quite adept at using multiple platforms to gain information, providing surgical educators with numerous innovative avenues to promote learning. With the growth of technology, and the restriction of work hours in surgical education, there has been an increase in use of simulation, including virtual reality, robotics, telemedicine, and gaming. The use of simulation has shifted the learning of basic surgical skills to the laboratory, reserving limited time in the operating room for the acquisition of complex surgical skills". Copyright © 2016 Elsevier Inc. All rights reserved.

  11. An Innovative Tool for Intraoperative Electron Beam Radiotherapy Simulation and Planning: Description and Initial Evaluation by Radiation Oncologists

    Energy Technology Data Exchange (ETDEWEB)

    Pascau, Javier, E-mail: jpascau@mce.hggm.es [Unidad de Medicina y Cirugia Experimental, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Departamento de Bioingenieria e Ingenieria Aeroespacial, Universidad Carlos III de Madrid, Madrid (Spain); Santos Miranda, Juan Antonio [Servicio de Oncologia Radioterapica, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Facultad de Medicina, Universidad Complutense de Madrid, Madrid (Spain); Calvo, Felipe A. [Servicio de Oncologia Radioterapica, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Facultad de Medicina, Universidad Complutense de Madrid, Madrid (Spain); Departamento de Oncologia, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Bouche, Ana; Morillo, Virgina [Consorcio Hospitalario Provincial de Castellon, Castellon (Spain); Gonzalez-San Segundo, Carmen [Servicio de Oncologia Radioterapica, Hospital General Universitario Gregorio Maranon, Madrid (Spain); Facultad de Medicina, Universidad Complutense de Madrid, Madrid (Spain); Ferrer, Carlos; Lopez Tarjuelo, Juan [Consorcio Hospitalario Provincial de Castellon, Castellon (Spain); and others

    2012-06-01

    Purpose: Intraoperative electron beam radiation therapy (IOERT) involves a modified strategy of conventional radiation therapy and surgery. The lack of specific planning tools limits the spread of this technique. The purpose of the present study is to describe a new simulation and planning tool and its initial evaluation by clinical users. Methods and Materials: The tool works on a preoperative computed tomography scan. A physician contours regions to be treated and protected and simulates applicator positioning, calculating isodoses and the corresponding dose-volume histograms depending on the selected electron energy. Three radiation oncologists evaluated data from 15 IOERT patients, including different tumor locations. Segmentation masks, applicator positions, and treatment parameters were compared. Results: High parameter agreement was found in the following cases: three breast and three rectal cancer, retroperitoneal sarcoma, and rectal and ovary monotopic recurrences. All radiation oncologists performed similar segmentations of tumors and high-risk areas. The average applicator position difference was 1.2 {+-} 0.95 cm. The remaining cancer sites showed higher deviations because of differences in the criteria for segmenting high-risk areas (one rectal, one pancreas) and different surgical access simulated (two rectal, one Ewing sarcoma). Conclusions: The results show that this new tool can be used to simulate IOERT cases involving different anatomic locations, and that preplanning has to be carried out with specialized surgical input.

  12. Clinical Impact of Emphysema Evaluated by High-Resolution Computed Tomography on Idiopathic Pulmonary Fibrosis Diagnosed by Surgical Lung Biopsy.

    Science.gov (United States)

    Kohashi, Yasuo; Arai, Toru; Sugimoto, Chikatoshi; Tachibana, Kazunobu; Akira, Masanori; Kitaichi, Masanori; Hayashi, Seiji; Inoue, Yoshikazu

    2016-01-01

    The prognosis of combined cases of pulmonary fibrosis and emphysema is unresolved partially because radiological differentiation between usual interstitial pneumonia and nonspecific interstitial pneumonia is difficult in coexisting emphysema cases. The purpose of this study was to clarify the clinical impact of emphysema on the survival of patients with idiopathic pulmonary fibrosis (IPF). One hundred and seven patients with interstitial lung diseases were diagnosed by surgical lung biopsies between 2006 and 2012, and 47 patients were diagnosed with IPF through multidisciplinary discussion. Emphysema on high-resolution computed tomography scans was evaluated semiquantitatively by visual scoring. Eight out of the 47 IPF patients showed a higher emphysema score (>3) and were diagnosed to have IPF-emphysema. The median survival time of patients with IPF-emphysema (1,734 days) from the initial diagnosis was significantly shorter than that of patients with IPF alone (2,229 days) by Kaplan-Meier analysis (p = 0.007, log-rank test). Univariate Cox proportional hazard regression analyses revealed that a higher total emphysema score (>3.0) was a significantly poor prognostic factor in addition to Krebs von den Lungen-6, surfactant protein-D, arterial oxygen tension, percent forced vital capacity, and percent diffusing capacity of carbon monoxide (%DLCO). Multivariate Cox proportional hazard regression analyses with the stepwise method showed that higher total emphysema score (>3) and %DLCO were significantly poor prognostic factors. The prognosis of IPF-emphysema was significantly worse than that of IPF alone. © 2016 S. Karger AG, Basel.

  13. Clinical and histologic evaluation of non-surgical periodontal therapy with enamel matrix derivative: a report of four cases.

    Science.gov (United States)

    Mellonig, James T; Valderrama, Pilar; Gregory, Holly J; Cochran, David L

    2009-09-01

    Enamel matrix derivative (EMD) is a composite of proteins that was demonstrated histologically to work as an adjunct to periodontal regenerative surgical therapy. The purpose of this study was to evaluate the clinical and histologic effects of EMD as an adjunct to scaling and root planing. Four patients with severe chronic periodontitis and scheduled to receive complete dentures were accrued. Probing depth and clinical attachment levels were obtained. Unlimited time was allowed for hand and ultrasonic instrumentation. A notch was placed in the root >or=1 to 2 mm from the apical extent of root planing. EMD was inserted into the pocket, and a periodontal dressing was placed. Patients were seen every 2 weeks for plaque control. At 6 months post-treatment, soft tissue measurements were repeated, and the teeth were removed en bloc and prepared for histomorphologic analysis. Probing depth reduction and clinical attachment level gain were obtained in three-fourths of the specimens. Three of the four specimens analyzed histologically demonstrated new cementum, bone, periodontal ligament, and connective tissue attachment coronal to the notch. In one specimen, the gingival margin had receded below the notch. The results were unexpected and may represent an aberration. However, the substantial reduction in deep probing depths and clinical attachment level gain in three of four specimens, in addition to the histologic findings of new cementum, new bone, a new periodontal ligament, and a new connective tissue attachment, suggest that EMD may be useful as an adjunct to scaling and root planing in single-rooted teeth.

  14. Innovation in values based public health nursing student selection: A qualitative evaluation of candidate and selection panel member perspectives.

    Science.gov (United States)

    McGraw, Caroline; Abbott, Stephen; Brook, Judy

    2018-02-19

    Values based recruitment emerges from the premise that a high degree of value congruence, or the extent to which an individual's values are similar to those of the health organization in which they work, leads to organizational effectiveness. The aim of this evaluation was to explore how candidates and selection panel members experienced and perceived innovative methods of values based public health nursing student selection. The evaluation was framed by a qualitative exploratory design involving semi-structured interviews and a group exercise. Data were thematically analyzed. Eight semi-structured interviews were conducted with selection panel members. Twenty-two successful candidates took part in a group exercise. The use of photo elicitation interviews and situational judgment questions in the context of selection to a university-run public health nursing educational program was explored. While candidates were ambivalent about the use of photo elicitation interviews, with some misunderstanding the task, selection panel members saw the benefits for improving candidate expression and reducing gaming and deception. Situational interview questions were endorsed by candidates and selection panel members due to their fidelity to real-life problems and the ability of panel members to discern value congruence from candidates' responses. Both techniques offered innovative solutions to candidate selection for entry to the public health nursing education program. © 2018 Wiley Periodicals, Inc.

  15. Evaluation of an Innovative Over-the-Counter Treatment for Symptoms of Reflux Disease: Quick-Dissolving Alginate Granules

    Science.gov (United States)

    Strugala, Vicki; Dettmar, Peter W.; Thomas, Edward C. M.

    2012-01-01

    Traditional antacids and alginate-based reflux suppressants are OTC products commonly used to treat reflux symptoms. There has been a lack of innovation of new formulations in this therapy area despite consumers finding established products unpalatable. Here we evaluate a novel product formulation which takes the form of quick-dissolving alginate granules in single-dose sachets (Gaviscon Direct Powder (GDP)). Market research and taste evaluation confirmed that reflux sufferers considered GDP to have good flavour and taste, no chalky aftertaste and dissolved rapidly in the mouth with 68% noting so within 10 seconds. GDP was considered convenient and easy to use. The consumer-driven product development was also shown to form a strong alginate raft in standardised in vitro conditions that met the specifications of the BP monograph (raft strength > 7.5 g). Gastric retention of GDP and a test meal was investigated in healthy volunteers using gamma scintigraphy in comparison to Liquid Gaviscon. Both products formed an alginate raft in the stomach above the test meal and emptied after the meal. The gastric retention of the GDP product was found to be noninferior to Liquid Gaviscon. In conclusion, the innovative GDP product formed an effective raft and was well liked by consumers. PMID:23320198

  16. Residency evaluation and adherence design study: Young ophthalmologists' perception of their residency programs – Clinical and surgical skills

    Directory of Open Access Journals (Sweden)

    Parikshit Gogate

    2017-01-01

    Full Text Available Background: Residency training is the basis of good clinical and surgical practice. Purpose: The aim is to know the demographics, training experience, and perception of young ophthalmologists to improve the present residency programs in India. Setting: Young ophthalmologists trained in India. Methods: A survey was conducted by the Academic and Research Committee of the All India Ophthalmology Society, in 2014–2016 of young ophthalmologists (those trained between 2002 and 2012, with 2–10 years' postresidency experience to gauge teaching of clinical and surgical skills during the postgraduate residency program. Statistical Analysis: Statistical Package for Social Sciences version 16. Results: Of the 1005 respondents, 531 fulfilled inclusion criteria. Average age was 32.6 years (standard deviation [SD] 4. On a scale of 0–10, clinical skills teaching was graded as (mean, SD: Slit lamp examination (7.2, SD 2.8, indirect ophthalmoscopy (6.2, SD 3.3, gonioscopy (5.7, SD 3.4, perimetry (6.2, SD 3.2, optical coherence tomography (4.6, SD 4, and orthoptic evaluation (4.3, SD 3.1. The mean (SD and median of surgeries performed independently was intracapsular cataract extraction 3.0 (14.9, 0; extracapsular cataract extraction 39.9 (53.2, 18; small incision cataract surgery 75.3 (64.4, 55; phacoemulsification 30 (52.6, 1; pterygium excision 31.5 (43.5, 15; dacryocystectomy 20.3 (38.1, 4; dacryocystorhinostomy 11.7 (26.2, 2; chalazion 46.4 (48.3, 30; trabeculectomies 4 (14.9, 0; strabismus correction 1.4 (4.9, 0; laser-assisted in situ Keratomileusis 1.5 (12.2, 0; retinal detachment 1.5 (12.5, 0; vitrectomy 3.0 (17.0, 0; keratoplasty 5.2 (17.8, 0; eyelid surgery 8.6 (18.9, 2 and ocular emergencies 41.7 (52.4, 20. Observed and assisted surgeries were more common. However, the range of grading was 0–10 in all categories. Conclusion: Residency training in India varies considerably from program to program. Standardization is needed to assure all graduates

  17. Biomarkers and echocardiography for evaluating the improvement of the ventricular diastolic function after surgical relief of hydronephrosis.

    Science.gov (United States)

    Yeh, Huei-Ming; Lin, Ting-Tse; Yeh, Chih-Fan; Huang, Ho-Shiang; Chang, Sheng-Nan; Lin, Jou-Wei; Tsai, Chia-Ti; Lai, Ling-Ping; Huang, Yi-You; Chu, Chun-Lin

    2017-01-01

    The pathophysiology of cardio-renal syndrome (CRS) is complex. Hydronephrosis caused by urolithiasis may cause cytokine release and lead to cardiac dysfunction. The aim of this study was to evaluate cardiac function changes observed in patients who received double J placement using feasible biomarkers and echocardiography. This was a prospective, single-center study. Eighty-seven patients who presented with acute unilateral hydronephrosis and received ureteroscope stone manipulation were enrolled. Echocardiography and cytokines were measured on the day of the operation and 24 hours after the procedure. Changes before and after surgery were assessed by the paired t-test and Wilcoxon test. Correlation analyses between echocardiographic diastolic indices and cytokine levels were performed using Pearson's correlation coefficients. Patients with hydronephrosis showed a higher left atrium volume index (LAVI), decreased E', and increased E/ E' ratio, which indicated diastolic dysfunction. Patients with hydronephrosis also exhibited decreased global strain rates during isovolumetric relaxation (SRIVR) and E/ SRIVR, which confirmed the diastolic dysfunction. Significant reductions in LAVI, increases in SRIVR and decreases in E/ SRIVR were observed after the operation. Biomarkers, such as TGF-β and serum NT-proBNP, were significantly decreased after surgery. In addition, a significant correlation was observed between the post-surgical decrease in TGF-β1 and increase in SRIVR. Unilateral hydronephrosis causes cardiac diastolic dysfunction, and relieving hydronephrosis could improve diastolic function. Improvements in cardiac dysfunction can be evaluated by echocardiography and measuring cytokine levels. The results of this study will inform efforts to improve the early diagnosis of CRS and prevent further deterioration of cardiac function when treating patients with hydronephrosis.

  18. Medical tongue piercing – development and evaluation of a surgical protocol and the perception of procedural discomfort of the participants

    Science.gov (United States)

    2014-01-01

    Background A system providing disabled persons with control of various assistive devices with the tongue has been developed at Aalborg University in Denmark. The system requires an activation unit attached to the tongue with a small piercing. The aim of this study was to establish and evaluate a safe and tolerable procedure for medical tongue piercing and to evaluate the expected and perceived procedural discomfort. Methods Four tetraplegic subjects volunteered for the study. A surgical protocol for a safe insertion of a tongue barbell piercing was presented using sterilized instruments and piercing parts. Moreover, post-procedural observations of participant complications such as bleeding, edema, and infection were recorded. Finally, procedural discomforts were monitored by VAS scores of pain, changes in taste and speech as well as problems related to hitting the teeth. Results The piercings were all successfully inserted in less than 5 min and the pain level was moderate compared with oral injections. No bleeding, infection, embedding of the piercing, or tooth/gingival injuries were encountered; a moderate edema was found in one case without affecting the speech. In two cases the piercing rod later had to be replaced by a shorter rod, because participants complained that the rod hit their teeth. The replacements prevented further problems. Moreover, loosening of balls was encountered, which could be prevented with the addition of dental glue. No cases of swallowing or aspiration of the piercing parts were recorded. Conclusions The procedure proved simple, fast, and safe for insertion of tongue piercings for tetraplegic subjects in a clinical setting. The procedure represented several precautions in order to avoid risks in these susceptible participants with possible co-morbidity. No serious complications were encountered, and the procedure was found tolerable to the participants. The procedure may be used in future studies with tongue piercings being a

  19. Acquiring minimally invasive surgical skills

    OpenAIRE

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room. This thesis has led to an enlarged insight in the organization of surgical skills training during residency training of surgical medical specialists.

  20. Systematic Evaluation Strategies for Innovative Programs in Health Professions Education: Need, Function and Components.

    Science.gov (United States)

    Taft, Thomas B., Jr.; Logan, Nelson S.

    As change occurs in various health sciences programs, evaluational strategies should be developed so that adaptive decisions may be made. Evaluation models taking into account inputs, methodology, and outputs (Stake, 1967, and Astin and Panes, 1971) need examination. Alternative measurement instruments for formative and summative evaluations,…

  1. Surgical Skills Beyond Scientific Management.

    Science.gov (United States)

    Whitfield, Nicholas

    2015-07-01

    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel's attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel-Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice.

  2. Evaluation of Students’ Perceptions Towards An Innovative Teaching-Learning Method During Pharmacology Revision Classes: Autobiography of Drugs

    Science.gov (United States)

    Ganjiwale, Jaishree

    2015-01-01

    Introduction Various studies in medical education have shown that active learning strategies should be incorporated into the teaching–learning process to make learning more effective, efficient and meaningful. Objectives The aim of this study was to evaluate student’s perceptions on an innovative revision method conducted in Pharmacology i.e. in form of Autobiography of Drugs. The main objective of study was to help students revise the core topics in Pharmacology in an interesting way. Settings and Design Questionnaire based survey on a newer method of pharmacology revision in two batches of second year MBBS students of a tertiary care teaching medical college. Materials and Methods Various sessions on Autobiography of Drugs were conducted amongst two batches of second year MBBS students, during their Pharmacology revision classes. Student’s perceptions were documented with the help of a five point likert scale through a questionnaire regarding quality, content and usefulness of this method. Statistical analysis used Descriptive analysis. Results Students of both the batches appreciated the innovative method taken up for revision. The median scores in most of the domains in both batches were four out of five, indicative of good response. Feedback from open-ended questions also revealed that the innovative module on “Autobiography of Drugs” was taken as a positive learning experience by students. Conclusions Autobiography of drugs has been used to help students recall topics that they have learnt through other teachings methods. Autobiography sessions in Pharmacology during revision slots, can be one of the interesting ways in helping students revise and recall topics which have already been taught in theory classes. PMID:26393138

  3. Whither surgical quality assurance of breast cancer surgery (surgical margins and local recurrence) after paterson.

    Science.gov (United States)

    Bundred, N J; Thomas, J; Dixon, J M J

    2017-10-01

    The Kennedy report into the actions of the disgraced Breast Surgeon, Paterson focussed on issues of informed consent for mastectomy, management of surgical margins and raised concerns about local recurrence rates and the increasing emphasis on cosmesis after mastectomy for breast cancer. This article assesses whether Kennedy's recommendations apply to the UK as a whole and how to address these issues. New GMC advice on consent and newer nonevidenced innovations in immediate reconstruction have altered the level of informed consent required. Patients deserve a better understanding of the issues of oncological versus cosmetic outcomes on which to base their decisions. Involvement of the whole multidisciplinary team including Oncologists is necessary in surgical planning. Failure to obtain clear microscopic margins at mastectomy leads to an increased local recurrence, yet has received little attention in the UK. Whereas, other countries have used surgical quality assurance audits to reduce local recurrence; local recurrence rates are not available and the extent of variation across the UK in margin involvement after surgery, its management and relationship to local recurrence needs auditing prospectively to reduce unnecessary morbidity. To reassure public, patients and the NHS management, an accreditation system with more rigour than NHSBSP QA and peer review is now required. Resource and efforts to support its introduction will be necessary from the Royal College of Surgeons and the Association of Breast Surgeons. New innovations require careful evaluation before their backdoor introduction to the NHS. Private Hospitals need to have the same standards imposed.

  4. Study and Evaluation of Innovative Fuel Handling Systems for Sodium-Cooled Fast Reactors: Fuel Handling Route Optimization

    Directory of Open Access Journals (Sweden)

    Franck Dechelette

    2014-01-01

    Full Text Available The research for technological improvement and innovation in sodium-cooled fast reactor is a matter of concern in fuel handling systems in a view to perform a better load factor of the reactor thanks to a quicker fuelling/defueling process. An optimized fuel handling route will also limit its investment cost. In that field, CEA has engaged some innovation study either of complete FHR or on the optimization of some specific components. This paper presents the study of three SFR fuel handling route fully described and compared to a reference FHR option. In those three FHR, two use a gas corridor to transfer spent and fresh fuel assembly and the third uses two casks with a sodium pot to evacuate and load an assembly in parallel. All of them are designed for the ASTRID reactor (1500 MWth but can be extrapolated to power reactors and are compatible with the mutualisation of one FHS coupled with two reactors. These three concepts are then intercompared and evaluated with the reference FHR according to four criteria: performances, risk assessment, investment cost, and qualification time. This analysis reveals that the “mixed way” FHR presents interesting solutions mainly in terms of design simplicity and time reduction. Therefore its study will be pursued for ASTRID as an alternative option.

  5. Innovation af innovation

    DEFF Research Database (Denmark)

    Harste, Gorm

    2009-01-01

    , at innovation af innovationen forsøges gennemført på en måde, hvor tiden kræves at forholde sig til sin egen tidslighed i form af fremtid, nutid, fortid og ikke mindst i form af samtidighed. I tiden skal vi iagttage, hvordan vi iagttager tiden. Vi dobbelt-koder tiden på samme måde, som forskning forsker i...... organisationssystemerne. De to typer systemer kan noget helt bestemt med fænomenet tid. De kan synkronisere. Analyseres organisationssystemer ser vi, imidlertid at innovation kræver ro. Stærkt innovative systemer er militærsystemet og kunstsystemet, der også inddrages, og hvor vi ser paradokset mellem innovation og...... involution. Tid er med et medium og ikke et lufttomt rum. Tid er end ikke en gasart, men udgør et solidt fluidum, som samfundet bader i og flyder i, konstant i bevægelse. Reformer forudsætter former, og innovation forudsætter involution. Kun sådan muliggøres evolution....

  6. Site Characterization Analysis Penetrometer System (SCAPS): An Innovative Technology Evaluation Report

    National Research Council Canada - National Science Library

    Jack, Lary

    1995-01-01

    ... of subsurface soil at hazardous waste sites. The effectiveness of each technology was evaluated by comparing each technology's results to the results obtained using conventional reference methods...

  7. Orchestrating innovation

    NARCIS (Netherlands)

    Berkers, F.T.H.M.; Klein Woolthuis, R.J.A.; Boer, J. de

    2015-01-01

    Orchestrating Innovation increases the probability of success, minimizing the probability of failure of technological innovations by creating sustained societal and economic value. Orchestrating innovation propagates to take into account and actively involve all relevant stakeholders of the (future)

  8. The evaluation of innovative production to ensure quality in sustainable buildings

    Directory of Open Access Journals (Sweden)

    Antonella Postorino

    2013-08-01

    Full Text Available The LaboReg has spent years to focus on the purpose of internal research on practical application of the achieved  results and the involvement in all phases of business, governments and local entrepreneurs in order to anticipate times and procedures to make a decision towards sustainable solutions. The synergy created between the academic world, the local government and the businesses has put together a research whose main objective is oriented towards the implementation of the productive sectors of the local construction materials to be used in the restoration and rehabilitation of historic buildings and new green building measures in the prospective of environmental sustainability and energy conservation. Within the research programme, interesting results have emerged in the field of experiments called “New Historical Materials.” In this field of ​​activity a research has emerged on the implementation of a prototype of a “new town photovoltaic roof tiles”. The study has provided a first significant result, that is the development of a model of assessment and control of production processes, and some innovative materials.

  9. [Evaluation of the safety of innovative drugs against viruses and infectious agents].

    Science.gov (United States)

    Kobayashi, Tetsu; Yusa, Keisuke; Kawasaki, Nana

    2013-01-01

    Recently, several novel cellular therapy products and biological drugs are being developed to treat various previously untreatable diseases. One of the most important issues regarding these innovations is how to ensure safety over infectious agents, including viruses and prions, in the earliest treatments with these products. The object of this study is a risk assessment of cases of human infectious with the agents and to present a sample risk management plan based on a collaboration among the National Institute of Health Sciences, universities, marketing authorization holders, and scientific societies. There are three subjects of study: (1) the viral safety of cellular therapy products, (2) the viral safety of biological drugs, and (3) the safety of prions. In this report, we describe the objects of the study, the project members, the study plan outline, and the ongoing plans. The results of the viral risk identification and the risk analysis of cellular therapy products will also be described, based on a review of the literature and case reports obtained during the first year of this project.

  10. Evaluation on Innovation approaches on Performance from Malaysian perspective: A study on Malaysian Building energy saving

    Directory of Open Access Journals (Sweden)

    Amlus M. H.

    2018-01-01

    Full Text Available Lately Malaysia energy consumption versus generation rapidly shows increasing due to increasing of load. This phenomenon happened following to advanced country development. Lacking on design and without energy management approach the energy consumption and monthly electrical bill will steadily increased and support the increasing of world carbon emission. Therefore the aim of this work is to approach the simplest innovation task-energy audit , which is load-apportioning strategy. This approach using matching the usage of equipment with fully utilized space and reschedules the time of usage. A one week data was collected by logged power meter at main switchboard at selected building using Fluke Power Recorder. From the data collected, current usage of every load can be determine, then load will be arrange into a group with same portion and same time of usage. The result shows clearly the energy consumption for every single day and indicates the highest and lowest peak. From this work the apportioning strategy implemented by rearrange the load following type of room application. After the arrangement, new measurement was taken and a very good result was established. This work also can be further apply for a huge load that can be save a lot of money for owner especially government by energy saving.

  11. Innovative Silicon Microgrippers for Biomedical Applications: Design, Mechanical Simulation and Evaluation of Protein Fouling

    Directory of Open Access Journals (Sweden)

    Cristina Potrich

    2018-03-01

    Full Text Available The demand of miniaturized, accurate and robust micro-tools for minimally invasive surgery or in general for micro-manipulation, has grown tremendously in recent years. To meet this need, a new-concept comb-driven microgripper was designed and fabricated. Two microgripper prototypes differing for both the number of links and the number of conjugate surface flexure hinges are presented. Their design takes advantage of an innovative concept based on the pseudo-rigid body model, while the study of microgripper mechanical potentialities in different configurations is supported by finite elements’ simulations. These microgrippers, realized by the deep reactive-ion etching technology, are intended as micro-tools for tissue or cell manipulation and for minimally invasive surgery; therefore, their biocompatibility in terms of protein fouling was assessed. Serum albumin dissolved in phosphate buffer was selected to mimic the physiological environment and its adsorption on microgrippers was measured. The presented microgrippers demonstrated having great potential as biomedical tools, showing a modest propensity to adsorb proteins, independently from the protein concentration and time of incubation.

  12. Facilitating evaluations of innovative, competence-based assessment: Creating understanding and involving multiple stakeholders

    NARCIS (Netherlands)

    Gulikers, J.T.M.; Baartman, L.K.J.; Biemans, H.

    2010-01-01

    Schools are held more responsible for evaluating, quality assuring and improving their student assessments. Teachers’ lack of understanding of new, competence-based assessments as well as the lack of key stakeholders’ involvement, hamper effective and efficient self-evaluations by teachers of

  13. Facilitating evaluations of innovative, competence-based assessments: creating understanding and involving multiple stakeholders.

    NARCIS (Netherlands)

    Gulikers, J.T.M.; Baartman, L.; Biemans, H.J.A.

    2010-01-01

    Schools are held more responsible for evaluating, quality assuring and improving their student assessments. Teachers’ lack of understanding of new, competence-based assessments as well as the lack of key stakeholders’ involvement, hamper effective and efficient self-evaluations by teachers of

  14. Logistic innovations in transport

    Directory of Open Access Journals (Sweden)

    Mirosław Antonowicz

    2014-03-01

    Full Text Available Introduction: The article discusses the issue of logistic innovations in transport. The essentials of logistic innovations in transport together with some examples of specific innovations are presented. The role of the client's needs in transport innovations is indicated. The most vital postulates affecting the innovativeness of shipping companies and derived from the author's experience as well as scholarly publications, are time, safety, reliability as well as comprehensiveness of service offer. Following the analysis of the issue, and on the grounds of Kaizen's and Lean's method, the concept of continuous innovations is suggested as very useful for the development of transport. The potential of clusters as the source of logistic innovations in transport is emphasised. Methods: The discussion of the issue was preceded by the author's analysis of written sources on innovativeness, the evaluation of ratings of innovativeness as well as the analysis of rewarded innovative solutions in transport subsequent to the businesses participation in the programme of innovative solutions in transport. The role of innovation practical business operations is argued following the analysis of some strategic documents such as: 2011 White Paper and the Strategy for the Development of Transport by 2020 adopted by the Polish government in 2013. Aim: The aim of the article is to present the role and significance of the issue of logistic innovations in transport and to cite instances of practical solutions implemented by shipping companies, the solutions which resulted in measurable effects. Following the author's observation of the instances of innovative solutions as well as his analysis of the ratings of innovativeness, the article aims to present the conclusions as for the specific kinds of activities which are indispensable to foster innovativeness in transport. Conclusions: The conclusions derived from the author's analyses and observations show that logistic

  15. Surgical orthodontics.

    Science.gov (United States)

    Strohl, Alexis M; Vitkus, Lauren

    2017-08-01

    The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.

  16. Surgical treatment and optical coherence tomographic evaluation for accidental laser-induced full-thickness macular holes.

    Science.gov (United States)<