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Sample records for extended pyelolithotomy intra-operative

  1. Extended endoscopic endonasal surgery using three-dimensional endoscopy in the intra-operative MRI suite for supra-diaphragmatic ectopic pituitary adenoma.

    Science.gov (United States)

    Fuminari, Komatsu; Hideki, Atsumi; Manabu, Osakabe; Mitsunori, Matsumae

    2015-01-01

    We describe a supra-diaphragmatic ectopic pituitary adenoma that was safely removed using the extended endoscopic endonasal approach, and discuss the value of three-dimensional (3D) endoscopy and intra-operative magnetic resonance imaging (MRI) to this type of procedure. A 61-year-old-man with bitemporal hemianopsia was referred to our hospital, where MRI revealed an enhanced suprasellar tumor compressing the optic chiasma. The tumor extended on the planum sphenoidale and partially encased the right internal carotid artery. An endocrinological assessment indicated normal pituitary function. The extended endoscopic endonasal approach was taken using a 3D endoscope in the intraoperative MRI suite. The tumor was located above the diaphragma sellae and separated from the normal pituitary gland. The pathological findings indicated non-functioning pituitary adenoma and thus the tumor was diagnosed as a supra-diaphragmatic ectopic pituitary adenoma. Intra-operative MRI provided useful information to minimize dural opening and the supra-diaphragmatic ectopic pituitary adenoma was removed from the complex neurovascular structure via the extended endoscopic endonasal approach under 3D endoscopic guidance in the intra-operative suite. Safe and effective removal of a supra-diaphragmatic ectopic pituitary adenoma was accomplished via the extended endoscopic endonasal approach with visual information provided by 3D endoscopy and intra-operative MRI.

  2. Intra-operative radiotherapy in oncology

    International Nuclear Information System (INIS)

    Gerard, J.P.; Braillon, G.; Sentenac, I.; Calvo, F.; Dubois, J.B.; Saint-Aubert, B.; Guillemin, C.; Roussel, A.

    1991-01-01

    This article is about a treatment used more and more frequently in the world, for some neoplasms: Intra-operative radiotherapy under electron beams. The main neoplasms concerned by this treatment are the stomach, pancreas, rectum, bladder, uterus cervix neoplasms and peritoneal sarcoma [fr

  3. Intra-operative radiation treatment of cancers

    International Nuclear Information System (INIS)

    Dubois, J.B.; Joyeux, H.; Solassol, C.; Pujol, H.

    1986-01-01

    Intra-operative radiation treatment (I.O.R.T.) is concerning the treatment either of an unresectable tumor or of tumor bed after complete excision of a primary tumor and its first draining lymph nodes. We describe X-ray and electrons techniques and we discuss the delivered doses according to experimental and clinical data. According to the residual disease (macroscopic or microscopic), to the healthy tissues in the target volume, and the histological type, single doses from 20 Gy to 40 Gy can be delivered. Our preliminary results are reported: 25 patients with resectable tumors of the cardia, the stomach and the pancreas, 5 patients with pelvic recurrences of colon and rectum carcinomas. Therapeutic results of the I.O.R.T. providing from the literature are discussed. The I.O.R.T. indications are defined as palliative (unresectable tumors) and curative (irradiation of tumor bed after complete excision of the tumor) [fr

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

    OpenAIRE

    Seo, Ill Young; Rim, Joung Sik

    2013-01-01

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

  5. Appropriateness of Intra-Operative Blood Transfusion In Children at ...

    African Journals Online (AJOL)

    Background: The decision to transfuse intra-operatively is based on preoperative haemoglobin (Hb), estimated blood loss and physiological variables. The visual estimate of blood loss is notoriously unreliable especially with small volumes of blood losses in children. Objectives :We sought therefore to determine the ...

  6. Comparative Study Of Intra-Operative Pelvimetry With Calipers And ...

    African Journals Online (AJOL)

    The pelvic measurement of patients who have had a caesarean section was done using Pelvic Calipers (intra-operative) and x-ray methods. In the former method, during Caesarean sections and after closure of the lower uterine segment incision, a pair of pelvic calipers was used to measure the true conjugate of the pelvis.

  7. Intra-operative parathyroid hormone measurements – experience of ...

    African Journals Online (AJOL)

    Background. Surgery is the treatment of choice for symptomatic primary hyperparathyroidism. The majority of research concerning intra-operative parathyroid hormone (ioPTH) measurements is conducted in university hospitals. Whether ioPTH measurements are feasible and useful in predicting the presence of remaining ...

  8. Packing of renal fossa: Useful technique for intractable bleeding after open pyelolithotomy surgery

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    Mohinder Kumar Malhotra

    2012-01-01

    Full Text Available There is no documented study to indicate the role of prolonged packing of renal fossa (24 to 48 hours to control bleeding in life threating haemorrhage following open pyelolithotomy without compromise in the renal functions. On the contrary emergency nephrectomy was performed for intractable bleeding during renal stone surgery in peripheral hospitals. Several studies have shown the usefulness of temporary packing to control bleeding in liver injuries and following open heart operations. Packing of the renal fossa with laparotomy pads in unstable patients, and transferring the patient to the surgical intensive care unit (ICU is also described in trauma but not in controlling bleeding after open pyelolithotomy .This study comprises of three such patients whose kidneys were salvaged by a simple procedure of temporary packing of renal fossa for period of 24-48 hours who had developed life threatening haemorrhage after open pyelolithotomy. This technique is simple and worth trying especially for surgeons who are contemplating nephrectomy as prolonged packing has not lead to any compromise in renal functions. The aim of this manuscript is very limited and clear. Packing is not a licence to carry out open pyelolithotomy without proper expertise and local backup or resources. Principles of safe and ethical surgical practice should never be violated as it can lead to medico legal complications.

  9. Premedication with oral Dextromethorphan reduces intra-operative Morphine requirement

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    R Talakoub

    2005-09-01

    Full Text Available Background: Intra-operative pain has adverse effects on hemodynamic parameters. Due to complications of opioids for pain relief, using non-opioids medication is preferred. The purpose of this study was to investigate the effect of oral dextrometorphan premedication on intra-operative Morphine requirement. Methods: After approval of the Ethics committee and informed consent, 40 adult patients who stand in American Society of Anesthesiologists Physical Status I and II, under general anesthesia for elective laparatomy were selected and classified in two equal groups randomly. In group A, oral dextromethorphan (60mg was administered at 10 PM and 6 AM preoperatively. In group B, placebo (dextrose was administered. After induction of general anesthesia and before skin incision, intravenous morphine (0.01 mg/kg was administered. During surgery, when systolic blood pressure or heart rate was increased more than 20% of the preoperative baseline, 0.01 mg/kg morphine was administered. At the end of surgery, the totally prescribed morphine (mg/kg and maximal increase in systolic, diastolic, mean arterial blood pressure and heart rate relative to the baseline values were calculated and statistically compared with student’s t-test. Results: The mean dose of administered morphine during surgery was significantly less in group A than group B (P<0.0001. Also, Maximal increase in systolic, diastolic and mean arterial blood pressure was significantly less in group A (p<0.003, p<0.004, p<0.0001, respectively. There was no significant difference in maximal heart rate increase between two groups (p<0.114. Conclusion: Oral dextromethorphan premedication may decrease intra-operative morphine requirement and reduce maximal increase in systolic and mean arterial blood pressure during surgery. Key words: Dextromethorphan, Morphine, Intra-operative, Premedication Hemodynamic

  10. Pediatric awake craniotomy and intra-operative stimulation mapping.

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    Balogun, James A; Khan, Osaama H; Taylor, Michael; Dirks, Peter; Der, Tara; Carter Snead Iii, O; Weiss, Shelly; Ochi, Ayako; Drake, James; Rutka, James T

    2014-11-01

    The indications for operating on lesions in or near areas of cortical eloquence balance the benefit of resection with the risk of permanent neurological deficit. In adults, awake craniotomy has become a versatile tool in tumor, epilepsy and functional neurosurgery, permitting intra-operative stimulation mapping particularly for language, sensory and motor cortical pathways. This allows for maximal tumor resection with considerable reduction in the risk of post-operative speech and motor deficits. We report our experience of awake craniotomy and cortical stimulation for epilepsy and supratentorial tumors located in and around eloquent areas in a pediatric population (n=10, five females). The presenting symptom was mainly seizures and all children had normal neurological examinations. Neuroimaging showed lesions in the left opercular (n=4) and precentral or peri-sylvian regions (n=6). Three right-sided and seven left-sided awake craniotomies were performed. Two patients had a history of prior craniotomy. All patients had intra-operative mapping for either speech or motor or both using cortical stimulation. The surgical goal for tumor patients was gross total resection, while for all epilepsy procedures, focal cortical resections were completed without any difficulty. None of the patients had permanent post-operative neurologic deficits. The patient with an epileptic focus over the speech area in the left frontal lobe had a mild word finding difficulty post-operatively but this improved progressively. Follow-up ranged from 6 to 27 months. Pediatric awake craniotomy with intra-operative mapping is a precise, safe and reliable method allowing for resection of lesions in eloquent areas. Further validations on larger number of patients will be needed to verify the utility of this technique in the pediatric population. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Retroperitoneal laparoscopic pyelolithotomy in renal pelvic stone versus open surgery - a comparative study.

    Science.gov (United States)

    Singal, Rikki; Dhar, Siddharth

    2018-01-01

    The introduction of endourological procedures such as percutaneous nephrolithotomy and ureterorenoscopy have led to a revolution in the the management of urinary stone disease. The indications for open stone surgery have been narrowed significantly, making it a second- or third-line treatment option. To study the safety and efficacy of retroperitoneal laparoscopic pyelolithotomy in retroperitoneal renal stone. We compared the results of laparoscopic and open surgery in terms of easy accessibility, operative period, renal injuries, and early recovery. This prospective study was conducted on renal pelvic stone cases from January 2009 to February 2016 in Suchkhand Hospital, Agra, India. The study included a total of 1700 cases with the diagnosis of solitary renal pelvic stones. In group A - 850 cases - retroperitoneal laparoscopic pyelolithotomy was performed, while group B - 850 cases - underwent open pyelolithotomy. The mean operative time was less in group B than group A (74.83 min vs. 94.43 min) which was significant (p<0.001). The blood loss was less in the laparoscopic group than in the open group (63 mL vs. 103mL). There were statistically significant differences in the post-operative pain scores, and postoperative complications compared to group B (p<0.001). The mean hospital stay was less in group A (p<0.03), which was significant. Laparoscopic surgery reduces analgesic requirements, hospital stay, and blood loss. The disadvantages include the reduced working space, the cost of equipment and the availability of a trained surgeon.

  12. Intra-operative probe for brain cancer: feasibility study

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    Vu Thi, M. H.; Charon, Y.; Duval, M. A.; Lefebvre, F.; Menard, L.; Pitre, S.; Pinot, L.; Siebert, R.

    2007-07-01

    The present work aims a new medical probe for surgeons devoted to brain cancers, in particular glioblastoma multiforme. Within the last years, our group has started the development of a new intra-operative beta imaging probe. More recently, we took an alternative approach for the same application: a fluorescence probe. In both cases the purpose is to differentiate normal from tumor brain tissue. In a first step, we developed set-ups capable to measure autofluorescence. They are based on a dedicated epi-fluorescence design and on specific fiber optic probes. Relative signal amplitude, spectral shape and fluorescence lifetime measurements are foreseen to distinguish normal and cancer tissue by analyzing fluorophores like NADH, lipopigments and porphyrines. The autofluorescence spectra are recorded in the 460-640 nm range with a low resolution spectrometer. For lifetime measurements a fast detector (APD) is used together with a TCSPC-carte. Intrinsic wavelength- and time-resolutions are a few nm and 200 ps, respectively. Different samples have been analyzed to validate our new detection system and to allow a first configuration of our medical fluorescence probe. First results from the tissue measurements are shown.

  13. Intra-operative radiation therapy in cancer of the pancreas

    International Nuclear Information System (INIS)

    Dubois, J.B.; Gu, S.D.; Saint-Aubert, B.; Joyeux, H.; Solassol, C.; Pujol, H.

    1991-01-01

    We report our experience concerning 22 pancreatic carcinoma bearing patients treated with intra-operative radiation therapy (IORT) after complete surgical excision: duodenopancreatectomy: 15 patients; isthmic and caudal pancreatectomy: 2 patients; total pancreatectomy: 5 patients. The dose delivered to the tumor bed was 20 Gy in 12 patients, 18 Gy in 3 patients and 15 Gy in 7 patients. Three patients died within the 1st month post-surgery from intercurrent diseases. Post-operative morbidity was not significantly modified by IORT as compared to purely surgical treated patients. Out of 19 evaluable patients, we observed local control in 16 patients (79.4%). Causes of death (15/19 patients) were: distant metastases with local control: 7 patients; in situ local failure: 3 patients; regional recurrence outside of the IORT fields: 2 patients; intercurrent diseases: 3 patients. Four patients are still alive without evolutive disease. The median overall survival is 6 months. The mean overall survival is 10.56 months. Excluding patients who died from complications and intercurrent diseases, the median survival is 10 mths and the mean survival 14.5 mths. These results emphasize the improvement in local control with IORT, but without significant improvement in survival which is dependent on local evolution and also systemic disease [fr

  14. Intra-operative blood transfusion among adult surgical patients in a ...

    African Journals Online (AJOL)

    This retrospective study was designed to audit the pattern of intra-operative whole blood transfusion among adult surgical patients over a two-year period. Data were collected on the rate of intra-operative transfusion, estimated blood loss, units of donor blood transfused, pattern of use of autologous blood and circumstances ...

  15. Intra-operative removal of chest tube in video-assisted thoracoscopic procedures

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    Moustafa M. El-Badry

    2017-12-01

    Conclusions: Intra-operative removal of chest tube during VATS procedures was a safe technique in well selected patients with an intra-operative successful air-leak test with radiological and clinical follow-up. This technique provided lesser post-operative pain with shorter hospital stay.

  16. The comparison of laparoscopic pyelolithotomy and percutaneous nephrolithotomy in the treatment of solitary large renal pelvic stones

    NARCIS (Netherlands)

    Tefekli, Ahmet; Tepeler, Abdulkadir; Akman, Tolga; Akçay, Muzaffer; Baykal, Murat; Karadağ, Mert Ali; Muslumanoglu, Ahmet Y.; de la Rosette, Jean

    2012-01-01

    The aim of the study is to investigate whether laparoscopic pyelolithotomy (LPL) could find a place in the management of large renal pelvic stones which are generally considered as excellent indications for percutaneous nephrolithotomy (PNL). Between 2006 and 2009, 26 consecutive patients with large

  17. Intra-operative radiotherapy of malignant tumors: Past, present and perspectives

    International Nuclear Information System (INIS)

    Mazeron, J.J.; Le Bourgeois, J.P.; Ganem, G.

    1986-01-01

    Intra-operative radiotherapy consists of electron or photon radiation which is used during the operative procedure. The treatment field is arranged very precisely after critical organs have been previously arranged out of the field. The target volume includes the remaining tumor which could not be removed surgically, and the surrounding tumor bed which is also felt to be high risk for recurrence. It is preferable to have as little tumor remaining as possible before the intra-operative treatment radiation is given. Intra-operative radiotherapy was developed less than a quarter century ago in Japon, and it was later used in U.S.A. The accumulated experience in Japan and U.S.A. is rewieved here. Intra-operative radiotherapy has only recently been introduced to France. The biology, physics and medical and technical problems of intra-operative therapy are discussed [fr

  18. Retroperitoneoscopic pyelolithotomy: A minimally invasive alternative for the management of large renal pelvic stone

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    Saurabh Sudhir Chipde

    2014-01-01

    Full Text Available Introduction: Large stones in renal pelvis can be treated with percutaneous nephrolithotomy (PCNL or pyelolithotomy (either by open or laparoscopic techniques. PCNL is difficult in undilated system. For pyelolithotomy, laparoscopy is more preferable over the open surgery. Surgeons are more familiar with the tansperitoneoscopic anatomy than retroperitoneoscopic one, but retroperitoneoscopic approach can be attempted if we anticipate the problems in the transperitoneal route. Case: A fifty years old gentleman presented to us with the complaint of dull aching right flank pain. On ultrasonographic examination, he was found to have a large stone in renal pelvis with minimal hydronephrosis and thickened omentum on right side. Xray KUB showed a large radio-opaque shadow in renal area. We did the CECT-Urogram of the patient to know the detailed anatomy, which showed a stone of 5.3 x 3.7 cm in right extra-rena pelvis without hydronephrosis and a large focal area of marked fat stranding in omentum on the right side in mid and lower abdomen with swirling of fat stranding on the superior aspect suggestive of omental infarction and torsion. Due to undilated caliceal system, we preferred laparoscopic surgery over the PCNL in this patient. As whole of the omental tissue was stuck on right side we decided to proceed with transperitoneoscopic route instead of retroperitoneoscopic one. The DJ stent was inserted preoperatively.The surgery was performed in the flank position with three ports, one 10mm port just antero-inferior to tip of 12th rib for camera and two 5mm working ports, one at anterior axillary line and other at renal angle. We created the retroperitoneal space with the customized balloon, made with the glove-fingure. Results: The operative time was 1 hour 40 minutes, and there were no intra or post-operative complications. The stone was removed in toto. Patient was orally allowed on first postoperative day and foleys was removed on second day. patient

  19. Treatment of cystine stones: combined approach using open pyelolithotomy, percutaneous pyelolithotripsy, extracorporeal shock wave lithotripsy and chemolysis

    DEFF Research Database (Denmark)

    Aabech, J; Andersen, J T

    1993-01-01

    Treatment of cystine stones in the urinary tract can be difficult because of a high frequency of recurrence, resistance to Extracorporeal Shock Wave Lithotripsy (ESWL), difficulty in localization and access to peripheral stones during Percutaneous Nephrolithotripsy (PCNL), and the insufficient...... effect of oral chemolysis. We present two cases of urinary cystine calculi treated with a combination of pyelolithotomy, PCNL, ESWL and percutaneous irrigation chemolysis, using N-acetylcysteine and Tromethamine-E....

  20. What is the optimal management of an intra-operative air leak in a colorectal anastomosis?

    Science.gov (United States)

    Mitchem, J B; Stafford, C; Francone, T D; Roberts, P L; Schoetz, D J; Marcello, P W; Ricciardi, R

    2018-02-01

    An airtight anastomosis on intra-operative leak testing has been previously demonstrated to be associated with a lower risk of clinically significant postoperative anastomotic leak following left-sided colorectal anastomosis. However, to date, there is no consistently agreed upon method for management of an intra-operative anastomotic leak. Therefore, we powered a noninferiority study to determine whether suture repair alone was an appropriate strategy for the management of an intra-operative air leak. This is a retrospective cohort analysis of prospectively collected data from a tertiary care referral centre. We included all consecutive patients with left-sided colorectal or ileorectal anastomoses and evidence of air leak during intra-operative leak testing. Patients were excluded if proximal diversion was planned preoperatively, a pre-existing proximal diversion was present at the time of surgery or an anastomosis was ultimately unable to be completed. The primary outcome measure was clinically significant anastomotic leak, as defined by the Surgical Infection Study Group at 30 days. From a sample of 2360 patients, 119 had an intra-operative air leak during leak testing. Sixty-eight patients underwent suture repair alone and 51 underwent proximal diversion or anastomotic reconstruction. The clinically significant leak rate was 9% (6/68; 95% CI: 2-15%) in the suture repair alone arm and 0% (0/51) in the diversion or reconstruction arm. Suture repair alone does not meet the criteria for noninferiority for the management of intra-operative air leak during left-sided colorectal anastomosis. Further repair of intra-operative air leak by suture repair alone should be reconsidered given these findings. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

  1. Rating of intra-operative neuro-monitoring results in operative correction of the spinal deformities

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    A. A. Skripnikov

    2015-01-01

    Full Text Available Purpose of the work was filing the electrophysiological phenomena observed in the process of intra-operative neuromonitoring followed by development of the results’ scale of intra-operative neuro-physiological testing of the pyramidal tract. Materials and мethods. The selection for evaluation included data of 147 protocols of intra-operative neuromonitoring in 135 patients (53 males, 82 females, aged from 1 y. 5 m. to 52 years (14,1±0,7 years with spinal deformities of different etiology who underwent instrumentation spinal correction followed by fixation of thoracic / thoracolumbar spine segments using various variants of internal systems of trans-pedicular fixation. Intra-operative neuro-monitoring was performed using system «ISIS IOM» (Inomed Medizintechnik GmbH, Germany. The changes of motor evoked potentials were evaluated according to this scale. Results. Five types of pyramidal system reaction to operative invasion were revealed. According to neurophysiological criteria three grades of the risk of neurological disorders development during operative spinal deformity correction and, correspondingly, three levels of anxiety for the surgeon were defined. Conclusion. Intra-operative neurophysiological monitoring is the effective highly technological instrument to prevent neurological disorders in the spinal deformity. Offered rating scale of the risk of neurological complications gives the possibility to highlight three levels of anxiety during operative invasion.

  2. [Identification and management of intra-operative suspicious tissues in 20 transsphenoidal surgery cases].

    Science.gov (United States)

    Liu, Jun-Feng; Ke, Chang-Shu; Chen, Xi; Xu, Yu; Zhang, Hua-Qiu; Chen, Juan; Gan, Chao; Li, Chao-Xi; Lei, Ting

    2013-05-01

    To determine appropriate protocols for the identification and management of intra operative suspicious tissues during transsphenoidal surgery. Clinical data and pathological reports of 20 patients with intra-operative suspicious tissues during transsphenoidal surgeries were analyzed retrospectively. The methods for discriminating between adenoma and normal pituitary tissues were reviewed. The postoperative pathological reports revealed that adenoma and normal pituitary tissues coexisted in 9 samples, while 5 samples were identified as normal pituitary tissues, 2 as adenoma tissues, and 4 as other tissues. Adenomas were distinguished from normal pituitary tissues on the basis of intra-operative appearance, texture, blood supply and possible existence of boundary. If decisions are difficult to made during surgeries from the appearance of the suspicious tissues, pathological examinations are advised as a guidance for the next steps.

  3. Intra-Operative Amylase Concentration in Peri-Pancreatic Fluid Predicts Pancreatic Fistula After Distal Pancreatectomy

    NARCIS (Netherlands)

    Nahm, C.B.; Reuver, P.R.; Hugh, T.J.; Pearson, A.; Gill, A.J.; Samra, J.S.; Mittal, A.

    2017-01-01

    Post-operative pancreatic fistula (POPF) is a potentially severe complication following distal pancreatectomy. The aim of this study was to assess the predictive value of intra-operative amylase concentration (IOAC) in peri-pancreatic fluid after distal pancreatectomy for the diagnosis of POPF.

  4. Evaluation of measures to decrease intra-operative bacterial contamination in orthopaedic implant surgery

    NARCIS (Netherlands)

    Knobben, BAS; van Horn, [No Value; van der Mei, HC; Busscher, HJ

    The aim of this study was to evaluate whether behavioural and systemic measures wilt decrease intra-operative contamination during total hip or knee replacements. The influence of these measures on subsequent prolonged wound discharge, superficial surgical site infection and deep periprosthetic

  5. l-Arginine Pathway Metabolites Predict Need for Intra-operative Shunt During Carotid Endarterectomy

    DEFF Research Database (Denmark)

    Szabo, P; Lantos, J; Nagy, L

    2016-01-01

    lactate levels were increased during reperfusion (p = .02). The median pre-operative concentration of l-arginine was lower in patients requiring an intra-operative shunt than in patients without need of shunt (median: 30.3 μmol/L [interquartile range 24.4-34.4 μmol/L] vs. 57.6 μmol/L [interquartile range...

  6. Outcome of renal transplantation with and without intra-operative diuretics.

    Science.gov (United States)

    Hanif, F; Macrae, A N; Littlejohn, M G; Clancy, M J; Murio, E

    2011-01-01

    This paper presents an e-survey of current clinical practice of use of intra-operative diuretics during renal transplantation in the United Kingdom and a study to compare outcome of renal transplants carried out with or without intra-operative diuretics in our centre. An e-mail questionnaire to renal transplant surgeons exploring their practice of renal transplantation with or without intra-operative diuretics, the type of a diuretic/s if used and the relevant doses. An observational study comparing the outcome of renal transplant recipients, group no-diuretics (GND, n = 80) carried out from 2004 to 2008 versus group diuretics (GD n = 69) renal transplant recipients who received intra-operative diuretics over a one year period is presented. Outcome measures were incidence of delayed graft function and a comparison of graft survival in both groups. Forty surgeons answered from 18 transplant centres with a response rate of 67%. 13 surgeons do not use diuretics. Mannitol is used by 10/40, Furosemide 6/40 and 11 surgeons use a combination of both. In comparative study there was no significant overall difference in one year graft survival of GD versus GND (N = 65/69, 94% and 75/80, 94% respectively, p = 0.08) and the incidence of delayed graft function was also comparable (16/69, 23% and 21/80, 26% respectively, p = 0.07). The donor characteristics in both groups were comparable. The study showed variation in clinical practice on the use of intra-operative diuretics in renal transplantation and it did not demonstrate that the use of diuretics can improve renal graft survival. Copyright © 2011 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  7. T cell lymphoblastic lymphoma/leukemia within an adrenocorticotropic hormone and thyroid stimulating hormone positive pituitary adenoma: A cytohistological correlation emphasizing importance of intra-operative squash smear.

    Science.gov (United States)

    Gupta, Rakesh K; Saran, Ravindra K; Srivastava, Arvind K; Jagetia, Anita; Garg, Lalit; Sharma, Mehar C

    2017-08-01

    We present a rare case of primary pituitary T cell lymphoma/leukemia (T-LBL) in association with adrenocorticotropic hormone (ACTH) and thyroid stimulating hormone (TSH) expressing pituitary adenoma in a 55-year-old woman highlighting the importance of intra-operative squash smears examination. The patient presented with complaints of headache, diminution of vision and recent onset altered sensorium. MRI revealed a mass lesion in the sellar-suprasellar region with non-visualization of pituitary gland separately, extending to involve adjacent structures diagnosed as invasive pituitary macroadenoma. Intra-operative tissue was sent for squash smear examination. The cytology showed a tumor comprising of sheets of immature lymphoid cells intermixed with clusters of pituitary acinar cells with many mitoses and tingible body macrophages. A diagnosis of presence of immature lymphoid cells within the pituitary was offered and differentials of infiltration by lymphoma cells from systemic disease versus primary central nervous lymphoma-like lymphoma arising in the pituitary adenoma were considered. Later paraffin section examination and immunohistochemistry corroborated with the squash findings and a final diagnosis of primary pituitary T cell lymphoma/leukemia in association with ACTH and TSH expressing pituitary adenoma was made. To date, only six cases of primary pituitary T cell lymphomas, including three T-LBL cases, have been reported. This is the seventh case and first one additionally describing cytohistological correlation and importance of intra-operative cytology. © 2017 Japanese Society of Neuropathology.

  8. Intra-operative digital imaging: assuring the alignment of components when undertaking total hip arthroplasty.

    Science.gov (United States)

    Hambright, D; Hellman, M; Barrack, R

    2018-01-01

    The aims of this study were to examine the rate at which the positioning of the acetabular component, leg length discrepancy and femoral offset are outside an acceptable range in total hip arthroplasties (THAs) which either do or do not involve the use of intra-operative digital imaging. A retrospective case-control study was undertaken with 50 patients before and 50 patients after the integration of an intra-operative digital imaging system in THA. The demographics of the two groups were comparable for body mass index, age, laterality and the indication for surgery. The digital imaging group had more men than the group without. Surgical data and radiographic parameters, including the inclination and anteversion of the acetabular component, leg length discrepancy, and the difference in femoral offset compared with the contralateral hip were collected and compared, as well as the incidence of altering the position of a component based on the intra-operative image. Digital imaging took a mean of five minutes (2.3 to 14.6) to perform. Intra-operative changes with the use of digital imaging were made for 43 patients (86%), most commonly to adjust leg length and femoral offset. There was a decrease in the incidence of outliers when using intra-operative imaging compared with not using it in regard to leg length discrepancy (20% versus 52%, p = 0.001) and femoral offset inequality (18% versus 44%, p = 0.004). There was also a difference in the incidence of outliers in acetabular inclination (0% versus 7%, p = 0.023) and version (0% versus 4%, p = 0.114) compared with historical results of a high-volume surgeon at the same centre. The use of intra-operative digital imaging in THA improves the accuracy of the positioning of the components at THA without adding a substantial amount of time to the operation. Cite this article: Bone Joint J 2018;100B(1 Supple A):36-43. ©2018 The British Editorial Society of Bone & Joint Surgery.

  9. The value of the intra-operative clinical mechanical axis measurement in open-wedge valgus high tibial osteotomies

    NARCIS (Netherlands)

    van de Pol, G.J.; Verdonschot, Nicolaas Jacobus Joseph; van Kampen, A.

    2012-01-01

    Introduction: In high tibial osteotomies (HTO) the correction needs to be precise and intra-operative assessment is essential. The purpose of this study was to evaluate the use of the intra-operative clinical mechanical axis measurement and compare it to the post-operative weight bearing situation

  10. Studies on the reliability of high-field intra-operative MRI in brain glioma resection

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    Zhi-jun SONG

    2011-07-01

    Full Text Available Objective To evaluate the reliability of high-field intra-operative magnetic resonance imaging(iMRI in detecting the residual tumors during glioma resection.Method One hundred and thirty-one cases of brain glioma(69 males and 62 females,aged from 7 to 79 years with mean of 39.6 years hospitalized from Nov.2009 to Aug.2010 were involved in present study.All the patients were evaluated using magnetic resonance imaging(MRI before the operation.The tumors were resected under conventional navigation microscope,and the high-field iMRI was used for all the patients when the operators considered the tumor was satisfactorily resected,while the residual tumor was difficult to detect under the microscope,but resected after being revealed by high-field iMRI.Histopathological examination was performed.The patients without residual tumors recieved high-field MRI scan at day 4 or 5 after operation to evaluate the accuracy of high-field iMRI during operation.Results High quality intra-operative images were obtained by using high-field iMRI.Twenty-eight cases were excluded because their residual tumors were not resected due to their location too close to functional area.Combined with the results of intra-operative histopathological examination and post-operative MRI at the early recovery stage,the sensitivity of high-field iMRI in residual tumor diagnosis was 98.0%(49/50,the specificity was 94.3%(50/53,and the accuracy was 96.1%(99/103.Conclusion High-quality intra-operative imaging could be acquired by high-field iMRI,which maybe used as a safe and reliable method in detecting the residual tumors during glioma resection.

  11. Role of imprint cytology in intra operative diagnosis of thyroid lesions.

    Science.gov (United States)

    Anila, K R; Krishna, G

    2014-07-01

    Intra-operative imprint cytology is an important diagnostic modality in the diagnosis of thyroid lesions. A correct intra-operative diagnosis helps eliminate the need for second surgery. To study diagnostic accuracy of imprint cytology and to compare the imprint cytology results with that of the corresponding paraffin section diagnosis in thyroidectomy cases. This is a prospective study of 84 patients who have undergone thyroidectomies over a period of one year at the Department of Surgery, Thiruvananthapuram, Kerala, India. The intraoperative imprint cytology smears were stained by Papanicolaou method. The imprint cytology interpretation was later compared with the paraffin section diagnosis. Of the 84 patients using haematoxylin and eosin stained histopathology sections as the gold standard, the diagnostic sensitivity of imprint cytology was 75% and specificity was 100%. Positive predictive value was 100%. Negative predictive value was 98.74%. Imprint cytology has high sensitivity and specificity in diagnosing lesions of the thyroid. The problems faced were in diagnosing follicular carcinomas and differentiating low grade lymphoma from lymphocytic thyroiditis. Imprint cytology is a simple, reliable diagnostic technique. It has high sensitivity and specificity in intra-operative diagnosis of lesions of thyroid. In spite of the advent of newer diagnostic modalities like frozen sections, imprint cytology still holds its unique position in the current perspective.

  12. Intra-operative mapping of the atria: the first step towards individualization of atrial fibrillation therapy?

    Science.gov (United States)

    Kik, Charles; Mouws, Elisabeth M J P; Bogers, Ad J J C; de Groot, Natasja M S

    2017-07-01

    Atrial fibrillation (AF), an age-related progressive disease, is becoming a worldwide epidemic with a prevalence rate of 33 million. Areas covered: In this expert review, an overview of important results obtained from previous intra-operative mapping studies is provided. In addition, our novel intra-operative high resolution mapping studies, its surgical considerations and data analyses are discussed. Furthermore, the importance of high resolution mapping studies of both sinus rhythm and AF for the development of future AF therapy is underlined by our most recent results. Expert commentary: Progression of AF is determined by the extensiveness of electropathology which is defined as conduction disorders caused by structural damage of atrial tissue. The severity of electropathology is a major determinant of therapy failure. At present, we do not have any diagnostic tool to determine the degree of electropathology in the individual patient and we can thus not select the most optimal treatment modality for the individual patient. An intra-operative, high resolution scale, epicardial mapping approach combined with quantification of electrical parameters may serve as a diagnostic tool to stage AF in the individual patient and to provide patient tailored therapy.

  13. Safe surgery: how accurate are we at predicting intra-operative blood loss?

    LENUS (Irish Health Repository)

    2012-02-01

    Introduction Preoperative estimation of intra-operative blood loss by both anaesthetist and operating surgeon is a criterion of the World Health Organization\\'s surgical safety checklist. The checklist requires specific preoperative planning when anticipated blood loss is greater than 500 mL. The aim of this study was to assess the accuracy of surgeons and anaesthetists at predicting intra-operative blood loss. Methods A 6-week prospective study of intermediate and major operations in an academic medical centre was performed. An independent observer interviewed surgical and anaesthetic consultants and registrars, preoperatively asking each to predict expected blood loss in millilitre. Intra-operative blood loss was measured and compared with these predictions. Parameters including the use of anticoagulation and anti-platelet therapy as well as intra-operative hypothermia and hypotension were recorded. Results One hundred sixty-eight operations were included in the study, including 142 elective and 26 emergency operations. Blood loss was predicted to within 500 mL of measured blood loss in 89% of cases. Consultant surgeons tended to underestimate blood loss, doing so in 43% of all cases, while consultant anaesthetists were more likely to overestimate (60% of all operations). Twelve patients (7%) had underestimation of blood loss of more than 500 mL by both surgeon and anaesthetist. Thirty per cent (n = 6\\/20) of patients requiring transfusion of a blood product within 24 hours of surgery had blood loss underestimated by more than 500 mL by both surgeon and anaesthetist. There was no significant difference in prediction between patients on anti-platelet or anticoagulation therapy preoperatively and those not on the said therapies. Conclusion Predicted intra-operative blood loss was within 500 mL of measured blood loss in 89% of operations. In 30% of patients who ultimately receive a blood transfusion, both the surgeon and anaesthetist significantly underestimate

  14. Intra-operative maternal complications of emergency cesarean section done in advanced labor

    International Nuclear Information System (INIS)

    Nisa, M.U.

    2013-01-01

    Background: Emergency cesarean section done in advanced labor is a big challenge in obstetrics due to increased risk of intraoperative complications. In the last decade, a rapid increase in cesarean section done in advanced labor has been observed. Difficult deli-very of the fetal head during cesarean section carries a high risk of intraoperative complications like cervical and uterine tears, intra operative hemorrhage and trauma to the baby. Objectives: The purpose of this study is to find out the frequency and risk factors for intra-operative complications in emergency cesarean section done in advanced labor, so that appropriate management protocols can be planned to reduce these complications. Study Design: Prospective cohort study. Materials and Methods: This prospective study was carried out in Obstetrics and Gynecology Unit - 2 of Services Institute of Medical Sciences, Services Hospital, Lahore; from 1st January 2007 to 31st December 2007. All patients undergoing emergency cesarean sections done on laboring mothers were included in the study. The sample was divided into two groups; emergency C-section done in advanced labor as the study group and emergency C-section in early labor as the control group. Data were collected regarding age, parity, booked or unbooked status, indications for cesarean section, level of competence of operating surgeon, intra-operative complications and the risk factors for these complications. Data were recorded on a structured proforma and compared between the two groups. Statistical Analysis: Data were analyzed using computer programme SPSS Version 14 for windows applying student t-test for quantitative and chai square test for qualitative parameters. A p-value < 0.05 was used as statistically significant. Results: Out of 2064 total deliveries in the year 2007, 1290 (62.5%) were vaginal deliveries and 774 (37.5%) were C-Sections. Out of 774 C-Section, 174 (23%) were elective and 600 (77%) were emergency. Out of 600 emergency C

  15. Estimation of intra-operator variability in perfusion parameter measurements using DCE-US.

    Science.gov (United States)

    Gauthier, Marianne; Leguerney, Ingrid; Thalmensi, Jessie; Chebil, Mohamed; Parisot, Sarah; Peronneau, Pierre; Roche, Alain; Lassau, Nathalie

    2011-03-28

    To investigate intra-operator variability of semi-quantitative perfusion parameters using dynamic contrast-enhanced ultrasonography (DCE-US), following bolus injections of SonoVue(®). The in vitro experiments were conducted using three in-house sets up based on pumping a fluid through a phantom placed in a water tank. In the in vivo experiments, B16F10 melanoma cells were xenografted to five nude mice. Both in vitro and in vivo, images were acquired following bolus injections of the ultrasound contrast agent SonoVue(®) (Bracco, Milan, Italy) and using a Toshiba Aplio(®) ultrasound scanner connected to a 2.9-5.8 MHz linear transducer (PZT, PLT 604AT probe) (Toshiba, Japan) allowing harmonic imaging ("Vascular Recognition Imaging") involving linear raw data. A mathematical model based on the dye-dilution theory was developed by the Gustave Roussy Institute, Villejuif, France and used to evaluate seven perfusion parameters from time-intensity curves. Intra-operator variability analyses were based on determining perfusion parameter coefficients of variation (CV). In vitro, different volumes of SonoVue(®) were tested with the three phantoms: intra-operator variability was found to range from 2.33% to 23.72%. In vivo, experiments were performed on tumor tissues and perfusion parameters exhibited values ranging from 1.48% to 29.97%. In addition, the area under the curve (AUC) and the area under the wash-out (AUWO) were two of the parameters of great interest since throughout in vitro and in vivo experiments their variability was lower than 15.79%. AUC and AUWO appear to be the most reliable parameters for assessing tumor perfusion using DCE-US as they exhibited the lowest CV values.

  16. Impact of intra-operative intraperitoneal chemotherapy on organ/space surgical site infection in patients with gastric cancer.

    Science.gov (United States)

    Liu, X; Duan, X; Xu, J; Jin, Q; Chen, F; Wang, P; Yang, Y; Tang, X

    2015-11-01

    Various risk factors for surgical site infection (SSI) have been identified such as age, overweight, duration of surgery, blood loss, etc. Intraperitoneal chemotherapy during surgery is a common procedure in patients with gastric cancer, yet its impact on SSI has not been evaluated. To evaluate whether intra-operative intraperitoneal chemotherapy is a key risk factor for organ/space SSI in patients with gastric cancer. All patients with gastric cancer who underwent surgery at the Department of Gastrointestinal Surgery between January 2008 and December 2013 were studied. The organ/space SSI rates were compared between patients who received intra-operative intraperitoneal chemotherapy and patients who did not receive intra-operative intraperitoneal chemotherapy, and the risk factors for organ/space SSI were analysed by univariate and multi-variate regression analyses. The microbial causes of organ/space SSI were also identified. Of the eligible 845 patients, 356 received intra-operative intraperitoneal chemotherapy, and the organ/space SSI rate was higher in these patients compared with patients who did not receive intra-operative intraperitoneal chemotherapy (9.01% vs 3.88%; P = 0.002). Univariate analysis confirmed the significance of this finding (odds ratio 2.443; P = 0.003). As a result, hospital stay was increased in patients who received intra-operative intraperitoneal chemotherapy {mean 20.91 days [95% confidence interval (CI) 19.76-22.06] vs 29.72 days (95% CI 25.46-33.99); P = 0.000}. The results also suggested that intra-operative intraperitoneal chemotherapy may be associated with more Gram-negative bacterial infections. Intra-operative intraperitoneal chemotherapy is a significant risk factor for organ/space SSI in patients with gastric cancer. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  17. Intra-operative 3-T MRI for paediatric brain tumours: challenges and perspectives

    International Nuclear Information System (INIS)

    Abernethy, L.J.; Avula, S.; Hughes, G.M.; Wright, E.J.; Mallucci, C.L.

    2012-01-01

    MRI is the ideal modality for imaging intracranial tumours. Intraoperative MRI (ioMRI) makes it possible to obtain scans during a neurosurgical operation that can aid complete macroscopic tumour resection - a major prognostic factor in the majority of brain tumours in children. Intra-operative MRI can also help limit damage to normal brain tissue. It therefore has the potential to improve the survival of children with brain tumours and to minimise morbidity, including neurological deficits. The use of ioMRI is also likely to reduce the need for second look surgery, and may reduce the need for chemotherapy and radiotherapy. High-field MRI systems provide better anatomical information and also enable effective utilisation of advanced MRI techniques such as perfusion imaging, diffusion tensor imaging, and magnetic resonance spectroscopy. However, high-field ioMRI facilities require substantial capital investment, and careful planning is required for optimal benefit. Safe ioMRI requires meticulous attention to detail and rigorous application of magnetic field safety precautions. Interpretation of ioMRI can be challenging and requires experience and understanding of artefacts that are common in the intra-operative setting. (orig.)

  18. Intra-operative neurophysiological mapping and monitoring during brain tumour surgery in children: an update.

    Science.gov (United States)

    Coppola, Angela; Tramontano, Vincenzo; Basaldella, Federica; Arcaro, Chiara; Squintani, Giovanna; Sala, Francesco

    2016-10-01

    Over the past decade, the reluctance to operate in eloquent brain areas has been reconsidered in the light of the advent of new peri-operative functional neuroimaging techniques and new evidence from neuro-oncology. To maximise tumour resection while minimising morbidity should be the goal of brain surgery in children as much as it is in adults, and preservation of brain functions is critical in the light of the increased survival and the expectations in terms of quality of life. Intra-operative neurophysiology is the gold standard to localise and preserve brain functions during surgery and is increasingly used in paediatric neurosurgery. Yet, the developing nervous system has peculiar characteristics in terms of anatomical and physiological maturation, and some technical aspects need to be tailored for its use in children, especially in infants. This paper will review the most recent advances in the field of intra-operative neurophysiology (ION) techniques during brain surgery, focussing on those aspects that are relevant to the paediatric neurosurgery practice.

  19. Intra-operative multi-site stimulation: Expanding methodology for cortical brain mapping of language functions.

    Science.gov (United States)

    Gonen, Tal; Gazit, Tomer; Korn, Akiva; Kirschner, Adi; Perry, Daniella; Hendler, Talma; Ram, Zvi

    2017-01-01

    Direct cortical stimulation (DCS) is considered the gold-standard for functional cortical mapping during awake surgery for brain tumor resection. DCS is performed by stimulating one local cortical area at a time. We present a feasibility study using an intra-operative technique aimed at improving our ability to map brain functions which rely on activity in distributed cortical regions. Following standard DCS, Multi-Site Stimulation (MSS) was performed in 15 patients by applying simultaneous cortical stimulations at multiple locations. Language functioning was chosen as a case-cognitive domain due to its relatively well-known cortical organization. MSS, performed at sites that did not produce disruption when applied in a single stimulation point, revealed additional language dysfunction in 73% of the patients. Functional regions identified by this technique were presumed to be significant to language circuitry and were spared during surgery. No new neurological deficits were observed in any of the patients following surgery. Though the neuro-electrical effects of MSS need further investigation, this feasibility study may provide a first step towards sophistication of intra-operative cortical mapping.

  20. Intra-operative 3D imaging system for robot-assisted fracture manipulation.

    Science.gov (United States)

    Dagnino, G; Georgilas, I; Tarassoli, P; Atkins, R; Dogramadzi, S

    2015-01-01

    Reduction is a crucial step in the treatment of broken bones. Achieving precise anatomical alignment of bone fragments is essential for a good fast healing process. Percutaneous techniques are associated with faster recovery time and lower infection risk. However, deducing intra-operatively the desired reduction position is quite challenging due to the currently available technology. The 2D nature of this technology (i.e. the image intensifier) doesn't provide enough information to the surgeon regarding the fracture alignment and rotation, which is actually a three-dimensional problem. This paper describes the design and development of a 3D imaging system for the intra-operative virtual reduction of joint fractures. The proposed imaging system is able to receive and segment CT scan data of the fracture, to generate the 3D models of the bone fragments, and display them on a GUI. A commercial optical tracker was included into the system to track the actual pose of the bone fragments in the physical space, and generate the corresponding pose relations in the virtual environment of the imaging system. The surgeon virtually reduces the fracture in the 3D virtual environment, and a robotic manipulator connected to the fracture through an orthopedic pin executes the physical reductions accordingly. The system is here evaluated through fracture reduction experiments, demonstrating a reduction accuracy of 1.04 ± 0.69 mm (translational RMSE) and 0.89 ± 0.71 ° (rotational RMSE).

  1. Comparison of pre-operative dGEMRIC imaging with intra-operative findings in femoroacetabular impingement: preliminary findings

    International Nuclear Information System (INIS)

    Bittersohl, Bernd; Apprich, Sebastian; Siebenrock, Klaus A.; Mamisch, Tallal Charles; Hosalkar, Harish S.; Werlen, Stefan A.

    2011-01-01

    To study standard MRI and dGEMRIC in patients with symptomatic FAI undergoing surgical intervention and compare them with intra-operative findings to see if they were corroborative. Sixteen patients with symptomatic FAI that warranted surgical intervention were prospectively studied. All patients underwent plain radiographic series for FAI assessment followed by standard MRI and dGEMRIC. Subsequently, patients were surgically treated with safe dislocation and the joint was evaluated for any macroscopic signs of damaged cartilage. Data were statistically analyzed. A total of 224 zones in 16 patients were evaluated. One hundred and sixteen zones were intra-operatively rated as normal with mean T1 values of 510.1 ms ± 141.2 ms. Eighty zones had evidence of damage with mean T1 values of 453.1 ms ± 113.6 ms. The difference in these T1 values was significant (p = 0.003). Correlation between standard MRI and intra-operative findings was moderate (r = 0.535, p < 0.001). Intra-operative findings revealed more damage than standard MRI. On standard MRI, 68.6% zones were graded normal while 31.4% had evidence of damage. On intra-operative visualization, 56.4% zones were graded normal and 43.6% had evidence of damage. Correlation between dGEMRIC and intra-operative findings turned out to be weak (r = 0.114, p < 0.126). On T1 assessment 31.4% of zones were graded as normal and 68.6% as damaged. dGEMRIC was significantly different between normal and affected cartilage based on intra-operative assessment. The correlation for morphological findings was limited, underestimating defects. By combining morphological with biochemical assessment dGEMRIC may play some role in the future to prognosticate outcomes and facilitate surgical planning and intervention. (orig.)

  2. Intra-operative monitoring of the common peroneal nerve during total knee replacement.

    Science.gov (United States)

    Unwin, A J; Thomas, M

    1994-01-01

    We present a method allowing intra-operative monitoring of the common peroneal nerve during total knee arthroplasty using a magnetic stimulator. Previous reports have shown no pre-operative method successful in selecting those patients prone to develop a post-operative palsy. The device, placed beneath the lumbar spine, stimulates the cauda equina; common peroneal nerve function is assessed via the response in extensor digitorum brevis. There is a loss of signal from the nerve with the use of a tourniquet 25 min following its application. The protocol therefore requires that a tourniquet is used at least only for fixation of the prosthetic components. The method is quick, safe, non-invasive and reproducible, and is of use both in at-risk patients and in research work. Images Figure 6. PMID:7837197

  3. Intra-Operative Amylase Concentration in Peri-Pancreatic Fluid Predicts Pancreatic Fistula After Distal Pancreatectomy.

    Science.gov (United States)

    Nahm, Christopher B; de Reuver, Philip R; Hugh, Thomas J; Pearson, Andrew; Gill, Anthony J; Samra, Jaswinder S; Mittal, Anubhav

    2017-06-01

    Post-operative pancreatic fistula (POPF) is a potentially severe complication following distal pancreatectomy. The aim of this study was to assess the predictive value of intra-operative amylase concentration (IOAC) in peri-pancreatic fluid after distal pancreatectomy for the diagnosis of POPF. Consecutive patients who underwent a distal pancreatectomy between November 2014 and September 2016 were included in the analysis. IOAC was measured, followed by drain fluid analysis for amylase on post-operative days (PODs) 1, 3, and 5. Receiver operator characteristic (ROC) analysis was performed to evaluate the discriminative capacity of IOAC as a predictor of POPF. IOAC was measured after distal pancreatectomy in 26 patients. The IOAC correlated significantly with (i) PODs 1, 3, and 5 drain amylase (p  1000 experienced a post-operative complication (OR 18.3, 95% CI 2.51-103, p pancreatectomy.

  4. Intra-operative application of optical coherence tomography with an operating microscope.

    Science.gov (United States)

    Just, T; Lankenau, E; Hüttmann, G; Pau, H W

    2009-09-01

    To introduce the use of optical coherence tomography with an operating microscope for intra-operative evaluation of the human larynx. A specially equipped operating microscope with integrated spectral domain optical coherence tomography apparatus was used during microlaryngoscopy. Technical improvements in optical coherence tomography equipment (e.g. pilot beam, variable focal distance, improved image quality and integration into an operating microscope) have enabled greater sensitivity and imaging speed and a non-contact approach. Spectral domain optical coherence tomography now enables a better correlation between optical coherence tomography images and histological findings. With this new technology, the precision of biopsy can be improved during microlaryngoscopy. Use of this new optical coherence tomography technology, integrated into an operating microscope, enables the surgeon to define the biopsy site location and resection plane precisely, while the optical zoom of the operating microscope can be used over the complete range.

  5. A standardized and safe method of sterile field maintenance during intra-operative horizontal plane fluoroscopy

    Directory of Open Access Journals (Sweden)

    Kaska Serge C

    2010-12-01

    Full Text Available Abstract Background Intra-operative fluoroscopy for orthopaedic procedures frequently involves imaging in the horizontal plane, which requires the lower portion of the C-arm (x-ray tube to be rotated from an unsterile zone (beneath the table into the sterile field. To protect the integrity of the sterile field the C-arm must be draped repeatedly throughout the surgical case. The current, un-standardized, practice employs draping procedures which violate the Association of peri-Operative Registered Nurses (AORN Standards and Recommended Practices, waste time and material, and pose an increased risk for surgical site infection. Presentation of the hypothesis Use of a novel sterile C-arm drape (C-armor that maintains the integrity of the sterile field, will improve operating room efficiency and reduce surgical site infection risk factors. This reduction in risk factors may potentially reduce surgical site infections in orthopaedic surgical cases requiring repeated horizontal x-ray imaging. Testing the Hypothesis Savings in time and material and the reduction in surgical site infection risk factors afforded by using C-armor are intuitive to those skilled in the practice of orthopaedic surgery. Testing for a reduction in the number of microorganisms introduced to the surgical site by improved C-arm draping would be challenging due to the multiple confounding factors during a surgical operation. Determination of an absolute reduction in surgical site infections may be possible, but will require accounting for many confounding variables and a large study sample in order to achieve statistical significance. Implications of the Hypothesis Improved intraoperative workflow, healthcare savings and a reduction in surgical site infection risk factors will be achieved by utilizing a standardized and safe method of sterile field maintenance during intra-operative horizontal plane fluoroscopy.

  6. Intra-operative Ultrasound as a Tool to Assess Free Borders of Primary Vascular Aortic Tumors During Resection

    Directory of Open Access Journals (Sweden)

    R.M. Andersen

    Full Text Available : Introduction: Primary vascular tumors are rare and, in general, have a poor prognosis. Complete resection is associated with a better prognosis. Radical resection depends on safe discrimination of tumor borders. Technical summary: A 54 year old woman presented with abdominal pain. Imaging revealed a mass in the thoracic aorta, highly suspicious of angiosarcoma which was confirmed post-operatively by histological analysis. Open surgery was performed. Prior to clamping of the aorta, intra-operative ultrasound established clear delineation of the tumor borders. Conclusion: Intra-operative ultrasound was, in this case, a safe and easy method to determine the tumor borders, providing a simple guide to in toto tumor removal. Keywords: Angiosarcoma, Intra-operative ultrasound, In toto tumor removal, Fludeoxyglucose positron emission tomography/computed tomography, Magnetic resonance imaging

  7. Intra-operative nuclear imaging based on positron-emitting radiotracers

    International Nuclear Information System (INIS)

    Shakir, Dzhoshkun Ismail

    2014-01-01

    Positron-emitting radiotracers are an important part of nuclear medical imaging processes. Besides the very famous glucose analog [ 18 F]FDG, many not so well known ones exist, among them the particularly interesting amino acid-based tracers like [ 18 F]FET. Although peri-operative imaging with positron-emitting radiotracers has become state-of- the-art in cases of many types of cancer, their capability is not fully exploited in the operating room yet. In this thesis we explore two intra-operative nuclear imaging modalities exploiting different aspects of positron radiation towards quality assurance in challenging surgical treatment scenarios. The first modality freehand PET provides a tomographic image of a volume of interest and aims at minimizing invasiveness by assisting the surgeon in pinpointing target structures marked with a radiotracer. The second imaging modality epiphanography generates an image of the radiotracer distribution on a surface of interest and aims at providing a means for improving the control of tumor resection margins. The word epiphanography is a compound of the Greek words επιφανεια (epiphaneia) for surface and ζωγραφια (ographia) for image, and hence means the image of the surface similar to the compound τομοζ (tomos) for slice/volume and ζωγραφια (ographia) for image, meaning the image of the volume, i.e. tomography. To our knowledge this is the first use of the word epiphanography in the context of nuclear medical imaging. In this thesis we present our approach to modeling, developing and calibrating these two novel imaging modalities. In addition, we present our work towards their clinical integration. In the case of freehand PET, we have already acquired the first intra-operative datasets of a patient. We present this first experience in the operating room together with our phantom studies. In the case of epiphanography, we present our phantom studies with neurosurgeons towards the integration of this

  8. Intra-operative warming with a forced-air warmer in preventing hypothermia after tourniquet deflation in elderly patients.

    Science.gov (United States)

    Kim, Y-S; Jeon, Y-S; Lee, J-A; Park, W-K; Koh, H-S; Joo, J-D; In, J-H; Seo, K-W

    2009-01-01

    This randomized, single-blind study aimed to explore the effects of intra-operative warming with a forced-air warmer in the prevention of hypothermia after tourniquet deflation in elderly patients undergoing unilateral total knee replacement arthroplasty under general anaesthesia. Patients were randomized to receive either intra-operative warming using a forced-air warmer with an upper body blanket (warming group; n = 12) or no intra-operative warming (nonwarming group; n = 12). Oesophageal temperature was measured as core body temperature. At 30 min following tourniquet inflation, the core body temperature started to increase in the warming group whereas it continued to drop in the non-warming group. This difference was statistically significant. The final core body temperature after tourniquet deflation was significantly higher in the warming group (mean +/- SD 36.1 +/- 0.2 degrees C) than in the non-warming group (35.4 +/- 0.3 degrees C). Intra-operative forced-air warming increased the core body temperature before tourniquet deflation and prevented subsequent hypothermia in elderly patients under general anaesthesia.

  9. Comparison of preoperative computerized tomography scan imaging of temporal bone with the intra-operative findings in patients undergoing mastiodectomy

    International Nuclear Information System (INIS)

    Gerami, H.; Naghavi, E.; Wahabi-Moghadam, M.; Forghanparast, K.; Akbar, Manzar H.

    2009-01-01

    Objective was to compare the consistency rates of pre- and intra-operative radiological findings in patients with chronic suppurative otitis media (CSOM). In a cross-sectional study, 80 patients with CSOM underwent pre-operative CT scanning and we compared the results with intra-operative clinical findings during mastiodectomy from 2000-2004 in the Otology Department, Amiralmomenin Hospital of Guilan Medical University, Rasht, Iran. Sensitivity, specificity, positive and negative predictive value of CT scan in tympanic and mastoid cholesteatoma, ossicular chain erosion, tegmentympani erosion, dehiscence of facial canal, lateral semicircular canal (LSCC) fistula were assessed. Then, correlation between radiological findings and intra-operative findings were calculated. The mean age of patients was 27.9+-16.3 years. Mostly were males (n=57 [71.3%]). Correlation of preoperative radiological images with intra-operative clinical findings were moderate to good on tympanic cholesteatoma, mastoid cholesteatoma and ossicular chain erosion, but weak and insignificant in cases of tegmen erosion, facial canal dehiscene and LSCC fistulae. Preoperative CT scan may be helpful in decision-making for surgery in cases of cholesteatoma and ossicular erosion. Despite of limitations radiological scanning is a useful adjunct to management of CSOM. (author)

  10. The ultrastructure of tumor cells in patients with rectal cancer after pre-operative irradiation and intra-operative cryotherapy

    International Nuclear Information System (INIS)

    Vyinnik, Yu.O.; Kotenko, O.Je.; Nevzorov, V.P.; Chyibyisov, L.P.

    2000-01-01

    Electronic microscopy of the tumor cells was performed to confirm the efficacy of combined pre-operative gamma-therapy and intraoperative cryotherapy (CT). Pre-operative irradiation at the dose of 20 Gy accompanied by intra-operative cryotherapy caused the changes in the ultrastructure, the depth and degree of which allow to consider them destructive and irreversible

  11. Lymphoscintigraphy and intra-operative gamma probe in detection of sentinel lymph node for breast cancer surgery

    International Nuclear Information System (INIS)

    Le Ngoc Ha; Le Manh Ha; Bui Quang Bieu

    2011-01-01

    Sentinel lymph node biopsy (SLNB) has been emerged as a highly accurate method of axillary staging in management of breast cancer patients. Sentinel lymph node detection (SLND) by lymphoscintigraphy and intra-operative gamma probe for SLNB have been widely used in the world. Objectives: the purpose of our study was to evaluate the result of techniques using lymphoscintigraphy and intra-operative gamma probe for SLND in breast carcinoma patients. Materials and Methods: 102 patients with early breast carcinoma were enrolled in the study. Lymphoscintigraphy using Tc-99m-human serum albumin colloid, intra-operative gamma probe were undergone for localization and SLNB. Total axillary lymph node was dissected in breast cancer surgery. Results: The success rate of lymphoscintigraphy and SLND was 98.0% (100/102 patients), mean number of sentinel lymph node (SLN)/patient was 1.56 ± 0.79 (ranged 1 - 3), number of lymphatic vessel/SLN was 1.5 ± 0.69 (ranged 1 - 4) and mean time for SLND on lymphoscintigraphy was 4.21 ± 13.4 minutes (2 - 15 minutes). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of radio-guided SLNB for axillary staging was 100%, 70.6%, 41.2%, 100% and 75.6 % respectively. Conclusions: radio-guided SLNB by lymphoscintigraphy and intra-operative gamma probe is feasible and reliable for axillary staging in early breast carcinoma patients. (author)

  12. Intra-operative ultrasound-based augmented reality guidance for laparoscopic surgery.

    Science.gov (United States)

    Singla, Rohit; Edgcumbe, Philip; Pratt, Philip; Nguan, Christopher; Rohling, Robert

    2017-10-01

    In laparoscopic surgery, the surgeon must operate with a limited field of view and reduced depth perception. This makes spatial understanding of critical structures difficult, such as an endophytic tumour in a partial nephrectomy. Such tumours yield a high complication rate of 47%, and excising them increases the risk of cutting into the kidney's collecting system. To overcome these challenges, an augmented reality guidance system is proposed. Using intra-operative ultrasound, a single navigation aid, and surgical instrument tracking, four augmentations of guidance information are provided during tumour excision. Qualitative and quantitative system benefits are measured in simulated robot-assisted partial nephrectomies. Robot-to-camera calibration achieved a total registration error of 1.0 ± 0.4 mm while the total system error is 2.5 ± 0.5 mm. The system significantly reduced healthy tissue excised from an average (±standard deviation) of 30.6 ± 5.5 to 17.5 ± 2.4 cm 3 ( p < 0.05) and reduced the depth from the tumor underside to cut from an average (±standard deviation) of 10.2 ± 4.1 to 3.3 ± 2.3 mm ( p < 0.05). Further evaluation is required in vivo, but the system has promising potential to reduce the amount of healthy parenchymal tissue excised.

  13. [Inflammatory pseudotumour of the liver. Importance of intra-operative histopathology].

    Science.gov (United States)

    Onieva-González, Francisco Gabriel; Galeano-Díaz, Francisco; Matito-Díaz, María José; López-Guerra, Diego; Fernández-Pérez, Juana; Blanco-Fernández, Gerardo

    2015-01-01

    Inflammatory pseudotumour is a rare entity, considered benign, and characterised by inflammatory cell mesenchymal proliferation. The case is presented 70 year-old man with fever of unknown origin syndrome. He was diagnosed with liver abscesses (one segment IV, adjacent to gallbladder fundus and segment VI), who progressed slowly after antibiotic treatment. In the absence of a diagnosis, although fine needle puncture-aspiration and different imaging tests were performed, elective surgery was decided. The intra-operative histopathology reported the existence of an inflammatory pseudotumour. Inflammatory pseudotumours are clinically classified into different types according to their aetiology, varying therapeutic management based on the same. It is very difficult to diagnose because of the absence of symptoms, blood disorders, or specific radiological findings. Definitive diagnosis often requires histopathological confirmation, in most cases by percutaneous liver puncture, but sometimes exploratory laparotomy or even performing a hepatectomy for confirmation is necessary. The natural history of inflammatory pseudotumour is its regression; thus conservative management may be used through regular checks until resolution, or can be treated with antibiotics, anti-inflammatories and even corticosteroids. Surgical resection is indicated for persistent unresolved systemic symptoms despite medical treatment, in those situations where growth is evident, with or without symptoms, when involving the hepatic hilum, and finally, in case where the possibility of malignancy cannot be ruled out. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  14. An investigation into the causes of unexpected intra-operative transoesophageal echocardiography findings.

    Science.gov (United States)

    Skinner, H J; Mahmoud, A; Uddin, A; Mathew, T

    2012-04-01

    There is uncertainty regarding echocardiography before cardiac surgery, especially with regard to timing and disease progression as well as potential errors. We investigated the causes of unexpected intra-operative transoesophageal echocardiography findings by performing a 33-month audit. We found that there were 50/797 (6%) unexpected findings that led to an alteration in surgical strategy in 34 (4%) patients. Of the unexpected findings, 25 (50%) were unrelated to pre-operative pathology. After reviewing pre-operative studies and reports, unexpected findings were found to be due to: reporting errors in 20 patients (44%); limitations in transthoracic compared to transoesophageal echocardiography in 14 patients (30%); disease progression in 10 patients (22%); and inter-observer variability in two patients (4%). We identified six reports out of 797 (0.8%) that contained potentially serious errors. Surgical management changed in 18/20 (90%) patients in whom the unexpected change was due to reporting error, compared to 16/30 (53%) patients whose pre-operative echocardiogram was correctly reported (p = 0.006). Our study suggests that pre-operative echocardiography reporting errors are common and important. Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland.

  15. Automatic Adjustments of a Trans-oesophageal Ultrasound Robot for Monitoring Intra-operative Catheters

    Science.gov (United States)

    Wang, Shuangyi; Housden, James; Singh, Davinder; Rhode, Kawal

    2017-12-01

    3D trans-oesophageal echocardiography (TOE) has become a powerful tool for monitoring intra-operative catheters used during cardiac procedures in recent years. However, the control of the TOE probe remains as a manual task and therefore the operator has to hold the probe for a long period of time and sometimes in a radiation environment. To solve this problem, an add-on robotic system has been developed for holding and manipulating a commercial TOE probe. This paper focuses on the application of making automatic adjustments to the probe pose in order to accurately monitor the moving catheters. The positioning strategy is divided into an initialization step based on a pre-planning method and a localized adjustments step based on the robotic differential kinematics and related image servoing techniques. Both steps are described in the paper along with simulation experiments performed to validate the concept. The results indicate an error less than 0.5 mm for the initialization step and an error less than 2 mm for the localized adjustments step. Compared to the much bigger live 3D image volume, it is concluded that the methods are promising. Future work will focus on evaluating the method in the real TOE scanning scenario.

  16. Retrospective analysis of dose delivery in intra-operative high dose rate brachytherapy

    International Nuclear Information System (INIS)

    Oh, M.; Avadhani, J.S.; Malhotra, H.K.; Cunningham, B.; Tripp, P.; Jaggernauth, W.; Podgorsak, M.B.

    2007-01-01

    Background. This study was performed to quantify the inaccuracy in clinical dose delivery due to the incomplete scatter conditions inherent in intra-operative high dose rate (IOHDR) brachytherapy. Methods. Treatment plans of 10 patients previously treated in our facility, which had irregular shapes of treated areas, were used. Treatment geometries reflecting each clinical case were simulated using a phantom assembly with no added build-up on top of the applicator. The treatment planning geometry (full scatter surrounding the applicator) was subsequently simulated for each case by adding bolus on top of the applicator. Results. For geometries representing the clinical IOHDR incomplete scatter environment, measured doses at the 5 mm and 10 mm prescription depths were lower than the corresponding prescribed doses by about 7.7% and 11.1%, respectively. Also, for the two prescription methods, an analysis of the measured dose distributions and their corresponding treatment plans showed average decreases of 1.2 mm and 2.2 mm in depth of prescription dose, respectively. Conclusions. Dosimetric calculations with the assumption of an infinite scatter environment around the applicator and target volume have shown to result in dose delivery errors that significantly decrease the prescription depth for IOHDR treatment.(author)

  17. Agreement between pre-operative and intra-operative bacteriological samples in 85 chronic peri-prosthetic infections.

    Science.gov (United States)

    Matter-Parrat, V; Ronde-Oustau, C; Boéri, C; Gaudias, J; Jenny, J-Y

    2017-04-01

    Whether pre-operative microbiological sampling contributes to the management of chronic peri-prosthetic infection remains controversial. We assessed agreement between the results of pre-operative and intra-operative samples in patients undergoing single-stage prosthesis exchange to treat chronic peri-prosthetic infection. Agreement between pre-operative and intra-operative samples exceeds 75% in patients undergoing single-stage exchange of a hip or knee prosthesis to treat chronic peri-prosthetic infection. This single-centre retrospective study included 85 single-stage prosthesis exchange procedures in 82 patients with chronic peri-prosthetic infection at the hip or knee. Agreement between pre-operative and intra-operative sample results was evaluated. Changes to the initial antibiotic regimen made based on the intra-operative sample results were recorded. Of 149 pre-operative samples, 109 yielded positive cultures, in 75/85 cases. Of 452 intra-operative samples, 354 yielded positive cultures, in 85/85 cases. Agreement was complete in 54 (63%) cases and partial in 9 (11%) cases; there was no agreement in the remaining 22 (26%) cases. The complete agreement rate was significantly lower than 75% (P=0.01). The initial antibiotic regimen was inadequate in a single case. Pre-operative sampling may contribute to the diagnosis of peri-prosthetic infection but is neither necessary nor sufficient to confirm the diagnosis and identify the causative agent. The spectrum of the initial antibiotic regimen cannot be safely narrowed based on the pre-operative sample results. We suggest the routine prescription of a probabilistic broad-spectrum antibiotic regimen immediately after the prosthesis exchange, even when a pathogen was identified before surgery. IV, retrospective study. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  18. Dose optimization of intra-operative high dose rate interstitial brachytherapy implants for soft tissue sarcoma

    Directory of Open Access Journals (Sweden)

    Jamema Swamidas

    2009-01-01

    Full Text Available Objective : A three dimensional (3D image-based dosimetric study to quantitatively compare geometric vs. dose-point optimization in combination with graphical optimization for interstitial brachytherapy of soft tissue sarcoma (STS. Materials and Methods : Fifteen consecutive STS patients, treated with intra-operative, interstitial Brachytherapy, were enrolled in this dosimetric study. Treatment plans were generated using dose points situated at the "central plane between the catheters", "between the catheters throughout the implanted volume", at "distances perpendicular to the implant axis" and "on the surface of the target volume" Geometrically optimized plans had dose points defined between the catheters, while dose-point optimized plans had dose points defined at a plane perpendicular to the implant axis and on the target surface. Each plan was graphically optimized and compared using dose volume indices. Results : Target coverage was suboptimal with coverage index (CI = 0.67 when dose points were defined at the central plane while it was superior when the dose points were defined at the target surface (CI=0.93. The coverage of graphically optimized plans (GrO was similar to non-GrO with dose points defined on surface or perpendicular to the implant axis. A similar pattern was noticed with conformity index (0.61 vs. 0.82. GrO were more conformal and less homogeneous compared to non-GrO. Sum index was superior for dose points defined on the surface of the target and relatively inferior for plans with dose points at other locations (1.35 vs. 1.27. Conclusions : Optimization with dose points defined away from the implant plane and on target results in superior target coverage with optimal values of other indices. GrO offer better target coverage for implants with non-uniform geometry and target volume.

  19. A novel intra-operative positron imager for rapid localization of tumor margins

    Science.gov (United States)

    Sabet, Hamid; Stack, Brendan C.; Nagarkar, Vivek V.

    2014-03-01

    We have developed an intra-operative and compact imaging tool for surgeons to detect PET- positive lesions. Currently, most such probes on the market are non-imaging, and provide no ancillary information of surveyed areas, such as clear delineations of malignant tissues. Our probe consists of a novel hybrid scintillator coupled to a compact silicon photomultiplier (SiPM) array with associated front-end electronics encapsulated in an ergonomic housing. Pulse shape discrimination electronics has been implemented and integrated into the downstream data acquisition system. The hybrid scintillator consists of a 0.4 mm thick layer of CsI:Tl scintillator coupled to a 1 mm thick LYSO crystal. To achieve high spatial resolution, CsI:Tl is pixelated to 0.5×0.5 mm2 pixels using laser ablation technique. While CsI:Tl act as beta-sensitive scintillator, LYSO senses the gamma radiation and can be used to navigate the probe to the locations of interest. The gamma response is also subtracted from the beta image for improved SNR and contrast. To achieve accurate centroid position estimation and uniform beta sensitivity over the entire imaging area, the LYSO thickness is optimized such that it acts as scintillation light diffuser by spreading CsI:Tl light over multiple SiPM pixels. The results show that the response of the two scintillators exposed to radiation could be easily distinguished based on their pulse shapes. The probe's spatial resolution is beta radiation even in presence of strong gamma background.

  20. Protecting Patients from an Unsafe System: The Etiology & Recovery of Intra-Operative Deviations in Care

    Science.gov (United States)

    Hu, Yue-Yung; Arriaga, Alexander F.; Roth, Emilie M.; Peyre, Sarah E.; Corso, Katherine A.; Swanson, Richard S.; Osteen, Robert T.; Schmitt, Pamela; Bader, Angela M.; Zinner, Michael J.; Greenberg, Caprice C.

    2012-01-01

    Objective To understand the etiology and resolution of unanticipated events in the operating room (OR). Background The majority of surgical adverse events occur intra-operatively. The OR represents a complex, high-risk system. The influence of different human, team, and organizational/environmental factors on safety and performance is unknown. Methods We video-recorded and transcribed 10 high-acuity operations, representing 43.7 hours of patient care. Deviations, defined as delays and/or episodes of decreased patient safety, were identified by majority consensus of a multidisciplinary team. Factors that contributed to each event and/or mitigated its impact were determined and attributed to the patient, providers, or environment/organization. Results Thirty-three deviations (10 delays, 17 safety compromises, 6 both) occurred – with a mean of one every 79.4 minutes. These deviations were multifactorial (mean 3.1 factors). Problems with communication and organizational structure appeared repeatedly at the root of both types of deviations. Delays tended to be resolved with vigilance, communication, coordination, and cooperation, while mediation of safety compromises was most frequently accomplished with vigilance, leadership, communication, and/or coordination. The organization/environment was not found to play a direct role in compensation. Conclusions Unanticipated events are common in the OR. Deviations result from poor organizational/environmental design and suboptimal team dynamics, with caregivers compensating to avoid patient harm. While recognized in other high risk domains, such human resilience has not yet been described in surgery and has major implications for the design of safety interventions. PMID:22750753

  1. A novel intra-operative, high-resolution atrial mapping approach.

    Science.gov (United States)

    Yaksh, Ameeta; van der Does, Lisette J M E; Kik, Charles; Knops, Paul; Oei, Frans B S; van de Woestijne, Pieter C; Bekkers, Jos A; Bogers, Ad J J C; Allessie, Maurits A; de Groot, Natasja M S

    2015-12-01

    A new technique is demonstrated for extensive high-resolution intra-operative atrial mapping that will facilitate the localization of atrial fibrillation (AF) sources and identification of the substrate perpetuating AF. Prior to the start of extra-corporal circulation, a 8 × 24-electrode array (2-mm inter-electrode distance) is placed subsequently on all the right and left epicardial atrial sites, including Bachmann's bundle, for recording of unipolar electrograms during sinus rhythm and (induced) AF. AF is induced by high-frequency pacing at the right atrial free wall. A pacemaker wire stitched to the right atrium serves as a reference signal. The indifferent pole is connected to a steal wire fixed to subcutaneous tissue. Electrograms are recorded by a computerized mapping system and, after amplification (gain 1000), filtering (bandwidth 0.5-400 Hz), sampling (1 kHz) and analogue to digital conversion (16 bits), automatically stored on hard disk. During the mapping procedure, real-time visualization secures electrogram quality. Analysis will be performed offline. This technique was performed in 168 patients of 18 years and older, with coronary and/or structural heart disease, with or without AF, electively scheduled for cardiac surgery and a ventricular ejection fraction above 40 %. The mean duration of the entire mapping procedure including preparation time was 9 ± 2 min. Complications related to the mapping procedure during or after cardiac surgery were not observed. We introduce the first epicardial atrial mapping approach with a high resolution of ≥1728 recording sites which can be performed in a procedure time of only 9±2 mins. This mapping technique can potentially identify areas responsible for initiation and persistence of AF and hopefully can individualize both diagnosis and therapy of AF.

  2. High-dose rate intra-operative radiation therapy for local advanced and recurrent colorectal cancer

    International Nuclear Information System (INIS)

    Harrison, L.B.; Mychalczak, B.; Enker, W.; Anderson, L.; Cohen, A.E.; Minsky, B.

    1996-01-01

    In an effort to improve the local control for advanced and recurrent cancers of the rectum, we have integrated high-dose rate intra-operative radiation therapy (HDR-IORT) into the treatment program. Between 11/92 and 10/95, 47 patients (pts) were treated. There were 26 males and 21 females whose ages ranged from 30-80 (median = 62) years. There were 19 pts with primary unresectable rectal cancer, and 28 pts who were treated for recurrent rectal cancer. Histology was adenocarcinoma - 45 pts, squamous cancer - 2 pts. The range of follow-up is 1-34 months (median = 14 months). The majority of primary unresectable pts received pre-operative radiation therapy (4500-5040 cGy) with chemotherapy (5-FU with Leucovorin) 4-6 weeks later, they underwent resection + HDR-IORT (1200 cGy). For the 28 pts with recurrent cancer, the majority received surgery and HDR-IORT alone because they had received prior RT. For the pts with primary unresectable disease, actuarial 2-year local control was 77%, actuarial distant metastasis-free survival was 71%, disease free survival was 66%, and overall survival was 84%. For those pts with recurrent disease, actuarial 2-year local control rate was 65%, distant metastasis-free survival was 65%, disease free survival was 47%, and overall survival was 61%. Complications occurred in 36%. There were no cases where the anatomical distribution of disease, or technical limitations prevented the adequate delivery of HDR-IORT. We conclude that this technique was most versatile, and enabled all appropriate pts to receive IORT. The preliminary data in terms of local control are encouraging, even for the poor prognostic sub-group of pts with recurrent cancer

  3. Potential predictors for the amount of intra-operative brain shift during deep brain stimulation surgery

    Science.gov (United States)

    Datteri, Ryan; Pallavaram, Srivatsan; Konrad, Peter E.; Neimat, Joseph S.; D'Haese, Pierre-François; Dawant, Benoit M.

    2011-03-01

    A number of groups have reported on the occurrence of intra-operative brain shift during deep brain stimulation (DBS) surgery. This has a number of implications for the procedure including an increased chance of intra-cranial bleeding and complications due to the need for more exploratory electrodes to account for the brain shift. It has been reported that the amount of pneumocephalus or air invasion into the cranial cavity due to the opening of the dura correlates with intraoperative brain shift. Therefore, pre-operatively predicting the amount of pneumocephalus expected during surgery is of interest toward accounting for brain shift. In this study, we used 64 DBS patients who received bilateral electrode implantations and had a post-operative CT scan acquired immediately after surgery (CT-PI). For each patient, the volumes of the pneumocephalus, left ventricle, right ventricle, third ventricle, white matter, grey matter, and cerebral spinal fluid were calculated. The pneumocephalus was calculated from the CT-PI utilizing a region growing technique that was initialized with an atlas-based image registration method. A multi-atlas-based image segmentation method was used to segment out the ventricles of each patient. The Statistical Parametric Mapping (SPM) software package was utilized to calculate the volumes of the cerebral spinal fluid (CSF), white matter and grey matter. The volume of individual structures had a moderate correlation with pneumocephalus. Utilizing a multi-linear regression between the volume of the pneumocephalus and the statistically relevant individual structures a Pearson's coefficient of r = 0.4123 (p = 0.0103) was found. This study shows preliminary results that could be used to develop a method to predict the amount of pneumocephalus ahead of the surgery.

  4. MO-E-BRD-03: Intra-Operative Breast Brachytherapy: Is One Stop Shopping Best?

    International Nuclear Information System (INIS)

    Libby, B.

    2015-01-01

    Is Non-invasive Image-Guided Breast Brachytherapy Good? – Jess Hiatt, MS Non-invasive Image-Guided Breast Brachytherapy (NIBB) is an emerging therapy for breast boost treatments as well as Accelerated Partial Breast Irradiation (APBI) using HDR surface breast brachytherapy. NIBB allows for smaller treatment volumes while maintaining optimal target coverage. Considering the real-time image-guidance and immobilization provided by the NIBB modality, minimal margins around the target tissue are necessary. Accelerated Partial Breast Irradiation in brachytherapy: is shorter better? - Dorin Todor, PhD VCU A review of balloon and strut devices will be provided together with the origins of APBI: the interstitial multi-catheter implant. A dosimetric and radiobiological perspective will help point out the evolution in breast brachytherapy, both in terms of devices and the protocols/clinical trials under which these devices are used. Improvements in imaging, delivery modalities and convenience are among the factors driving the ultrashort fractionation schedules but our understanding of both local control and toxicities associated with various treatments is lagging. A comparison between various schedules, from a radiobiological perspective, will be given together with a critical analysis of the issues. to review and understand the evolution and development of APBI using brachytherapy methods to understand the basis and limitations of radio-biological ‘equivalence’ between fractionation schedules to review commonly used and proposed fractionation schedules Intra-operative breast brachytherapy: Is one stop shopping best?- Bruce Libby, PhD. University of Virginia A review of intraoperative breast brachytherapy will be presented, including the Targit-A and other trials that have used electronic brachytherapy. More modern approaches, in which the lumpectomy procedure is integrated into an APBI workflow, will also be discussed. Learning Objectives: To review past and current

  5. Relevance of intra operative radiotherapy in the treatment of uterine carcinoma - Lyon preliminary experience

    International Nuclear Information System (INIS)

    Gerard, J.P.; Braillon, G.; Gilly, F.N.; Romestaing, P.; Sentenac, I.; Rocher, F.P.; Berger, C.; Chipier, V.; Dargent, D.; Chabert, P.; Raudrant, D.; Adeleine, P.

    1994-01-01

    Aim: Retrospective analysis of Intra operative Radiotherapy (IORT) in recurrent uterine carcinoma (RUC) and prospective pilot study of IORT in advanced cervix cancer (ACC) with high risk of local failure. Patients-Treatments: (1) RUC: from 1988 to 1991, 34 patients with RUC have been treated. Primary cancer was: cervix uterus: 28, endometrium: six. Site of recurrence: centro pelvis: four, latero pelvis: 25, lombo aortic: five. Total gross resection was only possible in 12 patients. A dose of 15 to 22 Gy was given by IORT according to the residual tumour size. External beam irradiation was added in 16 patients; (2) ACC: January 1991 to November 1992, 20 patients were included in this pilot study, stage IIB: seven, stage III: 12, stage IV: 1. Preoperative retroperitoneal pelviscopy showed 13 pN1 patients and NMR imaging ten tumours of 6 cm or larger in diameter. Treatment started with concomitant pelvic irradiation (44 Gy) and one concomitant cycle of 5 Fu-CDDP, followed by a short course of high dose rate upper vagina brachytherapy (4Gy). Four weeks later a radical Wertheim operation was performed together with IORT on the lateral pelvis. Results: (1) RUC: overall survival (Kaplan Meier) at 4 years is 32% (±8). Local relapse in the field of IORT was observed in six patients. Grade 2-3 complications: six patients (radiation proctitis, neuritis, vertebral collapse, ureteral stenosis); (2) ACC: the median follow up is short (18 months). Four cases of pelvic relapse, no postoperative death. The first line radio chemotherapy was associated with two G3 early complications. Postoperative radiation complication was less than 10% G3. Discussion: promising results of IORT in RUC have been observed especially if no irradiation is given during the primary treatment. Good feasibility of the pilot study of IORT in ACC was also observed. It could be followed by a multicentric feasibility trial. (authors). 38 refs., 4 tabs., 1 fig

  6. Hemodynamic effects of dexmedetomidine during intra-operative electrocorticography for epilepsy surgery

    Directory of Open Access Journals (Sweden)

    G Chaitanya

    2014-01-01

    Full Text Available Background: Dexmedetomidine, a predominant alpha-2-adrenergic agonist has been used in anesthetic practice to provide good sedation. The drug is being recently used in neuroanesthesia during awake surgery for brain tumors and in functional neurosurgery. Materials and Methods: This prospective study analyzed the hemodynamic effects of dexmedetomidine infusion during electrocorticography in patients undergoing surgery for mesial temporal sclerosis. Dexmedetomidine infusion was administered during intra-operative electrocorticography recording, 15 minutes after the end tidal MAC of N 2 O and isoflurane were decreased to zero. Anesthesia was maintained with O 2 :air mixture = 50:50, vecuronium and fentanyl. Heart rate (HR, mean arterial pressure (MAP and end tidal carbon dioxide (ETCO 2 were recorded across at induction, 2 min prior to dexmedetomidine (PreDEX, 5 min during dexmedetomidine infusion (DEX; 1 μg/kg, 5 min after stopping dexmedetomidine and 10 minutes after stopping dexmedetomidine. Results: Forty patients with mesial temporal sclerosis (M: F = 27:13, mean age = 28.15 ± 10.9 years; duration of epilepsy = 12.0 ± 7.9 years underwent anterior temporal lobe resection with amygdalohippocampectomy for drug-resistant epilepsy. Infusion of dexmedetomidine caused a transient fall in HR in 87.5% of patients and an increase in MAP in 62.5% of patients, which showed a tendency to revert back towards PreDEX values within 10 min after stopping the infusion. Sixty-five percent of the patients showed ≤25% reduction and 10% of them showed >25% reduction in HR. 47.5% of the patients showed ≤25% increase and 15% of them showed >25% increase in MAP. These changes were over a narrow range and within physiological limits. Conclusion: The infusion of dexmedetomidine for a short period causes reduction of HR and increase in MAP in patients, however the variations are within acceptable range.

  7. Intra-operative adjustment of standard planes in C-arm CT image data.

    Science.gov (United States)

    Brehler, Michael; Görres, Joseph; Franke, Jochen; Barth, Karl; Vetter, Sven Y; Grützner, Paul A; Meinzer, Hans-Peter; Wolf, Ivo; Nabers, Diana

    2016-03-01

    With the help of an intra-operative mobile C-arm CT, medical interventions can be verified and corrected, avoiding the need for a post-operative CT and a second intervention. An exact adjustment of standard plane positions is necessary for the best possible assessment of the anatomical regions of interest but the mobility of the C-arm causes the need for a time-consuming manual adjustment. In this article, we present an automatic plane adjustment at the example of calcaneal fractures. We developed two feature detection methods (2D and pseudo-3D) based on SURF key points and also transferred the SURF approach to 3D. Combined with an atlas-based registration, our algorithm adjusts the standard planes of the calcaneal C-arm images automatically. The robustness of the algorithms is evaluated using a clinical data set. Additionally, we tested the algorithm's performance for two registration approaches, two resolutions of C-arm images and two methods for metal artifact reduction. For the feature extraction, the novel 3D-SURF approach performs best. As expected, a higher resolution ([Formula: see text] voxel) leads also to more robust feature points and is therefore slightly better than the [Formula: see text] voxel images (standard setting of device). Our comparison of two different artifact reduction methods and the complete removal of metal in the images shows that our approach is highly robust against artifacts and the number and position of metal implants. By introducing our fast algorithmic processing pipeline, we developed the first steps for a fully automatic assistance system for the assessment of C-arm CT images.

  8. Intra-operative parathyroid hormone monitoring through central laboratory is accurate in renal secondary hyperparathyroidism.

    Science.gov (United States)

    Vulpio, Carlo; Bossola, Maurizio; Di Stasio, Enrico; Pepe, Gilda; Nure, Eda; Magalini, Sabina; Agnes, Salvatore

    2016-05-01

    The usefulness, the methods and the criteria of intra-operative monitoring of the parathyroid hormone (ioPTH) during parathyroidectomy (PTX) for renal secondary hyperparathyroidism (rSHPT) in patients on chronic hemodialysis remain still matter of debate. The present study aimed to evaluate the ability of a low cost central-laboratory second generation PTH assay to predict an incomplete resection of parathyroid glands (PTG). The ioPTH decay was determined In 42 consecutive patients undergoing PTX (15 subtotal and 27 total without auto-transplant of PTG) for rSHPT. The ioPTH monitoring included five samples: pre-intubation, post-manipulation of PTG and at 10, 20 and 30min post-PTG excision. The patients with PTH exceeding the normal value (65pg/ml) at the first postoperative week, 6 and 12months were classified as persistent rSHPT. The concentrations of ioPTH declined significantly over time in patients who received total or subtotal PTX; however, no difference was found between the two types of PTX. Irrespective of the type of PTX and the number of PTG removed, combining the absolute and percentage of ioPTH decay at 30min after PTG excision, we found high sensitivity (100%), specificity (92%), negative predictive value (100%) and accuracy (93%) in predicting the persistence of rSHPT. The monitoring of the ioPTH decline by a low cost central-laboratory second generation assay is extremely accurate in predicting the persistence of disease in patients on maintenance hemodialysis undergoing surgery for rSHPT. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  9. Effects of intra-operative fluoroscopic 3D-imaging on peri-operative imaging strategy in calcaneal fracture surgery.

    Science.gov (United States)

    Beerekamp, M S H; Backes, M; Schep, N W L; Ubbink, D T; Luitse, J S; Schepers, T; Goslings, J C

    2017-12-01

    Previous studies demonstrated that intra-operative fluoroscopic 3D-imaging (3D-imaging) in calcaneal fracture surgery is promising to prevent revision surgery and save costs. However, these studies limited their focus to corrections performed after 3D-imaging, thereby neglecting corrections after intra-operative fluoroscopic 2D-imaging (2D-imaging). The aim of this study was to assess the effects of additional 3D-imaging on intra-operative corrections, peri-operative imaging used, and patient-relevant outcomes compared to 2D-imaging alone. In this before-after study, data of adult patients who underwent open reduction and internal fixation (ORIF) of a calcaneal fracture between 2000 and 2014 in our level-I Trauma center were collected. 3D-imaging (BV Pulsera with 3D-RX, Philips Healthcare, Best, The Netherlands) was available as of 2007 at the surgeons' discretion. Patient and fracture characteristics, peri-operative imaging, intra-operative corrections and patient-relevant outcomes were collected from the hospital databases. Patients in whom additional 3D-imaging was applied were compared to those undergoing 2D-imaging alone. A total of 231 patients were included of whom 107 (46%) were operated with the use of 3D-imaging. No significant differences were found in baseline characteristics. The median duration of surgery was significantly longer when using 3D-imaging (2:08 vs. 1:54 h; p = 0.002). Corrections after additional 3D-imaging were performed in 53% of the patients. However, significantly fewer corrections were made after 2D-imaging when 3D-imaging was available (Risk difference (RD) -15%; 95% Confidence interval (CI) -29 to -2). Peri-operative imaging, besides intra-operative 3D-imaging, and patient-relevant outcomes were similar between groups. Intra-operative 3D-imaging provides additional information resulting in additional corrections. Moreover, 3D-imaging probably changed the surgeons' attitude to rely more on 3D-imaging, hence a 15%-decrease of

  10. Framework for a low-cost intra-operative image-guided neuronavigator including brain shift compensation

    OpenAIRE

    Bucki, Marek; Lobos, Claudio; Payan, Yohan

    2007-01-01

    In this paper we present a methodology to address the problem of brain tissue deformation referred to as 'brain-shift'. This deformation occurs throughout a neurosurgery intervention and strongly alters the accuracy of the neuronavigation systems used to date in clinical routine which rely solely on pre-operative patient imaging to locate the surgical target, such as a tumour or a functional area. After a general description of the framework of our intra-operative image-guided system, we desc...

  11. Intra-operative X-ray diagnostics in the detection and localization of residual concretions in the kidney

    International Nuclear Information System (INIS)

    Soekeland, J.; Degenhardt, W.

    1979-01-01

    Problems of intra-operative X-ray diagnostics in the detection and localization of residual concretions in the kidney are discussed, together with the limitations of image-intensifier techniques, automatic exposure control, and the use of modified dental X-ray equipment. A technique using a film-screen combination and X-ray tube designed for mammography is discussed, together with its applications and possible future development. (Auth.)

  12. Use of auditory evoked potentials for intra-operative awareness in anesthesia: a consciousness-based conceptual model.

    Science.gov (United States)

    Dong, Xuebao; Suo, Puxia; Yuan, Xin; Yao, Xuefeng

    2015-01-01

    Auditory evoked potentials (AEPs) have been used as a measure of the depth of anesthesia during the intra-operative process. AEPs are classically divided, on the basis of their latency, into first, fast, middle, slow, and late components. The use of auditory evoked potential has been advocated for the assessment of Intra-operative awareness (IOA), but has not been considered seriously enough to universalize it. It is because we have not explored enough the impact of auditory perception and auditory processing on the IOA phenomena as well as on the subsequent psychological impact of IOA on the patient. More importantly, we have seldom tried to look at the phenomena of IOP from the perspective of consciousness itself. This perspective is especially important because many of IOA phenomena exist in the subconscious domain than they do in the conscious domain of explicit recall. Two important forms of these subconscious manifestations of IOA are the implicit recall phenomena and post-operative dreams related to the operation. Here, we present an integrated auditory consciousness-based model of IOA. We start with a brief description of auditory awareness and the factors affecting it. Further, we proceed to the evaluation of conscious and subconscious information processing by auditory modality and how they interact during and after intra-operative period. Further, we show that both conscious and subconscious auditory processing affect the IOA experience and both have serious psychological implications on the patient subsequently. These effects could be prevented by using auditory evoked potential during monitoring of anesthesia, especially the mid-latency auditory evoked potentials (MLAERs). To conclude our model with present hypothesis, we propose that the use of auditory evoked potential should be universal with general anesthesia use in order to prevent the occurrences of distressing outcomes resulting from both conscious and subconscious auditory processing during

  13. Intra-operative hemodialysis during liver transplantation: an expanded role of the nephrology nurse.

    Science.gov (United States)

    Henson, Angela; Carpenter, Sally

    2010-01-01

    Hemodialysis is widely acknowledged as a treatment option to stabilize acute medical conditions where biochemistry management is paramount. One of the most challenging situations is during liver transplantation, when patients with moderate renal dysfunction are likely to become acutely acidotic. For nephrology nurses, this extended role requires increased knowledge, advanced skills, and a high level of communication with unfamiliar team members. With appropriate procedures and a supportive environment, delivering such a service is feasible.

  14. SU-E-T-285: Revisiting the Nomogram for Intra-Operative Planning Based Pd-103 Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Narayanan, S; Cho, P [Virginia Mason Medical Center, Seattle, WA (United States)

    2014-06-01

    Purpose: The seed implant technique at our institution involves using a published nomogram for seed ordering based on CT based volume studies of the prostate. Ultrasound volume studies are subsequently used in the operating room for planning a modified peripheral loading with urethra sparing seed implant. The purpose of this study is to determine the appropriate modality for prostate volume measurement and creating an updated nomogram for intra-operative planning specific to our technique for pd-103 brachytherapy for efficient seed ordering. Methods: Prostate volumes based on pre-implant CT (Pre-CT), intra-operative ultrasound (TRUS), and post-implant CT (post-CT) studies as well as the total airkerma strength (AKS) of the implants were analyzed for 135 seed implant cases (69 monotherapy, 66 boost). Regression analysis was performed to derive the relationship between the total AKS and pre-CT and TRUS volumes. The correlation between TRUS and pre-CT volumes and TRUS and post-CT volumes were also studied. Results: Ultrasound based prostate volume exhibited a stronger correlation with total AKS than the pre-implant CT volume (R{sup 2} = 0.97 vs 0.88 for monotherapy and 0.96 vs 0.89 for boost). In general the pre-CT overestimated the prostate volume leading to ordering of a larger number of seeds and thus leading to higher number of unused/wasted seeds. Newly derived TRUS based nomogram was better suited for our technique than the published data. The post-implant CT volume closely followed the ultrasound volume (R{sup 2} = 0.88) as compared to pre-implant CT volumes (R{sup 2} = 0.57). Conclusion: In an era of costconscious health care where waste reduction is of utmost importance, an updated technique-specific nomogram is useful for ordering optimal number of seeds resulting in significant cost savings. In addition, our study shows that ultrasound based prostate volume is a better predictor for seed ordering for intra-operative planning than pre-implant CT.

  15. Intra-operative cone beam computed tomography can help avoid reinterventions and reduce CT follow up after infrarenal EVAR.

    Science.gov (United States)

    Törnqvist, P; Dias, N; Sonesson, B; Kristmundsson, T; Resch, T

    2015-04-01

    Re-interventions after endovascular abdominal aortic aneurysm repair (EVAR) are common and therefore a strict imaging follow up protocol is required. The purpose of this study was to evaluate whether cone beam computed tomography (CBCT) can detect intra-operative complications and to compare this with angiography and the 1 month CT follow up (computed tomography angiography [CTA]). Fifty-one patients (44 men) were enrolled in a prospective trial. Patients underwent completion angiography and CBCT during infrarenal EVAR. Contrast was used except when pre-operative renal insufficiency was present or if the maximum contrast dose threshold was reached. CBCT reconstruction included the top of the stent graft to the iliac bifurcation. Endoleaks, kinks, or compressions were recorded. CBCT was technically successful in all patients. Twelve endoleaks were detected on completion digital subtraction angiography (CA). CBCT detected 4/5 type 1 endoleaks, but only one type 2 endoleak. CTA identified eight type 2 endoleaks and one residual type I endoleak. Two cases of stent compression were seen on CA. CBCT revealed five stent compressions and one kink, which resulted in four intra-operative adjunctive manoeuvres. CTA identified all cases of kinks or compressions that were left untreated. Two of them were corrected later. No additional kinks/compressions were found on CTA. Groin closure consisted of 78 fascia sutures, nine cut downs, and 11 percutaneous sutures. Seven femoral artery pseudoaneurysms (<1 cm) were detected on CTA, but no intervention was needed. CA is better than CBCT in detecting and categorizing endoleaks but CBCT (with or without contrast) is better than CA for detection of kinks or stentgraft compression. CTA plus CBCT identified all significant complications noted on the 1 month follow up CTA. The use of intra-operative CA and CBCT could replace early CTA after standard EVAR thus reducing overall radiation and contrast use. Technical development might further

  16. A Novel Stress-Diathesis Model to Predict Risk of Post-operative Delirium: Implications for Intra-operative Management

    Directory of Open Access Journals (Sweden)

    Renée El-Gabalawy

    2017-08-01

    Full Text Available Introduction: Risk assessment for post-operative delirium (POD is poorly developed. Improved metrics could greatly facilitate peri-operative care as costs associated with POD are staggering. In this preliminary study, we develop a novel stress-diathesis model based on comprehensive pre-operative psychiatric and neuropsychological testing, a blood oxygenation level-dependent (BOLD magnetic resonance imaging (MRI carbon dioxide (CO2 stress test, and high fidelity measures of intra-operative parameters that may interact facilitating POD.Methods: The study was approved by the ethics board at the University of Manitoba and registered at clinicaltrials.gov as NCT02126215. Twelve patients were studied. Pre-operative psychiatric symptom measures and neuropsychological testing preceded MRI featuring a BOLD MRI CO2 stress test whereby BOLD scans were conducted while exposing participants to a rigorously controlled CO2 stimulus. During surgery the patient had hemodynamics and end-tidal gases downloaded at 0.5 hz. Post-operatively, the presence of POD and POD severity was comprehensively assessed using the Confusion Assessment Measure –Severity (CAM-S scoring instrument on days 0 (surgery through post-operative day 5, and patients were followed up at least 1 month post-operatively.Results: Six of 12 patients had no evidence of POD (non-POD. Three patients had POD and 3 had clinically significant confusional states (referred as subthreshold POD; ST-POD (score ≥ 5/19 on the CAM-S. Average severity for delirium was 1.3 in the non-POD group, 3.2 in ST-POD, and 6.1 in POD (F-statistic = 15.4, p < 0.001. Depressive symptoms, and cognitive measures of semantic fluency and executive functioning/processing speed were significantly associated with POD. Second level analysis revealed an increased inverse BOLD responsiveness to CO2 pre-operatively in ST-POD and marked increase in the POD groups when compared to the non-POD group. An association was also noted for

  17. Utility of intra-operative ultrasound in choosing the appropriate site for blood pressure monitoring in Takayasu′s arteritis

    Directory of Open Access Journals (Sweden)

    Prasad Krishnamurthy Narasimha

    2013-01-01

    Full Text Available Takayasu′s arteritis (TA is rare, chronic progressive, pan-endarteritis involving the aorta and its main branches, with a specific predilection for young Asian women. Anaesthesia for TA patients is complicated by their severe uncontrolled hypertension, extreme arterial blood pressure differentials, aortic regurgitation (AR, end-organ dysfunction, stenosis/aneurysms of major blood vessels and difficulties encountered in monitoring arterial blood pressure. We present the usefulness of ultrasound during anaesthetic management of a 35-year-old woman posted for emergency caesarean section due to intra-uterine growth retardation, foetal tachycardia in active labour, who was already diagnosed to have TA along with moderate AR and uncontrolled hypertension, using epidural technique. The use of intra-operative doppler helped resolve the initial dilemma about the diagnosis and treatment of the differential blood pressure between the affected and the normal upper limb in the absence of prior arteriogram.

  18. Framework for a low-cost intra-operative image-guided neuronavigator including brain shift compensation.

    Science.gov (United States)

    Bucki, M; Lobos, C; Payan, Y

    2007-01-01

    In this paper we present a methodology to address the problem of brain tissue deformation referred to as 'brain-shift'. This deformation occurs throughout a neurosurgery intervention and strongly alters the accuracy of the neuronavigation systems used to date in clinical routine which rely solely on pre-operative patient imaging to locate the surgical target, such as a tumour or a functional area. After a general description of the framework of our intra-operative image-guided system, we describe a procedure to generate patient specific finite element meshes of the brain and propose a biomechanical model which can take into account tissue deformations and surgical procedures that modify the brain structure, like tumour or tissue resection.

  19. Randomized trial for superiority of high field strength intra-operative magnetic resonance imaging guided resection in pituitary surgery.

    Science.gov (United States)

    Tandon, Vivek; Raheja, Amol; Suri, Ashish; Chandra, P Sarat; Kale, Shashank S; Kumar, Rajinder; Garg, Ajay; Kalaivani, Mani; Pandey, Ravindra M; Sharma, Bhawani S

    2017-03-01

    Till date there are no randomized trials to suggest the superiority of intra-operative magnetic resonance imaging (IOMRI) guided trans-sphenoidal pituitary resection over two dimensional fluoroscopic (2D-F) guided resections. We conducted this trial to establish the superiority of IOMRI in pituitary surgery. Primary objective was to compare extent of tumor resection between the two study arms. It was a prospective, randomized, outcome assessor and statistician blinded, two arm (A: IOMRI, n=25 and B: 2D-F, n=25), parallel group clinical trial. 4 patients from IOMRI group cross-over to 2D-F group and were consequently analyzed in latter group, based on modified intent to treat method. A total of 50 patients were enrolled till completion of trial (n=25 in each study arm). Demographic profile and baseline parameters were comparable among the two arms (p>0.05) except for higher number of endoscopic procedures and experienced neurosurgeons (>10years) in arm B (p=0.02, 0.002 respectively). Extent of resection was similar in both study arms (A, 94.9% vs B, 93.6%; p=0.78), despite adjusting for experience of operating surgeon and use of microscope/endoscope for surgical resection. We observed that use of IOMRI helped optimize the extent of resection in 5/20 patients (25%) for pituitary tumor resection in-group A. Present study failed to observe superiorty of IOMRI over conventional 2D-F guided resection in pituitary macroadenoma surgery. By use of this technology, younger surgeons could validate their results intra-operatively and hence could increase EOR without causing any increase in complications. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Near-infrared laparoscopy for real-time intra-operative arterial and lymphatic perfusion imaging.

    LENUS (Irish Health Repository)

    Cahill, R A

    2012-02-01

    Multimodal laparoscopic imaging systems possessing the capability for extended spectrum irradiation and visualization within a unified camera system are now available to provide enhanced intracorporeal operative anatomic and dynamic perfusion assessment and potentially augmented patient outcome. While ultraviolet-range energies have limited penetration and hence are probably more useful for endoscopic mucosal interrogation, the near-infrared (NIR) spectrum is of greater potential utility for the purposes of examining inducible fluorescence in abdominopelvic tissue that can be achieved by administration of specific tracer agents, either directly into the circulation (e.g. for anastomotic perfusion assessment at the time of stapling) or into the lymphatic system (e.g. for lymph basin road-mapping and\\/or focussed target nodal assessment). This technology is also capable of supplementing anatomic recognition of the biliary system while implantable fibres can also be inserted intraoperatively for the purpose of safeguarding vital structures such as the oesphagus and ureters especially in difficult reoperations. It is likely that this technological capability will find a clear and common indication in colorectal specialist and general surgical departments worldwide in the near future.

  1. Observation of behavioural markers of non-technical skills in the operating room and their relationship to intra-operative incidents.

    Science.gov (United States)

    Siu, Joey; Maran, Nikki; Paterson-Brown, Simon

    2016-06-01

    The importance of non-technical skills in improving surgical safety and performance is now well recognised. Better understanding is needed of the impact that non-technical skills of the multi-disciplinary theatre team have on intra-operative incidents in the operating room (OR) using structured theatre-based assessment. The interaction of non-technical skills that influence surgical safety of the OR team will be explored and made more transparent. Between May-August 2013, a range of procedures in general and vascular surgery in the Royal Infirmary of Edinburgh were performed. Non-technical skills behavioural markers and associated intra-operative incidents were recorded using established behavioural marking systems (NOTSS, ANTS and SPLINTS). Adherence to the surgical safety checklist was also observed. A total of 51 procedures were observed, with 90 recorded incidents - 57 of which were considered avoidable. Poor situational awareness was a common area for surgeons and anaesthetists leading to most intra-operative incidents. Poor communication and teamwork across the whole OR team had a generally large impact on intra-operative incidents. Leadership was shown to be an essential set of skills for the surgeons as demonstrated by the high correlation of poor leadership with intra-operative incidents. Team-working and management skills appeared to be especially important for anaesthetists in the recovery from an intra-operative incident. A significant number of avoidable incidents occur during operative procedures. These can all be linked to failures in non-technical skills. Better training of both individual and team in non-technical skills is needed in order to improve patient safety in the operating room. Copyright © 2014 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  2. Fluorocholangiography: reincarnation in the laparoscopic era-evaluation of intra-operative cholangiography in 3635 laparoscopic cholecystectomies.

    Science.gov (United States)

    Nassar, Ahmad H M; Mirza, Ahmad; Qandeel, Haitham; Ahmed, Zubir; Zino, Samer

    2016-05-01

    The introduction of laparoscopic cholecystectomy (LC) resulted in the decline of routine intra-operative cholangiography (IOC). Common bile duct stones are being diagnosed preoperatively using magnetic resonance cholangiopancreatography (MRCP). We aim to evaluate the use and benefits of IOC during laparoscopic biliary surgery at a high-volume biliary surgery unit. Prospective data from 4088 patients undergoing LC over 22 years were analysed. Referral protocols allow one firm to receive the great majority of biliary emergencies and all suspected ductal stones. All patients with gall stones on ultrasound scanning, fit for surgery, will undergo LC during the index admission. MRCP and ERCP are not part of preoperative investigation. A four-port LC is performed with a size 5Fr ureteric catheter within an open cannula to obtain an IOC through right sub-costal port. Of 4088 patients, IOC was attempted in 3691 (90.2 %) and 3635 had a successful IOC (98.4 %). 75 % were females. The mean age was 59 years. Patients presented with one or more of the following: chronic biliary pain in 60 %, acute pain 26.7 %, acute cholecystitis 8.4 %, gallstone pancreatitis 7.8 % and jaundice with or without cholangitis in 19.2 %. A total of 1328 patients (36.5 %) had risk factors for CBD stones. The IOC was abnormal in 975 cases (26.8 %), recording 1599 abnormalities. IOC identified 774 patients with CBD stones (21.3 %), including previously unsuspected CBD stones in 4.7 %. IOC was false negative in 20 cases (0.5 %) found to have stones on basket exploration. A decision not to perform IOC in 453 cases (11 %) was made preoperatively in 74.2 % and intra-operatively in 12.3 %. IOC can be safely and routinely performed in LC. It helps to identify CBD stones, even in patients with no known risk factors, delineate bile duct anatomy and facilitate single-stage management of CBD stones.

  3. Evaluation of the use of intra-operative radiology for open placement of lag screws for the stabilization of sacroiliac luxation in cats.

    Science.gov (United States)

    Silveira, Francisco; Quinn, Robert J; Adrian, Anna M; Owen, Martin R; Bush, Mark A

    2017-01-16

    To assess the effect of intra-operative radiology on the quality of lag screw insertion for the management of sacroiliac joint luxations in cats. In this retrospective single-centre study, the surgical, anaesthetic and imaging records of 40 screws (32 cats) placed with lag effect for management of sacroiliac luxation were reviewed. Postoperative radiographs were assessed for sacroiliac joint reduction, screw position, and sacral width purchased by each screw. Cases were divided into two groups according to the use of (IOR) or the absence of intra-operative radiology (NIOR). A total of 23 lag screws were placed with the aid of intra-operative radiology and 17 without. Three of the 23 screws placed in the IOR group exited the sacrum as opposed to eight of 17 screws in the NIOR group (p = 0.03). Mean sacral width purchased by the screws in the IOR group (70.8%) was also significantly higher (p = 0.002) than in the NIOR group (54.6%). Mean general anaesthetic times for unilateral and bilateral screw placement for the IOR group and NIOR group were not significantly different. The use of intra-operative radiology can significantly improve the quality of lag screw insertion for the stabilization of sacroiliac luxations in cats, which should lead to a reduced incidence of postoperative screw loosening.

  4. Intra-operative rapid diagnostic method based on CK19 mRNA expression for the detection of lymph node metastases in breast cancer

    NARCIS (Netherlands)

    Visser, Mike; Jiwa, Mehdi; Horstman, Anja; Brink, Antoinette A. T. P.; Pol, Rene P.; van Diest, Paul; Snijders, Peter J. F.; Meijer, Chris J. L. M.

    2008-01-01

    Staging by sentinel node (SN) biopsy is the standard procedure for clinically node-negative breast cancer patients. Intra-operative analysis of the SN allows immediate axillary lymph node (ALN) dissection in SN positive patients, but a quick, reliable and reproducible method is lacking. We tested

  5. Intra-operative ultrasound hand-held strain imaging for the visualization of ablations produced in the liver with a toroidal HIFU transducer: first in vivo results

    Energy Technology Data Exchange (ETDEWEB)

    Chenot, J; Melodelima, D; N' Djin, W A; Souchon, Remi; Rivoire, M; Chapelon, J Y, E-mail: jeremy.chenot@inserm.f [Inserm, U556, Lyon, F-69003 (France)

    2010-06-07

    The use of hand-held ultrasound strain imaging for the intra-operative real-time visualization of HIFU (high-intensity focused ultrasound) ablations produced in the liver by a toroidal transducer was investigated. A linear 12 MHz ultrasound imaging probe was used to obtain radiofrequency signals. Using a fast cross-correlation algorithm, strain images were calculated and displayed at 60 frames s{sup -1}, allowing the use of hand-held strain imaging intra-operatively. Fourteen HIFU lesions were produced in four pigs. Intra-operative strain imaging of HIFU ablations in the liver was feasible owing to the high frame rate. The correlation between dimensions measured on gross pathology and dimensions measured on B-mode images and on strain images were R = 0.72 and R = 0.94 respectively. The contrast between ablated and non-ablated tissue was significantly higher (p < 0.05) in the strain images (22 dB) than in the B-mode images (9 dB). Strain images allowed equivalent or improved definition of ablated regions when compared with B-mode images. Real-time intra-operative hand-held strain imaging seems to be a promising complement to conventional B-mode imaging for the guidance of HIFU ablations produced in the liver during an open procedure. These results support that hand-held strain imaging outperforms conventional B-mode ultrasound and could potentially be used for the assessment of thermal therapies.

  6. Systematic Review and Meta-Analysis of Randomized Controlled Trials Evaluating Prophylactic Intra-Operative Wound Irrigation for the Prevention of Surgical Site Infections

    NARCIS (Netherlands)

    de Jonge, Stijn W.; Boldingh, Quirine J. J.; Solomkin, Joseph S.; Allegranzi, Benedetta; Egger, Matthias; Dellinger, E. Patchen; Boermeester, Marja A.

    2017-01-01

    Surgical site infections (SSIs) are one of the most common hospital-acquired infections. To reduce SSIs, prophylactic intra-operative wound irrigation (pIOWI) has been advocated, although the results to date are equivocal. To develop recommendations for the new World Health Organization (WHO) SSI

  7. VALIDATION OF MITRAL VALVE ANNULUS DIMENSIONS MEASURED BY 2D TRANS-THORACIC ECHOCARDIOGRAPHY WITH GOLD STANDARD DIRECT INTRA-OPERATIVE MEASUREMENT

    OpenAIRE

    Praveen; Yadav; Ankur; Saket; Kaushal

    2014-01-01

    CONTEXT: Precise estimation of Mitral valve annulus dimensions preoperatively through Echocardiography is of paramount importance in replacement/repair surgeries. However a frequent disagreement was experienced between anticipated size of prosthetic valve based on echocardiography and actual valve size. This fact encouraged the authors to validate the measurements through echocardiography with gold-standard direct intra operative measurement. AIM: To compare the mitral val...

  8. Feasibility of integrating a multi-camera optical tracking system in intra-operative electron radiation therapy scenarios

    International Nuclear Information System (INIS)

    García-Vázquez, V; Marinetto, E; Santos-Miranda, J A; Calvo, F A; Desco, M; Pascau, J

    2013-01-01

    Intra-operative electron radiation therapy (IOERT) combines surgery and ionizing radiation applied directly to an exposed unresected tumour mass or to a post-resection tumour bed. The radiation is collimated and conducted by a specific applicator docked to the linear accelerator. The dose distribution in tissues to be irradiated and in organs at risk can be planned through a pre-operative computed tomography (CT) study. However, surgical retraction of structures and resection of a tumour affecting normal tissues significantly modify the patient's geometry. Therefore, the treatment parameters (applicator dimension, pose (position and orientation), bevel angle, and beam energy) may require the original IOERT treatment plan to be modified depending on the actual surgical scenario. We propose the use of a multi-camera optical tracking system to reliably record the actual pose of the IOERT applicator in relation to the patient's anatomy in an environment prone to occlusion problems. This information can be integrated in the radio-surgical treatment planning system in order to generate a real-time accurate description of the IOERT scenario. We assessed the accuracy of the applicator pose by performing a phantom-based study that resembled three real clinical IOERT scenarios. The error obtained (2 mm) was below the acceptance threshold for external radiotherapy practice, thus encouraging future implementation of this approach in real clinical IOERT scenarios. (paper)

  9. Intra-operative radiation therapy in cancer of the pancreas. La radiotherapie peroperatoire dans les cancers du pancreas

    Energy Technology Data Exchange (ETDEWEB)

    Dubois, J.B.; Gu, S.D.; Saint-Aubert, B.; Joyeux, H.; Solassol, C.; Pujol, H. (Centre Regional de Lutte contre le Cancer, 34 - Montpellier (FR))

    1991-03-01

    We report our experience concerning 22 pancreatic carcinoma bearing patients treated with intra-operative radiation therapy (IORT) after complete surgical excision: duodenopancreatectomy: 15 patients; isthmic and caudal pancreatectomy: 2 patients; total pancreatectomy: 5 patients. The dose delivered to the tumor bed was 20 Gy in 12 patients, 18 Gy in 3 patients and 15 Gy in 7 patients. Three patients died within the 1st month post-surgery from intercurrent diseases. Post-operative morbidity was not significantly modified by IORT as compared to purely surgical treated patients. Out of 19 evaluable patients, we observed local control in 16 patients (79.4%). Causes of death (15/19 patients) were: distant metastases with local control: 7 patients; in situ local failure: 3 patients; regional recurrence outside of the IORT fields: 2 patients; intercurrent diseases: 3 patients. Four patients are still alive without evolutive disease. The median overall survival is 6 months. The mean overall survival is 10.56 months. Excluding patients who died from complications and intercurrent diseases, the median survival is 10 mths and the mean survival 14.5 mths. These results emphasize the improvement in local control with IORT, but without significant improvement in survival which is dependent on local evolution and also systemic disease.

  10. Feasibility of Optical Coherence Tomography (OCT for Intra-Operative Detection of Blood Flow during Gastric Tube Reconstruction

    Directory of Open Access Journals (Sweden)

    Sanne M. Jansen

    2018-04-01

    Full Text Available In this study; an OCT-based intra-operative imaging method for blood flow detection during esophagectomy with gastric tube reconstruction is investigated. Change in perfusion of the gastric tube tissue can lead to ischemia; with a high morbidity and mortality as a result. Anastomotic leakage (incidence 5–20% is one of the most severe complications after esophagectomy with gastric tube reconstruction. Optical imaging techniques provide for minimal-invasive and real-time visualization tools that can be used in intraoperative settings. By implementing an optical technique for blood flow detection during surgery; perfusion can be imaged and quantified and; if needed; perfusion can be improved by either a surgical intervention or the administration of medication. The feasibility of imaging gastric microcirculation in vivo using optical coherence tomography (OCT during surgery of patients with esophageal cancer by visualizing blood flow based on the speckle contrast from M-mode OCT images is studied. The percentage of pixels exhibiting a speckle contrast value indicative of flow was quantified to serve as an objective parameter to assess blood flow at 4 locations on the reconstructed gastric tube. Here; it was shown that OCT can be used for direct blood flow imaging during surgery and may therefore aid in improving surgical outcomes for patients.

  11. Inter- and intra-operator reliability and repeatability of shear wave elastography in the liver: a study in healthy volunteers.

    Science.gov (United States)

    Hudson, John M; Milot, Laurent; Parry, Craig; Williams, Ross; Burns, Peter N

    2013-06-01

    This study assessed the reproducibility of shear wave elastography (SWE) in the liver of healthy volunteers. Intra- and inter-operator reliability and repeatability were quantified in three different liver segments in a sample of 15 subjects, scanned during four independent sessions (two scans on day 1, two scans 1 wk later) by two operators. A total of 1440 measurements were made. Reproducibility was assessed using the intra-class correlation coefficient (ICC) and a repeated measures analysis of variance. The shear wave speed was measured and used to estimate Young's modulus using the Supersonics Imagine Aixplorer. The median Young's modulus measured through the inter-costal space was 5.55 ± 0.74 kPa. The intra-operator reliability was better for same-day evaluations (ICC = 0.91) than the inter-operator reliability (ICC = 0.78). Intra-observer agreement decreased when scans were repeated on a different day. Inter-session repeatability was between 3.3% and 9.9% for intra-day repeated scans, compared with to 6.5%-12% for inter-day repeated scans. No significant difference was observed in subjects with a body mass index greater or less than 25 kg/m(2). Copyright © 2013 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  12. Rapid intra-operative diagnosis of kidney cancer by attenuated total reflection infrared spectroscopy of tissue smears.

    Science.gov (United States)

    Pucetaite, Milda; Velicka, Martynas; Urboniene, Vidita; Ceponkus, Justinas; Bandzeviciute, Rimante; Jankevicius, Feliksas; Zelvys, Arunas; Sablinskas, Valdas; Steiner, Gerald

    2018-01-09

    Herein, a technique to analyze air-dried kidney tissue impression smears by means of attenuated total reflection infrared (ATR-IR) spectroscopy is presented. Spectral tumor markers-absorption bands of glycogen-are identified in the ATR-IR spectra of the kidney tissue smear samples. Thin kidney tissue cryo-sections currently used for IR spectroscopic analysis lack such spectral markers as the sample preparation causes irreversible molecular changes in the tissue. In particular, freeze-thaw cycle results in degradation of the glycogen and reduction or complete dissolution of its content. Supervised spectral classification was applied to the recorded spectra of the smears and the test spectra were classified with a high accuracy of 92% for normal tissue and 94% for tumor tissue, respectively. For further development, we propose that combination of the method with optical fiber ATR probes could potentially be used for rapid real-time intra-operative tissue analysis without interfering with either the established protocols of pathological examination or the ordinary workflow of operating surgeon. Such approach could ensure easier transition of the method to clinical applications where it may complement the results of gold standard histopathology examination and aid in more precise resection of kidney tumors. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. Splenectomy in a Nigerian Teaching Hospital: A comparison of sonographic correlation with intra-operative findings in trauma

    Directory of Open Access Journals (Sweden)

    Oludolapo Afuwape

    2013-01-01

    Full Text Available Background: Missed or inappropriately-treated splenic injury is a significant cause of preventable trauma-related death. Physical examination and abdominal ultrasonography are essential tools for early diagnosis of splenic injury. However, some injuries may not be accurately diagnosed by ultrasonography at initial evaluation. Aim: The aim of this study was to audit indications for splenectomy at the University College Hospital, Ibadan and to compare the intra-operative findings in trauma-related cases with the sonographic findings. Materials and Methods: We retrospectively reviewed all adult (12 years and older patients′ records who had splenectomy between July 2003 and June 2010. The data extracted included patient demographics and indications for splenectomy. In trauma cases, the mode of injury and vital signs at presentation, sonographic findings, and operation findings were recorded. The intervals between injury and sonography and duration to surgery were also noted respectively. Results: Eighty-four patients were reviewed in the 7-year review period. The male to female ratio was approximately 2:1. The ages ranged from 14 to 76 years with a peak incidence in the third decade. Elective indications for splenectomy were 14 (16.6%, while 70 (83.3% were emergency cases. Forty-four of the trauma-related patients had pre-operative abdominal ultrasound, of which 31 (70% was reported as sonographically normal prior to surgery, while the rest of the trauma-related cases were considered too ill for ultrasonography. Conclusion: Potentially significant injuries may be missed with screening sonography. For this reason, a physician must maintain a high index of suspicion and consider the patient′s clinical status or an alternative imaging modality in excluding a diagnosis of splenic injury.

  14. Characterization of a microDiamond detector in high-dose-per-pulse electron beams for intra operative radiation therapy.

    Science.gov (United States)

    Di Venanzio, C; Marinelli, Marco; Tonnetti, A; Verona-Rinati, G; Falco, M D; Pimpinella, M; Ciccotelli, A; De Stefano, S; Felici, G; Marangoni, F

    2015-12-01

    To characterize a synthetic diamond dosimeter (PTW Freiburg microDiamond 60019) in high dose-per-pulse electron beams produced by an Intra Operative Radiation Therapy (IORT) dedicated accelerator. The dosimetric properties of the microDiamond were assessed under 6, 8 and 9 MeV electron beams by a NOVAC11 mobile accelerator (Sordina IORT Technologies S.p.A.). The characterization was carried out with dose-per-pulse ranging from 26 to 105 mGy per pulse. The microDiamond performance was compared with an Advanced Markus ionization chamber and a PTW silicon diode E in terms of dose linearity, percentage depth dose (PDD) curves, beam profiles and output factors. A good linearity of the microDiamond response was verified in the dose range from 0.2 Gy to 28 Gy. A sensitivity of 1.29 nC/Gy was measured under IORT electron beams, resulting within 1% with respect to the one obtained in reference condition under (60)Co gamma irradiation. PDD measurements were found in agreement with the ones by the reference dosimeters, with differences in R50 values below 0.3 mm. Profile measurements evidenced a high spatial resolution of the microDiamond, slightly worse than the one of the silicon diode. The penumbra widths measured by the microDiamond resulted approximately 0.5 mm larger than the ones by the Silicon diode. Output factors measured by the microDiamond were found within 2% with those obtained by the Advanced Markus down to 3 cm diameter field sizes. The microDiamond dosimeter was demonstrated to be suitable for precise dosimetry in IORT applications under high dose-per-pulse conditions. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  15. Intra-operative wound irrigation to reduce surgical site infections after abdominal surgery: a systematic review and meta-analysis.

    Science.gov (United States)

    Mueller, Tara C; Loos, Martin; Haller, Bernhard; Mihaljevic, André L; Nitsche, Ulrich; Wilhelm, Dirk; Friess, Helmut; Kleeff, Jörg; Bader, Franz G

    2015-02-01

    Surgical site infection (SSI) remains to be one of the most frequent infectious complications following abdominal surgery. Prophylactic intra-operative wound irrigation (IOWI) before skin closure has been proposed to reduce bacterial wound contamination and the risk of SSI. However, current recommendations on its use are conflicting especially concerning antibiotic and antiseptic solutions because of their potential tissue toxicity and enhancement of bacterial drug resistances. To analyze the existing evidence for the effect of IOWI with topical antibiotics, povidone-iodine (PVP-I) solutions or saline on the incidence of SSI following open abdominal surgery, a systematic review and meta-analysis of randomized controlled trials (RCTs) was carried out according to the recommendations of the Cochrane Collaboration. Forty-one RCTs reporting primary data of over 9000 patients were analyzed. Meta-analysis on the effect of IOWI with any solution compared to no irrigation revealed a significant benefit in the reduction of SSI rates (OR = 0.54, 95 % confidence Interval (CI) [0.42; 0.69], p < 0.0001). Subgroup analyses showed that this effect was strongest in colorectal surgery and that IOWI with antibiotic solutions had a stronger effect than irrigation with PVP-I or saline. However, all of the included trials were at considerable risk of bias according to the quality assessment. These results suggest that IOWI before skin closure represents a pragmatic and economical approach to reduce postoperative SSI after abdominal surgery and that antibiotic solutions seem to be more effective than PVP-I solutions or simple saline, and it might be worth to re-evaluate their use for specific indications.

  16. Evaluation of hyperglycaemic response to intra-operative dexamethasone administration in patients undergoing elective intracranial surgery: A randomised, prospective study.

    Science.gov (United States)

    Sethi, Rakesh; Naqash, Imtiaz A; Bajwa, Sukhminder Jit Singh; Dutta, Vikas; Ramzan, Altaf Umar; Zahoor, Syed Amir

    2016-01-01

    The glucocorticoid dexamethasone in a bolus dose of 8-10 mg followed by quarterly dose of 4 mg is commonly used during intracranial surgery so as to reduce oedema and vascular permeability. However, the detrimental hyperglycaemic effects of dexamethasone may override its potentially beneficial effects. The present prospective, randomised study aimed at comparing the degree and magnitude of hyperglycaemia induced by prophylactic administration of dexamethasone in patients undergoing elective craniotomy. Sixty American Society of Anaesthesiologist (ASA) grade-I and II patients were randomly assigned to three groups of 20 patients each. Group-I received dexamethasone during surgery for the first time. Group-II received dexamethasone in addition to receiving it pre-operatively, whereas Group-III (control group) patients were administered normal saline as placebo. Baseline blood glucose (BG) was measured in all the three groups before induction of anaesthesia and thereafter after every hour for 4 h and then two-hourly. Besides intra- and intergroup comparison of BG, peak BG concentration was also recorded for each patient. Statistical analysis was carried out with analysis of variance (ANOVA) and Student's t-test and value of P < 0.05 was considered statistically significant. Baseline BG reading were higher and statistically significant in Group-II as compared with Group-I and Group-III (P < 0.05). However, peak BG levels were significantly higher in Group-I than in Group-II and III (P < 0.05). Similarly, the magnitude of change in peak BG was significantly higher in Group-I as compared to Group-II and III (P < 0.05). Peri-operative administration of dexamethasone during neurosurgical procedures can cause significant increase in BG concentration especially in patients who receive dexamethasone intra-operatively only.

  17. Frozen section is superior to imprint cytology for the intra-operative assessment of sentinel lymph node metastasis in Stage I Breast cancer patients

    Directory of Open Access Journals (Sweden)

    Makita Masujiro

    2006-05-01

    Full Text Available Abstract Background A standard intra-operative procedure for assessing sentinel lymph node metastasis in breast cancer patients has not yet been established. Patients and methods One hundred and thirty-eight patients with stage I breast cancer who underwent sentinel node biopsy using both imprint cytology and frozen section were analyzed. Results Seventeen of the 138 patients had sentinel node involvement. Results of imprint cytology included nine false negative cases (sensitivity, 47.1%. In contrast, only two cases of false negatives were found on frozen section (sensitivity, 88.2%. There were two false positive cases identified by imprint cytology (specificity, 98.3%. On the other hand, frozen section had 100% specificity. Conclusion These findings suggest that frozen section is superior to imprint cytology for the intra-operative determination of sentinel lymph node metastasis in stage I breast cancer patients.

  18. 后腹腔镜下肾窦内肾盂切开取石术%Retroperitoneal laparoscopic pyelolithotomy in the treatment of intrarenal pelvic calculi

    Institute of Scientific and Technical Information of China (English)

    林超; 时少显; 李海涛; 吕共生; 和学强; 陈家旺

    2008-01-01

    Objective To evaluate the clinical efficacy and safety of retroperitoneal laparoscopic pyelolithotomy in the treatment of intrarenal pelvic staghorn calculus or multiple renal calculi. Methods Fifteen patients(9 males and 6 females)with average age of 40 years old were treated. The diameters of the calculi were from 1.5 cm to 3.7 cm. Three trocars were used in this procedure as rou-tine. The renal sinus was exposed by separating the pelvis from outside to inside until reaching the in-fundibulum of the renal calyx. Then the renal calyx was cut open and the calculus was taken out. Double J stent was placed in the ureter and the incision of pelvis was closed by 3-0 absorbable suture. The drainage tube was pulled out 3-4 d post-operatively according to the drainage quantity. Double J stent was then pulled out 2 weeks after surgery. Results All the 15 procedures were successfully completed. The average operation time was 170 min and the average post-operative hospital stay was 7 d. During the 3-15 months' follow-up, 2 patients had calculus remnants with the size of 0. 2-0.5cm in diameter. Conclusions Retroperitoneal laparoscopic pyelolithotomy provides a minimally inva-sive treatment option in patients with intrarenal pelvic staghorn calculus or multiple renal calculi. It has the advantages of good exposure, little bleeding, small incision and fast recovery.%目的 探讨后腹腔镜下肾窦内肾盂切开取石治疗肾鹿角状及多发性结石的疗效. 方法肾多发及鹿角状结石患者15例.男9例,女6例.平均年龄40岁.结石直经1.5~3.7 cm.常规用3个穿刺器,建立气腹于腹膜后间隙,紧贴肾盂外膜向肾窦内分离,暴露出肾盏漏斗部,切开取石,输尿管内置入双J管,3-0可吸收线缝合肾盂切口.冲洗、放置引流管.术后3~4 d拔出引流管.2周左右拔出双J管. 结果 15例手术均获成功,平均手术时间170 rain.术后平均住院7 d.随访3~15个月,2例有0.2~0.5 cm结石残留. 结论 后腹腔

  19. Radio-guided surgery with the use of [99mTc-EDDA/HYNIC]octreotate in intra-operative detection of neuroendocrine tumours of the gastrointestinal tract.

    Science.gov (United States)

    Hubalewska-Dydejczyk, A; Kulig, J; Szybinski, P; Mikolajczak, R; Pach, D; Sowa-Staszczak, A; Fröss-Baron, K; Huszno, B

    2007-10-01

    Radio-guided surgery (RGS) is an intra-operative localising technique which enables identification of tissue "marked" by a specific radiotracer injected before surgery. It is mainly used for sentinel node mapping and for detection of parathyroid adenomas and other tumours, including neuroendocrine tumours of the gastrointestinal tract (GEP-NET). The aim of this study was to determine whether intra-operative radio-detection with the use of [(99m)Tc-EDDA/HYNIC]octreotate, a new somatostatin analogue, is able to reveal an unknown primary and secondary sites, thereby improving surgical treatment and the final outcome of GEP-NET. The study group included nine patients with suspected GEP-NET (four carcinoids, five pancreatic NET) localised with somatostatin receptor scintigraphy (with [(99m)Tc-EDDA/HYNIC]octreotate), who had negative results on other pre-operative imaging tests. At surgery, suspected tumours were measured in situ and ex vivo and precise exploration of the abdominal cavity was performed with the intra-operative scintillation detector (Navigator). Intra-operative gamma counting localised three carcinoids. In one patient SRS was false positive (owing to inflammatory infiltration). Compared with SRS, RGS revealed additional lymph node metastases in one case. RGS resulted in successful localisation of all pancreatic NET (the smallest lesion was 8 mm in diameter). [(99m)Tc-EDDA/HYNIC]octreotate SRS followed by RGS is a promising technique to improve the rate of detection and efficacy of treatment of GEP-NET, especially in the presence of occult endocrine tumours. The imaging properties of [(99m)Tc-EDDA/HYNIC]octreotate and the 1-day imaging protocol offer opportunities for more widespread application of this tracer followed by RGS in oncology.

  20. Radio-guided surgery with the use of [99mTc-EDDA/HYNIC]octreotate in intra-operative detection of neuroendocrine tumours of the gastrointestinal tract

    International Nuclear Information System (INIS)

    Hubalewska-Dydejczyk, A.; Kulig, J.; Szybinski, P.; Mikolajczak, R.; Pach, D.; Sowa-Staszczak, A.; Froess-Baron, K.; Huszno, B.

    2007-01-01

    Radio-guided surgery (RGS) is an intra-operative localising technique which enables identification of tissue ''marked'' by a specific radiotracer injected before surgery. It is mainly used for sentinel node mapping and for detection of parathyroid adenomas and other tumours, including neuroendocrine tumours of the gastrointestinal tract (GEP-NET). The aim of this study was to determine whether intra-operative radio-detection with the use of [ 99m Tc-EDDA/HYNIC]octreotate, a new somatostatin analogue, is able to reveal an unknown primary and secondary sites, thereby improving surgical treatment and the final outcome of GEP-NET. The study group included nine patients with suspected GEP-NET (four carcinoids, five pancreatic NET) localised with somatostatin receptor scintigraphy (with [ 99m Tc-EDDA/HYNIC]octreotate), who had negative results on other pre-operative imaging tests. At surgery, suspected tumours were measured in situ and ex vivo and precise exploration of the abdominal cavity was performed with the intra-operative scintillation detector (Navigator). Intra-operative gamma counting localised three carcinoids. In one patient SRS was false positive (owing to inflammatory infiltration). Compared with SRS, RGS revealed additional lymph node metastases in one case. RGS resulted in successful localisation of all pancreatic NET (the smallest lesion was 8 mm in diameter). [ 99m Tc-EDDA/HYNIC]octreotate SRS followed by RGS is a promising technique to improve the rate of detection and efficacy of treatment of GEP-NET, especially in the presence of occult endocrine tumours. The imaging properties of [ 99m Tc-EDDA/HYNIC]octreotate and the 1-day imaging protocol offer opportunities for more widespread application of this tracer followed by RGS in oncology. (orig.)

  1. Intra-operative fiducial-based CT/fluoroscope image registration framework for image-guided robot-assisted joint fracture surgery.

    Science.gov (United States)

    Dagnino, Giulio; Georgilas, Ioannis; Morad, Samir; Gibbons, Peter; Tarassoli, Payam; Atkins, Roger; Dogramadzi, Sanja

    2017-08-01

    Joint fractures must be accurately reduced minimising soft tissue damages to avoid negative surgical outcomes. To this regard, we have developed the RAFS surgical system, which allows the percutaneous reduction of intra-articular fractures and provides intra-operative real-time 3D image guidance to the surgeon. Earlier experiments showed the effectiveness of the RAFS system on phantoms, but also key issues which precluded its use in a clinical application. This work proposes a redesign of the RAFS's navigation system overcoming the earlier version's issues, aiming to move the RAFS system into a surgical environment. The navigation system is improved through an image registration framework allowing the intra-operative registration between pre-operative CT images and intra-operative fluoroscopic images of a fractured bone using a custom-made fiducial marker. The objective of the registration is to estimate the relative pose between a bone fragment and an orthopaedic manipulation pin inserted into it intra-operatively. The actual pose of the bone fragment can be updated in real time using an optical tracker, enabling the image guidance. Experiments on phantom and cadavers demonstrated the accuracy and reliability of the registration framework, showing a reduction accuracy (sTRE) of about [Formula: see text] (phantom) and [Formula: see text] (cadavers). Four distal femur fractures were successfully reduced in cadaveric specimens using the improved navigation system and the RAFS system following the new clinical workflow (reduction error [Formula: see text], [Formula: see text]. Experiments showed the feasibility of the image registration framework. It was successfully integrated into the navigation system, allowing the use of the RAFS system in a realistic surgical application.

  2. Intra-Operative Surgical Irrigation of the Surgical Incision: What Does the Future Hold-Saline, Antibiotic Agents, or Antiseptic Agents?

    Science.gov (United States)

    Edmiston, Charles E; Leaper, David J

    2016-12-01

    Intra-operative surgical site irrigation (lavage) is common practice in surgical procedures in general, with all disciplines advocating some form of irrigation before incision closure. This practice, however, has been neither standardized nor is there compelling evidence that it effectively reduces the risk of surgical site infection (SSI). This narrative review addresses the laboratory and clinical evidence that is available to support the practice of irrigation of the abdominal cavity and superficial/deep incisional tissues, using specific irrigation solutions at the end of an operative procedure to reduce the microbial burden at wound closure. Review of PubMed and OVID for pertinent, scientific, and clinical publications in the English language was performed. Incision irrigation was found to afford a three-fold benefit: First, to hydrate the bed; second, to assist in allowing better examination of the area immediately before closure; and finally, by removing superficial and deep incisional contamination and lowering the bioburden, expedite the healing process. The clinical practice of intra-operative peritoneal lavage is highly variable and is dependent solely on surgeon preference. By contrast, intra-operative irrigation after device-related procedures has become a standard of care for the prophylaxis of acute peri-prosthetic infection. The clinical evidence that supports the use of antibiotic irrigation is limited and based on retrospective analysis and few acceptable randomized controlled trials. The results of laboratory and animal studies using aqueous 0.05% chlorhexidine gluconate are favorable, suggesting that further studies are justified to determine its clinical efficacy. The adoption of appropriate and standardized intra-operative irrigation practices into peri-operative care bundles, which include other evidence-based strategies (weight-based antimicrobial prophylaxis, antimicrobial sutures, maintenance of normothermia, and glycemic control), offers

  3. Utilization of independent component analysis for accurate pathological ripple detection in intracranial EEG recordings recorded extra- and intra-operatively.

    Science.gov (United States)

    Shimamoto, Shoichi; Waldman, Zachary J; Orosz, Iren; Song, Inkyung; Bragin, Anatol; Fried, Itzhak; Engel, Jerome; Staba, Richard; Sharan, Ashwini; Wu, Chengyuan; Sperling, Michael R; Weiss, Shennan A

    2018-01-01

    To develop and validate a detector that identifies ripple (80-200 Hz) events in intracranial EEG (iEEG) recordings in a referential montage and utilizes independent component analysis (ICA) to eliminate or reduce high-frequency artifact contamination. Also, investigate the correspondence of detected ripples and the seizure onset zone (SOZ). iEEG recordings from 16 patients were first band-pass filtered (80-600 Hz) and Infomax ICA was next applied to derive the first independent component (IC1). IC1 was subsequently pruned, and an artifact index was derived to reduce the identification of high-frequency events introduced by the reference electrode signal. A Hilbert detector identified ripple events in the processed iEEG recordings using amplitude and duration criteria. The identified ripple events were further classified and characterized as true or false ripple on spikes, or ripples on oscillations by utilizing a topographical analysis to their time-frequency plot, and confirmed by visual inspection. The signal to noise ratio was improved by pruning IC1. The precision of the detector for ripple events was 91.27 ± 4.3%, and the sensitivity of the detector was 79.4 ± 3.0% (N = 16 patients, 5842 ripple events). The sensitivity and precision of the detector was equivalent in iEEG recordings obtained during sleep or intra-operatively. Across all the patients, true ripple on spike rates and also the rates of false ripple on spikes, that were generated due to filter ringing, classified the seizure onset zone (SOZ) with an area under the receiver operating curve (AUROC) of >76%. The magnitude and spectral content of true ripple on spikes generated in the SOZ was distinct as compared with the ripples generated in the NSOZ (p ripple rates and properties defined using this approach may accurately delineate the seizure onset zone. Strategies to improve the spatial resolution of intracranial EEG and reduce artifact can help improve the clinical utility of

  4. Psychological consideration in patients with cerebral gliomas candidates for intra-operative radiation therapy based on tumor location.

    Science.gov (United States)

    Seddighi, Afsoun; Akbari, Mohammad Esmaeil; Seddighi, Amir Saied; Nikouei, Amir

    2017-01-01

    Intra-operative Radiation Therapy (IORT) is gaining popularity as an adjuvant option to surgical resection, in treatment of glioblastoma multiforme (GBM) for increasing survival rate, which a highly aggressive cerebral tumor with poor prognosis. Τhe authors plan to investigate the effects of IORT combined with surgical resection on the psychological status of these patients based on tumor location. From December 2013 to February 2017, we have enrolled 109 patients with high grade cerebral gliomas, documented by Magnetic Resonance Spectroscopy (MRS). Patients with previous history of brain surgery or radiation, altered mental status and psychological content and patients diagnosed with metastases were excluded. Demographic data, tumor volume based on pre-operative Magnetic Resonance Imaging (MRI) and psychological status were recorded based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. The remaining 56 patients, were equally randomized into conventional (surgical resection-group A), and trial (surgical resection with IORT-group B) who underwent IORT using the 50kV INTRABEAM® system (Carl Zeiss Meditec AG, Germany). Psychological profiles of both groups were re-evaluated in the 3 rd post-operative month. Group A consisted of 18 males and 10 females with mean age of 54.4 years, while group B consisted of 16 males and 12 females with mean age of 57.8 years. Tumor volumetry revealed mean 81.52cc and 82.8cc for group A and B respectively. (P value 0.14) Patients were classified based on glioma location on pre-operative MRI: a) left parietal lobe (6 in group A, 5 in group B); b) left temporal lobe (7 in group A, 5 in group B); c) right parietal lobe (5 in group A, 6 in group B); d) left fronto-temporal lobe (4 in group A, 6 in group B); e) left parieto-temporal lobe (4 in group A, 5 in group B); and, f) right frontal lobe (2 in group A, 1 in group B). Group B received mean 8.05 Gy radiation for mean 11.2 minutes. Post

  5. Factors impacting short and long-term kidney graft survival: modification by single intra-operative -high-dose induction with ATG-Fresenius.

    Science.gov (United States)

    Kaden, Jürgen; May, Gottfried; Völp, Andreas; Wesslau, Claus

    2011-01-01

    A majority of recipients benefited from the intra-operative single high-dose induction (HDI) with ATG-Fresenius (ATG-F) still leaving a group of recipients who did not profit from this kind of induction. Therefore the aim of this retrospective analysis was 1st to identify the risk factors impacting short and long-term graft survival, and 2nd to assess the efficacy of this type of induction in kidney graft recipients with or without these risk factors. A total of 606 recipients receiving two different immunosuppressive treatment regimens (1st: Triple drug therapy [TDT, n=196] consisting mainly of steroids, azathioprine and cyclosporine; 2nd: TDT + 9 mg/kg ATG-F intra-operatively [HDI, n=410]) were included in this analysis and grouped according to their kidney graft survival time (short GST: ≤1 yr, n=100 and long GST: >5 yrs, n=506). The main risk factors associated with a shortened graft survival were pre-transplant sensitization, re-transplantation, rejections (in particular vascular or mixed ones) and the necessity of a long-term anti-rejection therapy. Adding ATG-F single high dose induction to TDT was more efficient in prolonging kidney graft survival than TDT alone not only in recipients without any risk factors (p<0.005) but also in recipients with at least one risk factor (p<0.021). Only in 4.6% of recipients having two or more risk factors this effect could not be demonstrated. The intra-operative single high-dose induction with ATG-F significantly improves the kidney graft survival in recipients with or without risk factors and can therefore be recommended.

  6. The unsuspected prosthetic joint infection : incidence and consequences of positive intra-operative cultures in presumed aseptic knee and hip revisions.

    Science.gov (United States)

    Jacobs, A M E; Bénard, M; Meis, J F; van Hellemondt, G; Goosen, J H M

    2017-11-01

    Positive cultures are not uncommon in cases of revision total knee and hip arthroplasty (TKA and THA) for presumed aseptic causes. The purpose of this study was to assess the incidence of positive intra-operative cultures in presumed aseptic revision of TKA and THA, and to determine whether the presence of intra-operative positive cultures results in inferior survival in such cases. A retrospective cohort study was assembled with 679 patients undergoing revision knee (340 cases) or hip arthroplasty (339 cases) for presumed aseptic causes. For all patients three or more separate intra-operative cultures were obtained. Patients were diagnosed with a previously unsuspected prosthetic joint infection (PJI) if two or more cultures were positive with the same organism. Records were reviewed for demographic details, pre-operative laboratory results and culture results. The primary outcome measure was infection-free implant survival at two years. The incidence of unsuspected PJI was 27 out of 340 (7.9%) in TKA and 41 out of 339 (12.1%) in THA. Following revision TKA, the rate of infection-free implant survival in patients with an unsuspected PJI was 88% (95% confidence intervals (CI) 60 to 97) at two years compared with 98% (95% CI 94 to 99) in patients without PJI (p = 0.001). After THA, the rate of survival was similar in those with unsuspected PJI (92% (95% CI 73 to 98) at two years) and those without (94% (95% CI 89 to 97), p = 0.31). Following revision of TKA and THA for aseptic diagnoses, around 10% of cases were found to have positive cultures. In the knee, such cases had inferior infection-free survival at two years compared with those with negative cultures; there was no difference between the groups following THA. Cite this article: Bone Joint J 2017;99-B:1482-9. ©2017 The British Editorial Society of Bone & Joint Surgery.

  7. Perioperative cardiac arrest: an evolutionary analysis of the intra-operative cardiac arrest incidence in tertiary centers in Brazil

    Directory of Open Access Journals (Sweden)

    Matheus Fachini Vane

    2016-03-01

    ência de parada cardíaca (PC. Postula-se que a incidência de parada cardíaca intraoperatória (PCI tem diminuído ao longo dos anos, especialmente em países desenvolvidos. A nossa hipótes foi que, como no resto do mundo, a incidência de PCI está diminuindo no Brasil, um país em desenvolvimento. Objetivos: O objetivo deste estudo foi pesquisar e avaliar na literatura as publicações que relacionam a incidência de PCI no Brasil e analisar a tendência na incidência de PCI. Conteúdo: Descobrimos quatro artigos que atenderam os critérios de inclusão, resultando em 204.072 pacientes submetidos à anestesia regional ou geral em dois hospitais terciários e acadêmicos, totalizando 627 casos de PCI. A média de incidência de PCI para o período de 25 anos foi de 30,72:10.000 anestesias. Houve uma diminuição de 39:10.000 anestesias para 13:10.000 anestesias no período analisado, com letalidade relacionada de 48,3% para 30,8%. Além disso, as principais causas de mortalidade relacionadas à anestesia mudaram de mau funcionamento de máquinas e overdose de medicamentos para hipovolemia e causas respiratórias. Conclusões: Houve uma clara redução na incidência de PCI nos últimos 25 anos no Brasil. Essa redução é observada em todo o mundo e pode ser o resultado de vários fatores, incluindo novas leis que regulam medicamentos no Brasil, incorporação de tecnologias, melhor nível de desenvolvimento humano do país e melhor assistência ao paciente. Keywords: Intra-operative complications, Heart arrest, Cardiopulmonary resuscitation, Anesthesia, Palavras-chave: Complicações intraoperatórias, Parada cardíaca, Reanimação cardiopulmonar, Anestesia

  8. Fracture Surgery of the extremities with the intra-operative use of 3D-RX: A randomized multicenter trial (EF3X-trial

    Directory of Open Access Journals (Sweden)

    Marmor Meir

    2011-07-01

    Full Text Available Abstract Background Posttraumatic osteoarthritis can develop after an intra-articular extremity fracture, leading to pain and loss of function. According to international guidelines, anatomical reduction and fixation are the basis for an optimal functional result. In order to achieve this during fracture surgery, an optimal view on the position of the bone fragments and fixation material is a necessity. The currently used 2D-fluoroscopy does not provide sufficient insight, in particular in cases with complex anatomy or subtle injury, and even an 18-26% suboptimal fracture reduction is reported for the ankle and foot. More intra-operative information is therefore needed. Recently the 3D-RX-system was developed, which provides conventional 2D-fluoroscopic images as well as a 3D-reconstruction of bony structures. This modality provides more information, which consequently leads to extra corrections in 18-30% of the fracture operations. However, the effect of the extra corrections on the quality of the anatomical fracture reduction and fixation as well as on patient relevant outcomes has never been investigated. The objective of this study protocol is to investigate the effectiveness of the intra-operative use of the 3D-RX-system as compared to the conventional 2D-fluoroscopy in patients with traumatic intra-articular fractures of the wrist, ankle and calcaneus. The effectiveness will be assessed in two different areas: 1 the quality of fracture reduction and fixation, based on the current golden standard, Computed Tomography. 2 The patient-relevant outcomes like functional outcome range of motion and pain. In addition, the diagnostic accuracy of the 3D-RX-scan will be determined in a clinical setting and a cost-effectiveness as well as a cost-utility analysis will be performed. Methods/design In this protocol for an international multicenter randomized clinical trial, adult patients (age > 17 years with a traumatic intra-articular fracture of the

  9. Improved long-term survival after intra-operative single high-dose ATG-Fresenius induction in renal transplantation: a single centre experience.

    Science.gov (United States)

    Kaden, Jürgen; May, Gottfried; Völp, Andreas; Wesslau, Claus

    2009-01-01

    In organ grafts donor-specific sensitization is initiated immediately after revascularization. Therefore, in 1990 we introduced the intra-operative single high-dose ATG-Fresenius (ATG-F) induction in addition to standard triple drug therapy (TDT) consisting of steroids, azathioprine and cyclosporin. A total of 778 first renal transplantations from deceased donors, performed between 1987 and 1998, were included in this evaluation. This retrospective analysis of clinic records and electronic databases presents data of all recipients of first kidney grafts who received two different ATG-F inductions (1(st) group: 9 mg/kg body weight as single high-dose intra-operatively, n=484; 2(nd) group: 3 mg/kg body weight on 7 or 8 consecutive days as multiple-dose starting also intra-operatively, n=78) and standard TDT alone (3(rd) group: TDT alone, n=216). The 10-year patient survival rates were 72.6+/-2.6% (TDT + ATG-F single high-dose), 79.5+/-5.1% (TDT + ATG-F multiple-dose) and 67.2+/-3.7%% (TDT alone; Kaplan-Meier estimates with standard errors; ATG-F vs TDT alone, p=0.001). The 10-year graft survival rates with censoring of patients that died with a functioning graft were 73.8+/-2.4%, 57.7+/-5.8% and 58.4+/-3.6% (Kaplan-Meier estimates with standard errors; 1(st) vs 2(nd )and 3(rd) group, respectively, p<0.001) and the 10-year graft survival rates with patient death counted as graft failure were 58.3+/-2.7%, 55.7+/-5.8% and 48.2+/-3.5% (Kaplan-Meier estimates with standard errors; ATG-F single high-dose vs TDT, p=0.023). In pre-sensitized recipients there were also significant differences in favour of ATG-F, more notably in the single high-dose ATG-F induction. A total of 69% of the patients in the two cohorts receiving ATG-F did not experience any transplant rejections compared to 56% in patients undergoing TDT alone (p=0.018). The incidence of infectious complications was comparable across all groups. According to evidence obtained from the routine documentation of 778

  10. Intra-operative Vector Flow Imaging Using Ultrasound of the Ascending Aorta among 40 Patients with Normal, Stenotic and Replaced Aortic Valves

    DEFF Research Database (Denmark)

    Hansen, Kristoffer Lindskov; Møller-Sørensen, Hasse; Kjaergaard, Jesper

    2016-01-01

    Stenosis of the aortic valve gives rise to more complex blood flows with increased velocities. The angleindependent vector flow ultrasound technique transverse oscillation was employed intra-operatively on the ascending aorta of (I) 20 patients with a healthy aortic valve and 20 patients with aor...... replacement corrects some of these changes. Transverse oscillation may be useful for assessment of aortic stenosis and optimization of valve surgery. (E-mail: lindskov@gmail.com) 2016 World Federation for Ultrasound in Medicine & Biology...... with aortic stenosis before (IIa) and after (IIb) valve replacement. The results indicate that aortic stenosis increased flow complexity (p , 0.0001), induced systolic backflow (p , 0.003) and reduced systolic jet width (p , 0.0001). After valve replacement, the systolic backflow and jet width were normalized...

  11. Analysis of radiation risk to patients from intra-operative use of the mobile X-ray system (C-arm

    Directory of Open Access Journals (Sweden)

    Yang-Sub Lee

    2015-01-01

    Full Text Available Background: The aim of this study was to investigate clinical applications of mobile C-arms and consequent radiation risk, to increase medical attention on radiation protection, and to provide basic data for safe radiation use in the operating room. Materials and Methods: In this study, a total of 374 surgical operations, conducted using a portable fluoroscopic X-ray system from January to March of 2013, were analyzed. Dose summaries produced by the General Electric C-arm and data elements in digital imaging and communications in the medicine header of Ziehm C-arm, fluoroscopy time were used to obtain dose-area product (DAP and effective dose. Corresponding mean and maximum values were calculated, and the resulting data on the frequency of application, fluoroscopy time, DAP, and effective dose were compared and analyzed in terms of surgical specialty and operation types. Results: Orthopedic surgery was the most frequent with 165 cases (44.1%. The highest DAP value and effective dose were found in liver transplant among surgical specialty fields, with mean values of 2.90 ± 3.76 mGy∙m 2 and 58 ± 75.2 mSv, respectively (P = 0.0001. The highest DAP value and effective dose were observed in intra-operative mesenteric portography among types of surgery, showing mean values of 2.90 ± 3.81 mGy∙m 2 and 58.03 ± 76.24 mSv, respectively (P = 0.0001. Conclusion: Because DAP varies significantly across surgical specialties and types of operation, aggressive efforts to understand the effects of radiation dose is critical for radiation protection from intra-operative use of mobile C-arms.

  12. Intra-operative pubic arch interference during prostate seed brachytherapy in patients with CT-based pubic arch interference of ≤1 cm

    International Nuclear Information System (INIS)

    Sejpal, Samir V.; Sathiaseelan, Vythialingam; Helenowski, Irene B.; Kozlowski, James M.; Carter, Michael F.; Nadler, Robert B.; Dalton, Daniel P.; McVary, Kevin T.; Lin, William W.; Garnett, John E.; Kalapurakal, John A.

    2009-01-01

    Purpose: There are only a few reports on the frequency of intra-operative pubic arch interference (I-PAI) during prostate seed brachytherapy (PB). Materials and methods: Two hundred and forty-three patients with a CT-based pubic arch interference (PAI) of ≤1 cm and a prostate volume of ≤50-60 cc underwent PB. Those patients requiring needle repositioning by ≥0.5 cm on the template were scored as having I-PAI. The incidence of I-PAI and its impact on biochemical control were analyzed. Results: Intra-operative PAI was encountered in 47 (19.3%) patients. Forty two patients (17.3%) had I-PAI in 1-2 needles, two (0.8%) had I-PAI in four needles and three patients (1.2%) had I-PAI in six needles. Overall, 1.4% of needles required repositioning due to I-PAI. BMI > 27 kg/m 2 and wider (>75 mm) pubic bone separation at mid ramus (PS-ML) were associated with a lower incidence of I-PAI. At a median follow-up of 50.1 months, the 3- and 5-year bPFS was 97.3% and 95.2%, respectively. The 5-year bPFS rates for patients with and without I-PAI were 95.6% and 95%, respectively (p = 0.28). Conclusions: The use of CT-based PAI of ≤1 cm as a selection criterion for PB is a simple and reliable method for minimizing the incidence of I-PAI and maintaining excellent biochemical control rates.

  13. Intra-operative cerebrospinal fluid sampling versus post-operative lumbar puncture for detection of leptomeningeal disease in malignant paediatric brain tumours.

    Directory of Open Access Journals (Sweden)

    Sharon Y Y Low

    Full Text Available Leptomeningeal disease is a feared sequelae of malignant paediatric brain tumours. Current methods for its detection is the combined use of cranio-spinal MRI, and CSF cytology from a post-operative lumbar puncture. In this study, the authors hypothesize that CSF taken at the start of surgery, either from an external ventricular drain or neuroendoscope will have equal sensitivity for positive tumour cells, in comparison to lumbar puncture. Secondary hypotheses include positive correlation between CSF cytology and MRI findings of LMD. From a clinical perspective, the key aim of the study was for affected paediatric patients to avoid an additional procedure of a lumbar puncture, often performed under anaesthesia after neurosurgical intervention.This is single-institution, retrospective study of paediatric patients diagnosed with malignant brain tumours. Its main aim was to compare cytological data from CSF collected at the time of surgery versus data from an interval lumbar puncture. In addition, MRI imaging of the same cohort of patients was examined for leptomeningeal disease and corroborated against CSF tumour cytology findings.Thirty patients are recruited for this study. Data analysis demonstrates a statistically significant association between our intra-operative CSF and LP sampling. Furthermore, our results also show for significant correlation between evidence of leptomeningeal disease on MRI findings versus intra-operative CSF positivity for tumour cells.Although this is a retrospective study with a limited population, our data concurs with potential to avoid an additional procedure for the paediatric patient diagnosed with a malignant brain tumour.

  14. Intra-operative computer navigation guided cervical pedicle screw insertion in thirty-three complex cervical spine deformities

    Directory of Open Access Journals (Sweden)

    S Rajasekaran

    2010-01-01

    Full Text Available Background: Cervical pedicle screw fixation is challenging due to the small osseous morphometrics and the close proximity of neurovascular elements. Computer navigation has been reported to improve the accuracy of pedicle screw placement. There are very few studies assessing its efficacy in the presence of deformity. Also cervical pedicle screw insertion in children has not been described before. We evaluated the safety and accuracy of Iso-C 3D-navigated pedicle screws in the deformed cervical spine. Materials and Methods: Thirty-three patients including 15 children formed the study group. One hundred and forty-five cervical pedicle screws were inserted using Iso-C 3D-based computer navigation in patients undergoing cervical spine stabilization for craniovertebral junction anomalies, cervico-thoracic deformities and cervical instabilities due to trauma, post-surgery and degenerative disorders. The accuracy and containment of screw placement was assessed from postoperative computerized tomography scans. Results: One hundred and thirty (89.7% screws were well contained inside the pedicles. Nine (6.1% Type A and six (4.2% Type B pedicle breaches were observed. In 136 levels, the screws were inserted in the classical description of pedicle screw application and in nine deformed vertebra, the screws were inserted in a non-classical fashion, taking purchase of the best bone stock. None of them had a critical breach. No patient had any neurovascular complications. Conclusion: Iso-C navigation improves the safety and accuracy of pedicle screw insertion and is not only successful in achieving secure pedicle fixation but also in identifying the best available bone stock for three-column bone fixation in altered anatomy. The advantages conferred by cervical pedicle screws can be extended to the pediatric population also.

  15. Attenuation measurements show that the presence of a TachoSil surgical patch will not compromise target irradiation in intra-operative electron radiation therapy or high-dose-rate brachytherapy.

    Science.gov (United States)

    Sarmento, Sandra; Costa, Filipa; Pereira, Alexandre; Lencart, Joana; Dias, Anabela; Cunha, Luís; Sousa, Olga; Silva, José Pedro; Santos, Lúcio

    2015-01-09

    Surgery of locally advanced and/or recurrent rectal cancer can be complemented with intra-operative electron radiation therapy (IOERT) to deliver a single dose of radiation directly to the unresectable margins, while sparing nearby sensitive organs/structures. Haemorrhages may occur and can affect the dose distribution, leading to an incorrect target irradiation. The TachoSil (TS) surgical patch, when activated, creates a fibrin clot at the surgical site to achieve haemostasis. The aim of this work was to determine the effect of TS on the dose distribution, and ascertain whether it could be used in combination with IOERT. This characterization was extended to include high dose rate (HDR) intraoperative brachytherapy, which is sometimes used at other institutions instead of IOERT. CT images of the TS patch were acquired for initial characterization. Dosimetric measurements were performed in a water tank phantom, using a conventional LINAC with a hard-docking system of cylindrical applicators. Percentage Depth Dose (PDD) curves were obtained, and measurements made at the depth of dose maximum for the three clinically used electron energies (6, 9 and 12MeV), first without any attenuator and then with the activated patch of TS completely covering the tip of the IOERT applicator. For HDR brachytherapy, a measurement setup was improvised using a solid water phantom and a Farmer ionization chamber. Our measurements show that the attenuation of a TachoSil patch is negligible, both for high energy electron beams (6 to 12MeV), and for a HDR (192)Ir brachytherapy source. Our results cannot be extrapolated to lower beam energies such as 50 kVp X-rays, which are sometimes used for breast IORT. The TachoSil surgical patch can be used in IORT procedures using 6MeV electron energies or higher, or HDR (192)Ir brachytherapy.

  16. Attenuation measurements show that the presence of a TachoSil surgical patch will not compromise target irradiation in intra-operative electron radiation therapy or high-dose-rate brachytherapy

    International Nuclear Information System (INIS)

    Sarmento, Sandra; Costa, Filipa; Pereira, Alexandre; Lencart, Joana; Dias, Anabela; Cunha, Luís; Sousa, Olga; Silva, José Pedro; Santos, Lúcio

    2015-01-01

    Surgery of locally advanced and/or recurrent rectal cancer can be complemented with intra-operative electron radiation therapy (IOERT) to deliver a single dose of radiation directly to the unresectable margins, while sparing nearby sensitive organs/structures. Haemorrhages may occur and can affect the dose distribution, leading to an incorrect target irradiation. The TachoSil (TS) surgical patch, when activated, creates a fibrin clot at the surgical site to achieve haemostasis. The aim of this work was to determine the effect of TS on the dose distribution, and ascertain whether it could be used in combination with IOERT. This characterization was extended to include high dose rate (HDR) intraoperative brachytherapy, which is sometimes used at other institutions instead of IOERT. CT images of the TS patch were acquired for initial characterization. Dosimetric measurements were performed in a water tank phantom, using a conventional LINAC with a hard-docking system of cylindrical applicators. Percentage Depth Dose (PDD) curves were obtained, and measurements made at the depth of dose maximum for the three clinically used electron energies (6, 9 and 12MeV), first without any attenuator and then with the activated patch of TS completely covering the tip of the IOERT applicator. For HDR brachytherapy, a measurement setup was improvised using a solid water phantom and a Farmer ionization chamber. Our measurements show that the attenuation of a TachoSil patch is negligible, both for high energy electron beams (6 to 12MeV), and for a HDR 192 Ir brachytherapy source. Our results cannot be extrapolated to lower beam energies such as 50 kVp X-rays, which are sometimes used for breast IORT. The TachoSil surgical patch can be used in IORT procedures using 6MeV electron energies or higher, or HDR 192 Ir brachytherapy

  17. SU-E-T-537: Comparison of Intra-Operative Soft X-Rays to Low Energy Electron Beams for Treatment of Superficial Lesions

    International Nuclear Information System (INIS)

    Chinsky, B; Diak, A; Gros, S; Sethi

    2014-01-01

    Purpose: Superficial soft x-ray applicators have recently been designed for use with existing intra-operative radiotherapy systems. These applicators may be used in treating superficial lesions which are conventionally treated with electron beams. The purpose of this abstract is to compare dose distributions of an intra-operative 50kV x-ray unit with low energy electrons for the treatment of superficial lesions. Methods: Dosimetric parameters for 1 and 3-cm diameter Intrabeam superficial x-ray applicators were measured with EBT3 Gafchromic film in a solid water phantom. Depth dose distributions and profiles (d=2, 5, 10 and 15mm) were obtained by prescribing a dose of 400cGy at 5mm depth below the phantom surface. Corresponding dose profiles for 6-MeV electrons were acquired from a Varian Clinac 21EX at 100 SSD. H and D calibration curves were generated for each modality for 0-800cGy. Results: Dose coverage, penumbra, dose uniformity, surface dose, and dose fall-off were examined. Compared to electrons, Intrabeam lateral dose coverage at 5mm depth was 70% larger with a much sharper (1/4) penumbra. Electron isodose levels bulged with depth, whereas Intrabeam isodose levels exhibited a convex cone shape. The Intrabeam dose profiles demonstrated horns in the dose distribution up to a 5mm depth and an exponential dose fall-off. Relative surface dose was higher for the Intrabeam applicators. Treatment times were comparable for both modalities. Conclusions: The very small penumbra of Intrabeam at shallow depths could be useful in treating superficial lesions adjacent to critical structures. The exponential dose fall-off of Intrabeam makes it appealing in the sparing of structures beyond the lesion. However, for lesions past a depth of 5mm, electrons would be desirable as they penetrate farther and provide skin sparing. Intrabeam may be preferable for sites that are difficult to treat with electrons due to mechanical and physical limitations

  18. Real-time simulation for intra-operative navigation in robotic surgery. Using a mass spring system for a basic study of organ deformation.

    Science.gov (United States)

    Kawamura, Kazuya; Kobayashi, Yo; Fujie, Masakatsu G

    2007-01-01

    Medical technology has advanced with the introduction of robot technology, making previous medical treatments that were very difficult far more possible. However, operation of a surgical robot demands substantial training and continual practice on the part of the surgeon because it requires difficult techniques that are different from those of traditional surgical procedures. We focused on a simulation technology based on the physical characteristics of organs. In this research, we proposed the development of surgical simulation, based on a physical model, for intra-operative navigation by a surgeon. In this paper, we describe the design of our system, in particular our organ deformation calculator. The proposed simulation system consists of an organ deformation calculator and virtual slave manipulators. We obtained adequate experimental results of a target node at a nearby point of interaction, because this point ensures better accuracy for our simulation model. The next research step would be to focus on a surgical environment in which internal organ models would be integrated into a slave simulation system.

  19. Multiple Myeloma Presenting as Massive Amyloid Deposition in a Parathyroid Gland Associated with Amyloid Goiter: A Medullary Thyroid Carcinoma Mimic on Intra-operative Frozen Section.

    Science.gov (United States)

    Hill, Kirk; Diaz, Jason; Hagemann, Ian S; Chernock, Rebecca D

    2018-06-01

    Clinical examples of amyloid deposition in parathyroid glands are exceedingly rare and usually present as an incidental finding in a patient with amyloid goiter. Here, we present the first histologically documented case of parathyroid amyloid deposition that presented as a mass. The patient did not have hyperparathyroidism. The parathyroid gland was submitted for intra-operative frozen section and concern for medullary thyroid carcinoma was raised. An important histologic clue arguing against medullary thyroid carcinoma was the evenly dispersed nature of the amyloid. Histologic perinuclear clearing and parathyroid hormone immunohistochemistry confirmed parathyroid origin on permanent sections. The patient was also found to have associated amyloid goiter. Mass spectrometry of the amyloid showed it to be composed of kappa light chains. On further work-up, the patient was diagnosed with multiple myeloma. Awareness of parathyroid amyloid deposition is important as it is a histologic mimic of medullary thyroid carcinoma, especially on frozen section. Amyloid typing with evaluation for multiple myeloma in any patient with kappa or lambda light chain restriction is also important.

  20. Comparison of the time taken for localised breast surgery pre- and post-introduction of intra-operative digital specimen mammography.

    Science.gov (United States)

    Carraro do Nascimento, Vinicius; Bourke, Anita G

    2018-02-01

    More than half of the patients with an impalpable malignant breast lesion have a mammographically detected and imaged-guided localisation, which can be technically challenging for the breast surgeon. Specimen imaging is used to confirm successful excision of the localised index lesion and has improved the operating list efficiency resulting in a higher number of excisions per surgical list. The aim of this study was to evaluate whether introducing IDSM (intra-operative digital specimen mammography) saved operation time for localised breast surgery. A single-centre retrospective review was undertaken to compare the operation time (from incision to wound closure) taken for excision of 114 consecutive image-guided localised impalpable breast lesions, performed using departmental specimen radiography (DSR), 6 months prior to the introduction of IDSM (Hologic, Trident ® ) in March 2013, with the theatre time taken for excision of 121 consecutive image-guided localised impalpable breast lesions in the 6 months following introduction of IDSM. There was no significant difference in mean surgical time, which were 47.8 (±27.3) minutes in the CSR group and 48.8 (±25.7) minutes in the IDSM group. We were expecting to confirm a reduction in theatre time with the introduction of IDSM. Surprisingly, no difference in operating times was demonstrated. Factors that influenced the impact of IDSM included the proximity of the imaging department to the operating theatre. © 2017 The Royal Australian and New Zealand College of Radiologists.

  1. Postoperative Complications Leading to Death after Coagulum Pyelolithotomy in a Tetraplegic Patient: Can We Prevent Prolonged Ileus, Recurrent Intestinal Obstruction due to Adhesions Requiring Laparotomies, Chest Infection Warranting Tracheostomy, and Mechanical Ventilation?

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2013-01-01

    Full Text Available A 22-year-old male sustained C-6 tetraplegia in 1992. In 1993, intravenous pyelography revealed normal kidneys. Suprapubic cystostomy was performed. He underwent open cystolithotomy in 2004 and 2008. In 2009, computed tomography revealed bilateral renal calculi. Coagulum pyelolithotomy of left kidney was performed. Pleura and peritoneum were opened. Peritoneum could not be closed. Following surgery, he developed pulmonary atelectasis; he required tracheostomy and mechanical ventilation. He did not tolerate nasogastric feeding. CT of abdomen revealed bilateral renal calculi and features of proximal small bowel obstruction. Laparotomy revealed small bowel obstruction due to dense inflammatory adhesions involving multiple small bowel loops which protruded through the defect in sigmoid mesocolon and fixed posteriorly over the area of previous intervention. All adhesions were divided. The wide defect in mesocolon was not closed. In 2010, this patient again developed vomiting and distension of abdomen. Laparotomy revealed multiple adhesions. He developed chest infection and required ventilatory support again. He developed pressure sores and depression. Later abdominal symptoms recurred. This patient’s general condition deteriorated and he expired in 2011. Conclusion. Risk of postoperative complications could have been reduced if minimally invasive surgery had been performed instead of open surgery to remove stones from left kidney. Suprapubic cystostomy predisposed to repeated occurrence of stones in urinary bladder and kidneys. Spinal cord physicians should try to establish intermittent catheterisation regime in tetraplegic patients.

  2. Simulated versus realistic intra operative radiation therapy (I.O.R.T.) treatment in operating room: from knowledge of stray radiation to action

    International Nuclear Information System (INIS)

    Andreoli, S.; Moretti, R.; Catalano, M.; Locatelli, F.

    2006-01-01

    Intra-Operative Radiation Therapy (I.O.R.T.) is carried out with electron beams produced by a Linac (Linear Accelerator) generally used for conventional radiotherapy with external beam, or by dedicated accelerators that can be employed directly into an operating room. I.O.R.T. refers to the application of radiation during a surgical intervention, after the removal of a neoplastic mass. I.O.R.T. uses on the tumour area a direct irradiation, for the possible localisation of sub-clinic illness or macroscopic residue in the case of non-radical resection. Intra-Operative Radiotherapy foresees a single session only, generally preceded or followed by radiotherapy with external beam. It allows the achievement of a selective radiation boost on the tumour volume. In some cases, it can also be used as a one-time/stand alone treatment in initial cancer of small volume, or in unresectable malignancies for palliative purpose. The technical advantages of I.O.R.T. consist in the direct visual control of the target volume, and in the possibility to protect the healthy tissues by moving them away from the path of the radiation beam. The use of electron beams allows the administration of a homogeneous dose to a selected layer of tissues surrounding the tumour. The following professional staff forms the Operative Group: radiation oncologist, surgeon, anaesthetist, medical physicist, radiation technologist, nurse.The choice of a simulation geometry very similar to the clinical situation allows to evaluate radioprotection data very close to the real situation. For a fixed layout, an anthropomorphic phantom was positioned on the operating bed and a breast I.O.R.T. treatment was simulated positioning all the accessories of the operating room in their typical positions. A detailed dose mapping was performed with a Victoreen 450P ionisation chamber and with environment film-dosimeter on the walls of the operating room during the simulation of the clinical treatment. The simulation appears

  3. Dual phase helical CT versus portal venous phase CT for the detection of colorectal liver metastases: Correlation with intra-operative sonography, surgical and pathological findings

    International Nuclear Information System (INIS)

    Scott, D. John; Guthrie, J. Ashley; Arnold, Paul; Ward, Janice; Atchley, Julian; Wilson, Daniel; Robinson, Philip J.

    2001-01-01

    AIM: To assess whether dual phase helical computed tomography (DPCT) of the liver improves the detection of colorectal liver metastases compared with portal venous phase (PVP) imaging alone. MATERIALS AND METHODS: DPCT was performed in 33 consecutive patients before laparotomy for resection of colorectal liver metastases. CT comprised 8-mm slice collimation with a pitch of 1 to 1.25; imaging was commenced 20-25 and 65-70 s after the start of injection of 150 ml of contrast medium at 5 ml/s to coincide with hepatic arterial phase (HAP) and PVP contrast enhancement, respectively. Four blinded observers independently reviewed the HAP, PVP and DPCT images recording the site and size of all lesions. Alternative-free response receiver operating characteristic (AFROC) methodology was used to analyse the results, which were correlated with surgery, intra-operative ultrasound and histology. RESULTS: The mean observer sensitivities for malignant lesion detection were 75.3% for DPCT, 69.7% for PVP imaging and 66.7% for HAP imaging alone. There was a statistically significant improvement in malignant lesion detection using DPCT when compared with PVP imaging alone (P < 0.05). The mean areas under the AFROC curves were 0.84 for DPCT and 0.82 for PVP (P < 0.03) imaging alone. CONCLUSION: The detection of colorectal liver metastases was marginally better with DPCT than with PVP imaging alone, but the discovery of additional lesions did not affect the management of any of the patients in this study. Scott, D.J. et al. (2001)

  4. Design and evaluation of a portable intra-operative unified-planning-and-guidance framework applied to distal radius fracture surgery.

    Science.gov (United States)

    Magaraggia, Jessica; Wei, Wei; Weiten, Markus; Kleinszig, Gerhard; Vetter, Sven; Franke, Jochen; John, Adrian; Egli, Adrian; Barth, Karl; Angelopoulou, Elli; Hornegger, Joachim

    2017-01-01

    During a standard fracture reduction and fixation procedure of the distal radius, only fluoroscopic images are available for planning of the screw placement and monitoring of the drill bit trajectory. Our prototype intra-operative framework integrates planning and drill guidance for a simplified and improved planning transfer. Guidance information is extracted using a video camera mounted onto a surgical drill. Real-time feedback of the drill bit position is provided using an augmented view of the planning X-rays. We evaluate the accuracy of the placed screws on plastic bones and on healthy and fractured forearm specimens. We also investigate the difference in accuracy between guided screw placement versus freehand. Moreover, the accuracy of the real-time position feedback of the drill bit is evaluated. A total of 166 screws were placed. On 37 plastic bones, our obtained accuracy was [Formula: see text] mm, [Formula: see text] and [Formula: see text] in tip position and orientation (azimuth and elevation), respectively. On the three healthy forearm specimens, our obtained accuracy was [Formula: see text] mm, [Formula: see text] and [Formula: see text]. On the two fractured specimens, we attained: [Formula: see text] mm, [Formula: see text] and [Formula: see text]. When screw plans were applied freehand (without our guidance system), the achieved accuracy was [Formula: see text] mm, [Formula: see text], while when they were transferred under guidance, we obtained [Formula: see text] mm, [Formula: see text]. Our results show that our framework is expected to increase the accuracy in screw positioning and to improve robustness w.r.t. freehand placement.

  5. Comparison of surgical outcomes after anterior cervical discectomy and fusion: does the intra-operative use of a microscope improve surgical outcomes.

    Science.gov (United States)

    Adogwa, Owoicho; Elsamadicy, Aladine; Reiser, Elizabeth; Ziegler, Cole; Freischlag, Kyle; Cheng, Joseph; Bagley, Carlos A

    2016-03-01

    The primary aim of this study was to assess and compare the complications profile as well as long-term clinical outcomes between patients undergoing an Anterior Cervical Discectomy and Fusion (ACDF) procedure with and without the use of an intra-operative microscope. One hundred and forty adult patients (non-microscope cohort: 81; microscope cohort: 59) undergoing ACDF at a major academic medical center were included in this study. Enrollment criteria included available demographic, surgical and clinical outcome data. All patients had prospectively collected patient-reported outcomes measures and a minimum 2-year follow-up. Patients completed the neck disability index (NDI), short-form 12 (SF-12) and visual analog pain scale (VAS) before surgery, then at 3, 6, 12, and 24 months after surgery. Clinical outcomes and complication rates were compared between both patient cohorts. Baseline characteristics were similar between both cohorts. The mean ± standard deviation duration of surgery was longer in the microscope cohort (microscope: 169±34 minutes vs. non-microscope: 98±42 minutes, Pmicroscope and non-microscope cohorts demonstrated similar improvement from base line in NDI (microscope: 13.52±25.77 vs. non-microscope: 19.51±27.47, Pmicroscope: 4.15±26.39 vs. non-microscope: 11.98±22.96, Pmicroscope: 9.47±32.38 vs. non-microscope: 16.19±30.44, Pmicroscope: 2.22±4.00 vs. non-microscope: 3.69±3.61, Pmicroscope does not improve overall surgery-related outcomes, nor does it lead to superior long-term outcomes in pain and functional disability, 2 years after index surgery.

  6. Pre-operative and intra-operative detection of axillary lymph node metastases in 108 patients with invasive lobular breast cancer undergoing mastectomy.

    Science.gov (United States)

    Novak, Jerica; Besic, Nikola; Dzodic, Radan; Gazic, Barbara; Vogrin, Andrej

    2018-02-05

    Despite the recent changes in the treatment of the axilla in selected breast cancer patient, positive sentinel lymph node (SLN) in patients undergoing mastectomy still necessitates axillary lymph node dissection (ALND). In invasive lobular carcinoma (ILC), pre-operative detection of the lymph node metastasis may be demanding due to its unique morphology. The aim of this study was to examine the benefit of preoperative axillary ultrasound (AUS), ultrasound-guided fine-needle aspiration biopsy (US-FNAB), and intra-operative imprint cytology (IIC), in order to avoid two-stage axillary surgery in patients with ILC undergoing mastectomy. The object of this study were 102 patients (median age 52, range 34-73 years) with clinically non-suspicious axilla in whom 108 mastectomies were performed after a pre-operative AUS investigation. Whenever a metastasis was detected in a sentinel lymph node, ALND was done. Reports of the pre-operative AUS investigation, US-FNAB, and IIC were compared with definitive histopathological reports of surgical specimens. In 46 cases lymph node metastases were diagnosed. AUS suspicious lymph nodes were found in 29/108 cases and histopathology confirmed metastases in 22/30 cases. US-FNAB was performed in 29 cases with AUS suspicious lymph nodes. Cytology proved metastases in 11/29 cases. Histopathology confirmed metastases in 10/11 cases with only isolated tumor cells found in one case. IIC investigation was performed in 63 cases and in 10/27 cases metastases were confirmed by histopathology. Pre-operative AUS, US-FNAB, and/or IIC investigation enabled ALND during a single surgical procedure in 20/46 patients with metastases in lymph nodes. Pre-operative AUS, US-FNAB, and/or IIC are/is beneficial in patients with ILC planned for mastectomy in order to decrease the number of two stage axillary procedures.

  7. Intra-Operative Inspired Fraction of Oxygen and the Risk of Surgical Site Infections in Patients with Type 1 Surgical Incisions.

    Science.gov (United States)

    Wanta, Brendan T; Hanson, Kristine T; Hyder, Joseph A; Stewart, Thomas M; Curry, Timothy B; Berbari, Elie F; Habermann, Elizabeth B; Kor, Daryl J; Brown, Michael J

    2018-04-02

    Whether the fraction of inspired oxygen (F I O 2 ) influences the risk of surgical site infection (SSI) is controversial. The World Health Organization and the World Federation of Societies of Anesthesiologists offer conflicting recommendations. In this study, we evaluate simultaneously three different definitions of F I O 2 exposure and the risk of SSI in a large surgical population. Patients with clean (type 1) surgical incisions who developed superficial and deep organ/space SSI within 30 days after surgery from January 2003 through December 2012 in five surgical specialties were matched to specialty-specific controls. Fraction of inspired oxygen exposure was defined as (1) nadir F I O 2 , (2) percentage of operative time with F I O 2 greater than 50%, and (3) cumulative hyperoxia exposure, calculated as the area under the curve (AUC) of F I O 2 by time for the duration in which F I O 2 greater than 50%. Stratified univariable and multivariable logistic regression models tested associations between F I O 2 and SSI. One thousand two hundred fifty cases of SSI were matched to 3,248 controls. Increased oxygen exposure, by any of the three measures, was not associated with the outcome of any SSI in a multivariable logistic regression model. Elevated body mass index (BMI; 35+ vs. operative oxygen exposure was associated with higher odds of SSI in the neurosurgical and spine populations. Increased intra-operative inspired fraction of oxygen was not associated with a reduction in SSI. These findings do not support the practice of increasing F I O 2 for the purpose of SSI reduction in patients with clean surgical incisions.

  8. Systematic Review and Meta-Analysis of Randomized Controlled Trials Evaluating Prophylactic Intra-Operative Wound Irrigation for the Prevention of Surgical Site Infections.

    Science.gov (United States)

    de Jonge, Stijn W; Boldingh, Quirine J J; Solomkin, Joseph S; Allegranzi, Benedetta; Egger, Matthias; Dellinger, E Patchen; Boermeester, Marja A

    Surgical site infections (SSIs) are one of the most common hospital-acquired infections. To reduce SSIs, prophylactic intra-operative wound irrigation (pIOWI) has been advocated, although the results to date are equivocal. To develop recommendations for the new World Health Organization (WHO) SSI prevention guidelines, a systematic literature review and a meta-analysis were conducted on the effectiveness of pIOWI using different agents as a means of reducing SSI. The PUBMED, Embase, CENTRAL, CINAHL, and WHO databases were searched. Randomized controlled trials (RCTs) comparing either pIOWI with no pIOWI or with pIOWI using different solutions and techniques were retrieved with SSI as the primary outcome. Meta-analyses were performed, and odds ratios (OR) and the mean difference with 95% confidence intervals (CI) were extracted and pooled with a random effects model. Twenty-one studies were suitable for analysis, and a distinction was made between intra-peritoneal, mediastinal, and incisional wound irrigation. A low quality of evidence demonstrated a statistically significant benefit for incisional wound irrigation with an aqueous povidone-iodine (PVP-I) solution in clean and clean contaminated wounds (OR 0.31; 95% CI 0.13-0.73; p = 0.007); 50 fewer SSIs per 1,000 procedures (from 19 fewer to 64 fewer)). Antibiotic irrigation had no significant effect in reducing SSIs (OR 1.16; 95% CI 0.64-2.12; p = 0.63). Low-quality evidence suggests considering the use of prophylactic incisional wound irrigation to prevent SSI with an aqueous povidone-iodine solution. Antibiotic irrigation does not show a benefit and therefore is discouraged.

  9. The effect of post-traumatic-stress-disorder on intra-operative analgesia in a veteran population during cataract procedures carried out using retrobulbar or topical anesthesia: a retrospective study.

    Science.gov (United States)

    Rapoport, Yuna; Wayman, Laura L; Chomsky, Amy S

    2017-06-07

    A growing proportion of veterans treated at the Veterans Health Administration (VA) have a history of post-traumatic-stress-disorder (PTSD), and there exists a higher rate of PTSD amongst veterans than the general population. The purpose of this study is to determine the correlation between PTSD and intra-operative analgesia, intra-operative time, and anesthesia type for cataract surgery in a veteran population. Secondary objectives are to determine if patient age, and first or second eye surgery affect intra-operative pain control or are correlated with type of anesthesia modality. A retrospective study of 330 cataract surgeries performed by resident physicians between January and September 2012 at the Veterans Affairs Medical Center Tennessee Valley Healthcare System, Nashville and Murfreesboro Campuses was completed. Three hundred and thirty veteran patients were selected if their cataract surgery was performed between January and September 2012. Combined cases were excluded. The primary outcome evaluated was intra-operative analgesia. Secondary outcomes included history of post-traumatic-stress-disorder, anesthesia type, first or second eye, pain control, intra-operative heart rate and blood pressure, age, and case complexity. Data was analyzed using an unpaired two-sample Welch's t-test assuming unequal variance and Z test of comparison of proportions. Patients with post-traumatic-stress-disorder reported higher pain scores, had longer operative times, and were more likely to have received a retrobulbar block. Operative time was not associated with an increased pain score, irrespective of anesthesia type, when controlled for PTSD. Complex cases had longer operative times, more sedation, and higher pain scores. P < 0.05 was used consistently. Post-traumatic stress disorder and anxiety are more prevalent in the veteran population. Our data suggests that a history of post-traumatic-stress-disorder was correlated with higher pain scores, longer operative times

  10. Diagnostic accuracy of touch imprint cytology for head and neck malignancies: a useful intra-operative tool in resource limited countries.

    Science.gov (United States)

    Naveed, Hania; Abid, Mariam; Hashmi, Atif Ali; Edhi, Muhammad Muzammamil; Sheikh, Ahmareen Khalid; Mudassir, Ghazala; Khan, Amir

    2017-01-01

    Intraoperative consultation is an important tool for the evaluation of the upper aerodigestive tract (UAT) malignancies. Although frozen section analysis is a preferred method of intra-operative consultation, however in resource limited countries like Pakistan, this facility is not available in most institutes; therefore, we aimed to evaluate the diagnostic accuracy of touch imprint cytology for UAT malignancies using histopathology of the same tissue as gold standard. The study involved 70 cases of UAT lesions operated during the study period. Intraoperatively, after obtaining the fresh biopsy specimen and prior to placing them in fixative, each specimen was imprinted on 4-6 glass slides, fixed immediately in 95% alcohol and stained with Hematoxylin and Eosin stain. After completion of the cytological procedure, the surgical biopsy specimen was processed. The slides of both touch Imprint cytology and histopathology were examined by two consultant histopathologists. The result of touch imprint cytology showed that touch imprint cytology was diagnostic in 68 cases (97.1%), 55 (78.6%) being malignant, 2 cases (2.9%) were suspicious for malignancy, 11 cases (15.7%) were negative for malignancy while 2 cases (2.9%) were false negative. Amongst the 70 cases, 55 cases (78.6%) were malignant showing squamous cell carcinoma in 49 cases (70%), adenoid cystic carcinoma in 2 cases (2.9%), non-Hodgkin lymphoma 2 cases (2.9%), Mucoepidermoid carcinoma 1 case (1.4%), spindle cell sarcoma in 1 case (1.4%). Two cases (2.9%) were suspicious of malignancy showing atypical squamoid cells on touch imprint cytology, while 13 cases (18.6%) were negative for malignancy, which also included 2 false negative cases. The overall diagnostic accuracy of touch imprint cytology came out to be 96.7% with a sensitivity and specificity of 96 and 100%, respectively while PPV and NPV of touch imprint cytology was found to be 100 and 84%, respectively. Our experience in this study has demonstrated

  11. The effect of two different intra-operative end-tidal carbon dioxide tensions on apnoeic duration in the recovery period in horses.

    Science.gov (United States)

    Thompson, Kate R; Bardell, David

    2016-03-01

    To compare the effect of two different intraoperative end-tidal carbon dioxide tensions on apnoeic duration in the recovery period in horses. Prospective randomized clinical study. Eighteen healthy client-owned adult horses (ASA I-II) admitted for elective surgery. Horses were of a median body mass of 595 (238-706) kg and a mean age of 9 ± 5 years. A standardized anaesthetic protocol was used. Horses were positioned in dorsal recumbency and randomly allocated to one of two groups. Controlled mechanical ventilation (CMV) was adjusted to maintain the end-tidal carbon dioxide tension (Pe'CO2 ) at 40 ± 5 mmHg (5.3 ± 0.7 kPa) (group 40) or 60 ± 5 mmHg (8.0 ± 0.7 kPa) (group 60). Arterial blood gas analysis was performed at the start of the anaesthetic period (T0), at one point during the anaesthetic (T1), immediately prior to disconnection from the breathing system (T2) and at the first spontaneous breath in the recovery box (T3). The time from disconnection from the breathing system to return to spontaneous ventilation (RSV) was recorded. Data were analysed using a two sample t-test or the Mann-Whitney U-test and significance assigned when p breathing significantly earlier than those in group 40, [52 (14-151) and 210 (103-542) seconds, respectively] (p tension (PaO2 ), pH, base excess (BE) and plasma bicarbonate (HCO3-) were not different between the groups at RSV, however, PaO2 was significantly lower in group 60 during (T1) and at the end of anaesthesia (T2). Aiming to maintain intra-operative Pe'CO2 at 60 ± 5 mmHg (8.0 ± 0.7 kPa) in mechanically ventilated horses resulted in more rapid RSV compared with when Pe'CO2 was maintained at 40 ± 5 mmHg (5.3 ± 0.7 kPa). © 2015 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  12. Intra-operative lymphatic mapping with Dextran Tc-99m and blue dye for sentinel node detection in patients with primary vulvar malignancies

    International Nuclear Information System (INIS)

    Morales, R.E.; Aguilar, C.R.; Cano, R.A.; Saavedra, P.; Santos, C.

    2004-01-01

    Full text: The purpose of this study was to determine the feasibility of sentinel lymph node detection using preoperative lymphoscintigraphy and intra-operative lymphatic mapping in patients with primary vulvar malignancies. Nine patients (29-84 years old) with primary vulvar malignancy were scheduled for sentinel node detection. Two patients had malignant melanoma of the vulva and seven had squamous cell carcinomas. Eight patients did not have a previous surgery of the primary tumour nor of the lymph nodes, one had an aspiration biopsy. Three hours before surgery 1-5 mCi of Tc-99m Dextran was injected intradermally in four points in the skin junction adjacent to the vulvar lesions. Static lymphoscintigraphy was performed using a planar GE gamma camera with a multipurpose low energy collimator, in anterior and lateral views. Images were displayed on a personal computer, through a Portable Imaging Processing software (PIP). In two cases a Siemens ECAM SPECT camera was used, due to necessity of having high-resolution images. Patten blue dye was injected in the junction between the skin and vulvar tumor, in the surgery room, after anaesthesia induction. Agamma probe (Navigator Gamma Guidance System) was used to detect the sentinel node. The activity in the sentinel node was measured in each case, before and after resection. Activity in the remaining tissue was also measured. Nodes were adequately placed in plastic bags and sent to pathology for H-E staining. Non-sentinel nodes were also resected and sent for pathology, except in two cases. Sentinel nodes (SN) were visualised on lymphoscintigraphy 1 to 5 minutes after injection of Tc-99m Dextran. In malignant melanoma drainage to the sentinel node was faster than for other tumours. There were five cases who had bilateral SN in inguinal regions, in other three cases, two SN were located on the same side, two in the inguinal region. In all cases the SN was identified corroborating to the skin mark and with enough

  13. Incremental value of combined 99MTc tetrofosmin parathyroid scintigraphy, rapid intra operative PTH assays and minimally invasive radio-guided surgery (MIRS) in optimizing parathyroidectomies

    International Nuclear Information System (INIS)

    Padma, S.; Kumar, S.; Babu, T.; Kumar, H.; Nair, V.; Nair, G.K.

    2004-01-01

    Objective: Aim of our study was to evaluate incremental diagnostic value of 99mTc Tetrofosmin parathyroid SPECT (TPSPECT), rapid intra operative quick parathyroid hormone measurement (QPTH) combined with radio guidance provided by scintillation probe (Minimally Invasive Radio guided Surgery MIRS) in parathyroid surgeries. While TPSPECT is an established investigation in preoperative workup of hyperparathyroidism patients , MIRS is a relatively new concept in Indian subcontinent. Methods: 29 pts (M: F = 18: 11), age range 16- 65 yrs (mean 41+ 9 yrs) having clinical and biochemical hyperparathyroidism underwent TPSPECT between Jan 02 -04, using 20 mci IV 99mTc Tetrofosmin. Pts with familial hyperparathyroidism , previous nodular goiters and previous neck irradiation were excluded from study. Scintigraphy comprised of immediate, delayed planar and SPECT imaging of neck and chest. Imagewise abnormal, persistent tracer uptake was considered positive for adenoma and diffuse uptake for hyperplasia. 26 pts underwent exploration (22 adenomas and 4 hyperplasias).18 pts had benefit of intraoperative QPTH. A select group (after Dec 2003) i.e. 9 pts got the assistance of radioguided probing. Peroperatively NM physician used cordless handheld gamma probe (Gamma Finder, World of Medicine, Germany) in neck and mediastinum to detect parathyroid adenoma / hyperplasias. A five fold increase in radioactive counts perceived by probe when compared to background was considered positive for parathyroid adenoma / hyperplasia. If PTH levels fell from baseline by at least 50%, the surgery was concluded as complete. Results: In all 22 pts suspected to have primary hyperparathyroidism TPSPECT identified adenomas (100 % sensitivity). While planar imaging had a sensitivity of 90.1% (20/22 pts), SPECT identified the adenoma in all pts. Interestingly only 3/22 pts had ectopic glands while 5 had more than one adenomas. The most commonly involved gland was left inferior. In secondary

  14. Tight intra-operative blood pressure control versus standard care for patients undergoing hip fracture repair - Hip Fracture Intervention Study for Prevention of Hypotension (HIP-HOP) trial: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Moppett, Iain Keith; White, Stuart; Griffiths, Richard; Buggy, Donal

    2017-07-25

    Hypotension during anaesthesia for hip fracture surgery is common. Recent data suggest that there is an association between the lowest intra-operative blood pressure and mortality, even when adjusted for co-morbidities. This is consistent with data derived from the wider surgical population, where magnitude and duration of hypotension are associated with mortality and peri-operative complications. However, there are no trial to data to support more aggressive blood pressure control. We are conducting a three-centre, randomised, double-blinded pilot study in three hospitals in the United Kingdom. The sample size will be 75 patients (25 from each centre). Randomisation will be done using computer-generated concealed tables. Both participants and investigators will be blinded to group allocation. Participants will be aged >70 years, cognitively intact (Abbreviated Mental Test Score 7 or greater), able to give informed consent and admitted directly through the emergency department with a fractured neck of the femur requiring operative repair. Patients randomised to tight blood pressure control or avoidance of intra-operative hypotension will receive active treatment as required to maintain both of the following: systolic arterial blood pressure >80% of baseline pre-operative value and mean arterial pressure >75 mmHg throughout. All participants will receive standard hospital care, including spinal or general anaesthesia, at the discretion of the clinical team. The primary outcome is a composite of the presence or absence of defined cardiovascular, renal and delirium morbidity within 7 days of surgery (myocardial injury, stroke, acute kidney injury, delirium). Secondary endpoints will include the defined individual morbidities, mortality, early mobility and discharge to usual residence. This is a small-scale pilot study investigating the feasibility of a trial of tight intra-operative blood pressure control in a frail elderly patient group with known high morbidity

  15. SU-F-T-44: A Comparison of the Pre-Plan, Intra-Operative Plan, and Post-Implant Dosimetry for a Prostate Implant Case Using Prefabricated Linear Polymer-Encapsulated Pd-103

    International Nuclear Information System (INIS)

    Sheu, R; Powers, A; McGee, H; Stock, R; Lo, Y

    2016-01-01

    Purpose: To investigate the reproducibility and limitations of Pd-103 prostate brachytherapy using fixed length linear sources (CivaString). Methods: An LDR prostate brachytherapy case which was preplanned on MR images with prefabricated linear polymer-encapsulated Pd-103 sources (CivaString) was studied and compared with ultrasound based intra-operative planning and CT based post-implant dosimetry. We evaluated the following parameters among the three studies: prostate geometry (volume and cross sectional area), needle position and alignment deviations, and dosimetry parameters (D90). Results: The prostate volumes and axial cross sectional areas at center of prostate were measured as 41.8, 39.3 and 36.8 cc, and 14.9, 14.3, and 11.3 respectively on pre-plan MR, inter-op US, and post-implant CT studies. The deviation of prostate volumes and axial cross sectional areas measured on pre-planning MR and intra-operative US were within 5%. 17 out of 19 pre-planned needles were positioned within 5mm (the template grid size). One needle location was adjusted intra-operatively and another needle was removed due to proximity to urethra. The needle pathways were not always parallel to the trans-rectal probe due to the flexibility of CivaString. The angle of deviation was up to 10 degrees. Two pairs of needles were exchanged to better fit the length of prostate at the time of implant. This resulted in a prostate D90 of 153.8 Gy (124%) and 131.4 Gy (106.7%) for intra-op and PID respectively. Conclusion: Preplanning is a necessary part of implants performed with prefabricated linear polymer sources. However, as is often the case, there were real-time deviations from the pre-plan. Intra-op planning provides the ability conform to anatomy at the time of implant. Therefore, we propose to develop a systematic way to order extra strings of different length to provide the flexibility to perform intra-operative planning with fixed length strands.

  16. SU-F-T-44: A Comparison of the Pre-Plan, Intra-Operative Plan, and Post-Implant Dosimetry for a Prostate Implant Case Using Prefabricated Linear Polymer-Encapsulated Pd-103

    Energy Technology Data Exchange (ETDEWEB)

    Sheu, R; Powers, A; McGee, H; Stock, R; Lo, Y [Mount Sinai Medical Center, New York, NY (United States)

    2016-06-15

    Purpose: To investigate the reproducibility and limitations of Pd-103 prostate brachytherapy using fixed length linear sources (CivaString). Methods: An LDR prostate brachytherapy case which was preplanned on MR images with prefabricated linear polymer-encapsulated Pd-103 sources (CivaString) was studied and compared with ultrasound based intra-operative planning and CT based post-implant dosimetry. We evaluated the following parameters among the three studies: prostate geometry (volume and cross sectional area), needle position and alignment deviations, and dosimetry parameters (D90). Results: The prostate volumes and axial cross sectional areas at center of prostate were measured as 41.8, 39.3 and 36.8 cc, and 14.9, 14.3, and 11.3 respectively on pre-plan MR, inter-op US, and post-implant CT studies. The deviation of prostate volumes and axial cross sectional areas measured on pre-planning MR and intra-operative US were within 5%. 17 out of 19 pre-planned needles were positioned within 5mm (the template grid size). One needle location was adjusted intra-operatively and another needle was removed due to proximity to urethra. The needle pathways were not always parallel to the trans-rectal probe due to the flexibility of CivaString. The angle of deviation was up to 10 degrees. Two pairs of needles were exchanged to better fit the length of prostate at the time of implant. This resulted in a prostate D90 of 153.8 Gy (124%) and 131.4 Gy (106.7%) for intra-op and PID respectively. Conclusion: Preplanning is a necessary part of implants performed with prefabricated linear polymer sources. However, as is often the case, there were real-time deviations from the pre-plan. Intra-op planning provides the ability conform to anatomy at the time of implant. Therefore, we propose to develop a systematic way to order extra strings of different length to provide the flexibility to perform intra-operative planning with fixed length strands.

  17. Extended objects

    International Nuclear Information System (INIS)

    Creutz, M.

    1976-01-01

    After some disconnected comments on the MIT bag and string models for extended hadrons, I review current understanding of extended objects in classical conventional relativistic field theories and their quantum mechanical interpretation

  18. Extended Emotions

    DEFF Research Database (Denmark)

    Krueger, Joel; Szanto, Thomas

    2016-01-01

    beyond the neurophysiological confines of organisms; some even argue that emotions can be socially extended and shared by multiple agents. Call this the extended emotions thesis (ExE). In this article, we consider different ways of understanding ExE in philosophy, psychology, and the cognitive sciences...

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

    Science.gov (United States)

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

    2014-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Manash Ranjan Sahoo

    2014-01-01

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

  1. Extended thermodynamics

    CERN Document Server

    Müller, Ingo

    1993-01-01

    Physicists firmly believe that the differential equations of nature should be hyperbolic so as to exclude action at a distance; yet the equations of irreversible thermodynamics - those of Navier-Stokes and Fourier - are parabolic. This incompatibility between the expectation of physicists and the classical laws of thermodynamics has prompted the formulation of extended thermodynamics. After describing the motifs and early evolution of this new branch of irreversible thermodynamics, the authors apply the theory to mon-atomic gases, mixtures of gases, relativistic gases, and "gases" of phonons and photons. The discussion brings into perspective the various phenomena called second sound, such as heat propagation, propagation of shear stress and concentration, and the second sound in liquid helium. The formal mathematical structure of extended thermodynamics is exposed and the theory is shown to be fully compatible with the kinetic theory of gases. The study closes with the testing of extended thermodynamics thro...

  2. Pre- and/or Intra-Operative Prescription of Diuretics, but Not Renin-Angiotensin-System Inhibitors, Is Significantly Associated with Acute Kidney Injury after Non-Cardiac Surgery: A Retrospective Cohort Study.

    Science.gov (United States)

    Tagawa, Miho; Ogata, Ai; Hamano, Takayuki

    2015-01-01

    Pre- and/or intra-operative use of diuretics, angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin II receptor blockers (ARB) constitutes a potentially modifiable risk factor for postoperative acute kidney injury (AKI). It has been studied whether use of these drugs predicts AKI after cardiac surgery. The objective of this study was to examine whether administration of these agents was independently associated with AKI after non-cardiac surgery. This was a retrospective observational study. Inclusion criteria were adult patients (age ≥ 18) who underwent non-cardiac surgery under general anesthesia from 2007 to 2009 at Kyoto Katsura Hospital. Exclusion criteria were urological surgery, missing creatinine values, and preoperative dialysis. The exposures of interest were pre- and/or intra-operative use of diuretics or ACE-I/ARB. Outcome variables were postoperative AKI as defined by the AKI Network (increase in creatinine ≥ 0.3 mg/dL or 150% within 48 hours, or urine output 6 hours). Multivariable logistic regression analyses were conducted and adjusted for potential confounders. Propensity scores (PS) for receiving diuretics or ACE-I/ARB therapy were estimated and PS adjustment, PS matching, and inverse probability weighting were performed. There were 137 AKI cases (5.0%) among 2,725 subjects. After statistical adjustment for patient and surgical characteristics, odds (95% CI) of postoperative AKI were 2.07 (1.10-3.89) (p = 0.02) and 0.89 (0.56-1.42) (p = 0.63) in users of diuretics and ACE-I/ARB, respectively, compared with non-users. PS adjustment, PS matching, and inverse probability weighting yielded similar results. The effect size of diuretics was significantly greater in the patients with lower propensity for diuretic use (p for interaction diuretics, but not ACE-I/ARB, was independently associated with postoperative AKI after non-cardiac surgery, especially in patients with low propensity for diuretic use. It might be reasonable to withhold

  3. Extending Puppet

    CERN Document Server

    Franceschi, Alessandro

    2014-01-01

    This book is a clear, detailed and practical guide to learn about designing and deploying you puppet architecture, with informative examples to highlight and explain concepts in a focused manner. This book is designed for users who already have good experience with Puppet, and will surprise experienced users with innovative topics that explore how to design, implement, adapt, and deploy a Puppet architecture. The key to extending Puppet is the development of types and providers, for which you must be familiar with Ruby.

  4. Consciousness extended

    DEFF Research Database (Denmark)

    Carrara-Augustenborg, Claudia

    2012-01-01

    There is no consensus yet regarding a conceptualization of consciousness able to accommodate all the features of such complex phenomenon. Different theoretical and empirical models lend strength to both the occurrence of a non-accessible informational broadcast, and to the mobilization of specific...... brain areas responsible for the emergence of the individual´s explicit and variable access to given segments of such broadcast. Rather than advocating one model over others, this chapter proposes to broaden the conceptualization of consciousness by letting it embrace both mechanisms. Within...... such extended framework, I propose conceptual and functional distinctions between consciousness (global broadcast of information), awareness (individual´s ability to access the content of such broadcast) and unconsciousness (focally isolated neural activations). My hypothesis is that a demarcation in terms...

  5. The NO Regular Defibrillation testing In Cardioverter Defibrillator Implantation (NORDIC ICD) trial: concept and design of a randomized, controlled trial of intra-operative defibrillation testing during de novo defibrillator implantation.

    Science.gov (United States)

    Bänsch, Dietmar; Bonnemeier, Hendrik; Brandt, Johan; Bode, Frank; Svendsen, Jesper Hastrup; Felk, Angelika; Hauser, Tino; Wegscheider, Karl

    2015-01-01

    Although defibrillation (DF) testing is still considered a standard procedure during implantable cardioverter-defibrillator (ICD) insertion and has been an essential element of all trials that demonstrated the survival benefit of ICD therapy, there are no large randomized clinical trials demonstrating that DF testing improves clinical outcome and if the outcome would remain the same by omitting DF testing. Between February 2011 and July 2013, we randomly assigned 1077 patients to ICD implantation with (n = 540) or without (n = 537) DF testing. The intra-operative DF testing was standardized across all participating centres. After inducing a fast ventricular tachycardia (VT) with a heart rate ≥240 b.p.m. or ventricular fibrillation (VF) with a low-energy T-wave shock, DF was attempted with an initial 15 J shock. If the shock reversed the VT or VF, DF testing was considered successful and terminated. If unsuccessful, two effective 24 J shocks were administered. If DF was unsuccessful, the system was reconfigured and another DF testing was performed. An ICD shock energy of 40 J had to be programmed in all patients for treatment of spontaneous VT/VF episodes. The primary endpoint was the average efficacy of the first ICD shock for all true VT/VF episodes in each patient during follow-up. The secondary endpoints included the frequency of system revisions, total fluoroscopy, implantation time, procedural serious adverse events, and all-cause, cardiac, and arrhythmic mortality during follow-up. Home Monitoring was used in all patients to continuously monitor the system integrity, device programming and performance. The NO Regular Defibrillation testing In Cardioverter Defibrillator Implantation (NORDIC ICD) trial is one of two large prospective randomized trials assessing the effect of DF testing omission during ICD implantation. NCT01282918. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email

  6. How Far Can Extended Knowledge Be Extended?

    DEFF Research Database (Denmark)

    Wray, K. Brad

    2018-01-01

    by an artifact, like a notebook or telescope. The chapter illustrates this by applying Pritchard’s account of extended knowledge to collaborating scientists. The beliefs acquired through collaborative research cannot satisfy both of Pritchard’s conditions of creditability. Further, there is evidence......Duncan Pritchard (2010) has developed a theory of extended knowledge based on the notion of extended cognition initially developed by Clark and Chalmers (1998). Pritchard’s account gives a central role to the notion of creditability, which requires the following two conditions to be met: (i...... that scientists are not prepared to take responsibility for the actions of the scientists with whom they collaborate....

  7. Extended Enterprise performance Management

    NARCIS (Netherlands)

    Bobbink, Maria Lammerdina; Hartmann, Andreas

    2014-01-01

    The allegiance of partnering organisations and their employees to an Extended Enterprise performance is its proverbial sword of Damocles. Literature on Extended Enterprises focuses on collaboration, inter-organizational integration and learning to avoid diminishing or missing allegiance becoming an

  8. Perspectives on extended Deterrence

    International Nuclear Information System (INIS)

    Tertrais, Bruno; Yost, David S.; Bunn, Elaine; Lee, Seok-soo; Levite, Ariel e.; Russell, James A.; Hokayem, Emile; Kibaroglu, Mustafa; Schulte, Paul; Thraenert, Oliver; Kulesa, Lukasz

    2010-05-01

    In November 2009, the Foundation for Strategic Research (Fondation pour la recherche strategique, FRS) convened a workshop on 'The Future of extended Deterrence', which included the participation of some of the best experts of this topic, from the United States, Europe, the Middle East and East Asia, as well as French and NATO officials. This document brings together the papers prepared for this seminar. Several of them were updated after the publication in April 2010 of the US Nuclear Posture Review. The seminar was organized with the support of the French Atomic energy Commission (Commissariat a l'energie atomique - CEA). Content: 1 - The future of extended deterrence: a brainstorming paper (Bruno Tertrais); 2 - US extended deterrence in NATO and North-East Asia (David S. Yost); 3 - The future of US extended deterrence (Elaine Bunn); 4 - The future of extended deterrence: a South Korean perspective (Seok-soo Lee); 5 - Reflections on extended deterrence in the Middle East (Ariel e. Levite); 6 - extended deterrence, security guarantees and nuclear weapons: US strategic and policy conundrums in the Gulf (James A. Russell); 7 - extended deterrence in the Gulf: a bridge too far? (Emile Hokayem); 8 - The future of extended deterrence: the case of Turkey (Mustafa Kibaroglu); 9 - The future of extended deterrence: a UK view (Paul Schulte); 10 - NATO and extended deterrence (Oliver Thraenert); 11 - extended deterrence and assurance in Central Europe (Lukasz Kulesa)

  9. Extended icosahedral structures

    CERN Document Server

    Jaric, Marko V

    1989-01-01

    Extended Icosahedral Structures discusses the concepts about crystal structures with extended icosahedral symmetry. This book is organized into six chapters that focus on actual modeling of extended icosahedral crystal structures. This text first presents a tiling approach to the modeling of icosahedral quasiperiodic crystals. It then describes the models for icosahedral alloys based on random connections between icosahedral units, with particular emphasis on diffraction properties. Other chapters examine the glassy structures with only icosahedral orientational order and the extent of tra

  10. Extending Database Integration Technology

    National Research Council Canada - National Science Library

    Buneman, Peter

    1999-01-01

    Formal approaches to the semantics of databases and database languages can have immediate and practical consequences in extending database integration technologies to include a vastly greater range...

  11. Extended family medicine training

    Science.gov (United States)

    Slade, Steve; Ross, Shelley; Lawrence, Kathrine; Archibald, Douglas; Mackay, Maria Palacios; Oandasan, Ivy F.

    2016-01-01

    Abstract Objective To examine trends in family medicine training at a time when substantial pedagogic change is under way, focusing on factors that relate to extended family medicine training. Design Aggregate-level secondary data analysis based on the Canadian Post-MD Education Registry. Setting Canada. Participants All Canadian citizens and permanent residents who were registered in postgraduate family medicine training programs within Canadian faculties of medicine from 1995 to 2013. Main outcome measures Number and proportion of family medicine residents exiting 2-year and extended (third-year and above) family medicine training programs, as well as the types and numbers of extended training programs offered in 2015. Results The proportion of family medicine trainees pursuing extended training almost doubled during the study period, going from 10.9% in 1995 to 21.1% in 2013. Men and Canadian medical graduates were more likely to take extended family medicine training. Among the 5 most recent family medicine exit cohorts (from 2009 to 2013), 25.9% of men completed extended training programs compared with 18.3% of women, and 23.1% of Canadian medical graduates completed extended training compared with 13.6% of international medical graduates. Family medicine programs vary substantially with respect to the proportion of their trainees who undertake extended training, ranging from a low of 12.3% to a high of 35.1% among trainees exiting from 2011 to 2013. Conclusion New initiatives, such as the Triple C Competency-based Curriculum, CanMEDS–Family Medicine, and Certificates of Added Competence, have emerged as part of family medicine education and credentialing. In acknowledgment of the potential effect of these initiatives, it is important that future research examine how pedagogic change and, in particular, extended training shapes the care family physicians offer their patients. As part of that research it will be important to measure the breadth and uptake of

  12. The Extended Enterprise concept

    DEFF Research Database (Denmark)

    Larsen, Lars Bjørn; Vesterager, Johan; Gobbi, Chiara

    1999-01-01

    This paper provides an overview of the work that has been done regarding the Extended Enterprise concept in the Common Concept team of Globeman 21 including references to results deliverables concerning the development of the Extended Enterprise concept. The first section presents the basic concept...... picture from Globeman21, which illustrates the Globeman21 way of realising the Extended Enterprise concept. The second section presents the Globeman21 EE concept in a life cycle perspective, which to a large extent is based on the thoughts and ideas behind GERAM (ISO/DIS 15704)....

  13. An extended technicolor model

    International Nuclear Information System (INIS)

    Appelquist, T.; Terning, J.

    1994-01-01

    An extended technicolor model is constructed. Quark and lepton masses, spontaneous CP violation, and precision electroweak measurements are discussed. Dynamical symmetry breaking is analyzed using the concept of the big MAC (most attractive channel)

  14. Extending mine life

    International Nuclear Information System (INIS)

    Anon.

    1984-01-01

    Mine layouts, new machines and techniques, research into problem areas of ground control and so on, are highlighted in this report on extending mine life. The main resources taken into account are coal mining, uranium mining, molybdenum and gold mining

  15. Rational extended thermodynamics

    CERN Document Server

    Müller, Ingo

    1998-01-01

    Ordinary thermodynamics provides reliable results when the thermodynamic fields are smooth, in the sense that there are no steep gradients and no rapid changes. In fluids and gases this is the domain of the equations of Navier-Stokes and Fourier. Extended thermodynamics becomes relevant for rapidly varying and strongly inhomogeneous processes. Thus the propagation of high­ frequency waves, and the shape of shock waves, and the regression of small-scale fluctuation are governed by extended thermodynamics. The field equations of ordinary thermodynamics are parabolic while extended thermodynamics is governed by hyperbolic systems. The main ingredients of extended thermodynamics are • field equations of balance type, • constitutive quantities depending on the present local state and • entropy as a concave function of the state variables. This set of assumptions leads to first order quasi-linear symmetric hyperbolic systems of field equations; it guarantees the well-posedness of initial value problems and f...

  16. The dialogically extended mind

    DEFF Research Database (Denmark)

    Fusaroli, Riccardo; Gangopadhyay, Nivedita; Tylén, Kristian

    2014-01-01

    A growing conceptual and empirical literature is advancing the idea that language extends our cognitive skills. One of the most influential positions holds that language – qua material symbols – facilitates individual thought processes by virtue of its material properties. Extending upon this model...... relate our approach to other ideas about collective minds and review a number of empirical studies to identify the mechanisms enabling the constitution of interpersonal cognitive systems....

  17. Extending Mondrian Memory Protection

    Science.gov (United States)

    2010-11-01

    a kernel semaphore is locked or unlocked. In addition, we extended the system call interface to receive notifications about user-land locking...operations (such as calls to the mutex and semaphore code provided by the C library). By patching the dynamically loadable GLibC5, we are able to test... semaphores , and spinlocks. RTO-MP-IST-091 10- 9 Extending Mondrian Memory Protection to loading extension plugins. This prevents any untrusted code

  18. Extended Life Coolant Testing

    Science.gov (United States)

    2016-06-06

    number. PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) 06-06-2016 2. REPORT TYPE Interim Report 3. DATES COVERED ... Corrosion Testing of Traditional and Extended Life Coolants 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Hansen, Gregory A. T...providing vehicle specific coolants. Several laboratory corrosion tests were performed according to ASTM D1384 and D2570, but with a 2.5x extended time

  19. Extended spider cognition.

    Science.gov (United States)

    Japyassú, Hilton F; Laland, Kevin N

    2017-05-01

    There is a tension between the conception of cognition as a central nervous system (CNS) process and a view of cognition as extending towards the body or the contiguous environment. The centralised conception requires large or complex nervous systems to cope with complex environments. Conversely, the extended conception involves the outsourcing of information processing to the body or environment, thus making fewer demands on the processing power of the CNS. The evolution of extended cognition should be particularly favoured among small, generalist predators such as spiders, and here, we review the literature to evaluate the fit of empirical data with these contrasting models of cognition. Spiders do not seem to be cognitively limited, displaying a large diversity of learning processes, from habituation to contextual learning, including a sense of numerosity. To tease apart the central from the extended cognition, we apply the mutual manipulability criterion, testing the existence of reciprocal causal links between the putative elements of the system. We conclude that the web threads and configurations are integral parts of the cognitive systems. The extension of cognition to the web helps to explain some puzzling features of spider behaviour and seems to promote evolvability within the group, enhancing innovation through cognitive connectivity to variable habitat features. Graded changes in relative brain size could also be explained by outsourcing information processing to environmental features. More generally, niche-constructed structures emerge as prime candidates for extending animal cognition, generating the selective pressures that help to shape the evolving cognitive system.

  20. aging hypotension and intra-operative cardiac arres

    African Journals Online (AJOL)

    anaesthesiologists. Results: Medical officers scored an average of 252 and 246 points, whereas interns scored an average of 216 and 215 points ... performance, and then to assess the validity and reliability of the .... Surgeon: “cutting skin”.

  1. Intra-operative pneumatic tourniquet - perceptions of use and ...

    African Journals Online (AJOL)

    applied pressure alone or excessive applied pressure caused by use of faulty equipment. It needs to be emphasised to these surgeons that regular checking of the pneumatic tourniquet apparatus is necessary in order. MRC/UCT Bioenergetics of Exercise Research Unit, Department of. Physiology. University of Cape Town.

  2. Intra-operative pneumatic tourniquet - perceptions of use and ...

    African Journals Online (AJOL)

    Fifty-four per cent of respondents personally checked the calibration of the pneumatic tourniquet, although 76% of respondents believe that the apparatus needs to be checked at least once per month. More respondents who did not check the tourniquet apparatus than respondents who did check it believe that applied ...

  3. Unexpected intra-operative diagnosis of a large cystic ...

    African Journals Online (AJOL)

    Case report. A 70-year-old woman was admitted to hospital for investigation of ... was no prior surgical history of note. ... function tests and enzyme levels were within normal limits. The patient consented to surgical exploration because of diagnostic uncertainty and ongoing symptoms. ... being confirmed at time of surgery.5,6.

  4. Intra-operative hearing monitoring methods in middle ear surgeries

    Directory of Open Access Journals (Sweden)

    Wei Ren

    2016-12-01

    Full Text Available Hearing loss is a condition affecting millions of people worldwide. Conductive hearing loss (CHL is mainly caused by middle ear diseases. The low frequency area is the pivotal part of speech frequencies and most frequently impaired in patients with CHL. Among various treatments of CHL, middle ear surgery is efficient to improve hearing. However, variable success rates and possible needs for prolonged revision surgery still frustrate both surgeons and patients. Nowadays, increasing numbers of researchers explore various methods to monitor the efficacy of ossicular reconstruction intraoperatively, including electrocochleography (ECochG, auditory brainstem response (ABR, auditory steady state response (ASSR, distortion product otoacoustic emissions (DPOAE, subjective whisper test, and optical coherence tomography (OCT. Here, we illustrate several methods used clinically by reviewing the literature.

  5. Intra-Operational Area Coordination: The Zone EOC Concept

    Science.gov (United States)

    2015-09-01

    200, operating as Asiana Airlines flight 214 , was on approach to runway 28L when it struck a seawall at San Francisco International Airport (SFIA...training and lacked the necessary training and experience to land a jumbo jet onto an airstrip with a sea wall. The Asiana Airline incident also...Crash of Asiana Flight 214 Accident Report Summary, 2014, accessed August 31, 2015, http://www.ntsb.gov/news/events/Pages/ 2014_Asiana_BMG

  6. The incidence and risk factors for intra-operative hypothermia ...

    African Journals Online (AJOL)

    ... at the Kenyatta National Hospital is 30%. Gender (male), lower body temperature at induction, use of caudal block and the volume of intravenous fluids infused were significant independent predictors of core hypothermia. The most significant predictor was body temperature at the time of induction of general anaesthesia.

  7. Broken Heart Syndrome – An intra operative complication

    Directory of Open Access Journals (Sweden)

    Zara Wani

    2018-03-01

    Full Text Available We report a case of Broken Heart Syndrome in a 56 year old Postmenopausal woman suffered while undergoing simple biopsy procedure for vocal cord polyp that lead to physical, mental and financial burden both for the patient as well as the doctors. A team of cardiologists based on clinical and echocardiographic findings made the diagnosis of this case.

  8. Extending quantum mechanics entails extending special relativity

    International Nuclear Information System (INIS)

    Aravinda, S; Srikanth, R

    2016-01-01

    The complementarity between signaling and randomness in any communicated resource that can simulate singlet statistics is generalized by relaxing the assumption of free will in the choice of measurement settings. We show how to construct an ontological extension for quantum mechanics (QMs) through the oblivious embedding of a sound simulation protocol in a Newtonian spacetime. Minkowski or other intermediate spacetimes are ruled out as the locus of the embedding by virtue of hidden influence inequalities. The complementarity transferred from a simulation to the extension unifies a number of results about quantum non-locality, and implies that special relativity has a different significance for the ontological model and for the operational theory it reproduces. Only the latter, being experimentally accessible, is required to be Lorentz covariant. There may be certain Lorentz non-covariant elements at the ontological level, but they will be inaccessible at the operational level in a valid extension. Certain arguments against the extendability of QM, due to Conway and Kochen (2009) and Colbeck and Renner (2012), are attributed to their assumption that the spacetime at the ontological level has Minkowski causal structure. (paper)

  9. An Extended Duopoly Game.

    Science.gov (United States)

    Eckalbar, John C.

    2002-01-01

    Illustrates how principles and intermediate microeconomic students can gain an understanding for strategic price setting by playing a relatively large oligopoly game. Explains that the game extends to a continuous price space and outlines appropriate applications. Offers the Mathematica code to instructors so that the assumptions of the game can…

  10. Transversally extended string

    International Nuclear Information System (INIS)

    Akama, Keiichi

    1988-01-01

    Starting with the space-time action of the transversally extended string, we derive its world-sheet action, which is that of a gravitational and gauge theory with matter fields on the world-sheet, with additional effects of the second fundamental quantity. (author)

  11. Extended artistic appreciation.

    Science.gov (United States)

    Wilson, Robert A

    2013-04-01

    I propose that in at least some cases, objects of artistic appreciation are best thought of not simply as causes of artistic appreciation, but as parts of the cognitive machinery that drives aesthetic appreciation. In effect, this is to say that aesthetic appreciation operates via extended cognitive systems.

  12. Towards Extended Vantage Theory

    Science.gov (United States)

    Glaz, Adam

    2010-01-01

    The applicability of Vantage Theory (VT), a model of (colour) categorization, to linguistic data largely depends on the modifications and adaptations of the model for the purpose. An attempt to do so proposed here, called Extended Vantage Theory (EVT), slightly reformulates the VT conception of vantage by capitalizing on some of the entailments of…

  13. Extended Irreversible Thermodynamics

    CERN Document Server

    Jou, David

    2010-01-01

    This is the 4th edition of the highly acclaimed monograph on Extended Irreversible Thermodynamics, a theory that goes beyond the classical theory of irreversible processes. In contrast to the classical approach, the basic variables describing the system are complemented by non-equilibrium quantities. The claims made for extended thermodynamics are confirmed by the kinetic theory of gases and statistical mechanics. The book covers a wide spectrum of applications, and also contains a thorough discussion of the foundations and the scope of the current theories on non-equilibrium thermodynamics. For this new edition, the authors critically revised existing material while taking into account the most recent developments in fast moving fields such as heat transport in micro- and nanosystems or fast solidification fronts in materials sciences. Several fundamental chapters have been revisited emphasizing physics and applications over mathematical derivations. Also, fundamental questions on the definition of non-equil...

  14. Extended quantum mechanics

    International Nuclear Information System (INIS)

    Pavel Bona

    2000-01-01

    The work can be considered as an essay on mathematical and conceptual structure of nonrelativistic quantum mechanics which is related here to some other (more general, but also to more special and 'approximative') theories. Quantum mechanics is here primarily reformulated in an equivalent form of a Poisson system on the phase space consisting of density matrices, where the 'observables', as well as 'symmetry generators' are represented by a specific type of real valued (densely defined) functions, namely the usual quantum expectations of corresponding selfjoint operators. It is shown in this paper that inclusion of additional ('nonlinear') symmetry generators (i. e. 'Hamiltonians') into this reformulation of (linear) quantum mechanics leads to a considerable extension of the theory: two kinds of quantum 'mixed states' should be distinguished, and operator - valued functions of density matrices should be used in the role of 'nonlinear observables'. A general framework for physical theories is obtained in this way: By different choices of the sets of 'nonlinear observables' we obtain, as special cases, e.g. classical mechanics on homogeneous spaces of kinematical symmetry groups, standard (linear) quantum mechanics, or nonlinear extensions of quantum mechanics; also various 'quasiclassical approximations' to quantum mechanics are all sub theories of the presented extension of quantum mechanics - a version of the extended quantum mechanics. A general interpretation scheme of extended quantum mechanics extending the usual statistical interpretation of quantum mechanics is also proposed. Eventually, extended quantum mechanics is shown to be (included into) a C * -algebraic (hence linear) quantum theory. Mathematical formulation of these theories is presented. The presentation includes an analysis of problems connected with differentiation on infinite-dimensional manifolds, as well as a solution of some problems connected with the work with only densely defined unbounded

  15. Propelling Extended Objects

    Science.gov (United States)

    Humbert, Richard

    2010-01-01

    A force acting on just part of an extended object (either a solid or a volume of a liquid) can cause all of it to move. That motion is due to the transmission of the force through the object by its material. This paper discusses how the force is distributed to all of the object by a gradient of stress or pressure in it, which creates the local…

  16. Extending Critical Performativity

    DEFF Research Database (Denmark)

    Spicer, André; Alvesson, Mats; Kärreman, Dan

    2016-01-01

    In this article we extend the debate about critical performativity. We begin by outlining the basic tenets of critical performativity and how this has been applied in the study of management and organization. We then address recent critiques of critical performance. We note these arguments suffer...... of public importance; engaging with non-academic groups using dialectical reasoning; scaling up insights through movement building; and propagating deliberation...

  17. Extended Theories of Gravity

    International Nuclear Information System (INIS)

    Capozziello, Salvatore; De Laurentis, Mariafelicia

    2011-01-01

    Extended Theories of Gravity can be considered as a new paradigm to cure shortcomings of General Relativity at infrared and ultraviolet scales. They are an approach that, by preserving the undoubtedly positive results of Einstein’s theory, is aimed to address conceptual and experimental problems recently emerged in astrophysics, cosmology and High Energy Physics. In particular, the goal is to encompass, in a self-consistent scheme, problems like inflation, dark energy, dark matter, large scale structure and, first of all, to give at least an effective description of Quantum Gravity. We review the basic principles that any gravitational theory has to follow. The geometrical interpretation is discussed in a broad perspective in order to highlight the basic assumptions of General Relativity and its possible extensions in the general framework of gauge theories. Principles of such modifications are presented, focusing on specific classes of theories like f(R)-gravity and scalar–tensor gravity in the metric and Palatini approaches. The special role of torsion is also discussed. The conceptual features of these theories are fully explored and attention is paid to the issues of dynamical and conformal equivalence between them considering also the initial value problem. A number of viability criteria are presented considering the post-Newtonian and the post-Minkowskian limits. In particular, we discuss the problems of neutrino oscillations and gravitational waves in extended gravity. Finally, future perspectives of extended gravity are considered with possibility to go beyond a trial and error approach.

  18. Extended Testability Analysis Tool

    Science.gov (United States)

    Melcher, Kevin; Maul, William A.; Fulton, Christopher

    2012-01-01

    The Extended Testability Analysis (ETA) Tool is a software application that supports fault management (FM) by performing testability analyses on the fault propagation model of a given system. Fault management includes the prevention of faults through robust design margins and quality assurance methods, or the mitigation of system failures. Fault management requires an understanding of the system design and operation, potential failure mechanisms within the system, and the propagation of those potential failures through the system. The purpose of the ETA Tool software is to process the testability analysis results from a commercial software program called TEAMS Designer in order to provide a detailed set of diagnostic assessment reports. The ETA Tool is a command-line process with several user-selectable report output options. The ETA Tool also extends the COTS testability analysis and enables variation studies with sensor sensitivity impacts on system diagnostics and component isolation using a single testability output. The ETA Tool can also provide extended analyses from a single set of testability output files. The following analysis reports are available to the user: (1) the Detectability Report provides a breakdown of how each tested failure mode was detected, (2) the Test Utilization Report identifies all the failure modes that each test detects, (3) the Failure Mode Isolation Report demonstrates the system s ability to discriminate between failure modes, (4) the Component Isolation Report demonstrates the system s ability to discriminate between failure modes relative to the components containing the failure modes, (5) the Sensor Sensor Sensitivity Analysis Report shows the diagnostic impact due to loss of sensor information, and (6) the Effect Mapping Report identifies failure modes that result in specified system-level effects.

  19. Extended Wordsearches in Chemistry

    Science.gov (United States)

    Cotton, Simon

    1998-04-01

    Students can be encouraged to develop their factual knowledge by use of puzzles. One strategy described here is the extended wordsearch, where the wordsearch element generates a number of words or phrases from which the answers to a series of questions are selected. The wordsearch can be generated with the aid of computer programs, though in order to make them suitable for students with dyslexia or other learning difficulties, a simpler form is more appropriate. These problems can be employed in a variety of contexts, for example, as topic tests and classroom end-of-lesson fillers. An example is provided in the area of calcium chemistry. Sources of suitable software are listed.

  20. Classical extended superconformal symmetries

    International Nuclear Information System (INIS)

    Viswanathan, R.R.

    1990-10-01

    Super-covariant differential operators are defined in two dimensions which map supersymmetry doublets to other doublets. The possibility of constructing a closed algebra among the fields appearing in such operators is explored. Such an algebra exists for Grassmann-odd differential operators. A representation for these operators in terms of free-field doublets is constructed. An explicit closed algebra involving fields of spin 2 and 5/2, in addition to the stress tensor and the supersymmetry generator, is constructed from such a free-field representation as an example of a non-linear extended superconformal algebra. (author). 9 refs

  1. Extending juvenility in grasses

    Energy Technology Data Exchange (ETDEWEB)

    Kaeppler, Shawn; de Leon Gatti, Natalia; Foerster, Jillian

    2017-04-11

    The present invention relates to compositions and methods for modulating the juvenile to adult developmental growth transition in plants, such as grasses (e.g. maize). In particular, the invention provides methods for enhancing agronomic properties in plants by modulating expression of GRMZM2G362718, GRMZM2G096016, or homologs thereof. Modulation of expression of one or more additional genes which affect juvenile to adult developmental growth transition such as Glossy15 or Cg1, in conjunction with such modulation of expression is also contemplated. Nucleic acid constructs for down-regulation of GRMZM2G362718 and/or GRMZM2G096016 are also contemplated, as are transgenic plants and products produced there from, that demonstrate altered, such as extended juvenile growth, and display associated phenotypes such as enhanced yield, improved digestibility, and increased disease resistance. Plants described herein may be used, for example, as improved forage or feed crops or in biofuel production.

  2. Extended biorthogonal matrix polynomials

    Directory of Open Access Journals (Sweden)

    Ayman Shehata

    2017-01-01

    Full Text Available The pair of biorthogonal matrix polynomials for commutative matrices were first introduced by Varma and Tasdelen in [22]. The main aim of this paper is to extend the properties of the pair of biorthogonal matrix polynomials of Varma and Tasdelen and certain generating matrix functions, finite series, some matrix recurrence relations, several important properties of matrix differential recurrence relations, biorthogonality relations and matrix differential equation for the pair of biorthogonal matrix polynomials J(A,B n (x, k and K(A,B n (x, k are discussed. For the matrix polynomials J(A,B n (x, k, various families of bilinear and bilateral generating matrix functions are constructed in the sequel.

  3. Extended conformal algebras

    International Nuclear Information System (INIS)

    Goddard, Peter

    1990-01-01

    The algebra of the group of conformal transformations in two dimensions consists of two commuting copies of the Virasoro algebra. In many mathematical and physical contexts, the representations of ν which are relevant satisfy two conditions: they are unitary and they have the ''positive energy'' property that L o is bounded below. In an irreducible unitary representation the central element c takes a fixed real value. In physical contexts, the value of c is a characteristic of a theory. If c < 1, it turns out that the conformal algebra is sufficient to ''solve'' the theory, in the sense of relating the calculation of the infinite set of physically interesting quantities to a finite subset which can be handled in principle. For c ≥ 1, this is no longer the case for the algebra alone and one needs some sort of extended conformal algebra, such as the superconformal algebra. It is these algebras that this paper aims at addressing. (author)

  4. Extended Poisson Exponential Distribution

    Directory of Open Access Journals (Sweden)

    Anum Fatima

    2015-09-01

    Full Text Available A new mixture of Modified Exponential (ME and Poisson distribution has been introduced in this paper. Taking the Maximum of Modified Exponential random variable when the sample size follows a zero truncated Poisson distribution we have derived the new distribution, named as Extended Poisson Exponential distribution. This distribution possesses increasing and decreasing failure rates. The Poisson-Exponential, Modified Exponential and Exponential distributions are special cases of this distribution. We have also investigated some mathematical properties of the distribution along with Information entropies and Order statistics of the distribution. The estimation of parameters has been obtained using the Maximum Likelihood Estimation procedure. Finally we have illustrated a real data application of our distribution.

  5. Extended fuel cycle length

    International Nuclear Information System (INIS)

    Bruyere, M.; Vallee, A.; Collette, C.

    1986-09-01

    Extended fuel cycle length and burnup are currently offered by Framatome and Fragema in order to satisfy the needs of the utilities in terms of fuel cycle cost and of overall systems cost optimization. We intend to point out the consequences of an increased fuel cycle length and burnup on reactor safety, in order to determine whether the bounding safety analyses presented in the Safety Analysis Report are applicable and to evaluate the effect on plant licensing. This paper presents the results of this examination. The first part indicates the consequences of increased fuel cycle length and burnup on the nuclear data used in the bounding accident analyses. In the second part of this paper, the required safety reanalyses are presented and the impact on the safety margins of different fuel management strategies is examined. In addition, systems modifications which can be required are indicated

  6. Irreducibility conditions for extended superfields

    International Nuclear Information System (INIS)

    Sokatchev, E.

    1981-05-01

    The irreducible supermultiplets contained in an extended superfield are presented as sets of covariant derivatives of the superfield. Differential irreducibility constraints are easily obtained from this decomposition. (author)

  7. Extending cosmology: the metric approach

    OpenAIRE

    Mendoza, S.

    2012-01-01

    Comment: 2012, Extending Cosmology: The Metric Approach, Open Questions in Cosmology; Review article for an Intech "Open questions in cosmology" book chapter (19 pages, 3 figures). Available from: http://www.intechopen.com/books/open-questions-in-cosmology/extending-cosmology-the-metric-approach

  8. Extended cognition and epistemic luck

    NARCIS (Netherlands)

    Carter, J.A.

    2013-01-01

    When extended cognition is extended into mainstream epistemology, an awkward tension arises when considering cases of environmental epistemic luck. Surprisingly, it is not at all clear how the mainstream verdict that agents lack knowledge in cases of environmental luck can be reconciled with

  9. Scale-invariant extended inflation

    International Nuclear Information System (INIS)

    Holman, R.; Kolb, E.W.; Vadas, S.L.; Wang, Y.

    1991-01-01

    We propose a model of extended inflation which makes use of the nonlinear realization of scale invariance involving the dilaton coupled to an inflaton field whose potential admits a metastable ground state. The resulting theory resembles the Jordan-Brans-Dicke version of extended inflation. However, quantum effects, in the form of the conformal anomaly, generate a mass for the dilaton, thus allowing our model to evade the problems of the original version of extended inflation. We show that extended inflation can occur for a wide range of inflaton potentials with no fine-tuning of dimensionless parameters required. Furthermore, we also find that it is quite natural for the extended-inflation period to be followed by an epoch of slow-rollover inflation as the dilaton settles down to the minimum of its induced potential

  10. Viability of bull semen extended with commercial semen extender ...

    African Journals Online (AJOL)

    Andrea Raseona

    stored at 24 °C. Sperm motility parameters, morphology, and viability were analysed ... body size, slow average daily weight gain, decreased fertility, extended .... were determined by counting a total of 200 spermatozoa per each stained slide.

  11. Cosmological dynamics of extended chameleons

    International Nuclear Information System (INIS)

    Tamanini, Nicola; Wright, Matthew

    2016-01-01

    We investigate the cosmological dynamics of the recently proposed extended chameleon models at both background and linear perturbation levels. Dynamical systems techniques are employed to fully characterize the evolution of the universe at the largest distances, while structure formation is analysed at sub-horizon scales within the quasi-static approximation. The late time dynamical transition from dark matter to dark energy domination can be well described by almost all extended chameleon models considered, with no deviations from ΛCDM results at both background and perturbation levels. The results obtained in this work confirm the cosmological viability of extended chameleons as alternative dark energy models.

  12. Extended asymptotic functions - some examples

    International Nuclear Information System (INIS)

    Todorov, T.D.

    1981-01-01

    Several examples of extended asymptotic functions of two variables are given. This type of asymptotic functions has been introduced as an extension of continuous ordinary functions. The presented examples are realizations of some Schwartz distributions delta(x), THETA(x), P(1/xsup(n)) and can be multiplied in the class of the asymptotic functions as opposed to the theory of Schwartz distributions. The examples illustrate the method of construction of extended asymptotic functions similar to the distributions. The set formed by the extended asymptotic functions is also considered. It is shown, that this set is not closed with respect to addition and multiplication

  13. Cosmological dynamics of extended chameleons

    Energy Technology Data Exchange (ETDEWEB)

    Tamanini, Nicola [Institut de Physique Théorique, CEA-Saclay, CNRS UMR 3681, Université Paris-Saclay, F-91191 Gif-sur-Yvette (France); Wright, Matthew, E-mail: nicola.tamanini@cea.fr, E-mail: matthew.wright.13@ucl.ac.uk [Department of Mathematics, University College London, Gower Street, London, WC1E 6BT (United Kingdom)

    2016-04-01

    We investigate the cosmological dynamics of the recently proposed extended chameleon models at both background and linear perturbation levels. Dynamical systems techniques are employed to fully characterize the evolution of the universe at the largest distances, while structure formation is analysed at sub-horizon scales within the quasi-static approximation. The late time dynamical transition from dark matter to dark energy domination can be well described by almost all extended chameleon models considered, with no deviations from ΛCDM results at both background and perturbation levels. The results obtained in this work confirm the cosmological viability of extended chameleons as alternative dark energy models.

  14. Symmetric extendibility of quantum states

    OpenAIRE

    Nowakowski, Marcin L.

    2015-01-01

    Studies on symmetric extendibility of quantum states become especially important in a context of analysis of one-way quantum measures of entanglement, distilabillity and security of quantum protocols. In this paper we analyse composite systems containing a symmetric extendible part with a particular attention devoted to one-way security of such systems. Further, we introduce a new one-way monotone based on the best symmetric approximation of quantum state. We underpin those results with geome...

  15. Topological defects in extended inflation

    International Nuclear Information System (INIS)

    Copeland, E.J.; Kolb, E.W.; Chicago Univ., IL; Liddle, A.R.

    1990-04-01

    We consider the production of topological defects, especially cosmic strings, in extended inflation models. In extended inflation, the Universe passes through a first-order phase transition via bubble percolation, which naturally allows defects to form at the end of inflation. The correlation length, which determines the number density of the defects, is related to the mean size of bubbles when they collide. This mechanism allows a natural combination of inflation and large-scale structure via cosmic strings. 18 refs

  16. Quasi-extended asymptotic functions

    International Nuclear Information System (INIS)

    Todorov, T.D.

    1979-01-01

    The class F of ''quasi-extended asymptotic functions'' is introduced. It contains all extended asymptotic functions as well as some new asymptotic functions very similar to the Schwartz distributions. On the other hand, every two quasiextended asymptotic functions can be multiplied as opposed to the Schwartz distributions; in particular, the square delta 2 of an asymptotic function delta similar to Dirac's delta-function, is constructed as an example

  17. Some problems with extended inflation

    International Nuclear Information System (INIS)

    Weinberg, E.J.

    1989-01-01

    The recently proposed extended inflation scenario is examined. Upper bounds on the Brans-Dicke parameter ω are obtained by requiring that the recovery from the supercooled regime be such that the presently observed Universe could have emerged. These bounds are well below the present-day experimental limits, implying that one must use models which have a potential to fix the present value of the Brans-Dicke-like scalar field. The implications for extended inflation in such models are discussed

  18. Topological defects in extended inflation

    International Nuclear Information System (INIS)

    Copeland, E.J.; Kolb, E.W.; Liddle, A.R.

    1990-01-01

    We consider the production of topological defects, especially cosmic strings, in extended-inflation models. In extended inflation, the Universe passes through a first-order phase transition via bubble percolation, which naturally allows defects to form at the end of inflation. The correlation length, which determines the number density of the defects, is related to the mean size of the bubbles when they collide. This mechanism allows a natural combination of inflation and large-scale structure via cosmic strings

  19. Extended likelihood inference in reliability

    International Nuclear Information System (INIS)

    Martz, H.F. Jr.; Beckman, R.J.; Waller, R.A.

    1978-10-01

    Extended likelihood methods of inference are developed in which subjective information in the form of a prior distribution is combined with sampling results by means of an extended likelihood function. The extended likelihood function is standardized for use in obtaining extended likelihood intervals. Extended likelihood intervals are derived for the mean of a normal distribution with known variance, the failure-rate of an exponential distribution, and the parameter of a binomial distribution. Extended second-order likelihood methods are developed and used to solve several prediction problems associated with the exponential and binomial distributions. In particular, such quantities as the next failure-time, the number of failures in a given time period, and the time required to observe a given number of failures are predicted for the exponential model with a gamma prior distribution on the failure-rate. In addition, six types of life testing experiments are considered. For the binomial model with a beta prior distribution on the probability of nonsurvival, methods are obtained for predicting the number of nonsurvivors in a given sample size and for predicting the required sample size for observing a specified number of nonsurvivors. Examples illustrate each of the methods developed. Finally, comparisons are made with Bayesian intervals in those cases where these are known to exist

  20. Bacteriospermia in extended porcine semen.

    Science.gov (United States)

    Althouse, Gary C; Lu, Kristina G

    2005-01-15

    Bacteriospermia is a frequent finding in freshly extended porcine semen and can result in detrimental effects on semen quality and longevity if left uncontrolled. The primary source of bacterial contamination is the boar. Other sources that have been identified include environment, personnel, and the water used for extender preparation. A 1-year retrospective study was performed on submissions of extended porcine semen for routine quality control bacteriological screening at the University of Pennsylvania. Out of 250 sample submissions, 78 (31.2%) tested positive for bacterial contamination. The most popular contaminants included Enterococcus spp. (20.5%), Stenotrophomonas maltophilia (15.4%), Alcaligenes xylosoxidans (10.3%), Serratia marcescens (10.3%), Acinetobacter lwoffi (7.7%), Escherichia coli (6.4%), Pseudomonas spp. (6.4%), and others (23.0%). Prudent individual hygiene, good overall sanitation, and regular monitoring can contribute greatly in controlling bacterial load. Strategies that incorporate temperature-dependent bacterial growth and hyperthermic augmentation of antimicrobial activity are valuable for effective control of susceptible bacterial loads. Aminoglycosides remain the most popular antimicrobial class used in porcine semen extenders, with beta-lactam and lincosamide use increasing. With the advent of more novel antimicrobial selection and semen extender compositions in swine, prudent application and understanding of in vitro pharmacodynamics are becoming paramount to industry success in the use of this breeding modality.

  1. Extended Year, Extended Contracts: Increasing Teacher Salary Options.

    Science.gov (United States)

    Gandara, Patricia

    1992-01-01

    Reports on an attempt to raise teacher salaries through an extended contract made possible through year-round school schedules. Teacher satisfaction with the 1987 experiment in three California schools (the Orchard Plan) has been high. Elements that have contributed to job satisfaction are discussed. (SLD)

  2. Extended cognition in science communication.

    Science.gov (United States)

    Ludwig, David

    2014-11-01

    The aim of this article is to propose a methodological externalism that takes knowledge about science to be partly constituted by the environment. My starting point is the debate about extended cognition in contemporary philosophy and cognitive science. Externalists claim that human cognition extends beyond the brain and can be partly constituted by external devices. First, I show that most studies of public knowledge about science are based on an internalist framework that excludes the environment we usually utilize to make sense of science and does not allow the possibility of extended knowledge. In a second step, I argue that science communication studies should adopt a methodological externalism and accept that knowledge about science can be partly realized by external information resources such as Wikipedia. © The Author(s) 2013.

  3. Exclusion Bounds for Extended Anyons

    Science.gov (United States)

    Larson, Simon; Lundholm, Douglas

    2018-01-01

    We introduce a rigorous approach to the many-body spectral theory of extended anyons, that is quantum particles confined to two dimensions that interact via attached magnetic fluxes of finite extent. Our main results are many-body magnetic Hardy inequalities and local exclusion principles for these particles, leading to estimates for the ground-state energy of the anyon gas over the full range of the parameters. This brings out further non-trivial aspects in the dependence on the anyonic statistics parameter, and also gives improvements in the ideal (non-extended) case.

  4. Adjustable extender for instrument module

    International Nuclear Information System (INIS)

    Sevec, J.B.; Stein, A.D.

    1975-01-01

    A blank extender module used to mount an instrument module in front of its console for repair or test purposes has been equipped with a rotatable mount and means for locking the mount at various angles of rotation for easy accessibility. The rotatable mount includes a horizontal conduit supported by bearings within the blank module. The conduit is spring-biased in a retracted position within the blank module and in this position a small gear mounted on the conduit periphery is locked by a fixed pawl. The conduit and instrument mount can be pulled into an extended position with the gear clearing the pawl to permit rotation and adjustment of the instrument

  5. Extended memory management under RTOS

    Science.gov (United States)

    Plummer, M.

    1981-01-01

    A technique for extended memory management in ROLM 1666 computers using FORTRAN is presented. A general software system is described for which the technique can be ideally applied. The memory manager interface with the system is described. The protocols by which the manager is invoked are presented, as well as the methods used by the manager.

  6. Geometrical interpretation of extended supergravity

    International Nuclear Information System (INIS)

    Townsend, P.K.; Nieuwenhuizen, P.van

    1977-01-01

    SO 2 extended supergravity is shown to be a geometrical theory, whose underlying gauge group is OSp(4,2). The couplings which gauge the SO 2 symmetry as well as the accompanying cosmological and masslike terms are directly obtained, and the usual SO 2 model is obtained after a Wigner-Inoenue group contraction. (Auth.)

  7. Spin-4 extended conformal algebras

    International Nuclear Information System (INIS)

    Kakas, A.C.

    1988-01-01

    We construct spin-4 extended conformal algebras using the second hamiltonian structure of the KdV hierarchy. In the presence of a U(1) current a family of spin-4 algebras exists but the additional requirement that the spin-1 and spin-4 currents commute fixes the algebra uniquely. (orig.)

  8. Departies: conceptualizing extended youth parties

    DEFF Research Database (Denmark)

    Fjær, Eivind Grip; Tutenges, Sébastien

    2017-01-01

    Every year, millions of young people travel away from home to party for days or weeks on end in permissive environments, such as music festivals, dance parties, and nightlife resorts. The studies that have been conducted on these extended youth parties have focused primarily on specific risk...

  9. Applying and extending Oracle Spatial

    CERN Document Server

    Simon Gerard Greener, Siva Ravada

    2013-01-01

    This book is an advanced practical guide to applying and extending Oracle Spatial.This book is for existing users of Oracle and Oracle Spatial who have, at a minimum, basic operational experience of using Oracle or an equivalent database. Advanced skills are not required.

  10. Extended unemployment and UI benefits

    OpenAIRE

    Robert G. Valletta; Katherine Kuang

    2010-01-01

    During the current labor market downturn, unemployment duration has reached levels well above its previous highs. Analysis of unemployment data suggests that extended unemployment insurance benefits have not been important factors in the increase in the duration of unemployment or in the elevated unemployment rate.

  11. Engage, Enhance, and Extend Learning!

    Science.gov (United States)

    Keren-Kolb, Liz

    2013-01-01

    Educators often say that technology is more than a gimmick or add-on, and that it should engage, enhance, or extend learning in ways that traditional tools do not. Yet they seldom stop to define these terms, and they can be confusing, especially for teachers and preservice teachers. Recently, while collaborating on an English language arts and…

  12. Extended recency effect extended: blocking, presentation mode, and retention interval.

    Science.gov (United States)

    Glidden, L M; Pawelski, C; Mar, H; Zigman, W

    1979-07-01

    The effect of blocking of stimulus items on the free recall of EMR adolescents was examined. In Experiment 1 a multitrial free-recall list of 15 pictures was presented either simultaneously in groups of 3, or sequentially, one at a time. Consistent ordering was used in both conditions, so that on each trial, each item in each set of 3 pictures was presented contiguously with the other 2 items from that set. In addition, recall came immediately or after a filled or unfilled delay of 24.5 seconds. Results showed that simultaneous presentation led to higher recall, subjective organization, and clustering than did sequential presentation, but analysis of serial-position curves showed a much reduced extended recency effect in comparison with previous studies. Experiment 2 was designed to determine whether the cause of the reduced extended recency was the use of pictures rather than words as stimuli. Stimuli were presented either as pictures, as pictures with auditory labels, or as words with auditory labels, with both simultaneous and consistent ordering for all conditions. Results indicated a strong extended recency effect for all groups, eliminating presentation mode as a causal factor in the data of Experiment 1. We concluded that blocking leads to increased organization and recall over a variety of presentation modes, rates, and block sizes.

  13. The extended bigraded Toda hierarchy

    International Nuclear Information System (INIS)

    Carlet, Guido

    2006-01-01

    We generalize the Toda lattice hierarchy by considering N + M dependent variables. We construct roots and logarithms of the Lax operator which are uniquely defined operators with coefficients that are ε-series of differential polynomials in the dependent variables, and we use them to provide a Lax pair definition of the extended bigraded Toda hierarchy, generalizing [4]. Using R-matrix theory we give the bi-Hamiltonian formulation of this hierarchy and we prove the existence of a tau function for its solutions. Finally we study the dispersionless limit and its connection with a class of Frobenius manifolds on the orbit space of the extended affine Weyl groups W-tilde (N) (A N+M-1 ) of the A series, defined by Dubrovin and Zhang (1998 Compos. Math. 111 167)

  14. An extended Harry Dym hierarchy

    International Nuclear Information System (INIS)

    Ma Wenxiu

    2010-01-01

    An extended Harry Dym hierarchy is constructed by using eigenfunctions and adjoint eigenfunctions of the spectral problems of the Harry Dym hierarchy associated with the pseudo-differential operator L = u∂ + u 0 + u 1 ∂ -1 + .... The corresponding Lax presentation possesses a self-consistent source involving squared eigenfunctions. The resulting extended Harry Dym hierarchy is reduced to the Harry Dym hierarchy with self-consistent sources under the n-reduction, L n = (L n ) ≥2 , and the k-constrained Harry Dym hierarchy under the k-constraint, L k = (L k ) ≥2 + Σ N i=1 q i ∂ -1 r i ∂ 2 . A few particular examples are computed, together with their Lax pairs.

  15. Black holes from extended inflation

    International Nuclear Information System (INIS)

    Hsu, S.D.H.; Lawrence Berkeley Lab., CA

    1990-01-01

    It is argued that models of extended inflation, in which modified Einstein gravity allows a graceful exit from the false vacuum, lead to copious production of black holes. The critical temperature of the inflationary phase transition must be >10 8 GeV in order to avoid severe cosmological problems in a universe dominated by black holes. We speculate on the possibility that the interiors of false vacuum regions evolve into baby universes. (orig.)

  16. Locating and extending livelihoods research

    DEFF Research Database (Denmark)

    Prowse, Martin

    2008-01-01

    Much poverty and development research is not explicit about its methodology or philosophical foundations. Based on the extended case method of Burawoy and the epistemological standpoint of critical realism, this paper discusses a methodological approach for reflexive inductive livelihoods researc...... that overcomes the unproductive social science dualism of positivism and social constructivism. The approach is linked to a conceptual framework and a menu of research methods that can be sequenced and iterated in light of research questions....

  17. Extended producer responsibility in oligopoly

    OpenAIRE

    Hiroaki Ino

    2007-01-01

    I investigate the optimal environmental tax under a policy based on extended producer responsibility (EPR) in oligopoly markets. I introduce the recycling market and explicitly consider how these policies affect the incentive for recycling. I derive the optimal tax rule, which depends on the weighted sum of the markup in the product market and the markdown in the recycling market. In contrast to the existing works that emphasize that the optimal tax rate is lower than the marginal external da...

  18. EAES: Extended Advanced Encryption Standard with Extended Security

    OpenAIRE

    Abul Kalam Azad; Md. Yamin Mollah

    2018-01-01

    Though AES is the highest secure symmetric cipher at present, many attacks are now effective against AES too which is seen from the review of recent attacks of AES. This paper describes an extended AES algorithm with key sizes of 256, 384 and 512 bits with round numbers of 10, 12 and 14 respectively. Data block length is 128 bits, same as AES. But unlike AES each round of encryption and decryption of this proposed algorithm consists of five stages except the last one which consists of four st...

  19. EAES: Extended Advanced Encryption Standard with Extended Security

    Directory of Open Access Journals (Sweden)

    Abul Kalam Azad

    2018-05-01

    Full Text Available Though AES is the highest secure symmetric cipher at present, many attacks are now effective against AES too which is seen from the review of recent attacks of AES. This paper describes an extended AES algorithm with key sizes of 256, 384 and 512 bits with round numbers of 10, 12 and 14 respectively. Data block length is 128 bits, same as AES. But unlike AES each round of encryption and decryption of this proposed algorithm consists of five stages except the last one which consists of four stages. Unlike AES, this algorithm uses two different key expansion algorithms with two different round constants that ensure higher security than AES. Basically, this algorithm takes one cipher key and divides the selected key of two separate sub-keys: FirstKey and SecondKey. Then expand them through two different key expansion schedules. Performance analysis shows that the proposed extended AES algorithm takes almost same amount of time to encrypt and decrypt the same amount of data as AES but with higher security than AES.

  20. Renormalization of Extended QCD2

    International Nuclear Information System (INIS)

    Fukaya, Hidenori; Yamamura, Ryo

    2015-01-01

    Extended QCD (XQCD), proposed by Kaplan [D. B. Kaplan, arXiv:1306.5818], is an interesting reformulation of QCD with additional bosonic auxiliary fields. While its partition function is kept exactly the same as that of original QCD, XQCD naturally contains properties of low-energy hadronic models. We analyze the renormalization group flow of 2D (X)QCD, which is solvable in the limit of a large number of colors N c , to understand what kind of roles the auxiliary degrees of freedom play and how the hadronic picture emerges in the low-energy region

  1. Axelrod Model with Extended Conservativeness

    Science.gov (United States)

    Dybiec, Bartłomiej

    2012-11-01

    Similarity of opinions and memory about recent interactions are two main factors determining likelihood of social contacts. Here, we explore the Axelrod model with an extended conservativeness which incorporates not only similarity between individuals but also a preference to the last source of accepted information. The additional preference given to the last source of information increases the initial decay of the number of ideas in the system, changes the character of the phase transition between homogeneous and heterogeneous final states and could increase the number of stable regions (clusters) in the final state.

  2. Implications of Extended Solar Minima

    Science.gov (United States)

    Adams, Mitzi L.; Davis, J. M.

    2009-01-01

    Since the discovery of periodicity in the solar cycle, the historical record of sunspot number has been carefully examined, attempting to make predictions about the next cycle. Much emphasis has been on predicting the maximum amplitude and length of the next cycle. Because current space-based and suborbital instruments are designed to study active phenomena, there is considerable interest in estimating the length and depth of the current minimum. We have developed criteria for the definition of a minimum and applied it to the historical sunspot record starting in 1749. In doing so, we find that 1) the current minimum is not yet unusually long and 2) there is no obvious way of predicting when, using our definition, the current minimum may end. However, by grouping the data into 22- year cycles there is an interesting pattern of extended minima that recurs every fourth or fifth 22-year cycle. A preliminary comparison of this pattern with other records, suggests the possibility of a correlation between extended minima and lower levels of solar irradiance.

  3. Extended inflation with induced gravity

    International Nuclear Information System (INIS)

    Accetta, F.S.; Trester, J.J.; Department of Physics, Yale University, New Haven, Connecticut 06520)

    1989-01-01

    We consider a recently proposed extended model of inflation which improves upon the original old inflation scenario by achieving a graceful exit from the false-vacuum phase. In this paper extended inflation is generalized to include a potential V(phi) for the Brans-Dicke-type field phi. We find that whereas a graceful exit can still be had, the inclusion of a potential places constraints on the percolation time scale for exiting the inflationary phase. Additional constraints on V(phi) and the false-vacuum energy density rho /sub F/ from density and gravitational-wave perturbations are discussed. For initially small values of phi the false vacuum undergoes power-law inflation, while for initially large values of phi the expansion is exponential. Within true-vacuum regions slow-rolling inflation can occur. As a result, this model generically leads to multiple episodes of inflation. We discuss the significance these multiple episodes of inflation may have on the formation of large-scale structure and the production of voids

  4. Extended suicide with a pet.

    Science.gov (United States)

    Cooke, Brian K

    2013-01-01

    The combination of the killing of a pet and a suicide is a perplexing scenario that is largely unexplored in the literature. Many forensic psychiatrists and psychologists may be unaccustomed to considering the significance of the killing of a pet. The subject is important, however, because many people regard their pets as members of their family. A case is presented of a woman who killed her pet dog and herself by carbon monoxide poisoning. The purpose of this article is to provide an initial exploration of the topic of extended suicide with a pet. Forensic mental health evaluations may have a role in understanding the etiology of this event and in opining as to the culpability of individuals who attempt to or successfully kill a pet and then commit suicide. Because the scientific literature is lacking, there is a need to understand this act from a variety of perspectives. First, a social and anthropological perspective will be presented that summarizes the history of the practice of killing of one's pet, with a focus on the ancient Egyptians. A clinical context will examine what relationship animals have to mental illness. A vast body of existing scientific data showing the relevance of human attachment to pets suggests that conclusions from the phenomena of homicide-suicide and filicide-suicide are applicable to extended suicide with a pet. Finally, recommendations will be proposed for both clinical and forensic psychiatrists faced with similar cases.

  5. Pipe crawler with extendable legs

    International Nuclear Information System (INIS)

    Zollinger, W.T.

    1992-01-01

    A pipe crawler for moving through a pipe in inchworm fashion having front and rear leg assemblies separated by air cylinders to increase and decrease the spacing between assemblies. Each leg of the four legs of an assembly is moved between a wall-engaging, extended position and a retracted position by a separate air cylinder. The air cylinders of the leg assemblies are preferably arranged in pairs of oppositely directed cylinders with no pair lying in the same axial plane as another pair. Therefore, the cylinders can be as long as a leg assembly is wide and the crawler can crawl through sections of pipes where the diameter is twice that of other sections. The crawler carries a valving system, a manifold to distribute air supplied by a single umbilical air hose to the various air cylinders in a sequence controlled electrically by a controller. The crawler also utilizes a rolling mechanism, casters in this case, to reduce friction between the crawler and pipe wall thereby further extending the range of the pipe crawler. 8 figs

  6. Pipe crawler with extendable legs

    Science.gov (United States)

    Zollinger, W.T.

    1992-06-16

    A pipe crawler for moving through a pipe in inchworm fashion having front and rear leg assemblies separated by air cylinders to increase and decrease the spacing between assemblies. Each leg of the four legs of an assembly is moved between a wall-engaging, extended position and a retracted position by a separate air cylinder. The air cylinders of the leg assemblies are preferably arranged in pairs of oppositely directed cylinders with no pair lying in the same axial plane as another pair. Therefore, the cylinders can be as long as a leg assembly is wide and the crawler can crawl through sections of pipes where the diameter is twice that of other sections. The crawler carries a valving system, a manifold to distribute air supplied by a single umbilical air hose to the various air cylinders in a sequence controlled electrically by a controller. The crawler also utilizes a rolling mechanism, casters in this case, to reduce friction between the crawler and pipe wall thereby further extending the range of the pipe crawler. 8 figs.

  7. Harmonic superspaces of extended supersymmetry

    International Nuclear Information System (INIS)

    Ivanov, E.; Kalitzin, S.; Nguyen Ai Viet; Ogievetsky, V.

    1984-01-01

    The main technical apparatus of the harmonic superspace approach to extended SUSY, the calculus of harmonic variables on homogeneous spaces of the SUSY automorphism groups, is presented in detail for N=2, 3, 4. The basic harmonics for the coset manifolds G/H with G=SU(2), H=U(1); G=SU(3), H=SU(2)xU(1) and H=U(1)xU(1); G=SU(4), H=SU(3)xU(1), H=SU(2)xSU(2)xU(1), H=SU(2)xU(1)xU(1) and H=U(1)xU(1)xU(1); G=USp(2), H=SU(2)xSU(2), H=SU(2)xU(1) and H=U(1)xU(1) are tabulated a number of useful relations among them

  8. Learning Extended Finite State Machines

    Science.gov (United States)

    Cassel, Sofia; Howar, Falk; Jonsson, Bengt; Steffen, Bernhard

    2014-01-01

    We present an active learning algorithm for inferring extended finite state machines (EFSM)s, combining data flow and control behavior. Key to our learning technique is a novel learning model based on so-called tree queries. The learning algorithm uses the tree queries to infer symbolic data constraints on parameters, e.g., sequence numbers, time stamps, identifiers, or even simple arithmetic. We describe sufficient conditions for the properties that the symbolic constraints provided by a tree query in general must have to be usable in our learning model. We have evaluated our algorithm in a black-box scenario, where tree queries are realized through (black-box) testing. Our case studies include connection establishment in TCP and a priority queue from the Java Class Library.

  9. Hamiltonian dynamics of extended objects

    Science.gov (United States)

    Capovilla, R.; Guven, J.; Rojas, E.

    2004-12-01

    We consider relativistic extended objects described by a reparametrization-invariant local action that depends on the extrinsic curvature of the worldvolume swept out by the object as it evolves. We provide a Hamiltonian formulation of the dynamics of such higher derivative models which is motivated by the ADM formulation of general relativity. The canonical momenta are identified by looking at boundary behaviour under small deformations of the action; the relationship between the momentum conjugate to the embedding functions and the conserved momentum density is established. The canonical Hamiltonian is constructed explicitly; the constraints on the phase space, both primary and secondary, are identified and the role they play in the theory is described. The multipliers implementing the primary constraints are identified in terms of the ADM lapse and shift variables and Hamilton's equations are shown to be consistent with the Euler Lagrange equations.

  10. Center for Extended Magnetohydrodynamics Modeling

    Energy Technology Data Exchange (ETDEWEB)

    Ramos, Jesus [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States)

    2017-02-14

    This researcher participated in the DOE-funded Center for Extended Magnetohydrodynamics Modeling (CEMM), a multi-institutional collaboration led by the Princeton Plasma Physics Laboratory with Dr. Stephen Jardin as the overall Principal Investigator. This project developed advanced simulation tools to study the non-linear macroscopic dynamics of magnetically confined plasmas. The collaborative effort focused on the development of two large numerical simulation codes, M3D-C1 and NIMROD, and their application to a wide variety of problems. Dr. Ramos was responsible for theoretical aspects of the project, deriving consistent sets of model equations applicable to weakly collisional plasmas and devising test problems for verification of the numerical codes. This activity was funded for twelve years.

  11. Hamiltonian dynamics of extended objects

    International Nuclear Information System (INIS)

    Capovilla, R; Guven, J; Rojas, E

    2004-01-01

    We consider relativistic extended objects described by a reparametrization-invariant local action that depends on the extrinsic curvature of the worldvolume swept out by the object as it evolves. We provide a Hamiltonian formulation of the dynamics of such higher derivative models which is motivated by the ADM formulation of general relativity. The canonical momenta are identified by looking at boundary behaviour under small deformations of the action; the relationship between the momentum conjugate to the embedding functions and the conserved momentum density is established. The canonical Hamiltonian is constructed explicitly; the constraints on the phase space, both primary and secondary, are identified and the role they play in the theory is described. The multipliers implementing the primary constraints are identified in terms of the ADM lapse and shift variables and Hamilton's equations are shown to be consistent with the Euler-Lagrange equations

  12. Hamiltonian dynamics of extended objects

    Energy Technology Data Exchange (ETDEWEB)

    Capovilla, R [Departamento de FIsica, Centro de Investigacion y de Estudios Avanzados del IPN, Apdo Postal 14-740, 07000 Mexico, DF (Mexico); Guven, J [School of Theoretical Physics, Dublin Institute for Advanced Studies, 10 Burlington Road, Dublin 4 (Ireland); Rojas, E [Instituto de Ciencias Nucleares, Universidad Nacional Autonoma de Mexico, Apdo Postal 70-543, 04510 Mexico, DF (Mexico)

    2004-12-07

    We consider relativistic extended objects described by a reparametrization-invariant local action that depends on the extrinsic curvature of the worldvolume swept out by the object as it evolves. We provide a Hamiltonian formulation of the dynamics of such higher derivative models which is motivated by the ADM formulation of general relativity. The canonical momenta are identified by looking at boundary behaviour under small deformations of the action; the relationship between the momentum conjugate to the embedding functions and the conserved momentum density is established. The canonical Hamiltonian is constructed explicitly; the constraints on the phase space, both primary and secondary, are identified and the role they play in the theory is described. The multipliers implementing the primary constraints are identified in terms of the ADM lapse and shift variables and Hamilton's equations are shown to be consistent with the Euler-Lagrange equations.

  13. THE EXTENDED VIRGO CLUSTER CATALOG

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Suk; Rey, Soo-Chang; Lee, Youngdae; Chung, Jiwon; Pak, Mina; Yi, Wonhyeong; Lee, Woong [Department of Astronomy and Space Science, Chungnam National University, 99 Daehak-ro, Daejeon 305-764 (Korea, Republic of); Jerjen, Helmut [Research School of Astronomy and Astrophysics, The Australian National University, Cotter Road, Weston, ACT 2611 (Australia); Lisker, Thorsten [Astronomisches Rechen-Institut, Zentrum für Astronomie der Universität Heidelberg (ZAH), Mönchhofstraße 12-14, D-69120 Heidelberg (Germany); Sung, Eon-Chang [Korea Astronomy and Space Science institute, 776 Daedeokdae-ro, Daejeon 305-348 (Korea, Republic of)

    2015-01-01

    We present a new catalog of galaxies in the wider region of the Virgo cluster, based on the Sloan Digital Sky Survey (SDSS) Data Release 7. The Extended Virgo Cluster Catalog (EVCC) covers an area of 725 deg{sup 2} or 60.1 Mpc{sup 2}. It is 5.2 times larger than the footprint of the classical Virgo Cluster Catalog (VCC) and reaches out to 3.5 times the virial radius of the Virgo cluster. We selected 1324 spectroscopically targeted galaxies with radial velocities less than 3000 km s{sup –1}. In addition, 265 galaxies that have been overlooked in the SDSS spectroscopic survey but have available redshifts in the NASA Extragalactic Database are also included. Our selection process secured a total of 1589 galaxies, 676 of which are not included in the VCC. The certain and possible cluster members are defined by means of redshift comparison with a cluster infall model. We employed two independent and complementary galaxy classification schemes: the traditional morphological classification based on the visual inspection of optical images and a characterization of galaxies from their spectroscopic features. SDSS u, g, r, i, and z passband photometry of all EVCC galaxies was performed using Source Extractor. We compare the EVCC galaxies with the VCC in terms of morphology, spatial distribution, and luminosity function. The EVCC defines a comprehensive galaxy sample covering a wider range in galaxy density that is significantly different from the inner region of the Virgo cluster. It will be the foundation for forthcoming galaxy evolution studies in the extended Virgo cluster region, complementing ongoing and planned Virgo cluster surveys at various wavelengths.

  14. Extended Power Up-rates

    International Nuclear Information System (INIS)

    Jon Ball

    2006-01-01

    Full text of publication follows: Nuclear energy is a reliable and cost-competitive global source of power. With rising oil and gas prices, nuclear continues to provide economic and environmental benefits. Extended Power Up-rate (EPU) provides a means for existing nuclear assets to generate increased power and substantially reduce electrical generation costs. GE Energy's Nuclear Business is the global leader in boiling water reactor (BWR) technology. The experience-base of plants that have successfully achieved EPU includes Spain, Switzerland, Sweden, Germany and the United States. The GE experience-base includes fourteen BWRs with over fifty-eight reactor-years of operating experience at EPU conditions. Other than the expected plant modifications needed to accommodate higher steam flows, flow-induced vibration (FIV) has been identified as the major area of concern when up-rating. Two plants have experienced damage to their steam dryers that has lead to an extensive program to improve the understanding of the effects of up-rates. This program includes extensive in-plant data collection, the development of a scale model test facility to study components susceptible to FIV and improvements in analytical techniques for evaluating loading on reactor internals. As global energy demands increase, oil and gas prices escalate, and environmental concerns over greenhouse effects challenge us to find environmentally friendly sources of energy, Nuclear is the most viable and economical source of power in the world. With a focused effort on plant reliability, existing plants can undergo Extended Power Up-rate, and continue to meet the ever-increasing energy demands in the world. (author)

  15. Density fluctuations in extended inflation

    International Nuclear Information System (INIS)

    Guth, A.H.; Jain, B.

    1992-01-01

    We estimate the density perturbation spectrum δρ/ρ in the extended inflationary model, in which the scalar curvature is coupled to a Brans-Dicke field. Through a conformal transformation and a redefinition of the Brans-Dicke field, the action of the theory is cast into a form with no coupling to the scalar curvature and a canonical kinetic term for the redefined field. Following Kolb, Salopek, and Turner, we calculate δρ/ρ using the transformed action and the standard recipe developed for conventional inflation. This recipe is expected to give a valid order-of-magnitude estimate, but a precise calculation would require a more careful treatment of several aspects of the problem. The spectrum behaves as a positive power of the wavelength, a feature that might be useful in building models to account for the observed large-scale structure of the universe. Our result for the overall amplitude of density perturbations differs slightly from that of the previous authors, and the reasons for these differences are discussed. We also point out that the conformal transformation method can be applied to a wider class of generalized gravity theories

  16. N=2 extended supersymmetric GUTs

    International Nuclear Information System (INIS)

    Fayet, P.

    1984-01-01

    We construct N = 2 extended SUSY GUTs which provide a general association between massive spin-1 gauge bosons, spin-1/2 inos and spin-0 Higgs bosons. The corresponding gauge hypermultiplets are of four different types, while leptons and quarks are associated with mirror and spin-0 partners. The anticommutators of the two supersymmetry generators provide two spin-0 symmetry generators Zsub(s) and Zsub(p), which do not commute. Their field-independent parts and do commute, however, and appear as central charges in the symmetry algebra of the spontaneously broken gauge theory. These central charges and are linear combinations of global symmetry generators with grand unification generators such as the weak hypercharge (but not the electrical charge). They survive the electroweak symmetry breaking. They do not vanish for massive gauge hypermultiplets of types II and III, which verify M 2 = 2 + 2 > 0 and M 2 > 2 + 2 > 0, respectively. The formula M 2 approx.= 2 + 2 determines the mass spectrum on the grand unification scale, up to electroweak corrections. Finally, we indicate how our mass relations can be interpreted in a 5- or 6-dimensional formalism, the central charges appearing as the extra components of the covariant momentum along the compact fifth or sixth dimensions; and how to evaluate the grand unification mass msub(x) in terms of the lengths of the latter (msub(x)approx.=(h/2π)/Lsub(5(6))c). (orig./HSI)

  17. Extended attention span training system

    Science.gov (United States)

    Pope, Alan T.; Bogart, Edward H.

    1991-01-01

    Attention Deficit Disorder (ADD) is a behavioral disorder characterized by the inability to sustain attention long enough to perform activities such as schoolwork or organized play. Treatments for this disorder include medication and brainwave biofeedback training. Brainwave biofeedback training systems feed back information to the trainee showing him how well he is producing the brainwave pattern that indicates attention. The Extended Attention Span Training (EAST) system takes the concept a step further by making a video game more difficult as the player's brainwaves indicate that attention is waning. The trainee can succeed at the game only by maintaining an adequate level of attention. The EAST system is a modification of a biocybernetic system that is currently being used to assess the extent to which automated flight management systems maintain pilot engagement. This biocybernetic system is a product of a program aimed at developing methods to evaluate automated flight deck designs for compatibility with human capabilities. The EAST technology can make a contribution in the fields of medical neuropsychology and neurology, where the emphasis is on cautious, conservative treatment of youngsters with attention disorders.

  18. A quantum extended Kalman filter

    International Nuclear Information System (INIS)

    Emzir, Muhammad F; Woolley, Matthew J; Petersen, Ian R

    2017-01-01

    In quantum physics, a stochastic master equation (SME) estimates the state (density operator) of a quantum system in the Schrödinger picture based on a record of measurements made on the system. In the Heisenberg picture, the SME is a quantum filter. For a linear quantum system subject to linear measurements and Gaussian noise, the dynamics may be described by quantum stochastic differential equations (QSDEs), also known as quantum Langevin equations, and the quantum filter reduces to a so-called quantum Kalman filter. In this article, we introduce a quantum extended Kalman filter (quantum EKF), which applies a commutative approximation and a time-varying linearization to systems of nonlinear QSDEs. We will show that there are conditions under which a filter similar to a classical EKF can be implemented for quantum systems. The boundedness of estimation errors and the filtering problem with ‘state-dependent’ covariances for process and measurement noises are also discussed. We demonstrate the effectiveness of the quantum EKF by applying it to systems that involve multiple modes, nonlinear Hamiltonians, and simultaneous jump-diffusive measurements. (paper)

  19. Geometric construction of extended supergravity

    International Nuclear Information System (INIS)

    Kostelecky, V.A.

    1982-01-01

    This work describes the explict construction of the locally SO(4)-invariant, on-shell de Sitter supergravity. First, aspects of classical differential geometry used in the construction of local gauge theories are reviewed. Emphasis is placed on fiber bundles and their uses in Yang-Mills and Einstein theories. Next, the extension of the formalism to differential supergeometry is outlined. Applications to extended supergravities are discussed. Finally, the O(4) deSitter supergravity is obtained by considering a bundle of frames constructed using the orthosymplectic superalgebra osp(4/4). The structure group of this bundle is Sl(2C) x SO(4) and the tangent space to the base supermanifold is homeomorphic to the coset osp(4/4)/sl(2C) x so(4). Constraints taken into the Bianchi identifies yield a realization of the superalgebra in the function space of connections, vielbeins, curvatures and torsions of the bundle. Auxiliary fields, transformation laws and equations of motion are determined. Consistency of the realization is verified, proving closure of the algebra. The associated Poincare supergravity is obtained by a contraction

  20. Extended analysis of Mo VI

    International Nuclear Information System (INIS)

    Edlen, B.; Rahimullah, K.; Tauheed, A.; Chaghtai, M.S.Z.

    1985-01-01

    The analysis of the RbI-like spectrum Mo VI has been extended to include a total of some 110 classified lines and 44 energy levels belonging to the one-electron configurations 4s 2 4p 6 ( 1 S)nl with n ranging up to 9 and l up to 7. The analysis is based on recordings of vacuum spark spectra made at Lund in the region 230-2350 A, complemented by a list of lines from 2193 to 6336 A observed and identified by Romanov and Striganov in a Penning type arc discharge. The one-electron level system is partly mixed with core-excited configurations, not treated in the present paper. Especially the nf series is strongly perturbed by 4s 2 4p 5 4d 2 , and an anomalous behaviour of the ng series is explained by interaction with the 2 G term of 4s4p 6 4d 2 . The ionization limit, derived from 6h, 7i and 8k by means of the polarization formula, is found to be 555 132+-2 cm -1 . (orig.)

  1. A quantum extended Kalman filter

    Science.gov (United States)

    Emzir, Muhammad F.; Woolley, Matthew J.; Petersen, Ian R.

    2017-06-01

    In quantum physics, a stochastic master equation (SME) estimates the state (density operator) of a quantum system in the Schrödinger picture based on a record of measurements made on the system. In the Heisenberg picture, the SME is a quantum filter. For a linear quantum system subject to linear measurements and Gaussian noise, the dynamics may be described by quantum stochastic differential equations (QSDEs), also known as quantum Langevin equations, and the quantum filter reduces to a so-called quantum Kalman filter. In this article, we introduce a quantum extended Kalman filter (quantum EKF), which applies a commutative approximation and a time-varying linearization to systems of nonlinear QSDEs. We will show that there are conditions under which a filter similar to a classical EKF can be implemented for quantum systems. The boundedness of estimation errors and the filtering problem with ‘state-dependent’ covariances for process and measurement noises are also discussed. We demonstrate the effectiveness of the quantum EKF by applying it to systems that involve multiple modes, nonlinear Hamiltonians, and simultaneous jump-diffusive measurements.

  2. Technological Packages Extended To Farmers by Non ...

    African Journals Online (AJOL)

    Global Approaches to Extension Practice: A Journal of Agricultural Extension ... extended to farmers by Non Governmental Organizations in the Niger Delta area of Nigeria. ... Modern snailery was the only identified agro forestry technology extended, ... technologies were the significant soil management practices extended.

  3. Extended storage of spent fuel

    International Nuclear Information System (INIS)

    1992-10-01

    This document is the final report on the IAEA Co-ordinated Research Programme on the Behaviour of Spent Fuel and Storage Facility Components during Long Term Storage (BEFAST-II, 1986-1991). It contains the results on wet and dry spent fuel storage technologies obtained from 16 organizations representing 13 countries who participated in the co-ordinated research programme. Considerable quantities of spent fuel continue to arise and accumulate. Many countries are investigating the option of extended spent fuel storage prior to reprocessing or fuel disposal. Wet storage continues to predominate as an established technology with the construction of additional away-from-reactor storage pools. However, dry storage is increasingly used with most participants considering dry storage concepts for the longer term. Depending on the cladding type options of dry storage in air or inert gas are proposed. Dry storage is becoming widely used as a supplement to wet storage for zirconium alloy clad oxide fuels. Storage periods as long as under wet conditions appear to be feasible. Dry storage will also continue to be used for Al clad and Magnox type fuel. Enhancement of wet storage capacity will remain an important activity. Rod consolidation to increase wet storage capacity will continue in the UK and is being evaluated for LWR fuel in the USA, and may start in some other countries. High density storage racks have been successfully introduced in many existing pools and are planned for future facilities. For extremely long wet storage (≥50 years), there is a need to continue work on fuel integrity investigations and LWR fuel performance modelling. it might be that pool component performance in some cases could be more limiting than the FA storage performance. It is desirable to make concerted efforts in the field of corrosion monitoring and prediction of fuel cladding and poll component behaviour in order to maintain good experience of wet storage. Refs, figs and tabs

  4. Extending solid state laser performance

    Science.gov (United States)

    Miesak, Ed

    2017-02-01

    Coherent Diode-Pumped Solid-State Orlando (CDO), formerly known as Lee Laser, headquartered in Orlando Florida produces CW and pulsed solid state lasers. Primary wavelengths include 1064 nm, 532 nm, and 355 nm. Other wavelengths produced include 1320 nm, 15xx nm, and 16xx nm. Pulse widths are in the range of singles to hundreds of nanoseconds. Average powers are in the range of a few watts to 1000 watts. Pulse repetition rates are typically in the range of 100 Hz to 100 KHz. Laser performance parameters are often modified according to customer requests. Laser parameters that can be adjusted include average power, pulse repetition rate, pulse length, beam quality, and wavelength. Laser parameters are typically cross-coupled such that adjusting one may change some or all of the others. Customers often request one or more parameters be changed without changing any of the remaining parameters. CDO has learned how to accomplish this successfully with rapid turn-around times and minimal cost impact. The experience gained by accommodating customer requests has produced a textbook of cause and effect combinations of laser components to accomplish almost any parameter change request. Understanding the relationships between component combinations provides valuable insight into lasing effects allowing designers to extend laser performance beyond what is currently available. This has led to several break through products, i.e. >150W average power 355 nm, >60W average power 6 ps 1064 nm, pulse lengths longer than 400 ns at 532 nm with average power >100W, >400W 532 nm with pulse lengths in the 100 ns range.

  5. Retroperitoneoscopic pyelolithotomy: a good alternative treatment for renal pelvic calculi in children.

    Science.gov (United States)

    Cezarino, Bruno Nicolino; Park, Rubens; Moscardi, Paulo Renato Marcelo; Lopes, Roberto Iglesias; Denes, Francisco T; Srougi, Miguel

    2016-01-01

    Nephrolitiasis, once considered an adult disease, has become increasingly prevalent in children, with na increase from 6% to 10 % annually in past 25 years. Kidney stones in pediatric population can result from metabolic diseases in up to 50% of children affected. Other factors associated with litiasis are infection, dietary factors, and anatomic malformations of urinary tract. Standard treatment procedures for pediatric population are similar to adult population. Extracorporeal shock wave lithotripsy (ESWL), ureterorenoscopy (URS), percutaneous nepfrolithotomy (PCNL), as well as laparoscopic and retroperitoneoscopic approaches can be indicated in selected cases. The advantages of laparoscopic or retroperitoneoscopic approaches are shorter mean operation time, no trauma of renal parenchyma, lower bleeding risk, and higher stone-free rates, especially in pelvic calculi with extrarenal pelvis, where the stone is removed intact. A 10 year-old girl presented with right abdominal flank pain, macroscopic hematuria,with previous history of urinary infections.. Further investigation showed an 1,5 centimeter calculi in right kidney pelvis. A previous ureterorenoscopy was tried with no success, and a double J catheter was placed. After discussing options, a retroperitoneoscopic pielolithotomy was performed. The procedure occurred with no complications, and the calculi was completely removed. The foley catheter was removed in first postoperative day and she was discharged 2 days after surgery. Double J stent was removed after 2 weeks. Retroperitoneoscopic pielolithotomy is a feasible and safe procedure in children, with same outcomes of the procedure for adult population. Copyright® by the International Brazilian Journal of Urology.

  6. Big Gods: Extended prosociality or group binding?

    Science.gov (United States)

    Galen, Luke W

    2016-01-01

    Big Gods are described as having a "prosocial" effect. However, this conflates parochialism (group cohesion) with cooperation extended to strangers or out-group members. An examination of the cited experimental studies indicates that religion is actually associated with increased within-group parochialism, rather than extended or universal prosociality, and that the same general mechanisms underlie both religious and secular effects.

  7. Extended, Embodied Cognition and Second Language Acquisition

    Science.gov (United States)

    Atkinson, Dwight

    2010-01-01

    A "cognitivist" approach to cognition has traditionally dominated second language acquisition (SLA) studies. In this article, I examine two alternative approaches--"extended cognition" and "embodied cognition"--for how they might help us conceptualize SLA. More specifically, I present: (i) summaries of extended and embodied cognition, followed by…

  8. Impacts of extended working hours in logging

    Science.gov (United States)

    Dana Mitchell; Tom Gallagher

    2008-01-01

    Last year at the 2007 AIM in Minneapolis, MN, the authors presented the human factors impacts to consider when implementing extended working hours in the logging industry. In a continuation of this project, we have researched existing literature to identify possible actions that logging business owners can take to reduce the impact of extended working hours on their...

  9. Extended Producer Responsibility in the Aviation Sector

    OpenAIRE

    Brito, Marisa; Laan, Erwin; Irion, B.D.

    2007-01-01

    textabstractIn this paper we investigate recent initiatives with respect to extended producer responsibility in the aviation sector. We compare those with the existing practices in the automobile sector and the emerging regulations in the shipping sector. We describe the challenges and the lessons to be learned from the evolution and state of extended producer responsibility in these two industries.

  10. [Pre-operation evaluation and intra-operation management of cochlear implantation].

    Science.gov (United States)

    Zhang, Dao-xing; Hu, Bao-hua; Xiao, Yu-li; Shi, Bo-ning

    2004-10-01

    To summarize pre-operation evaluation experiences in cochlear implantation. Performing auditory evaluation and image analysis seriously in 158 severe hearing loss or total deaf cases before cochlear implantation, comparing their performance with the findings during and post operation. Among the total 158 cases, 116 cases with normal structure, 42 cases with the abnormal findings of the inner or middle ear. Stapedial gusher happened in 6 cases, 1 case was not predicted before operation. Except 1 case with serious malformation, the findings of other 157 cases in operation were consistent with the pre-operation evaluation. We helped all patients reconstruct auditory conduction with cochlear implantation, and the average hearing level up to 37.6 dB SPL. Performing image analysis seriously before operation and planning for operation according to HRCT can do great help to cochlear implantation. The operation under the HRCT instruction has less complications.

  11. Estimation and comparison of intra operative blood loss in patients with and without venous thromboembolism prophylaxis

    International Nuclear Information System (INIS)

    Ahsin, S.; Bashir, A.; Faiz, S.A.; Tahir, J.; Ijaz, A.

    2014-01-01

    To estimate and compare intraoperative blood loss in surgical patients with and without deep vein thrombosis (DVT) prophylaxis using unfractionated heparin Study Design: Clinical Trial Place and Duration: Surgery Department of Fauji Foundation Hospital and Physiology Department Foundation University Medical College from October 2011 to August 2012 Patients and Methodology: Patients were selected by non probability purposive sampling. Patients fulfilling the inclusion criteria were divided into 2 groups 25 each on the basis of order of presentation at Fauji Foundation Hospital until cohort numbers were reached. Group I received no heparin whereas group II received heparin. Written informed consent was taken from the patient after explaining the procedure of the study. Coagulation profile was done for both groups before the planned surgery. Heparin in a dose of 5000 units was administered subcutaneously to group II on the morning of the planned surgery and it was stopped 24 hours post operatively. Blood loss was estimated in both groups by weighing cotton swabs pre and post operatively. Data was analyzed by SPSS version 17. Results: Demographic data and surgical procedure time between the two groups did not differ. Blood loss between the two groups did not show any statistically significant difference. Conclusion: DVT prophylaxis using unfractionated heparin did not lead to any significant overt blood loss when compared with those without it. (author)

  12. Intra-operative colloid administration increases the clearance of a post-operative fluid load

    DEFF Research Database (Denmark)

    Borup, Tine; Hahn, Robert; Holte, K

    2009-01-01

    using volume kinetics based on the plasma dilution alone. The pre-operative plasma clearance was compared with the post-operative plasma clearance and patients served as their own control. RESULTS: The urinary excretion averaged 350 ml for the pre-operative infusion and 612 ml post-operatively, which...

  13. An evaluation of intra-operative and post-operative blood loss in ...

    African Journals Online (AJOL)

    Background: Total knee replacement is a rewarding and reliable procedure, producing a lasting relief to severe knee pains. However, significant blood loss usually in the post-operative period may be a challenge, necessitating prompt restoration of circulating blood volume to minimize morbidity and mortality. The aim of this ...

  14. Broken Heart Syndrome – An intra operative complication

    African Journals Online (AJOL)

    Zara Wani

    2017-03-09

    Mar 9, 2017 ... diomyopathy, Stress Cardiomyopathy1 is an acute reversible left ventricular dysfunction in the absence ... acute coronary syndrome with charac- teristics features of typical chest pain, pulmonary edema, ... Beta-blockers5 and intensive care is the prime mode of treatment, which provides good recovery and ...

  15. Intra-operative hyperthermia in a young Angus bull with a fatal outcome

    OpenAIRE

    Skelding, Alicia; Valverde, Alexander

    2017-01-01

    A healthy, 9-month-old black Angus bull was presented for elective penile-preputial translocation and caudal epididymectomy. After premedication and induction, general anesthesia was maintained with inhalant anesthetic. Over an hour into the anesthetic period the bull developed severe hyperthermia and hypercapnia that resulted in fatality despite treatment efforts.

  16. Intra-operative hyperthermia in a young Angus bull with a fatal outcome.

    Science.gov (United States)

    Skelding, Alicia; Valverde, Alexander

    2017-06-01

    A healthy, 9-month-old black Angus bull was presented for elective penile-preputial translocation and caudal epididymectomy. After premedication and induction, general anesthesia was maintained with inhalant anesthetic. Over an hour into the anesthetic period the bull developed severe hyperthermia and hypercapnia that resulted in fatality despite treatment efforts.

  17. Quick insulin radioimmunoassay and its utilization for intra operative localization of insulinoma

    International Nuclear Information System (INIS)

    Ursich, M.J.M.; Fukui, R.T.; Aguiar Pupo, A. de; Machado, M.C.C.

    1988-01-01

    A quick insuLin radioimmunoassay performed in 90 minutes is described and the results are compared with those obtained with the conventional method. The realibility of the new procedure is pointed. (M.A.C.) [pt

  18. Efficacy of an Intra-Operative Imaging Software System for Anatomic Anterior Cruciate Ligament Reconstruction Surgery

    Directory of Open Access Journals (Sweden)

    Xudong Zhang

    2012-01-01

    Full Text Available An imaging software system was studied for improving the performance of anatomic anterior cruciate ligament (ACL reconstruction which requires identifying ACL insertion sites for bone tunnel placement. This software predicts and displays the insertion sites based on the literature data and patient-specific bony landmarks. Twenty orthopaedic surgeons performed simulated arthroscopic ACL surgeries on 20 knee specimens, first without and then with the visual guidance by fluoroscopic imaging, and their tunnel entry positions were recorded. The native ACL insertion morphologies of individual specimens were quantified in relation to CT-based bone models and then used to evaluate the software-generated insertion locations. Results suggested that the system was effective in leading surgeons to predetermined locations while the application of averaged insertion morphological information in individual surgeries can be susceptible to inaccuracy and uncertainty. Implications on challenges associated with developing engineering solutions to aid in re-creating or recognizing anatomy in surgical care delivery are discussed.

  19. Evaluation of accuracy of intra operative imprint cytology for detection of breast lesions

    International Nuclear Information System (INIS)

    Mahmood, Z.; Shahbaz, A.; Qureshi, A.; Aziz, N.; Niazi, S.; Qureshi, S.; Bukhari, M.H.

    2010-01-01

    Objective: To determine the accuracy of imprint cytology as an intraoperative diagnostic procedure for breast lesions with histopathological correlation. Materials and Methods: This was a descriptive study on 40 cases of breast lesions comprising of inflammatory, benign and malignant lesions including their margins etc. It was conducted at King Edward Medical University, Lahore in collaboration with all Surgical Departments of Mayo Hospital. Relevant clinical data was recorded in a proforma. Both touch and scrape imprints were prepared from all the lesions and stained with May-Grunwaled Giemsa and Haematoxylin and Eosin stains. The imprints were subsequently compared with histopathology sections. Results: When we used atypical cases as negative both touch and scrape imprints gave sensitivity, specificity, positive predictive value, negative predictive value and accuracy at 100%. However when we used cases with atypia as positive, sensitivity and negative predictive value were 100% with both touch and scrape imprints. Specificity, positive predictive value and accuracy were 71%, 86%, 85.5% respectively with touch imprints and 78%, 89%, 89% respectively with scrape imprints. No diagnostic difference was noted between the results of both stains. All the imprints were well correlated with histopathological diagnosis. Conclusion: Imprint cytology is an accurate and simple intraoperative method for diagnosing breast lesions. It can provide the surgeons with information regarding immediate clinical and surgical interventions. (author)

  20. Characteristics and quality of intra-operative cell salvage in paediatric scoliosis surgery.

    Science.gov (United States)

    Perez-Ferrer, A; Gredilla-Díaz, E; de Vicente-Sánchez, J; Navarro-Suay, R; Gilsanz-Rodríguez, F

    2016-02-01

    To determine the haematological and microbiological characteristics of blood recovered by using a cell saver with a rigid centrifuge bowl (100ml) in paediatric scoliosis surgery and to determine whether it conforms to the standard expected in adult patients. A cross-sectional, descriptive cohort study was performed on 24 consecutive red blood cell (RBC) units recovered from the surgical field and processed by a Haemolite® 2+ (Haemonetics Corp., Braintree, MA, EE. UU.) cell saver. Data were collected regarding age, weight, surgical approach (anterior or posterior), processed shed volume and volume of autologous RBC recovered, full blood count, and blood culture obtained from the RBC concentrate, and incidence of fever after reinfusion. The processed shed volume was very low (939±569ml) with high variability (coefficient of variation=0.6), unlike the recovered volume 129±50ml (coefficient of variation=0.38). A statistically significant correlation between the processed shed volume and recovered RBC concentrate haematocrit was found (Pearson, r=.659, P=.001). Haematological parameters in the recovered concentrate were: Hb 11±5.3g dl(-1); haematocrit: 32.1±15.4% (lower than expected); white cells 5.34±4.22×103 ul(-)1; platelets 37.88±23.5×103 ul(-1) (mean±SD). Blood culture was positive in the RBC concentrate recovered in 13 cases (54.2%) in which Staphylococcus coagulase (-) was isolated. Cell salvage machines with rigid centrifuge bowls (including paediatric small volume) do not obtain the expected haematocrit if low volumes are processed, and therefore they are not the best choice in paediatric surgery. Copyright © 2015 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Intra-operative protective mechanical ventilation in lung transplantation: a randomised, controlled trial.

    Science.gov (United States)

    Verbeek, G L; Myles, P S; Westall, G P; Lin, E; Hastings, S L; Marasco, S F; Jaffar, J; Meehan, A C

    2017-08-01

    Primary graft dysfunction occurs in up to 25% of patients after lung transplantation. Contributing factors include ventilator-induced lung injury, cardiopulmonary bypass, ischaemia-reperfusion injury and excessive fluid administration. We evaluated the feasibility, safety and efficacy of an open-lung protective ventilation strategy aimed at reducing ventilator-induced lung injury. We enrolled adult patients scheduled to undergo bilateral sequential lung transplantation, and randomly assigned them to either a control group (volume-controlled ventilation with 5 cmH 2 O, positive end-expiratory pressure, low tidal volumes (two-lung ventilation 6 ml.kg -1 , one-lung ventilation 4 ml.kg -1 )) or an alveolar recruitment group (regular step-wise positive end-expiratory pressure-based alveolar recruitment manoeuvres, pressure-controlled ventilation set at 16 cmH 2 O with 10 cmH 2 O positive end-expiratory pressure). Ventilation strategies were commenced from reperfusion of the first lung allograft and continued for the duration of surgery. Regular PaO 2 /F I O 2 ratios were calculated and venous blood samples collected for inflammatory marker evaluation during the procedure and for the first 24 h of intensive care stay. The primary end-point was the PaO 2 /F I O 2 ratio at 24 h after first lung reperfusion. Thirty adult patients were studied. The primary outcome was not different between groups (mean (SD) PaO 2 /F I O 2 ratio control group 340 (111) vs. alveolar recruitment group 404 (153); adjusted p = 0.26). Patients in the control group had poorer mean (SD) PaO 2 /F I O 2 ratios at the end of the surgical procedure and a longer median (IQR [range]) time to tracheal extubation compared with the alveolar recruitment group (308 (144) vs. 402 (154) (p = 0.03) and 18 (10-27 [5-468]) h vs. 15 (11-36 [5-115]) h (p = 0.01), respectively). An open-lung protective ventilation strategy during surgery for lung transplantation is feasible, safe and achieves favourable ventilation parameters. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

  2. Motorization of a surgical microscope for intra-operative navigation and intuitive control.

    Science.gov (United States)

    Finke, M; Schweikard, A

    2010-09-01

    During surgical procedures, various medical systems, e.g. microscope or C-arm, are used. Their precise and repeatable manual positioning can be very cumbersome and interrupts the surgeon's work flow. Robotized systems can assist the surgeon but they require suitable kinematics and control. However, positioning must be fast, flexible and intuitive. We describe a fully motorized surgical microscope. Hardware components as well as implemented applications are specified. The kinematic equations are described and a novel control concept is proposed. Our microscope combines fast manual handling with accurate, automatic positioning. Intuitive control is provided by a small remote control mounted to one of the surgical instruments. Positioning accuracy and repeatability are system assists the surgeon, so that he can position the microscope precisely and repeatedly without interrupting the clinical workflow. The combination of manual und automatic control guarantees fast and flexible positioning during surgical procedures. Copyright 2010 John Wiley & Sons, Ltd.

  3. Intra-Operative Indocyanine Green-Videoangiography (ICG-VA) in ...

    African Journals Online (AJOL)

    Methods: Fifteen consecutive patients with anterior circulation aneurysms who underwent craniotomy and clipping of the aneurysms were included in this study. Intraoperative ICG-VA was performed in all cases after exposure of the aneurysm and the branches in the vicinity of the aneurysm or the parent vessel before ...

  4. SU-F-T-80: A Mobile Application for Intra-Operative Electron Radiotherapy Treatment Planning

    International Nuclear Information System (INIS)

    Williams, C; Crowley, E; Wolfgang, J

    2016-01-01

    Purpose: Intraoperative electron radiotherapy (IORT) poses a unique set of challenges for treatment planning. Planning must be performed in a busy operating room environment over a short timeframe often with little advance knowledge of the treatment depth or applicator size. Furthermore, IORT accelerators can have a large number of possible applicators, requiring extensive databooks that must be searched for the appropriate dosimetric parameters. The goal of this work is to develop a software tool to assist in the planning process that is suited to the challenges faced in the IORT environment. Methods: We developed a mobile application using HTML5 and Javascript that can be deployed to tablet devices suitable for use in the operating room. The user selects the desired treatment parameters cone diameter, bevel angle, and energy (a total of 141 datasets) and desired bolus. The application generates an interactive display that allows the user to dynamically select points on the depth-dose curve and to visualize the shape of the corresponding isodose contours. The user can indicate a prescription isodose line or depth. The software performs a monitor unit calculation and generates a PDF report. Results: We present our application, which is now used routinely in our IORT practice. It has been employed successfully in over 23 cases. The interactivity of the isodose distributions was found to be of particular use to physicians who are less-frequent IORT users, as well as for the education of residents and trainees. Conclusion: This software has served as a useful tool in IORT planning, and demonstrates the need for treatment planning tools that are designed for the specialized challenges encountered in IORT. This software is the subject of a license agreement with the IntraOp Medical Corporation. This software is the subject of a license agreement between Massachusetts General Hospital / Partners Healthcare and the IntraOp Medical Corporation. CLW is consulting on software development with the IntraOp Medical Corporation.

  5. Is intra-operative gamma probe detection really necessary for inguinal sentinel lymph node biopsy?

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira Filho, Renato Santos de; Santos, Ivan Dunshe Abranches Oliveira; Ferreira, Lydia Massako; Almeida, Fernando Augusto de; Simoes, Milvia Maria; Enokihara, Silvia; Barbieri, Antonio; Tovo Filho, Reinaldo [Universidade Federal de Sao Paulo (UNIFESP - EPM), SP (Brazil). Disciplina de Cirurgia Plastica

    2000-11-01

    Sentinel node (SN) biopsy has changed the surgical treatment of malignant melanoma. The literature has emphasized the importance of gamma probe detection (GPD) of the SN. Our objective was to evaluate the efficacy of patent blue dye (PBD) and GPD for SN biopsy in different lymphatic basins. Patients with cutaneous malignant melanoma in stages I and II were submitted to biopsy of the SN, identified by PBD and GPD, as part of a research project. Patients were seen at Hospital Sao Paulo by a multidisciplinary group (Plastic Surgery Tumor Branch, Nuclear Medicine and Pathology). 64 patients with localized malignant melanoma were studied. The median age was 46.5 years. The primary tumor was located in the neck, trunk or extremities. Preoperative lymphoscintigraphy, lymphatic mapping with PBD and intraoperative GPD were performed on all patients. The SN was examined by conventional and immuno-histological staining. If the SN was not found or contained micrometastases, only complete lymphadenectomy was performed. The SN was identified by PBD if it was blue-stained, and by GPD if demonstrated activity five times greater than the adipose tissue of the neighborhood. Seventy lymphatic basins were explored. Lymphoscintigraphy showed ambiguous drainage em 7 patients. GPD identified the SN in 68 basins (97%) and PBD in 53 (76%). PBD and GPD identified SN in 100% of the inguinal basins. For the remaining basins both techniques were complementary. A metastatic SN was found in 10 basins. Three patients with negative SN had recurrence (median follow-up=11 months). Although both GPD and PBD are useful and complementary, PBD alone identified the SN in 100% of the inguinal lymphatic basins. (author)

  6. Is intra-operative gamma probe detection really necessary for inguinal sentinel lymph node biopsy?

    International Nuclear Information System (INIS)

    Oliveira Filho, Renato Santos de; Santos, Ivan Dunshe Abranches Oliveira; Ferreira, Lydia Massako; Almeida, Fernando Augusto de; Simoes, Milvia Maria; Enokihara, Silvia; Barbieri, Antonio; Tovo Filho, Reinaldo

    2000-01-01

    Sentinel node (SN) biopsy has changed the surgical treatment of malignant melanoma. The literature has emphasized the importance of gamma probe detection (GPD) of the SN. Our objective was to evaluate the efficacy of patent blue dye (PBD) and GPD for SN biopsy in different lymphatic basins. Patients with cutaneous malignant melanoma in stages I and II were submitted to biopsy of the SN, identified by PBD and GPD, as part of a research project. Patients were seen at Hospital Sao Paulo by a multidisciplinary group (Plastic Surgery Tumor Branch, Nuclear Medicine and Pathology). 64 patients with localized malignant melanoma were studied. The median age was 46.5 years. The primary tumor was located in the neck, trunk or extremities. Preoperative lymphoscintigraphy, lymphatic mapping with PBD and intraoperative GPD were performed on all patients. The SN was examined by conventional and immuno-histological staining. If the SN was not found or contained micrometastases, only complete lymphadenectomy was performed. The SN was identified by PBD if it was blue-stained, and by GPD if demonstrated activity five times greater than the adipose tissue of the neighborhood. Seventy lymphatic basins were explored. Lymphoscintigraphy showed ambiguous drainage em 7 patients. GPD identified the SN in 68 basins (97%) and PBD in 53 (76%). PBD and GPD identified SN in 100% of the inguinal basins. For the remaining basins both techniques were complementary. A metastatic SN was found in 10 basins. Three patients with negative SN had recurrence (median follow-up=11 months). Although both GPD and PBD are useful and complementary, PBD alone identified the SN in 100% of the inguinal lymphatic basins. (author)

  7. Experimental study of the intra-operative radiation therapy for pancreatic cancer

    International Nuclear Information System (INIS)

    Kodera, Taro; Matsuno, Seiki; Kobari, Masao; Akaishi, Satoshi; Sakamoto, Kiyohiko

    1988-01-01

    The radiosensitivity of pancreatic cancer, optimum dose of irradiation and the effect of 1-[4'-Hydroxy-2'-Butenoxy) Methyl]-2-Nitrosoimidaole (RK-28) on irradiation were investigated using an experimental pancreatic cancer of hamster and the following results were obtained: i) The mean lethal dose (Do) and the 50 % tumor control dose (TCD 50 ) against the pancreatic cancer were 3.5 Gy and 73.7 ± 6.9 Gy, respectively. These results indicate that the pancreatic cancer is resistant to irradiation, which could be explained by the existence of hypoxic cells consisting of 35 % of the tumor. ii) The dose of intraoperative irradiation (10 - 40 Gy) seemed to be insufficient to bring long-term anti-tumor effect and long-term survival since that dose resulted in only temporary regression of the tumor. iii) The hypoxic cell sensitizer (RK28), which is known to specifically enhance the sensitivity of hypoxic cells to irradiation, lowered TCD 50 of the pancreatic cancer to 53.8 ± 1.57 Gy. Therefore, RK-28 was effective in the treatment of the experimental pancreatic cancer (the enhancement ratio : 1.37). When combined with 30 or 40 Gy of irradiation, which is applicable to intraoperative irradiation, RK-28 induced a longer period of tumor suppression and a higher tumor regression ratio than irradiation alone. These results indicate that RK-28 significantly increases the effect of intraoperative irradiation and this combination therapy could possibly induce remarkable effect on tumor regression and long-term survival. (author)

  8. Demonstration of infective endocarditis by cardiac CT and transoesophageal echocardiography: comparison with intra-operative findings.

    Science.gov (United States)

    Koo, Hyun Jung; Yang, Dong Hyun; Kang, Joon-Won; Lee, Joo Yeon; Kim, Dae-Hee; Song, Jong-Min; Kang, Duk-Hyun; Song, Jae-Kwan; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae-Won; Lim, Tae-Hwan

    2018-02-01

    We aimed to compare imaging findings of infective endocarditis between computed tomography (CT) and transoesophageal echocardiography (TEE) using surgical inspection as a reference standard. Forty-nine patients (aged 54 ± 17 years, 69% men) who underwent pre-operative CT and TEE for infective endocarditis were included. Twelve of these patients had prosthetic valve endocarditis. Imaging findings of infective endocarditis were classified as vegetation, leaflet perforation, abscess/pseudoaneurysm, and paravalvular leakage. Diagnostic performances of CT and TEE were evaluated using surgical inspection as a reference standard. Interobserver agreements for CT findings were obtained using Cohen's κ test. The detection rates of infective endocarditis per patient with CT and TEE were 93.9% (46/49) and 95.9% (47/49), respectively. In per-imaging analysis, the sensitivities of CT and TEE were not significantly different for both native and prosthetic valve infective endocarditis (sensitivity: vegetation, 100% in TEE and 90.9% in CT; leaflet perforation, 87.5% in TEE and 50.0% in CT; abscess/pseudoaneurysm, 40.0% in TEE and 60.0% in CT; paravalvular leakage, 100% in TEE and 50.0% in CT). Interobserver agreements for CT findings were substantial or excellent (0.79-0.88). Cardiac CT can accurately demonstrate infective endocarditis in pre-operative patients with a similar diagnostic accuracy to TEE. The interobserver agreements for the CT findings of infective endocarditis were excellent. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

  9. Intra-operative Cerenkov Imaging for Guiding Breast Cancer Surgery and Assessing Tumor Margins

    Science.gov (United States)

    2014-03-01

    application, 13/492,606 • One travel award to attend WMIC in Dublin (2012) • One class taught as lead instructor ( Mechatronics system ) • Three classes...paraffin- embedded tissue: five years on. Cytometry. 1989;10:229–241. 15. Meng LJ, Fu G, Roy EJ, Suppe B, Chen CT. An ultrahigh resolution SPECT system for...residual cancer. This grant aims to develop a system to assess tumor margins during surgery, with the eventual goal of reducing re-excision surgery

  10. Intra-operative defibrillation testing and clinical shock efficacy in patients with implantable cardioverter-defibrillators

    DEFF Research Database (Denmark)

    Bänsch, Dietmar; Bonnemeier, Hendrik; Brandt, Johan

    2015-01-01

    AIMS: This trial was designed to test the hypothesis that shock efficacy during follow-up is not impaired in patients implanted without defibrillation (DF) testing during first implantable cardioverter-defibrillator (ICD) implantation. METHODS AND RESULTS: Between February 2011 and July 2013, 107...

  11. [Anterior odontoid screw fixation using intra-operative cone-beam computed tomography and navigation].

    Science.gov (United States)

    Castro-Castro, Julián

    2014-01-01

    The purpose of this study was to asses the value of intraoperative cone-beam CT (O-arm) and stereotactic navigation for the insertion of anterior odontoid screws. this was a retrospective review of patients receiving surgical treatment for traumatic odontoid fractures during a period of 18 months. Procedures were guided with O-arm assistance in all cases. The screw position was verified with an intraoperative CT scan. Intraoperative and clinical parameters were evaluated. Odontoid fracture fusion was assessed on postoperative CT scans obtained at 3 and 6 months' follow-up Five patients were included in this series; 4 patients (80%) were male. Mean age was 63.6 years (range 35-83 years). All fractures were acute type ii odontoid fractures. The mean operative time was 116minutes (range 60-160minutes). Successful screw placement, judged by intraoperative computed tomography, was attained in all 5 patients (100%). The average preoperative and postoperative times were 8.6 (range 2-22 days) and 4.2 days (range 3-7 days) respectively. No neurological deterioration occurred after surgery. The rate of bone fusion was 80% (4/5). Although this initial study evaluated a small number of patients, anterior odontoid screw fixation utilizing the O-arm appears to be safe and accurate. This system allows immediate CT imaging in the operating room to verify screw position. Copyright © 2014 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  12. Intra-operative haemodynamic volatility in a patient undergoing retroperitoneal cyst excision

    Directory of Open Access Journals (Sweden)

    Thrivikrama Padur Tantry

    2012-01-01

    Full Text Available Excision of a suspected retroperitoneal, duodenal duplication cyst was performed in a pre-operatively normotensive patient under combined epidural and general anaesthesia. Intraoperatively, the cystic tumour was discovered to be a retroperitoneal mass, free from duodenal or adrenal origin. Development of severe arrhythmias, ST segment changes and hypertensive spikes during cyst handling and dissection suggested the possibility of a catecholamine-secreting tumour. These were managed effectively with pharmacological agents. Subsequently, histopathology of the specimen revealed a paraganglioma. Vasoactive tumour has to be suspected in every patient undergoing anaesthesia for retroperitoneal cystic lesion.

  13. Intra-operative placement of catheters for interstitial microwave-induced hyperthermia and iridium brachytherapy

    International Nuclear Information System (INIS)

    Coughlin, C.T.; Wong, T.Z.; Strohbehn, J.W.; Colacchio, T.A.; Belch, R.Z.; Sutton, J.E. Jr.; Douple, E.B.

    1984-01-01

    The authors have previously described a system for delivery of microwave-induced hyperthermia utilizing flexible coaxial cables that are modified to serve as microwave antennas. These small (--1.6mm o.d.) antennas ae introduced into 2mm o.d. nylon catheters implanted in the tumor. This system has been further modified for use in the treatment of surgically unresectible abdominal, pelvic, and head and neck tumors. The modifications are described that were used to treat two pelvic, one upper abdominal, and one base of tongue tumor. The nylon catheters are implanted during surgery. After a short recovery period, the microwave antennas are inserted and the tumor region is heated for --1hr. The antennas are removed, iridium-192 seeds are placed in the catheters, 2800 - 5000 rad (CGy) doses are delivered, followed by a 1hr hyperthermia treatment. The temperature distributions and future applications are discussed

  14. Intra-operative Assessment of the Spinal Cord Function: Awakening Compared to Ankle Clonus Test

    International Nuclear Information System (INIS)

    Amin, Wafik A.; Tealab, Ayman I.; Ei-Gendy, Eslah H.; Esmat, Hesham A.

    2006-01-01

    The spinal cord is at high risk of injury during special procedures such as correction of scoliosis. Recovery from impairement is directly proportional to the time of removal of the instrumentations. For this, methods used to detect the neurologic injury should be continuous, fast, sensitive and specific. The present study was performed to evaluate the ankle clonus as a test for the integrity of the spinal cord function intraoperatively. Twenty eight scoliotic patients were included in the study. The ankle clonus was tested before, during and after the correction and fixation followed by the wake-up test to correlate the results of both rests. The haemodynamics changes at the time of the two tests were compared. It was found out that, the ankle clonus test correlated well with the wake-up test, with only two false positive results. No false negative results were recorded which was an important finding. The haemodynamic changes were better during the ankle clonus test than during the wake-up test. It was concluded that the ankle clonus test is reliable, safe, and faster than the wake-up test. It is recommended to use the test to evaluate the integrity of the spinal cord during the operations with potential risk to the cord. In case the result of the ankle clonus is positive, the wake-up test should be done before an attempt to release or remove the instrumentations. (author)

  15. The relationship between intra-operative entropy of the EEG and ...

    African Journals Online (AJOL)

    Adele

    Datex Ohmeda Division, Instrumentarium Corporation, Helsinki,. Finland). General anesthesia was induced with Propofol 2mg/kg and. Alfentanyl 10µg/kg. Neuromuscular blockade was instituted with. Rocuronium 0.6mg/kg. Anesthesia was maintained with Isoflurane. 1.5%. At the end of the procedure the neuromuscular ...

  16. SU-F-T-80: A Mobile Application for Intra-Operative Electron Radiotherapy Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Williams, C [Brigham and Women’s Hospital & Dana Farber Cancer Institute, Boston, MA (United States); Harvard Medical School, Boston, MA (United States); Crowley, E; Wolfgang, J [Harvard Medical School, Boston, MA (United States); Massachusetts General Hospital, Boston, MA (United States)

    2016-06-15

    Purpose: Intraoperative electron radiotherapy (IORT) poses a unique set of challenges for treatment planning. Planning must be performed in a busy operating room environment over a short timeframe often with little advance knowledge of the treatment depth or applicator size. Furthermore, IORT accelerators can have a large number of possible applicators, requiring extensive databooks that must be searched for the appropriate dosimetric parameters. The goal of this work is to develop a software tool to assist in the planning process that is suited to the challenges faced in the IORT environment. Methods: We developed a mobile application using HTML5 and Javascript that can be deployed to tablet devices suitable for use in the operating room. The user selects the desired treatment parameters cone diameter, bevel angle, and energy (a total of 141 datasets) and desired bolus. The application generates an interactive display that allows the user to dynamically select points on the depth-dose curve and to visualize the shape of the corresponding isodose contours. The user can indicate a prescription isodose line or depth. The software performs a monitor unit calculation and generates a PDF report. Results: We present our application, which is now used routinely in our IORT practice. It has been employed successfully in over 23 cases. The interactivity of the isodose distributions was found to be of particular use to physicians who are less-frequent IORT users, as well as for the education of residents and trainees. Conclusion: This software has served as a useful tool in IORT planning, and demonstrates the need for treatment planning tools that are designed for the specialized challenges encountered in IORT. This software is the subject of a license agreement with the IntraOp Medical Corporation. This software is the subject of a license agreement between Massachusetts General Hospital / Partners Healthcare and the IntraOp Medical Corporation. CLW is consulting on software development with the IntraOp Medical Corporation.

  17. Intra-operative reliability of ShapeMatch cutting guide placement in total knee arthroplasty.

    Science.gov (United States)

    Clark, Gavin; Leong, Anthony; McEwen, Peter; Steele, Robert; Tran, Ton; Trivett, Adrian

    2013-01-01

    Custom cutting guides based on pre-operative imaging have been introduced for total knee arthroplasty (TKA). The aim of this prospective cohort study was to assess the reliability of repeated placement of custom cutting guides by multiple surgeons in a group of patients undergoing TKA. Custom cutting guides (ShapeMatch®, Stryker Orthopaedics) were designed from pre-operative MRI scans. The treating surgeon placed each guide on the femur and tibia of each patient three times without pinning the block. The three-dimensional position and orientation of the guide was measured for each repetition using a computer navigation system. The surgeon was blinded to the navigation system display. Data from 24 patients and 6 surgeons were analyzed. Intraclass correlation coefficients for all measurement parameters were in the range 0.889-0.997 (excellent), and all comparisons were statistically significant (p reliable.

  18. The symmetric extendibility of quantum states

    International Nuclear Information System (INIS)

    Nowakowski, Marcin L

    2016-01-01

    Studies on the symmetric extendibility of quantum states have become particularly important in the context of the analysis of one-way quantum measures of entanglement, and the distillability and security of quantum protocols. In this paper we analyze composite systems containing a symmetric extendible part, with particular attention devoted to the one-way security of such systems. Further, we introduce a new one-way entanglement monotone based on the best symmetric approximation of a quantum state and the extendible number of a quantum state. We underpin these results with geometric observations about the structures of multi-party settings which posses substantial symmetric extendible components in their subspaces. The impossibility of reducing the maximal symmetric extendibility by means of the one-way local operations and classical communication method is pointed out on multiple copies. Finally, we state a conjecture linking symmetric extendibility with the one-way distillability and security of all quantum states, analyzing the behavior of a private key in the neighborhood of symmetric extendible states. (paper)

  19. Extended Cognitive System and Epistemic Subject

    Directory of Open Access Journals (Sweden)

    Trybulec Barbara

    2015-03-01

    Full Text Available The concept of an extended cognitive system is central to contemporary studies of cognition. In the paper I analyze the place of the epistemic subject within the extended cognitive system. Is it extended as well? In answering this question I focus on the differences between the first and the second wave of arguments for the extended mind thesis. I argue that the position of Cognitive Integration represented by Richard Menary is much more intuitive and fruitful in analyses of cognition and knowledge than the early argument formulated by Andy Clark and David Chalmers. Cognitive Integration is compatible with virtue epistemology of John Greco’s agent reliabilism. The epistemic subject is constituted by its cognitive character composed of an integrated set of cognitive abilities and processes. Some of these processes are extended, they are a manipulation of external informational structures and, as such, they constitute epistemic practices. Epistemic practices are normative; to conduct them correctly the epistemic subject needs to obey epistemic norms embedded in the cultural context. The epistemic subject is not extended because of the casual coupling with external informational artifacts which extend his mind from inside the head and into the world. Rather, cognitive practices constitute the subject’s mind, they transform his cognitive abilities, and this is what makes the mind and epistemic subject “extended”.

  20. Socially Extended Cognition and Shared Intentionality

    Directory of Open Access Journals (Sweden)

    Holger Lyre

    2018-05-01

    Full Text Available The paper looks at the intersection of extended cognition and social cognition. The central claim is that the mechanisms of shared intentionality can equally be considered as coupling mechanisms of cognitive extension into the social domain. This claim will be demonstrated by investigating a detailed example of cooperative action, and it will be argued that such cases imply that socially extended cognition is not only about cognitive vehicles, but that content must additionally be taken into account. It is finally outlined how social content externalism can in principle be grounded in socially extended cognition.

  1. PREVALENCE OF EXTENDED SPECTRUM β-LACTAMASES ...

    African Journals Online (AJOL)

    DR. AMINU

    ABSTRACT. Confirmed variants of enterobacteriaceae isolated from 143 patients that attended Murtala. Mohammed Specialist Hospital Kano, were screened for extended spectrum β-lactamases (ESBLs) production using Clinical Laboratory Standards Institute (CLSI) breakpoint. Suspected ESBLs producers were ...

  2. Extended Adjuvant Therapy for Breast Cancer

    Science.gov (United States)

    An NCI Cancer Currents blog on findings from a recent clinical trial which showed that extending adjuvant therapy with an aromatase inhibitor can have important benefits for some women with early-stage cancer.

  3. Conformal invariance of extended spinning particle mechanics

    International Nuclear Information System (INIS)

    Siegel, W.

    1988-01-01

    Recently a mechanics action has been considered with extended, local, one-dimensional supersymmetry. The authors show this action is conformally invariant in arbitrary spacetime dimensions, and derive the corresponding quantum mechanical restriction on the Lorentz representations it describes

  4. Encoded Extended Spectrum Beta-Lactamases Produced

    African Journals Online (AJOL)

    26.1 % Klebsiella spp were positive for extended spectrum beta-lactamases ... issue, and TEM, OXA and SHV type ESBL were the most common genotypes. ... mechanism of action. ..... and Multiplex PCR Screening of AmpC Genes from.

  5. Extended Reconstructed Sea Surface Temperature (ERSST)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The Extended Reconstructed Sea Surface Temperature (ERSST) dataset is a global monthly sea surface temperature analysis derived from the International Comprehensive...

  6. Evolution equations for extended dihadron fragmentation functions

    International Nuclear Information System (INIS)

    Ceccopieri, F.A.; Bacchetta, A.

    2007-03-01

    We consider dihadron fragmentation functions, describing the fragmentation of a parton in two unpolarized hadrons, and in particular extended dihadron fragmentation functions, explicitly dependent on the invariant mass, M h , of the hadron pair. We first rederive the known results on M h -integrated functions using Jet Calculus techniques, and then we present the evolution equations for extended dihadron fragmentation functions. Our results are relevant for the analysis of experimental measurements of two-particle-inclusive processes at different energies. (orig.)

  7. Possibility of extending space-time coordinates

    International Nuclear Information System (INIS)

    Wang Yongcheng.

    1993-11-01

    It has been shown that one coordinate system can describe a whole space-time region except some supersurfaces on which there are coordinate singularities. The conditions of extending a coordinate from real field to complex field are studied. It has been shown that many-valued coordinate transformations may help us to extend space-time regions and many-valued metric functions may make one coordinate region to describe more than one space-time regions. (author). 11 refs

  8. Some Aspects of Extended Kinetic Equation

    Directory of Open Access Journals (Sweden)

    Dilip Kumar

    2015-09-01

    Full Text Available Motivated by the pathway model of Mathai introduced in 2005 [Linear Algebra and Its Applications, 396, 317–328] we extend the standard kinetic equations. Connection of the extended kinetic equation with fractional calculus operator is established. The solution of the general form of the fractional kinetic equation is obtained through Laplace transform. The results for the standard kinetic equation are obtained as the limiting case.

  9. Musical Manipulations and the Emotionally Extended Mind

    Directory of Open Access Journals (Sweden)

    Joel Krueger

    2015-05-01

    Full Text Available I respond to Kersten's criticism in his article "Music and Cognitive Extension" of my approach to the musically extended emotional mind in Krueger (2014. I specify how we manipulate—and in so doing, integrate with—music when, as active listeners, we become part of a musically extended cognitive system. I also indicate how Kersten's account might be enriched by paying closer attention to the way that music functions as an environmental artifact for emotion regulation.

  10. Extended Access List untuk Mengendalikan Trafik Jaringan

    Directory of Open Access Journals (Sweden)

    Hari Antoni Musril

    2016-12-01

    Full Text Available Keamana jaringan komputer saat ini menjadi hal penting untuk diterapkan. Banyak organisasi yang telah menjadikan teknologi informasi sebagai bahagian penting dalam menunjang aktivitasnya. Akses pengguna yang tidak dibatasi menjadi ancaman bagi sebuah organisasi, karena banyak data dan informasi penting yang tersebar dalam perangkat jaringan komputer di organisasi tersebut dapat disusupi oleh pihak yang tidak berwenang. Salah satu usaha yang dapat dilakukan adalah dengan menerapkan extended access list yang merupakan salah satu bagian dari metode access control list. Extended access list dapat menyaring lalu lintas data suatu jaringan dengan mengontrol apakah paket-paket tersebut dilewatkan atau dihentikan. Extended access list juga dapat menjamin keamanan untuk setiap komputer sehingga jalur komunikasi serta hak akses setiap komputer dapat berjalan dengan baik. Extended access list memungkinkan penyaringan berdasarkan sumber atau alamat tujuan, protokol yang dipilih, port yang digunakan, dan apakah koneksi sudah ditetapkan. Tulisan ini membahas penerapan extended access list dalam jaringan supaya dapat melakukan filter terhadap paket data yang melewati jaringan. Penerapannya menggunakan software Packet Tracer 6.1.1 untuk membuat prototipe jaringan dan mensimulasikannya. Sehingga nanti dapat diterapkan pada jaringan yang sebenarnya. List yang dibangun pada penelitian ini diterapkan untuk protokol antara lain : TCP (WWW, FTP, Telnet, SMTP, POP3, UDP (DNS, dan ICMP (Ping. Hasilnya didapatkan extended access list yang dikonfigurasi pada router dalam topologi penelitian ini mampu melakukan filter terhadap paket yang melewati jaringan. Hasil konfigurasinya sangat spesifik, sehingga penerapan hak akses permit dan deny dapat dilakukan sesuai dengan aturan dan skenario yang dirancang.

  11. Extending Double Optical Gating to the Midinfrared

    Science.gov (United States)

    Gorman, Timothy; Camper, Antoine; Agostini, Pierre; Dimauro, Louis

    2015-05-01

    In the past decade there has been great interest in creating broadband isolated attosecond pulses (IAPs). Primarily these IAPs have been generated using Ti:Sapphire 800nm short pulses, namely through spatiotemporal gating with the attosecond lighthouse technique, amplitude gating, polarization gating, and double optical gating (DOG). Here we present theoretical calculations and experimental investigations into extending DOG to using a 2 μm driving wavelength, the benefits of which include extended harmonic cutoff and longer input driving pulse durations. It is proposed that broadband IAPs with cutoffs extending up to 250 eV can be generated in Argon by using >30 fs pulses from the passively-CEP stabilized 2 μm idler out of an optical parametric amplifier combined with a collinear DOG experimental setup.

  12. Structural Analysis of Extended Plasma Focus Chamber

    International Nuclear Information System (INIS)

    Mohd Azhar Ahmad; Abdul Halim Baijan; Siti Aiasah Hashim

    2016-01-01

    Accelerator Development Centre (ADC) of Nuclear Malaysia intends to upgrade the plasma focus device. It involves the extension part placed on top of the existing plasma focus vacuum chamber. This extended vacuum chamber purposely to give an extra space in conducting experiments on the existing plasma focus chamber. The aim of upgrading the plasma focus device is to solve the limitation in research and analysis of sample due to its done in an open system that cause analysis of samples is limited and less optimal. This extended chamber was design in considering the ease of fabrication as well as durability of its structural. Thus, this paper discusses the structural analysis in term of pressure loading effect in extended chamber. (author)

  13. The validity of the extended energy principle

    International Nuclear Information System (INIS)

    Chance, M.S.; Johnson, J.L.; Kulsrud, R.M.

    1994-04-01

    A recent analysis of plasma stability based on modifications of the extended energy principle for magnetohydrodynamic stability led to conclusions that are too optimistic. The original interpretation of this principle is indeed applicable. The present analysis demonstrates explicitly the fallacy of using the wrong functional for δW in the extended energy principle. It then shows that the original energy principle functional δW B is also obtained for a model in which a surface mass is incorporated to provide pressure balance. This work therefore indicates, but does not prove, that the eigenfunctions that are obtained from a minimization of the extended energy principle with the proper kinetic energy norm provide a good representation of what would be achieved with an exact treatment

  14. An extended range neutron rem counter

    International Nuclear Information System (INIS)

    Birattari, C.; Nuccetelli, C.; Pelliccioni, M.; Silari, M.

    1990-01-01

    Extensive Monte Carlo calculations have been carried out to assess the possibility of extending the sensitivity of a neutron rem counter of the Andersson-Braun type up to several hundred MeV. The validity of the model adopted has first been checked by comparing with experimental data the calculated response curve and the angular dependence of the sensitivity for a well known commercial rem counter. Next, a number of modifications to the configuration of the moderator-attenuator have been investigated. The response functions and angular distributions produced by two simple solutions yielding an instrument with a sensitivity extended up to 400 MeV are presented. The response of the original rem counter and of its two modified versions to nine test spectra has also been calculated. The resulting instrument is transportable rather than portable, but the availability of an extended range neutron survey meter would be of great advantage at medium and high energy particle accelerator facilities. (orig.)

  15. The Extended Family and Children's Educational Success

    DEFF Research Database (Denmark)

    Jæger, Mads Meier

    2012-01-01

    Research on family background and educational success focuses almost exclusively on two generations and on parents and children. This paper argues that the extended family makes up a significant part of the total effect of family background on educational success. Empirical results based...... on the Wisconsin Longitudinal Study show that, net of family factors shared by siblings from the same immediate family, factors shared by first cousins from the same extended family account for a nontrivial part of the total variance in children’s educational success. Results also show that while socioeconomic...... characteristics of grandparents and aunts and uncles have few direct effects on educational success, resources in the extended family compensate lacking resources in low-SES families, which in turn promote children’s educational success. The main conclusion is that the total effect of family background...

  16. Extended inflation from higher dimensional theories

    International Nuclear Information System (INIS)

    Holman, R.; Kolb, E.W.; Vadas, S.L.; Wang, Yun.

    1990-04-01

    The possibility is considered that higher dimensional theories may, upon reduction to four dimensions, allow extended inflation to occur. Two separate models are analayzed. One is a very simple toy model consisting of higher dimensional gravity coupled to a scalar field whose potential allows for a first-order phase transition. The other is a more sophisticated model incorporating the effects of non-trivial field configurations (monopole, Casimir, and fermion bilinear condensate effects) that yield a non-trivial potential for the radius of the internal space. It was found that extended inflation does not occur in these models. It was also found that the bubble nucleation rate in these theories is time dependent unlike the case in the original version of extended inflation

  17. Extended inflation from higher-dimensional theories

    International Nuclear Information System (INIS)

    Holman, R.; Kolb, E.W.; Vadas, S.L.; Wang, Y.

    1991-01-01

    We consider the possibility that higher-dimensional theories may, upon reduction to four dimensions, allow extended inflation to occur. We analyze two separate models. One is a very simple toy model consisting of higher-dimensional gravity coupled to a scalar field whose potential allows for a first-order phase transition. The other is a more sophisticated model incorporating the effects of nontrivial field configurations (monopole, Casimir, and fermion bilinear condensate effects) that yield a nontrivial potential for the radius of the internal space. We find that extended inflation does not occur in these models. We also find that the bubble nucleation rate in these theories is time dependent unlike the case in the original version of extended inflation

  18. Loop amplitudes in an extended gravity theory

    Science.gov (United States)

    Dunbar, David C.; Godwin, John H.; Jehu, Guy R.; Perkins, Warren B.

    2018-05-01

    We extend the S-matrix of gravity by the addition of the minimal three-point amplitude or equivalently adding R3 terms to the Lagrangian. We demonstrate how Unitarity can be used to simply examine the renormalisability of this theory and determine the R4 counter-terms that arise at one-loop. We find that the combination of R4 terms that arise in the extended theory is complementary to the R4 counter-term associated with supersymmetric Lagrangians.

  19. Sum rules in extended RPA theories

    International Nuclear Information System (INIS)

    Adachi, S.; Lipparini, E.

    1988-01-01

    Different moments m k of the excitation strength function are studied in the framework of the second RPA and of the extended RPA in which 2p2h correlations are explicitly introduced into the ground state by using first-order perturbation theory. Formal properties of the equations of motion concerning sum rules are derived and compared with those exhibited by the usual 1p1h RPA. The problem of the separation of the spurious solutions in extended RPA calculations is also discussed. (orig.)

  20. Extended Cognition: Feedback Loops and Coupled Systems

    Directory of Open Access Journals (Sweden)

    Olga Markic

    2017-12-01

    Full Text Available The article explores two waves of active externalism. I first introduce the distinction between passive and active externalism and analyse a proposal of active externalism based on the principle of parity proposed by Clark and Chalmers. There are two main obstacles, causal-constitution fallacy and cognitive bloat, that threaten the extended cognition hypothesis. The second wave of discussions based on the complementarity principle deals with cognitive systems with feedback loops between internal and external elements and is a more radical departure from functionalism and traditional thinking about cognition. I conclude with some remarks on potential ethical considerations of extended cognition.

  1. An extended topological Yang-Mills theory

    International Nuclear Information System (INIS)

    Deguchi, Shinichi

    1992-01-01

    Introducing infinite number of fields, we construct an extended version of the topological Yang-Mills theory. The properties of the extended topological Yang-Mills theory (ETYMT) are discussed from standpoint of the covariant canonical quantization. It is shown that the ETYMT becomes a cohomological topological field theory or a theory equivalent to a quantum Yang-Mills theory with anti-self-dual constraint according to subsidiary conditions imposed on state-vector space. On the basis of the ETYMT, we may understand a transition from an unbroken phase to a physical phase (broken phase). (author)

  2. Extended Interneuronal Network of the Dentate Gyrus

    Directory of Open Access Journals (Sweden)

    Gergely G. Szabo

    2017-08-01

    Full Text Available Local interneurons control principal cells within individual brain areas, but anecdotal observations indicate that interneuronal axons sometimes extend beyond strict anatomical boundaries. Here, we use the case of the dentate gyrus (DG to show that boundary-crossing interneurons with cell bodies in CA3 and CA1 constitute a numerically significant and diverse population that relays patterns of activity generated within the CA regions back to granule cells. These results reveal the existence of a sophisticated retrograde GABAergic circuit that fundamentally extends the canonical interneuronal network.

  3. Modeling of extended defects in silicon

    International Nuclear Information System (INIS)

    Law, M.E.; Jones, K.S.; Earles, S.K.; Lilak, A.D.; Xu, J.W.

    1997-01-01

    Transient Enhanced Diffusion (TED) is one of the biggest modeling challenges present in predicting scaled technologies. Damage from implantation of dopant ions changes the diffusivities of the dopants and precipitates to form complex extended defects. Developing a quantitative model for the extended defect behavior during short time, low temperature anneals is a key to explaining TED. This paper reviews some of the modeling developments over the last several years, and discusses some of the challenges that remain to be addressed. Two examples of models compared to experimental work are presented and discussed

  4. Extending Symfony 2 web application framework

    CERN Document Server

    Armand, Sébastien

    2014-01-01

    Symfony is a high performance PHP framework for developing MVC web applications. Symfony1 allowed for ease of use but its shortcoming was the difficulty of extending it. However, this difficulty has now been eradicated by the more powerful and extensible Symfony2. Information on more advanced techniques for extending Symfony can be difficult to find, so you need one resource that contains the advanced features in a way you can understand. This tutorial offers solutions to all your Symfony extension problems. You will get to grips with all the extension points that Symfony, Twig, and Doctrine o

  5. The inflation sector of extended inflation

    International Nuclear Information System (INIS)

    Kolb, E.W.

    1990-11-01

    In extended inflation the inflationary era is brought to a close by the process of percolation of true vacuum bubbles produced in a first-order phase transition. In this paper I discuss several effects that might obtain if the Universe undergoes an inflationary first-order phase transition. 17 refs

  6. Antibiotic Susceptibility Pattern of Extended Spectrum ...

    African Journals Online (AJOL)

    Purpose: To evaluate the antibiotic susceptibility pattern of various bacterial pathogens including extended spectrum betalactamase (ESBL) producers in Kano, Nigeria. Method: A total of 604 consecutive clinical samples obtained from Aminu Kano Teaching Hospital (AKTH), Kano between January and July 2010 were ...

  7. THROUGHPUT ANALYSIS OF EXTENDED ARQ SCHEMES

    African Journals Online (AJOL)

    PUBLICATIONS1

    ABSTRACT. Various Automatic Repeat Request (ARQ) schemes have been used to combat errors that befall in- formation transmitted in digital communication systems. Such schemes include simple ARQ, mixed mode ARQ and Hybrid ARQ (HARQ). In this study we introduce extended ARQ schemes and derive.

  8. Reasoning about cardinal directions between extended objects

    OpenAIRE

    Liu, Weiming; Zhang, Xiaotong; Li, Sanjiang; Ying, Mingsheng

    2010-01-01

    Direction relations between extended spatial objects are important commonsense knowledge. Recently, Goyal and Egenhofer proposed a formal model, known as Cardinal Direction Calculus (CDC), for representing direction relations between connected plane regions. CDC is perhaps the most expressive qualitative calculus for directional information, and has attracted increasing interest from areas such as artificial intelligence, geographical information science, and image retrieval. Given a network ...

  9. 17. IAEA fusion energy conference. Extended synopses

    International Nuclear Information System (INIS)

    1998-01-01

    Book of extended synopses of the papers, accepted by a international programme committee for presentation at the 17th IAEA Fusion Energy Conference in Yokohama, Japan. The subjects covered are magnetic confinement experiments, plasma heating and current drive, ITER EDA, inertial fusion energy, innovative concepts, fusion technology and theory

  10. Dewey on extended cognition and epistemology

    NARCIS (Netherlands)

    Vaesen, K.

    2014-01-01

    There is a surge of attempts to draw out the epistemological consequences of views according to which cognition is deeply embedded, embodied and/or extended (e-cog). The principal machinery used for doing so is that of analytic epistemology. Here I argue that Dewey's pragmatic epistemology may be

  11. Hamiltonian structure of linearly extended Virasoro algebra

    International Nuclear Information System (INIS)

    Arakelyan, T.A.; Savvidi, G.K.

    1991-01-01

    The Hamiltonian structure of linearly extended Virasoro algebra which admits free bosonic field representation is described. An example of a non-trivial extension is found. The hierarchy of integrable non-linear equations corresponding to this Hamiltonian structure is constructed. This hierarchy admits the Lax representation by matrix Lax operator of second order

  12. Extended School Year. Information Capsule. Volume 0910

    Science.gov (United States)

    Blazer, Christie

    2010-01-01

    Extended school years are being considered by districts around the country as educators search for new ways to raise student achievement. The addition of time to the school calendar is also supported by President Barack Obama, who recently stated that American students do not spend enough time in school. This Information Capsule addresses research…

  13. Extended data acquisition support at GSI

    International Nuclear Information System (INIS)

    Marinescu, D.C.; Busch, F.; Hultzsch, H.; Lowsky, J.; Richter, M.

    1984-01-01

    The Experiment Data Acquisition and Analysis System (EDAS) of GSI, designed to support the data processing associated with nuclear physics experiments, provides three modes of operation: real-time, interactive replay and batch replay. The real-time mode is used for data acquisition and data analysis during an experiment performed at the heavy ion accelerator at GSI. An experiment may be performed either in Stand Alone Mode, using only the Experiment Computers, or in Extended Mode using all computing resources available. The Extended Mode combines the advantages of the real-time response of a dedicated minicomputer with the availability of computing resources in a large computing environment. This paper first gives an overview of EDAS and presents the GSI High Speed Data Acquisition Network. Data Acquisition Modes and the Extended Mode are then introduced. The structure of the system components, their implementation and the functions pertinent to the Extended Mode are presented. The control functions of the Experiment Computer sub-system are discussed in detail. Two aspects of the design of the sub-system running on the mainframe are stressed, namely the use of a multi-user installation for real-time processing and the use of a high level programming language, PL/I, as an implementation language for a system which uses parallel processing. The experience accumulated is summarized in a number of conclusions

  14. [Combined hormonal contraception in cycles artificially extended].

    Science.gov (United States)

    Bustillos-Alamilla, Edgardo; Zepeda-Zaragoza, J; Hernández-Ruiz, M A; Briones-Landa, Carlos Humberto

    2010-01-01

    To compare the bleeding patterns, satisfaction and tolerability of 3 different contraceptive in an extended regimens in the service of Family Planning of the North Central Hospital of PEMEX. Healthy, adult women with desire of contraception for one year (N 120) were randomly assigned to receive oral contraceptive drospirenone/ethinyl E2 (group1), the norelgestromin/ethinyl E2 transdermal patch (group 2) and vaginal ring etonogestrel/ ethinyl E2 (group 3) in an extended regimen (42 consecutive days, 1 hormone-free week). Study assessments were conducted at scheduled visits at the time of initial screening, at baseline after 1, 3, 6, and 12 months. Subjects recorded menstrual associated symptoms bleeding data and completed satisfaction questionnaires. Subjects and investigators provided overall assessments of the regimens. Extended use of 3 different contraceptive resulted in fewer bleeding days in every group (66.6%, 55% and 58.3% P 0.0024), and less mastalgia and menstrual pain. Subjects were highly satisfied with three regimens (93.3%, 96.6% and 91.6% P 0.00421). Although not mayor adverse events were reported with this regimen, there was an increase in spotting days; it decreased with each successive cycle of therapy. Efficacy and safety were similar to those reported for traditional cycle. Extended-contraceptive regimen delays menses and reduces bleeding, a profile that may be preferred by women who seek flexibility with their contraceptive method.

  15. Extendable linearised adjustment model for deformation analysis

    NARCIS (Netherlands)

    Hiddo Velsink

    2015-01-01

    Author supplied: "This paper gives a linearised adjustment model for the affine, similarity and congruence transformations in 3D that is easily extendable with other parameters to describe deformations. The model considers all coordinates stochastic. Full positive semi-definite covariance matrices

  16. Extendable linearised adjustment model for deformation analysis

    NARCIS (Netherlands)

    Velsink, H.

    2015-01-01

    This paper gives a linearised adjustment model for the affine, similarity and congruence transformations in 3D that is easily extendable with other parameters to describe deformations. The model considers all coordinates stochastic. Full positive semi-definite covariance matrices and correlation

  17. Q-Method Extended Kalman Filter

    Science.gov (United States)

    Zanetti, Renato; Ainscough, Thomas; Christian, John; Spanos, Pol D.

    2012-01-01

    A new algorithm is proposed that smoothly integrates non-linear estimation of the attitude quaternion using Davenport s q-method and estimation of non-attitude states through an extended Kalman filter. The new method is compared to a similar existing algorithm showing its similarities and differences. The validity of the proposed approach is confirmed through numerical simulations.

  18. Onsager's reciprocity theorem in extended irreversible thermodynamics

    International Nuclear Information System (INIS)

    Garcia-Colin, L.S.; Velasco, R.M.

    1992-01-01

    In this paper we shall discuss the Onsager relations for the transport coefficients in a dilute monatomic gas described by the extended irreversible thermodynamics. Our discussion is based on a 26 variables description of the system and its corresponding comparison with the kinetic reciprocity between coefficients is shown (Author)

  19. 17. IAEA fusion energy conference. Extended synopses

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-12-31

    Book of extended synopses of the papers, accepted by a international programme committee for presentation at the 17th IAEA Fusion Energy Conference in Yokohama, Japan. The subjects covered are magnetic confinement experiments, plasma heating and current drive, ITER EDA, inertial fusion energy, innovative concepts, fusion technology and theory Refs, figs, tabs

  20. Extended plate and beam demonstration home

    Science.gov (United States)

    Patricia Gunderson; Vladimir Kochkin; Xiping Wang

    2018-01-01

    An extended plate and beam (EP&B) design was developed at Home Innovation Research Labs (Upper Marlboro, Maryland) in an effort to provide traditional light-frame wall construction details that are compatible with continuous insulating sheathing. This would encourage wide-spread adoption of high-R walls and promote greater energy efficiency in new houses. The...

  1. Experimental limits on antigravity in extended supergravity

    OpenAIRE

    Bellucci, S.; Faraoni, V.

    1995-01-01

    The available tests of the equivalence principle constrain the mass of the Higgs-like boson appearing in extended supergravity theories. We determine the constraints imposed by the present and future high precision experiments on the antigravity fields arising from $N=2,8$ supergravity.

  2. The Extended Mind Thesis and Mechanistic Explanations

    DEFF Research Database (Denmark)

    Fazekas, Peter

    2013-01-01

    The Extended Mind Thesis (EMT) is traditionally formulated against the bedrock of functionalism, and ongoing debates are typically bogged down with questions concerning the exact relationship between EMT and different versions of functionalism. In this paper, I offer a novel ally for EMT: the new...

  3. Simulation and analysis of shared extended mind

    NARCIS (Netherlands)

    Bosse, T.; Jonker, C.M.; Schut, M.C.; Treur, J.

    Some types of animals exploit patterns created in the environment as external mental states, thus obtaining an extension of their mind. In the case of social animals the creation and exploitation of such patterns can be shared, which supports a form of shared extended mind or collective

  4. Extending the Body for Interaction with Reality

    DEFF Research Database (Denmark)

    Feuchtner, Tiare; Müller, Jörg

    2017-01-01

    In this paper, we explore how users can control remote devices with a virtual long arm, while preserving the perception that the artificial arm is actually part of their own body. Instead of using pointing, speech, or a remote control, the users’ arm is extended in augmented reality, allowing...

  5. Extended working hours: Impacts on workers

    Science.gov (United States)

    D. Mitchell; T. Gallagher

    2010-01-01

    Some logging business owners are trying to manage their equipment assets by increasing the scheduled machine hours. The intent is to maximize the total tons produced by a set of equipment. This practice is referred to as multi-shifting, double-shifting, or extended working hours. One area often overlooked is the impact that working non-traditional hours can have on...

  6. Consistent spectroscopy for a extended gauge model

    International Nuclear Information System (INIS)

    Oliveira Neto, G. de.

    1990-11-01

    The consistent spectroscopy was obtained with a Lagrangian constructed with vector fields with a U(1) group extended symmetry. As consistent spectroscopy is understood the determination of quantum physical properties described by the model in an manner independent from the possible parametrizations adopted in their description. (L.C.J.A.)

  7. Features of the extended-release metformin

    Directory of Open Access Journals (Sweden)

    T O Yalochkina

    2013-03-01

    Full Text Available Реферат по материалам статьи Ali S, Fonseca V. Overview of metformin: special focus on metformin extended release. Expert Opin Pharmacother. 2012 Aug;13(12:1797-805.

  8. Timepiece: Extending and Enhancing Learning Time.

    Science.gov (United States)

    Anderson, Lorin W., Ed.; Walberg, Herbert J., Ed.

    This publication offers suggestions for making more productive use of time, a scarce and valued educational resource. The chapter authors, authorities on the use of educational time, write about how to extend and enhance learning time within and outside schools. In "Productive Use of Time," Herbert Walberg describes how learning time can be…

  9. Extending and embedding the Python interpreter

    NARCIS (Netherlands)

    G. van Rossum (Guido)

    1995-01-01

    textabstractPython is an interpreted, object-oriented programming language. This document describes how to write modules in C or C++ to extend the Python interpreter with new modules. Those modules can define new functions but also new object types and their methods. The document also describes

  10. On energy conservation in extended magnetohydrodynamics

    International Nuclear Information System (INIS)

    Kimura, Keiji; Morrison, P. J.

    2014-01-01

    A systematic study of energy conservation for extended magnetohydrodynamic models that include Hall terms and electron inertia is performed. It is observed that commonly used models do not conserve energy in the ideal limit, i.e., when viscosity and resistivity are neglected. In particular, a term in the momentum equation that is often neglected is seen to be needed for conservation of energy

  11. Extended KN algebras and extended conformal field theories over higher genus Riemann surfaces

    International Nuclear Information System (INIS)

    Ceresole, A.; Huang Chaoshang

    1990-01-01

    A global operator formalism for extended conformal field theories over higher genus Riemann surfaces is introduced and extended KN algebra are obtained by means of the KN bases. The BBSS construction of the spin-3 operator is carried out for Kac-Moody algebra A 2 over a Riemann surface of arbitrary genus. (orig.)

  12. Extended Target Recognition in Cognitive Radar Networks

    Directory of Open Access Journals (Sweden)

    Xiqin Wang

    2010-11-01

    Full Text Available We address the problem of adaptive waveform design for extended target recognition in cognitive radar networks. A closed-loop active target recognition radar system is extended to the case of a centralized cognitive radar network, in which a generalized likelihood ratio (GLR based sequential hypothesis testing (SHT framework is employed. Using Doppler velocities measured by multiple radars, the target aspect angle for each radar is calculated. The joint probability of each target hypothesis is then updated using observations from different radar line of sights (LOS. Based on these probabilities, a minimum correlation algorithm is proposed to adaptively design the transmit waveform for each radar in an amplitude fluctuation situation. Simulation results demonstrate performance improvements due to the cognitive radar network and adaptive waveform design. Our minimum correlation algorithm outperforms the eigen-waveform solution and other non-cognitive waveform design approaches.

  13. Extending applicability of bimetric theory: chameleon bigravity

    Science.gov (United States)

    De Felice, Antonio; Mukohyama, Shinji; Uzan, Jean-Philippe

    2018-02-01

    This article extends bimetric formulations of massive gravity to make the mass of the graviton to depend on its environment. This minimal extension offers a novel way to reconcile massive gravity with local tests of general relativity without invoking the Vainshtein mechanism. On cosmological scales, it is argued that the model is stable and that it circumvents the Higuchi bound, hence relaxing the constraints on the parameter space. Moreover, with this extension the strong coupling scale is also environmentally dependent in such a way that it is kept sufficiently higher than the expansion rate all the way up to the very early universe, while the present graviton mass is low enough to be phenomenologically interesting. In this sense the extended bigravity theory serves as a partial UV completion of the standard bigravity theory. This extension is very generic and robust and a simple specific example is described.

  14. Extended phase graphs with anisotropic diffusion

    Science.gov (United States)

    Weigel, M.; Schwenk, S.; Kiselev, V. G.; Scheffler, K.; Hennig, J.

    2010-08-01

    The extended phase graph (EPG) calculus gives an elegant pictorial description of magnetization response in multi-pulse MR sequences. The use of the EPG calculus enables a high computational efficiency for the quantitation of echo intensities even for complex sequences with multiple refocusing pulses with arbitrary flip angles. In this work, the EPG concept dealing with RF pulses with arbitrary flip angles and phases is extended to account for anisotropic diffusion in the presence of arbitrary varying gradients. The diffusion effect can be expressed by specific diffusion weightings of individual magnetization pathways. This can be represented as an action of a linear operator on the magnetization state. The algorithm allows easy integration of diffusion anisotropy effects. The formalism is validated on known examples from literature and used to calculate the effective diffusion weighting in multi-echo sequences with arbitrary refocusing flip angles.

  15. APPROACHES FOR SOLVING BIMATRIX INFORMATIONAL EXTENDED GAMES

    Directory of Open Access Journals (Sweden)

    Boris HÂNCU

    2015-12-01

    Full Text Available Different ways of solving bimatrix games in complete and perfect information (or over the set of informational extended strategies are studied in the present paper. The Nash and Bayes-Nash solutions for informational extended games are discussed.MODALITĂŢI DE SOLUŢIONARE A JOCURILOR BIMATRICEALE INFORMAŢIONAL EXTINSEÎn acest articol sunt analizate diferite moduri de soluţionare a jocurilor bimatriceale în informaţie completă a şi perfectă. Informaţia perfectă permite jucătorilor să utilizeze strategii informaţional extinse. Se analizează asoluţii de tip Nash şi Bayes-Nash pentru jocuri în strategii informaţional extinse.

  16. Does string theory lead to extended inflation?

    Science.gov (United States)

    Campbell, Bruce A.; Linde, Andrei; Olive, Keith A.

    1991-05-01

    We consider the relationship between string theory and currently proposed models of extended inflation. In doing so, we discuss the conformal actions in string theory and in Jordan-Brans-Dicke gravity. We show explicitly the equivalence of pictures in which either gauge or gravitational couplings are changing with time. We demonstrate that the existence of the dilation in string theory does not naturally lead to extended inflation as currently discussed. We also discuss the resolution of the graceful exit problem of old inflation in Einstein gravity using either power-law inflation, or exponential inflation with a changing bubble formation rate. On leave of absence from School of Physics and Astronomy, University of Minnesota, Minneapolis, MN 55455, USA.

  17. Extended RPA study of nuclear collective phenomena

    International Nuclear Information System (INIS)

    Drozdz, S.

    1987-01-01

    A fully microscopic study of nuclear collective phenomena is presented within the framework of an extended RPA which includes 1p-1h and 2p-2h excitations in a consistent way. This theory allows us to obtain a very realistic description of various excitation spectra. As a result, a strong evidence of correlation effects beyond mean-field theory emerges. The effective interaction used is a G-matrix derived from the meson-exchange potential. The extended theory introduces also additional correlations which screen the long-large part of the effective interaction. This effect significantly enhances the stability of the ground state against density fluctuations. In this connection a possible importance of relativistic effects is also discussed. 99 refs., 19 figs., 5 tabs. (author)

  18. Parapharyngeal meningioma extending from the intracranial space

    International Nuclear Information System (INIS)

    Uchibori, M.; Odake, G.; Ueda, S.; Yasuda, N.; Hisa, I.

    1990-01-01

    A 50-year old woman with a giant parapharyngeal meningioma extending from the intracranial cavity was admitted to our hospital. The parapharyngeal tumor was biopsied using the transoral approach, and a histological section diagnosis suggested meningioma. Thereafter, further examination by magnetic resonance images (MRI) and contrast enhanced CT scans revealed a diffuse meningioma en plaque in the posterior fossa. Invasion extended from the clival dura to the right sigmoid sinus. The extracranial extension of a meningioma is very rare but a few cases have been reported. In almost all of the reported cases, a large intracranial meningioma was simultaneously or previously verified by CT scans. Our case was special in that the intracranial mass was not voluminous but showed en plaque extension, and also because the pathway of the extracranial extension through the jugular foramen was clearly visualized by CT and MRI. Obliteration and invasion of the right sigmoid sinus and the internal jugular vein by tumor were also demonstrated. (orig.)

  19. Optimizing Extender Code for NCSX Analyses

    International Nuclear Information System (INIS)

    Richman, M.; Ethier, S.; Pomphrey, N.

    2008-01-01

    Extender is a parallel C++ code for calculating the magnetic field in the vacuum region of a stellarator. The code was optimized for speed and augmented with tools to maintain a specialized NetCDF database. Two parallel algorithms were examined. An even-block work-distribution scheme was comparable in performance to a master-slave scheme. Large speedup factors were achieved by representing the plasma surface with a spline rather than Fourier series. The accuracy of this representation and the resulting calculations relied on the density of the spline mesh. The Fortran 90 module db access was written to make it easy to store Extender output in a manageable database. New or updated data can be added to existing databases. A generalized PBS job script handles the generation of a database from scratch

  20. Note on the extended noncommutativity of coordinates

    International Nuclear Information System (INIS)

    Boulahoual, Amina; Sedra, My. Brahim

    2001-04-01

    We present in this short note an idea about a possible extension of the standard noncommutative algebra to the formal differential operators framework. In this sense, we develop an analysis and derive an extended noncommutative algebra given by [x a , x b ] * =i(θ+χ) ab where θ ab , is the standard noncommutative parameter and χ ab (x)≡χ ab μ (x)δ μ =1/2(x a θ μ b -x b θ a )δ μ is an antisymmetric non-constant vector-field shown to play the role of the extended deformation parameter. This idea was motivated by the importance of noncommutative geometry framework in the current subject of D-brane and matrix theory physics. (author)

  1. Optical absorption in compact and extended dendrimers

    International Nuclear Information System (INIS)

    Supritz, C.; Engelmann, A.; Reineker, P.

    2005-01-01

    Dendrimers are highly branched molecules, which are expected to be useful, for example, as efficient artificial light harvesting systems, in nano-technological or in medical applications. There are two different classes of dendrimers: compact dendrimers with constant distance between neighboring branching points throughout the macromolecule and extended dendrimers, where this distance increases from the system periphery to the center. We investigate the linear optical absorption spectra of these dendrimer types using the Frenkel exciton concept. The electron-phonon interaction is taken into account by introducing a heat bath that interacts with the exciton in a stochastic manner. We discuss compact dendrimers with equal excitation energies at all molecules, dendrimers with a functionalized core as well as with a whole branch functionalized. Furthermore the line shape of a compact dendrimer is discussed when neighboring molecules at the periphery interact and when all molecules have randomly distributed excitation energies due to disorder. Finally, we discuss two models for extended dendrimers

  2. Extended Josephson Relation and Abrikosov lattice deformation

    International Nuclear Information System (INIS)

    Matlock, Peter

    2012-01-01

    From the point of view of time-dependent Ginzburg Landau (TDGL) theory, a Josephson-like relation is derived for an Abrikosov vortex lattice accelerated and deformed by applied fields. Beginning with a review of the Josephson Relation derived from the two ingredients of a lattice-kinematics assumption in TDGL theory and gauge invariance, we extend the construction to accommodate a time-dependent applied magnetic field, a Floating-Kernel formulation of normal current, and finally lattice deformation due to the electric field and inertial effects of vortex-lattice motion. The resulting Josephson-like relation, which we call an Extended Josephson Relation, applies to a much wider set of experimental conditions than the original Josephson Relation, and is explicitly compatible with the considerations of TDGL theory.

  3. Extending The Shelf Life Of Blood Platelets

    Science.gov (United States)

    Surgenor, Douglas M.

    1988-01-01

    New method of storing human blood platelets extends vitality for transfusions. Packaged as suspension in sterile liquid in plastic blood bags. Each bag placed between pair of plastic grids, and rubberbands placed around sandwich thus formed to hold together. Stored upright in open air or in container through which air pumped at rate of at least 45 L/min. Ensures that platelets receive ample oxygen and expiratory carbon dioxide form platelets removed before pH drops to harmful levels.

  4. An extended characterisation theorem for quantum logics

    International Nuclear Information System (INIS)

    Sharma, C.S.; Mukherjee, M.K.

    1977-01-01

    Two theorems are proved. In the first properties of an important mapping from an orthocomplemented lattice to itself are studied. In the second the characterisation theorem of Zierler (Pacific J. Math.; 11:1151 (1961)) is extended to obtain a very useful theorem characterising orthomodular lattices. Since quantum logics are merely sigma-complete orthomodular lattices, the principal result is, for application in quantum physics, a characterisation theorem for quantum logics. (author)

  5. Affordances and the musically extended mind

    OpenAIRE

    Joel eKrueger

    2014-01-01

    I defend a model of the musically extended mind. I consider how acts of “musicking” grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of “musical affordances” and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances – via soliciting different forms of entrainment – enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel exper...

  6. An extended chemical analysis of gallstone

    OpenAIRE

    Chandran, P.; Kuchhal, N. K.; Garg, P.; Pundir, C. S.

    2007-01-01

    Chemical composition of gall stones is essential for aetiopathogensis of gallstone disease. We have reported quantitative chemical analysis of total cholesterol bilirubin, calcium, iron and inorganic phosphate in 120 gallstones from haryana. To extend this chemical analysis of gall stones by studying more cases and by analyzing more chemical constituents. A quantitative chemical analysis of total cholesterol, total bilirubin, fatty acids, triglycerides, phospholipids, bile acids, soluble prot...

  7. Lepton flavor violation in an extended MSSM

    CERN Document Server

    Espinosa-Castañeda, R.; Gómez-Bock, M.; Mondragón, M.

    2016-01-01

    In this work we explore a lepton flavor violation effect induced at one loop for a flavor structure in an extended minimal standard supersymmetric model, considering an ansatz for the trilinear term. In particular we find a finite expression which will show the impact of this phenomena in the $h\\to \\mu \\tau$ decay, produced by a mixing in the trilinear coupling of the soft supersymmetric Lagrangian.

  8. Extending Profiles with Stereotypes for Composite Concepts

    OpenAIRE

    Quartel, Dick; Dijkman, R.M.; van Sinderen, Marten J.; Briand, L.; Williams, C.

    2005-01-01

    This paper proposes an extension of the UML 2.0 profiling mechanism. This extension facilitates a language designer to introduce composite concepts as separate conceptual and notational elements in a modelling language. Composite concepts are compositions of existing concepts. To facilitate the introduction of composite concepts, the notion of stereotype is extended. This extension defines how a composite concept can be specified and added to a language’s metamodel, ithout modifying the exist...

  9. Behaviour of the extended Toda lattice

    Science.gov (United States)

    Wattis, Jonathan A. D.; Gordoa, Pilar R.; Pickering, Andrew

    2015-11-01

    We consider the first member of an extended Toda lattice hierarchy. This system of equations is differential with respect to one independent variable and differential-delay with respect to a second independent variable. We use asymptotic analysis to consider the long wavelength limits of the system. By considering various magnitudes for the parameters involved, we derive reduced equations related to the Korteweg-de Vries and potential Boussinesq equations.

  10. Extending Science lessons with Virtual Reality

    OpenAIRE

    Minocha, Shailey; Tudor, Ana-Despina; Tilling, Steve; Needham, Richard

    2016-01-01

    The Open University, Field Studies Council and Association for Science Education are conducting research into the use of Google Expeditions and other virtual reality tools to a) augment and extend field work experiences; and b) as an additional tool in the classrooms along with resources such as videos, photographs. \\ud \\ud The following aspects were discussed in this workshop:\\ud \\ud Does the virtual reality technology improve student engagement, and what are the implications for teachers?\\u...

  11. Extended Temperature Solar Cell Technology Development

    Science.gov (United States)

    Landis, Geoffrey A.; Jenkins, Phillip; Scheiman, David; Rafaelle, Ryne

    2004-01-01

    Future NASA missions will require solar cells to operate both in regimes closer to the sun, and farther from the sun, where the operating temperatures will be higher and lower than standard operational conditions. NASA Glenn is engaged in testing solar cells under extended temperature ranges, developing theoretical models of cell operation as a function of temperature, and in developing technology for improving the performance of solar cells for both high and low temperature operation.

  12. An extended Henon-Heiles system

    International Nuclear Information System (INIS)

    Hone, A.N.W.; Novikov, V.; Verhoeven, C.

    2008-01-01

    We consider an integrable system of partial differential equations possessing a Lax pair with an energy-dependent Lax operator of second order, of the type described by Antonowicz and Fordy. By taking the travelling wave reduction of this system we show that the integrable case (ii) Henon-Heiles system can be extended by adding an arbitrary number of non-polynomial (rational) terms to the potential

  13. Extended BRS algebra and color confinement criteria

    International Nuclear Information System (INIS)

    Shintani, Meiun.

    1983-09-01

    We examine the color-confinement criteria proposed by Kugo and Ojima. With the use of the extended BRS symmetry and the Nakanishi's theorem, we look for the representations of the BRS algebra compatible with the first condition of their criteria (the K-O condition) and then ask whether or not they are physically acceptable. As a result, the quartet mechanism does not work, and the K-O condition is not regarded as a confinement condition. (author)

  14. Deterministic automata for extended regular expressions

    Directory of Open Access Journals (Sweden)

    Syzdykov Mirzakhmet

    2017-12-01

    Full Text Available In this work we present the algorithms to produce deterministic finite automaton (DFA for extended operators in regular expressions like intersection, subtraction and complement. The method like “overriding” of the source NFA(NFA not defined with subset construction rules is used. The past work described only the algorithm for AND-operator (or intersection of regular languages; in this paper the construction for the MINUS-operator (and complement is shown.

  15. The renewable tradition (extended play remix

    Directory of Open Access Journals (Sweden)

    Mark Amerika

    2009-12-01

    Full Text Available Drawing from a network of appropriation artists, process philosophers, performance poets, pla(ygiarists, and other remix provocateurs, this experimental artist essay investigates the act of remixologically inhabiting the body language of others and, in the process, devises an aesthetic theory that situates the contemporary artist as a "postproduction medium" whose methodologies further extend avant-garde practice into the 21st century.

  16. Extended Deterministic Mean-Field Games

    KAUST Repository

    Gomes, Diogo A.

    2016-04-21

    In this paper, we consider mean-field games where the interaction of each player with the mean field takes into account not only the states of the players but also their collective behavior. To do so, we develop a random variable framework that is particularly convenient for these problems. We prove an existence result for extended mean-field games and establish uniqueness conditions. In the last section, we consider the Master Equation and discuss properties of its solutions.

  17. Extended equivalent dipole model for radiated emissions

    OpenAIRE

    Obiekezie, Chijioke S.

    2016-01-01

    This work is on the characterisation of radiated fields from electronic devices. An equivalent dipole approach is used. Previous work showed that this was an effective approach for single layer printed circuit boards where an infinite ground plane can be assumed. In this work, this approach is extended for the characterisation of more complex circuit boards or electronic systems.\\ud For complex electronic radiators with finite ground planes, the main challenge is characterising field diffract...

  18. Extended Deterministic Mean-Field Games

    KAUST Repository

    Gomes, Diogo A.; Voskanyan, Vardan K.

    2016-01-01

    In this paper, we consider mean-field games where the interaction of each player with the mean field takes into account not only the states of the players but also their collective behavior. To do so, we develop a random variable framework that is particularly convenient for these problems. We prove an existence result for extended mean-field games and establish uniqueness conditions. In the last section, we consider the Master Equation and discuss properties of its solutions.

  19. Range extender module. Enabler for electric mobility; Range-Extender-Modul. Wegbereiter fuer elektrische Mobilitaet

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Robert; Fraidl, Guenter Karl; Hubmann, Christian; Kapus, Paul Ernst; Kunzemann, Ralf; Sifferlinger, Bernhard; Beste, Frank [AVL List GmbH, Graz (Austria)

    2009-10-15

    The Range Extender as an auxiliary power supply for extended driving ranges is of significant importance in achieving a high level of customer acceptance for electric vehicles. The AVL concept is optimized for electric power generation in single-point operation and allows a compactly integrated, cost-efficient and weight-efficient module design. The internal combustion engine requirements of the Pure Range Extender from AVL permit not only the use of simplified four-stroke concepts but also the application of emission-optimized and fuel consumption-optimized two-stroke and rotary piston engines. (orig.)

  20. [Ischemic cholangiopathy induced by extended burns].

    Science.gov (United States)

    Cohen, Laurence; Angot, Emilie; Goria, Odile; Koning, Edith; François, Arnaud; Sabourin, Jean-Christophe

    2013-04-01

    Ischemic cholangiopathy is a recently described entity occurring mainly after hepatic grafts. Very few cases after intensive care unit (ICU) for extended burn injury were reported. We report the case of a 73-year-old woman consulting in an hepatology unit, for a jaundice appearing during a hospitalisation in an intensive care unit and increasing from her leaving from ICU, where she was treated for an extended burn injury. She had no pre-existing biological features of biliary disease. Biological tests were normal. Magnetic resonance imaging acquisitions of biliary tracts pointed out severe stenosing lesions of diffuse cholangiopathy concerning intrahepatic biliary tract, mainly peri-hilar. Biopsie from the liver confirmed the diagnosis, showing a biliary cirrhosis with bile infarcts. This case is the fourth case of ischemic cholangiopathy after extended burn injury, concerning a patient without a prior history of hepatic or biliary illness and appearing after hospitalisation in intensive care unit. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  1. Origin of density fluctuations in extended inflation

    International Nuclear Information System (INIS)

    Kolb, E.W.; Salopek, D.S.; Turner, M.S.

    1990-01-01

    We calculate both the curvature and isocurvature density fluctuations that arise due to quantum fluctuations in a simple model of extended inflation based upon the Jordan-Brans-Dicke theory. The curvature fluctuations that arise due to quantum fluctuations in the Brans-Dicke field in general have a non-scale-invariant spectrum and an amplitude that is cosmologically acceptable and interesting without having to tune any coupling constant to a very small value. The curvature perturbations that arise due to the Higgs field are subdominant. If there are other massless fields in the theory, e.g., an axion or an ilion, then isocurvature fluctuations arise in these fields too. Production of gravitational waves and the massless particles associated with excitations of the Brans-Dicke field are also discussed. Several attempts at more realistic models of extended inflation are also analyzed. The importance of the Einstein conformal frame in calculating curvature fluctuations is emphasized. When viewed in this frame, extended inflation closely resembles slow-rollover inflation with an exponential potential, and the usual formula for the amplitude of curvature perturbations applies directly

  2. Origin of density fluctuations in extended inflation

    International Nuclear Information System (INIS)

    Kolb, E.W.; Salopek, D.S.; Turner, M.S.

    1990-05-01

    The density fluctuations (both curvature and isocurvature) that arise due to quantum fluctuations in a simple model of extended inflation based upon the Jordan-Brans-Dicke theory are calculated. Curvature fluctuations arise due to quantum fluctuations in the Brans-Dicke field, in general have a nonscale-invariant spectrum, and can have an amplitude that is cosmologically acceptable and interesting without having to tune any coupling constant to a very small value. The density perturbations that arise due to the inflation field are subdominant. If there are other massless fields in the theory, e.g., an axion or an ilion, then isocurvature fluctuations arise in these fields too. Production of gravitational waves and the massless particles associated with excitations of the Brans-Dicke field are also discussed. Several attempts at more realistic models of extended inflation are also analyzed. The importance of the Einstein conformal frame in calculating curvature fluctuations is emphasized. When viewed in this frame, extended inflation closely resembles slow-rollover inflation with an exponential potential and the usual formula for the amplitude of curvature perturbations applies

  3. The extended Betz-Lanchester limit

    Energy Technology Data Exchange (ETDEWEB)

    Cuerva, A.; Sanz-Andres, A. [Universidad Politecnica de Madrid (Spain). IDR/UPM, E.T.S.I.

    2005-04-01

    A proposal for an extended formulation of the power coefficient of a wind turbine is presented. This new formulation is a generalization of the Betz-Lanchester expression for the power coefficient as function of the axial deceleration of the wind speed provoked by the wind turbine in operation. The extended power coefficient takes into account the benefits of the power produced and the cost associated to the production of this energy. By the simple model proposed is evidenced that the purely energetic optimum operation condition giving rise to the Betz-Lanchester limit (maximum energy produced) does not coincide with the global optimum operational condition (maximum benefit generated) if cost of energy and degradation of the wind turbine during operation is considered. The new extended power coefficient is a general parameter useful to define global optimum operation conditions for wind turbines, considering not only the energy production but also the maintenance cost and the economic cost associated to the life reduction of the machine. (author)

  4. The deep space 1 extended mission

    Science.gov (United States)

    Rayman, Marc D.; Varghese, Philip

    2001-03-01

    The primary mission of Deep Space 1 (DS1), the first flight of the New Millennium program, completed successfully in September 1999, having exceeded its objectives of testing new, high-risk technologies important for future space and Earth science missions. DS1 is now in its extended mission, with plans to take advantage of the advanced technologies, including solar electric propulsion, to conduct an encounter with comet 19P/Borrelly in September 2001. During the extended mission, the spacecraft's commercial star tracker failed; this critical loss prevented the spacecraft from achieving three-axis attitude control or knowledge. A two-phase approach to recovering the mission was undertaken. The first involved devising a new method of pointing the high-gain antenna to Earth using the radio signal received at the Deep Space Network as an indicator of spacecraft attitude. The second was the development of new flight software that allowed the spacecraft to return to three-axis operation without substantial ground assistance. The principal new feature of this software is the use of the science camera as an attitude sensor. The differences between the science camera and the star tracker have important implications not only for the design of the new software but also for the methods of operating the spacecraft and conducting the mission. The ambitious rescue was fully successful, and the extended mission is back on track.

  5. Thermodynamic volume and the extended Smarr relation

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, Seungjoon; Jeong, Jaehoon; Park, Sang-A; Yi, Sang-Heon [Department of Physics, College of Science, Yonsei University,Seoul 120-749 (Korea, Republic of)

    2017-04-10

    We continue to explore the scaling transformation in the reduced action formalism of gravity models. As an extension of our construction, we consider the extended forms of the Smarr relation for various black holes, adopting the cosmological constant as the bulk pressure as in some literatures on black holes. Firstly, by using the quasi-local formalism for charges, we show that, in a general theory of gravity, the volume in the black hole thermodynamics could be defined as the thermodynamic conjugate variable to the bulk pressure in such a way that the first law can be extended consistently. This, so called, thermodynamic volume can be expressed explicitly in terms of the metric and field variables. Then, by using the scaling transformation allowed in the reduced action formulation, we obtain the extended Smarr relation involving the bulk pressure and the thermodynamic volume. In our approach, we do not resort to Euler’s homogeneous scaling of charges while incorporating the would-be hairy contribution without any difficulty.

  6. Dark energy and extended dark matter halos

    Science.gov (United States)

    Chernin, A. D.; Teerikorpi, P.; Valtonen, M. J.; Dolgachev, V. P.; Domozhilova, L. M.; Byrd, G. G.

    2012-03-01

    The cosmological mean matter (dark and baryonic) density measured in the units of the critical density is Ωm = 0.27. Independently, the local mean density is estimated to be Ωloc = 0.08-0.23 from recent data on galaxy groups at redshifts up to z = 0.01-0.03 (as published by Crook et al. 2007, ApJ, 655, 790 and Makarov & Karachentsev 2011, MNRAS, 412, 2498). If the lower values of Ωloc are reliable, as Makarov & Karachentsev and some other observers prefer, does this mean that the Local Universe of 100-300 Mpc across is an underdensity in the cosmic matter distribution? Or could it nevertheless be representative of the mean cosmic density or even be an overdensity due to the Local Supercluster therein. We focus on dark matter halos of groups of galaxies and check how much dark mass the invisible outer layers of the halos are able to host. The outer layers are usually devoid of bright galaxies and cannot be seen at large distances. The key factor which bounds the size of an isolated halo is the local antigravity produced by the omnipresent background of dark energy. A gravitationally bound halo does not extend beyond the zero-gravity surface where the gravity of matter and the antigravity of dark energy balance, thus defining a natural upper size of a system. We use our theory of local dynamical effects of dark energy to estimate the maximal sizes and masses of the extended dark halos. Using data from three recent catalogs of galaxy groups, we show that the calculated mass bounds conform with the assumption that a significant amount of dark matter is located in the invisible outer parts of the extended halos, sufficient to fill the gap between the observed and expected local matter density. Nearby groups of galaxies and the Virgo cluster have dark halos which seem to extend up to their zero-gravity surfaces. If the extended halo is a common feature of gravitationally bound systems on scales of galaxy groups and clusters, the Local Universe could be typical or even

  7. Comparison of different extenders and storage temperature on the ...

    African Journals Online (AJOL)

    Semen was pooled and randomly allocated to four groups and diluted at a ratio of 1:1 (v/v) with Beltsville thawing solution (BTS), Kobidil+, egg yolk citrate (EYC) and non-extended semen (Control). Each extender had two similar semen samples, making a total of eight samples. Extended and non-extended semen were ...

  8. Extended radio sources in the cluster environment

    International Nuclear Information System (INIS)

    Burns, J.O. Jr.

    1979-01-01

    Extended radio galaxies that lie in rich and poor clusters were studied. A sample of 3CR and 4C radio sources that spatially coincide with poor Zwicky clusters of galaxies was observed to obtain accurate positions and flux densities. Then interferometer observations at a resolution of approx. = 10 arcsec were performed on the sample. The resulting maps were used to determine the nature of the extended source structure, to make secure optical identifications, and to eliminate possible background sources. The results suggest that the environments around both classical double and head-tail radio sources are similar in rich and poor clusters. The majority of the poor cluster sources exhibit some signs of morphological distortion (i.e., head-tails) indicative of dynamic interaction with a relatively dense intracluster medium. A large fraction (60 to 100%) of all radio sources appear to be members of clusters of galaxies if one includes both poor and rich cluster sources. Detailed total intensity and polarization observations for a more restricted sample of two classical double sources and nine head-tail galaxies were also performed. The purpose was to examine the spatial distributions of spectral index and polarization. Thin streams of radio emission appear to connect the nuclear radio-point components to the more extended structures in the head-tail galaxies. It is suggested that a non-relativistic plasma beam can explain both the appearance of the thin streams and larger-scale structure as well as the energy needed to generate the observed radio emission. The rich and poor radio cluster samples are combined to investigate the relationship between source morphology and the scale sizes of clustering. There is some indication that a large fraction of radio sources, including those in these samples, are in superclusters of galaxies

  9. Phase diagram of an extended Agassi model

    Science.gov (United States)

    García-Ramos, J. E.; Dukelsky, J.; Pérez-Fernández, P.; Arias, J. M.

    2018-05-01

    Background: The Agassi model [D. Agassi, Nucl. Phys. A 116, 49 (1968), 10.1016/0375-9474(68)90482-X] is an extension of the Lipkin-Meshkov-Glick (LMG) model [H. J. Lipkin, N. Meshkov, and A. J. Glick, Nucl. Phys. 62, 188 (1965), 10.1016/0029-5582(65)90862-X] that incorporates the pairing interaction. It is a schematic model that describes the interplay between particle-hole and pair correlations. It was proposed in the 1960s by D. Agassi as a model to simulate the properties of the quadrupole plus pairing model. Purpose: The aim of this work is to extend a previous study by Davis and Heiss [J. Phys. G: Nucl. Phys. 12, 805 (1986), 10.1088/0305-4616/12/9/006] generalizing the Agassi model and analyze in detail the phase diagram of the model as well as the different regions with coexistence of several phases. Method: We solve the model Hamiltonian through the Hartree-Fock-Bogoliubov (HFB) approximation, introducing two variational parameters that play the role of order parameters. We also compare the HFB calculations with the exact ones. Results: We obtain the phase diagram of the model and classify the order of the different quantum phase transitions appearing in the diagram. The phase diagram presents broad regions where several phases, up to three, coexist. Moreover, there is also a line and a point where four and five phases are degenerated, respectively. Conclusions: The phase diagram of the extended Agassi model presents a rich variety of phases. Phase coexistence is present in extended areas of the parameter space. The model could be an important tool for benchmarking novel many-body approximations.

  10. Comparação entre o teste de despertar e a monitoração neurofisiológica intra-operatória com potencial evocado somato-sensitivo nas cirurgias de escoliose Comparación entre el teste de despertar y la monitorización neurofisiológica intraoperatoria con potencial evocado somato sensorial en las cirugías de escoliosis Comparison between the wake-up test and the intra-operative neurophysiologic monitoring with somato-sensitive evoked potentials in surgery for scoliosis

    Directory of Open Access Journals (Sweden)

    Eduardo Barros Puertas

    2009-03-01

    , entre el período de enero de 1985 ha mayo de 2001. Los procedimientos fueron divididos en dos grupos, siendo 80 pacientes operados sin monitoración intra-operatória, utilizado la prueba del despertar, en el período de enero de 1985 a enero de 1998. A partir de mayo de 1998 las cirugías comenzaron a ser supervisadas con monitoración del potencial evocado somato-sensitivo (PESS para la prevención de lesión neurológica, formando así un segundo grupo de 31 pacientes. RESULTADOS: en el primer grupo, un paciente presento lesión neurológica irreversible y cuatro pacientes tuvieron lesión neurológica reversible. Entre los 31 pacientes, com monitoración neurofisiológica somato sensitiva, ocho pacientes presentaron lesión neurológica reversible evidenciada en el intra-operatório, sin ninguna repercusión clínica después del procedimiento. CONCLUSIÓN: los actuales resultados sugieren la eficacia de la monitoración intra-operatória, con el potencial evocado somato-sensitivo, para la prevención de lesiones neurológicas, en las cirugías correctivas de curvas rígidas de escoliosis idiopática.OBJECTIVE: the objective of this study is to compare the incidence of neurological injuries in corrective surgeries for rigid curves of idiopathic scoliosis using only the wake-up test and using the intraoperative neurophysiologic monitoring with somato sensitive evoked potentials. METHODS: we performed 111 surgeries to correct idiopathic scoliosis, with rigid curves through instrumentation and posterior fusion in the period January 1985 to May 2001. The procedures were divided into two groups, with 80 patients operated without the intra-operative monitoring, using only the wake-up test, from January 1985 to January 1998. From May 1998 the surgeries began to be monitored with somato-sensitive evoked potential (PESS for prevention of neurological damage, forming a second group of 31 patients. RESULTS: in the first group, one patient had irreversible neurological damage

  11. The eighth national electromagnetics meeting. Extended abstracts

    International Nuclear Information System (INIS)

    Eloranta, E.; Jokela, K.

    1998-01-01

    The National Electromagnetics Meeting has been arranged annually since 1991 in Finland. The purpose of the meeting is to convene the persons working with problems of electromagnetics and to enhance the interaction between different research groups in different disciplines. The eighth meeting was held at the Radiation and Nuclear Safety Authority (STUK) August 27, 1998. The meeting is also the national meeting of the URSI (L'Union Radio-Scientifique Internationals)(Commission B: Fields and Waves) and the IEEE MTT/AP/ED Finland Chapter (Institute of Electrical and Electronics Engineers, Inc.). The report includes the extended abstracts of the presentations given in the National Electromagnetics Meeting at STUK. (orig.)

  12. Extended Holomorphic Anomaly in Gauge Theory

    CERN Document Server

    Krefl, Daniel

    2011-01-01

    The partition function of an N=2 gauge theory in the Omega-background satisfies, for generic value of the parameter beta=-eps_1/eps_2, the, in general extended, but otherwise beta-independent, holomorphic anomaly equation of special geometry. Modularity together with the (beta-dependent) gap structure at the various singular loci in the moduli space completely fixes the holomorphic ambiguity, also when the extension is non-trivial. In some cases, the theory at the orbifold radius, corresponding to beta=2, can be identified with an "orientifold" of the theory at beta=1. The various connections give hints for embedding the structure into the topological string.

  13. Extended Carbon Cognition as a Machine

    DEFF Research Database (Denmark)

    Lippert, Ingmar

    2011-01-01

    . Grounded in ethnographic fieldwork at a leading multinational in the financial services sector over a period of more than 12 months, I focus on everyday work practices as taking place in a capitalist context. It is through practical work that the presences of carbon emissions are imagined and brought....... As a result of this analysis carbon accounting emerges as enabled through an extended system of cognition. The paper concludes by tentatively suggesting a view on this machinery as co-constituting a wider -- to borrow Guattari's term -- Universe: A Universe of references to carbon. Following these relations...

  14. Extended micro objects as dark matter particles

    Science.gov (United States)

    Belotsky, K.; Rubin, S.; Svadkovsky, I.

    2017-05-01

    Models of various forms of composite dark matter (DM) predicted by particle theory and the DM constituents formed by gravity that are not reduced to new elementary particle candidates are discussed. Main attention is paid to a gravitational origin of the DM. The influence of extended mass spectrum of primordial black holes on observational limits is considered. It is shown that non-uniformly deformed extra space can be considered as point-like masses which possess only gravitational interaction with each other and with the ordinary particles. The recently discussed six-dimensional stable wormholes could contribute to the DM. The contribution of dark atoms is also considered.

  15. libgapmis: extending short-read alignments.

    Science.gov (United States)

    Alachiotis, Nikolaos; Berger, Simon; Flouri, Tomáš; Pissis, Solon P; Stamatakis, Alexandros

    2013-01-01

    A wide variety of short-read alignment programmes have been published recently to tackle the problem of mapping millions of short reads to a reference genome, focusing on different aspects of the procedure such as time and memory efficiency, sensitivity, and accuracy. These tools allow for a small number of mismatches in the alignment; however, their ability to allow for gaps varies greatly, with many performing poorly or not allowing them at all. The seed-and-extend strategy is applied in most short-read alignment programmes. After aligning a substring of the reference sequence against the high-quality prefix of a short read--the seed--an important problem is to find the best possible alignment between a substring of the reference sequence succeeding and the remaining suffix of low quality of the read--extend. The fact that the reads are rather short and that the gap occurrence frequency observed in various studies is rather low suggest that aligning (parts of) those reads with a single gap is in fact desirable. In this article, we present libgapmis, a library for extending pairwise short-read alignments. Apart from the standard CPU version, it includes ultrafast SSE- and GPU-based implementations. libgapmis is based on an algorithm computing a modified version of the traditional dynamic-programming matrix for sequence alignment. Extensive experimental results demonstrate that the functions of the CPU version provided in this library accelerate the computations by a factor of 20 compared to other programmes. The analogous SSE- and GPU-based implementations accelerate the computations by a factor of 6 and 11, respectively, compared to the CPU version. The library also provides the user the flexibility to split the read into fragments, based on the observed gap occurrence frequency and the length of the read, thereby allowing for a variable, but bounded, number of gaps in the alignment. We present libgapmis, a library for extending pairwise short-read alignments. We

  16. Extended tree-level gauge mediation

    DEFF Research Database (Denmark)

    Monaco, M.; Nardecchia, M.; Romanino, A.

    2011-01-01

    Tree-level gauge mediation (TGM) is a scenario of SUSY breaking in which the tree-level exchange of heavy (possibly GUT) vector fields generates flavor-universal sfermion masses. In this work we extend this framework to the case of E(6) that is the natural extension of the minimal case studied so...... if the gauge group does not contain SU(5). If SUSY breaking is mediated purely by the U(1) generator that commutes with SO(10) we obtain universal sfermion masses and thus can derive the CMSSM boundary conditions in a novel scenario....

  17. Extending the applicability of multigrid methods

    International Nuclear Information System (INIS)

    Brannick, J; Brezina, M; Falgout, R; Manteuffel, T; McCormick, S; Ruge, J; Sheehan, B; Xu, J; Zikatanov, L

    2006-01-01

    Multigrid methods are ideal for solving the increasingly large-scale problems that arise in numerical simulations of physical phenomena because of their potential for computational costs and memory requirements that scale linearly with the degrees of freedom. Unfortunately, they have been historically limited by their applicability to elliptic-type problems and the need for special handling in their implementation. In this paper, we present an overview of several recent theoretical and algorithmic advances made by the TOPS multigrid partners and their collaborators in extending applicability of multigrid methods. specific examples that are presented include quantum chromodynamics, radiation transport, and electromagnetics

  18. Relic gravitational waves and extended inflation

    International Nuclear Information System (INIS)

    Turner, M.S.; Wilczek, F.

    1990-01-01

    In extended inflation, a new version of inflation where the transition from an inflationary to a radiation-dominated Universe is accomplished by bubble nucleation, bubble collisions supply a potent---and potentially detectable---source of gravitational waves. The energy density in relic gravitons from bubble collisions is expected to be about 10 -5 of closure density. Their characteristic wavelength depends upon the reheating temperature T RH: λ∼(10 4 cm)[(10 14 GeV)/T RH ]. If black holes are produced by bubble collisions, they will evaporate producing shorter-wavelength gravitons

  19. Exploring Social Structures in Extended Team Model

    DEFF Research Database (Denmark)

    Zahedi, Mansooreh; Ali Babar, Muhammad

    2013-01-01

    Extended Team Model (ETM) as a type of offshore outsourcing is increasingly becoming popular mode of Global Software Development (GSD). There is little knowledge about the social structures in ETM and their impact on collaboration. Within a large interdisciplinary project to develop the next...... generation of GSD technologies, we are exploring the role of social structures to support collaboration. This paper reports some details of our research design and initial findings about the mechanisms to support social structures and their impact on collaboration in an ETM....

  20. The eighth national electromagnetics meeting. Extended abstracts

    Energy Technology Data Exchange (ETDEWEB)

    Eloranta, E.; Jokela, K. [eds.

    1998-09-01

    The National Electromagnetics Meeting has been arranged annually since 1991 in Finland. The purpose of the meeting is to convene the persons working with problems of electromagnetics and to enhance the interaction between different research groups in different disciplines. The eighth meeting was held at the Radiation and Nuclear Safety Authority (STUK) August 27, 1998. The meeting is also the national meeting of the URSI (L`Union Radio-Scientifique Internationals)(Commission B: Fields and Waves) and the IEEE MTT/AP/ED Finland Chapter (Institute of Electrical and Electronics Engineers, Inc.). The report includes the extended abstracts of the presentations given in the National Electromagnetics Meeting at STUK. (orig.)

  1. Asymptotic freedom in extended conformal supergravities

    International Nuclear Information System (INIS)

    Fradkin, E.S.; Tseytlin, A.A.

    1982-01-01

    We present the calculation of the one-loop β-function in extended conformal supergravities. N = 1, 2, 3 theories (free or coupled to the Einstein supergravities) are found to the asymptotically free (like the N = 0 Weyl theory) while the N = 4 theory becomes finite under some plausible hypothesis. The results support the possibility to solve the problem of ghosts in these theories. The obtained sequence of SU(N) β-functions appears to be in remarkable correspondence with that for gauged O(N) supergravity theories. (orig.)

  2. Quark mobility in extended nuclear matter

    International Nuclear Information System (INIS)

    Sivers, D.

    1988-01-01

    The propagation of an energetic quark through extended nuclear matter is analyzed in terms of a simple model in which localization of color is imposed through chromoelectric flux tubes. A mobile quark in the nuclear medium creates a disturbance which affects neighboring nucleons. The model suggests that the spatial properties of the disturbance involve a competition among different dynamical mechanisms. Experimental measurements involving the target fragmentation region in deep-inelastic leptoproduction on large nuclei may help specify some of the important features of nuclear dynamics. copyright 1988 Academic Press, Inc

  3. Dynamical Symmetry Breaking of Extended Gauge Symmetries

    OpenAIRE

    Appelquist, Thomas; Shrock, Robert

    2003-01-01

    We construct asymptotically free gauge theories exhibiting dynamical breaking of the left-right, strong-electroweak gauge group $G_{LR} = {\\rm SU}(3)_c \\times {\\rm SU}(2)_L \\times {\\rm SU}(2)_R \\times {\\rm U}(1)_{B-L}$, and its extension to the Pati-Salam gauge group $G_{422}={\\rm SU}(4)_{PS} \\times {\\rm SU}(2)_L \\times {\\rm SU}(2)_R$. The models incorporate technicolor for electroweak breaking, and extended technicolor for the breaking of $G_{LR}$ and $G_{422}$ and the generation of fermion ...

  4. Equilibrium double layers in extended Pierce diodes

    International Nuclear Information System (INIS)

    Ciubotariu-Jassy, C.I.

    1992-01-01

    The extended Pierce diode is similar to the standard (or classical) Pierce diode, but has passive circuit elements in place of the short circuit between the electrodes. This device is important as an approximation to real bounded plasma systems. It consists of two parallel plane electrodes (an emitter located at x=0 and a collector located at x=l) and a collisionless cold electron beam travelling between them. The electrons are neutralized by a background of comoving massive ions. This situation is analysed in this paper and new equilibrium double layer (DL) plasma structures are obtained. (author) 6 refs., 3 figs

  5. Cambridge IGCSE mathematics core and extended

    CERN Document Server

    Pimentel, Ric

    2013-01-01

    The most cost effective and straightforward way to teach the revised syllabus, with all the core and extended content covered by a single book and accompanying free digital resources.  . This title has been written for the revised Cambridge IGCSE Mathematics (0580) syllabus, for first teaching from 2013.  . ·         Gives students the practice they require to deepen their understanding through plenty of questions. ·         Consolidates learning with unique digital resources on the CD, included free with every Student's Book.  . We are working with Cambridge International Examinations to gain

  6. The extended arm of health professionals?

    DEFF Research Database (Denmark)

    Norlyk, Annelise; Martinsen, Bente

    2013-01-01

    responsibility for both the patient's well-being and for the patient's compliance with the daily regimen. Relatives were caught in a conflicting double role. They were the extended arm of the health professionals but also the caring, supporting partner. A tension arose between relatives' desire to help....... Due to the early discharge and the increasing demands on patients for self-care, patients' relatives seem to play a pivotal role in fast-track programmes. However, research is limited into how patients' close relatives are affected by and involved in the postoperative recovery process. Design...

  7. Extended inflation with nonminimally coupled inflation field

    International Nuclear Information System (INIS)

    Panchapakesan, N.; Sethi, S.K.

    1992-01-01

    In this paper, an extended inflation model, in which the inflation field is nonminimally coupled to the gravity, is discussed. It is shown that the nucleation rate of bubbles, during a phase transition in the inflaton field, can increase as the transition proceeds for a wide range of parameters of the inflaton potential. The bounce action for three possible cases - the strong gravity regime, the thick-walled Coleman-DeLuccia bubbles and the thin-walled bubbles - is evaluated. The resulting bubble distribution for all the cases is shown to be in conformity with cosmological constraints for ω < 500

  8. Extending Teach and Repeat to Pivoting Wheelchairs

    Directory of Open Access Journals (Sweden)

    Guillermo Del Castillo

    2003-02-01

    Full Text Available The paper extends the teach-and-repeat paradigm that has been successful for the control of holonomic robots to nonholonomic wheelchairs which may undergo pivoting action over the course of their taught movement. Due to the nonholonomic nature of the vehicle kinematics, estimation is required -- in the example given herein, based upon video detection of wall-mounted cues -- both in the teaching and the tracking events. In order to accommodate motion that approaches pivoting action as well as motion that approaches straight-line action, the estimation equations of the Extended Kalman Filter and the control equations are formulated using two different definitions of a nontemporal independent variable. The paper motivates the need for pivoting action in real-life settings by reporting extensively on the abilities and limitations of estimation-based teach-and-repeat action where pivoting and near-pivoting action is disallowed. Following formulation of the equations in the near-pivot mode, the paper reports upon experiments where taught trajectories which entail a seamless mix of near-straight and near-pivot action are tracked.

  9. Extended sequence diagram for human system interaction

    International Nuclear Information System (INIS)

    Hwang, Jong Rok; Choi, Sun Woo; Ko, Hee Ran; Kim, Jong Hyun

    2012-01-01

    Unified Modeling Language (UML) is a modeling language in the field of object oriented software engineering. The sequence diagram is a kind of interaction diagram that shows how processes operate with one another and in what order. It is a construct of a message sequence chart. It depicts the objects and classes involved in the scenario and the sequence of messages exchanged between the objects needed to carry out the functionality of the scenario. This paper proposes the Extended Sequence Diagram (ESD), which is capable of depicting human system interaction for nuclear power plants, as well as cognitive process of operators analysis. In the conventional sequence diagram, there is a limit to only identify the activities of human and systems interactions. The ESD is extended to describe operators' cognitive process in more detail. The ESD is expected to be used as a task analysis method for describing human system interaction. The ESD can also present key steps causing abnormal operations or failures and diverse human errors based on cognitive condition

  10. Extended parental care in communal social groups

    Directory of Open Access Journals (Sweden)

    Stephen H. Forbes

    2002-11-01

    Full Text Available Recent developments in social insect research have challenged the need for close kinship as a prerequisite for the evolution of stable group living. In a model communal bee species, Lasioglossum (Chilalictus hemichalceum, previous allozyme work indicated that groups of cooperating adult females are not relatives. Yet at any given time, not all group members perform the risky task of foraging. We previously hypothesized that tolerance for non-foragers was a component of extended parental care, previously known only for kin based social systems. DNA microsatellites were used to study colony genetic structure in order to test this hypothesis. Microsatellite polymorphism was substantial (He = 0.775. Overall intracolony relatedness, mainly of immatures, was low but significant in nine, late season nests (r = 0.136 plus or minus0.023, indicating that broods contain five to six unrelated sib ships. Detailed analyses of kinship between pairs of individuals revealed that most pairs were unrelated and most related pairs were siblings. Mothers are absent for 89-91% of the developing immature females, and 97% of developing males. Alternatively, 46% of adult females had neither sibs nor offspring in their nests. These findings indicate that the extended parental care model applies broadly to both kin based and nonkin based social systems in the Hymenoptera.

  11. Laguna Verde after the extended power increase

    International Nuclear Information System (INIS)

    Herrera C, M. N.; Castaneda G, M. A.; Cardenas J, J. B.; Garcia de la C, F. M.

    2012-10-01

    The project of extended power increase that was implemented in both units of the nuclear power plant of Laguna Verde beginning with the stage feasibility evaluation in nuclear side of the facilities, that is to say the affectation of the power increase in the equipment s, systems and components of the nuclear power plant; besides the feasibility evaluation a study cost-benefit for the rehabilitated and modernization of the equipment s, systems and components of Plant Balance was realized. Once considered technical and economically feasible the project began the engineering evaluations required to carry out the licensing of the new operation conditions, as well as beginning to the elaboration of the technical specifications purchase of the equipment s, systems and components of the Plant Balance. While on one hand was carried out the administration of the licensing of the extended power increase for other was carried out the necessary engineering to make the physical changes in the conventional side of the nuclear power plant. Once concluded the constructive stage beginning the final stage of the project, the starting-up tests, operation and performance of the Units under the new operation conditions. This work describes this last stage that contains the technical base, the realized tests and the obtained results. (Author)

  12. Hamiltonian Anomalies from Extended Field Theories

    Science.gov (United States)

    Monnier, Samuel

    2015-09-01

    We develop a proposal by Freed to see anomalous field theories as relative field theories, namely field theories taking value in a field theory in one dimension higher, the anomaly field theory. We show that when the anomaly field theory is extended down to codimension 2, familiar facts about Hamiltonian anomalies can be naturally recovered, such as the fact that the anomalous symmetry group admits only a projective representation on the Hilbert space, or that the latter is really an abelian bundle gerbe over the moduli space. We include in the discussion the case of non-invertible anomaly field theories, which is relevant to six-dimensional (2, 0) superconformal theories. In this case, we show that the Hamiltonian anomaly is characterized by a degree 2 non-abelian group cohomology class, associated to the non-abelian gerbe playing the role of the state space of the anomalous theory. We construct Dai-Freed theories, governing the anomalies of chiral fermionic theories, and Wess-Zumino theories, governing the anomalies of Wess-Zumino terms and self-dual field theories, as extended field theories down to codimension 2.

  13. Manipulating affective state using extended picture presentations.

    Science.gov (United States)

    Sutton, S K; Davidson, R J; Donzella, B; Irwin, W; Dottl, D A

    1997-03-01

    Separate, extended series of positive, negative, and neutral pictures were presented to 24 (12 men, 12 women) undergraduates. Each series was presented on a different day, with full counterbalancing of presentation orders. Affective state was measured using (a) orbicularis oculi activity in response to acoustic startle probes during picture presentation, (b) corrugator supercilii activity between and during picture presentation, and (c) changes in self-reports of positive and negative affect. Participants exhibited larger eyeblink reflex magnitudes when viewing negative than when viewing positive pictures. Corrugator activity was also greater during the negative than during the positive picture set, during both picture presentation and the period between pictures. Self-reports of negative affect increased in response to the negative picture set, and self-reports of positive affect were greatest following the positive picture set. These findings suggest that extended picture presentation is an effective method of manipulating affective state and further highlight the utility of startle probe and facial electromyographic measures in providing on-line readouts of affective state.

  14. Application of extended gamma sources to radiography

    International Nuclear Information System (INIS)

    Borisov, A.E.; Ivanov, V.S.; Majorov, A.N.; Firstov, V.G.

    1977-01-01

    The possibility to use extended sources for gamma radiographic control of small diameter pipe-sockets welded joints has been studied. Special gamma radiation sources basing on Tm 170 have been developed. To prevent influence of the nonuniform radioactivity distribution in the sources on control results, the steel welded pipe-sockets of different diameter and thickness have been X-rayed under stable rotation velocity of sources. Data are presented on dependence of the radiographic control sensitivity on pipe-socket diameter, wall thickness, as well as on focus distances. The Tm 170 sources have been shown to be better used for thin-wall articles control with focus distances up to 5 mm, when the sensitivity is maximum. It has been found that the maximum geometric unsharpness of 1-6 mm appears in articles with 3-10 mm thickness and relative defect size of 1-5%. Extended sources make it possible to carry out the control in unaccessable places and with small focus distances with high capacity

  15. Extended release formulations for local anaesthetic agents.

    Science.gov (United States)

    Weiniger, C F; Golovanevski, L; Domb, A J; Ickowicz, D

    2012-08-01

    Systemic toxicity through overdose of local anaesthetic agents is a real concern. By encapsulating local anaesthetics in biodegradable carriers to produce a system for prolonged release, their duration of action can be extended. This encapsulation should also improve the safety profile of the local anaesthetic as it is released at a slower rate. Work with naturally occurring local anaestheticss has also shown promise in the area of reducing systemic and neurotoxicity. Extended duration local anaesthetic formulations in current development or clinical use include liposomes, hydrophobic based polymer particles such as Poly(lactic-co-glycolic acid) microspheres, pasty injectable and solid polymers like Poly(sebacic-co-ricinoleic acid) P(SA:RA) and their combination with synthetic and natural local anaesthetic. Their duration of action, rationale and limitations are reviewed. Direct comparison of the different agents is limited by their chemical properties, the drug doses encapsulated and the details of in vivo models described. Anaesthesia © 2012 The Association of Anaesthetists of Great Britain and Ireland.

  16. Extended Lagrangian Excited State Molecular Dynamics.

    Science.gov (United States)

    Bjorgaard, J A; Sheppard, D; Tretiak, S; Niklasson, A M N

    2018-02-13

    An extended Lagrangian framework for excited state molecular dynamics (XL-ESMD) using time-dependent self-consistent field theory is proposed. The formulation is a generalization of the extended Lagrangian formulations for ground state Born-Oppenheimer molecular dynamics [Phys. Rev. Lett. 2008 100, 123004]. The theory is implemented, demonstrated, and evaluated using a time-dependent semiempirical model, though it should be generally applicable to ab initio theory. The simulations show enhanced energy stability and a significantly reduced computational cost associated with the iterative solutions of both the ground state and the electronically excited states. Relaxed convergence criteria can therefore be used both for the self-consistent ground state optimization and for the iterative subspace diagonalization of the random phase approximation matrix used to calculate the excited state transitions. The XL-ESMD approach is expected to enable numerically efficient excited state molecular dynamics for such methods as time-dependent Hartree-Fock (TD-HF), Configuration Interactions Singles (CIS), and time-dependent density functional theory (TD-DFT).

  17. A Novel Biped Pattern Generator Based on Extended ZMP and Extended Cart-Table Model

    Directory of Open Access Journals (Sweden)

    Guangbin Sun

    2015-07-01

    Full Text Available This paper focuses on planning patterns for biped walking on complex terrains. Two problems are solved: ZMP (zero moment point cannot be used on uneven terrain, and the conventional cart-table model does not allow vertical CM (centre of mass motion. For the ZMP definition problem, we propose the extended ZMP (EZMP concept as an extension of ZMP to uneven terrains. It can be used to judge dynamic balance on universal terrains. We achieve a deeper insight into the connection and difference between ZMP and EZMP by adding different constraints. For the model problem, we extend the cart-table model by using a dynamic constraint instead of constant height constraint, which results in a mathematically symmetric set of three equations. In this way, the vertical motion is enabled and the resultant equations are still linear. Based on the extended ZMP concept and extended cart-table model, a biped pattern generator using triple preview controllers is constructed and implemented simultaneously to three dimensions. Using the proposed pattern generator, the Atlas robot is simulated. The simulation results show the robot can walk stably on rather complex terrains by accurately tracking extended ZMP.

  18. Extended MRI findings of intersection syndrome

    International Nuclear Information System (INIS)

    Lee, Roger P.; Hatem, Stephen F.; Recht, Michael P.

    2009-01-01

    The symptoms and physical findings of intersection syndrome have been well described in the clinical medical literature. However, the magnetic resonance imaging (MRI) findings in patients with intersection syndrome of the forearm have only recently been described in a small number of patients. We review our experience with imaging of intersection syndrome, describe previously unreported MRI findings, and emphasize modifications to MRI protocols for its evaluation. Institutional review board approval was obtained for this retrospective review of patients with MRI findings consistent with intersection syndrome of the forearm during the period from January 2004 to September 2006. Six patients were identified, three males and three females, with an average age of 39.3 years. The MRI examinations were reviewed to assess signal abnormalities within and adjacent to the first and second dorsal extensor tendon compartments (DETC): tendinosis, peritendinous edema or fluid, muscle edema, subcutaneous edema, and juxtacortical edema. The overall longitudinal extent of signal alterations was measured as well as the distance from Lister's tubercle to the crossover of the first and second DETC. Review of the MRIs showed increased intrasubstance tendon signal suggesting tendinosis in two of the six patients, peritendinous edema or fluid in all six patients, muscle edema in five of the six patients, and subcutaneous edema in three of the six patients. Juxtacortical edema was seen in one patient. Peritendinous edema or fluid extended distally beyond the radiocarpal joint in three of the six patients. The average distance from Lister's tubercle to the crossover of the first and second DETC was 3.95 cm, in keeping with recently published data. Intersection syndrome is an uncommon MRI diagnosis. In addition to the previously described MRI findings of edema adjacent to the first or second DETC, possibly with proximal extension and subcutaneous edema, we have identified additional

  19. An Organization's Extended (Soft) Competencies Model

    Science.gov (United States)

    Rosas, João; Macedo, Patrícia; Camarinha-Matos, Luis M.

    One of the steps usually undertaken in partnerships formation is the assessment of organizations’ competencies. Typically considered competencies of a functional or technical nature, which provide specific outcomes can be considered as hard competencies. Yet, the very act of collaboration has its specific requirements, for which the involved organizations must be apt to exercise other type of competencies that affect their own performance and the partnership success. These competencies are more of a behavioral nature, and can be named as soft-competencies. This research aims at addressing the effects of the soft competencies on the performance of the hard ones. An extended competencies model is thus proposed, allowing the construction of adjusted competencies profiles, in which the competency levels are adjusted dynamically according to the requirements of collaboration opportunities.

  20. Extending Stochastic Network Calculus to Loss Analysis

    Directory of Open Access Journals (Sweden)

    Chao Luo

    2013-01-01

    Full Text Available Loss is an important parameter of Quality of Service (QoS. Though stochastic network calculus is a very useful tool for performance evaluation of computer networks, existing studies on stochastic service guarantees mainly focused on the delay and backlog. Some efforts have been made to analyse loss by deterministic network calculus, but there are few results to extend stochastic network calculus for loss analysis. In this paper, we introduce a new parameter named loss factor into stochastic network calculus and then derive the loss bound through the existing arrival curve and service curve via this parameter. We then prove that our result is suitable for the networks with multiple input flows. Simulations show the impact of buffer size, arrival traffic, and service on the loss factor.

  1. Higgs boson from an extended symmetry

    International Nuclear Information System (INIS)

    Barbieri, Riccardo; Bellazzini, Brando; Rychkov, Vyacheslav S.; Varagnolo, Alvise

    2007-01-01

    The variety of ideas put forward in the context of a composite picture for the Higgs boson calls for a simple and effective description of the related phenomenology. Such a description is given here by means of a minimal model and is explicitly applied to the example of a Higgs-top sector from an SO(5) symmetry. We discuss the spectrum, the electroweak precision tests, B-physics, and naturalness. We show the difficulty in complying with the different constraints. The extended gauge sector relative to the standard SU(2)xU(1), if there is any, has little or no impact on these considerations. We also discuss the relation of the minimal model with its 'little Higgs' or holographic extensions based on the same symmetry

  2. Chiral flavor violation from extended gauge mediation

    Energy Technology Data Exchange (ETDEWEB)

    Evans, Jared A. [Department of Physics, University of Illinois at Urbana-Champaign,Urbana, IL 61801 (United States); Shih, David; Thalapillil, Arun [NHETC, Department of Physics and Astronomy,Rutgers University, Piscataway, NJ 08854 (United States)

    2015-07-08

    Models of extended gauge mediation, in which large A-terms arise through direct messenger-MSSM superpotential couplings, are well-motivated by the discovery of the 125 GeV Higgs. However, since these models are not necessarily MFV, the flavor constraints could be stringent. In this paper, we perform the first detailed and quantitative study of the flavor violation in these models. To facilitate our study, we introduce a new tool called FormFlavor for computing precision flavor observables in the general MSSM. We validate FormFlavor and our qualitative understanding of the flavor violation in these models by comparing against analytical expressions. Despite being non-MFV, we show that these models are protected against the strongest constraints by a special flavor texture, which we dub chiral flavor violation (χFV). This results in only mild bounds from current experiments, and exciting prospects for experiments in the near future.

  3. Relic gravitational waves and extended inflation

    International Nuclear Information System (INIS)

    Turner, M.S.; Wilczek, F.

    1990-08-01

    In extended inflation, a new version of inflation where the transition from the false-vacuum phase to a radiation-dominated Universe is accomplished by bubble nucleation and percolation, bubble collisions supply a potent-and potentially detectable-source of gravitational waves. The present energy density in relic gravity waves from bubble collisions is expected to be about 10(exp -5) of closure density-many orders of magnitude greater than that of the gravity waves produced by quantum fluctuations. Their characteristic wavelength depends upon the reheating temperature T(sub RH): lambda is approximately 10(exp 4) cm (10(exp 14) GeV/T(sub RH)). If large numbers of black holes are produced, a not implausible outcome, they will evaporate producing comparable amounts of shorter wavelength waves, lambda is approximately 10(exp -6) cm (T(sub RH)/10(exp 14) GeV)

  4. Extended equal areas criterion: foundations and applications

    Energy Technology Data Exchange (ETDEWEB)

    Yusheng, Xue [Nanjim Automation Research Institute, Nanjim (China)

    1994-12-31

    The extended equal area criterion (EEAC) provides analytical expressions for ultra fast transient stability assessment, flexible sensitivity analysis, and means to preventive and emergency controls. Its outstanding performances have been demonstrated by thousands upon thousands simulations on more than 50 real power systems and by on-line operation records in an EMS environment of Northeast China Power System since September 1992. However, the researchers have mainly based on heuristics and simulations. This paper lays a theoretical foundation of EEAC and brings to light the mechanism of transient stability. It proves true that the dynamic EEAC furnishes a necessary and sufficient condition for stability of multi machine systems with any detailed models, in the sense of the integration accuracy. This establishes a new platform for further advancing EEAC and better understanding of problems. An overview of EEAC applications in China is also given in this paper. (author) 30 refs.

  5. Extended Higgs sectors in radiative neutrino models

    Directory of Open Access Journals (Sweden)

    Oleg Antipin

    2017-05-01

    Full Text Available Testable Higgs partners may be sought within the extensions of the SM Higgs sector aimed at generating neutrino masses at the loop level. We study a viability of extended Higgs sectors for two selected models of radiative neutrino masses: a one-loop mass model, providing the Higgs partner within a real triplet scalar representation, and a three-loop mass model, providing it within its two-Higgs-doublet sector. The Higgs sector in the one-loop model may remain stable and perturbative up to the Planck scale, whereas the three-loop model calls for a UV completion around 106 GeV. Additional vector-like lepton and exotic scalar fields, which are required to close one- and three-loop neutrino-mass diagrams, play a decisive role for the testability of the respective models. We constrain the parameter space of these models using LHC bounds on diboson resonances.

  6. Extended Linear Models with Gaussian Priors

    DEFF Research Database (Denmark)

    Quinonero, Joaquin

    2002-01-01

    In extended linear models the input space is projected onto a feature space by means of an arbitrary non-linear transformation. A linear model is then applied to the feature space to construct the model output. The dimension of the feature space can be very large, or even infinite, giving the model...... a very big flexibility. Support Vector Machines (SVM's) and Gaussian processes are two examples of such models. In this technical report I present a model in which the dimension of the feature space remains finite, and where a Bayesian approach is used to train the model with Gaussian priors...... on the parameters. The Relevance Vector Machine, introduced by Tipping, is a particular case of such a model. I give the detailed derivations of the expectation-maximisation (EM) algorithm used in the training. These derivations are not found in the literature, and might be helpful for newcomers....

  7. Two-photon superradiance in extended medium

    International Nuclear Information System (INIS)

    Branzan, V.; Enache, N.

    1993-01-01

    The possibility of collectivization of an ensemble of atoms of an extended system (the distance between atoms is larger or equal to the wave-length of a spontaneous emitted radiation) during two-photon spontaneous decay is theoretically investigated. It is demonstrated that such systems of inverted atoms should emit phase-correlated pairs of photons. The time-space correlation among atoms is realized due to the two-photon exchanging through the electromagnetic field's vacuum. An increase of the spontaneous decay rate of the two-atom inverted ensemble is demonstrated. The dependence of two-photon superradiance on the sample geometry is investigated. A non-equilibrium method of the elimination of the atoms level Fermi-operators is proposed. (Author)

  8. The Extended Relativity Theory in Clifford Spaces

    CERN Document Server

    Castro, C

    2004-01-01

    A brief review of some of the most important features of the Extended Relativity theory in Clifford-spaces ( $C$-spaces) is presented whose " point" coordinates are noncommuting Clifford-valued quantities and which incoporate the lines, areas, volumes, .... degrees of freedom associated with the collective particle, string, membrane, ... dynamics of the $p$-loop histories (closed p-branes) living in target $D$-dimensional spacetime backgrounds. $C$-space Relativity naturally incoporates the ideas of an invariant length (Planck scale), maximal acceleration, noncommuting coordinates, supersymmetry, holography, superluminal propagation, higher derivative gravity with torsion and variable dimensions/signatures that allows to study the dynamics of all (closed ) p-branes, for all values of $ p $, in a unified footing. It resolves the ordering ambiguities in QFT and the problem of time in Cosmology. A discussion of the maximal-acceleration Relativity principle in phase-spaces follows along with the study of the inva...

  9. Extended Analysis of the Casimir Force

    Directory of Open Access Journals (Sweden)

    Lehnert B.

    2014-04-01

    Full Text Available There are several arguments for the conventional form of the Zero Point Energy fre- quency spectrum to be put in doubt. It has thus to be revised in to that of a self-consistent system in statistical equilibrium where the total energy de nsity and the equivalent pres- sure become finite. An extended form of the Casimir force is th ereby proposed to be used as a tool for determining the local magnitude of the same pressure. This can be done in terms of measurements on the force between a pair po lished plane plates consisting of different metals, the plates having very small or zero air gaps. T his corre- sponds to the largest possible Casimir force. Even then, the re may arise problems with other adhering forces, possibly to be clarified in further experiments.

  10. Spontaneously broken extended supersymmetry: Full superfield formulation

    International Nuclear Information System (INIS)

    Kandelakis, E.S.

    1984-01-01

    The superfield description, given by Samuel and Wess, of the non-linear Akulov-Volkov realization of (broken) supersymmetry, is generalized for the interesting cases of N=2 and 4 extended supersymmetry. The generalization, in terms of the full-superfield formulation, is straightforward. For the proof we first define the corresponding THETA-algebras; we then present explicitly many of the calculations. The schematic explanation makes the generalization manifest. We perform, for N=2, the coupling of the A-V field to standard-matter, in the way introduced by S-W, and schematically we make manifest the generalization for every N. The importance of our results consists in a complete, calculable description of the A-V fields (goldstinos) and of their interactions, easily applied to the tasks of today's phenomenology. (orig.) [de

  11. Extended Kac-Moody algebras and applications

    International Nuclear Information System (INIS)

    Ragoucy, E.; Sorba, P.

    1991-04-01

    The notion of a Kac-Moody algebra defined on the S 1 circle is extended to super Kac-Moody algebras defined on MxG N , M being a smooth closed compact manifold of dimension greater than one, and G N the Grassman algebra with N generators. All the central extensions of these algebras are computed. Then, for each such algebra the derivation algebra constructed from the MxG N diffeomorphism is determined. The twists of such super Kac-Moody algebras as well as the generalization to non-compact surfaces are partially studied. Finally, the general construction is applied to the study of conformal and superconformal algebras, as well as area-preserving diffeomorphisms algebra and its supersymmetric extension. (author) 65 refs

  12. Extended investigation on road fatality in Brunei.

    Science.gov (United States)

    Yusof, N B; Hoque, M A; Steele, M C; Yong, S Y

    2018-06-08

    Road fatality is one of the leading causes of death in Brunei with 79 deaths in 1993, the highest ever recorded. The Brunei government has been trying to reduce this by implementing new traffic measures and successfully reduced fatalities to 24 fatalities in 2014. Yearly road fatality has been fluctuating, but there has been a declining tendency overall. The aim of this study is to investigate road fatality in Brunei by extending the research. We developed a multiple regression model and carried out an analysis on road fatality in Brunei. Our analysis indicates that the road fatality appears to rise depending on the increase in the number of young drivers between 15 to 24 years and the number of unemployed people. Comparisons of Brunei road fatality rate per 10,000 vehicles are made with some other countries and we conclude that Brunei has approximately the same rate as Australia in 2014.

  13. International symposium on marine pollution. Extended synopses

    International Nuclear Information System (INIS)

    1998-01-01

    The marine environment - understanding and protecting for the future were at the forefront of the International Symposium on Marine Pollution convened in Monaco from 5 to 9 October 1998, as one of the major events of the UN International Year of the Oceans. New achievements were reported in identifying the sources of pollution, on the behaviour and fate of contaminants in seawater, biota and sediments, on the use of radioactive and non-radioactive tracers for studies of transport and circulation processes in the world's oceans and seas, on studies of radioactive waste dumping sites and nuclear weapons test sites, on local, regional and global computer modelling of the transport of contaminants and on many other topics in marine pollution. New developments in high sensitivity analytical measurements of contaminants with emphasis on nuclear and isotopic methods were also presented. This document contains extended synopses of 390 oral and poster presentations made at the symposium. Each synopsis was indexed separately

  14. Affordances and the musically extended mind.

    Science.gov (United States)

    Krueger, Joel

    2014-01-06

    I defend a model of the musically extended mind. I consider how acts of "musicking" grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of "musical affordances" and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances - via soliciting different forms of entrainment - enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel experiences out of us with an expanded complexity and phenomenal character. I argue that music therefore ought to be thought of as part of the vehicle needed to realize these emotional experiences. I appeal to different sources of empirical work to develop this idea.

  15. Do we need an extended evolutionary synthesis?

    Science.gov (United States)

    Pigliucci, Massimo

    2007-12-01

    The Modern Synthesis (MS) is the current paradigm in evolutionary biology. It was actually built by expanding on the conceptual foundations laid out by its predecessors, Darwinism and neo-Darwinism. For sometime now there has been talk of a new Extended Evolutionary Synthesis (EES), and this article begins to outline why we may need such an extension, and how it may come about. As philosopher Karl Popper has noticed, the current evolutionary theory is a theory of genes, and we still lack a theory of forms. The field began, in fact, as a theory of forms in Darwin's days, and the major goal that an EES will aim for is a unification of our theories of genes and of forms. This may be achieved through an organic grafting of novel concepts onto the foundational structure of the MS, particularly evolvability, phenotypic plasticity, epigenetic inheritance, complexity theory, and the theory of evolution in highly dimensional adaptive landscapes.

  16. Socially extended intentions-in-action

    DEFF Research Database (Denmark)

    Blomberg, Olle

    2011-01-01

    According to a widely accepted constraint on the content of intentions, here called the exclusivity constraint, one cannot intend to perform another agent’s action, even if one might be able to intend that she performs it. For example, while one can intend that one’s guest leaves before midnight......, one cannot intend to perform her act of leaving. However, Deborah Tollefsen’s (2005) account of joint activity requires participants to have intentions-in-action (in John Searle’s (1983) sense) that violate this constraint. I argue that the exclusivity constraint should not be accepted...... as an unconditional constraint on the contents of intentions-in-action: one may intend to perform a basic action that belongs both to oneself and to another agent. Based on the phenomenology of tool use, I first argue that intentions-in-action of one’s basic actions may be technologically extended, meaning...

  17. Extended constitutive laws for lamellar phases

    Directory of Open Access Journals (Sweden)

    Chi-Deuk Yoo

    2013-10-01

    Full Text Available Classically, stress and strain rate in linear viscoelastic materials are related by a constitutive relationship involving the viscoelastic modulus G(t. The same constitutive law, within Linear Response Theory, relates currents of conserved quantities and gradients of existing conjugate variables, and it involves the autocorrelation functions of the currents in equilibrium. We explore the consequences of the latter relationship in the case of a mesoscale model of a block copolymer, and derive the resulting relationship between viscous friction and order parameter diffusion that would result in a lamellar phase. We also explicitly consider in our derivation the fact that the dissipative part of the stress tensor must be consistent with the uniaxial symmetry of the phase. We then obtain a relationship between the stress and order parameter autocorrelation functions that can be interpreted as an extended constitutive law, one that offers a way to determine them from microscopic experiment or numerical simulation.

  18. Angle-resolved photoemission extended fine structure

    International Nuclear Information System (INIS)

    Barton, J.J.

    1985-03-01

    Measurements of the Angle-Resolved Photoemission Extended Fine Structure (ARPEFS) from the S(1s) core level of a c(2 x 2)S/Ni(001) are analyzed to determine the spacing between the S overlayer and the first and second Ni layers. ARPEFS is a type of photoelectron diffraction measurement in which the photoelectron kinetic energy is swept typically from 100 to 600 eV. By using this wide range of intermediate energies we add high precision and theoretical simplification to the advantages of the photoelectron diffraction technique for determining surface structures. We report developments in the theory of photoelectron scattering in the intermediate energy range, measurement of the experimental photoemission spectra, their reduction to ARPEFS, and the surface structure determination from the ARPEFS by combined Fourier and multiple-scattering analyses. 202 refs., 67 figs., 2 tabs

  19. Generalized extended Navier-Stokes theory

    DEFF Research Database (Denmark)

    Hansen, J. S.; Daivis, Peter J.; Dyre, Jeppe C.

    2013-01-01

    in molecular fluids. To discuss these phenomena in detail, molecular dynamics simulations of molecular chlorine are performed for three different state points. In general, the theory captures the behavior for small wavevector and frequencies as expected. For example, in the hydrodynamic regime......The extended Navier-Stokes theory accounts for the coupling between the translational and rotational molecular degrees of freedom. In this paper, we generalize this theory to non-zero frequencies and wavevectors, which enables a new study of spatio-temporal correlation phenomena present...... and for molecular fluids with small moment of inertia like chlorine, the theory predicts that the longitudinal and transverse intrinsic angular velocity correlation functions are almost identical, which is also seen in the molecular dynamics simulations. However, the theory fails at large wavevector and frequencies...

  20. Affordances and the musically extended mind

    Directory of Open Access Journals (Sweden)

    Joel eKrueger

    2014-01-01

    Full Text Available I defend a model of the musically extended mind. I consider how acts of musicking grant access to novel emotional experiences otherwise inaccessible. First, I discuss the idea of musical affordances and specify both what musical affordances are and how they invite different forms of entrainment. Next, I argue that musical affordances—via soliciting different forms of entrainment—enhance the functionality of various endogenous, emotion-granting regulative processes, drawing novel experiences out of us with an expanded complexity and phenomenal character. I suggest that music therefore ought to be thought of as part of the vehicle needed to realize these emotional experiences. I appeal to different sources of empirical work to develop this idea.

  1. Extending Sociotechnical design to project conception

    DEFF Research Database (Denmark)

    Kampf, Constance

    2009-01-01

    between knowledge and technology through knowledge communication processes, cultural and rhetorical contexts. This connection is examined from a process point of view through the development of project goals and objectives to situate technology. The data comes from a Project Management course in which...... the students were asked to design and plan projects to situate a mobile phone game in the social context around a museum in Helsinki or their online course management system.   The paper traces the evolution of students' project goals and objectives with respect to knowledge communication theory, demonstrating...... the potential of knowledge communication concepts for socio-technical design processes, as well as the implications of socio-technical design processes in extending our understanding of knowledge communication. Keywords: Knowledge Communication, Knowledge Management, Socio-Technical Design, Project Management....

  2. Properties of sulfur-extended asphalt concrete

    Directory of Open Access Journals (Sweden)

    Gladkikh Vitaliy

    2016-01-01

    Full Text Available Currently, increased functional reliability of asphalt concrete coatings associated with various modifying additives that improve the durability of pavements. Promising builder is a technical sulfur. Asphalt concrete, made using a complex binder consisting of petroleum bitumen and technical sulfur, were calledsSulfur-Extended Asphalt Concrete. Such asphalt concrete, due to changes in the chemical composition of particulate and bitumen, changes the intensity of the interaction at the interface have increased rates of physical and mechanical properties. There was a lack of essential knowledge concerning mechanical properties of the sulfur-bituminous concrete with such an admixture; therefore, we had carried out the necessary examination. It is revealed that a new material satisfies local regulations in terms of compressive and tensile strength, shear resistance, and internal friction.

  3. Life extending control: An interdisciplinary engineering thrust

    Science.gov (United States)

    Lorenzo, Carl F.; Merrill, Walter C.

    1991-01-01

    The concept of Life Extending Control (LEC) is introduced. Possible extensions to the cyclic damage prediction approach are presented based on the identification of a model from elementary forms. Several candidate elementary forms are presented. These extensions will result in a continuous or differential form of the damage prediction model. Two possible approaches to the LEC based on the existing cyclic damage prediction method, the measured variables LEC and the estimated variables LEC, are defined. Here, damage estimates or measurements would be used directly in the LEC. A simple hydraulic actuator driven position control system example is used to illustrate the main ideas behind LEC. Results from a simple hydraulic actuator example demonstrate that overall system performance (dynamic plus life) can be maximized by accounting for component damage in the control design.

  4. Extended Endoscopic Endonasal Approach for Suprasellar Craniopharyngioma.

    Science.gov (United States)

    Locatelli, D; Pozzi, F; Agresta, G; Padovan, S; Karligkiotis, A; Castelnuovo, P

    2018-02-01

    Objectives  We illustrate a suprasellar craniopharyngiomas treated with an extended endoscopic endonasal approach (EEEA). Design  Case report of a 43-year-old male affected by cerebral lesion located in suprasellar region involving the third ventricle and compressing the neurovascular structures, causing an anterosuperior dislocation of the chiasma. There is a complete disruption of the pituitary stalk that can explain the clinical finding of partial anterior hypopituitarism and hyperprolactinemia. The lesion is characterized by a solid and cystic component. Considering the absence of lateral extension and the suprasellar location of the lesion, an EEEA is preferred. Setting  University Hospital "Ospedale di Circolo," Department of Neurosurgery, Varese, Italy. Participants  Neurosurgical and ENT Skull Base Team. Main Outcome Measures  A bilateral parasagittal approach is performed using a four-hand technique. The first step of the surgery is the preparation of the Hadad's flap. The approach is extended to the planum sphenoidalis to expose the suprasellar region. The lesion is completely removed employing also an ultrasound aspirator. Skull base reconstruction is performed with three-layer technique: graft of fat tissue, fascia lata, and nasoseptal flap. Results  No postoperative complications occurred. In the post-op, the patient presents a panhypopituitarism and an improvement in neurological status. The visual deficit remains stable. Post-op magnetic resonance imaging at 1 year documents the complete absence of pathological contrast enhancement. Conclusions  EEEA is a feasible approach in treating craniopharyngioma with suprasellar extension. The advantages include optimal visualization, good resection rate, and absence of brain retraction. The link to the video can be found at: https://youtu.be/IYm-8P1jbBo .

  5. Extended Endoscopic Endonasal Approach for Craniopharyngioma Removal.

    Science.gov (United States)

    Messerer, Mahmoud; Maduri, Rodolfo; Daniel, Roy Thomas

    2018-02-01

    Objective  Endoscopic transsphenoidal extended endoscopic approach (EEA) represents a valid alternative to microsurgery for craniopharyngiomas removal, especially for retrochiasmatic lesions without large parasellar extension. The present video illustrates the salient surgical steps of the EEA for craniopahryngioma removal. Patient  A 52-year-old man presented with a bitemporal hemianopia and a bilateral decreased visual acuity. MRI showed a Kassam type III cystic craniopharyngioma with a solid component ( Fig. 1 , panels A and B). Surgical Procedure  The head is rotated 10 degrees toward the surgeons. The nasal step is started through the left nostril with a middle turbinectomy. A nasoseptal flap is harvested and positioned in the left choana. The binostril approach allows a large sphenoidotomy to expose the key anatomic landmarks. The craniotomy boundaries are the planum sphenoidale superiorly, the median opticocarotid recesses, the internal carotid artery laterally and the clival recess inferiorly. After dural opening and superior intercavernous sinus coagulation, the tumor is entirely removed ( Fig. 2 , panels A and B). Skull base reconstruction is ensured by fascia lata grafting and nasoseptal flap positioning. Results  Postoperative MRI showed the complete tumor resection ( Fig. 1 , panels C and D). At 3 months postoperatively, the bitemporal hemianopia regressed and the visual acuity improved. A novel left homonymous hemianopia developed secondary to optic tract manipulation. Conclusions  The extended EEA is a valid surgical approach for craniopharyngioma resection. A comprehensive knowledge of the sellar and parasellar anatomy is mandatory for safe tumor removal with decreased morbidity and satisfactory oncologic results. The link to the video can be found at: https://youtu.be/NrCPPnVK2qA .

  6. The extending lithosphere (Arthur Holmes Medal Lecture)

    Science.gov (United States)

    Brun, Jean-Pierre

    2017-04-01

    Extension of the lithosphere gives birth to a wide range of structures, with characteristic widths between 10 and 1000 km, which includes continental rifts, passive margins, oceanic rifts, core complexes, or back-arc basins. Because the rheology of rocks strongly depends on temperature, this variety of extensional structures falls in two broad categories of extending lithospheres according to the initial Moho temperature TM. "Cold extending systems", with TM 750°C and crustal-dominated strength, lead, depending on strain rate, to either wide rifts or metamorphic core complexes. A much less quoted product of extension is the exhumation of high-pressure (HP ) metamorphic rocks occurring in domains of back-arc extension driven by slab rollback (e.g. Aegean; Appennines-Calabrian) or when the subduction upper plate undergoes extension for plate kinematics reasons (e.g. Norwegian Caledonides; Papua New Guinea). In these tectonic environments, well-documented pressure-temperature-time (P - T - t) paths of HP rocks show a two-stage retrogression path whose the first part corresponds to an isothermal large pressure drop ΔP proportional to the maximum pressure Pmax recorded by the rocks. This linear relation between ΔP and Pmax, which likely results from a stress switch between compression and extension at the onset of exhumation, is in fact observed in all HP metamorphism provinces worldwide, suggesting that the exhumation of HP rocks in extension is a general process rather than an uncommon case. In summary, the modes and products of extension are so diverse that, taken all together, they constitute a very versatile natural laboratory to decipher the rheological complexities of the continental lithosphere and their mechanical implications.

  7. Functional theory of extended Coulomb systems

    International Nuclear Information System (INIS)

    Martin, R.M.; Ortiz, G.

    1997-01-01

    A consistent formulation is presented for a functional theory of extended quantum many-particle systems with long-range Coulomb interactions, which extends the density-functional theory of Hohenberg and Kohn to encompass the theory of dielectrics formulated in terms of electric fields and polarization. We show that a complete description of insulators in the thermodynamic limit requires a functional of density and macroscopic polarization; nevertheless, for any insulator the state with zero macroscopic electric field can be considered a reference state that is a functional of the density alone. Dielectric phenomena involve the behavior of the material in the presence of macroscopic electric fields that induce changes of the macroscopic polarization from its equilibrium value in the reference state. In the thermodynamic limit there is strictly no ground state and constraints must be placed upon the electronic wave functions in order to have a well-defined energy functional; within these constrained subspaces the Hohenberg-Kohn theorems can be generalized in terms of the density and the change in the macroscopic polarization. The essential role of the polarization is shown by an explicit example of two potentials that lead to the same periodic density in a crystal, but different macroscopic electric fields and polarization. In the Kohn-Sham approach both the kinetic and the exchange-correlation energy are shown to depend upon the changes in polarization; this leads to generalized Kohn-Sham equations with a nonlocal operator. The effect can be traced to the polarization of the average exchange-correlation hole itself in the presence of macroscopic fields, which is essential for an exact description of static dielectric phenomena. copyright 1997 The American Physical Society

  8. Extended driving impairs nocturnal driving performances.

    Directory of Open Access Journals (Sweden)

    Patricia Sagaspe

    Full Text Available Though fatigue and sleepiness at the wheel are well-known risk factors for traffic accidents, many drivers combine extended driving and sleep deprivation. Fatigue-related accidents occur mainly at night but there is no experimental data available to determine if the duration of prior driving affects driving performance at night. Participants drove in 3 nocturnal driving sessions (3-5 am, 1-5 am and 9 pm-5 am on open highway. Fourteen young healthy men (mean age [+/-SD] = 23.4 [+/-1.7] years participated Inappropriate line crossings (ILC in the last hour of driving of each session, sleep variables, self-perceived fatigue and sleepiness were measured. Compared to the short (3-5 am driving session, the incidence rate ratio of inappropriate line crossings increased by 2.6 (95% CI, 1.1 to 6.0; P<.05 for the intermediate (1-5 am driving session and by 4.0 (CI, 1.7 to 9.4; P<.001 for the long (9 pm-5 am driving session. Compared to the reference session (9-10 pm, the incidence rate ratio of inappropriate line crossings were 6.0 (95% CI, 2.3 to 15.5; P<.001, 15.4 (CI, 4.6 to 51.5; P<.001 and 24.3 (CI, 7.4 to 79.5; P<.001, respectively, for the three different durations of driving. Self-rated fatigue and sleepiness scores were both positively correlated to driving impairment in the intermediate and long duration sessions (P<.05 and increased significantly during the nocturnal driving sessions compared to the reference session (P<.01. At night, extended driving impairs driving performances and therefore should be limited.

  9. Flow Range of Centrifugal Compressor Being Extended

    Science.gov (United States)

    Skoch, Gary J.

    2001-01-01

    General Aviation will benefit from turbine engines that are both fuel-efficient and reliable. Current engines fall short of their potential to achieve these attributes. The reason is compressor surge, which is a flow stability problem that develops when the compressor is subjected to conditions that are outside of its operating range. Compressor surge can occur when fuel flow to the engine is increased, temporarily back pressuring the compressor and pushing it past its stability limit, or when the compressor is subjected to inlet flow-field distortions that may occur during takeoff and landing. Compressor surge can result in the loss of an aircraft. As a result, engine designers include a margin of safety between the operating line of the engine and the stability limit line of the compressor. Unfortunately, the most efficient operating line for the compressor is usually closer to its stability limit line than it is to the line that provides an adequate margin of safety. A wider stable flow range will permit operation along the most efficient operating line of the compressor, improving the specific fuel consumption of the engine and reducing emissions. The NASA Glenn Research Center is working to extend the stable flow range of the compressor. Significant extension has been achieved in axial compressors by injecting air upstream of the compressor blade rows. Recently, the technique was successfully applied to a 4:1 pressure ratio centrifugal compressor by injecting streams of air into the diffuser. Both steady and controlled unsteady injection were used to inject air through the diffuser shroud surface and extend the range. Future work will evaluate the effect of air injection through the diffuser hub surface and diffuser vanes with the goal of maximizing the range extension while minimizing the amount of injected air that is required.

  10. Planning of the Extended Reach well Dieksand 2; Planung der Extended Reach Bohrung Dieksand 2

    Energy Technology Data Exchange (ETDEWEB)

    Frank, U.; Berners, H. [RWE-DEA AG, Hamburg (Germany). Drilling Team Mittelplate und Dieksand; Hadow, A.; Klop, G.; Sickinger, W. [Wintershall AG Erdoelwerke, Barnstdorf (Germany); Sudron, K.

    1998-12-31

    The Mittelplate oil field is located 7 km offshore the town of Friedrichskoog. Reserves are estimated at 30 million tonnes of oil. At a production rate of 2,500 t/d, it will last about 33 years. The transport capacity of the offshore platform is limited, so that attempts were made to enhance production by constructing the extended reach borehole Dieksand 2. Details are presented. (orig.) [Deutsch] Das Erdoelfeld Mittelplate liegt am suedlichen Rand des Nationalparks Schleswig Holsteinisches Wattenmeer, ca. 7000 m westlich der Ortschaft Friedrichskoog. Die gewinnbaren Reserven betragen ca. 30 Millionen t Oel. Bei einer Foerderkapazitaet von 2.500 t/Tag betraegt die Foerderdauer ca. 33 Jahre. Aufgrund der begrenzten Transportkapazitaeten von der Insel, laesst sich durch zusaetzliche Bohrungen von der kuenstlichen Insel Mittelplate keine entscheidende Erhoehung der Foerderkapazitaet erzielen. Ab Sommer 1996 wurde erstmals die Moeglichkeit der Lagerstaettenerschliessung von Land untersucht. Ein im Mai 1997 in Hamburg etabliertes Drilling Team wurde mit der Aufgabe betraut, die Extended Reach Bohrung Dieksand 2 zu planen und abzuteufen. Die Planungsphasen fuer die Extended Reach Bohrung Dieksand 2 wurden aufgezeigt. Die fuer den Erfolg einer Extended Reach Bohrung wichtigen Planungsparameter wurden erlaeutert. Es wurden Wege gezeigt, wie bei diesem Projekt technische und geologische Risiken in der Planung mit beruecksichtigt und nach Beginn der Bohrung weiter bearbeitet werden koennen. (orig.)

  11. Extended mind and after: socially extended mind and actor-network.

    Science.gov (United States)

    Kono, Tetsuya

    2014-03-01

    The concept of extended mind has been impressively developed over the last 10 years by many philosophers and cognitive scientists. The extended mind thesis (EM) affirms that the mind is not simply ensconced inside the head, but extends to the whole system of brain-body-environment. Recently, some philosophers and psychologists try to adapt the idea of EM to the domain of social cognition research. Mind is socially extended (SEM). However, EM/SEM theory has problems to analyze the interactions among a subject and its surroundings with opposition, antagonism, or conflict; it also tends to think that the environment surrounding the subject is passive or static, and to neglect the power of non-human actants to direct and regulate the human subject. In these points, actor-network theory (ANT) proposed by Latour and Callon is more persuasive, while sharing some important ideas with EM/SEM theory. Actor-network is a hybrid community which is composed of a series of heterogeneous elements, animate and inanimate for a certain period of time. I shall conclude that EM/SEM could be best analyzed as a special case of actor-network. EM/SEM is a system which can be controlled by a human agent alone. In order to understand collective behavior, philosophy and psychology have to study the actor-network in which human individuals are situated.

  12. Center for Extended Magnetohydrodynamic Modeling Cooperative Agreement

    International Nuclear Information System (INIS)

    Sovinec, Carl R.

    2008-01-01

    The Center for Extended Magnetohydrodynamic Modeling (CEMM) is developing computer simulation models for predicting the behavior of magnetically confined plasmas. Over the first phase of support from the Department of Energy's Scientific Discovery through Advanced Computing (SciDAC) initiative, the focus has been on macroscopic dynamics that alter the confinement properties of magnetic field configurations. The ultimate objective is to provide computational capabilities to predict plasma behavior - not unlike computational weather prediction - to optimize performance and to increase the reliability of magnetic confinement for fusion energy. Numerical modeling aids theoretical research by solving complicated mathematical models of plasma behavior including strong nonlinear effects and the influences of geometrical shaping of actual experiments. The numerical modeling itself remains an area of active research, due to challenges associated with simulating multiple temporal and spatial scales. The research summarized in this report spans computational and physical topics associated with state of the art simulation of magnetized plasmas. The tasks performed for this grant are categorized according to whether they are primarily computational, algorithmic, or application-oriented in nature. All involve the development and use of the Non-Ideal Magnetohydrodynamics with Rotation, Open Discussion (NIMROD) code, which is described at http://nimrodteam.org. With respect to computation, we have tested and refined methods for solving the large algebraic systems of equations that result from our numerical approximations of the physical model. Collaboration with the Terascale Optimal PDE Solvers (TOPS) SciDAC center led us to the SuperLU-DIST software library for solving large sparse matrices using direct methods on parallel computers. Switching to this solver library boosted NIMROD's performance by a factor of five in typical large nonlinear simulations, which has been publicized

  13. Extended replacement of the thoracic aorta.

    Science.gov (United States)

    Hino, Yutaka; Okada, Kenji; Oka, Takanori; Inoue, Takeshi; Tanaka, Akiko; Omura, Atsushi; Kano, Hiroya; Okita, Yutaka

    2013-01-01

    We present our experience of total aortic arch replacement. Twenty-nine patients (21 males and 8 females; mean age 63.3 ± 13.3 years) with extended thoracic aortic aneurysms underwent graft replacement. The pathology of the diseased aorta was non-dissecting aneurysm in 11 patients, including one aortitis and aortic dissection in 18 patients (acute type A: one, chronic type A: 11, chronic type B: six). Five patients had Marfan syndrome. In their previous operation, two patients had undergone the Bentall procedure, three had endovascular stenting, one had aortic root replacement with valve sparing and 12 had hemi-arch replacement for acute type A dissection. Approaches to the aneurysm were as follows: posterolateral thoracotomy with rib-cross incision in 16, posterolateral thoracotomy extended to the retroperitoneal abdominal aorta in seven, mid-sternotomy and left pleurotomy in three, anterolateral thoracotomy with partial lower sternotomy in two and clam-shell incision in one patient. Extension of aortic replacement was performed from the aortic root to the descending aorta in 4, from the ascending aorta to the descending aorta in 17 and from the ascending to the abdominal aorta in eight patients. Arterial inflow for cardiopulmonary bypass consisted of the femoral artery in 15 patients, ascending aorta and femoral artery in seven, descending or abdominal aorta in five and ascending aorta in two. Venous drainage site was the femoral vein in 10, pulmonary artery in eight, right atrium in five, femoral artery with right atrium/pulmonary artery in four and pulmonary artery with right atrium in two patients. The operative mortality, 30-day mortality and hospital mortality was one (cardiac arrest due to aneurysm rupture), one (rupture of infected aneurysm) and one (brain contusion), respectively. Late mortality occurred in three patients due to pneumonia, ruptured residual aneurysm and intracranial bleeding. Actuarial survival at 5 years after the operations was 80.6

  14. Extended blackout mitigation strategy for PWR

    International Nuclear Information System (INIS)

    Prošek, Andrej; Volkanovski, Andrija

    2015-01-01

    Highlights: • Equipment for mitigation of the extended blackout is investigated. • Analysis is done with deterministic safety analysis methods. • Strategy to prevent core heatup and not overfill steam generator is proposed. • Six types of reactor coolant system loss scenarios are investigated. • Pump flowrates and available start time to feed steam generators is determined. - Abstract: The accident at the Fukushima Daiichi nuclear power plant demonstrated the vulnerability of the plants on the loss of electrical power and loss of the ultimate heat sink events. A set of measures are proposed and currently implemented in response of the accident at the Fukushima Daiichi nuclear power plant. Those measures include diverse and flexible mitigation strategies that increase the defence-in-depth for beyond-design-basis scenarios. Mitigation strategies are based on the utilization of the portable equipment to provide power and water to the nuclear power plants in order to maintain or restore key safety functions. The verification of the proposed measures with the plant specific safety analyses is endorsed in the mitigation strategies. This paper investigates utilization of the turbine driven auxiliary feedwater pump (TD-AFW) or portable water injection pump for the mitigation of the event of loss of all alternate current sources and batteries (extended station blackout). Methodology for assessment of the required pump injection flow rate with the application of the standard deterministic safety analysis code is developed and presented. The required injection rate to the steam generators is calculated from the cumulative water mass injected by the turbine driven auxiliary feedwater pump in the analysed scenarios, when desired normal level is maintained automatically. The developed methodology allows assessment of the required injections rates of pump, TD-AFW or portable, for different plant configurations and number of flow rate changes. The methodology is applied

  15. Extended blackout mitigation strategy for PWR

    Energy Technology Data Exchange (ETDEWEB)

    Prošek, Andrej, E-mail: andrej.prosek@ijs.si; Volkanovski, Andrija, E-mail: andrija.volkanovski@ijs.si

    2015-12-15

    Highlights: • Equipment for mitigation of the extended blackout is investigated. • Analysis is done with deterministic safety analysis methods. • Strategy to prevent core heatup and not overfill steam generator is proposed. • Six types of reactor coolant system loss scenarios are investigated. • Pump flowrates and available start time to feed steam generators is determined. - Abstract: The accident at the Fukushima Daiichi nuclear power plant demonstrated the vulnerability of the plants on the loss of electrical power and loss of the ultimate heat sink events. A set of measures are proposed and currently implemented in response of the accident at the Fukushima Daiichi nuclear power plant. Those measures include diverse and flexible mitigation strategies that increase the defence-in-depth for beyond-design-basis scenarios. Mitigation strategies are based on the utilization of the portable equipment to provide power and water to the nuclear power plants in order to maintain or restore key safety functions. The verification of the proposed measures with the plant specific safety analyses is endorsed in the mitigation strategies. This paper investigates utilization of the turbine driven auxiliary feedwater pump (TD-AFW) or portable water injection pump for the mitigation of the event of loss of all alternate current sources and batteries (extended station blackout). Methodology for assessment of the required pump injection flow rate with the application of the standard deterministic safety analysis code is developed and presented. The required injection rate to the steam generators is calculated from the cumulative water mass injected by the turbine driven auxiliary feedwater pump in the analysed scenarios, when desired normal level is maintained automatically. The developed methodology allows assessment of the required injections rates of pump, TD-AFW or portable, for different plant configurations and number of flow rate changes. The methodology is applied

  16. Analysis of RTM extended images for VTI media

    KAUST Repository

    Li, Vladimir; Tsvankin, Ilya; Alkhalifah, Tariq Ali

    2015-01-01

    velocity analysis remain generally valid in the extended image space for complex media. The dependence of RMO on errors in the anisotropy parameters provides essential insights for anisotropic wavefield tomography using extended images.

  17. Fluorene: An extended experimental thermodynamic study

    International Nuclear Information System (INIS)

    Monte, Manuel J.S.; Pinto, Sónia P.; Lobo Ferreira, Ana I.M.C.; Amaral, Luísa M.P.F.; Freitas, Vera L.S.; Ribeiro da Silva, Maria D.M.C.

    2012-01-01

    Highlights: ► Experimental results of an extended thermodynamic study on fluorene are presented. ► Enthalpy of combustion and vapor pressures of liquid and crystalline phase were measured. ► Enthalpy of sublimation was derived from three different experimental methods. ► New values of enthalpies of sublimation and of formation of fluorene are recommended. - Abstract: This work reports new experimental thermodynamic results on fluorene. Vapor pressures of both crystalline and liquid phases were measured using a pressure gauge (capacitance diaphragm manometer) and Knudsen effusion methods over a wide temperature range (292.20 to 412.16) K yielding accurate determination of enthalpy and entropy of sublimation and of vaporization. The enthalpy of sublimation was also determined using Calvet microcalorimetry. The enthalpy of fusion was derived from vapor pressure results and from d.s.c. experiments. Static bomb calorimetry was used to determine the enthalpy of combustion of fluorene from which the standard enthalpy of formation in the crystalline phase was calculated. The enthalpy of formation in the gaseous phase was calculated combining the result derived for the crystalline phase with the enthalpy of sublimation.

  18. Mechanics of extended masses in general relativity

    International Nuclear Information System (INIS)

    Harte, Abraham I

    2012-01-01

    The 'external' or 'Right' motion of extended bodies is studied in general relativity. Compact material objects of essentially arbitrary shape, spin, internal composition and velocity are allowed as long as there is no direct (non-gravitational) contact with other sources of stress-energy. Physically reasonable linear and angular momenta are proposed for such bodies and exact equations describing their evolution are derived. Changes in the momenta depend on a certain 'effective metric' that is closely related to a non-perturbative generalization of the Detweiler-Whiting R-field originally introduced in the self-force literature. If the effective metric inside a self-gravitating body can be adequately approximated by an appropriate power series, the instantaneous gravitational force and torque exerted on it is shown to be identical to the force and torque exerted on an appropriate test body moving in the effective metric. This result holds to all multipole orders. The only instantaneous effect of a body's self-field is to finitely renormalize the 'bare' multipole moments of its stress-energy tensor. The MiSaTaQuWa expression for the gravitational self-force is recovered as a simple application. A gravitational self-torque is obtained as well. Lastly, it is shown that the effective metric in which objects appear to move is approximately a solution to the vacuum Einstein equation if the physical metric is an approximate solution to Einstein's equation linearized about a vacuum background. (paper)

  19. Constraints based analysis of extended cybernetic models.

    Science.gov (United States)

    Mandli, Aravinda R; Venkatesh, Kareenhalli V; Modak, Jayant M

    2015-11-01

    The cybernetic modeling framework provides an interesting approach to model the regulatory phenomena occurring in microorganisms. In the present work, we adopt a constraints based approach to analyze the nonlinear behavior of the extended equations of the cybernetic model. We first show that the cybernetic model exhibits linear growth behavior under the constraint of no resource allocation for the induction of the key enzyme. We then quantify the maximum achievable specific growth rate of microorganisms on mixtures of substitutable substrates under various kinds of regulation and show its use in gaining an understanding of the regulatory strategies of microorganisms. Finally, we show that Saccharomyces cerevisiae exhibits suboptimal dynamic growth with a long diauxic lag phase when growing on a mixture of glucose and galactose and discuss on its potential to achieve optimal growth with a significantly reduced diauxic lag period. The analysis carried out in the present study illustrates the utility of adopting a constraints based approach to understand the dynamic growth strategies of microorganisms. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Conceptual Framework To Extend Life Cycle Assessment ...

    Science.gov (United States)

    Life Cycle Assessment (LCA) is a decision-making tool that accounts for multiple impacts across the life cycle of a product or service. This paper presents a conceptual framework to integrate human health impact assessment with risk screening approaches to extend LCA to include near-field chemical sources (e.g., those originating from consumer products and building materials) that have traditionally been excluded from LCA. A new generation of rapid human exposure modeling and high-throughput toxicity testing is transforming chemical risk prioritization and provides an opportunity for integration of screening-level risk assessment (RA) with LCA. The combined LCA and RA approach considers environmental impacts of products alongside risks to human health, which is consistent with regulatory frameworks addressing RA within a sustainability mindset. A case study is presented to juxtapose LCA and risk screening approaches for a chemical used in a consumer product. The case study demonstrates how these new risk screening tools can be used to inform toxicity impact estimates in LCA and highlights needs for future research. The framework provides a basis for developing tools and methods to support decision making on the use of chemicals in products. This paper presents a conceptual framework for including near-field exposures into Life Cycle Assessment using advanced human exposure modeling and high-throughput tools

  1. An extended chemical analysis of gallstone.

    Science.gov (United States)

    Chandran, P; Kuchhal, N K; Garg, P; Pundir, C S

    2007-09-01

    Chemical composition of gall stones is essential for aetiopathogensis of gallstone disease. We have reported quantitative chemical analysis of total cholesterol bilirubin, calcium, iron and inorganic phosphate in 120 gallstones from haryana. To extend this chemical analysis of gall stones by studying more cases and by analyzing more chemical constituents. A quantitative chemical analysis of total cholesterol, total bilirubin, fatty acids, triglycerides, phospholipids, bile acids, soluble proteins, sodium potassium, magnesium, copper, oxalate and chlorides of biliary calculi (52 cholesterol, 76 mixed and 72 pigment) retrieved from surgical operation of 200 patients from Haryana state was carried out. Total cholesterol as the major component and total bilirubin, phospholipids, triglycerides, bile acids, fatty acids (esterified), soluble protein, calcium, magnesium, iron, copper, sodium, potassium, inorganic phosphate, oxalate and chloride as minor components were found in all types of calculi. The cholesterol stones had higher content of total cholesterol, phospholipids, fatty acids (esterified), inorganic phosphate and copper compared to mixed and pigment stones. The mixed stones had higher content of iron and triglycerides than to cholesterol and pigment stones. The pigment stones were richer in total bilirubin, bile acids, calcium, oxalate, magnesium, sodium, potassium, chloride and soluble protein compared to cholesterol and mixed stones. Although total cholesterol was a major component of cholesterol, mixed and pigment gall stone in Haryana, the content of most of the other lipids, cations and anions was different in different gall stones indicating their different mechanism of formation.

  2. Flavor-changing processes in extended technicolor

    International Nuclear Information System (INIS)

    Appelquist, Thomas; Piai, Maurizio; Christensen, Neil; Shrock, Robert

    2004-01-01

    We analyze constraints on a class of extended technicolor (ETC) models from neutral flavor-changing processes induced by (dimension-six) four-fermion operators. The ETC gauge group is taken to commute with the standard model gauge group. The models in the class are distinguished by how the left- and right-handed (L,R) components of the quarks and charged leptons transform under the ETC group. We consider K 0 -K 0 and other pseudoscalar meson mixings, and conclude that they are adequately suppressed if the L and R components of the relevant quarks are assigned to the same (fundamental or conjugate-fundamental) representation of the ETC group. Models in which the L and R components of the down-type quarks are assigned to relatively conjugate representations, while they can lead to realistic CKM mixing and intrafamily mass splittings, do not adequately suppress these mixing processes. We identify an approximate global symmetry that elucidates these behavioral differences and can be used to analyze other possible representation assignments. Flavor-changing decays, involving quarks and/or leptons, are adequately suppressed for any ETC representation assignment of the L and R components of the quarks, as well as the leptons. We draw lessons for future ETC model building

  3. International symposium on marine pollution. Extended synopses

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-12-31

    The marine environment - understanding and protecting for the future were at the forefront of the International Symposium on Marine Pollution convened in Monaco from 5 to 9 October 1998, as one of the major events of the UN International Year of the Oceans. New achievements were reported in identifying the sources of pollution, on the behaviour and fate of contaminants in seawater, biota and sediments, on the use of radioactive and non-radioactive tracers for studies of transport and circulation processes in the world`s oceans and seas, on studies of radioactive waste dumping sites and nuclear weapons test sites, on local, regional and global computer modelling of the transport of contaminants and on many other topics in marine pollution. New developments in high sensitivity analytical measurements of contaminants with emphasis on nuclear and isotopic methods were also presented. This document contains extended synopses of 390 oral and poster presentations made at the symposium. Each synopsis was indexed separately. Refs, figs, tabs

  4. Extended suicide using an atypical stud gun.

    Science.gov (United States)

    Hagemeier, L; Schyma, C; Madea, B

    2009-08-10

    Suicides with stud guns are uncommon, but are well documented in the literature. On rare occasions, stud guns are also used as a homicide weapon. This case report describes an extended suicide in which a husband killed his wife and their two dogs, which lived on the property. The husband then committed suicide with a shot from the stud gun into his skull. He was a 70-year-old pensioner, a retired butcher, who was found by his son. He was lying in a supine position on a carpet in the living room, with the stud gun stuck in his skull. During autopsy, high concentrations of an antihistamine were found in the blood of each corpse; this drug is used as a soporific. In contrast to the literature, which mainly describes powder deposits due to the use of conventional stud guns, in this case a stud gun was used in which the expanding gases and powder escaped together with the central bolt at the front of the device; powder drains were not involved. Detailed findings of the autopsy are given with reference to this type of stud gun.

  5. Extended BRS algebra and color confinement

    International Nuclear Information System (INIS)

    Shintani, Meiun.

    1984-02-01

    We examine the color confinement scheme and its realizations proposed by Kugo and Ojima. Using the Nakanishi's theorem, we obtain a representation of the extended BRS algebra compatible with the so-called K-O condition of their confinement criteria. However, it turns out that the representation is not physically acceptable, and thus their scheme lacks self-consistency at the level of realizations. We also clarify what kind of ghost structures are suggested by the well-definedness or ill-definedness of the charge operator Nsup(a) constituting a part of the global color charge operator. It is shown that there are four possible cancellation mechanisms of ghosts. In particular, it turns out that the octet of ghosts suggested by Nishijima in his confinement theory arises from the well-definedness of the Nsup(a) charge, whereas the elementary quartet arises from the ill-definedness of the Nsup(a). Moreover, from the octet structures, we deduce the confinement condition which replaces the K-O condition. (author)

  6. Economics and extended longevity: a case study.

    Science.gov (United States)

    Gori, G B; Richter, B J; Yu, W K

    1984-07-01

    Preventive and therapeutic advances have brought life expectancy in the United States to well over 70 years and have shifted mortality causes from acute to chronic diseases, the determinants of which are genetics, lifestyle, the environment, and aging itself. Plausible approaches to chronic disease prevention are likely to increase longevity further, with some foreseeable effects on demographic and economic projections. Primarily, longevity advances would swell forecasts of population size, and would thus have to be met by production advances in order to maintain or improve living standards. This study, a restricted example, considers the probable demographic and economic consequences of a limited prevention program in the context of the Ford Motor Company, based on actual experience and certain expectations up to the year 2000. According to the results, prevention would reduce outlays for life insurance, disability, and health care, but would also generate the higher costs of extending pension plans. Undoubtedly, prevention will continue to be highly ranked in society's pursuit of happiness, and society must prepare to meet its effects with appropriate social and economic policies.

  7. Extending CANTUP code analysis to probabilistic evaluations

    International Nuclear Information System (INIS)

    Florea, S.

    2001-01-01

    The structural analysis with numerical methods based on final element method plays at present a central role in evaluations and predictions of structural systems which require safety and reliable operation in aggressive environmental conditions. This is the case too for the CANDU - 600 fuel channel, where besides the corrosive and thermal aggression upon the Zr97.5Nb2.5 pressure tubes, a lasting irradiation adds which has marked consequences upon the materials properties evolution. This results in an unavoidable spreading in the materials properties in time, affected by high uncertainties. Consequently, the deterministic evaluation with computation codes based on finite element method are supplemented by statistic and probabilistic methods of evaluation of the response of structural components. This paper reports the works on extending the thermo-mechanical evaluation of the fuel channel components in the frame of probabilistic structure mechanics based on statistical methods and developed upon deterministic CANTUP code analyses. CANTUP code was adapted from LAHEY 77 platform onto Microsoft Developer Studio - Fortran Power Station 4.0 platform. To test the statistical evaluation of the creeping behaviour of pressure tube, the value of longitudinal elasticity modulus (Young) was used, as random variable, with a normal distribution around value, as used in deterministic analyses. The influence of the random quantity upon the hog and effective stress developed in the pressure tube for to time values, specific to primary and secondary creep was studied. The results obtained after a five year creep, corresponding to the secondary creep are presented

  8. Extended trochanteric osteotomy: current concepts review.

    Science.gov (United States)

    Sambandam, Senthil Nathan; Duraisamy, Gopinath; Chandrasekharan, Jayadev; Mounasamy, Varatharaj

    2016-04-01

    Revision total hip arthroplasty is a technically demanding procedure which has gained importance for more than two decades. It was a nightmare for revision surgeons during its initial years of inception before the advent of extended trochanteric osteotomy (ETO). This technique gains access to the femoral medullary canal without compromising the bone stock and aids removal of primary implant and cement mantle without further damaging the parent bone. Like any other surgery, ETO does have certain limitations and complications as reported by various authors. Though it has been routinely used by revision surgeons, thorough knowledge of technical details of ETO is still lacking. So this review article is aimed at addressing the indications, surgical procedure, fixation technique, implant selection and complication of ETO which has been presented over a period of years by various authors. We searched in the most commonly used portals like MEDLINE (PubMed) and Google scholar using appropriate terminologies for the literature regarding the various preoperative, intraoperative and postoperative clinical scenarios in which revision surgeons utilized ETO. ETO is an important tool in the revision surgeon's armamentarium and can be used in variety of clinical scenarios and for various intraoperative needs and goals. Awareness about biomechanics of ETO, indications, implants selection, fixation techniques and complications is paramount for good intraoperative and postoperative outcome. ETO by posterior approach continues to be a work horse approach for most revision surgeons all over the world.

  9. Nicotinamide extends replicative lifespan of human cells.

    Science.gov (United States)

    Kang, Hyun Tae; Lee, Hyung Il; Hwang, Eun Seong

    2006-10-01

    We found that an ongoing application of nicotinamide to normal human fibroblasts not only attenuated expression of the aging phenotype but also increased their replicative lifespan, causing a greater than 1.6-fold increase in the number of population doublings. Although nicotinamide by itself does not act as an antioxidant, the cells cultured in the presence of nicotinamide exhibited reduced levels of reactive oxygen species (ROS) and oxidative damage products associated with cellular senescence, and a decelerated telomere shortening rate without a detectable increase in telomerase activity. Furthermore, in the treated cells growing beyond the original Hayflick limit, the levels of p53, p21WAF1, and phospho-Rb proteins were similar to those in actively proliferating cells. The nicotinamide treatment caused a decrease in ATP levels, which was stably maintained until the delayed senescence point. Nicotinamide-treated cells also maintained high mitochondrial membrane potential but a lower respiration rate and superoxide anion level. Taken together, in contrast to its demonstrated pro-aging effect in yeast, nicotinamide extends the lifespan of human fibroblasts, possibly through reduction in mitochondrial activity and ROS production.

  10. Extending ITER materials design to welded joints

    Energy Technology Data Exchange (ETDEWEB)

    Tavassoli, A.-A.F. [DMN/Dir, CEA/Saclay, Commissariat a l' Energie Atomique, 91191 Gif sur Yvette cedex (France)]. E-mail: tavassoli@cea.fr

    2007-08-01

    This paper extends the ITER materials properties documentation to weld metals and incorporates the needs of Test Blanket Modules for higher temperature materials properties. Since the main structural material selected for ITER is type 316L(N)-IG, the paper is focused on weld metals and joining techniques for this steel. Materials properties data are analysed according to the French design and construction rules for nuclear components (RCC-MR) and design allowables are equally derived using the same rules. Particular attention is paid to the type of weld metal, to the type and position of welding and their influence on the materials properties data and design allowables. The primary goal of this work, starting with 19-12-2 weld metal, is to produce comprehensive materials properties documentations that when combined with codification and inspection documents would satisfy ITER licensing needs. As a result, structural stability and capability of welded joints during manufacturing of ITER components and their subsequent service, including the effects of irradiation and eventual incidental or accidental situations, are also covered.

  11. The Extended Baryonic Halo of NGC 3923

    Directory of Open Access Journals (Sweden)

    Bryan W. Miller

    2017-07-01

    Full Text Available Galaxy halos and their globular cluster systems build up over time by the accretion of small satellites. We can learn about this process in detail by observing systems with ongoing accretion events and comparing the data with simulations. Elliptical shell galaxies are systems that are thought to be due to ongoing or recent minor mergers. We present preliminary results of an investigation of the baryonic halo—light profile, globular clusters, and shells/streams—of the shell galaxy NGC 3923 from deep Dark Energy Camera (DECam g and i-band imaging. We present the 2D and radial distributions of the globular cluster candidates out to a projected radius of about 185 kpc, or ∼ 37 R e , making this one of the most extended cluster systems studied. The total number of clusters implies a halo mass of M h ∼ 3 × 10 13 M ⊙ . Previous studies had identified between 22 and 42 shells, making NGC 3923 the system with the largest number of shells. We identify 23 strong shells and 11 that are uncertain. Future work will measure the halo mass and mass profile from the radial distributions of the shell, N-body models, and line-of-sight velocity distribution (LOSVD measurements of the shells using the Multi Unit Spectroscopic Explorer (MUSE.

  12. Comments on the extended energy principle

    International Nuclear Information System (INIS)

    Lehnert, B.

    1993-01-01

    The present analysis concerns a plasma confined in a magnetic field, which consists of one part due to the plasma current density and one part due to steady currents in fixed external conductors. Unrestricted free-boundary displacements are studied that lead to an unbalanced pressure force at the plasma boundary and to a corresponding change in potential energy. Thus the total change in energy is due to two factors: (i) the work done against the plasma volume forces, and (ii) the work done against the unbalanced pressure forces at the plasma boundary. These two contributions can be of comparable magnitude. As a consequence, the conventional extended energy principle has to be reconsidered. This reconsideration applies in particular to its final formulation, where unrestricted displacements are made to replace restricted ones in an expression for the potential energy change deduced from the work of the plasma volume force only. The final formulation therefore leads to an incomplete and incorrect result, as caused by a logical jump in the argument when making such a replacement. The conventional MHD analysis on perturbed plasmas thus has to be revised, by taking induced surface currents properly into account. This applies to all plasmas in inhomogeneous externally applied magnetic fields. (Author)

  13. Extended Life Testing of Duplex Ball Bearings

    Science.gov (United States)

    Mobley, Jeffrey; Robertson, Michael; Hodges, Charles

    2016-01-01

    Sierra Nevada Corporation’s Space Systems performed bearing life testing for the Scan Mirror Motor/Encoder Assembly (SMMA), part of the Scan Mirror Assembly on-board the Aerosol Polarimetry Sensor (APS) on the NASA Glory Spacecraft. The baseline bearing life test duration extended beyond the launch date for the Glory Spacecraft; a risk that the program was willing to undertake with the understanding that if any anomalies or failures occurred before the required life was achieved, then the mission objectives or operating profile could be modified on orbit to take those results into account. Even though the Glory Spacecraft failed to reach orbit during its launch in March of 2011, the bearing life testing was continued through a mutual understanding of value between Sierra Nevada Corporation and our customer; with a revised goal of testing to failure rather than completing a required number of life cycles. Life testing thus far has not only exceeded the original mission required life, but has also exceeded the published test data for Cumulative Degradation Factor (CDF) from NASA/CR-2009-215681. Many lessons were learned along the way regarding long life testing. The bearing life test has been temporarily suspended due to test support equipment issues.

  14. Module theory, extending modules and generalizations

    CERN Document Server

    Tercan, Adnan

    2016-01-01

    The main focus of this monograph is to offer a comprehensive presentation of known and new results on various generalizations of CS-modules and CS-rings. Extending (or CS) modules are generalizations of injective (and also semisimple or uniform) modules. While the theory of CS-modules is well documented in monographs and textbooks, results on generalized forms of the CS property as well as dual notions are far less present in the literature. With their work the authors provide a solid background to module theory, accessible to anyone familiar with basic abstract algebra. The focus of the book is on direct sums of CS-modules and classes of modules related to CS-modules, such as relative (injective) ejective modules, (quasi) continuous modules, and lifting modules. In particular, matrix CS-rings are studied and clear proofs of fundamental decomposition results on CS-modules over commutative domains are given, thus complementing existing monographs in this area. Open problems round out the work and establish the...

  15. The preoperative venogram in planning extended craniectomies

    International Nuclear Information System (INIS)

    Lanzieri, C.F.; Duchesneau, P.M.; Rosenbloom, S.A.; Weinstein, M.A.; Sacher, M.

    1987-01-01

    A technique of extended craniectomy sometimes allows removal of large central or transtentorial mass lesions at a single operative sitting because it affords better exposure and control of normal structures. While seeking to avoid multiple craniotomies, this method requires permanent ligation of the transverse venous sinus. Unless there is adequate collateral venous drainage from the ipsilateral hemisphere, the patient is at risk for venous infarction in the post-craniectomy period. The purpose of this study is to propose a method of establishing the presence of collateral venous drainage preoperatively. Each carotid artery is injected with the head in a neutral position and with the head turned to the side ipsilateral to the carotid artery injection in an attempt to divert the venous flow. Fifty patients were examined using this method; seven were being evaluated for possible craniectomies. The technique identified nine patients with potential venous collaterals (20%). They would otherwise have been considered nonoperable: two of the six patients eventually operated upon (33%) fell into this category. In general, the operative procedure may be safe more often on the left than the right (45%) vs (20%). Particular attention must be given to the pattern of venous drainage from the posterior temporal lobe to avoid isolation of the venous drainage from this area. (orig.)

  16. 48 CFR 52.217-8 - Option To Extend Services.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Option To Extend Services....217-8 Option To Extend Services. As prescribed in 17.208(f), insert a clause substantially the same as the following: Option To Extend Services (NOV 1999) The Government may require continued performance...

  17. On the Cλ-extended w∞-symmetry

    International Nuclear Information System (INIS)

    Douari, J.; El Kinani, E.H.

    2003-08-01

    Starting from the C λ -extended oscillator algebras, we obtain a new deformed w ∞ -algebra. More precisely, we show that the C λ -extended w ∞ -algebra generators may be expressed via the annihilation and creation operators of the C λ -extended oscillator algebras a and a † as an infinite-dimensional extension of the realization of sp(2) algebra. (author)

  18. PCNL - a comparative study in nonoperated and in previously operated (open nephrolithotomy/pyelolithotomy patients - a single-surgeon experience

    Directory of Open Access Journals (Sweden)

    Rahul Gupta

    2011-12-01

    Full Text Available PURPOSE: Re-procedure in patients with history of open stone surgery is usually challenging due to the alteration in the retroperitoneal anatomy. The aim of this study was to determine the possible impact of open renal surgery on the efficacy and morbidity of subsequent percutaneous nephrolithotomy (PCNL. MATERIALS AND METHODS: From March 2009 until September 2010, 120 patients underwent PCNL. Of these, 20 patients were excluded (tubeless or bilateral simultaneous PCNL. Of the remaining 100, 55 primary patients were categorized as Group 1 and the remaining (previous open nephrolithotomy as Group 2. Standard preoperative evaluation was carried out prior to intervention, Statistical analysis was performed using SPSS v. 11 with the chi-square test, independent samples t-test, and Mann-Whitney U test. A p-value < 0.05 was taken as statistically significant. RESULTS: Both groups were similar in demographic profile and stone burden. Attempts to access the PCS was less in Group 1 compared to Group 2 (1.2 + 1 2 vs 3 + 1.3 respectively and this was statistically significant (p < 0.04. However, the mean operative time between the two groups was not statistically significant (p = 0.44. Blood transfusion rate was comparable in the two groups (p = 0.24. One patient in Group 2 developed hemothorax following a supra-11th puncture. Remaining complications were comparable in both groups. CONCLUSION: Patients with past history of renal stone surgery may need more attempts to access the pelvicaliceal system and have difficulty in tract dilation secondary to retroperitoneal scarring. But overall morbidity and efficacy is same in both groups.

  19. Comparative study on five different commercial extenders for boar semen.

    Science.gov (United States)

    Vyt, P; Maes, D; Dejonckheere, E; Castryck, F; Van Soom, A

    2004-02-01

    Increasing interest in a longer preservation of diluted boar sperm raises questions in the field concerning the choice of the extender. The aim of this study was to evaluate the longevity of boar sperm extended in currently used commercial semen extenders. Three long-term extenders and two short-term extenders were compared for different semen quality parameters that can be assessed under routine laboratory conditions. Sperm morphology, motility, pH and bacteriological contamination were investigated during a 7-day period. The number of dead spermatozoa did not differ significantly among the extenders (p > 0.05). Sperm motility was not only related with storage period but most of all with pH, especially in long-term extenders. Differences between the different extenders were prominent (p extender showed good motility during the whole test period. In all cases, the pH of the extended semen increased by 0.3-0.5 in the first days of storage and was significantly correlated with a decrease in motility. Bacteriological quality had no significant influence on motility or pH of the semen. In conclusion, we can state that in both short-term extenders and in only one long-term extender, sperm longevity, as evaluated by the parameters used in this study, was sufficient during the preservation period. To preserve the quality of diluted boar semen during long-term storage, the choice of the long-term extender is important. In addition, the monitoring of the pH of extended boar semen in our study emphasizes the importance of the buffering capacity of semen extenders.

  20. Do glycine-extended hormone precursors have clinical significance?

    DEFF Research Database (Denmark)

    Rehfeld, Jens Frederik

    2014-01-01

    Half of the known peptide hormones are C-terminally amidated. Subsequent biogenesis studies have shown that the immediate precursor is a glycine-extended peptide. The clinical interest in glycine-extended hormones began in 1994, when it was suggested that glycine-extended gastrin stimulated cancer...... and clinical effects of glycine-extended precursors for most other amidated hormones than gastrin and cholecystokinin (CCK). The idea of glycine-extended peptides as independent messengers was interesting. But clinical science has to move ahead from ideas that cannot be supported at key points after decades...

  1. EXTENDED SPEECH EMOTION RECOGNITION AND PREDICTION

    Directory of Open Access Journals (Sweden)

    Theodoros Anagnostopoulos

    2014-11-01

    Full Text Available Humans are considered to reason and act rationally and that is believed to be their fundamental difference from the rest of the living entities. Furthermore, modern approaches in the science of psychology underline that humans as a thinking creatures are also sentimental and emotional organisms. There are fifteen universal extended emotions plus neutral emotion: hot anger, cold anger, panic, fear, anxiety, despair, sadness, elation, happiness, interest, boredom, shame, pride, disgust, contempt and neutral position. The scope of the current research is to understand the emotional state of a human being by capturing the speech utterances that one uses during a common conversation. It is proved that having enough acoustic evidence available the emotional state of a person can be classified by a set of majority voting classifiers. The proposed set of classifiers is based on three main classifiers: kNN, C4.5 and SVM RBF Kernel. This set achieves better performance than each basic classifier taken separately. It is compared with two other sets of classifiers: one-against-all (OAA multiclass SVM with Hybrid kernels and the set of classifiers which consists of the following two basic classifiers: C5.0 and Neural Network. The proposed variant achieves better performance than the other two sets of classifiers. The paper deals with emotion classification by a set of majority voting classifiers that combines three certain types of basic classifiers with low computational complexity. The basic classifiers stem from different theoretical background in order to avoid bias and redundancy which gives the proposed set of classifiers the ability to generalize in the emotion domain space.

  2. Aspects of T-Dually Extended Superspaces

    Science.gov (United States)

    Polacek, Martin

    This dissertation is divided into three main parts where we derive various properties of the T-dually extended superspaces. In the first part we reformulate the manifestly T-dual description of the massless sector of the closed bosonic string, directly from the geometry associated with the (left and right) affine Lie algebra of the coset space Poincare/Lorentz. This construction initially doubles not only the (space-time) coordinates for translations but also those for Lorentz transformations (and their "dual"). As a result, the Lorentz connection couples directly to the string (as does the vielbein), rather than being introduced indirectly through covariant derivatives as previously. This not only reproduces the old definition of T-dual torsion, but automatically gives a general, covariant definition of T-dual curvature (but still with some undetermined connections). In the second part we give the manifestly T-dual formulation of the massless sector of the classical 3D Type II superstring in off-shell 3D N = 2 superspace, including the action. It has a simple relation to the known superspace of 4D N = 1 supergravity in 4D M-theory via 5D F-theory. The pre-potential appears as part of the vielbein, without derivatives. In the last and the most involved part we find the pre-potential in the superspace with AdS5 x S5 background. The pre-potential appears as part of the vielbeins, without derivatives. In both subspaces (AdS5 and S 5) we use Poincare coordinates. We pick one bulk coordinate in AdS5 and one bulk coordinate in S 5 to define the space-cone gauge. Such space-cone gauge destroys the bulk Lorentz covariance. However, it still preserves boundary Lorentz covariance (and gives projective superspace) SO ( 3, 1) ⊗ SO (4) and so symmetries of boundary CFT are manifest.

  3. The extended reciprocity: Strong belief outperforms persistence.

    Science.gov (United States)

    Kurokawa, Shun

    2017-05-21

    The existence of cooperation is a mysterious phenomenon and demands explanation, and direct reciprocity is one key potential explanation for the evolution of cooperation. Direct reciprocity allows cooperation to evolve for cooperators who switch their behavior on the basis of information about the opponent's behavior. Here, relevant to direct reciprocity is information deficiency. When the opponent's last move is unknown, how should players behave? One possibility is to choose cooperation with some default probability without using any further information. In fact, our previous paper (Kurokawa, 2016a) examined this strategy. However, there might be beneficial information other than the opponent's last move. A subsequent study of ours (Kurokawa, 2017) examined the strategy which uses the own last move when the opponent's last move is unknown, and revealed that referring to the own move and trying to imitate it when information is absent is beneficial. Is there any other beneficial information else? How about strong belief (i.e., have infinite memory and believe that the opponent's behavior is unchanged)? Here, we examine the evolution of strategies with strong belief. Analyzing the repeated prisoner's dilemma game and using evolutionarily stable strategy (ESS) analysis against an invasion by unconditional defectors, we find the strategy with strong belief is more likely to evolve than the strategy which does not use information other than the opponent player's last move and more likely to evolve than the strategy which uses not only the opponent player's last move but also the own last move. Strong belief produces the extended reciprocity and facilitates the evolution of cooperation. Additionally, we consider the two strategies game between strategies with strong belief and any strategy, and we consider the four strategies game in which unconditional cooperators, unconditional defectors, pessimistic reciprocators with strong belief, and optimistic reciprocators with

  4. Longitudinal changes in extended roles in radiography

    International Nuclear Information System (INIS)

    Price, R.C.; Miller, L.R.; Mellor, F.

    2002-01-01

    Purpose: The purpose of this research was to identify the extent and scope of changes to radiography practice. Method: Questionnaires were sent to radiology managers at acute National Health Service (NHS) hospitals in 2000 as a follow-up to an initial survey conducted in 1998. Information was sought on region, teaching/non-teaching status, the nature of extended role tasks undertaken and the year in which these tasks were first undertaken. Results: Some 172 questionnaires were returned from a total of 253 dispatched (68%). In 161 hospitals radiographers administered intravenous injections and performed barium enemas in 119 hospitals, while a red-dot system was in operation in 141 hospitals. Reporting by radiographers had increased since 1998. Replies indicated that, at 124 hospitals, radiographers were reporting in ultrasound. Skeletal reporting was the second most-frequently-reported activity, with 63 hospitals indicating that radiographers reported in this modality, while barium enemas were reported by radiographers in 34 hospitals. Reporting was also undertaken by radiographers in mammography, nuclear medicine, paediatrics and chest radiography in a small minority of hospitals. There was no statistically significant difference between the adoption of tasks in non-teaching and teaching hospitals with the exception of radiographer-performed barium enemas (P=0.014) and red-dot systems (P=0.05). Radiographers were more likely to undertake both of these activities at non-teaching hospitals than in teaching hospitals. Regional differences were apparent in reporting, with a greater prevalence in the English regions than Northern Ireland, Scotland and Wales. Conclusion: The study provided data that demonstrated the extent to which hospitals are utilizing the developing skills of radiographers. This has important implications for future education and training needs for radiographers and for delivery of imaging services

  5. Extending and implementing the Persistent ID pillars

    Science.gov (United States)

    Car, Nicholas; Golodoniuc, Pavel; Klump, Jens

    2017-04-01

    The recent double decade anniversary of scholarly persistent identifier use has triggered journal special editions such as "20 Years of Persistent Identifiers". For such a publication, it is apt to consider the longevity of some persistent identifier (PID) mechanisms (Digital Object Identifiers) and the partial disappearance of others (Life Sciences IDs). We have previously postulated a set of "PID Pillars" [1] which are design principles aimed at ensuring PIDs can survive technology and social change and thus persist for the long term that we have drawn from our observations of PIDs at work over many years. The principles: describe how to ensure identifiers' system and organisation independence; codify the delivery of essential PID system functions; mandate a separation of PID functions from data delivery mechanisms; and require generation of policies detailing how change is handled. In this presentation, first we extend on our previous work of introducing the pillars by refining their descriptions, giving specific suggestions for each and presenting some work that addresses them. Second, we propose a baseline data model for persistent identifiers that, if used, would assist the separation of PID metadata and PID system functioning. This would allow PID system function specifics to change over time (e.g. resolver services or even resolution protocols) and yet preserve the PIDs themselves. Third, we detail our existing PID system — the PID Service [2] — that partially implements the pillars and describe both its successes and shortcomings. Finally, we describe our planned next-generation system that will aim to use the baseline data model and fully implement the pillars.

  6. Extending applicability of terahertz spectroscopy for biosensing

    Science.gov (United States)

    Parthasarathy, Ramakrishnan

    Terahertz (THz) vibrational resonance spectroscopy has recently emerged as a promising technique for fingerprinting biological molecules. Absorption spectra in this frequency range (0.1-10 THz) reflect molecular internal vibrations involving the weakest hydrogen bonds and/or non-bonded interactions, which are species specific. Of prime importance is improving detection sensitivity of molecules with low absorption characteristics in the THz gap. Also of importance is the characterization of biological molecules in the THz gap (10-25 cm-1) by physical parameters (refractive index and absorption coefficient) rather than sample dependent parameters (transmission, reflection) and extending spectroscopy to the low THz range where remote sensing is most viable. To address the sensitivity issue, it is shown that periodic arrays of rectangular slots with subwavelength width provide for local electromagnetic field enhancements due to edge effects in the low frequency range of interest, 10-25 cm-1 (300-750 GHz). Periodic structures of Au, doped Si and InSb were studied. InSb is confirmed to offer the highest results with the local power enhancements on the order of 1100 at frequency 14 cm -1. InSb and Si have large skin depths in the frequency range of interest and so the analysis of their structures was done through the Fourier expansion method of field diffracted from gratings. Au however has small skin depths at these frequencies compared to the thickness. Surface impedance boundary conditions were employed to model the Au structure, for which the Fourier expansion method was unsuitable owing to the huge magnitude of Au permittivity. The applications possibly include development of novel bio-sensors, with the strongly enhanced local electromagnetic fields leading to increased detection sensitivity, and monitoring biophysical processes such as DNA denaturation. Transmission and reflection data from parallel, independent experiments are utilized in the Interference

  7. Electric refuse collection vehicle with a range extender; Elektrisches Abfallsammelfahrzeug mit Range Extender

    Energy Technology Data Exchange (ETDEWEB)

    Fuchs, Andreas

    2012-10-15

    At the Frankfurt Motor Show IAA 2012, MAN will be presenting the Metropolis, a heavy-duty truck for use in urban areas that produces no emissions and is ultra-quiet. Using mains electricity generated from renewable sources, it can operate without producing any CO{sub 2}. The truck's modular lithium-ion battery is located under the ab. A quiet and efficient diesel engine from the Volkswagen Group generates power as needed and functions as a range extender for the truck. At the end of 2012, the MAN Metropolis will start a two-year field test as a refuse collection vehicle. (orig.)

  8. [Inter-and intra-operator variability in the analysis of semen parameters: results from a quality control program].

    Science.gov (United States)

    Daoud, Salima; Chakroun-Feki, Nozha; Sellami, Afifa; Ammar-Keskes, Leila; Rebai, Tarek

    2016-01-01

    Semen analysis is a key part of male infertility investigation. The necessity of quality management implementation in the andrology laboratory has been recognized in order to ensure the reliability of its results. The aim of this study was to evaluate intra- and inter-individual variability in the assessment of semen parameters in our laboratory through a quality control programme. Four participants from the laboratory with different experience levels have participated in this study. Semen samples of varying quality were assessed for sperm motility, concentration and morphology and the results were used to evaluate inter-participant variability. In addition, replicates of each semen sample were analyzed to determine intra-individual variability for semen parameters analysis. The average values of inter-participant coefficients of variation for sperm motility, concentration and morphology were 12.8%, 19.8% and 48.9% respectively. The mean intra-participant coefficients of variation were, respectively, 6.9%, 12.3% and 42.7% for sperm motility, concentration and morphology. Despite some random errors of under- or overestimation, the overall results remained within the limits of acceptability for all participants. Sperm morphology assessment was particularly influenced by the participant's level of experience. The present data emphasize the need for appropriate training of the laboratory staff and for regular participation in internal quality control programmes in order to improve the reliability of laboratory results.

  9. Automatic intra-operative generation of geometric left atrium/pulmonary vein models from rotational X-ray angiography.

    Science.gov (United States)

    Meyer, Carsten; Manzke, Robert; Peters, Jochen; Ecabert, Olivier; Kneser, Reinhard; Reddy, Vivek Y; Chan, Raymond C; Weese, Jürgen

    2008-01-01

    Pre-procedural imaging with cardiac CT or MR has become popular for guiding complex electrophysiology procedures such as those used for atrial fibrillation ablation therapy. Electroanatomical mapping and ablation within the left atrium and pulmonary veins (LAPV) is facilitated using such data, however the pre-procedural anatomy can be quite different from that at the time of intervention. Recently, a method for intra-procedural LAPV imaging has been developed based on contrast-enhanced 3-D rotational X-ray angiography (3-D RA). These intraprocedural data now create a compelling need for rapid and automated extraction of the LAPV geometry for catheter guidance. We present a new approach to automatic intra-procedural generation of LAPV surfaces from 3-D RA volumes. Using model-based segmentation, our technique is robust to imaging noise and artifacts typical of 3-D RA imaging, strongly minimizes the user interaction time required for segmentation, and eliminates inter-subject variability. Our findings in 33 patients indicate that intra-procedural LAPV surface models accurately represent the anatomy at the time of intervention and are comparable to pre-procedural models derived from CTA or MRA.

  10. Intra-operative cell salvage and sickle cell trait in liver transplantation: time to re-consider?

    Science.gov (United States)

    Loh, P S; Gilder, F; Klinck, J

    2018-04-19

    Sickle cell trait (SCT), characterized by the sickle hemoglobin (HbS) gene in a heterozygous state is the most common hemoglobinopathy worldwide that is typically asymptomatic in affected individuals [1]. In Europe, migration has increased the prevalence, raising concerns about its clinical impact [1]. For example, the use of intraoperative cell salvage may induce sickling because of hypoxia during processing [2]. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Intra-operative lidocaine in the prevention of vomiting after elective tonsillectomy in children: A randomised controlled trial.

    Science.gov (United States)

    Echevarría, Ghislaine C; Altermatt, Fernando R; Paredes, Sebastian; Puga, Valentina; Auad, Hernán; Veloso, Ana M; Elgueta, María F

    2018-05-01

    Postoperative vomiting (POV) is a frequent complication of tonsillectomy in children. In adult patients undergoing abdominal surgeries, the use of intravenous lidocaine infusion can prevent POV. To evaluate the anti-emetic effect of an intravenous lidocaine infusion used as an adjuvant to general anaesthesia, in children undergoing elective ear, nose and throat surgery. Double-blind, randomised, controlled study. Hospital-based, single-centre study in Chile. ASA I-II children, aged 2 to 12 years, scheduled for elective tonsillectomy. We standardised the induction and maintenance of anaesthesia. Patients were randomly allocated to lidocaine (1.5 mg kg intravenous lidocaine over 5 min followed by 2 mg kg h) or 0.9% saline (at the same rate and volume). Infusions were continued until the end of the surgery. Presence of at least one episode of vomiting, retching or both in the first 24 h postoperatively (POV). Plasma concentrations of lidocaine and postoperative pain. Ninety-two children were enrolled. Primary outcome data were available for 91. In the Lidocaine group, 28 of 46 patients (60.8%) experienced POV, compared with 37 of 45 patients (82.2%) in the Saline group [difference in proportions 21.3% (95% confidence interval (CI) 2.8 to 38.8), P = 0.024]. The intention-to-treat analysis showed that when we assumed that the patient in the Saline group lost to follow-up did not have POV, the difference in proportions decreased to 19.6% (95% CI, 0.9 to 37.2), with an unadjusted odds ratio of 0.38 (95% CI, 0.15 to 0.97, P = 0.044). The odds of having POV were 62% less likely in those patients receiving lidocaine compared with patients in the Saline group. The mean lidocaine plasma concentration was 3.91 μg ml (range: 0.87 to 4.88). Using an intravenous lidocaine infusion as an adjuvant to general anaesthesia decreased POV in children undergoing elective tonsillectomy. ClinicalTrials.gov Identifier: NCT01986309.

  12. Design and dosimetry characteristics of a commercial applicator system for intra-operative electron beam therapy utilizing ELEKTA Precise accelerator.

    Science.gov (United States)

    Nevelsky, Alexander; Bernstein, Zvi; Bar-Deroma, Raquel; Kuten, Abraham; Orion, Itzhak

    2010-07-19

    The design concept and dosimetric characteristics of a new applicator system for intraoperative radiation therapy (IORT) are presented in this work. A new hard-docking commercial system includes polymethylmethacrylate (PMMA) applicators with different diameters and applicator end angles and a set of secondary lead collimators. A telescopic device allows changing of source-to-surface distance (SSD). All measurements were performed for 6, 9, 12 and 18 MeV electron energies. Output factors and percentage depth doses (PDD) were measured in a water phantom using a plane-parallel ion chamber. Isodose contours and radiation leakage were measured using a solid water phantom and radiographic films. The dependence of PDD on SSD was checked for the applicators with the smallest and the biggest diameters. SSD dependence of the output factors was measured. Hardcopies of PDD and isodose contours were prepared to help the team during the procedure on deciding applicator size and energy to be chosen. Applicator output factors are a function of energy, applicator size and applicator type. Dependence of SSD correction factors on applicator size and applicator type was found to be weak. The same SSD correction will be applied for all applicators in use for each energy. The radiation leakage through the applicators is clinically acceptable. The applicator system enables effective collimation of electron beams for IORT. The data presented are sufficient for applicator, energy and monitor unit selection for IORT treatment of a patient.

  13. Intra-operative remifentanil might influence pain levels in the immediate postoperative period after major abdominal surgery

    DEFF Research Database (Denmark)

    Hansen, EG; Duedahl, Tina H; Rømsing, Janne

    2005-01-01

    Remifentanil, a widely used analgesic agent in anaesthesia, has a rapid onset and short duration of action. In clinical settings, this requires an appropriate pain strategy to prevent unacceptable pain in the post-operative period. The aim of this study was to investigate whether remifentanil had...... any impact on post-operative pain and opioid consumption after major abdominal surgery....

  14. Intra-operative on-line discrimination of kidney cancer from normal tissue by IR ATR spectroscopy of extracellular fluid

    Science.gov (United States)

    Urboniene, V.; Velicka, M.; Ceponkus, J.; Pucetaite, M.; Jankevicius, F.; Sablinskas, V.; Steiner, G.

    2016-03-01

    Determination of cancerous and normal kidney tissues during partial, simple or radical nephrectomy surgery was performed by using differences in the IR absorption spectra of extracellular fluid taken from the corresponding tissue areas. The samples were prepared by stamping of the kidney tissue on ATR diamond crystal. The spectral measurements were performed directly in the OR during surgery for 58 patients. It was found that intensities of characteristic spectral bands of glycogen (880-1200 cm-1) in extracellular fluid are sensitive to the type of the tissue and can be used as spectral markers of tumours. Characteristic spectral band of lactic acid (1730 cm-1) - product of the anaerobic glycolysis, taking place in the cancer cells is not suitable for use as a spectral marker of cancerous tissue, since it overlaps with the band of carbonyl stretch in phospholipids and fatty acids. Results of hierarchical cluster analysis of the spectra show that the spectra of healthy and tumour tissue films can be reliably separated into two groups. On the other hand, possibility to differentiate between tumours of different types and grades remains in question. While the fluid from highly malignant G3 tumour tissue contains highly pronounced glycogen spectral bands and can be well separated from benign and G1 tumours by principal component analysis, the variations between spectra from sample to sample prevent from obtaining conclusive results about the grouping between different tumour types and grades. The proposed method is instant and can be used in situ and even in vivo.

  15. Effects of tramadol or morphine in dogs undergoing castration on intra-operative electroencephalogram responses and post-operative pain.

    Science.gov (United States)

    Kongara, K; Chambers, J P; Johnson, C B; Dukkipati, V S R

    2013-11-01

    To compare the effects of pre-operatively administered tramadol with those of morphine on electroencephalographic responses to surgery and post-operative pain in dogs undergoing castration. Dogs undergoing castration were treated with either pre-operative morphine (0.5 mg/kg S/C, n = 8) or tramadol (3 mg/kg S/C, n = 8). All dogs also received 0.05 mg/kg acepromazine and 0.04 mg/kg atropine S/C in addition to the test analgesic. Anaesthesia was induced with thiopentone administered I/V to effect and maintained with halothane in oxygen. Respiratory rate, heart rate, end-tidal halothane tension (EtHal) and end-tidal CO2 tension (EtCO2) were monitored throughout surgery. Electroencephalograms (EEG) were recorded continuously using a three electrode montage. Median frequency (F50), total power (Ptot) and 95% spectral edge frequency (F95) derived from EEG power spectra recorded before skin incision (baseline) were compared with those recorded during ligation of the spermatic cords of both testicles. Post-operatively, pain was assessed after 1, 3, 6 and 9 h using the short form of the Glasgow composite measure pain scale (CMPS-SF). Dogs premedicated with tramadol had higher mean F50 (12.2 (SD 0.2) Hz) and lower Ptot (130.39 (SD 12.1) µv(2)) compared with those premedicated with morphine (11.5 (SD 0.2) Hz and 161.8 (SD 15.1) µv(2), respectively; p0.05). The F95 of the EEG did not differ between the two groups during the ligation of either testicle (p > 0.05). Post-operatively, no significant differences in the CMPS-SF score were found between animals premedicated with tramadol and morphine at any time during the post-operative period. No dog required rescue analgesia. Tramadol and morphine administered pre-operatively provided a similar degree of post-operative analgesia in male dogs at the doses tested.

  16. In Vivo Stabilized SB3, an Attractive GRPR Antagonist, for Pre- and Intra-Operative Imaging for Prostate Cancer.

    Science.gov (United States)

    Bakker, Ingrid L; van Tiel, Sandra T; Haeck, Joost; Doeswijk, Gabriela N; de Blois, Erik; Segbers, Marcel; Maina, Theodosia; Nock, Berthold A; de Jong, Marion; Dalm, Simone U

    2018-03-19

    The gastrin-releasing peptide receptor (GRPR), overexpressed on various tumor types, is an attractive target for receptor-mediated imaging and therapy. Another interesting approach would be the use of GRPR radioligands for pre-operative imaging and subsequent radio-guided surgery, with the goal to improve surgical outcome. GRPR radioligands were successfully implemented in clinical studies, especially Sarabesin 3 (SB3) is an appealing GRPR antagonist with high receptor affinity. Gallium-68 labeled SB3 has good in vivo stability, after labeling with Indium-111; however, the molecule shows poor in vivo stability, which negatively impacts tumor-targeting capacity. A novel approach to increase in vivo stability of radiopeptides is by co-administration of the neutral endopeptidase (NEP) inhibitor, phosphoramidon (PA). We studied in vivo stability and biodistribution of [ 111 In]SB3 without/with (-/+) PA in mice. Furthermore, SPECT/MRI on a novel, state-of-the-art platform was performed. GRPR affinity of SB3 was determined on PC295 xenograft sections using [ 125 I]Tyr 4 -bombesin with tracer only or with increasing concentrations of SB3. For in vivo stability, mice were injected with 200/2000 pmol [ 111 In]SB3 -/+ 300 μg PA. Blood was collected and analyzed. Biodistribution and SPECT/MRI studies were performed at 1, 4, and 24 h postinjection (p.i.) of 2.5 MBq/200 pmol or 25 MBq/200 pmol [ 111 In]SB3 -/+ 300 μg PA in PC-3-xenografted mice. SB3 showed high affinity for GRPR (IC 50 3.5 nM). Co-administration of PA resulted in twice higher intact peptide in vivo vs [ 111 In]SB3 alone. Biodistribution studies at 1, 4, and 24 h p.i. show higher tumor uptake values with PA co-administration (19.7 ± 3.5 vs 10.2 ± 1.5, 17.6 ± 5.1 vs 8.3 ± 1.1, 6.5 ± 3.3 vs 3.1 ± 1.9 % ID/g tissue (P < 0.0001)). Tumor imaging with SPECT/MRI clearly improved after co-injection of PA. Co-administration of PA increased in vivo tumor targeting capacity of [ 111 In]SB3, making this an attractive combination for GRPR-targeted tumor imaging.

  17. Pre-operative planning and intra-operative guidance in modern neurosurgery: a review of 300 cases.

    Science.gov (United States)

    Wadley, J.; Dorward, N.; Kitchen, N.; Thomas, D.

    1999-01-01

    Operative neurosurgery has recently entered an exciting era of image guided surgery or neuronavigation and application of this novel technology is beginning to have a significant impact in many ways in a variety of intracranial procedures. In order to fully assess the advantages of image guided techniques over conventional planning and surgery in selected cases, detailed prospective evaluation has been carried out during the advanced development of an optically tracked neuronavigation system. Over a 2-year period, 300 operative neurosurgical procedures have been performed with the assistance of interactive image guidance, as well as the development of new software applications and hardware tools. A broad range of intracranial neurosurgical procedures were seen to benefit from image guidance, including 163 craniotomies, 53 interactive stereotactic biopsies, 7 tracked neuroendoscopies and 37 complex skull base procedures. The most common pathological diagnoses were cerebral glioma in 98 cases, meningioma in 64 and metastasis in 23. Detailed analysis of a battery of postoperative questions revealed benefits in operative planning, appreciation of anatomy, lesion location, safety of surgery and greatly enhanced surgical confidence. The authors believe that image guided surgical technology, with new developments such as those described, has a significant role to play in contemporary neurosurgery and its widespread adoption in practice will be realised in the near future. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 PMID:10615186

  18. Beliefs and Values about Intra-Operative Teaching and Learning: A Case Study of Surgical Teachers and Trainees

    Science.gov (United States)

    Ong, Caroline C.; Dodds, Agnes; Nestel, Debra

    2016-01-01

    Surgeons require advanced psychomotor skills, critical decision-making and teamwork skills. Much of surgical skills training involve progressive trainee participation in supervised operations where case variability, operating team interaction and environment affect learning, while surgical teachers face the key challenge of ensuring patient…

  19. Intra-operative Patient-Controlled Sedation (PCS:Propofol versus Midazolam Supplementation During Epidural Analgesia (Clinical and Hormonal Study

    Directory of Open Access Journals (Sweden)

    Hassan S Al-khayat

    2008-01-01

    Full Text Available This study was done on sixty adult males scheduled to have an epidural analgesia for elective inguinal hernia repair. The study was designed to compare propofol and midazolam with regard to their suitability for the patient-controlled sedation (PCS technique during epidural analgesia. Patients were divided into three equal groups and premedicated with 0.2mg.kg -1 oral midazolam. Group I (G1 served as control. Using PCS technique, the pump was programmed to deliver on demand a bolus dose of 0.5 mg.kg- 1 of propofol in Group II (G2 or 0.1mg.kg -1 midazolam in Group III(G3. Patient′s sedation status was assessed by sedation score, comfort scale and by psychometric testing. The total delivered dose of each tested drug was calculated. Serum concentrations of propfol and midazolam, plasma cortisol and free fatty acids were measured. Propofol and midazolam PCS technique produced excellent and easily controllable sedation. The dose needed to produce steady state sedation was 2.8±1.42 and 0.11±0.6 mg.kg -1 .h- 1 for propofol and midazolam respectively. Propofol was more suitable than midazolam for PCS because of its rapid onset, favorable recovery profile and low side effects. PCS proved to be a stress-free and acceptable technique.

  20. Theoretical characterization of the spatial resolution intra-operative probes; Caracterizacion teorica de la resolucion espacial de sondas intraoperatorias

    Energy Technology Data Exchange (ETDEWEB)

    Agramunt Chaler, S.; Jurado Bruggeman, D.; Munoz Montplet, C.

    2013-07-01

    This work intends to check that the characterization of the spatial profiles obtained by a an intraoperative probe in the presence of a point source is possible enough making use only of the parameters down time sensitivity and opening of the collimator. (Author)

  1. The role of extended family in diverse teens’ sexual health

    OpenAIRE

    Grossman, Jennifer M.; Tracy, Allison; Richer, Amanda; Erkut, Sumru

    2014-01-01

    Despite increasing extended family involvement in childrearing, particularly in minority families, few studies investigate their role in talking with teens about sex or how this relates to teens’ sexual behavior. This mixed methods study assesses extended family sexuality communication through a survey of 1492 diverse middle school students and interviews with 32 students. Logistic regression shows that participants who report having had sex are more likely to report talking with extended fam...

  2. Matchings Extend to Hamiltonian Cycles in 5-Cube

    Directory of Open Access Journals (Sweden)

    Wang Fan

    2018-02-01

    Full Text Available Ruskey and Savage asked the following question: Does every matching in a hypercube Qn for n ≥ 2 extend to a Hamiltonian cycle of Qn? Fink confirmed that every perfect matching can be extended to a Hamiltonian cycle of Qn, thus solved Kreweras’ conjecture. Also, Fink pointed out that every matching can be extended to a Hamiltonian cycle of Qn for n ∈ {2, 3, 4}. In this paper, we prove that every matching in Q5 can be extended to a Hamiltonian cycle of Q5.

  3. Boolean Operations, Joins, and the Extended Low Hierarchy

    OpenAIRE

    Hemaspaandra, Lane A.; Jiang, Zhigen; Rothe, Joerg; Watanabe, Osamu

    1999-01-01

    We prove that the join of two sets may actually fall into a lower level of the extended low hierarchy than either of the sets. In particular, there exist sets that are not in the second level of the extended low hierarchy, EL_2, yet their join is in EL_2. That is, in terms of extended lowness, the join operator can lower complexity. Since in a strong intuitive sense the join does not lower complexity, our result suggests that the extended low hierarchy is unnatural as a complexity measure. We...

  4. 78 FR 23702 - Copayment for Extended Care Services

    Science.gov (United States)

    2013-04-22

    ... considered unavailable when calculating the veteran's maximum monthly copayment obligation for extended care... a material way the economy, a sector of the economy, productivity, competition, jobs, the...

  5. Extending the amygdala in theories of threat processing

    Science.gov (United States)

    Fox, Andrew S.; Oler, Jonathan A.; Tromp, Do P.M.; Fudge, Julie L.; Kalin, Ned H.

    2015-01-01

    The central extended amygdala is an evolutionarily conserved set of interconnected brain regions that play an important role in threat processing to promote survival. Two core components of the central extended amygdala, the central nucleus of the amygdala (Ce) and the lateral bed nucleus of the stria terminalis (BST) are highly similar regions that serve complimentary roles by integrating fear- and anxiety-relevant information. Survival depends on the central extended amygdala's ability to rapidly integrate and respond to threats that vary in their immediacy, proximity, and characteristics. Future studies will benefit from understanding alterations in central extended amygdala function in relation to stress-related psychopathology. PMID:25851307

  6. 75 FR 47710 - TRICARE; Extended Care Health Option

    Science.gov (United States)

    2010-08-09

    ... TRICARE; Extended Care Health Option AGENCY: Office of the Secretary, Department of Defense. ACTION: Final... Care Health Option (ECHO) from $2,500 per month to $36,000 per year, and for other non-legislated.... That program, known as the Extended Care Heath Option (ECHO), replaced the Program for Persons with...

  7. LR-parsing of Extended Context-free Grammars

    DEFF Research Database (Denmark)

    Madsen, Ole Lehrmann; Kristensen, Bent Bruun

    1976-01-01

    To improve the readability of a grammar it is common to use extended context free grammars (ECFGs) which are context free grammars (CFGs) extended with the repetition operator (*), the alternation operator (¦) and parentheses to express the right hand sides of the productions. The topic treated h...

  8. Is extended biopsy protocol justified in all patients with suspected ...

    African Journals Online (AJOL)

    Objective: To determine the significance of an extended 10-core transrectal biopsy protocol in different categories of patients with suspected prostate cancer using digital guidance. Materials and Methods: We studied 125 men who were being evaluated for prostate cancer. They all had an extended 10-core digitally guided ...

  9. An application of augmented MDA for the extended healthcare enterprise

    NARCIS (Netherlands)

    Jones, Valerie M.; van Halteren, Aart; Konstantas, D.; Widya, I.A.; Bults, Richard G.A.

    2007-01-01

    Mobile health systems extend the Enterprise Computing System (ECS) of the healthcare provider by bringing services to the patient any time and anywhere. We propose a methodology for the development of such extended ECSs which applies a model-driven design and development approach augmented with

  10. Properties of extended inorganic solids predicted/rationalized by ...

    Indian Academy of Sciences (India)

    Administrator

    Due to the vastly complex nature of the problem, guidelines for the preparation of extended inorganic solids with specific electronic properties remain meagre. Here we present the use of First Principles LMTO band structure calculations for the rationalization of the properties of a number of interesting extended solids.

  11. Cryosurvival of goat spermatozoa in tris-egg yolk extender ...

    African Journals Online (AJOL)

    The effect of vitamin E supplementation in tris-egg yolk extender on sperm parameters of West African Dwarf (WAD) goat bucks was determined. Tris-egg yolk extenders supplemented with different levels of ... of WAD goat bucks during cryopreservation. Keywords: Antioxidants, bucks, freezing, oxidative stress, sperm ...

  12. 20 CFR 615.6 - Extended Benefits; weekly amount.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Extended Benefits; weekly amount. 615.6 Section 615.6 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR EXTENDED... compensation payable during such benefit year. (2) If the method in paragraph (a)(1)(iii) of this section is...

  13. Subsurface offset behaviour in velocity analysis with extended reflectivity images

    NARCIS (Netherlands)

    Mulder, W.A.

    2012-01-01

    Migration velocity analysis with the wave equation can be accomplished by focusing of extended migration images, obtained by introducing a subsurface offset or shift. A reflector in the wrong velocity model will show up as a curve in the extended image. In the correct model, it should collapse to a

  14. Subsurface offset behaviour in velocity analysis with extended reflectivity images

    NARCIS (Netherlands)

    Mulder, W.A.

    2013-01-01

    Migration velocity analysis with the constant-density acoustic wave equation can be accomplished by the focusing of extended migration images, obtained by introducing a subsurface shift in the imaging condition. A reflector in a wrong velocity model will show up as a curve in the extended image. In

  15. Cryosurvival of goat spermatozoa in tris-egg yolk extender ...

    African Journals Online (AJOL)

    The effect of melatonin supplementation in semen extenders on cryosurvival of spermatozoa obtained from West African Dwarf (WAD) goat bucks was studied. Tris-egg yolk extenders supplemented with different levels of melatonin (0, 2, 4, 6 and 8 mM) were diluted with semen samples. The diluted semen samples were ...

  16. Polyurethanes elastomers with amide chain extenders of uniform length

    NARCIS (Netherlands)

    van der Schuur, J.M.; Noordover, B.A.J.; Noordover, Bart; Gaymans, R.J.

    2006-01-01

    Toluene diisocyanate based polyurethanes with amide extenders were synthesized poly(propylene oxide) with a number average molecular weight of 2000 and endcapped with toluene diisocyanate was used as the polyether segment. The chain extenders were based on poly(hexamethylene terephthalamide):

  17. Polyuretehane elastomers with amide chain extenders of uniform length

    NARCIS (Netherlands)

    Schuur, van der M.; Noordover, B.A.J.; Gaymans, R.J.

    2006-01-01

    Toluene diisocyanate based polyurethanes with amide extenders were synthesized poly(propylene oxide) with a number average molecular weight of 2000 and endcapped with toluene diisocyanate was used as the polyether segment. The chain extenders were based on poly(hexamethylene terephthalamide):

  18. Gauge fixing of Chern-Simons N-extended supergravity

    Energy Technology Data Exchange (ETDEWEB)

    Ney, W G [Centro Brasileiro de Pesquisas Fisicas (CBPF), Rio de Janeiro, RJ (Brazil); Centro Federal de Educacao Tecnologica (CEFET), Campos dos Goytacazes, RJ (Brazil); Piguet, O [Universidade Federal do Espirito Santo (UFES), ES 29000-001, Vitoria (Brazil); Spalenza, W [Centro Brasileiro de Pesquisas Fisicas (CBPF), Rio de Janeiro, RJ (Brazil)

    2004-08-01

    We treat N-extended supergravity in 2+1 space-time dimensions as a Yang-Mills gauge field with Chern-Simons action associated to the N-extended Poincare supergroup. We fix the gauge of this theory within the Batalin-Vilkovisky scheme. (orig.)

  19. Gauge fixing of Chern-Simons N-extended supergravity

    International Nuclear Information System (INIS)

    Ney, W.G.; Piguet, O.; Spalenza, W.

    2004-01-01

    We treat N-extended supergravity in 2+1 space-time dimensions as a Yang-Mills gauge field with Chern-Simons action associated to the N-extended Poincare supergroup. We fix the gauge of this theory within the Batalin-Vilkovisky scheme. (orig.)

  20. Extended red(dened) regions in 2MASS (Frieswijk+, 2010)

    NARCIS (Netherlands)

    Frieswijk, W. W. F.; Shipman, R. F.

    Basic parameters of 2909 extended red regions in the outer Galactic plane (1320 at 60" and 1589 at 90" resolution). The sources have been extracted from the Two Micron All Sky Survey (2MASS, Cat. ). For each source Galactic coordinates, total number of resolution cells, linear extend in longitude