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Sample records for maximal surgical effort

  1. Maximal effort cytoreductive surgery for disseminated ovarian cancer in a UK setting: challenges and possibilities

    OpenAIRE

    Fotopoulou, C; Jones, BP; Savvatis, K; Campbell, J; Kyrgiou, M; Farthing, A; Brett, S; Roux, R; Hall, M; Rustin, G; Gabra, H; Jiao, L; St?mpfle, R

    2016-01-01

    ? 2016 Springer-Verlag Berlin HeidelbergObjective: To assess surgical morbidity and mortality of maximal effort cytoreductive surgery for disseminated epithelial ovarian cancer (EOC) in a UK tertiary center. Methods/materials: A monocentric prospective analysis of surgical morbidity and mortality was performed for all consecutive EOC patients who underwent extensive cytoreductive surgery between 01/2013 and 12/2014. Surgical complexity was assessed by the Mayo clinic surgical complexity score...

  2. Maximal effort cytoreductive surgery for disseminated ovarian cancer in a UK setting: challenges and possibilities.

    Science.gov (United States)

    Fotopoulou, Christina; Jones, Benjamin P; Savvatis, Konstantinos; Campbell, Jeremy; Kyrgiou, Maria; Farthing, Alan; Brett, Stephen; Roux, Rene; Hall, Marcia; Rustin, Gordon; Gabra, Hani; Jiao, Long; Stümpfle, Richard

    2016-09-01

    To assess surgical morbidity and mortality of maximal effort cytoreductive surgery for disseminated epithelial ovarian cancer (EOC) in a UK tertiary center. A monocentric prospective analysis of surgical morbidity and mortality was performed for all consecutive EOC patients who underwent extensive cytoreductive surgery between 01/2013 and 12/2014. Surgical complexity was assessed by the Mayo clinic surgical complexity score (SCS). Only patients with high SCS ≥5 were included in the analysis. We evaluated 118 stage IIIC/IV patients, with a median age of 63 years (range 19-91); 47.5 % had ascites and 29 % a pleural effusion. Median duration of surgery was 247 min (range 100-540 min). Median surgical complexity score was 10 (range 5-15) consisting of bowel resection (71 %), stoma formation (13.6 %), diaphragmatic stripping/resection (67 %), liver/liver capsule resection (39 %), splenectomy (20 %), resection stomach/lesser sac (26.3 %), pleurectomy (17 %), coeliac trunk/subdiaphragmatic lymphadenectomy (8 %). Total macroscopic tumor clearance rate was 89 %. Major surgical complication rate was 18.6 % (n = 22), with a 28-day and 3-month mortality of 1.7 and 3.4 %, respectively. The anastomotic leak rate was 0.8 %; fistula/bowel perforation 3.4 %; thromboembolism 3.4 % and reoperation 4.2 %. Median intensive care unit and hospital stay were 1.7 (range 0-104) and 8 days (range 4-118), respectively. Four patients (3.3 %) failed to receive chemotherapy within the first 8 postoperative weeks. Maximal effort cytoreductive surgery for EOC is feasible within a UK setting with acceptable morbidity, low intestinal stoma rates and without clinically relevant delays to postoperative chemotherapy. Careful patient selection, and coordinated multidisciplinary effort appear to be the key for good outcome. Future evaluations should include quality of life analyses.

  3. Increase in Jumping Height Associated with Maximal Effort Vertical Depth Jumps.

    Science.gov (United States)

    Bedi, John F.; And Others

    1987-01-01

    In order to assess if there existed a statistically significant increase in jumping performance when dropping from different heights, 32 males, aged 19 to 26, performed a series of maximal effort vertical jumps after dropping from eight heights onto a force plate. Results are analyzed. (Author/MT)

  4. The Effects of Rear-Wheel Camber on Maximal Effort Mobility Performance in Wheelchair Athletes

    NARCIS (Netherlands)

    Mason, B.; van der Woude, L.; Tolfrey, K.; Goosey-Tolfrey, V.

    This study examined the effect of rear-wheel camber on maximal effort wheelchair mobility performance. 14 highly trained wheelchair court sport athletes performed a battery of field tests in 4 standardised camber settings (15°, 18°, 20°, 24°) with performance analysed using a velocometer. 20 m

  5. A maximal incremental effort alters tear osmolarity depending on the fitness level in military helicopter pilots.

    Science.gov (United States)

    Vera, Jesús; Jiménez, Raimundo; Madinabeitia, Iker; Masiulis, Nerijus; Cárdenas, David

    2017-10-01

    Fitness level modulates the physiological responses to exercise for a variety of indices. While intense bouts of exercise have been demonstrated to increase tear osmolarity (Tosm), it is not known if fitness level can affect the Tosm response to acute exercise. This study aims to compare the effect of a maximal incremental test on Tosm between trained and untrained military helicopter pilots. Nineteen military helicopter pilots (ten trained and nine untrained) performed a maximal incremental test on a treadmill. A tear sample was collected before and after physical effort to determine the exercise-induced changes on Tosm. The Bayesian statistical analysis demonstrated that Tosm significantly increased from 303.72 ± 6.76 to 310.56 ± 8.80 mmol/L after performance of a maximal incremental test. However, while the untrained group showed an acute Tosm rise (12.33 mmol/L of increment), the trained group experienced a stable Tosm physical effort (1.45 mmol/L). There was a significant positive linear association between fat indices and Tosm changes (correlation coefficients [r] range: 0.77-0.89), whereas the Tosm changes displayed a negative relationship with the cardiorespiratory capacity (VO2 max; r = -0.75) and performance parameters (r = -0.75 for velocity, and r = -0.67 for time to exhaustion). The findings from this study provide evidence that fitness level is a major determinant of Tosm response to maximal incremental physical effort, showing a fairly linear association with several indices related to fitness level. High fitness level seems to be beneficial to avoid Tosm changes as consequence of intense exercise. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Effect of sex on wasted left ventricular effort following maximal exercise.

    Science.gov (United States)

    Lane, A D; Ranadive, S M; Yan, H; Kappus, R M; Cook, M D; Sun, P; Woods, J A; Wilund, K; Fernhall, B

    2013-09-01

    Wasted left ventricular effort (∆Ew) refers to work required of the left ventricle to eject blood that does not result in increased stroke volume and is related to left ventricular hypertrophy. Literature shows that men and women have differing ventricular and vascular responses to and following exercise. Our purpose was to determine how ∆Ew changes post-exercise in men and women and examine potential mechanisms. We hypothesized a reduction in ∆Ew that would be greater in men and that central pulse wave velocity and wave intensity (WIA) would be related to ∆Ew. Blood pressures, central pulse wave velocity (cPWV), and WIA were obtained at rest, 15 and 30 min after maximal exercise. Both sexes reduced ∆Ew post-maximal exercise (p>0.05 for interaction), but women had higher ∆Ew at each time point (p<0.05). The first peak of WIA increased 15 min post-exercise only in women (p<0.05). cPWV was attenuated (p<0.05) in women at 15 min and men at 30 min (p<0.05) post-exercise with a significant time by sex interaction (p<0.05). WIA (1st peak) was correlated (p<0.05) to ∆Ew in both sexes before and 15 min post-exercise, but cPWV was only associated with ∆Ew in men at 30 min post-exercise. We conclude that both sexes decrease ∆Ew after maximal exercise, but vascular and ventricular changes associated with the attenuation of ∆Ew are not uniform between sexes. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Subthalamic nucleus activity optimizes maximal effort motor responses in Parkinson's disease.

    Science.gov (United States)

    Anzak, Anam; Tan, Huiling; Pogosyan, Alek; Foltynie, Thomas; Limousin, Patricia; Zrinzo, Ludvic; Hariz, Marwan; Ashkan, Keyoumars; Bogdanovic, Marko; Green, Alexander L; Aziz, Tipu; Brown, Peter

    2012-09-01

    The neural substrates that enable individuals to achieve their fastest and strongest motor responses have long been enigmatic. Importantly, characterization of such activities may inform novel therapeutic strategies for patients with hypokinetic disorders, such as Parkinson's disease. Here, we ask whether the basal ganglia may play an important role, not only in the attainment of maximal motor responses under standard conditions but also in the setting of the performance enhancements known to be engendered by delivery of intense stimuli. To this end, we recorded local field potentials from deep brain stimulation electrodes implanted bilaterally in the subthalamic nuclei of 10 patients with Parkinson's disease, as they executed their fastest and strongest handgrips in response to a visual cue, which was accompanied by a brief 96-dB auditory tone on random trials. We identified a striking correlation between both theta/alpha (5-12 Hz) and high-gamma/high-frequency (55-375 Hz) subthalamic nucleus activity and force measures, which explained close to 70% of interindividual variance in maximal motor responses to the visual cue alone, when patients were ON their usual dopaminergic medication. Loud auditory stimuli were found to enhance reaction time and peak rate of development of force still further, independent of whether patients were ON or OFF l-DOPA, and were associated with increases in subthalamic nucleus power over a broad gamma range. However, the contribution of this broad gamma activity to the performance enhancements observed was only modest (≤13%). The results implicate frequency-specific subthalamic nucleus activities as substantial factors in optimizing an individual's peak motor responses at maximal effort of will, but much less so in the performance increments engendered by intense auditory stimuli.

  8. Maximizing DOE R and D efforts in tru waste management learning from international programs

    International Nuclear Information System (INIS)

    Saxman, P.A.; Loughead, J.S.C.

    1990-01-01

    Through the International Technology Exchange Program, Department of Energy (DOE) technical specialists maintain a formal dialogue with research and Development (R and D) specialists from nuclear programs in other countries. The objective of these exchanges is to seek innovative waste management solutions, maximize progress for ongoing R and D activities, and minimize the development time required for implementation of transuranic (TRU) waste processing technologies and waste assay developments. Based on information provided by PNC during the exchange, DOE specialists evaluated PNC's efforts to implement technologies and techniques from their R and D program activities. This paper presents several projects with particular potential for DOE operations, and suggests several ways that these concepts could be used to advantage by DOE or commercial programs

  9. Metabolic interpretation of ventilatory parameters during maximal effort test and their applicability to sports

    Directory of Open Access Journals (Sweden)

    Luis Eduardo Barreto Martins

    2007-09-01

    Full Text Available One important tool for producing specifi c and individualized training intensities is to determine ventilatory threshold (VT, respiratory compensation point (RCP and maximal oxygen uptake (VO2max by means of maximum effort testing. However, in order to be able to interpret these data in a wide-ranging manner, it is also important to understand the metabolic responses that occur during the test as the systems transporting and utilizing O2 and producing CO2 adjust. This review article presents an overview of the metabolic responses that take place during a hypothetical maximum effort test, and the applicability of the fi gures thus obtained to the training of athletes. ABSTRACT A determinação das velocidades atingidas no limiar ventilatório (LV, ponto de compensação respiratório (PCR e consumo máximo de O2 (VO2max através de um teste de esforço máximo, é uma ferramenta importante para a aplicação de intensidades de treinamento específicas e individualizadas. Mas para poder interpretar os dados de uma forma abrangente, também é importante o entendimento das respostas metabólicas presentes no ajuste dos sistemas de transporte e utilização de O2 e produção de CO2 durante a realização do teste. Esta revisão apresenta um panorama das respostas metabólicas que acontecem durante a realização de um teste de esforço máximo hipotético, e a aplicabilidade dos valores obtidos no treinamento de atletas.

  10. Laboratory and Field-Based Evaluation of Short-Term Effort with Maximal Intensity in Individuals with Intellectual Disabilities

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    Lencse-Mucha Judit

    2015-12-01

    Full Text Available Results of previous studies have not indicated clearly which tests should be used to assess short-term efforts of people with intellectual disabilities. Thus, the aim of the present study was to evaluate laboratory and field-based tests of short-term effort with maximal intensity of subjects with intellectual disabilities. Twenty four people with intellectual disability, who trained soccer, participated in this study. The 30 s Wingate test and additionally an 8 s test with maximum intensity were performed on a bicycle ergometer. The fatigue index, maximal and mean power, relative maximal and relative mean power were measured. Overall, nine field-based tests were conducted: 5, 10 and 20 m sprints, a 20 m shuttle run, a seated medicine ball throw, a bent arm hang test, a standing broad jump, sit-ups and a hand grip test. The reliability of the 30 s and 8 s Wingate tests for subjects with intellectual disability was confirmed. Significant correlation was observed for mean power between the 30 s and 8 s tests on the bicycle ergometer at a moderate level (r >0.4. Moreover, significant correlations were indicated between the results of laboratory tests and field tests, such as the 20 m sprint, the 20 m shuttle run, the standing long jump and the medicine ball throw. The strongest correlation was in the medicine ball throw. The 30 s Wingate test is a reliable test assessing maximal effort in subjects with intellectual disability. The results of this research confirmed that the 8 s test on a bicycle ergometer had a moderate correlation with the 30 s Wingate test in this population, thus, this comparison needs further investigation to examine alternativeness of the 8 s to 30 s Wingate tests. The non-laboratory tests could be used to indirectly assess performance in short-term efforts with maximal intensity.

  11. Laboratory and Field-Based Evaluation of Short-Term Effort with Maximal Intensity in Individuals with Intellectual Disabilities

    Science.gov (United States)

    Lencse-Mucha, Judit; Molik, Bartosz; Marszałek, Jolanta; Kaźmierska-Kowalewska, Kalina; Ogonowska-Słodownik, Anna

    2015-01-01

    Results of previous studies have not indicated clearly which tests should be used to assess short-term efforts of people with intellectual disabilities. Thus, the aim of the present study was to evaluate laboratory and field-based tests of short-term effort with maximal intensity of subjects with intellectual disabilities. Twenty four people with intellectual disability, who trained soccer, participated in this study. The 30 s Wingate test and additionally an 8 s test with maximum intensity were performed on a bicycle ergometer. The fatigue index, maximal and mean power, relative maximal and relative mean power were measured. Overall, nine field-based tests were conducted: 5, 10 and 20 m sprints, a 20 m shuttle run, a seated medicine ball throw, a bent arm hang test, a standing broad jump, sit-ups and a hand grip test. The reliability of the 30 s and 8 s Wingate tests for subjects with intellectual disability was confirmed. Significant correlation was observed for mean power between the 30 s and 8 s tests on the bicycle ergometer at a moderate level (r >0.4). Moreover, significant correlations were indicated between the results of laboratory tests and field tests, such as the 20 m sprint, the 20 m shuttle run, the standing long jump and the medicine ball throw. The strongest correlation was in the medicine ball throw. The 30 s Wingate test is a reliable test assessing maximal effort in subjects with intellectual disability. The results of this research confirmed that the 8 s test on a bicycle ergometer had a moderate correlation with the 30 s Wingate test in this population, thus, this comparison needs further investigation to examine alternativeness of the 8 s to 30 s Wingate tests. The non-laboratory tests could be used to indirectly assess performance in short-term efforts with maximal intensity. PMID:26834874

  12. Contribution of Leg-Muscle Forces to Paddle Force and Kayak Speed During Maximal-Effort Flat-Water Paddling.

    Science.gov (United States)

    Nilsson, Johnny E; Rosdahl, Hans G

    2016-01-01

    The purpose was to investigate the contribution of leg-muscle-generated forces to paddle force and kayak speed during maximal-effort flat-water paddling. Five elite male kayakers at national and international level participated. The participants warmed up at progressively increasing speeds and then performed a maximal-effort, nonrestricted paddling sequence. This was followed after 5 min rest by a maximal-effort paddling sequence with the leg action restricted--the knee joints "locked." Left- and right-side foot-bar and paddle forces were recorded with specially designed force devices. In addition, knee angular displacement of the right and left knees was recorded with electrogoniometric technique, and the kayak speed was calculated from GPS signals sampled at 5 Hz. The results showed that reduction in both push and pull foot-bar forces resulted in a reduction of 21% and 16% in mean paddle-stroke force and mean kayak speed, respectively. Thus, the contribution of foot-bar force from lower-limb action significantly contributes to kayakers' paddling performance.

  13. Does the incremental shuttle walk test require maximal effort in young obese women?

    Directory of Open Access Journals (Sweden)

    S.P. Jürgensen

    2016-01-01

    Full Text Available Obesity is a chronic disease with a multifaceted treatment approach that includes nutritional counseling, structured exercise training, and increased daily physical activity. Increased body mass elicits higher cardiovascular, ventilatory and metabolic demands to varying degrees during exercise. With functional capacity assessment, this variability can be evaluated so individualized guidance for exercise training and daily physical activity can be provided. The aim of the present study was to compare cardiovascular, ventilatory and metabolic responses obtained during a symptom-limited cardiopulmonary exercise test (CPX on a treadmill to responses obtained by the incremental shuttle walk test (ISWT in obese women and to propose a peak oxygen consumption (VO2 prediction equation through variables obtained during the ISWT. Forty obese women (BMI ≥30 kg/m2 performed one treadmill CPX and two ISWTs. Heart rate (HR, arterial blood pressure (ABP and perceived exertion by the Borg scale were measured at rest, during each stage of the exercise protocol, and throughout the recovery period. The predicted maximal heart rate (HRmax was calculated (210 – age in years (16 and compared to the HR response during the CPX. Peak VO2 obtained during CPX correlated significantly (P<0.05 with ISWT peak VO2 (r=0.79 as well as ISWT distance (r=0.65. The predictive model for CPX peak VO2, using age and ISWT distance explained 67% of the variability. The current study indicates the ISWT may be used to predict aerobic capacity in obese women when CPX is not a viable option.

  14. Unifying a fragmented effort: a qualitative framework for improving international surgical teaching collaborations.

    Science.gov (United States)

    Fallah, Parisa Nicole; Bernstein, Mark

    2017-09-07

    Access to adequate surgical care is limited globally, particularly in low- and middle-income countries (LMICs). To address this issue, surgeons are becoming increasingly involved in international surgical teaching collaborations (ISTCs), which include educational partnerships between surgical teams in high-income countries and those in LMICs. The purpose of this study is to determine a framework for unifying, systematizing, and improving the quality of ISTCs so that they can better address the global surgical need. A convenience sample of 68 surgeons, anesthesiologists, physicians, residents, nurses, academics, and administrators from the U.S., Canada, and Norway was used for the study. Participants all had some involvement in ISTCs and came from multiple specialties and institutions. Qualitative methodology was used, and participants were interviewed using a pre-determined set of open-ended questions. Data was gathered over two months either in-person, over the phone, or on Skype. Data was evaluated using thematic content analysis. To organize and systematize ISTCs, participants reported a need for a centralized/systematized process with designated leaders, a universal data bank of current efforts/progress, communication amongst involved parties, full-time administrative staff, dedicated funds, a scholarly approach, increased use of technology, and more research on needs and outcomes. By taking steps towards unifying and systematizing ISTCs, the quality of ISTCs can be improved. This could lead to an advancement in efforts to increase access to surgical care worldwide.

  15. Maximizing coupling strength of magnetically anchored surgical instruments: how thick can we go?

    Science.gov (United States)

    Best, Sara L; Bergs, Richard; Gedeon, Makram; Paramo, Juan; Fernandez, Raul; Cadeddu, Jeffrey A; Scott, Daniel J

    2011-01-01

    The Magnetic Anchoring and Guidance System (MAGS) includes an external magnet that controls intra-abdominal surgical instruments via magnetic attraction forces. We have performed NOTES (Natural Orifice Transluminal Endoscopic Surgery) and LESS (Laparoendoscopic Single Site) procedures using MAGS instruments in porcine models with up to 2.5-cm-thick abdominal walls, but this distance may not be sufficient in some humans. The purpose of this study was to determine the maximal abdominal wall thickness for which the current MAGS platform is suitable. Successive iterations of prototype instruments were developed; those evaluated in this study include external (134-583 g, 38-61 mm diameter) and internal (8-39 g, 10-22 mm diameter) components using various grades, diameters, thicknesses, and stacking/shielding/focusing configurations of permanent Neodymium-iron-boron (NdFeB) magnets. Nine configurations were tested for coupling strength across distances of 0.1-10 cm. The force-distance tests across an air medium were conducted at 0.5-mm increments using a robotic arm fitted with a force sensor. A minimum theoretical instrument drop-off (decoupling) threshold was defined as the separation distance at which force decreased below the weight of the heaviest internal component (39 g). Magnetic attraction forces decreased exponentially over distance. For the nine configurations tested, the average forces were 3,334 ± 1,239 gf at 0.1 cm, 158 ± 98 gf at 2.5 cm, and 8.7 ± 12 gf at 5 cm; the drop-off threshold was 3.64 ± 0.8 cm. The larger stacking configurations and magnets yielded up to a 592% increase in attraction force at 2.5 cm and extended the drop-off threshold distance by up to 107% over single-stack anchors. For the strongest configuration, coupling force ranged from 5,337 gf at 0.1 cm to 0 gf at 6.95 cm and yielded a drop-off threshold distance of 4.78 cm. This study suggests that the strongest configuration of currently available MAGS instruments is suitable for

  16. A Selective Role for Dopamine in Learning to Maximize Reward But Not to Minimize Effort: Evidence from Patients with Parkinson's Disease.

    Science.gov (United States)

    Skvortsova, Vasilisa; Degos, Bertrand; Welter, Marie-Laure; Vidailhet, Marie; Pessiglione, Mathias

    2017-06-21

    Instrumental learning is a fundamental process through which agents optimize their choices, taking into account various dimensions of available options such as the possible reward or punishment outcomes and the costs associated with potential actions. Although the implication of dopamine in learning from choice outcomes is well established, less is known about its role in learning the action costs such as effort. Here, we tested the ability of patients with Parkinson's disease (PD) to maximize monetary rewards and minimize physical efforts in a probabilistic instrumental learning task. The implication of dopamine was assessed by comparing performance ON and OFF prodopaminergic medication. In a first sample of PD patients ( n = 15), we observed that reward learning, but not effort learning, was selectively impaired in the absence of treatment, with a significant interaction between learning condition (reward vs effort) and medication status (OFF vs ON). These results were replicated in a second, independent sample of PD patients ( n = 20) using a simplified version of the task. According to Bayesian model selection, the best account for medication effects in both studies was a specific amplification of reward magnitude in a Q-learning algorithm. These results suggest that learning to avoid physical effort is independent from dopaminergic circuits and strengthen the general idea that dopaminergic signaling amplifies the effects of reward expectation or obtainment on instrumental behavior. SIGNIFICANCE STATEMENT Theoretically, maximizing reward and minimizing effort could involve the same computations and therefore rely on the same brain circuits. Here, we tested whether dopamine, a key component of reward-related circuitry, is also implicated in effort learning. We found that patients suffering from dopamine depletion due to Parkinson's disease were selectively impaired in reward learning, but not effort learning. Moreover, anti-parkinsonian medication restored the

  17. Cortical and spinal excitability during and after lengthening contractions of the human plantar flexor muscles performed with maximal voluntary effort.

    Directory of Open Access Journals (Sweden)

    Daniel Hahn

    Full Text Available This study was designed to investigate the sites of potential specific modulations in the neural control of lengthening and subsequent isometric maximal voluntary contractions (MVCs versus purely isometric MVCs of the plantar flexor muscles, when there is enhanced torque during and following stretch. Ankle joint torque during maximum voluntary plantar flexion was measured by a dynamometer when subjects (n = 10 lay prone on a bench with the right ankle tightly strapped to a foot-plate. Neural control was analysed by comparing soleus motor responses to electrical nerve stimulation (M-wave, V-wave, electrical stimulation of the cervicomedullary junction (CMEP and transcranial magnetic stimulation of the motor cortex (MEP. Enhanced torque of 17 ± 8% and 9 ± 8% was found during and 2.5-3 s after lengthening MVCs, respectively. Cortical and spinal responsiveness was similar to that in isometric conditions during the lengthening MVCs, as shown by unchanged MEPs, CMEPs and V-waves, suggesting that the major voluntary motor pathways are not subject to substantial inhibition. Following the lengthening MVCs, enhanced torque was accompanied by larger MEPs (p ≤ 0.05 and a trend to greater V-waves (p ≤ 0.1. In combination with stable CMEPs, increased MEPs suggest an increase in cortical excitability, and enlarged V-waves indicate greater motoneuronal output or increased stretch reflex excitability. The new results illustrate that neuromotor pathways are altered after lengthening MVCs suggesting that the underlying mechanisms of the enhanced torque are not purely mechanical in nature.

  18. Aggressive Surgical Management of Congenital Diaphragmatic Hernia: Worth the Effort?: A Multicenter, Prospective, Cohort Study.

    Science.gov (United States)

    Harting, Matthew T; Hollinger, Laura; Tsao, Kuojen; Putnam, Luke R; Wilson, Jay M; Hirschl, Ronald B; Skarsgard, Erik D; Tibboel, Dick; Brindle, Mary E; Lally, Pamela A; Miller, Charles C; Lally, Kevin P

    2018-05-01

    The objectives of this study were (i) to evaluate infants with congenital diaphragmatic hernia (CDH) that do not undergo repair, (ii) to identify nonrepair rate by institution, and (iii) to compare institutional outcomes based on nonrepair rate. Approximately 20% of infants with CDH go unrepaired and the threshold to offer surgical repair is variable. Data were abstracted from a multicenter, prospectively collected database. Standard clinical variables, including repair (or nonrepair), and outcome were analyzed. Institutions were grouped based on volume and rate of nonrepair. Preoperative mortality predictors were identified using logistic regression, expected mortality for each center was calculated, and observed /expected (O/E) ratios were computed for center groups and compared by Kruskal-Wallis ANOVA. A total of 3965 infants with CDH were identified and 691 infants (17.5%) were not repaired. Nonrepaired patients had lower Apgar scores (P HiLo = 5.1-16.7% and HiHi = 17.6-38.5%), leaving 3 groups: HiLo, HiHi, and Lo. Predictors of mortality were lower birth weight, lower Apgar scores, prenatal diagnosis, and presence of congenital anomalies. O/E ratios for mortality in the HiLo, HiHi, and Lo groups were 0.81, 0.94, and 1.21, respectively (P HiLo centers have 2.73 (2.4-3.1, 95% confidence interval) survivors beyond expectation. There are significant differences between repaired and nonrepaired CDH infants and significant center variation in rate of nonrepair exists. Aggressive surgical management, leading to a low rate of nonrepair, is associated with improved risk-adjusted mortality.

  19. Evidence for a Standardized Preadmission Showering Regimen to Achieve Maximal Antiseptic Skin Surface Concentrations of Chlorhexidine Gluconate, 4%, in Surgical Patients.

    Science.gov (United States)

    Edmiston, Charles E; Lee, Cheong J; Krepel, Candace J; Spencer, Maureen; Leaper, David; Brown, Kellie R; Lewis, Brian D; Rossi, Peter J; Malinowski, Michael J; Seabrook, Gary R

    2015-11-01

    To reduce the amount of skin surface bacteria for patients undergoing elective surgery, selective health care facilities have instituted a preadmission antiseptic skin cleansing protocol using chlorhexidine gluconate. A Cochrane Collaborative review suggests that existing data do not justify preoperative skin cleansing as a strategy to reduce surgical site infection. To develop and evaluate the efficacy of a standardized preadmission showering protocol that optimizes skin surface concentrations of chlorhexidine gluconate and to compare the findings with the design and methods of published studies on preoperative skin preparation. A randomized prospective analysis in 120 healthy volunteers was conducted at an academic tertiary care medical center from June 1, 2014, to September, 30, 2014. Data analysis was performed from October 13, 2014, to October 27, 2014. A standardized process of dose, duration, and timing was used to maximize antiseptic skin surface concentrations of chlorhexidine gluconate applied during preoperative showering. The volunteers were randomized to 2 chlorhexidine gluconate, 4%, showering groups (2 vs 3 showers), containing 60 participants each, and 3 subgroups (no pause, 1-minute pause, or 2-minute pause before rinsing), containing 20 participants each. Volunteers used 118 mL of chlorhexidine gluconate, 4%, for each shower. Skin surface concentrations of chlorhexidine gluconate were analyzed using colorimetric assay at 5 separate anatomic sites. Individual groups were analyzed using paired t test and analysis of variance. Preadmission showers using chlorhexidine gluconate, 4%. The primary outcome was to develop a standardized approach for administering the preadmission shower with chlorhexidine gluconate, 4%, resulting in maximal, persistent skin antisepsis by delineating a precise dose (volume) of chlorhexidine gluconate, 4%; duration (number of showers); and timing (pause) before rinsing. The mean (SD) composite chlorhexidine gluconate

  20. Surgical results from treating children with syndactyly through the collective effort system at "SOS Hand Recife" between 2005 and 2009

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    Mauri Cortez

    2014-08-01

    Full Text Available Objective:to evaluate the results from and parents' satisfaction with treatment for children with syndactyly who were operated at the "SOS Hand Recife" hospital between 2005 and 2009.Methods:data for assessing the results were gathered from the patients' medical files. The subjective scores, which were ascertained prospectively, were as follows: greater than or equal to 9, good result; between 6 and 8, fair result; less than 6, poor result. The results were analyzed statistically. This study was approved by the institution's ethics committee.Results:among the 35 cases, 21 (60% consisted of simple syndactyly and 14 (40% were complex; 22 (62.8% were boys and 13 (37.1% were girls. The complex cases were predominantly among males. The main complications were infection (11.4%, bleeding (11.4% and pain (8.6%. There were more complications in the complex cases (42.8% than in the simple cases (33.3%. The mean scores from the parents' subjective evaluations were as follows: 7.6 for esthetics (7.7 in simple cases and 7.3 in complex cases; 8.2 for function (8.6 in simple cases and 7.6 in complex cases; 8.3 for the parents' general satisfaction level (8.6 in simple cases and 8.0 in complex cases; and 85.7% of the parents would recommend the surgery to others while 14.5% would not. A strong association was observed between the specialist's objective assessment and the scores given by the parents (p < 0.05.Conclusion:the surgical results from treating syndactyly presented differences between the simple and complex types, even though the parents' esthetic evaluations and satisfaction were similar.

  1. Chair Talk: Resources to Maximize Administrative Efforts

    Science.gov (United States)

    MacDonald, H.; Chan, M. A.; Bierly, E. W.; Manduca, C. A.; Ormand, C. J.

    2009-12-01

    Earth science department chairs are generally scientists who have little/no formal administrative training. The common rotation of faculty members in three-six year cycles distributes the heavy leadership responsibilities but involves little preparation beforehand to deal with budgets, fundraising, personnel issues, confrontations, and crises. The amount of information exchange and support upon exit and handoff to the next chair is variable. Resources for chairs include workshops, meetings (ranging from annual meetings of geoscience chairs to monthly meetings of small groups of chairs from various disciplines on a campus), discussions, and online resources. These resources, some of which we designed in the past several years, provide information and support for chairs, help them share best practices, and reduce time spent “reinventing the wheel”. Most of these resources involve groups of chairs in our discipline who meet together. The AGU Board of Heads and Chairs of Earth and Space Science Departments offers annual one-day workshops at the Fall AGU meeting. The specific topics vary from year to year; they have included goals and roles of heads and chairs, fundraising and Advisory Boards, student recruitment, interdisciplinarity, dual-career couples, and undergraduate research. The workshop provides ample opportunities for open discussion. Annual one-two day meetings of groups of geoscience department chairs (e.g., research universities in a particular region) provide an opportunity for chairs to share specific data about their departments (e.g., salaries, graduate student stipends, information about facilities) and discuss strategies. At the College of William and Mary, a small group of chairs meets monthly throughout the year; each session includes time for open discussion as well as a more structured discussion on a particular topic (e.g., merit review, development and fundraising, mentoring early career faculty and the tenure process, leadership styles, dealing with difficult situations, working with alumni). Through the Association for Women Geoscientists, we have offered annual one-hour lunch discussions at AGU and GSA meetings on issues facing women chairs and deans. Focusing on a different topic each year, these discussions include sharing good solutions, problem solving on various case scenarios, and so forth. In addition, the Building Strong Geoscience Departments program has offered workshops on different aspects of building strong geoscience departments, distributed reports, and made a variety of materials that would be useful to geoscience chairs available on their website. These programs and resources should continue and build to provide more continuity within departments and to increase a broader experience base of faculty. One of the greatest resources for chairs is to have personal connections with other chairs (via these programs), who can be called upon for advice, ideas, or general support. The sense of collective community could act in a powerful way to inspire and encourage more innovations and creative solutions to promote stronger departments.

  2. Entropy maximization

    Indian Academy of Sciences (India)

    Abstract. It is shown that (i) every probability density is the unique maximizer of relative entropy in an appropriate class and (ii) in the class of all pdf f that satisfy. ∫ fhi dμ = λi for i = 1, 2,...,...k the maximizer of entropy is an f0 that is pro- portional to exp(. ∑ ci hi ) for some choice of ci . An extension of this to a continuum of.

  3. Entropy Maximization

    Indian Academy of Sciences (India)

    It is shown that (i) every probability density is the unique maximizer of relative entropy in an appropriate class and (ii) in the class of all pdf that satisfy ∫ f h i d = i for i = 1 , 2 , … , … k the maximizer of entropy is an f 0 that is proportional to exp ⁡ ( ∑ c i h i ) for some choice of c i . An extension of this to a continuum of ...

  4. Changes of glucose utilization by erythrocytes, lactic acid concentration in the serum and blood cells, and haematocrit value during one hour rest after maximal effort in individuals differing in physical efficiency.

    Science.gov (United States)

    Tomasik, M

    1982-01-01

    Glucose utilization by the erythrocytes, lactic acid concentration in the blood and erythrocytes, and haematocrit value were determined before exercise and during one hour rest following maximal exercise in 97 individuals of either sex differing in physical efficiency. In the investigations reported by the author individuals with strikingly high physical fitness performed maximal work one-third greater than that performed by individuals with medium fitness. The serum concentration of lactic acid was in all individuals above the resting value still after 60 minutes of rest. On the other hand, this concentration returned to the normal level in the erythrocytes but only in individuals with strikingly high efficiency. Glucose utilization by the erythrocytes during the restitution period was highest immediately after the exercise in all studied individuals and showed a tendency for more rapid return to resting values again in individuals with highest efficiency. The investigation of very efficient individuals repeated twice demonstrated greater utilization of glucose by the erythrocytes at the time of greater maximal exercise. This was associated with greater lactic acid concentration in the serum and erythrocytes throughout the whole one-hour rest period. The observed facts suggest an active participation of erythrocytes in the process of adaptation of the organism to exercise.

  5. MAXIM: The Blackhole Imager

    Science.gov (United States)

    Gendreau, Keith; Cash, Webster; Gorenstein, Paul; Windt, David; Kaaret, Phil; Reynolds, Chris

    2004-01-01

    The Beyond Einstein Program in NASA's Office of Space Science Structure and Evolution of the Universe theme spells out the top level scientific requirements for a Black Hole Imager in its strategic plan. The MAXIM mission will provide better than one tenth of a microarcsecond imaging in the X-ray band in order to satisfy these requirements. We will overview the driving requirements to achieve these goals and ultimately resolve the event horizon of a supermassive black hole. We will present the current status of this effort that includes a study of a baseline design as well as two alternative approaches.

  6. Modelos para predição da carga máxima no teste clínico de esforço cardiopulmonar Maximal workload prediction models in the clinical cardio-pulmonary effort test

    Directory of Open Access Journals (Sweden)

    Fernando dos Santos Nogueira

    2006-08-01

    Full Text Available OBJETIVO: Este estudo buscou derivar equações generalizadas para predição da carga máxima para homens e mulheres jovens. MÉTODOS: O método da ergoespirometria direta (Aerosport® TEEM 100, Estados Unidos da América do Norte foi empregado para determinar o VO2máx e a carga máxima (Wmáx, no cicloergômetro (Monark®, Brasil, de 30 homens (25 ± 5 anos, 75,0 ± 10,7 kg; 48,4 ± 8,8 mL . kg -1 . min -1 e 243 ± 51 Watts e 30 mulheres (26 ± 5 anos, 56,7 ± 5,9 kg, 39,8 ± 7,6 mL . kg -1 . min -1 e 172 ± 37 Watts. A idade e a massa corporal foram empregadas como variáveis independentes. Para todos os testes estatísticos aceitou-se o nível de significância de p OBJECTIVE: This study sought to derive generalized equations for predicting maximal workload for young men and women. METHODS: Direct ergospirometry (Aerosport® TEEM 100, USA was used to determine VO2máx and the maximal work load (Wmax on the cycle ergometer test (Monark®, Brazil of thirty men (25 ± 5 years, 75.0 ± 10.7 kg; 48.4 ± 8.8 mL . kg -1 . min -1 and 243 ± 51 Watts and thirty women (26 ± 5 years, 56.7 ± 5.9 kg, 39.8 ± 7.6 mL . kg -1 . min -1 and 172 ± 37 Watts. Age and body mass were used as independent variables. For all statistic tests, a p < 0.05 significance level was adopted. RESULTS: In the multiple linear adjustment, the maximal workload was explained by age and body mass as 54% (r = 0.73 for men, and as 76% (r = 0.87 for women, with standard errors of 0.66 W . kg -1 and 25 Watts. The proposed equations were cross-validated using another sample with similar age and VO2máx characteristics comprised of fifteen men and fifteen women. The intraclass correlation between the predicted Wmax values and those measures by ergospirometry were 0.70 and 0.69, with standard errors of 28.4 and 15.8 Watts, respectively, for men and women. CONCLUSIONS: This study exhibits valid generalized equations for determining the maximal cycle ergonometer workload for men and

  7. Maximizing and customer loyalty: Are maximizers less loyal?

    Directory of Open Access Journals (Sweden)

    Linda Lai

    2011-06-01

    Full Text Available Despite their efforts to choose the best of all available solutions, maximizers seem to be more inclined than satisficers to regret their choices and to experience post-decisional dissonance. Maximizers may therefore be expected to change their decisions more frequently and hence exhibit lower customer loyalty to providers of products and services compared to satisficers. Findings from the study reported here (N = 1978 support this prediction. Maximizers reported significantly higher intentions to switch to another service provider (television provider than satisficers. Maximizers' intentions to switch appear to be intensified and mediated by higher proneness to regret, increased desire to discuss relevant choices with others, higher levels of perceived knowledge of alternatives, and higher ego involvement in the end product, compared to satisficers. Opportunities for future research are suggested.

  8. Profit maximization mitigates competition

    DEFF Research Database (Denmark)

    Dierker, Egbert; Grodal, Birgit

    1996-01-01

    We consider oligopolistic markets in which the notion of shareholders' utility is well-defined and compare the Bertrand-Nash equilibria in case of utility maximization with those under the usual profit maximization hypothesis. Our main result states that profit maximization leads to less price...... competition than utility maximization. Since profit maximization tends to raise prices, it may be regarded as beneficial for the owners as a whole. Moreover, if profit maximization is a good proxy for utility maximization, then there is no need for a general equilibrium analysis that takes the distribution...... of profits among consumers fully into account and partial equilibrium analysis suffices...

  9. Effortful echolalia.

    Science.gov (United States)

    Hadano, K; Nakamura, H; Hamanaka, T

    1998-02-01

    We report three cases of effortful echolalia in patients with cerebral infarction. The clinical picture of speech disturbance is associated with Type 1 Transcortical Motor Aphasia (TCMA, Goldstein, 1915). The patients always spoke nonfluently with loss of speech initiative, dysarthria, dysprosody, agrammatism, and increased effort and were unable to repeat sentences longer than those containing four or six words. In conversation, they first repeated a few words spoken to them, and then produced self initiated speech. The initial repetition as well as the subsequent self initiated speech, which were realized equally laboriously, can be regarded as mitigated echolalia (Pick, 1924). They were always aware of their own echolalia and tried to control it without effect. These cases demonstrate that neither the ability to repeat nor fluent speech are always necessary for echolalia. The possibility that a lesion in the left medial frontal lobe, including the supplementary motor area, plays an important role in effortful echolalia is discussed.

  10. Maximally incompatible quantum observables

    Energy Technology Data Exchange (ETDEWEB)

    Heinosaari, Teiko, E-mail: teiko.heinosaari@utu.fi [Turku Centre for Quantum Physics, Department of Physics and Astronomy, University of Turku, FI-20014 Turku (Finland); Schultz, Jussi, E-mail: jussi.schultz@gmail.com [Dipartimento di Matematica, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milano (Italy); Toigo, Alessandro, E-mail: alessandro.toigo@polimi.it [Dipartimento di Matematica, Politecnico di Milano, Piazza Leonardo da Vinci 32, I-20133 Milano (Italy); Istituto Nazionale di Fisica Nucleare, Sezione di Milano, Via Celoria 16, I-20133 Milano (Italy); Ziman, Mario, E-mail: ziman@savba.sk [RCQI, Institute of Physics, Slovak Academy of Sciences, Dúbravská cesta 9, 84511 Bratislava (Slovakia); Faculty of Informatics, Masaryk University, Botanická 68a, 60200 Brno (Czech Republic)

    2014-05-01

    The existence of maximally incompatible quantum observables in the sense of a minimal joint measurability region is investigated. Employing the universal quantum cloning device it is argued that only infinite dimensional quantum systems can accommodate maximal incompatibility. It is then shown that two of the most common pairs of complementary observables (position and momentum; number and phase) are maximally incompatible.

  11. Maximally incompatible quantum observables

    International Nuclear Information System (INIS)

    Heinosaari, Teiko; Schultz, Jussi; Toigo, Alessandro; Ziman, Mario

    2014-01-01

    The existence of maximally incompatible quantum observables in the sense of a minimal joint measurability region is investigated. Employing the universal quantum cloning device it is argued that only infinite dimensional quantum systems can accommodate maximal incompatibility. It is then shown that two of the most common pairs of complementary observables (position and momentum; number and phase) are maximally incompatible.

  12. Kohl’s Furthers Efforts to Maximize Efficiency

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-03-01

    Kohl’s Department Stores partnered with the U.S. Department of Energy (DOE) to develop and implement solutions to retrofit existing buildings to reduce annual energy consumption by at least 30% versus requirements set by ASHRAE/ANSI/IESNA Standard 90.1-20041 as part of DOE’s Commercial Building Partnership (CBP) program.

  13. Maximizers versus satisficers

    OpenAIRE

    Andrew M. Parker; Wandi Bruine de Bruin; Baruch Fischhoff

    2007-01-01

    Our previous research suggests that people reporting a stronger desire to maximize obtain worse life outcomes (Bruine de Bruin et al., 2007). Here, we examine whether this finding may be explained by the decision-making styles of self-reported maximizers. Expanding on Schwartz et al. (2002), we find that self-reported maximizers are more likely to show problematic decision-making styles, as evidenced by self-reports of less behavioral coping, greater dependence on others when making decisions...

  14. Maximal combustion temperature estimation

    International Nuclear Information System (INIS)

    Golodova, E; Shchepakina, E

    2006-01-01

    This work is concerned with the phenomenon of delayed loss of stability and the estimation of the maximal temperature of safe combustion. Using the qualitative theory of singular perturbations and canard techniques we determine the maximal temperature on the trajectories located in the transition region between the slow combustion regime and the explosive one. This approach is used to estimate the maximal temperature of safe combustion in multi-phase combustion models

  15. Maximally multipartite entangled states

    Science.gov (United States)

    Facchi, Paolo; Florio, Giuseppe; Parisi, Giorgio; Pascazio, Saverio

    2008-06-01

    We introduce the notion of maximally multipartite entangled states of n qubits as a generalization of the bipartite case. These pure states have a bipartite entanglement that does not depend on the bipartition and is maximal for all possible bipartitions. They are solutions of a minimization problem. Examples for small n are investigated, both analytically and numerically.

  16. Maximizers versus satisficers

    Directory of Open Access Journals (Sweden)

    Andrew M. Parker

    2007-12-01

    Full Text Available Our previous research suggests that people reporting a stronger desire to maximize obtain worse life outcomes (Bruine de Bruin et al., 2007. Here, we examine whether this finding may be explained by the decision-making styles of self-reported maximizers. Expanding on Schwartz et al. (2002, we find that self-reported maximizers are more likely to show problematic decision-making styles, as evidenced by self-reports of less behavioral coping, greater dependence on others when making decisions, more avoidance of decision making, and greater tendency to experience regret. Contrary to predictions, self-reported maximizers were more likely to report spontaneous decision making. However, the relationship between self-reported maximizing and worse life outcomes is largely unaffected by controls for measures of other decision-making styles, decision-making competence, and demographic variables.

  17. Is CP violation maximal

    International Nuclear Information System (INIS)

    Gronau, M.

    1984-01-01

    Two ambiguities are noted in the definition of the concept of maximal CP violation. The phase convention ambiguity is overcome by introducing a CP violating phase in the quark mixing matrix U which is invariant under rephasing transformations. The second ambiguity, related to the parametrization of U, is resolved by finding a single empirically viable definition of maximal CP violation when assuming that U does not single out one generation. Considerable improvement in the calculation of nonleptonic weak amplitudes is required to test the conjecture of maximal CP violation. 21 references

  18. Surgical Assisting

    Science.gov (United States)

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

  19. Abortion - surgical

    Science.gov (United States)

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

  20. Guinea pig maximization test

    DEFF Research Database (Denmark)

    Andersen, Klaus Ejner

    1985-01-01

    Guinea pig maximization tests (GPMT) with chlorocresol were performed to ascertain whether the sensitization rate was affected by minor changes in the Freund's complete adjuvant (FCA) emulsion used. Three types of emulsion were evaluated: the oil phase was mixed with propylene glycol, saline...

  1. Efeito de oito semanas de suplementação com creatina monoidratada sobre o trabalho total relativo em esforços intermitentes máximos no cicloergômetro de homens treinados Effect of eight weeks of creatine supplementation on relative total work in intermittent maximal efforts in the cycle ergometer of trained men

    Directory of Open Access Journals (Sweden)

    Leandro Ricardo Altimari

    2006-06-01

    Full Text Available Este estudo investigou o efeito de um longo período de suplementação com creatina monoidratada (Cr m sobre o trabalho total relativo (TTR em esforços intermitentes máximos no cicloergômetro de homens treinados. Vinte seis indivíduos foram divididos aleatoriamente em grupo creatina (CR, n=13 e grupo placebo (PL, n=13. Os sujeitos receberam em sistema duplo-cego, doses de Cr m ou placebo-maltodextrina (20 g.d-1 por 5 dias e 3 g.d-1 durante 51 dias subseqüentes. Os grupos tiveram seus hábitos alimentares e sua condição física previamente controlados. Para determinação do TTR os sujeitos foram submetidos a protocolo de exercício em cicloergômetro composto de três Testes de Wingate de 30s separados por dois minutos recuperação, antes e após o período de suplementação. ANOVA, seguido pelo teste post hoc de Tukey, quando pThis study investigated the effect of long-term supplementation with creatine monohydrate (Cr m on relative total work (RTW in intermittent maximal efforts in the cycle ergometer of trained men. Twenty six individuals were randomly divided in creatine group (CR, n=13 and placebo group (PL, n=13. The subjects received in a double-blind manner, doses of Cr m or placebo-maltodextrin (20 g.d-1 for 5 days and 3 g.d-1 for 51 subsequent days. The groups had their alimentary habits and physical fitness controlled previously. For determination of the RTW the subjects were submitted to exercise protocol in cycle ergometer comprised three 30s Anaerobic Wingate Test interspersed with two minutes recovery, before and after the supplementation period. ANOVA, followed by the Tukey post hoc test, when p<0.05, were used for data treatment. There was a significant time effect for RTW (F1,24=8.00; p<0.05, with the CR group demonstrating significant greater (3% on the RTW production compared to PL group after the supplementation period (690.54 ± 46.83 vs 655.71 ± 74.34 J.kg-1 respectively; p<0.05. The results of the present study

  2. Tri-maximal vs. bi-maximal neutrino mixing

    International Nuclear Information System (INIS)

    Scott, W.G

    2000-01-01

    It is argued that data from atmospheric and solar neutrino experiments point strongly to tri-maximal or bi-maximal lepton mixing. While ('optimised') bi-maximal mixing gives an excellent a posteriori fit to the data, tri-maximal mixing is an a priori hypothesis, which is not excluded, taking account of terrestrial matter effects

  3. Effort problem of chemical pipelines

    Energy Technology Data Exchange (ETDEWEB)

    Okrajni, J.; Ciesla, M.; Mutwil, K. [Silesian Technical University, Katowice (Poland)

    1998-12-31

    The problem of the technical state assessment of the chemical pipelines working under mechanical and thermal loading has been shown in the paper. The pipelines effort after the long time operating period has been analysed. Material geometrical and loading conditions of the crack initiation and crack growth process in the chosen object has been discussed. Areas of the maximal effort have been determined. The material structure charges after the long time operating period have been described. Mechanisms of the crack initiation and crack growth in the pipeline elements have been analysed and mutual relations between the chemical and mechanical influences have been shown. (orig.) 16 refs.

  4. Social group utility maximization

    CERN Document Server

    Gong, Xiaowen; Yang, Lei; Zhang, Junshan

    2014-01-01

    This SpringerBrief explains how to leverage mobile users' social relationships to improve the interactions of mobile devices in mobile networks. It develops a social group utility maximization (SGUM) framework that captures diverse social ties of mobile users and diverse physical coupling of mobile devices. Key topics include random access control, power control, spectrum access, and location privacy.This brief also investigates SGUM-based power control game and random access control game, for which it establishes the socially-aware Nash equilibrium (SNE). It then examines the critical SGUM-b

  5. Surgical lighting

    NARCIS (Netherlands)

    Knulst, A.J.

    2017-01-01

    The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,

  6. Surgical smoke.

    Science.gov (United States)

    Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

    2009-10-01

    Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.

  7. Maximal Bell's inequality violation for non-maximal entanglement

    International Nuclear Information System (INIS)

    Kobayashi, M.; Khanna, F.; Mann, A.; Revzen, M.; Santana, A.

    2004-01-01

    Bell's inequality violation (BIQV) for correlations of polarization is studied for a product state of two two-mode squeezed vacuum (TMSV) states. The violation allowed is shown to attain its maximal limit for all values of the squeezing parameter, ζ. We show via an explicit example that a state whose entanglement is not maximal allow maximal BIQV. The Wigner function of the state is non-negative and the average value of either polarization is nil

  8. Maximally Symmetric Composite Higgs Models.

    Science.gov (United States)

    Csáki, Csaba; Ma, Teng; Shu, Jing

    2017-09-29

    Maximal symmetry is a novel tool for composite pseudo Goldstone boson Higgs models: it is a remnant of an enhanced global symmetry of the composite fermion sector involving a twisting with the Higgs field. Maximal symmetry has far-reaching consequences: it ensures that the Higgs potential is finite and fully calculable, and also minimizes the tuning. We present a detailed analysis of the maximally symmetric SO(5)/SO(4) model and comment on its observational consequences.

  9. Principles of maximally classical and maximally realistic quantum ...

    Indian Academy of Sciences (India)

    Principles of maximally classical and maximally realistic quantum mechanics. S M ROY. Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400 005, India. Abstract. Recently Auberson, Mahoux, Roy and Singh have proved a long standing conjecture of Roy and Singh: In 2N-dimensional phase space, ...

  10. A fractional optimal control problem for maximizing advertising efficiency

    OpenAIRE

    Igor Bykadorov; Andrea Ellero; Stefania Funari; Elena Moretti

    2007-01-01

    We propose an optimal control problem to model the dynamics of the communication activity of a firm with the aim of maximizing its efficiency. We assume that the advertising effort undertaken by the firm contributes to increase the firm's goodwill and that the goodwill affects the firm's sales. The aim is to find the advertising policies in order to maximize the firm's efficiency index which is computed as the ratio between "outputs" and "inputs" properly weighted; the outputs are represented...

  11. Implications of maximal Jarlskog invariant and maximal CP violation

    International Nuclear Information System (INIS)

    Rodriguez-Jauregui, E.; Universidad Nacional Autonoma de Mexico

    2001-04-01

    We argue here why CP violating phase Φ in the quark mixing matrix is maximal, that is, Φ=90 . In the Standard Model CP violation is related to the Jarlskog invariant J, which can be obtained from non commuting Hermitian mass matrices. In this article we derive the conditions to have Hermitian mass matrices which give maximal Jarlskog invariant J and maximal CP violating phase Φ. We find that all squared moduli of the quark mixing elements have a singular point when the CP violation phase Φ takes the value Φ=90 . This special feature of the Jarlskog invariant J and the quark mixing matrix is a clear and precise indication that CP violating Phase Φ is maximal in order to let nature treat democratically all of the quark mixing matrix moduli. (orig.)

  12. Phenomenology of maximal and near-maximal lepton mixing

    International Nuclear Information System (INIS)

    Gonzalez-Garcia, M. C.; Pena-Garay, Carlos; Nir, Yosef; Smirnov, Alexei Yu.

    2001-01-01

    The possible existence of maximal or near-maximal lepton mixing constitutes an intriguing challenge for fundamental theories of flavor. We study the phenomenological consequences of maximal and near-maximal mixing of the electron neutrino with other (x=tau and/or muon) neutrinos. We describe the deviations from maximal mixing in terms of a parameter ε(equivalent to)1-2sin 2 θ ex and quantify the present experimental status for |ε| e mixing comes from solar neutrino experiments. We find that the global analysis of solar neutrino data allows maximal mixing with confidence level better than 99% for 10 -8 eV 2 ∼ 2 ∼ -7 eV 2 . In the mass ranges Δm 2 ∼>1.5x10 -5 eV 2 and 4x10 -10 eV 2 ∼ 2 ∼ -7 eV 2 the full interval |ε| e mixing in atmospheric neutrinos, supernova neutrinos, and neutrinoless double beta decay

  13. Maximal quantum Fisher information matrix

    International Nuclear Information System (INIS)

    Chen, Yu; Yuan, Haidong

    2017-01-01

    We study the existence of the maximal quantum Fisher information matrix in the multi-parameter quantum estimation, which bounds the ultimate precision limit. We show that when the maximal quantum Fisher information matrix exists, it can be directly obtained from the underlying dynamics. Examples are then provided to demonstrate the usefulness of the maximal quantum Fisher information matrix by deriving various trade-off relations in multi-parameter quantum estimation and obtaining the bounds for the scalings of the precision limit. (paper)

  14. Maximize x(a - x)

    Science.gov (United States)

    Lange, L. H.

    1974-01-01

    Five different methods for determining the maximizing condition for x(a - x) are presented. Included is the ancient Greek version and a method attributed to Fermat. None of the proofs use calculus. (LS)

  15. Finding Maximal Quasiperiodicities in Strings

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Pedersen, Christian N. S.

    2000-01-01

    of length n in time O(n log n) and space O(n). Our algorithm uses the suffix tree as the fundamental data structure combined with efficient methods for merging and performing multiple searches in search trees. Besides finding all maximal quasiperiodic substrings, our algorithm also marks the nodes......Apostolico and Ehrenfeucht defined the notion of a maximal quasiperiodic substring and gave an algorithm that finds all maximal quasiperiodic substrings in a string of length n in time O(n log2 n). In this paper we give an algorithm that finds all maximal quasiperiodic substrings in a string...... in the suffix tree that have a superprimitive path-label....

  16. On the maximal diphoton width

    CERN Document Server

    Salvio, Alberto; Strumia, Alessandro; Urbano, Alfredo

    2016-01-01

    Motivated by the 750 GeV diphoton excess found at LHC, we compute the maximal width into $\\gamma\\gamma$ that a neutral scalar can acquire through a loop of charged fermions or scalars as function of the maximal scale at which the theory holds, taking into account vacuum (meta)stability bounds. We show how an extra gauge symmetry can qualitatively weaken such bounds, and explore collider probes and connections with Dark Matter.

  17. Surgical orthodontics.

    Science.gov (United States)

    Strohl, Alexis M; Vitkus, Lauren

    2017-08-01

    The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.

  18. Maximization

    Directory of Open Access Journals (Sweden)

    A. Garmroodi Asil

    2017-09-01

    To further reduce the sulfur dioxide emission of the entire refining process, two scenarios of acid gas or air preheats are investigated when either of them is used simultaneously with the third enrichment scheme. The maximum overall sulfur recovery efficiency and highest combustion chamber temperature is slightly higher for acid gas preheats but air preheat is more favorable because it is more benign. To the best of our knowledge, optimization of the entire GTU + enrichment section and SRU processes has not been addressed previously.

  19. Maximizing Entropy over Markov Processes

    DEFF Research Database (Denmark)

    Biondi, Fabrizio; Legay, Axel; Nielsen, Bo Friis

    2013-01-01

    The channel capacity of a deterministic system with confidential data is an upper bound on the amount of bits of data an attacker can learn from the system. We encode all possible attacks to a system using a probabilistic specification, an Interval Markov Chain. Then the channel capacity...... as a reward function, a polynomial algorithm to verify the existence of an system maximizing entropy among those respecting a specification, a procedure for the maximization of reward functions over Interval Markov Chains and its application to synthesize an implementation maximizing entropy. We show how...... to use Interval Markov Chains to model abstractions of deterministic systems with confidential data, and use the above results to compute their channel capacity. These results are a foundation for ongoing work on computing channel capacity for abstractions of programs derived from code....

  20. Maximizing entropy over Markov processes

    DEFF Research Database (Denmark)

    Biondi, Fabrizio; Legay, Axel; Nielsen, Bo Friis

    2014-01-01

    The channel capacity of a deterministic system with confidential data is an upper bound on the amount of bits of data an attacker can learn from the system. We encode all possible attacks to a system using a probabilistic specification, an Interval Markov Chain. Then the channel capacity...... as a reward function, a polynomial algorithm to verify the existence of a system maximizing entropy among those respecting a specification, a procedure for the maximization of reward functions over Interval Markov Chains and its application to synthesize an implementation maximizing entropy. We show how...... to use Interval Markov Chains to model abstractions of deterministic systems with confidential data, and use the above results to compute their channel capacity. These results are a foundation for ongoing work on computing channel capacity for abstractions of programs derived from code. © 2014 Elsevier...

  1. Real-time topic-aware influence maximization using preprocessing.

    Science.gov (United States)

    Chen, Wei; Lin, Tian; Yang, Cheng

    2016-01-01

    Influence maximization is the task of finding a set of seed nodes in a social network such that the influence spread of these seed nodes based on certain influence diffusion model is maximized. Topic-aware influence diffusion models have been recently proposed to address the issue that influence between a pair of users are often topic-dependent and information, ideas, innovations etc. being propagated in networks are typically mixtures of topics. In this paper, we focus on the topic-aware influence maximization task. In particular, we study preprocessing methods to avoid redoing influence maximization for each mixture from scratch. We explore two preprocessing algorithms with theoretical justifications. Our empirical results on data obtained in a couple of existing studies demonstrate that one of our algorithms stands out as a strong candidate providing microsecond online response time and competitive influence spread, with reasonable preprocessing effort.

  2. Estimation of inspection effort

    International Nuclear Information System (INIS)

    Mullen, M.F.; Wincek, M.A.

    1979-06-01

    An overview of IAEA inspection activities is presented, and the problem of evaluating the effectiveness of an inspection is discussed. Two models are described - an effort model and an effectiveness model. The effort model breaks the IAEA's inspection effort into components; the amount of effort required for each component is estimated; and the total effort is determined by summing the effort for each component. The effectiveness model quantifies the effectiveness of inspections in terms of probabilities of detection and quantities of material to be detected, if diverted over a specific period. The method is applied to a 200 metric ton per year low-enriched uranium fuel fabrication facility. A description of the model plant is presented, a safeguards approach is outlined, and sampling plans are calculated. The required inspection effort is estimated and the results are compared to IAEA estimates. Some other applications of the method are discussed briefly. Examples are presented which demonstrate how the method might be useful in formulating guidelines for inspection planning and in establishing technical criteria for safeguards implementation

  3. Chamaebatiaria millefolium (Torr.) Maxim.: fernbush

    Science.gov (United States)

    Nancy L. Shaw; Emerenciana G. Hurd

    2008-01-01

    Fernbush - Chamaebatiaria millefolium (Torr.) Maxim. - the only species in its genus, is endemic to the Great Basin, Colorado Plateau, and adjacent areas of the western United States. It is an upright, generally multistemmed, sweetly aromatic shrub 0.3 to 2 m tall. Bark of young branches is brown and becomes smooth and gray with age. Leaves are leathery, alternate,...

  4. Surgical competence.

    Science.gov (United States)

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

    2003-08-01

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

  5. MAXIMIZING THE BENEFITS OF ERP SYSTEMS

    Directory of Open Access Journals (Sweden)

    Paulo André da Conceição Menezes

    2010-04-01

    Full Text Available The ERP (Enterprise Resource Planning systems have been consolidated in companies with different sizes and sectors, allowing their real benefits to be definitively evaluated. In this study, several interactions have been studied in different phases, such as the strategic priorities and strategic planning defined as ERP Strategy; business processes review and the ERP selection in the pre-implementation phase, the project management and ERP adaptation in the implementation phase, as well as the ERP revision and integration efforts in the post-implementation phase. Through rigorous use of case study methodology, this research led to developing and to testing a framework for maximizing the benefits of the ERP systems, and seeks to contribute for the generation of ERP initiatives to optimize their performance.

  6. Surgical Navigation

    DEFF Research Database (Denmark)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan

    2017-01-01

    Purpose: This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indicatio...

  7. Surgical Instrument

    NARCIS (Netherlands)

    Dankelman, J.; Horeman, T.

    2009-01-01

    The present invention relates to a surgical instrument for minimall-invasive surgery, comprising a handle, a shaft and an actuating part, characterised by a gastight cover surrounding the shaft, wherein the cover is provided with a coupler that has a feed- through opening with a loskable seal,

  8. IMNN: Information Maximizing Neural Networks

    Science.gov (United States)

    Charnock, Tom; Lavaux, Guilhem; Wandelt, Benjamin D.

    2018-04-01

    This software trains artificial neural networks to find non-linear functionals of data that maximize Fisher information: information maximizing neural networks (IMNNs). As compressing large data sets vastly simplifies both frequentist and Bayesian inference, important information may be inadvertently missed. Likelihood-free inference based on automatically derived IMNN summaries produces summaries that are good approximations to sufficient statistics. IMNNs are robustly capable of automatically finding optimal, non-linear summaries of the data even in cases where linear compression fails: inferring the variance of Gaussian signal in the presence of noise, inferring cosmological parameters from mock simulations of the Lyman-α forest in quasar spectra, and inferring frequency-domain parameters from LISA-like detections of gravitational waveforms. In this final case, the IMNN summary outperforms linear data compression by avoiding the introduction of spurious likelihood maxima.

  9. Is the β phase maximal?

    International Nuclear Information System (INIS)

    Ferrandis, Javier

    2005-01-01

    The current experimental determination of the absolute values of the CKM elements indicates that 2 vertical bar V ub /V cb V us vertical bar =(1-z), with z given by z=0.19+/-0.14. This fact implies that irrespective of the form of the quark Yukawa matrices, the measured value of the SM CP phase β is approximately the maximum allowed by the measured absolute values of the CKM elements. This is β=(π/6-z/3) for γ=(π/3+z/3), which implies α=π/2. Alternatively, assuming that β is exactly maximal and using the experimental measurement sin(2β)=0.726+/-0.037, the phase γ is predicted to be γ=(π/2-β)=66.3 o +/-1.7 o . The maximality of β, if confirmed by near-future experiments, may give us some clues as to the origin of CP violation

  10. Strategy to maximize maintenance operation

    OpenAIRE

    Espinoza, Michael

    2005-01-01

    This project presents a strategic analysis to maximize maintenance operations in Alcan Kitimat Works in British Columbia. The project studies the role of maintenance in improving its overall maintenance performance. It provides strategic alternatives and specific recommendations addressing Kitimat Works key strategic issues and problems. A comprehensive industry and competitive analysis identifies the industry structure and its competitive forces. In the mature aluminium industry, the bargain...

  11. Scalable Nonlinear AUC Maximization Methods

    OpenAIRE

    Khalid, Majdi; Ray, Indrakshi; Chitsaz, Hamidreza

    2017-01-01

    The area under the ROC curve (AUC) is a measure of interest in various machine learning and data mining applications. It has been widely used to evaluate classification performance on heavily imbalanced data. The kernelized AUC maximization machines have established a superior generalization ability compared to linear AUC machines because of their capability in modeling the complex nonlinear structure underlying most real world-data. However, the high training complexity renders the kernelize...

  12. Effort-Based Career Opportunities and Working Time

    OpenAIRE

    Bratti, M.; Staffolani, S.

    2005-01-01

    The authors evaluate the economic effects of the hypothesis of effort-based career opportunities, described as a situation in which a firm creates incentives for employees to work longer hours than bargained (or desired), by making career prospects depend on relative working hours. Firms' personnel management policies may tend to increase working time (or workers' effort) in order to maximize profits. Effort-based career opportunities raise working time, production and output per worker, and ...

  13. FLOUTING MAXIMS IN INDONESIA LAWAK KLUB CONVERSATION

    Directory of Open Access Journals (Sweden)

    Rahmawati Sukmaningrum

    2017-04-01

    Full Text Available This study aims to identify the types of maxims flouted in the conversation in famous comedy show, Indonesia Lawak Club. Likewise, it also tries to reveal the speakers‘ intention of flouting the maxim in the conversation during the show. The writers use descriptive qualitative method in conducting this research. The data is taken from the dialogue of Indonesia Lawak club and then analyzed based on Grice‘s cooperative principles. The researchers read the dialogue‘s transcripts, identify the maxims, and interpret the data to find the speakers‘ intention for flouting the maxims in the communication. The results show that there are four types of maxims flouted in the dialogue. Those are maxim of quality (23%, maxim of quantity (11%, maxim of manner (31%, and maxim of relevance (35. Flouting the maxims in the conversations is intended to make the speakers feel uncomfortable with the conversation, show arrogances, show disagreement or agreement, and ridicule other speakers.

  14. Maximal Abelian sets of roots

    CERN Document Server

    Lawther, R

    2018-01-01

    In this work the author lets \\Phi be an irreducible root system, with Coxeter group W. He considers subsets of \\Phi which are abelian, meaning that no two roots in the set have sum in \\Phi \\cup \\{ 0 \\}. He classifies all maximal abelian sets (i.e., abelian sets properly contained in no other) up to the action of W: for each W-orbit of maximal abelian sets we provide an explicit representative X, identify the (setwise) stabilizer W_X of X in W, and decompose X into W_X-orbits. Abelian sets of roots are closely related to abelian unipotent subgroups of simple algebraic groups, and thus to abelian p-subgroups of finite groups of Lie type over fields of characteristic p. Parts of the work presented here have been used to confirm the p-rank of E_8(p^n), and (somewhat unexpectedly) to obtain for the first time the 2-ranks of the Monster and Baby Monster sporadic groups, together with the double cover of the latter. Root systems of classical type are dealt with quickly here; the vast majority of the present work con...

  15. Should the pulmonary scintigraphy of pre-surgery examination of bronchial carcinomas be made at rest or under effort?

    International Nuclear Information System (INIS)

    David, N.; Olivier, P.; Arsena, T.; Quiri, N.; Hassan, N.; Haouzi, P.; Borelly, J.; Marie, P.Y.; Karcher, G.; Bertrand, A.

    1997-01-01

    One of the key elements in deciding whether a patient, bearing a bronchial carcinoma, should be subject to a surgery is the predicted value of the post-surgery maximal exhaled volume per second (MEVS), usually determined by means of an at-rest pulmonary perfusion scintigraphy. At the same time, this parameter remains rather badly correlated to mortality and peri-surgical morbidity. The goal of this study was to determine whether under-effort pulmonary perfusion scintigraphy, i.e. in peri-surgical conditions gives different results in this case. Twenty patients bearing bronchial carcinoma have benefited by a pulmonary scintigraphy, successively, in the end of an exercise on ergo-metric bicycle and at rest. Two mCi of Tc-labelled macro-aggregate albumin were injected after effort, then 10 mCi one hour later, at rest. The homo-lateral lung perfusion to tumor, expresses in % of total pulmonary perfusion (% TP), was reduced at rest (-8 ± 6%) and at effort (-10 ± 8%), in comparison with the normal values. On the analysis of ensemble of population (43 ± 7% vs 41 ± 9%, NS) the % TP did not changed significantly between the at-rest and under-effort acquisitions. At the same time, 4 patients presented important variation, amounting up to 20% of total pulmonary perfusion: the % TP increased in 2 cases and decreased in the other 2 cases. In conclusion, in the patients bearing bronchial carcinoma, the relative perfusion of tumoral lung varies under effort in a non-negligible number of cases (4/20). Additional studies are necessary to establish the value of under-effort pulmonary scintigraphy, in the evaluation of the post-surgery respiratory functional capacity

  16. Welcome to cultural competency: surgery's efforts to acknowledge diversity in residency training.

    Science.gov (United States)

    Ly, Catherine L; Chun, Maria B J

    2013-01-01

    Although cultural competency is not a new concept in healthcare, it has only recently been formally embraced as important in the field of surgery. All physicians, including and especially surgeons, must acknowledge the potential influence of culture in order to provide effective and equitable care for patients of all backgrounds. The Accreditation Council for Graduate Medical Education (ACGME) recognizes cultural competency as a component of "patient care," "professionalism," and "interpersonal and communication skills." A systematic literature search was conducted using the MEDLINE, EBSCOhost, Web of Science, and Google Scholar databases. All publications focusing on surgical residents and the assessment of patient care, professionalism, interpersonal and communication skills, or specifically cultural competency and/or were considered. This initial search resulted in 12 articles. To further refine the review, publications discussing curricula in residencies other than surgery, the assessment of technical, or clinical skills and/or without any explicit focus on cultural competency were excluded. Based on the specified inclusion and exclusion criteria, 5 articles were selected. These studies utilized various methods to improve surgical residents' cultural competency, including lectures, Objective Structural Clinical Examinations (OSCE), and written exercises and evaluations. A number of surgical residency programs have made promising strides in training culturally competent surgeons. Ultimately, in order to maximize our collective efforts to improve the quality of health care, the development of cultural competency curricula must be made a priority and such training should be a requirement for all trainees in surgical residency programs. Copyright © 2013 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  17. Accomplishments and challenges of surgical simulation.

    Science.gov (United States)

    Satava, R M

    2001-03-01

    For nearly a decade, advanced computer technologies have created extraordinary educational tools using three-dimensional (3D) visualization and virtual reality. Pioneering efforts in surgical simulation with these tools have resulted in a first generation of simulators for surgical technical skills. Accomplishments include simulations with 3D models of anatomy for practice of surgical tasks, initial assessment of student performance in technical skills, and awareness by professional societies of potential in surgical education and certification. However, enormous challenges remain, which include improvement of technical fidelity, standardization of accurate metrics for performance evaluation, integration of simulators into a robust educational curriculum, stringent evaluation of simulators for effectiveness and value added to surgical training, determination of simulation application to certification of surgical technical skills, and a business model to implement and disseminate simulation successfully throughout the medical education community. This review looks at the historical progress of surgical simulators, their accomplishments, and the challenges that remain.

  18. Managing diabetes with integrated teams: maximizing your efforts with limited time.

    Science.gov (United States)

    Kruger, Davida F; Lorenzi, Gayle M; Dokken, Betsy B; Sadler, Christopher E; Mann, Kelly; Valentine, Virginia

    2012-03-01

    The importance of glycemic control has been well established. In response, the American Diabetes Association has established goals for glycemic control and other cardiovascular parameters, including blood pressure and low-density and high-density lipoprotein cholesterol. However, the National Health and Nutrition Examination Survey has shown that only about half (57%) of patients with diabetes meet a glycated hemoglobin A(1c) (HbA(1c)) goal of team care, coupled with appropriately chosen pharmacologic therapy and patient education that fosters the development of critical thinking skills and the ability to make self-management decisions, have been shown to improve glycemic control and cardiovascular outcomes.

  19. Maximizing industry benefit through cooperation between federal, state and private-sector floricultural research efforts

    Science.gov (United States)

    he USDA-ARS Greenhouse Production Research Group was established to provide a federally funded research emphasis on greenhouse crop production. It has focused on broad production issues (nutrition, water management, and energy conservation) by coordinating research between in-house researchers, Uni...

  20. Planning for partnerships: Maximizing surge capacity resources through service learning.

    Science.gov (United States)

    Adams, Lavonne M; Reams, Paula K; Canclini, Sharon B

    2015-01-01

    Infectious disease outbreaks and natural or human-caused disasters can strain the community's surge capacity through sudden demand on healthcare activities. Collaborative partnerships between communities and schools of nursing have the potential to maximize resource availability to meet community needs following a disaster. This article explores how communities can work with schools of nursing to enhance surge capacity through systems thinking, integrated planning, and cooperative efforts.

  1. Maximizing benefits from resource development

    International Nuclear Information System (INIS)

    Skjelbred, B.

    2002-01-01

    The main objectives of Norwegian petroleum policy are to maximize the value creation for the country, develop a national oil and gas industry, and to be at the environmental forefront of long term resource management and coexistence with other industries. The paper presents a graph depicting production and net export of crude oil for countries around the world for 2002. Norway produced 3.41 mill b/d and exported 3.22 mill b/d. Norwegian petroleum policy measures include effective regulation and government ownership, research and technology development, and internationalisation. Research and development has been in five priority areas, including enhanced recovery, environmental protection, deep water recovery, small fields, and the gas value chain. The benefits of internationalisation includes capitalizing on Norwegian competency, exploiting emerging markets and the assurance of long-term value creation and employment. 5 figs

  2. Maximizing synchronizability of duplex networks

    Science.gov (United States)

    Wei, Xiang; Emenheiser, Jeffrey; Wu, Xiaoqun; Lu, Jun-an; D'Souza, Raissa M.

    2018-01-01

    We study the synchronizability of duplex networks formed by two randomly generated network layers with different patterns of interlayer node connections. According to the master stability function, we use the smallest nonzero eigenvalue and the eigenratio between the largest and the second smallest eigenvalues of supra-Laplacian matrices to characterize synchronizability on various duplexes. We find that the interlayer linking weight and linking fraction have a profound impact on synchronizability of duplex networks. The increasingly large inter-layer coupling weight is found to cause either decreasing or constant synchronizability for different classes of network dynamics. In addition, negative node degree correlation across interlayer links outperforms positive degree correlation when most interlayer links are present. The reverse is true when a few interlayer links are present. The numerical results and understanding based on these representative duplex networks are illustrative and instructive for building insights into maximizing synchronizability of more realistic multiplex networks.

  3. VIOLATION OF CONVERSATION MAXIM ON TV ADVERTISEMENTS

    Directory of Open Access Journals (Sweden)

    Desak Putu Eka Pratiwi

    2015-07-01

    Full Text Available Maxim is a principle that must be obeyed by all participants textually and interpersonally in order to have a smooth communication process. Conversation maxim is divided into four namely maxim of quality, maxim of quantity, maxim of relevance, and maxim of manner of speaking. Violation of the maxim may occur in a conversation in which the information the speaker has is not delivered well to his speaking partner. Violation of the maxim in a conversation will result in an awkward impression. The example of violation is the given information that is redundant, untrue, irrelevant, or convoluted. Advertisers often deliberately violate the maxim to create unique and controversial advertisements. This study aims to examine the violation of maxims in conversations of TV ads. The source of data in this research is food advertisements aired on TV media. Documentation and observation methods are applied to obtain qualitative data. The theory used in this study is a maxim theory proposed by Grice (1975. The results of the data analysis are presented with informal method. The results of this study show an interesting fact that the violation of maxim in a conversation found in the advertisement exactly makes the advertisements very attractive and have a high value.

  4. Literality and Cognitive Effort

    DEFF Research Database (Denmark)

    Lacruz, Isabel; Carl, Michael; Yamada, Masaru

    2018-01-01

    We introduce a notion of pause-word ratio computed using ranges of pause lengths rather than lower cutoffs for pause lengths. Standard pause-word ratios are indicators of cognitive effort during different translation modalities.The pause range version allows for the study of how different types...... remoteness. We use data from the CRITT TPR database, comparing translation and post-editing from English to Japanese and from English to Spanish, and study the interaction of pause-word ratio for short pauses ranging between 300 and 500ms with syntactic remoteness, measured by the CrossS feature, semantic...... remoteness, measured by HTra, and syntactic and semantic remoteness, measured by Literality....

  5. Breckinridge Project, initial effort

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    1982-09-01

    Report III, Volume 1 contains those specifications numbered A through J, as follows: General Specifications (A); Specifications for Pressure Vessels (C); Specifications for Tanks (D); Specifications for Exchangers (E); Specifications for Fired Heaters (F); Specifications for Pumps and Drivers (G); and Specifications for Instrumentation (J). The standard specifications of Bechtel Petroleum Incorporated have been amended as necessary to reflect the specific requirements of the Breckinridge Project, and the more stringent specifications of Ashland Synthetic Fuels, Inc. These standard specifications are available to the Initial Effort (Phase Zero) work performed by all contractors and subcontractors. Report III, Volume 1 also contains the unique specifications prepared for Plants 8, 15, and 27. These specifications will be substantially reviewed during Phase I of the project, and modified as necessary for use during the engineering, procurement, and construction of this project.

  6. Mapping telemedicine efforts

    DEFF Research Database (Denmark)

    Kierkegaard, Patrick

    2015-01-01

    are being utilized? What medical disciplines are being addressed using telemedicine systems? Methods: All data was surveyed from the "Telemedicinsk Landkort", a newly created database designed to provide a comprehensive and systematic overview of all telemedicine technologies in Denmark. Results......Objectives: The aim of this study is to survey telemedicine services currently in operation across Denmark. The study specifically seeks to answer the following questions: What initiatives are deployed within the different regions? What are the motivations behind the projects? What technologies......: The results of this study suggest that a growing number of telemedicine initiatives are currently in operation across Denmark but that considerable variations existed in terms of regional efforts as the number of operational telemedicine projects varied from region to region. Conclusions: The results...

  7. Aging and loss decision making: increased risk aversion and decreased use of maximizing information, with correlated rationality and value maximization.

    Science.gov (United States)

    Kurnianingsih, Yoanna A; Sim, Sam K Y; Chee, Michael W L; Mullette-Gillman, O'Dhaniel A

    2015-01-01

    We investigated how adult aging specifically alters economic decision-making, focusing on examining alterations in uncertainty preferences (willingness to gamble) and choice strategies (what gamble information influences choices) within both the gains and losses domains. Within each domain, participants chose between certain monetary outcomes and gambles with uncertain outcomes. We examined preferences by quantifying how uncertainty modulates choice behavior as if altering the subjective valuation of gambles. We explored age-related preferences for two types of uncertainty, risk, and ambiguity. Additionally, we explored how aging may alter what information participants utilize to make their choices by comparing the relative utilization of maximizing and satisficing information types through a choice strategy metric. Maximizing information was the ratio of the expected value of the two options, while satisficing information was the probability of winning. We found age-related alterations of economic preferences within the losses domain, but no alterations within the gains domain. Older adults (OA; 61-80 years old) were significantly more uncertainty averse for both risky and ambiguous choices. OA also exhibited choice strategies with decreased use of maximizing information. Within OA, we found a significant correlation between risk preferences and choice strategy. This linkage between preferences and strategy appears to derive from a convergence to risk neutrality driven by greater use of the effortful maximizing strategy. As utility maximization and value maximization intersect at risk neutrality, this result suggests that OA are exhibiting a relationship between enhanced rationality and enhanced value maximization. While there was variability in economic decision-making measures within OA, these individual differences were unrelated to variability within examined measures of cognitive ability. Our results demonstrate that aging alters economic decision-making for

  8. Aging and loss decision making: increased risk aversion and decreased use of maximizing information, with correlated rationality and value maximization

    Directory of Open Access Journals (Sweden)

    Yoanna Arlina Kurnianingsih

    2015-05-01

    Full Text Available We investigated how adult aging specifically alters economic decision-making, focusing on examining alterations in uncertainty preferences (willingness to gamble and choice strategies (what gamble information influences choices within both the gains and losses domains. Within each domain, participants chose between certain monetary outcomes and gambles with uncertain outcomes. We examined preferences by quantifying how uncertainty modulates choice behavior as if altering the subjective valuation of gambles. We explored age-related preferences for two types of uncertainty, risk and ambiguity. Additionally, we explored how aging may alter what information participants utilize to make their choices by comparing the relative utilization of maximizing and satisficing information types through a choice strategy metric. Maximizing information was the ratio of the expected value of the two options, while satisficing information was the probability of winning.We found age-related alterations of economic preferences within the losses domain, but no alterations within the gains domain. Older adults (OA; 61 to 80 years old were significantly more uncertainty averse for both risky and ambiguous choices. OA also exhibited choice strategies with decreased use of maximizing information. Within OA, we found a significant correlation between risk preferences and choice strategy. This linkage between preferences and strategy appears to derive from a convergence to risk neutrality driven by greater use of the effortful maximizing strategy. As utility maximization and value maximization intersect at risk neutrality, this result suggests that OA are exhibiting a relationship between enhanced rationality and enhanced value maximization. While there was variability in economic decision-making measures within OA, these individual differences were unrelated to variability within examined measures of cognitive ability. Our results demonstrate that aging alters economic

  9. Muscle strength, working capacity and effort in patients with fibromyalgia

    DEFF Research Database (Denmark)

    Nørregaard, J; Bülow, P M; Lykkegaard, J J

    1997-01-01

    exercise capacity, work status and psychometric scoring (SCL-90-R) were correlated. The fibromyalgia patients exhibited significant reduction in voluntary muscle strength of the knee and elbow, flexors and extensors in the order of 20-30%. However, the coefficient of variation was higher among patients......, thus indicating lower effort. The physical performance during an ergometer test corresponded to a maximal oxygen consumption of 21 ml/kg-1 x min-1. The maximal increase in heart rate was only 63% (44-90%) of the predicted increase. Degree of effort or physical capacity did not correlate to psychometric...... scores. Work status was related to psychometric scoring, but not to physical capacity or effort. In conclusion, we found a low degree of effort but near normal physical capacity in the fibromyalgia patients....

  10. Maximizing ROI (return on information)

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, B.

    2000-05-01

    The role and importance of managing information are discussed, underscoring the importance by quoting from the report of the International Data Corporation, according to which Fortune 500 companies lost $ 12 billion in 1999 due to inefficiencies resulting from intellectual re-work, substandard performance , and inability to find knowledge resources. The report predicts that this figure will rise to $ 31.5 billion by 2003. Key impediments to implementing knowledge management systems are identified as : the cost and human resources requirement of deployment; inflexibility of historical systems to adapt to change; and the difficulty of achieving corporate acceptance of inflexible software products that require changes in 'normal' ways of doing business. The author recommends the use of model, document and rule-independent systems with a document centered interface (DCI), employing rapid application development (RAD) and object technologies and visual model development, which eliminate these problems, making it possible for companies to maximize their return on information (ROI), and achieve substantial savings in implementation costs.

  11. Maximizing the optical network capacity.

    Science.gov (United States)

    Bayvel, Polina; Maher, Robert; Xu, Tianhua; Liga, Gabriele; Shevchenko, Nikita A; Lavery, Domaniç; Alvarado, Alex; Killey, Robert I

    2016-03-06

    Most of the digital data transmitted are carried by optical fibres, forming the great part of the national and international communication infrastructure. The information-carrying capacity of these networks has increased vastly over the past decades through the introduction of wavelength division multiplexing, advanced modulation formats, digital signal processing and improved optical fibre and amplifier technology. These developments sparked the communication revolution and the growth of the Internet, and have created an illusion of infinite capacity being available. But as the volume of data continues to increase, is there a limit to the capacity of an optical fibre communication channel? The optical fibre channel is nonlinear, and the intensity-dependent Kerr nonlinearity limit has been suggested as a fundamental limit to optical fibre capacity. Current research is focused on whether this is the case, and on linear and nonlinear techniques, both optical and electronic, to understand, unlock and maximize the capacity of optical communications in the nonlinear regime. This paper describes some of them and discusses future prospects for success in the quest for capacity. © 2016 The Authors.

  12. Stretch-sensitive paresis and effort perception in hemiparesis.

    Science.gov (United States)

    Vinti, Maria; Bayle, Nicolas; Hutin, Emilie; Burke, David; Gracies, Jean-Michel

    2015-08-01

    In spastic paresis, stretch applied to the antagonist increases its inappropriate recruitment during agonist command (spastic co-contraction). It is unknown whether antagonist stretch: (1) also affects agonist recruitment; (2) alters effort perception. We quantified voluntary activation of ankle dorsiflexors, effort perception, and plantar flexor co-contraction during graded dorsiflexion efforts at two gastrocnemius lengths. Eighteen healthy (age 41 ± 13) and 18 hemiparetic (age 54 ± 12) subjects performed light, medium and maximal isometric dorsiflexion efforts with the knee flexed or extended. We determined dorsiflexor torque, Root Mean Square EMG and Agonist Recruitment/Co-contraction Indices (ARI/CCI) from the 500 ms peak voluntary agonist recruitment in a 5-s maximal isometric effort in tibialis anterior, soleus and medial gastrocnemius. Subjects retrospectively reported effort perception on a 10-point visual analog scale. During gastrocnemius stretch in hemiparetic subjects, we observed: (1) a 25 ± 7 % reduction of tibialis anterior voluntary activation (maximum reduction 98 %; knee extended vs knee flexed; p = 0.007, ANOVA); (2) an increase in dorsiflexion effort perception (p = 0.03, ANCOVA). Such changes did not occur in healthy subjects. Effort perception depended on tibialis anterior recruitment only (βARI(TA) = 0.61, p hemiparesis, voluntary ability to recruit agonist motoneurones is impaired--sometimes abolished--by antagonist stretch, a phenomenon defined here as stretch-sensitive paresis. In addition, spastic co-contraction increases effort perception, an additional incentive to evaluate and treat this phenomenon.

  13. Swedish nuclear waste efforts

    International Nuclear Information System (INIS)

    Rydberg, J.

    1981-09-01

    After the introduction of a law prohibiting the start-up of any new nuclear power plant until the utility had shown that the waste produced by the plant could be taken care of in an absolutely safe way, the Swedish nuclear utilities in December 1976 embarked on the Nuclear Fuel Safety Project, which in November 1977 presented a first report, Handling of Spent Nuclear Fuel and Final Storage of Vitrified Waste (KBS-I), and in November 1978 a second report, Handling and Final Storage of Unreprocessed Spent Nuclear Fuel (KBS II). These summary reports were supported by 120 technical reports prepared by 450 experts. The project engaged 70 private and governmental institutions at a total cost of US $15 million. The KBS-I and KBS-II reports are summarized in this document, as are also continued waste research efforts carried out by KBS, SKBF, PRAV, ASEA and other Swedish organizations. The KBS reports describe all steps (except reprocessing) in handling chain from removal from a reactor of spent fuel elements until their radioactive waste products are finally disposed of, in canisters, in an underground granite depository. The KBS concept relies on engineered multibarrier systems in combination with final storage in thoroughly investigated stable geologic formations. This report also briefly describes other activities carried out by the nuclear industry, namely, the construction of a central storage facility for spent fuel elements (to be in operation by 1985), a repository for reactor waste (to be in operation by 1988), and an intermediate storage facility for vitrified high-level waste (to be in operation by 1990). The R and D activities are updated to September 1981

  14. Worldwide effort against smoking.

    Science.gov (United States)

    1986-07-01

    The 39th World Health Assembly, which met in May 1986, recognized the escalating health problem of smoking-related diseases and affirmed that tobacco smoking and its use in other forms are incompatible with the attainment of "Health for All by the Year 2000." If properly implemented, antismoking campaigns can decrease the prevalence of smoking. Nations as a whole must work toward changing smoking habits, and governments must support these efforts by officially stating their stand against smoking. Over 60 countries have introduced legislation affecting smoking. The variety of policies range from adopting a health education program designed to increase peoples' awareness of its dangers to increasing taxes to deter smoking by increasing tobacco prices. Each country must adopt an antismoking campaign which works most effectively within the cultural parameters of the society. Other smoking policies include: printed warnings on cigarette packages; health messages via radio, television, mobile teams, pamphlets, health workers, clinic walls, and newspapers; prohibition of smoking in public areas and transportation; prohibition of all advertisement of cigarettes and tobacco; and the establishment of upper limits of tar and nicotine content in cigarettes. The tobacco industry spends about $2000 million annually on worldwide advertising. According to the World Health Organization (WHO), controlling this overabundance of tobacco advertisements is a major priority in preventing the spread of smoking. Cigarette and tobacco advertising can be controlled to varying degrees, e.g., over a dozen countries have enacted a total ban on advertising on television or radio, a mandatory health warning must accompany advertisements in other countries, and tobacco companies often are prohibited from sponsoring sports events. Imposing a substantial tax on cigarettes is one of the most effective means to deter smoking. However, raising taxes and banning advertisements is not enough because

  15. Gamma loop contributing to maximal voluntary contractions in man.

    Science.gov (United States)

    Hagbarth, K E; Kunesch, E J; Nordin, M; Schmidt, R; Wallin, E U

    1986-01-01

    A local anaesthetic drug was injected around the peroneal nerve in healthy subjects in order to investigate whether the resulting loss in foot dorsiflexion power in part depended on a gamma-fibre block preventing 'internal' activation of spindle end-organs and thereby depriving the alpha-motoneurones of an excitatory spindle inflow during contraction. The motor outcome of maximal dorsiflexion efforts was assessed by measuring firing rates of individual motor units in the anterior tibial (t.a.) muscle, mean voltage e.m.g. from the pretibial muscles, dorsiflexion force and range of voluntary foot dorsiflexion movements. The tests were performed with and without peripheral conditioning stimuli, such as agonist or antagonist muscle vibration or imposed stretch of the contracting muscles. As compared to control values of t.a. motor unit firing rates in maximal isometric voluntary contractions, the firing rates were lower and more irregular during maximal dorsiflexion efforts performed during subtotal peroneal nerve blocks. During the development of paresis a gradual reduction of motor unit firing rates was observed before the units ceased responding to the voluntary commands. This change in motor unit behaviour was accompanied by a reduction of the mean voltage e.m.g. activity in the pretibial muscles. At a given stage of anaesthesia the e.m.g. responses to maximal voluntary efforts were more affected than the responses evoked by electric nerve stimuli delivered proximal to the block, indicating that impaired impulse transmission in alpha motor fibres was not the sole cause of the paresis. The inability to generate high and regular motor unit firing rates during peroneal nerve blocks was accentuated by vibration applied over the antagonistic calf muscles. By contrast, in eight out of ten experiments agonist stretch or vibration caused an enhancement of motor unit firing during the maximal force tasks. The reverse effects of agonist and antagonist vibration on the

  16. Does mental exertion alter maximal muscle activation?

    Directory of Open Access Journals (Sweden)

    Vianney eRozand

    2014-09-01

    Full Text Available Mental exertion is known to impair endurance performance, but its effects on neuromuscular function remain unclear. The purpose of this study was to test the hypothesis that mental exertion reduces torque and muscle activation during intermittent maximal voluntary contractions of the knee extensors. Ten subjects performed in a randomized order three separate mental exertion conditions lasting 27 minutes each: i high mental exertion (incongruent Stroop task, ii moderate mental exertion (congruent Stroop task, iii low mental exertion (watching a movie. In each condition, mental exertion was combined with ten intermittent maximal voluntary contractions of the knee extensor muscles (one maximal voluntary contraction every 3 minutes. Neuromuscular function was assessed using electrical nerve stimulation. Maximal voluntary torque, maximal muscle activation and other neuromuscular parameters were similar across mental exertion conditions and did not change over time. These findings suggest that mental exertion does not affect neuromuscular function during intermittent maximal voluntary contractions of the knee extensors.

  17. AUC-Maximizing Ensembles through Metalearning.

    Science.gov (United States)

    LeDell, Erin; van der Laan, Mark J; Petersen, Maya

    2016-05-01

    Area Under the ROC Curve (AUC) is often used to measure the performance of an estimator in binary classification problems. An AUC-maximizing classifier can have significant advantages in cases where ranking correctness is valued or if the outcome is rare. In a Super Learner ensemble, maximization of the AUC can be achieved by the use of an AUC-maximining metalearning algorithm. We discuss an implementation of an AUC-maximization technique that is formulated as a nonlinear optimization problem. We also evaluate the effectiveness of a large number of different nonlinear optimization algorithms to maximize the cross-validated AUC of the ensemble fit. The results provide evidence that AUC-maximizing metalearners can, and often do, out-perform non-AUC-maximizing metalearning methods, with respect to ensemble AUC. The results also demonstrate that as the level of imbalance in the training data increases, the Super Learner ensemble outperforms the top base algorithm by a larger degree.

  18. Formation Control of the MAXIM L2 Libration Orbit Mission

    Science.gov (United States)

    Folta, David; Hartman, Kate; Howell, Kathleen; Marchand, Belinda

    2004-01-01

    The Micro-Arcsecond X-ray Imaging Mission (MAXIM), a proposed concept for the Structure and Evolution of the Universe (SEU) Black Hole Imager mission, is designed to make a ten million-fold improvement in X-ray image clarity of celestial objects by providing better than 0.1 micro-arcsecond imaging. Currently the mission architecture comprises 25 spacecraft, 24 as optics modules and one as the detector, which will form sparse sub-apertures of a grazing incidence X-ray interferometer covering the 0.3-10 keV bandpass. This formation must allow for long duration continuous science observations and also for reconfiguration that permits re-pointing of the formation. To achieve these mission goals, the formation is required to cooperatively point at desired targets. Once pointed, the individual elements of the MAXIM formation must remain stable, maintaining their relative positions and attitudes below a critical threshold. These pointing and formation stability requirements impact the control and design of the formation. In this paper, we provide analysis of control efforts that are dependent upon the stability and the configuration and dimensions of the MAXIM formation. We emphasize the utilization of natural motions in the Lagrangian regions to minimize the control efforts and we address continuous control via input feedback linearization (IFL). Results provide control cost, configuration options, and capabilities as guidelines for the development of this complex mission.

  19. On maximal massive 3D supergravity

    OpenAIRE

    Bergshoeff , Eric A; Hohm , Olaf; Rosseel , Jan; Townsend , Paul K

    2010-01-01

    ABSTRACT We construct, at the linearized level, the three-dimensional (3D) N = 4 supersymmetric " general massive supergravity " and the maximally supersymmetric N = 8 " new massive supergravity ". We also construct the maximally supersymmetric linearized N = 7 topologically massive supergravity, although we expect N = 6 to be maximal at the non-linear level. (Bergshoeff, Eric A) (Hohm, Olaf) (Rosseel, Jan) P.K.Townsend@da...

  20. Inclusive Fitness Maximization:An Axiomatic Approach

    OpenAIRE

    Okasha, Samir; Weymark, John; Bossert, Walter

    2014-01-01

    Kin selection theorists argue that evolution in social contexts will lead organisms to behave as if maximizing their inclusive, as opposed to personal, fitness. The inclusive fitness concept allows biologists to treat organisms as akin to rational agents seeking to maximize a utility function. Here we develop this idea and place it on a firm footing by employing a standard decision-theoretic methodology. We show how the principle of inclusive fitness maximization and a related principle of qu...

  1. Toward a Rational and Mechanistic Account of Mental Effort.

    Science.gov (United States)

    Shenhav, Amitai; Musslick, Sebastian; Lieder, Falk; Kool, Wouter; Griffiths, Thomas L; Cohen, Jonathan D; Botvinick, Matthew M

    2017-07-25

    In spite of its familiar phenomenology, the mechanistic basis for mental effort remains poorly understood. Although most researchers agree that mental effort is aversive and stems from limitations in our capacity to exercise cognitive control, it is unclear what gives rise to those limitations and why they result in an experience of control as costly. The presence of these control costs also raises further questions regarding how best to allocate mental effort to minimize those costs and maximize the attendant benefits. This review explores recent advances in computational modeling and empirical research aimed at addressing these questions at the level of psychological process and neural mechanism, examining both the limitations to mental effort exertion and how we manage those limited cognitive resources. We conclude by identifying remaining challenges for theoretical accounts of mental effort as well as possible applications of the available findings to understanding the causes of and potential solutions for apparent failures to exert the mental effort required of us.

  2. The Effort Paradox: Effort Is Both Costly and Valued.

    Science.gov (United States)

    Inzlicht, Michael; Shenhav, Amitai; Olivola, Christopher Y

    2018-04-01

    According to prominent models in cognitive psychology, neuroscience, and economics, effort (be it physical or mental) is costly: when given a choice, humans and non-human animals alike tend to avoid effort. Here, we suggest that the opposite is also true and review extensive evidence that effort can also add value. Not only can the same outcomes be more rewarding if we apply more (not less) effort, sometimes we select options precisely because they require effort. Given the increasing recognition of effort's role in motivation, cognitive control, and value-based decision-making, considering this neglected side of effort will not only improve formal computational models, but also provide clues about how to promote sustained mental effort across time. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Activity versus outcome maximization in time management.

    Science.gov (United States)

    Malkoc, Selin A; Tonietto, Gabriela N

    2018-04-30

    Feeling time-pressed has become ubiquitous. Time management strategies have emerged to help individuals fit in more of their desired and necessary activities. We provide a review of these strategies. In doing so, we distinguish between two, often competing, motives people have in managing their time: activity maximization and outcome maximization. The emerging literature points to an important dilemma: a given strategy that maximizes the number of activities might be detrimental to outcome maximization. We discuss such factors that might hinder performance in work tasks and enjoyment in leisure tasks. Finally, we provide theoretically grounded recommendations that can help balance these two important goals in time management. Published by Elsevier Ltd.

  4. On the maximal superalgebras of supersymmetric backgrounds

    International Nuclear Information System (INIS)

    Figueroa-O'Farrill, Jose; Hackett-Jones, Emily; Moutsopoulos, George; Simon, Joan

    2009-01-01

    In this paper we give a precise definition of the notion of a maximal superalgebra of certain types of supersymmetric supergravity backgrounds, including the Freund-Rubin backgrounds, and propose a geometric construction extending the well-known construction of its Killing superalgebra. We determine the structure of maximal Lie superalgebras and show that there is a finite number of isomorphism classes, all related via contractions from an orthosymplectic Lie superalgebra. We use the structure theory to show that maximally supersymmetric waves do not possess such a maximal superalgebra, but that the maximally supersymmetric Freund-Rubin backgrounds do. We perform the explicit geometric construction of the maximal superalgebra of AdS 4 X S 7 and find that it is isomorphic to osp(1|32). We propose an algebraic construction of the maximal superalgebra of any background asymptotic to AdS 4 X S 7 and we test this proposal by computing the maximal superalgebra of the M2-brane in its two maximally supersymmetric limits, finding agreement.

  5. Task-oriented maximally entangled states

    International Nuclear Information System (INIS)

    Agrawal, Pankaj; Pradhan, B

    2010-01-01

    We introduce the notion of a task-oriented maximally entangled state (TMES). This notion depends on the task for which a quantum state is used as the resource. TMESs are the states that can be used to carry out the task maximally. This concept may be more useful than that of a general maximally entangled state in the case of a multipartite system. We illustrate this idea by giving an operational definition of maximally entangled states on the basis of communication tasks of teleportation and superdense coding. We also give examples and a procedure to obtain such TMESs for n-qubit systems.

  6. Maximizing your return on people.

    Science.gov (United States)

    Bassi, Laurie; McMurrer, Daniel

    2007-03-01

    Though most traditional HR performance metrics don't predict organizational performance, alternatives simply have not existed--until now. During the past ten years, researchers Laurie Bassi and Daniel McMurrer have worked to develop a system that allows executives to assess human capital management (HCM) and to use those metrics both to predict organizational performance and to guide organizations' investments in people. The new framework is based on a core set of HCM drivers that fall into five major categories: leadership practices, employee engagement, knowledge accessibility, workforce optimization, and organizational learning capacity. By employing rigorously designed surveys to score a company on the range of HCM practices across the five categories, it's possible to benchmark organizational HCM capabilities, identify HCM strengths and weaknesses, and link improvements or back-sliding in specific HCM practices with improvements or shortcomings in organizational performance. The process requires determining a "maturity" score for each practice, based on a scale of 1 (low) to 5 (high). Over time, evolving maturity scores from multiple surveys can reveal progress in each of the HCM practices and help a company decide where to focus improvement efforts that will have a direct impact on performance. The authors draw from their work with American Standard, South Carolina's Beaufort County School District, and a bevy of financial firms to show how improving HCM scores led to increased sales, safety, academic test scores, and stock returns. Bassi and McMurrer urge HR departments to move beyond the usual metrics and begin using HCM measurement tools to gauge how well people are managed and developed throughout the organization. In this new role, according to the authors, HR can take on strategic responsibility and ensure that superior human capital management becomes central to the organization's culture.

  7. Maximally Entangled Multipartite States: A Brief Survey

    International Nuclear Information System (INIS)

    Enríquez, M; Wintrowicz, I; Życzkowski, K

    2016-01-01

    The problem of identifying maximally entangled quantum states of a composite quantum systems is analyzed. We review some states of multipartite systems distinguished with respect to certain measures of quantum entanglement. Numerical results obtained for 4-qubit pure states illustrate the fact that the notion of maximally entangled state depends on the measure used. (paper)

  8. Utility maximization and mode of payment

    NARCIS (Netherlands)

    Koning, R.H.; Ridder, G.; Heijmans, R.D.H.; Pollock, D.S.G.; Satorra, A.

    2000-01-01

    The implications of stochastic utility maximization in a model of choice of payment are examined. Three types of compatibility with utility maximization are distinguished: global compatibility, local compatibility on an interval, and local compatibility on a finite set of points. Keywords:

  9. Corporate Social Responsibility and Profit Maximizing Behaviour

    OpenAIRE

    Becchetti, Leonardo; Giallonardo, Luisa; Tessitore, Maria Elisabetta

    2005-01-01

    We examine the behavior of a profit maximizing monopolist in a horizontal differentiation model in which consumers differ in their degree of social responsibility (SR) and consumers SR is dynamically influenced by habit persistence. The model outlines parametric conditions under which (consumer driven) corporate social responsibility is an optimal choice compatible with profit maximizing behavior.

  10. Inclusive fitness maximization: An axiomatic approach.

    Science.gov (United States)

    Okasha, Samir; Weymark, John A; Bossert, Walter

    2014-06-07

    Kin selection theorists argue that evolution in social contexts will lead organisms to behave as if maximizing their inclusive, as opposed to personal, fitness. The inclusive fitness concept allows biologists to treat organisms as akin to rational agents seeking to maximize a utility function. Here we develop this idea and place it on a firm footing by employing a standard decision-theoretic methodology. We show how the principle of inclusive fitness maximization and a related principle of quasi-inclusive fitness maximization can be derived from axioms on an individual׳s 'as if preferences' (binary choices) for the case in which phenotypic effects are additive. Our results help integrate evolutionary theory and rational choice theory, help draw out the behavioural implications of inclusive fitness maximization, and point to a possible way in which evolution could lead organisms to implement it. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Maximal Entanglement in High Energy Physics

    Directory of Open Access Journals (Sweden)

    Alba Cervera-Lierta, José I. Latorre, Juan Rojo, Luca Rottoli

    2017-11-01

    Full Text Available We analyze how maximal entanglement is generated at the fundamental level in QED by studying correlations between helicity states in tree-level scattering processes at high energy. We demonstrate that two mechanisms for the generation of maximal entanglement are at work: i $s$-channel processes where the virtual photon carries equal overlaps of the helicities of the final state particles, and ii the indistinguishable superposition between $t$- and $u$-channels. We then study whether requiring maximal entanglement constrains the coupling structure of QED and the weak interactions. In the case of photon-electron interactions unconstrained by gauge symmetry, we show how this requirement allows reproducing QED. For $Z$-mediated weak scattering, the maximal entanglement principle leads to non-trivial predictions for the value of the weak mixing angle $\\theta_W$. Our results are a first step towards understanding the connections between maximal entanglement and the fundamental symmetries of high-energy physics.

  12. Micro-surgical endodontics.

    Science.gov (United States)

    Eliyas, S; Vere, J; Ali, Z; Harris, I

    2014-02-01

    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  13. Cognitive effort: A neuroeconomic approach

    Science.gov (United States)

    Braver, Todd S.

    2015-01-01

    Cognitive effort has been implicated in numerous theories regarding normal and aberrant behavior and the physiological response to engagement with demanding tasks. Yet, despite broad interest, no unifying, operational definition of cognitive effort itself has been proposed. Here, we argue that the most intuitive and epistemologically valuable treatment is in terms of effort-based decision-making, and advocate a neuroeconomics-focused research strategy. We first outline psychological and neuroscientific theories of cognitive effort. Then we describe the benefits of a neuroeconomic research strategy, highlighting how it affords greater inferential traction than do traditional markers of cognitive effort, including self-reports and physiologic markers of autonomic arousal. Finally, we sketch a future series of studies that can leverage the full potential of the neuroeconomic approach toward understanding the cognitive and neural mechanisms that give rise to phenomenal, subjective cognitive effort. PMID:25673005

  14. Bipartite Bell Inequality and Maximal Violation

    International Nuclear Information System (INIS)

    Li Ming; Fei Shaoming; Li-Jost Xian-Qing

    2011-01-01

    We present new bell inequalities for arbitrary dimensional bipartite quantum systems. The maximal violation of the inequalities is computed. The Bell inequality is capable of detecting quantum entanglement of both pure and mixed quantum states more effectively. (general)

  15. HEALTH INSURANCE: CONTRIBUTIONS AND REIMBURSEMENT MAXIMAL

    CERN Document Server

    HR Division

    2000-01-01

    Affected by both the salary adjustment index on 1.1.2000 and the evolution of the staff members and fellows population, the average reference salary, which is used as an index for fixed contributions and reimbursement maximal, has changed significantly. An adjustment of the amounts of the reimbursement maximal and the fixed contributions is therefore necessary, as from 1 January 2000.Reimbursement maximalThe revised reimbursement maximal will appear on the leaflet summarising the benefits for the year 2000, which will soon be available from the divisional secretariats and from the AUSTRIA office at CERN.Fixed contributionsThe fixed contributions, applicable to some categories of voluntarily insured persons, are set as follows (amounts in CHF for monthly contributions):voluntarily insured member of the personnel, with complete coverage:815,- (was 803,- in 1999)voluntarily insured member of the personnel, with reduced coverage:407,- (was 402,- in 1999)voluntarily insured no longer dependent child:326,- (was 321...

  16. Maximal Inequalities for Dependent Random Variables

    DEFF Research Database (Denmark)

    Hoffmann-Jorgensen, Jorgen

    2016-01-01

    Maximal inequalities play a crucial role in many probabilistic limit theorem; for instance, the law of large numbers, the law of the iterated logarithm, the martingale limit theorem and the central limit theorem. Let X-1, X-2,... be random variables with partial sums S-k = X-1 + ... + X-k. Then a......Maximal inequalities play a crucial role in many probabilistic limit theorem; for instance, the law of large numbers, the law of the iterated logarithm, the martingale limit theorem and the central limit theorem. Let X-1, X-2,... be random variables with partial sums S-k = X-1 + ... + X......-k. Then a maximal inequality gives conditions ensuring that the maximal partial sum M-n = max(1) (...

  17. Maximizing Function through Intelligent Robot Actuator Control

    Data.gov (United States)

    National Aeronautics and Space Administration — Maximizing Function through Intelligent Robot Actuator Control Successful missions to Mars and beyond will only be possible with the support of high-performance...

  18. An ethical justification of profit maximization

    DEFF Research Database (Denmark)

    Koch, Carsten Allan

    2010-01-01

    In much of the literature on business ethics and corporate social responsibility, it is more or less taken for granted that attempts to maximize profits are inherently unethical. The purpose of this paper is to investigate whether an ethical argument can be given in support of profit maximizing...... behaviour. It is argued that some form of consequential ethics must be applied, and that both profit seeking and profit maximization can be defended from a rule-consequential point of view. It is noted, however, that the result does not apply unconditionally, but requires that certain form of profit (and...... utility) maximizing actions are ruled out, e.g., by behavioural norms or formal institutions....

  19. A definition of maximal CP-violation

    International Nuclear Information System (INIS)

    Roos, M.

    1985-01-01

    The unitary matrix of quark flavour mixing is parametrized in a general way, permitting a mathematically natural definition of maximal CP violation. Present data turn out to violate this definition by 2-3 standard deviations. (orig.)

  20. A cosmological problem for maximally symmetric supergravity

    International Nuclear Information System (INIS)

    German, G.; Ross, G.G.

    1986-01-01

    Under very general considerations it is shown that inflationary models of the universe based on maximally symmetric supergravity with flat potentials are unable to resolve the cosmological energy density (Polonyi) problem. (orig.)

  1. Insulin resistance and maximal oxygen uptake

    DEFF Research Database (Denmark)

    Seibaek, Marie; Vestergaard, Henrik; Burchardt, Hans

    2003-01-01

    BACKGROUND: Type 2 diabetes, coronary atherosclerosis, and physical fitness all correlate with insulin resistance, but the relative importance of each component is unknown. HYPOTHESIS: This study was undertaken to determine the relationship between insulin resistance, maximal oxygen uptake......, and the presence of either diabetes or ischemic heart disease. METHODS: The study population comprised 33 patients with and without diabetes and ischemic heart disease. Insulin resistance was measured by a hyperinsulinemic euglycemic clamp; maximal oxygen uptake was measured during a bicycle exercise test. RESULTS......: There was a strong correlation between maximal oxygen uptake and insulin-stimulated glucose uptake (r = 0.7, p = 0.001), and maximal oxygen uptake was the only factor of importance for determining insulin sensitivity in a model, which also included the presence of diabetes and ischemic heart disease. CONCLUSION...

  2. Maximal supergravities and the E10 model

    International Nuclear Information System (INIS)

    Kleinschmidt, Axel; Nicolai, Hermann

    2006-01-01

    The maximal rank hyperbolic Kac-Moody algebra e 10 has been conjectured to play a prominent role in the unification of duality symmetries in string and M theory. We review some recent developments supporting this conjecture

  3. Open Maximal Mucosa-Sparing Functional Total Laryngectomy

    Directory of Open Access Journals (Sweden)

    Pavel Dulguerov

    2017-10-01

    Full Text Available BackgroundTotal laryngectomy after (chemoradiotherapy is associated with a high incidence of fistula and therefore flaps are advocated. The description of a transoral robotic total laryngectomy prompted us to develop similar minimally invasive open approaches for functional total laryngectomy.MethodsA retrospective study of consecutive unselected patients with a dysfunctional larynx after (chemoradiation that underwent open maximal mucosal-sparing functional total laryngectomy (MMSTL between 2014 and 2016 is presented. The surgical technique is described, and the complications and functional outcome are reviewed.ResultsThe cohorts included 10 patients who underwent open MMSTL. No pedicled flap was used. Only one postoperative fistula was noted (10%. All patients resumed oral diet and experienced a functional tracheo-esophageal voice.ConclusionMMSTL could be used to perform functional total laryngectomy without a robot and with minimal incidence of complications.

  4. Gaussian maximally multipartite-entangled states

    Science.gov (United States)

    Facchi, Paolo; Florio, Giuseppe; Lupo, Cosmo; Mancini, Stefano; Pascazio, Saverio

    2009-12-01

    We study maximally multipartite-entangled states in the context of Gaussian continuous variable quantum systems. By considering multimode Gaussian states with constrained energy, we show that perfect maximally multipartite-entangled states, which exhibit the maximum amount of bipartite entanglement for all bipartitions, only exist for systems containing n=2 or 3 modes. We further numerically investigate the structure of these states and their frustration for n≤7 .

  5. Gaussian maximally multipartite-entangled states

    International Nuclear Information System (INIS)

    Facchi, Paolo; Florio, Giuseppe; Pascazio, Saverio; Lupo, Cosmo; Mancini, Stefano

    2009-01-01

    We study maximally multipartite-entangled states in the context of Gaussian continuous variable quantum systems. By considering multimode Gaussian states with constrained energy, we show that perfect maximally multipartite-entangled states, which exhibit the maximum amount of bipartite entanglement for all bipartitions, only exist for systems containing n=2 or 3 modes. We further numerically investigate the structure of these states and their frustration for n≤7.

  6. Neutrino mass textures with maximal CP violation

    International Nuclear Information System (INIS)

    Aizawa, Ichiro; Kitabayashi, Teruyuki; Yasue, Masaki

    2005-01-01

    We show three types of neutrino mass textures, which give maximal CP violation as well as maximal atmospheric neutrino mixing. These textures are described by six real mass parameters: one specified by two complex flavor neutrino masses and two constrained ones and the others specified by three complex flavor neutrino masses. In each texture, we calculate mixing angles and masses, which are consistent with observed data, as well as Majorana CP phases

  7. Why firms should not always maximize profits

    OpenAIRE

    Kolstad, Ivar

    2006-01-01

    Though corporate social responsibility (CSR) is on the agenda of most major corporations, corporate executives still largely support the view that corporations should maximize the returns to their owners. There are two lines of defence for this position. One is the Friedmanian view that maximizing owner returns is the corporate social responsibility of corporations. The other is a position voiced by many executives, that CSR and profits go together. This paper argues that the first position i...

  8. Maximally Informative Observables and Categorical Perception

    OpenAIRE

    Tsiang, Elaine

    2012-01-01

    We formulate the problem of perception in the framework of information theory, and prove that categorical perception is equivalent to the existence of an observable that has the maximum possible information on the target of perception. We call such an observable maximally informative. Regardless whether categorical perception is real, maximally informative observables can form the basis of a theory of perception. We conclude with the implications of such a theory for the problem of speech per...

  9. Multidisciplinary Efforts Driving Translational Theranostics

    Science.gov (United States)

    Hu, Tony Y.

    2014-01-01

    This themed issue summarizes significant efforts aimed at using “biological language” to discern between “friends” and “foes” in the context of theranostics for true clinical application. It is expected that the success of theranostics depends on multidisciplinary efforts, combined to expedite our understanding of host responses to “customized” theranostic agents and formulating individualized therapies. PMID:25285169

  10. Learning Environment and Student Effort

    Science.gov (United States)

    Hopland, Arnt O.; Nyhus, Ole Henning

    2016-01-01

    Purpose: The purpose of this paper is to explore the relationship between satisfaction with learning environment and student effort, both in class and with homework assignments. Design/methodology/approach: The authors use data from a nationwide and compulsory survey to analyze the relationship between learning environment and student effort. The…

  11. Respiratory effort from the photoplethysmogram.

    Science.gov (United States)

    Addison, Paul S

    2017-03-01

    The potential for a simple, non-invasive measure of respiratory effort based on the pulse oximeter signal - the photoplethysmogram or 'pleth' - was investigated in a pilot study. Several parameters were developed based on a variety of manifestations of respiratory effort in the signal, including modulation changes in amplitude, baseline, frequency and pulse transit times, as well as distinct baseline signal shifts. Thirteen candidate parameters were investigated using data from healthy volunteers. Each volunteer underwent a series of controlled respiratory effort maneuvers at various set flow resistances and respiratory rates. Six oximeter probes were tested at various body sites. In all, over three thousand pleth-based effort-airway pressure (EP) curves were generated across the various airway constrictions, respiratory efforts, respiratory rates, subjects, probe sites, and the candidate parameters considered. Regression analysis was performed to determine the existence of positive monotonic relationships between the respiratory effort parameters and resulting airway pressures. Six of the candidate parameters investigated exhibited a distinct positive relationship (poximeter probe and an ECG (P2E-Effort) and the other using two pulse oximeter probes placed at different peripheral body sites (P2-Effort); and baseline shifts in heart rate, (BL-HR-Effort). In conclusion, a clear monotonic relationship was found between several pleth-based parameters and imposed respiratory loadings at the mouth across a range of respiratory rates and flow constrictions. The results suggest that the pleth may provide a measure of changing upper airway dynamics indicative of the effort to breathe. Copyright © 2017 The Author. Published by Elsevier Ltd.. All rights reserved.

  12. Shareholder, stakeholder-owner or broad stakeholder maximization

    OpenAIRE

    Mygind, Niels

    2004-01-01

    With reference to the discussion about shareholder versus stakeholder maximization it is argued that the normal type of maximization is in fact stakeholder-owner maxi-mization. This means maximization of the sum of the value of the shares and stake-holder benefits belonging to the dominating stakeholder-owner. Maximization of shareholder value is a special case of owner-maximization, and only under quite re-strictive assumptions shareholder maximization is larger or equal to stakeholder-owner...

  13. American Pediatric Surgical Association

    Science.gov (United States)

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  14. Abortion - surgical - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  15. Urogynecologic Surgical Mesh Implants

    Science.gov (United States)

    ... procedures performed to treat pelvic floor disorders with surgical mesh: Transvaginal mesh to treat POP Transabdominal mesh to treat ... address safety risks Final Order for Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair Final Order for Effective ...

  16. Effort rights-based management

    DEFF Research Database (Denmark)

    Squires, Dale; Maunder, Mark; Allen, Robin

    2017-01-01

    Effort rights-based fisheries management (RBM) is less widely used than catch rights, whether for groups or individuals. Because RBM on catch or effort necessarily requires a total allowable catch (TAC) or total allowable effort (TAE), RBM is discussed in conjunction with issues in assessing fish...... populations and providing TACs or TAEs. Both approaches have advantages and disadvantages, and there are trade-offs between the two approaches. In a narrow economic sense, catch rights are superior because of the type of incentives created, but once the costs of research to improve stock assessments...

  17. Vacua of maximal gauged D=3 supergravities

    International Nuclear Information System (INIS)

    Fischbacher, T; Nicolai, H; Samtleben, H

    2002-01-01

    We analyse the scalar potentials of maximal gauged three-dimensional supergravities which reveal a surprisingly rich structure. In contrast to maximal supergravities in dimensions D≥4, all these theories possess a maximally supersymmetric (N=16) ground state with negative cosmological constant Λ 2 gauged theory, whose maximally supersymmetric groundstate has Λ = 0. We compute the mass spectra of bosonic and fermionic fluctuations around these vacua and identify the unitary irreducible representations of the relevant background (super)isometry groups to which they belong. In addition, we find several stationary points which are not maximally supersymmetric, and determine their complete mass spectra as well. In particular, we show that there are analogues of all stationary points found in higher dimensions, among them are de Sitter (dS) vacua in the theories with noncompact gauge groups SO(5, 3) 2 and SO(4, 4) 2 , as well as anti-de Sitter (AdS) vacua in the compact gauged theory preserving 1/4 and 1/8 of the supersymmetries. All the dS vacua have tachyonic instabilities, whereas there do exist nonsupersymmetric AdS vacua which are stable, again in contrast to the D≥4 theories

  18. Pandemic Influenza: Domestic Preparedness Efforts

    National Research Council Canada - National Science Library

    Lister, Sarah A

    2005-01-01

    .... Though influenza pandemics occur with some regularity, and the United States has been involved in specific planning efforts since the early 1990s, the H5N1 situation has created a sense of urgency...

  19. Surgical Respiratory Emergencies in the Newborn

    African Journals Online (AJOL)

    1974-06-15

    Jun 15, 1974 ... is only 20 ml and there is very little breathing reserve. Many causes of surgical ... Prematurity is often associated with congenital abnor- malities and also with ... junction and the large negative pressure created by the efforts of ...

  20. Effort Estimation in BPMS Migration

    OpenAIRE

    Drews, Christopher; Lantow, Birger

    2018-01-01

    Usually Business Process Management Systems (BPMS) are highly integrated in the IT of organizations and are at the core of their business. Thus, migrating from one BPMS solution to another is not a common task. However, there are forces that are pushing organizations to perform this step, e.g. maintenance costs of legacy BPMS or the need for additional functionality. Before the actual migration, the risk and the effort must be evaluated. This work provides a framework for effort estimation re...

  1. An information maximization model of eye movements

    Science.gov (United States)

    Renninger, Laura Walker; Coughlan, James; Verghese, Preeti; Malik, Jitendra

    2005-01-01

    We propose a sequential information maximization model as a general strategy for programming eye movements. The model reconstructs high-resolution visual information from a sequence of fixations, taking into account the fall-off in resolution from the fovea to the periphery. From this framework we get a simple rule for predicting fixation sequences: after each fixation, fixate next at the location that minimizes uncertainty (maximizes information) about the stimulus. By comparing our model performance to human eye movement data and to predictions from a saliency and random model, we demonstrate that our model is best at predicting fixation locations. Modeling additional biological constraints will improve the prediction of fixation sequences. Our results suggest that information maximization is a useful principle for programming eye movements.

  2. Utility Maximization in Nonconvex Wireless Systems

    CERN Document Server

    Brehmer, Johannes

    2012-01-01

    This monograph formulates a framework for modeling and solving utility maximization problems in nonconvex wireless systems. First, a model for utility optimization in wireless systems is defined. The model is general enough to encompass a wide array of system configurations and performance objectives. Based on the general model, a set of methods for solving utility maximization problems is developed. The development is based on a careful examination of the properties that are required for the application of each method. The focus is on problems whose initial formulation does not allow for a solution by standard convex methods. Solution approaches that take into account the nonconvexities inherent to wireless systems are discussed in detail. The monograph concludes with two case studies that demonstrate the application of the proposed framework to utility maximization in multi-antenna broadcast channels.

  3. Maximizing band gaps in plate structures

    DEFF Research Database (Denmark)

    Halkjær, Søren; Sigmund, Ole; Jensen, Jakob Søndergaard

    2006-01-01

    periodic plate using Bloch theory, which conveniently reduces the maximization problem to that of a single base cell. Secondly, we construct a finite periodic plate using a number of the optimized base cells in a postprocessed version. The dynamic properties of the finite plate are investigated......Band gaps, i.e., frequency ranges in which waves cannot propagate, can be found in elastic structures for which there is a certain periodic modulation of the material properties or structure. In this paper, we maximize the band gap size for bending waves in a Mindlin plate. We analyze an infinite...... theoretically and experimentally and the issue of finite size effects is addressed....

  4. Singularity Structure of Maximally Supersymmetric Scattering Amplitudes

    DEFF Research Database (Denmark)

    Arkani-Hamed, Nima; Bourjaily, Jacob L.; Cachazo, Freddy

    2014-01-01

    We present evidence that loop amplitudes in maximally supersymmetric (N=4) Yang-Mills theory (SYM) beyond the planar limit share some of the remarkable structures of the planar theory. In particular, we show that through two loops, the four-particle amplitude in full N=4 SYM has only logarithmic ...... singularities and is free of any poles at infinity—properties closely related to uniform transcendentality and the UV finiteness of the theory. We also briefly comment on implications for maximal (N=8) supergravity theory (SUGRA)....

  5. Learning curves for mutual information maximization

    International Nuclear Information System (INIS)

    Urbanczik, R.

    2003-01-01

    An unsupervised learning procedure based on maximizing the mutual information between the outputs of two networks receiving different but statistically dependent inputs is analyzed [S. Becker and G. Hinton, Nature (London) 355, 161 (1992)]. For a generic data model, I show that in the large sample limit the structure in the data is recognized by mutual information maximization. For a more restricted model, where the networks are similar to perceptrons, I calculate the learning curves for zero-temperature Gibbs learning. These show that convergence can be rather slow, and a way of regularizing the procedure is considered

  6. Finding Maximal Pairs with Bounded Gap

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Lyngsø, Rune B.; Pedersen, Christian N. S.

    1999-01-01

    . In this paper we present methods for finding all maximal pairs under various constraints on the gap. In a string of length n we can find all maximal pairs with gap in an upper and lower bounded interval in time O(n log n+z) where z is the number of reported pairs. If the upper bound is removed the time reduces...... to O(n+z). Since a tandem repeat is a pair where the gap is zero, our methods can be seen as a generalization of finding tandem repeats. The running time of our methods equals the running time of well known methods for finding tandem repeats....

  7. Effort in Multitasking: Local and Global Assessment of Effort.

    Science.gov (United States)

    Kiesel, Andrea; Dignath, David

    2017-01-01

    When performing multiple tasks in succession, self-organization of task order might be superior compared to external-controlled task schedules, because self-organization allows optimizing processing modes and thus reduces switch costs, and it increases commitment to task goals. However, self-organization is an additional executive control process that is not required if task order is externally specified and as such it is considered as time-consuming and effortful. To compare self-organized and externally controlled task scheduling, we suggest assessing global subjective and objectives measures of effort in addition to local performance measures. In our new experimental approach, we combined characteristics of dual tasking settings and task switching settings and compared local and global measures of effort in a condition with free choice of task sequence and a condition with cued task sequence. In a multi-tasking environment, participants chose the task order while the task requirement of the not-yet-performed task remained the same. This task preview allowed participants to work on the previously non-chosen items in parallel and resulted in faster responses and fewer errors in task switch trials than in task repetition trials. The free-choice group profited more from this task preview than the cued group when considering local performance measures. Nevertheless, the free-choice group invested more effort than the cued group when considering global measures. Thus, self-organization in task scheduling seems to be effortful even in conditions in which it is beneficiary for task processing. In a second experiment, we reduced the possibility of task preview for the not-yet-performed tasks in order to hinder efficient self-organization. Here neither local nor global measures revealed substantial differences between the free-choice and a cued task sequence condition. Based on the results of both experiments, we suggest that global assessment of effort in addition to

  8. Surgical Treatment of Acute Pancreatitis.

    Science.gov (United States)

    Werner, Jens; Uhl, Waldemar; Büchler, Markus W.

    2003-10-01

    Patients with predicted severe necrotizing pancreatitis as diagnosed by C-reactive protein (>150 mg/L) and/or contrast-enhanced computed tomography should be managed in the intensive care unit. Prophylactic broad-spectrum antibiotics reduce infection rates and survival in severe necrotizing pancreatitis. Endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy is a causative therapy for gallstone pancreatitis with impacted stones, biliary sepsis, or obstructive jaundice. Fine needle aspiration for bacteriology should be performed to differentiate between sterile and infected pancreatic necrosis in patients with sepsis syndrome. Infected pancreatic necrosis in patients with clinical signs and symptoms of sepsis is an indication for surgery. Patients with sterile pancreatic necrosis should be managed conservatively. Surgery in patients with sterile necrosis may be indicated in cases of persistent necrotizing pancreatitis and in the rare cases of "fulminant acute pancreatitis." Early surgery, within 14 days after onset of the disease, is not recommended in patients with necrotizing pancreatitis. The surgical approach should be organ-preserving (debridement/necrosectomy) and combined with a postoperative management concept that maximizes postoperative evacuation of retroperitoneal debris and exudate. Minimally invasive surgical procedures have to be regarded as an experimental approach and should be restricted to controlled trials. Cholecystectomy should be performed to avoid recurrence of gallstone-associated acute pancreatitis.

  9. Surgical infections: a microbiological study

    Directory of Open Access Journals (Sweden)

    Santosh Saini

    Full Text Available Surgical infections are mostly polymicrobial, involving both aerobes and anaerobes. One hundred seventeen cases comprised of abscesses (n=51, secondary peritonitis (n=25, necrotizing fascitis (n=22 and wounds with devitalized tissues (n=19 were studied. The number of microorganisms isolated per lesion was highest in secondary peritonitis (2.32. The aerobe/ anaerobe ratio was 0.81 in secondary peritonitis and 1.8 in necrotizing fascitis. Most secondary peritonitis (80%, necrotizing fascitis (75% and wounds with devitalized tissues (66.7% were polymicrobial. Common microorganisms isolated in our study were E. coli, Staphylococcus aureus, Klebsiella spp., Pseudomonas aeruginosa, Bacteroides fragilis and Peptostreptococcus spp. The most effective antibiotics for S. aureus were clindamycin (79.1% and cefuroxime (70.8%. For Gram-negatives (Klebsiella spp., E. coli and Proteus spp., the most effective antibiotics were cefotaxime, ceftizoxime, amikacin and ciprofloxacin. Pseudomonas aeruginosa was maximally sensitive to amikacin (35.2% and ciprofloxacin (35.2%. The greatest degree of multidrug resistance to all the drugs was found in P. aeruginosa (52.9%, followed by Klebsiella spp. (33.3%, Proteus spp. (33.3%, E. coli (22.2%, and S. aureus (12.5%. All the anaerobes that we isolated were 100% sensitive to metronidazole and chloramphenicol, followed by clindamycin (95% to 100%. Apart from antibiotic therapy, non-antimicrobial methods, such as hyperbaric oxygen therapy and debridement also play an important role in the treatment of surgical infections.

  10. YOUTH BASKETBALL SPECIFIC EFFORT TEST

    Directory of Open Access Journals (Sweden)

    Philippe Campillo

    2004-12-01

    Full Text Available The test, as it is presented, must be modified to produce more pertinent results. The measure before the maximum jumps in RJ can also show at what intensity the athletes produce the jump repetitions. The knowledge of the maximal performance during a jump constitutes a reference with which one can evaluate a subject's commitment and efficiency during the test. The results of the study show that this type of test protocol can be a good method to evaluate the physical condition of an athlete during training.

  11. Dopamine, behavioral economics, and effort

    Directory of Open Access Journals (Sweden)

    John D Salamone

    2009-09-01

    Full Text Available Abstract. There are numerous problems with the hypothesis that brain dopamine (DA systems, particularly in the nucleus accumbens, directly mediate the rewarding or primary motivational characteristics of natural stimuli such as food. Research and theory related to the functions of mesolimbic DA are undergoing a substantial conceptual restructuring, with the traditional emphasis on hedonia and primary reward yielding to other concepts and lines of inquiry. The present review is focused upon the involvement of nucleus accumbens DA in behavioral activation and effort-related processes. Viewed from the framework of behavioral economics, the effects of accumbens DA depletions and antagonism on food-reinforced behavior are highly dependent upon the work requirements of the instrumental task, and DA depleted rats are more sensitive to increases in response costs (i.e., ratio requirements. Moreover, interference with accumbens DA transmission exerts a powerful influence over effort-related choice behavior. Rats with accumbens DA depletions or antagonism reallocate their instrumental behavior away from food-reinforced tasks that have high response requirements, and instead these rats select a less-effortful type of food-seeking behavior. Nucleus accumbens DA and adenosine interact in the regulation of effort-related functions, and other brain structures (anterior cingulate cortex, amygdala, ventral pallidum also are involved. Studies of the brain systems regulating effort-based processes may have implications for understanding drug abuse, as well as energy-related disorders such as psychomotor slowing, fatigue or anergia in depression and other neurological disorders.

  12. Maximum effort in the minimum-effort game

    Czech Academy of Sciences Publication Activity Database

    Engelmann, Dirk; Normann, H.-T.

    2010-01-01

    Roč. 13, č. 3 (2010), s. 249-259 ISSN 1386-4157 Institutional research plan: CEZ:AV0Z70850503 Keywords : minimum-effort game * coordination game * experiments * social capital Subject RIV: AH - Economics Impact factor: 1.868, year: 2010

  13. Maximizing the Range of a Projectile.

    Science.gov (United States)

    Brown, Ronald A.

    1992-01-01

    Discusses solutions to the problem of maximizing the range of a projectile. Presents three references that solve the problem with and without the use of calculus. Offers a fourth solution suitable for introductory physics courses that relies more on trigonometry and the geometry of the problem. (MDH)

  14. Robust Utility Maximization Under Convex Portfolio Constraints

    International Nuclear Information System (INIS)

    Matoussi, Anis; Mezghani, Hanen; Mnif, Mohamed

    2015-01-01

    We study a robust maximization problem from terminal wealth and consumption under a convex constraints on the portfolio. We state the existence and the uniqueness of the consumption–investment strategy by studying the associated quadratic backward stochastic differential equation. We characterize the optimal control by using the duality method and deriving a dynamic maximum principle

  15. Ehrenfest's Lottery--Time and Entropy Maximization

    Science.gov (United States)

    Ashbaugh, Henry S.

    2010-01-01

    Successful teaching of the Second Law of Thermodynamics suffers from limited simple examples linking equilibrium to entropy maximization. I describe a thought experiment connecting entropy to a lottery that mixes marbles amongst a collection of urns. This mixing obeys diffusion-like dynamics. Equilibrium is achieved when the marble distribution is…

  16. Reserve design to maximize species persistence

    Science.gov (United States)

    Robert G. Haight; Laurel E. Travis

    2008-01-01

    We develop a reserve design strategy to maximize the probability of species persistence predicted by a stochastic, individual-based, metapopulation model. Because the population model does not fit exact optimization procedures, our strategy involves deriving promising solutions from theory, obtaining promising solutions from a simulation optimization heuristic, and...

  17. Maximal indecomposable past sets and event horizons

    International Nuclear Information System (INIS)

    Krolak, A.

    1984-01-01

    The existence of maximal indecomposable past sets MIPs is demonstrated using the Kuratowski-Zorn lemma. A criterion for the existence of an absolute event horizon in space-time is given in terms of MIPs and a relation to black hole event horizon is shown. (author)

  18. Maximization of eigenvalues using topology optimization

    DEFF Research Database (Denmark)

    Pedersen, Niels Leergaard

    2000-01-01

    to localized modes in low density areas. The topology optimization problem is formulated using the SIMP method. Special attention is paid to a numerical method for removing localized eigenmodes in low density areas. The method is applied to numerical examples of maximizing the first eigenfrequency, One example...

  19. Maximizing Resource Utilization in Video Streaming Systems

    Science.gov (United States)

    Alsmirat, Mohammad Abdullah

    2013-01-01

    Video streaming has recently grown dramatically in popularity over the Internet, Cable TV, and wire-less networks. Because of the resource demanding nature of video streaming applications, maximizing resource utilization in any video streaming system is a key factor to increase the scalability and decrease the cost of the system. Resources to…

  20. A THEORY OF MAXIMIZING SENSORY INFORMATION

    NARCIS (Netherlands)

    Hateren, J.H. van

    1992-01-01

    A theory is developed on the assumption that early sensory processing aims at maximizing the information rate in the channels connecting the sensory system to more central parts of the brain, where it is assumed that these channels are noisy and have a limited dynamic range. Given a stimulus power

  1. Maximizing scientific knowledge from randomized clinical trials

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Atar, Dan; Pitt, Bertram

    2010-01-01

    Trialists have an ethical and financial responsibility to plan and conduct clinical trials in a manner that will maximize the scientific knowledge gained from the trial. However, the amount of scientific information generated by randomized clinical trials in cardiovascular medicine is highly vari...

  2. A Model of College Tuition Maximization

    Science.gov (United States)

    Bosshardt, Donald I.; Lichtenstein, Larry; Zaporowski, Mark P.

    2009-01-01

    This paper develops a series of models for optimal tuition pricing for private colleges and universities. The university is assumed to be a profit maximizing, price discriminating monopolist. The enrollment decision of student's is stochastic in nature. The university offers an effective tuition rate, comprised of stipulated tuition less financial…

  3. Logit Analysis for Profit Maximizing Loan Classification

    OpenAIRE

    Watt, David L.; Mortensen, Timothy L.; Leistritz, F. Larry

    1988-01-01

    Lending criteria and loan classification methods are developed. Rating system breaking points are analyzed to present a method to maximize loan revenues. Financial characteristics of farmers are used as determinants of delinquency in a multivariate logistic model. Results indicate that debt-to-asset and operating ration are most indicative of default.

  4. Developing maximal neuromuscular power: Part 1--biological basis of maximal power production.

    Science.gov (United States)

    Cormie, Prue; McGuigan, Michael R; Newton, Robert U

    2011-01-01

    This series of reviews focuses on the most important neuromuscular function in many sport performances, the ability to generate maximal muscular power. Part 1 focuses on the factors that affect maximal power production, while part 2, which will follow in a forthcoming edition of Sports Medicine, explores the practical application of these findings by reviewing the scientific literature relevant to the development of training programmes that most effectively enhance maximal power production. The ability of the neuromuscular system to generate maximal power is affected by a range of interrelated factors. Maximal muscular power is defined and limited by the force-velocity relationship and affected by the length-tension relationship. The ability to generate maximal power is influenced by the type of muscle action involved and, in particular, the time available to develop force, storage and utilization of elastic energy, interactions of contractile and elastic elements, potentiation of contractile and elastic filaments as well as stretch reflexes. Furthermore, maximal power production is influenced by morphological factors including fibre type contribution to whole muscle area, muscle architectural features and tendon properties as well as neural factors including motor unit recruitment, firing frequency, synchronization and inter-muscular coordination. In addition, acute changes in the muscle environment (i.e. alterations resulting from fatigue, changes in hormone milieu and muscle temperature) impact the ability to generate maximal power. Resistance training has been shown to impact each of these neuromuscular factors in quite specific ways. Therefore, an understanding of the biological basis of maximal power production is essential for developing training programmes that effectively enhance maximal power production in the human.

  5. Understanding Violations of Gricean Maxims in Preschoolers and Adults

    Directory of Open Access Journals (Sweden)

    Mako eOkanda

    2015-07-01

    Full Text Available This study used a revised Conversational Violations Test to examine Gricean maxim violations in 4- to 6-year-old Japanese children and adults. Participants’ understanding of the following maxims was assessed: be informative (first maxim of quantity, avoid redundancy (second maxim of quantity, be truthful (maxim of quality, be relevant (maxim of relation, avoid ambiguity (second maxim of manner, and be polite (maxim of politeness. Sensitivity to violations of Gricean maxims increased with age: 4-year-olds’ understanding of maxims was near chance, 5-year-olds understood some maxims (first maxim of quantity and maxims of quality, relation, and manner, and 6-year-olds and adults understood all maxims. Preschoolers acquired the maxim of relation first and had the greatest difficulty understanding the second maxim of quantity. Children and adults differed in their comprehension of the maxim of politeness. The development of the pragmatic understanding of Gricean maxims and implications for the construction of developmental tasks from early childhood to adulthood are discussed.

  6. ASME Code Efforts Supporting HTGRs

    Energy Technology Data Exchange (ETDEWEB)

    D.K. Morton

    2012-09-01

    In 1999, an international collaborative initiative for the development of advanced (Generation IV) reactors was started. The idea behind this effort was to bring nuclear energy closer to the needs of sustainability, to increase proliferation resistance, and to support concepts able to produce energy (both electricity and process heat) at competitive costs. The U.S. Department of Energy has supported this effort by pursuing the development of the Next Generation Nuclear Plant, a high temperature gas-cooled reactor. This support has included research and development of pertinent data, initial regulatory discussions, and engineering support of various codes and standards development. This report discusses the various applicable American Society of Mechanical Engineers (ASME) codes and standards that are being developed to support these high temperature gascooled reactors during construction and operation. ASME is aggressively pursuing these codes and standards to support an international effort to build the next generation of advanced reactors so that all can benefit.

  7. ASME Code Efforts Supporting HTGRs

    Energy Technology Data Exchange (ETDEWEB)

    D.K. Morton

    2011-09-01

    In 1999, an international collaborative initiative for the development of advanced (Generation IV) reactors was started. The idea behind this effort was to bring nuclear energy closer to the needs of sustainability, to increase proliferation resistance, and to support concepts able to produce energy (both electricity and process heat) at competitive costs. The U.S. Department of Energy has supported this effort by pursuing the development of the Next Generation Nuclear Plant, a high temperature gas-cooled reactor. This support has included research and development of pertinent data, initial regulatory discussions, and engineering support of various codes and standards development. This report discusses the various applicable American Society of Mechanical Engineers (ASME) codes and standards that are being developed to support these high temperature gascooled reactors during construction and operation. ASME is aggressively pursuing these codes and standards to support an international effort to build the next generation of advanced reactors so that all can benefit.

  8. Effort Estimation in BPMS Migration

    Directory of Open Access Journals (Sweden)

    Christopher Drews

    2018-04-01

    Full Text Available Usually Business Process Management Systems (BPMS are highly integrated in the IT of organizations and are at the core of their business. Thus, migrating from one BPMS solution to another is not a common task. However, there are forces that are pushing organizations to perform this step, e.g. maintenance costs of legacy BPMS or the need for additional functionality. Before the actual migration, the risk and the effort must be evaluated. This work provides a framework for effort estimation regarding the technical aspects of BPMS migration. The framework provides questions for BPMS comparison and an effort evaluation schema. The applicability of the framework is evaluated based on a simplified BPMS migration scenario.

  9. Maximizing Macromolecule Crystal Size for Neutron Diffraction Experiments

    Science.gov (United States)

    Judge, R. A.; Kephart, R.; Leardi, R.; Myles, D. A.; Snell, E. H.; vanderWoerd, M.; Curreri, Peter A. (Technical Monitor)

    2002-01-01

    A challenge in neutron diffraction experiments is growing large (greater than 1 cu mm) macromolecule crystals. In taking up this challenge we have used statistical experiment design techniques to quickly identify crystallization conditions under which the largest crystals grow. These techniques provide the maximum information for minimal experimental effort, allowing optimal screening of crystallization variables in a simple experimental matrix, using the minimum amount of sample. Analysis of the results quickly tells the investigator what conditions are the most important for the crystallization. These can then be used to maximize the crystallization results in terms of reducing crystal numbers and providing large crystals of suitable habit. We have used these techniques to grow large crystals of Glucose isomerase. Glucose isomerase is an industrial enzyme used extensively in the food industry for the conversion of glucose to fructose. The aim of this study is the elucidation of the enzymatic mechanism at the molecular level. The accurate determination of hydrogen positions, which is critical for this, is a requirement that neutron diffraction is uniquely suited for. Preliminary neutron diffraction experiments with these crystals conducted at the Institute Laue-Langevin (Grenoble, France) reveal diffraction to beyond 2.5 angstrom. Macromolecular crystal growth is a process involving many parameters, and statistical experimental design is naturally suited to this field. These techniques are sample independent and provide an experimental strategy to maximize crystal volume and habit for neutron diffraction studies.

  10. Reproductive effort in viscous populations

    NARCIS (Netherlands)

    Pen, Ido

    Here I study a kin selection model of reproductive effort, the allocation of resources to fecundity versus survival, in a patch-structured population. Breeding females remain in the same patch for life. Offspring have costly, partial long-distance dispersal and compete for breeding sites, which

  11. Technique of the transcervical-subxiphoid-videothoracoscopic maximal thymectomy

    Directory of Open Access Journals (Sweden)

    Zielinski Marcin

    2007-01-01

    Full Text Available Background: The aim of this study is to present the new technique of transcervical-subxiphoid-videothoracoscopic "maximal"thymectomy introduced by the authors of this study for myasthenia gravis. Materials and Methods: Two hundred and sixteen patients with Osserman scores ranging from I-III were operated on from 1/9/2000 to 31/12/2006 for this study. The operation was performed through four incisions: a transverse 5-8 cm incision in the neck, a 4-6 cm subxiphoid incision and two 1 cm incisions for videothoracoscopic (VTS ports. The cervical part of the procedure was performed with an open technique while the intrathoracic part was performed using a video-assisted thoracoscopic surgical (VATS technique. The whole thymus with the surrounding fatty tissue containing possible ectopic foci of the thymic tissue was removed. Such an operation can be performed by one surgical team (the one team approach or by two teams working simultaneously (two team approach. The early and late results as well as the incidence and localization of ectopic thymic foci have been presented in this report. Results: There were 216 patients in this study of which 178 were women and 38 were men. The ages of the patients ranged from 11 to 69 years (mean 29.7 years. The duration of myasthenia was 2-180 months (mean 28.3 months. Osserman scores were in the range of I-III. Almost 27% of the patients were taking steroids or immunosuppressive drugs preoperatively. The mean operative time was 201.5 min (120-330 min for a one-team approach and it was 146 (95-210 min for a two-team approach (P < 0.05. While there was no postoperative mortality, the postoperative morbidity was 12%. The incidence of ectopic thymic foci was 68.4%. The rates of complete remission after one, two, three, four and five years of follow-up were 26.3, 36.5, 42.9, 46.8 and 50.2%, respectively. Conclusion: Transcervical-subxiphoid-VTS maximal thymectomy is a complete and highly effective treatment modality for

  12. Refined reservoir description to maximize oil recovery

    International Nuclear Information System (INIS)

    Flewitt, W.E.

    1975-01-01

    To assure maximized oil recovery from older pools, reservoir description has been advanced by fully integrating original open-hole logs and the recently introduced interpretive techniques made available through cased-hole wireline saturation logs. A refined reservoir description utilizing normalized original wireline porosity logs has been completed in the Judy Creek Beaverhill Lake ''A'' Pool, a reefal carbonate pool with current potential productivity of 100,000 BOPD and 188 active wells. Continuous porosity was documented within a reef rim and cap while discontinuous porous lenses characterized an interior lagoon. With the use of pulsed neutron logs and production data a separate water front and pressure response was recognized within discrete environmental units. The refined reservoir description aided in reservoir simulation model studies and quantifying pool performance. A pattern water flood has now replaced the original peripheral bottom water drive to maximize oil recovery

  13. Maximal frustration as an immunological principle.

    Science.gov (United States)

    de Abreu, F Vistulo; Mostardinha, P

    2009-03-06

    A fundamental problem in immunology is that of understanding how the immune system selects promptly which cells to kill without harming the body. This problem poses an apparent paradox. Strong reactivity against pathogens seems incompatible with perfect tolerance towards self. We propose a different view on cellular reactivity to overcome this paradox: effector functions should be seen as the outcome of cellular decisions which can be in conflict with other cells' decisions. We argue that if cellular systems are frustrated, then extensive cross-reactivity among the elements in the system can decrease the reactivity of the system as a whole and induce perfect tolerance. Using numerical and mathematical analyses, we discuss two simple models that perform optimal pathogenic detection with no autoimmunity if cells are maximally frustrated. This study strongly suggests that a principle of maximal frustration could be used to build artificial immune systems. It would be interesting to test this principle in the real adaptive immune system.

  14. Derivative pricing based on local utility maximization

    OpenAIRE

    Jan Kallsen

    2002-01-01

    This paper discusses a new approach to contingent claim valuation in general incomplete market models. We determine the neutral derivative price which occurs if investors maximize their local utility and if derivative demand and supply are balanced. We also introduce the sensitivity process of a contingent claim. This process quantifies the reliability of the neutral derivative price and it can be used to construct price bounds. Moreover, it allows to calibrate market models in order to be co...

  15. Control of Shareholders’ Wealth Maximization in Nigeria

    OpenAIRE

    A. O. Oladipupo; C. O. Okafor

    2014-01-01

    This research focuses on who controls shareholder’s wealth maximization and how does this affect firm’s performance in publicly quoted non-financial companies in Nigeria. The shareholder fund was the dependent while explanatory variables were firm size (proxied by log of turnover), retained earning (representing management control) and dividend payment (representing measure of shareholders control). The data used for this study were obtained from the Nigerian Stock Exchange [NSE] fact book an...

  16. Definable maximal discrete sets in forcing extensions

    DEFF Research Database (Denmark)

    Törnquist, Asger Dag; Schrittesser, David

    2018-01-01

    Let  be a Σ11 binary relation, and recall that a set A is -discrete if no two elements of A are related by . We show that in the Sacks and Miller forcing extensions of L there is a Δ12 maximal -discrete set. We use this to answer in the negative the main question posed in [5] by showing...

  17. Dynamic Convex Duality in Constrained Utility Maximization

    OpenAIRE

    Li, Yusong; Zheng, Harry

    2016-01-01

    In this paper, we study a constrained utility maximization problem following the convex duality approach. After formulating the primal and dual problems, we construct the necessary and sufficient conditions for both the primal and dual problems in terms of FBSDEs plus additional conditions. Such formulation then allows us to explicitly characterize the primal optimal control as a function of the adjoint process coming from the dual FBSDEs in a dynamic fashion and vice versa. Moreover, we also...

  18. Single maximal versus combination punch kinematics.

    Science.gov (United States)

    Piorkowski, Barry A; Lees, Adrian; Barton, Gabor J

    2011-03-01

    The aim of this study was to determine the influence of punch type (Jab, Cross, Lead Hook and Reverse Hook) and punch modality (Single maximal, 'In-synch' and 'Out of synch' combination) on punch speed and delivery time. Ten competition-standard volunteers performed punches with markers placed on their anatomical landmarks for 3D motion capture with an eight-camera optoelectronic system. Speed and duration between key moments were computed. There were significant differences in contact speed between punch types (F(2,18,84.87) = 105.76, p = 0.001) with Lead and Reverse Hooks developing greater speed than Jab and Cross. There were significant differences in contact speed between punch modalities (F(2,64,102.87) = 23.52, p = 0.001) with the Single maximal (M+/- SD: 9.26 +/- 2.09 m/s) higher than 'Out of synch' (7.49 +/- 2.32 m/s), 'In-synch' left (8.01 +/- 2.35 m/s) or right lead (7.97 +/- 2.53 m/s). Delivery times were significantly lower for Jab and Cross than Hook. Times were significantly lower 'In-synch' than a Single maximal or 'Out of synch' combination mode. It is concluded that a defender may have more evasion-time than previously reported. This research could be of use to performers and coaches when considering training preparations.

  19. Formation Control for the MAXIM Mission

    Science.gov (United States)

    Luquette, Richard J.; Leitner, Jesse; Gendreau, Keith; Sanner, Robert M.

    2004-01-01

    Over the next twenty years, a wave of change is occurring in the space-based scientific remote sensing community. While the fundamental limits in the spatial and angular resolution achievable in spacecraft have been reached, based on today s technology, an expansive new technology base has appeared over the past decade in the area of Distributed Space Systems (DSS). A key subset of the DSS technology area is that which covers precision formation flying of space vehicles. Through precision formation flying, the baselines, previously defined by the largest monolithic structure which could fit in the largest launch vehicle fairing, are now virtually unlimited. Several missions including the Micro-Arcsecond X-ray Imaging Mission (MAXIM), and the Stellar Imager will drive the formation flying challenges to achieve unprecedented baselines for high resolution, extended-scene, interferometry in the ultraviolet and X-ray regimes. This paper focuses on establishing the feasibility for the formation control of the MAXIM mission. MAXIM formation flying requirements are on the order of microns, while Stellar Imager mission requirements are on the order of nanometers. This paper specifically addresses: (1) high-level science requirements for these missions and how they evolve into engineering requirements; and (2) the development of linearized equations of relative motion for a formation operating in an n-body gravitational field. Linearized equations of motion provide the ground work for linear formation control designs.

  20. Gradient Dynamics and Entropy Production Maximization

    Science.gov (United States)

    Janečka, Adam; Pavelka, Michal

    2018-01-01

    We compare two methods for modeling dissipative processes, namely gradient dynamics and entropy production maximization. Both methods require similar physical inputs-how energy (or entropy) is stored and how it is dissipated. Gradient dynamics describes irreversible evolution by means of dissipation potential and entropy, it automatically satisfies Onsager reciprocal relations as well as their nonlinear generalization (Maxwell-Onsager relations), and it has statistical interpretation. Entropy production maximization is based on knowledge of free energy (or another thermodynamic potential) and entropy production. It also leads to the linear Onsager reciprocal relations and it has proven successful in thermodynamics of complex materials. Both methods are thermodynamically sound as they ensure approach to equilibrium, and we compare them and discuss their advantages and shortcomings. In particular, conditions under which the two approaches coincide and are capable of providing the same constitutive relations are identified. Besides, a commonly used but not often mentioned step in the entropy production maximization is pinpointed and the condition of incompressibility is incorporated into gradient dynamics.

  1. Wrong-Site Surgery, Retained Surgical Items, and Surgical Fires : A Systematic Review of Surgical Never Events.

    Science.gov (United States)

    Hempel, Susanne; Maggard-Gibbons, Melinda; Nguyen, David K; Dawes, Aaron J; Miake-Lye, Isomi; Beroes, Jessica M; Booth, Marika J; Miles, Jeremy N V; Shanman, Roberta; Shekelle, Paul G

    2015-08-01

    Serious, preventable surgical events, termed never events, continue to occur despite considerable patient safety efforts. To examine the incidence and root causes of and interventions to prevent wrong-site surgery, retained surgical items, and surgical fires in the era after the implementation of the Universal Protocol in 2004. We searched 9 electronic databases for entries from 2004 through June 30, 2014, screened references, and consulted experts. Two independent reviewers identified relevant publications in June 2014. One reviewer used a standardized form to extract data and a second reviewer checked the data. Strength of evidence was established by the review team. Data extraction was completed in January 2015. Incidence of wrong-site surgery, retained surgical items, and surgical fires. We found 138 empirical studies that met our inclusion criteria. Incidence estimates for wrong-site surgery in US settings varied by data source and procedure (median estimate, 0.09 events per 10,000 surgical procedures). The median estimate for retained surgical items was 1.32 events per 10,000 procedures, but estimates varied by item and procedure. The per-procedure surgical fire incidence is unknown. A frequently reported root cause was inadequate communication. Methodologic challenges associated with investigating changes in rare events limit the conclusions of 78 intervention evaluations. Limited evidence supported the Universal Protocol (5 studies), education (4 studies), and team training (4 studies) interventions to prevent wrong-site surgery. Limited evidence exists to prevent retained surgical items by using data-matrix-coded sponge-counting systems (5 pertinent studies). Evidence for preventing surgical fires was insufficient, and intervention effects were not estimable. Current estimates for wrong-site surgery and retained surgical items are 1 event per 100,000 and 1 event per 10,000 procedures, respectively, but the precision is uncertain, and the per

  2. Maximizing time from the constraining European Working Time Directive (EWTD): The Heidelberg New Working Time Model.

    Science.gov (United States)

    Schimmack, Simon; Hinz, Ulf; Wagner, Andreas; Schmidt, Thomas; Strothmann, Hendrik; Büchler, Markus W; Schmitz-Winnenthal, Hubertus

    2014-01-01

    The introduction of the European Working Time Directive (EWTD) has greatly reduced training hours of surgical residents, which translates into 30% less surgical and clinical experience. Such a dramatic drop in attendance has serious implications such compromised quality of medical care. As the surgical department of the University of Heidelberg, our goal was to establish a model that was compliant with the EWTD while avoiding reduction in quality of patient care and surgical training. We first performed workload analyses and performance statistics for all working areas of our department (operation theater, emergency room, specialized consultations, surgical wards and on-call duties) using personal interviews, time cards, medical documentation software as well as data of the financial- and personnel-controlling sector of our administration. Using that information, we specifically designed an EWTD-compatible work model and implemented it. Surgical wards and operating rooms (ORs) were not compliant with the EWTD. Between 5 pm and 8 pm, three ORs were still operating two-thirds of the time. By creating an extended work shift (7:30 am-7:30 pm), we effectively reduced the workload to less than 49% from 4 pm and 8 am, allowing the combination of an eight-hour working day with a 16-hour on call duty; thus, maximizing surgical resident training and ensuring patient continuity of care while maintaining EDTW guidelines. A precise workload analysis is the key to success. The Heidelberg New Working Time Model provides a legal model, which, by avoiding rotating work shifts, assures quality of patient care and surgical training.

  3. Deriving DICOM surgical extensions from surgical workflows

    Science.gov (United States)

    Burgert, O.; Neumuth, T.; Gessat, M.; Jacobs, S.; Lemke, H. U.

    2007-03-01

    The generation, storage, transfer, and representation of image data in radiology are standardized by DICOM. To cover the needs of image guided surgery or computer assisted surgery in general one needs to handle patient information besides image data. A large number of objects must be defined in DICOM to address the needs of surgery. We propose an analysis process based on Surgical Workflows that helps to identify these objects together with use cases and requirements motivating for their specification. As the first result we confirmed the need for the specification of representation and transfer of geometric models. The analysis of Surgical Workflows has shown that geometric models are widely used to represent planned procedure steps, surgical tools, anatomical structures, or prosthesis in the context of surgical planning, image guided surgery, augmented reality, and simulation. By now, the models are stored and transferred in several file formats bare of contextual information. The standardization of data types including contextual information and specifications for handling of geometric models allows a broader usage of such models. This paper explains the specification process leading to Geometry Mesh Service Object Pair classes. This process can be a template for the definition of further DICOM classes.

  4. Cardiorespiratory Coordination in Repeated Maximal Exercise

    Directory of Open Access Journals (Sweden)

    Sergi Garcia-Retortillo

    2017-06-01

    Full Text Available Increases in cardiorespiratory coordination (CRC after training with no differences in performance and physiological variables have recently been reported using a principal component analysis approach. However, no research has yet evaluated the short-term effects of exercise on CRC. The aim of this study was to delineate the behavior of CRC under different physiological initial conditions produced by repeated maximal exercises. Fifteen participants performed 2 consecutive graded and maximal cycling tests. Test 1 was performed without any previous exercise, and Test 2 6 min after Test 1. Both tests started at 0 W and the workload was increased by 25 W/min in males and 20 W/min in females, until they were not able to maintain the prescribed cycling frequency of 70 rpm for more than 5 consecutive seconds. A principal component (PC analysis of selected cardiovascular and cardiorespiratory variables (expired fraction of O2, expired fraction of CO2, ventilation, systolic blood pressure, diastolic blood pressure, and heart rate was performed to evaluate the CRC defined by the number of PCs in both tests. In order to quantify the degree of coordination, the information entropy was calculated and the eigenvalues of the first PC (PC1 were compared between tests. Although no significant differences were found between the tests with respect to the performed maximal workload (Wmax, maximal oxygen consumption (VO2 max, or ventilatory threshold (VT, an increase in the number of PCs and/or a decrease of eigenvalues of PC1 (t = 2.95; p = 0.01; d = 1.08 was found in Test 2 compared to Test 1. Moreover, entropy was significantly higher (Z = 2.33; p = 0.02; d = 1.43 in the last test. In conclusion, despite the fact that no significant differences were observed in the conventionally explored maximal performance and physiological variables (Wmax, VO2 max, and VT between tests, a reduction of CRC was observed in Test 2. These results emphasize the interest of CRC

  5. Recognizing surgical patterns

    NARCIS (Netherlands)

    Bouarfa, L.

    2012-01-01

    In the Netherlands, each year over 1700 patients die from preventable surgical errors. Numerous initiatives to improve surgical practice have had some impact, but problems persist. Despite the introduction of checklists and protocols, patient safety in surgery remains a continuing challenge. This is

  6. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.

    2008-01-01

    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

  7. A Literature Review of Renal Surgical Anatomy and Surgical Strategies for Partial Nephrectomy.

    Science.gov (United States)

    Klatte, Tobias; Ficarra, Vincenzo; Gratzke, Christian; Kaouk, Jihad; Kutikov, Alexander; Macchi, Veronica; Mottrie, Alexandre; Porpiglia, Francesco; Porter, James; Rogers, Craig G; Russo, Paul; Thompson, R Houston; Uzzo, Robert G; Wood, Christopher G; Gill, Inderbir S

    2015-12-01

    A detailed understanding of renal surgical anatomy is necessary to optimize preoperative planning and operative technique and provide a basis for improved outcomes. To evaluate the literature regarding pertinent surgical anatomy of the kidney and related structures, nephrometry scoring systems, and current surgical strategies for partial nephrectomy (PN). A literature review was conducted. Surgical renal anatomy fundamentally impacts PN surgery. The renal artery divides into anterior and posterior divisions, from which approximately five segmental terminal arteries originate. The renal veins are not terminal. Variations in the vascular and lymphatic channels are common; thus, concurrent lymphadenectomy is not routinely indicated during PN for cT1 renal masses in the setting of clinically negative lymph nodes. Renal-protocol contrast-enhanced computed tomography or magnetic resonance imaging is used for standard imaging. Anatomy-based nephrometry scoring systems allow standardized academic reporting of tumor characteristics and predict PN outcomes (complications, remnant function, possibly histology). Anatomy-based novel surgical approaches may reduce ischemic time during PN; these include early unclamping, segmental clamping, tumor-specific clamping (zero ischemia), and unclamped PN. Cancer cure after PN relies on complete resection, which can be achieved by thin margins. Post-PN renal function is impacted by kidney quality, remnant quantity, and ischemia type and duration. Surgical renal anatomy underpins imaging, nephrometry scoring systems, and vascular control techniques that reduce global renal ischemia and may impact post-PN function. A contemporary ideal PN excises the tumor with a thin negative margin, delicately secures the tumor bed to maximize vascularized remnant parenchyma, and minimizes global ischemia to the renal remnant with minimal complications. In this report we review renal surgical anatomy. Renal mass imaging allows detailed delineation of the

  8. Factors influencing immediate post-release survival of spectacled eiders following surgical implantation of transmitters with percutaneous antennae

    Science.gov (United States)

    Sexson, Matthew G.; Mulcahy, Daniel M.; Spriggs, Maria; Myers, Gwen E.

    2014-01-01

    Surgically implanted transmitters are a common method for tracking animal movements. Immediately following surgical implantation, animals pass through a critical recovery phase when behaviors may deviate from normal and the likelihood of individual survival may be reduced. Therefore, data collected during this period may be censored to minimize bias introduced by surgery-related behaviors or mortality. However, immediate post-release mortalities negate a sampling effort and reduce the amount of data potentially collected after the censoring period. Wildlife biologists should employ methods to support an animal’s survival through this period, but factors contributing to immediate post-release survival have not been formally assessed. We evaluated factors that potentially influenced the immediate post-release survival of 56 spectacled eiders (Somateria fischeri) marked with coelomically implanted satellite transmitters with percutaneous antennae in northern Alaska in 2010 and 2011. We modeled survival through the first 14 days following release and assessed the relative importance and effect of 15 covariates hypothesized to influence survival during this immediate post-release period. Estimated daily survival rate increased over the duration of the immediate post-release period; the probability of mortality was greatest within the first 5 days following release. Our top-ranking model included the effect of 2 blood analytes, pH and hematocrit, measured prior to surgical implantation of a transmitter. We found a positive response to pH; eiders exhibiting acidemia (low pH) prior to surgery were less likely to survive the immediate post-release period. We found a curvilinear response to hematocrit; eiders exhibiting extremely low or high pre-surgery hematocrit were also less likely to survive the immediate post-release period. In the interest of maximizing the survival of marked birds following release, hematological data obtained prior to surgical implantation of

  9. Wearable Technology for Global Surgical Teleproctoring.

    Science.gov (United States)

    Datta, Néha; MacQueen, Ian T; Schroeder, Alexander D; Wilson, Jessica J; Espinoza, Juan C; Wagner, Justin P; Filipi, Charles J; Chen, David C

    2015-01-01

    In underserved communities around the world, inguinal hernias represent a significant burden of surgically-treatable disease. With traditional models of international surgical assistance limited to mission trips, a standardized framework to strengthen local healthcare systems is lacking. We established a surgical education model using web-based tools and wearable technology to allow for long-term proctoring and assessment in a resource-poor setting. This is a feasibility study examining wearable technology and web-based performance rating tools for long-term proctoring in an international setting. Using the Lichtenstein inguinal hernia repair as the index surgical procedure, local surgeons in Paraguay and Brazil were trained in person by visiting international expert trainers using a formal, standardized teaching protocol. Surgeries were captured in real-time using Google Glass and transmitted wirelessly to an online video stream, permitting real-time observation and proctoring by mentoring surgeon experts in remote locations around the world. A system for ongoing remote evaluation and support by experienced surgeons was established using the Lichtenstein-specific Operative Performance Rating Scale. Data were collected from 4 sequential training operations for surgeons trained in both Paraguay and Brazil. With continuous internet connectivity, live streaming of the surgeries was successful. The Operative Performance Rating Scale was immediately used after each operation. Both surgeons demonstrated proficiency at the completion of the fourth case. A sustainable model for surgical training and proctoring to empower local surgeons in resource-poor locations and "train trainers" is feasible with wearable technology and web-based communication. Capacity building by maximizing use of local resources and expertise offers a long-term solution to reducing the global burden of surgically-treatable disease. Copyright © 2015 Association of Program Directors in Surgery

  10. The properties and interrelationships of various force-time parameters during maximal repeated rhythmic grip.

    Science.gov (United States)

    Nakada, Masakatsu; Demura, Shinichi; Yamaji, Shunsuke

    2007-01-01

    The purpose of this study was to examine the properties and interrelationships of various force-time parameters including the inflection point for the rate of decline in force during a maximal repeated rhythmic grip. Fifteen healthy males (age M=21.5, SD=2.1 yr, height M=172.4, SD=5.7 cm, body mass M=68.2, SD=9.2 kg) participated in this study. Subjects performed a maximal repeated rhythmic grip with maximal effort with a target frequency of 30 grip.min(-1) for 6 min. The force value decreased linearly and markedly until about 70% of maximal strength for about 55 s after the onset of a maximal repeated rhythmic grip, and then decreased moderately. Because all parameters showed fair or good correlations between 3 min and 6 min, they are considered to be able to sufficiently evaluate muscle endurance for 3 min instead of 6 min. However, there were significant differences between 3 min and 6 min in the integrated area, the final force, the rate of the decrement constant (k) fitting the force decreasing data to y=ae(-kx)+b and the force of maximal difference between the force and a straight line from peak force to the final force. Their parameters may vary generally by the length of a steady state, namely, a measurement time. The final force value before finishing and the rate of the decrement constant (k) reflect the latter phase during a maximal repeated rhythmic grip. Although many parameters show relatively high mutual relationships, the rate constant (k) shows relatively low correlations with other parameters. We inferred that decreasing the time until 80% of maximal strength and the amount of the decrement force for the first 1 min reflect a linear decrease in the initial phase.

  11. Glioma Surgery: Technological Advances to Achieve a Maximal Safe Resection.

    Science.gov (United States)

    Altieri, Roberto; Zenga, Francesco; Fontanella, Marco Maria; Cofano, Fabio; Agnoletti, Alessandro; Spena, Giannantonio; Crobeddu, Emanuela; Fornaro, Riccardo; Ducati, Alessandro; Garbossa, Diego

    2015-11-01

    Glioblastoma multiforme (GBM) is the most frequent primary central nervous system (CNS) tumor. Despite the best treatment and advances in therapy, prognosis remains poor. One of the mainstays of therapy in GBM is surgical excision. Several studies have confirmed that the extent of resection (EOR) positively influences overall survival (OS) in patients with high-grade gliomas (HGGs). A literature search was performed using PubMed to assess the useful neurosurgical tools to achieve the best neurosurgical performance. In order to achieve the major extent of resection, preserving neurological function, many tools are now available, especially neuronavigation, intraoperative fluorescence, intraoperative ultrasound, and neuromonitoring. In addition to the maximal excision of tumor, the neurosurgeon can use photodynamic therapy (PTD) and local drug delivery (LDD) to improve the local control and bridge conventional radio and chemotherapy. EOR improves OS in patients with HGGs. There are technological possibilities for achieving a complete resection preserving neurological function, and it is not acceptable to perform only biopsy of these lesions.

  12. Voluntary versus Enforced Team Effort

    Directory of Open Access Journals (Sweden)

    Claudia Keser

    2011-08-01

    Full Text Available We present a model where each of two players chooses between remuneration based on either private or team effort. Although at least one of the players has the equilibrium strategy to choose private remuneration, we frequently observe both players to choose team remuneration in a series of laboratory experiments. This allows for high cooperation payoffs but also provides individual free-riding incentives. Due to significant cooperation, we observe that, in team remuneration, participants make higher profits than in private remuneration. We also observe that, when participants are not given the option of private remuneration, they cooperate significantly less.

  13. Fontan Surgical Planning: Previous Accomplishments, Current Challenges, and Future Directions.

    Science.gov (United States)

    Trusty, Phillip M; Slesnick, Timothy C; Wei, Zhenglun Alan; Rossignac, Jarek; Kanter, Kirk R; Fogel, Mark A; Yoganathan, Ajit P

    2018-04-01

    The ultimate goal of Fontan surgical planning is to provide additional insights into the clinical decision-making process. In its current state, surgical planning offers an accurate hemodynamic assessment of the pre-operative condition, provides anatomical constraints for potential surgical options, and produces decent post-operative predictions if boundary conditions are similar enough between the pre-operative and post-operative states. Moving forward, validation with post-operative data is a necessary step in order to assess the accuracy of surgical planning and determine which methodological improvements are needed. Future efforts to automate the surgical planning process will reduce the individual expertise needed and encourage use in the clinic by clinicians. As post-operative physiologic predictions improve, Fontan surgical planning will become an more effective tool to accurately model patient-specific hemodynamics.

  14. Postactivation potentiation biases maximal isometric strength assessment.

    Science.gov (United States)

    Lima, Leonardo Coelho Rabello; Oliveira, Felipe Bruno Dias; Oliveira, Thiago Pires; Assumpção, Claudio de Oliveira; Greco, Camila Coelho; Cardozo, Adalgiso Croscato; Denadai, Benedito Sérgio

    2014-01-01

    Postactivation potentiation (PAP) is known to enhance force production. Maximal isometric strength assessment protocols usually consist of two or more maximal voluntary isometric contractions (MVCs). The objective of this study was to determine if PAP would influence isometric strength assessment. Healthy male volunteers (n = 23) performed two five-second MVCs separated by a 180-seconds interval. Changes in isometric peak torque (IPT), time to achieve it (tPTI), contractile impulse (CI), root mean square of the electromyographic signal during PTI (RMS), and rate of torque development (RTD), in different intervals, were measured. Significant increases in IPT (240.6 ± 55.7 N·m versus 248.9 ± 55.1 N·m), RTD (746 ± 152 N·m·s(-1) versus 727 ± 158 N·m·s(-1)), and RMS (59.1 ± 12.2% RMSMAX  versus 54.8 ± 9.4% RMSMAX) were found on the second MVC. tPTI decreased significantly on the second MVC (2373 ± 1200 ms versus 2784 ± 1226 ms). We conclude that a first MVC leads to PAP that elicits significant enhancements in strength-related variables of a second MVC performed 180 seconds later. If disconsidered, this phenomenon might bias maximal isometric strength assessment, overestimating some of these variables.

  15. Gain maximization in a probabilistic entanglement protocol

    Science.gov (United States)

    di Lorenzo, Antonio; Esteves de Queiroz, Johnny Hebert

    Entanglement is a resource. We can therefore define gain as a monotonic function of entanglement G (E) . If a pair with entanglement E is produced with probability P, the net gain is N = PG (E) - (1 - P) C , where C is the cost of a failed attempt. We study a protocol where a pair of quantum systems is produced in a maximally entangled state ρm with probability Pm, while it is produced in a partially entangled state ρp with the complementary probability 1 -Pm . We mix a fraction w of the partially entangled pairs with the maximally entangled ones, i.e. we take the state to be ρ = (ρm + wUlocρpUloc+) / (1 + w) , where Uloc is an appropriate unitary local operation designed to maximize the entanglement of ρ. This procedure on one hand reduces the entanglement E, and hence the gain, but on the other hand it increases the probability of success to P =Pm + w (1 -Pm) , therefore the net gain N may increase. There may be hence, a priori, an optimal value for w, the fraction of failed attempts that we mix in. We show that, in the hypothesis of a linear gain G (E) = E , even assuming a vanishing cost C -> 0 , the net gain N is increasing with w, therefore the best strategy is to always mix the partially entangled states. Work supported by CNPq, Conselho Nacional de Desenvolvimento Científico e Tecnológico, proc. 311288/2014-6, and by FAPEMIG, Fundação de Amparo à Pesquisa de Minas Gerais, proc. IC-FAPEMIG2016-0269 and PPM-00607-16.

  16. Surgical data science: The new knowledge domain.

    Science.gov (United States)

    Vedula, S Swaroop; Hager, Gregory D

    2017-04-01

    Healthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care with the goal of maximizing quality and value of care. While innovations in diagnostic and therapeutic technologies have driven past improvements in quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytic techniques, and translation or integration of research findings into patient care. We foresee the emergence of Surgical/Interventional Data Science (SDS) as a key element to addressing these limitations and creating a sustainable path toward evidence-based improvement of interventional healthcare pathways. SDS will create tools to measure, model and quantify the pathways or processes within the context of patient health states or outcomes, and use information gained to inform healthcare decisions, guidelines, best practices, policy, and training, thereby improving the safety and quality of healthcare and its value. Data is pervasive throughout the surgical care pathway; thus, SDS can impact various aspects of care including prevention, diagnosis, intervention, or post-operative recovery. Existing literature already provides preliminary results suggesting how a data science approach to surgical decision-making could more accurately predict severe complications using complex data from pre-, intra-, and post-operative contexts, how it could support intra-operative decision-making using both existing knowledge and continuous data streams throughout the surgical care pathway, and how it could enable effective collaboration between human care providers and intelligent technologies. In addition, SDS is poised to play a central role in surgical education, for example, through objective assessments, automated virtual coaching, and robot

  17. Surgical data science: The new knowledge domain

    Science.gov (United States)

    Vedula, S. Swaroop; Hager, Gregory D.

    2017-01-01

    Healthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care with the goal of maximizing quality and value of care. While innovations in diagnostic and therapeutic technologies have driven past improvements in quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytic techniques, and translation or integration of research findings into patient care. We foresee the emergence of Surgical/Interventional Data Science (SDS) as a key element to addressing these limitations and creating a sustainable path toward evidence-based improvement of interventional healthcare pathways. SDS will create tools to measure, model and quantify the pathways or processes within the context of patient health states or outcomes, and use information gained to inform healthcare decisions, guidelines, best practices, policy, and training, thereby improving the safety and quality of healthcare and its value. Data is pervasive throughout the surgical care pathway; thus, SDS can impact various aspects of care including prevention, diagnosis, intervention, or post-operative recovery. Existing literature already provides preliminary results suggesting how a data science approach to surgical decision-making could more accurately predict severe complications using complex data from pre-, intra-, and post-operative contexts, how it could support intra-operative decision-making using both existing knowledge and continuous data streams throughout the surgical care pathway, and how it could enable effective collaboration between human care providers and intelligent technologies. In addition, SDS is poised to play a central role in surgical education, for example, through objective assessments, automated virtual coaching, and robot

  18. Surgical data science: the new knowledge domain

    Directory of Open Access Journals (Sweden)

    Vedula S. Swaroop

    2017-04-01

    Full Text Available Healthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care, with the goal of maximizing the quality and value of care. Whereas innovations in diagnostic and therapeutic technologies have driven past improvements in the quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytical techniques, and translation or integration of research findings into patient care. We foresee the emergence of surgical/interventional data science (SDS as a key element to addressing these limitations and creating a sustainable path toward evidence-based improvement of interventional healthcare pathways. SDS will create tools to measure, model, and quantify the pathways or processes within the context of patient health states or outcomes and use information gained to inform healthcare decisions, guidelines, best practices, policy, and training, thereby improving the safety and quality of healthcare and its value. Data are pervasive throughout the surgical care pathway; thus, SDS can impact various aspects of care, including prevention, diagnosis, intervention, or postoperative recovery. The existing literature already provides preliminary results, suggesting how a data science approach to surgical decision-making could more accurately predict severe complications using complex data from preoperative, intraoperative, and postoperative contexts, how it could support intraoperative decision-making using both existing knowledge and continuous data streams throughout the surgical care pathway, and how it could enable effective collaboration between human care providers and intelligent technologies. In addition, SDS is poised to play a central role in surgical education, for example, through objective

  19. Maximizing percentage depletion in solid minerals

    International Nuclear Information System (INIS)

    Tripp, J.; Grove, H.D.; McGrath, M.

    1982-01-01

    This article develops a strategy for maximizing percentage depletion deductions when extracting uranium or other solid minerals. The goal is to avoid losing percentage depletion deductions by staying below the 50% limitation on taxable income from the property. The article is divided into two major sections. The first section is comprised of depletion calculations that illustrate the problem and corresponding solutions. The last section deals with the feasibility of applying the strategy and complying with the Internal Revenue Code and appropriate regulations. Three separate strategies or appropriate situations are developed and illustrated. 13 references, 3 figures, 7 tables

  20. What currency do bumble bees maximize?

    Directory of Open Access Journals (Sweden)

    Nicholas L Charlton

    2010-08-01

    Full Text Available In modelling bumble bee foraging, net rate of energetic intake has been suggested as the appropriate currency. The foraging behaviour of honey bees is better predicted by using efficiency, the ratio of energetic gain to expenditure, as the currency. We re-analyse several studies of bumble bee foraging and show that efficiency is as good a currency as net rate in terms of predicting behaviour. We suggest that future studies of the foraging of bumble bees should be designed to distinguish between net rate and efficiency maximizing behaviour in an attempt to discover which is the more appropriate currency.

  1. New Maximal Two-distance Sets

    DEFF Research Database (Denmark)

    Lisonek, Petr

    1996-01-01

    A two-distance set in E^d is a point set X inthe d-dimensional Euclidean spacesuch that the distances between distinct points in Xassume only two different non-zero values. Based on results from classical distance geometry, we developan algorithm to classify, for a given dimension, all maximal...... (largest possible)two-distance sets in E^d.Using this algorithm we have completed the full classificationfor all dimensions less than or equal to 7, andwe have found one set in E^8 whosemaximality follows from Blokhuis' upper bound on sizes of s-distance sets.While in the dimensions less than or equal to 6...

  2. Maximizing policy learning in international committees

    DEFF Research Database (Denmark)

    Nedergaard, Peter

    2007-01-01

    , this article demonstrates that valuable lessons can be learned about policy learning, in practice and theoretically, by analysing the cooperation in the OMC committees. Using the Advocacy Coalition Framework as the starting point of analysis, 15 hypotheses on policy learning are tested. Among other things......, it is concluded that in order to maximize policy learning in international committees, empirical data should be made available to committees and provided by sources close to the participants (i.e. the Commission). In addition, the work in the committees should be made prestigious in order to attract well...

  3. Pouliot type duality via a-maximization

    International Nuclear Information System (INIS)

    Kawano, Teruhiko; Ookouchi, Yutaka; Tachikawa, Yuji; Yagi, Futoshi

    2006-01-01

    We study four-dimensional N=1Spin(10) gauge theory with a single spinor and N Q vectors at the superconformal fixed point via the electric-magnetic duality and a-maximization. When gauge invariant chiral primary operators hit the unitarity bounds, we find that the theory with no superpotential is identical to the one with some superpotential at the infrared fixed point. The auxiliary field method in the electric theory offers a satisfying description of the infrared fixed point, which is consistent with the better picture in the magnetic theory. In particular, it gives a clear description of the emergence of new massless degrees of freedom in the electric theory

  4. Surgical ethics: surgical virtue and more.

    Science.gov (United States)

    Vercler, Christian J

    2015-01-01

    The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.

  5. Analysis Efforts Supporting NSTX Upgrades

    International Nuclear Information System (INIS)

    Zhang, H.; Titus, P.; Rogoff, P.; Zolfaghari, A.; Mangra, D.; Smith, M.

    2010-01-01

    The National Spherical Torus Experiment (NSTX) is a low aspect ratio, spherical torus (ST) configuration device which is located at Princeton Plasma Physics Laboratory (PPPL) This device is presently being updated to enhance its physics by doubling the TF field to 1 Tesla and increasing the plasma current to 2 Mega-amperes. The upgrades include a replacement of the centerstack and addition of a second neutral beam. The upgrade analyses have two missions. The first is to support design of new components, principally the centerstack, the second is to qualify existing NSTX components for higher loads, which will increase by a factor of four. Cost efficiency was a design goal for new equipment qualification, and reanalysis of the existing components. Showing that older components can sustain the increased loads has been a challenging effort in which designs had to be developed that would limit loading on weaker components, and would minimize the extent of modifications needed. Two areas representing this effort have been chosen to describe in more details: analysis of the current distribution in the new TF inner legs, and, second, analysis of the out-of-plane support of the existing TF outer legs.

  6. APS Education and Diversity Efforts

    Science.gov (United States)

    Prestridge, Katherine; Hodapp, Theodore

    2015-11-01

    American Physical Society (APS) has a wide range of education and diversity programs and activities, including programs that improve physics education, increase diversity, provide outreach to the public, and impact public policy. We present the latest programs spearheaded by the Committee on the Status of Women in Physics (CSWP), with highlights from other diversity and education efforts. The CSWP is working to increase the fraction of women in physics, understand and implement solutions for gender-specific issues, enhance professional development opportunities for women in physics, and remedy issues that impact gender inequality in physics. The Conferences for Undergraduate Women in Physics, Professional Skills Development Workshops, and our new Professional Skills program for students and postdocs are all working towards meeting these goals. The CSWP also has site visit and conversation visit programs, where department chairs request that the APS assess the climate for women in their departments or facilitate climate discussions. APS also has two significant programs to increase participation by underrepresented minorities (URM). The newest program, the APS National Mentoring Community, is working to provide mentoring to URM undergraduates, and the APS Bridge Program is an established effort that is dramatically increasing the number of URM PhDs in physics.

  7. Developing maximal neuromuscular power: part 2 - training considerations for improving maximal power production.

    Science.gov (United States)

    Cormie, Prue; McGuigan, Michael R; Newton, Robert U

    2011-02-01

    This series of reviews focuses on the most important neuromuscular function in many sport performances: the ability to generate maximal muscular power. Part 1, published in an earlier issue of Sports Medicine, focused on the factors that affect maximal power production while part 2 explores the practical application of these findings by reviewing the scientific literature relevant to the development of training programmes that most effectively enhance maximal power production. The ability to generate maximal power during complex motor skills is of paramount importance to successful athletic performance across many sports. A crucial issue faced by scientists and coaches is the development of effective and efficient training programmes that improve maximal power production in dynamic, multi-joint movements. Such training is referred to as 'power training' for the purposes of this review. Although further research is required in order to gain a deeper understanding of the optimal training techniques for maximizing power in complex, sports-specific movements and the precise mechanisms underlying adaptation, several key conclusions can be drawn from this review. First, a fundamental relationship exists between strength and power, which dictates that an individual cannot possess a high level of power without first being relatively strong. Thus, enhancing and maintaining maximal strength is essential when considering the long-term development of power. Second, consideration of movement pattern, load and velocity specificity is essential when designing power training programmes. Ballistic, plyometric and weightlifting exercises can be used effectively as primary exercises within a power training programme that enhances maximal power. The loads applied to these exercises will depend on the specific requirements of each particular sport and the type of movement being trained. The use of ballistic exercises with loads ranging from 0% to 50% of one-repetition maximum (1RM) and

  8. Maximization techniques for oilfield development profits

    International Nuclear Information System (INIS)

    Lerche, I.

    1999-01-01

    In 1981 Nind provided a quantitative procedure for estimating the optimum number of development wells to emplace on an oilfield to maximize profit. Nind's treatment assumed that there was a steady selling price, that all wells were placed in production simultaneously, and that each well's production profile was identical and a simple exponential decline with time. This paper lifts these restrictions to allow for price fluctuations, variable with time emplacement of wells, and production rates that are more in line with actual production records than is a simple exponential decline curve. As a consequence, it is possible to design production rate strategies, correlated with price fluctuations, so as to maximize the present-day worth of a field. For price fluctuations that occur on a time-scale rapid compared to inflation rates it is appropriate to have production rates correlate directly with such price fluctuations. The same strategy does not apply for price fluctuations occurring on a time-scale long compared to inflation rates where, for small amplitudes in the price fluctuations, it is best to sell as much product as early as possible to overcome inflation factors, while for large amplitude fluctuations the best strategy is to sell product as early as possible but to do so mainly on price upswings. Examples are provided to show how these generalizations of Nind's (1981) formula change the complexion of oilfield development optimization. (author)

  9. Disc degeneration: current surgical options

    Directory of Open Access Journals (Sweden)

    C Schizas

    2010-10-01

    Full Text Available Chronic low back pain attributed to lumbar disc degeneration poses a serious challenge to physicians. Surgery may be indicated in selected cases following failure of appropriate conservative treatment. For decades, the only surgical option has been spinal fusion, but its results have been inconsistent. Some prospective trials show superiority over usual conservative measures while others fail to demonstrate its advantages. In an effort to improve results of fusion and to decrease the incidence of adjacent segment degeneration, total disc replacement techniques have been introduced and studied extensively. Short-term results have shown superiority over some fusion techniques. Mid-term results however tend to show that this approach yields results equivalent to those of spinal fusion. Nucleus replacement has gained some popularity initially, but evidence on its efficacy is scarce. Dynamic stabilisation, a technique involving less rigid implants than in spinal fusion and performed without the need for bone grafting, represents another surgical option. Evidence again is lacking on its superiority over other surgical strategies and conservative measures. Insertion of interspinous devices posteriorly, aiming at redistributing loads and relieving pain, has been used as an adjunct to disc removal surgery for disc herniation. To date however, there is no clear evidence on their efficacy. Minimally invasive intradiscal thermocoagulation techniques have also been tried, but evidence of their effectiveness is questioned. Surgery using novel biological solutions may be the future of discogenic pain treatment. Collaboration between clinicians and basic scientists in this multidisciplinary field will undoubtedly shape the future of treating symptomatic disc degeneration.

  10. Sports massage with ozonised oil or non-ozonised oil: Comparative effects on recovery parameters after maximal effort in cyclists.

    Science.gov (United States)

    Paoli, Antonio; Bianco, Antonino; Battaglia, Giuseppe; Bellafiore, Marianna; Grainer, Alessandro; Marcolin, Giuseppe; Cardoso, Claudia C; Dall'aglio, Roberto; Palma, Antonio

    2013-11-01

    To study the effects of passive rest (PR) and sports massage with (SMOZO) and without (SM) ozonised oil on sports performance psycho-physiological indices in competitive amateur cyclists after 3 pre-fatiguing Wingate cycle and post-recovery ramp tests. An intra-subjects experimental design with repeated measures. Department of Human Anatomy and Physiology, University of Padua. Fifteen male competitive cyclists (age: 27 ± 3.5 years, body weight: 77.6 ± 8.3 kg, height: 178 ± 7.7 cm) were studied. Subjects' power output (P), heart rate (HR), Visual Analogue Scale (VAS) score and blood lactate (BL) clearance in response to PR, SMOZO and SM recoveries were compared. There were no significant differences in cyclists' heart rate patterns in the three experimental conditions (p > 0.05). After SMOZO recovery, athletes showed a higher Pmax (p oil during sports massage increases blood lactate removal, improves performance and reduces the perception of fatigue in cyclists from 3 Wingate tests. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Oceanographic Data in Europe: Minimal Effort for Data Providers, Maximal Ease of Use and Access for Data Users

    Science.gov (United States)

    De Bruin, T.

    2017-12-01

    SeaDataCloud/SeaDataNet (SDC/SDN) is both a consortium and a data infrastructure as well as a (series of) European oceanographic data management project(s), allowing data providers to store data at a data centre of their choice (usually a type of National Oceanographic Data Center), while exposing and making the data available for download via a chain of interconnected data portals at local, regional, pan-European and global levels. SDC/SDN as an infrastructure connects over 100 data centers from 35 countries in and around Europe. The infrastructure has been operational since early 2009 and provides the user an overview of all available data as well as the possibility to download the data in an uniform format. This presentation will give a short introduction to the SDC/SDN infrastructure and describe how its development was based on sound data management principles. The emphasis will be on how the system is interconnected with other, non-discipline specific (metadata) portals such as the Group of Earth Observations System of Systems (GEOSS), allowing oceanographic data stored at a local level in a data centre to be exposed at a global level to a wide audience from various disciplines.

  12. Social facilitation in virtual reality-enhanced exercise: competitiveness moderates exercise effort of older adults.

    Science.gov (United States)

    Anderson-Hanley, Cay; Snyder, Amanda L; Nimon, Joseph P; Arciero, Paul J

    2011-01-01

    This study examined the effect of virtual social facilitation and competitiveness on exercise effort in exergaming older adults. Fourteen exergaming older adults participated. Competitiveness was assessed prior to the start of exercise. Participants were trained to ride a "cybercycle;" a virtual reality-enhanced stationary bike with interactive competition. After establishing a cybercycling baseline, competitive avatars were introduced. Pedaling effort (watts) was assessed. Repeated measures ANOVA revealed a significant group (high vs low competitiveness) × time (pre- to post-avatar) interaction (F[1,12] = 13.1, P = 0.003). Virtual social facilitation increased exercise effort among more competitive exercisers. Exercise programs that match competitiveness may maximize exercise effort.

  13. Surgical site infections

    African Journals Online (AJOL)

    Decrease the inflammatory response Vasodilatation leads to better perfusion and ... Must NOT be allowed to come in contact with brain, meninges, eyes or .... project (SCIP): Evolution of National Quality Measure. Surgical. Infection 2008 ...

  14. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  15. Ambulatory Surgical Measures - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  16. Surgical Management of Hemorrhoids

    Science.gov (United States)

    Agbo, S. P.

    2011-01-01

    Hemorrhoids are common human afflictions known since the dawn of history. Surgical management of this condition has made tremendous progress from complex ligation and excision procedures in the past to simpler techniques that allow the patient to return to normal life within a short period. Newer techniques try to improve on the post-operative complications of older ones. The surgical options for the management of hemorrhoids today are many. Capturing all in a single article may be difficult if not impossible. The aim of this study therefore is to present in a concise form some of the common surgical options in current literature, highlighting some important post operative complications. Current literature is searched using MEDLINE, EMBASE and the Cochrane library. The conclusion is that even though there are many surgical options in the management of hemorrhoids today, most employ the ligature and excision technique with newer ones having reduced post operative pain and bleeding. PMID:22413048

  17. Surgical site infections

    African Journals Online (AJOL)

    Surgical site infections (SSIs) are a worldwide problem that has ... deep tissue is found on clinical examination, re-opening, histopathological or radiological investigation ..... Esposito S, Immune system and SSI, Journal of Chemotherapy, 2001.

  18. Surgical management of pain

    African Journals Online (AJOL)

    If these therapies fail, and with a thorough multidisciplinary approach involving carefully ... Generally, surgical pain management is divided into neuro- modulative .... 9 suggested. It is important to be sure that the underlying instability or.

  19. [Simulation in surgical training].

    Science.gov (United States)

    Nabavi, A; Schipper, J

    2017-01-01

    Patient safety during operations hinges on the surgeon's skills and abilities. However, surgical training has come under a variety of restrictions. To acquire dexterity with decreasingly "simple" cases, within the legislative time constraints and increasing expectations for surgical results is the future challenge. Are there alternatives to traditional master-apprentice learning? A literature review and analysis of the development, implementation, and evaluation of surgical simulation are presented. Simulation, using a variety of methods, most important physical and virtual (computer-generated) models, provides a safe environment to practice basic and advanced skills without endangering patients. These environments have specific strengths and weaknesses. Simulations can only serve to decrease the slope of learning curves, but cannot be a substitute for the real situation. Thus, they have to be an integral part of a comprehensive training curriculum. Our surgical societies have to take up that challenge to ensure the training of future generations.

  20. Termination of prehospital resuscitative efforts

    DEFF Research Database (Denmark)

    Mikkelsen, Søren; Schaffalitzky de Muckadell, Caroline; Binderup, Lars Grassmé

    2017-01-01

    -and-death decision-making in the patient's medical records is required. We suggest that a template be implemented in the prehospital medical records describing the basis for any ethical decisions. This template should contain information regarding the persons involved in the deliberations and notes on ethical......BACKGROUND: Discussions on ethical aspects of life-and-death decisions within the hospital are often made in plenary. The prehospital physician, however, may be faced with ethical dilemmas in life-and-death decisions when time-critical decisions to initiate or refrain from resuscitative efforts...... need to be taken without the possibility to discuss matters with colleagues. Little is known whether these considerations regarding ethical issues in crucial life-and-death decisions are documented prehospitally. This is a review of the ethical considerations documented in the prehospital medical...

  1. Maximizing results for lipofilling in facial reconstruction.

    Science.gov (United States)

    Barret, Juan P; Sarobe, Neus; Grande, Nelida; Vila, Delia; Palacin, Jose M

    2009-07-01

    Lipostructure (also known as structural fat grafts, lipofilling, or fat grafting) has become a technique with a good reputation and reproducible results. The application of this technology in patients undergoing reconstruction is a novel surgical alternative. Obtaining good results in this patient population is very difficult, but the application of small fat grafts with a strict Coleman technique produces long-term cosmetic effects. Adult-derived stem cells have been pointed out as important effectors of this regenerative technology, and future research should focus in this direction.

  2. Comparison of three protocols for measuring the maximal respiratory pressures

    Directory of Open Access Journals (Sweden)

    Isabela Maria B. Sclauser Pessoa

    Full Text Available Introduction To avoid the selection of submaximal efforts during the assessment of maximal inspiratory and expiratory pressures (MIP and MEP, some reproducibility criteria have been suggested. Criteria that stand out are those proposed by the American Thoracic Society (ATS and European Respiratory Society (ERS and by the Brazilian Thoracic Association (BTA. However, no studies were found that compared these criteria or assessed the combination of both protocols. Objectives To assess the pressure values selected and the number of maneuvers required to achieve maximum performance using the reproducibility criteria proposed by the ATS/ERS, the BTA and the present study. Materials and method 113 healthy subjects (43.04 ± 16.94 years from both genders were assessed according to the criteria proposed by the ATS/ERS, BTA and the present study. Descriptive statistics were used for analysis, followed by ANOVA for repeated measures and post hoc LSD or by Friedman test and post hoc Wilcoxon, according to the data distribution. Results The criterion proposed by the present study resulted in a significantly higher number of maneuvers (MIP and MEP – median and 25%-75% interquartile range: 5[5-6], 4[3-5] and 3[3-4] for the present study criterion, BTA and ATS/ERS, respectively; p < 0.01 and higher pressure values (MIP – mean and 95% confidence interval: 103[91.43-103.72], 100[97.19-108.83] and 97.6[94.06-105.95]; MEP: median and 25%-75% interquartile range: 124.2[101.4-165.9], 123.3[95.4-153.8] and 118.4[95.5-152.7]; p < 0.05. Conclusion The proposed criterion resulted in the selection of pressure values closer to the individual’s maximal capacity. This new criterion should be considered in future studies concerning MIP and MEP measurements.

  3. Shareholder, stakeholder-owner or broad stakeholder maximization

    DEFF Research Database (Denmark)

    Mygind, Niels

    2004-01-01

    With reference to the discussion about shareholder versus stakeholder maximization it is argued that the normal type of maximization is in fact stakeholder-owner maxi-mization. This means maximization of the sum of the value of the shares and stake-holder benefits belonging to the dominating...... including the shareholders of a company. Although it may be the ultimate goal for Corporate Social Responsibility to achieve this kind of maximization, broad stakeholder maximization is quite difficult to give a precise definition. There is no one-dimensional measure to add different stakeholder benefits...... not traded on the mar-ket, and therefore there is no possibility for practical application. Broad stakeholder maximization instead in practical applications becomes satisfying certain stakeholder demands, so that the practical application will be stakeholder-owner maximization un-der constraints defined...

  4. Post surgical complications from students' large animal surgical ...

    African Journals Online (AJOL)

    A retrospective study of post surgical complications was conducted on records of students' Large Animal Surgical Laboratories in the Faculty of Veterinary Medicine (F.V.M.), Ahmadu Bello University (A.B.U), Zaria from 1989 to 1993. Three hundred and eleven surgical complications were recorded from five surgical ...

  5. View from Silicon Valley: Maximizing the Scientific Impact of Global Brain Initiatives through Entrepreneurship.

    Science.gov (United States)

    Joshi, Pushkar S; Ghosh, Kunal K

    2016-11-02

    In this era of technology-driven global neuroscience initiatives, the role of the neurotechnology industry remains woefully ambiguous. Here, we explain why industry is essential to the success of these global initiatives, and how it can maximize the scientific impact of these efforts by (1) scaling and ultimately democratizing access to breakthrough neurotechnologies, and (2) commercializing technologies as part of integrated, end-to-end solutions that accelerate neuroscientific discovery. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. First results with two light flavours of quarks with maximally twisted mass

    International Nuclear Information System (INIS)

    Jansen, K.; Urbach, C.

    2006-10-01

    We report on first results of an ongoing effort to simulate lattice QCD with two degenerate flavours of quarks by means of the twisted mass formulation tuned to maximal twist. By utilising recent improvements of the HMC algorithm, pseudo-scalar masses well below 300 MeV are simulated on volumes L 3 .T with T=2L and L>2 fm and at values of the lattice spacing a f =2+1+1 flavours are discussed. (orig.)

  7. Maximizing Lumen Gain With Directional Atherectomy.

    Science.gov (United States)

    Stanley, Gregory A; Winscott, John G

    2016-08-01

    To describe the use of a low-pressure balloon inflation (LPBI) technique to delineate intraluminal plaque and guide directional atherectomy in order to maximize lumen gain and achieve procedure success. The technique is illustrated in a 77-year-old man with claudication who underwent superficial femoral artery revascularization using a HawkOne directional atherectomy catheter. A standard angioplasty balloon was inflated to 1 to 2 atm during live fluoroscopy to create a 3-dimensional "lumenogram" of the target lesion. Directional atherectomy was performed only where plaque impinged on the balloon at a specific fluoroscopic orientation. The results of the LPBI technique were corroborated with multimodality diagnostic imaging, including digital subtraction angiography, intravascular ultrasound, and intra-arterial pressure measurements. With the LPBI technique, directional atherectomy can routinely achieve <10% residual stenosis, as illustrated in this case, thereby broadly supporting a no-stent approach to lower extremity endovascular revascularization. © The Author(s) 2016.

  8. Primordial two-component maximally symmetric inflation

    Science.gov (United States)

    Enqvist, K.; Nanopoulos, D. V.; Quirós, M.; Kounnas, C.

    1985-12-01

    We propose a two-component inflation model, based on maximally symmetric supergravity, where the scales of reheating and the inflation potential at the origin are decoupled. This is possible because of the second-order phase transition from SU(5) to SU(3)×SU(2)×U(1) that takes place when φ≅φcinflation at the global minimum, and leads to a reheating temperature TR≅(1015-1016) GeV. This makes it possible to generate baryon asymmetry in the conventional way without any conflict with experimental data on proton lifetime. The mass of the gravitinos is m3/2≅1012 GeV, thus avoiding the gravitino problem. Monopoles are diluted by residual inflation in the broken phase below the cosmological bounds if φcUSA.

  9. Distributed-Memory Fast Maximal Independent Set

    Energy Technology Data Exchange (ETDEWEB)

    Kanewala Appuhamilage, Thejaka Amila J.; Zalewski, Marcin J.; Lumsdaine, Andrew

    2017-09-13

    The Maximal Independent Set (MIS) graph problem arises in many applications such as computer vision, information theory, molecular biology, and process scheduling. The growing scale of MIS problems suggests the use of distributed-memory hardware as a cost-effective approach to providing necessary compute and memory resources. Luby proposed four randomized algorithms to solve the MIS problem. All those algorithms are designed focusing on shared-memory machines and are analyzed using the PRAM model. These algorithms do not have direct efficient distributed-memory implementations. In this paper, we extend two of Luby’s seminal MIS algorithms, “Luby(A)” and “Luby(B),” to distributed-memory execution, and we evaluate their performance. We compare our results with the “Filtered MIS” implementation in the Combinatorial BLAS library for two types of synthetic graph inputs.

  10. Quench dynamics of topological maximally entangled states.

    Science.gov (United States)

    Chung, Ming-Chiang; Jhu, Yi-Hao; Chen, Pochung; Mou, Chung-Yu

    2013-07-17

    We investigate the quench dynamics of the one-particle entanglement spectra (OPES) for systems with topologically nontrivial phases. By using dimerized chains as an example, it is demonstrated that the evolution of OPES for the quenched bipartite systems is governed by an effective Hamiltonian which is characterized by a pseudospin in a time-dependent pseudomagnetic field S(k,t). The existence and evolution of the topological maximally entangled states (tMESs) are determined by the winding number of S(k,t) in the k-space. In particular, the tMESs survive only if nontrivial Berry phases are induced by the winding of S(k,t). In the infinite-time limit the equilibrium OPES can be determined by an effective time-independent pseudomagnetic field Seff(k). Furthermore, when tMESs are unstable, they are destroyed by quasiparticles within a characteristic timescale in proportion to the system size.

  11. Maximizing policy learning in international committees

    DEFF Research Database (Denmark)

    Nedergaard, Peter

    2007-01-01

    , this article demonstrates that valuable lessons can be learned about policy learning, in practice and theoretically, by analysing the cooperation in the OMC committees. Using the Advocacy Coalition Framework as the starting point of analysis, 15 hypotheses on policy learning are tested. Among other things......In the voluminous literature on the European Union's open method of coordination (OMC), no one has hitherto analysed on the basis of scholarly examination the question of what contributes to the learning processes in the OMC committees. On the basis of a questionnaire sent to all participants......, it is concluded that in order to maximize policy learning in international committees, empirical data should be made available to committees and provided by sources close to the participants (i.e. the Commission). In addition, the work in the committees should be made prestigious in order to attract well...

  12. Lovelock black holes with maximally symmetric horizons

    Energy Technology Data Exchange (ETDEWEB)

    Maeda, Hideki; Willison, Steven; Ray, Sourya, E-mail: hideki@cecs.cl, E-mail: willison@cecs.cl, E-mail: ray@cecs.cl [Centro de Estudios CientIficos (CECs), Casilla 1469, Valdivia (Chile)

    2011-08-21

    We investigate some properties of n( {>=} 4)-dimensional spacetimes having symmetries corresponding to the isometries of an (n - 2)-dimensional maximally symmetric space in Lovelock gravity under the null or dominant energy condition. The well-posedness of the generalized Misner-Sharp quasi-local mass proposed in the past study is shown. Using this quasi-local mass, we clarify the basic properties of the dynamical black holes defined by a future outer trapping horizon under certain assumptions on the Lovelock coupling constants. The C{sup 2} vacuum solutions are classified into four types: (i) Schwarzschild-Tangherlini-type solution; (ii) Nariai-type solution; (iii) special degenerate vacuum solution; and (iv) exceptional vacuum solution. The conditions for the realization of the last two solutions are clarified. The Schwarzschild-Tangherlini-type solution is studied in detail. We prove the first law of black-hole thermodynamics and present the expressions for the heat capacity and the free energy.

  13. Maximal energy extraction under discrete diffusive exchange

    Energy Technology Data Exchange (ETDEWEB)

    Hay, M. J., E-mail: hay@princeton.edu [Department of Astrophysical Sciences, Princeton University, Princeton, New Jersey 08544 (United States); Schiff, J. [Department of Mathematics, Bar-Ilan University, Ramat Gan 52900 (Israel); Fisch, N. J. [Department of Astrophysical Sciences, Princeton University, Princeton, New Jersey 08544 (United States); Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543 (United States)

    2015-10-15

    Waves propagating through a bounded plasma can rearrange the densities of states in the six-dimensional velocity-configuration phase space. Depending on the rearrangement, the wave energy can either increase or decrease, with the difference taken up by the total plasma energy. In the case where the rearrangement is diffusive, only certain plasma states can be reached. It turns out that the set of reachable states through such diffusive rearrangements has been described in very different contexts. Building upon those descriptions, and making use of the fact that the plasma energy is a linear functional of the state densities, the maximal extractable energy under diffusive rearrangement can then be addressed through linear programming.

  14. Maximizing profitability in a hospital outpatient pharmacy.

    Science.gov (United States)

    Jorgenson, J A; Kilarski, J W; Malatestinic, W N; Rudy, T A

    1989-07-01

    This paper describes the strategies employed to increase the profitability of an existing ambulatory pharmacy operated by the hospital. Methods to generate new revenue including implementation of a home parenteral therapy program, a home enteral therapy program, a durable medical equipment service, and home care disposable sales are described. Programs to maximize existing revenue sources such as increasing the capture rate on discharge prescriptions, increasing "walk-in" prescription traffic and increasing HMO prescription volumes are discussed. A method utilized to reduce drug expenditures is also presented. By minimizing expenses and increasing the revenues for the ambulatory pharmacy operation, net profit increased from +26,000 to over +140,000 in one year.

  15. Maximizing the benefits of a dewatering system

    International Nuclear Information System (INIS)

    Matthews, P.; Iverson, T.S.

    1999-01-01

    The use of dewatering systems in the mining, industrial sludge and sewage waste treatment industries is discussed, also describing some of the problems that have been encountered while using drilling fluid dewatering technology. The technology is an acceptable drilling waste handling alternative but it has had problems associated with recycled fluid incompatibility, high chemical costs and system inefficiencies. This paper discussed the following five action areas that can maximize the benefits and help reduce costs of a dewatering project: (1) co-ordinate all services, (2) choose equipment that fits the drilling program, (3) match the chemical treatment with the drilling fluid types, (4) determine recycled fluid compatibility requirements, and (5) determine the disposal requirements before project start-up. 2 refs., 5 figs

  16. Mixtures of maximally entangled pure states

    Energy Technology Data Exchange (ETDEWEB)

    Flores, M.M., E-mail: mflores@nip.up.edu.ph; Galapon, E.A., E-mail: eric.galapon@gmail.com

    2016-09-15

    We study the conditions when mixtures of maximally entangled pure states remain entangled. We found that the resulting mixed state remains entangled when the number of entangled pure states to be mixed is less than or equal to the dimension of the pure states. For the latter case of mixing a number of pure states equal to their dimension, we found that the mixed state is entangled provided that the entangled pure states to be mixed are not equally weighted. We also found that one can restrict the set of pure states that one can mix from in order to ensure that the resulting mixed state is genuinely entangled. Also, we demonstrate how these results could be applied as a way to detect entanglement in mixtures of the entangled pure states with noise.

  17. Maximally reliable Markov chains under energy constraints.

    Science.gov (United States)

    Escola, Sean; Eisele, Michael; Miller, Kenneth; Paninski, Liam

    2009-07-01

    Signal-to-noise ratios in physical systems can be significantly degraded if the outputs of the systems are highly variable. Biological processes for which highly stereotyped signal generations are necessary features appear to have reduced their signal variabilities by employing multiple processing steps. To better understand why this multistep cascade structure might be desirable, we prove that the reliability of a signal generated by a multistate system with no memory (i.e., a Markov chain) is maximal if and only if the system topology is such that the process steps irreversibly through each state, with transition rates chosen such that an equal fraction of the total signal is generated in each state. Furthermore, our result indicates that by increasing the number of states, it is possible to arbitrarily increase the reliability of the system. In a physical system, however, an energy cost is associated with maintaining irreversible transitions, and this cost increases with the number of such transitions (i.e., the number of states). Thus, an infinite-length chain, which would be perfectly reliable, is infeasible. To model the effects of energy demands on the maximally reliable solution, we numerically optimize the topology under two distinct energy functions that penalize either irreversible transitions or incommunicability between states, respectively. In both cases, the solutions are essentially irreversible linear chains, but with upper bounds on the number of states set by the amount of available energy. We therefore conclude that a physical system for which signal reliability is important should employ a linear architecture, with the number of states (and thus the reliability) determined by the intrinsic energy constraints of the system.

  18. Fewer intensive care unit refusals and a higher capacity utilization by using a cyclic surgical case schedule

    NARCIS (Netherlands)

    van Houdenhoven, Mark; van Oostrum, Jeroen M.; Wullink, Gerhard; Hans, Elias W.; Hurink, Johann L.; Bakker, Jan; Kazemier, Geert

    Purpose: Mounting health care costs force hospital managers to maximize utilization of scarce resources and simultaneously improve access to hospital services. This article assesses the benefits of a cyclic case scheduling approach that exploits a master surgical schedule (MSS). An MSS maximizes

  19. A Criterion to Identify Maximally Entangled Four-Qubit State

    International Nuclear Information System (INIS)

    Zha Xinwei; Song Haiyang; Feng Feng

    2011-01-01

    Paolo Facchi, et al. [Phys. Rev. A 77 (2008) 060304(R)] presented a maximally multipartite entangled state (MMES). Here, we give a criterion for the identification of maximally entangled four-qubit states. Using this criterion, we not only identify some existing maximally entangled four-qubit states in the literature, but also find several new maximally entangled four-qubit states as well. (general)

  20. Maximal lattice free bodies, test sets and the Frobenius problem

    DEFF Research Database (Denmark)

    Jensen, Anders Nedergaard; Lauritzen, Niels; Roune, Bjarke Hammersholt

    Maximal lattice free bodies are maximal polytopes without interior integral points. Scarf initiated the study of maximal lattice free bodies relative to the facet normals in a fixed matrix. In this paper we give an efficient algorithm for computing the maximal lattice free bodies of an integral m...... method is inspired by the novel algorithm by Einstein, Lichtblau, Strzebonski and Wagon and the Groebner basis approach by Roune....

  1. Foraging effort in relation to the constraints of reproduction in free-ranging albatrosses

    OpenAIRE

    Shaffer, Scott A; Costa, D P; Weimerskirch, H

    2003-01-01

    1. Theoretical models predict that animals will vary their effort to maximize different currencies such as time and energy when the constraints of reproduction change during breeding, but this has been poorly studied in free-ranging animals. 2. Foraging effort (energy per unit time) was examined by comparing mass changes, foraging costs and activity-specific behaviours of Wandering Albatrosses (Diomedea exulans Linnaeus) during the incubation and chick-brooding stages. In 1998, 38 albatrosses...

  2. [Limitation of the therapeutic effort].

    Science.gov (United States)

    Herreros, B; Palacios, G; Pacho, E

    2012-03-01

    The limitation of the therapeutic effort (LTE) consists in not applying extraordinary or disproportionate measures for therapeutic purposes that are proposed for a patient with poor life prognosis and/or poor quality of life. There are two types. The first is to not initiate certain measures or to withdraw them when they are established. A decision of the LTE should be based on some rigorous criteria, so that we make the following proposal. First, it is necessary to know the most relevant details of the case to make a decision: the preferences of the patient, the preferences of the family when pertinent, the prognosis (severity), the quality of life and distribution of the limited resources. After, the decision should be made. In this phase, participatory deliberation should be established to clarify the end of the intervention. Finally, if it is decided to perform an LTE, it should be decided how to do it. Special procedures, disproportionate measures, that are useless and vain should not be initiated for the therapeutic objective designed (withdraw them if they have been established). When it has been decided to treat a condition (interim measures), the treatment should be maintained. This complex phase may need stratification of he measures. Finally, the necessary palliative measures should be established. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  3. Surgical Outreach for Children by International Humanitarian Organizations: A Review.

    Science.gov (United States)

    Kynes, J Matthew; Zeigler, Laura; McQueen, Kelly

    2017-06-28

    Low- and middle-income countries carry a disproportionate share of the global burden of pediatric surgical disease and have limited local healthcare infrastructure and human resources to address this burden. Humanitarian efforts that have improved or provided access to necessary basic or emergency surgery for children in these settings have included humanitarian assistance and disaster relief, short-term surgical missions, and long-term projects such as building pediatric specialty hospitals and provider networks. Each of these efforts may also include educational initiatives designed to increase local capacity. This article will provide an overview of pediatric humanitarian surgical outreach including reference to available evidence-based analyses of these platforms and make recommendations for surgical outreach initiatives for children.

  4. Endodontic, surgical and periodontal treatment of dens invaginatus. Case report.

    Science.gov (United States)

    Castellarin, M; Demitri, V; Politi, M

    2001-01-01

    The aim of this paper is to propose a single stage global treatment of endodontic, periapical and periodontal lesions in a lateral maxillary incisor with dens invaginatus. A 24 year-old woman presenting a lateral maxillary incisor with dens invaginatus in association with periapica1 and periodontal lesions underwent simultaneous surgical, endodontic and periodontal regenerative procedures. At 2, 6, 12, 18 months follow-up the radiographic healing appeared to be improved and the periapical lesion healed completely 1 year after surgical intervention. Surgery in association with endodontic and periodontal procedures represents the treatment of choice to maximize long term prognosis in cases of dens invaginatus with chronic periapical and periodontal lesions.

  5. Mental and physical effort affect vigilance differently

    NARCIS (Netherlands)

    Smit, A.S.; Eling, P.A.T.M.; Hopman, M.T.E.; Coenen, A.M.L.

    2005-01-01

    Both physical and mental effort are thought to affect vigilance. Mental effort is known for its vigilance declining effects, but the effects of physical effort are less clear. This study investigated whether these two forms of effort affect the EEG and subjective alertness differently. Participants

  6. Mental and physical effort affect vigilance differently.

    NARCIS (Netherlands)

    Smit, A.S.; Eling, P.A.T.M.; Hopman, M.T.E.; Coenen, A.M.L.

    2005-01-01

    Both physical and mental effort are thought to affect vigilance. Mental effort is known for its vigilance declining effects, but the effects of physical effort are less clear. This study investigated whether these two forms of effort affect the EEG and subjective alertness differently. Participants

  7. 3D Surgical Simulation

    Science.gov (United States)

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2009-01-01

    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  8. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff

    2012-01-01

    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...

  9. Charter School Discipline: Examples of Policies and School Climate Efforts from the Field

    Science.gov (United States)

    Kern, Nora; Kim, Suzie

    2016-01-01

    Students need a safe and supportive school environment to maximize their academic and social-emotional learning potential. A school's discipline policies and practices directly impact school climate and student achievement. Together, discipline policies and positive school climate efforts can reinforce behavioral expectations and ensure student…

  10. On maximal surfaces in asymptotically flat space-times

    International Nuclear Information System (INIS)

    Bartnik, R.; Chrusciel, P.T.; O Murchadha, N.

    1990-01-01

    Existence of maximal and 'almost maximal' hypersurfaces in asymptotically flat space-times is established under boundary conditions weaker than those considered previously. We show in particular that every vacuum evolution of asymptotically flat data for Einstein equations can be foliated by slices maximal outside a spatially compact set and that every (strictly) stationary asymptotically flat space-time can be foliated by maximal hypersurfaces. Amongst other uniqueness results, we show that maximal hypersurface can be used to 'partially fix' an asymptotic Poincare group. (orig.)

  11. SURGICAL SITE INFECTION: REVIEW

    Directory of Open Access Journals (Sweden)

    P. H. M. Bonai

    2016-07-01

    Full Text Available Nosocomial infection or nosocomial infection (NI is one of the factors that increase the cost of maintaining patients in the health system, even in processes that should safely occur, such as hospital patients and performing simple and routine surgical procedures surgical centers and clinics leading to complications resulting from these infections that prolong hospital stay and promote pain and suffering to the patient, resulting in the defense of the quality of services and influencing negatively the hospitals. Therefore, the aim of this study was to review the factors that result in surgical site infection, with the purpose of better understanding of the subject and the possibility of preventive actions to better treatment outcome of the patient.

  12. Maritime energy and security: Synergistic maximization or necessary tradeoffs?

    International Nuclear Information System (INIS)

    Nyman, Elizabeth

    2017-01-01

    Offshore energy is big business. The traditional source of maritime energy, offshore petroleum and gas, has been on the rise since a reliable method of extraction was discovered in the mid-20th century. Lately, it has been joined by offshore wind and tidal power as alternative “green” sources of maritime energy. Yet all of this has implications for maritime environmental regimes as well, as maritime energy extraction/generation can have a negative effect on the ocean environment. This paper considers two major questions surrounding maritime energy and environmental concerns. First, how and why do these two concerns, maritime energy and environmental protection, play against each other? Second, how can states both secure their energy and environmental securities in the maritime domain? Maximizing maritime energy output necessitates some environmental costs and vice versa, but these costs vary with the type of offshore energy technology used and with the extent to which states are willing to expend effort to protect both environmental and energy security. - Highlights: • Security is a complicated concept with several facets including energy and environmental issues. • Offshore energy contributes to energy supply but can have environmental and monitoring costs. • Understanding the contribution of offshore energy to security depends on which security facet is deemed most important.

  13. Blood detection in wireless capsule endoscopy using expectation maximization clustering

    Science.gov (United States)

    Hwang, Sae; Oh, JungHwan; Cox, Jay; Tang, Shou Jiang; Tibbals, Harry F.

    2006-03-01

    Wireless Capsule Endoscopy (WCE) is a relatively new technology (FDA approved in 2002) allowing doctors to view most of the small intestine. Other endoscopies such as colonoscopy, upper gastrointestinal endoscopy, push enteroscopy, and intraoperative enteroscopy could be used to visualize up to the stomach, duodenum, colon, and terminal ileum, but there existed no method to view most of the small intestine without surgery. With the miniaturization of wireless and camera technologies came the ability to view the entire gestational track with little effort. A tiny disposable video capsule is swallowed, transmitting two images per second to a small data receiver worn by the patient on a belt. During an approximately 8-hour course, over 55,000 images are recorded to a worn device and then downloaded to a computer for later examination. Typically, a medical clinician spends more than two hours to analyze a WCE video. Research has been attempted to automatically find abnormal regions (especially bleeding) to reduce the time needed to analyze the videos. The manufacturers also provide the software tool to detect the bleeding called Suspected Blood Indicator (SBI), but its accuracy is not high enough to replace human examination. It was reported that the sensitivity and the specificity of SBI were about 72% and 85%, respectively. To address this problem, we propose a technique to detect the bleeding regions automatically utilizing the Expectation Maximization (EM) clustering algorithm. Our experimental results indicate that the proposed bleeding detection method achieves 92% and 98% of sensitivity and specificity, respectively.

  14. Retained surgical sponge

    International Nuclear Information System (INIS)

    Koyama, Masashi; Kurono, Kenji; Iida, Akihiko; Suzuki, Hirochika; Hara, Masaki; Mizutani, Hirokazu; Ohba, Satoru; Mizutani, Masaru; Nakajima, Yoichiro.

    1993-01-01

    The CT, US, and MRI findings of confirmed retained surgical sponges were reviewed. The CT examinations in eight lesions demonstrated round or oval masses with heterogeneous internal structures. The US examinations in 5 lesions demonstrated low echogenic masses with high echogenic internal structures, which suggested retained surgical sponges. MR imagings in three lesions showed slightly high intensity comparable to that of muscles on T1-weighted images and high signal intensity on T2-weighted images, suggesting fluid collections of high protein concentration. (author)

  15. A Note of Caution on Maximizing Entropy

    Directory of Open Access Journals (Sweden)

    Richard E. Neapolitan

    2014-07-01

    Full Text Available The Principle of Maximum Entropy is often used to update probabilities due to evidence instead of performing Bayesian updating using Bayes’ Theorem, and its use often has efficacious results. However, in some circumstances the results seem unacceptable and unintuitive. This paper discusses some of these cases, and discusses how to identify some of the situations in which this principle should not be used. The paper starts by reviewing three approaches to probability, namely the classical approach, the limiting frequency approach, and the Bayesian approach. It then introduces maximum entropy and shows its relationship to the three approaches. Next, through examples, it shows that maximizing entropy sometimes can stand in direct opposition to Bayesian updating based on reasonable prior beliefs. The paper concludes that if we take the Bayesian approach that probability is about reasonable belief based on all available information, then we can resolve the conflict between the maximum entropy approach and the Bayesian approach that is demonstrated in the examples.

  16. Optimal topologies for maximizing network transmission capacity

    Science.gov (United States)

    Chen, Zhenhao; Wu, Jiajing; Rong, Zhihai; Tse, Chi K.

    2018-04-01

    It has been widely demonstrated that the structure of a network is a major factor that affects its traffic dynamics. In this work, we try to identify the optimal topologies for maximizing the network transmission capacity, as well as to build a clear relationship between structural features of a network and the transmission performance in terms of traffic delivery. We propose an approach for designing optimal network topologies against traffic congestion by link rewiring and apply them on the Barabási-Albert scale-free, static scale-free and Internet Autonomous System-level networks. Furthermore, we analyze the optimized networks using complex network parameters that characterize the structure of networks, and our simulation results suggest that an optimal network for traffic transmission is more likely to have a core-periphery structure. However, assortative mixing and the rich-club phenomenon may have negative impacts on network performance. Based on the observations of the optimized networks, we propose an efficient method to improve the transmission capacity of large-scale networks.

  17. New features of the maximal abelian projection

    International Nuclear Information System (INIS)

    Bornyakov, V.G.; Polikarpov, M.I.; Syritsyn, S.N.; Schierholz, G.; Suzuki, T.

    2005-12-01

    After fixing the Maximal Abelian gauge in SU(2) lattice gauge theory we decompose the nonabelian gauge field into the so called monopole field and the modified nonabelian field with monopoles removed. We then calculate respective static potentials and find that the potential due to the modified nonabelian field is nonconfining while, as is well known, the monopole field potential is linear. Furthermore, we show that the sum of these potentials approximates the nonabelian static potential with 5% or higher precision at all distances considered. We conclude that at large distances the monopole field potential describes the classical energy of the hadronic string while the modified nonabelian field potential describes the string fluctuations. Similar decomposition was observed to work for the adjoint static potential. A check was also made of the center projection in the direct center gauge. Two static potentials, determined by projected Z 2 and by modified nonabelian field without Z 2 component were calculated. It was found that their sum is a substantially worse approximation of the SU(2) static potential than that found in the monopole case. It is further demonstrated that similar decomposition can be made for the flux tube action/energy density. (orig.)

  18. Trainability of muscular activity level during maximal voluntary co-contraction: comparison between bodybuilders and nonathletes.

    Directory of Open Access Journals (Sweden)

    Sumiaki Maeo

    Full Text Available Antagonistic muscle pairs cannot be fully activated simultaneously, even with maximal effort, under conditions of voluntary co-contraction, and their muscular activity levels are always below those during agonist contraction with maximal voluntary effort (MVE. Whether the muscular activity level during the task has trainability remains unclear. The present study examined this issue by comparing the muscular activity level during maximal voluntary co-contraction for highly experienced bodybuilders, who frequently perform voluntary co-contraction in their training programs, with that for untrained individuals (nonathletes. The electromyograms (EMGs of biceps brachii and triceps brachii muscles during maximal voluntary co-contraction of elbow flexors and extensors were recorded in 11 male bodybuilders and 10 nonathletes, and normalized to the values obtained during the MVE of agonist contraction for each of the corresponding muscles (% EMGMVE. The involuntary coactivation level in antagonist muscle during the MVE of agonist contraction was also calculated. In both muscles, % EMGMVE values during the co-contraction task for bodybuilders were significantly higher (P<0.01 than those for nonathletes (biceps brachii: 66±14% in bodybuilders vs. 46±13% in nonathletes, triceps brachii: 74±16% vs. 57±9%. There was a significant positive correlation between a length of bodybuilding experience and muscular activity level during the co-contraction task (r = 0.653, P = 0.03. Involuntary antagonist coactivation level during MVE of agonist contraction was not different between the two groups. The current result indicates that long-term participation in voluntary co-contraction training progressively enhances muscular activity during maximal voluntary co-contraction.

  19. Trainability of Muscular Activity Level during Maximal Voluntary Co-Contraction: Comparison between Bodybuilders and Nonathletes

    Science.gov (United States)

    Maeo, Sumiaki; Takahashi, Takumi; Takai, Yohei; Kanehisa, Hiroaki

    2013-01-01

    Antagonistic muscle pairs cannot be fully activated simultaneously, even with maximal effort, under conditions of voluntary co-contraction, and their muscular activity levels are always below those during agonist contraction with maximal voluntary effort (MVE). Whether the muscular activity level during the task has trainability remains unclear. The present study examined this issue by comparing the muscular activity level during maximal voluntary co-contraction for highly experienced bodybuilders, who frequently perform voluntary co-contraction in their training programs, with that for untrained individuals (nonathletes). The electromyograms (EMGs) of biceps brachii and triceps brachii muscles during maximal voluntary co-contraction of elbow flexors and extensors were recorded in 11 male bodybuilders and 10 nonathletes, and normalized to the values obtained during the MVE of agonist contraction for each of the corresponding muscles (% EMGMVE). The involuntary coactivation level in antagonist muscle during the MVE of agonist contraction was also calculated. In both muscles, % EMGMVE values during the co-contraction task for bodybuilders were significantly higher (Pbodybuilders vs. 46±13% in nonathletes, triceps brachii: 74±16% vs. 57±9%). There was a significant positive correlation between a length of bodybuilding experience and muscular activity level during the co-contraction task (r = 0.653, P = 0.03). Involuntary antagonist coactivation level during MVE of agonist contraction was not different between the two groups. The current result indicates that long-term participation in voluntary co-contraction training progressively enhances muscular activity during maximal voluntary co-contraction. PMID:24260233

  20. Surgical infections with Mycoplasma

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Prag, Jørgen Brorson; Jensen, J S

    1997-01-01

    Mycoplasma hominis and Ureaplasma urealyticum are common inhabitants of the human genital tract. Evidence for an aetiological role in pyelonephritis, pelvic inflammatory disease, post-abortion and post-partum fever has been presented. There are sporadic reports of Mycoplasma causing serious...... extragenital infection such as septicemia, septic arthritis, neonatal meningitis and encephalitis. We review 38 cases of surgical infections with Mycoplasma....

  1. [Surgical therapy of gynecomastia].

    Science.gov (United States)

    Heckmann, A; Leclère, F M; Vogt, P M; Steiert, A

    2011-09-01

    Nowadays surgical intervention is an essential part of the treatment of idiopathic gynecomastia. Choosing the right method is crucial and is based on the current status in the clinical and histological evaluation. Before finalizing the process of choosing a specific method a prior interdisciplinary evaluation of the patient is necessary to ascertain clear indications for a surgical intervention. Liposuction is one of the methods which have become popular in recent years. The advantages are the possible combination with traditional techniques, such as subcutaneous mastectomy or periareolar mastopexy. The main indication is for gynecomastia stage IIa/b and is justifiable due to the reduction in surgical complications and scarring. Furthermore this technique provides an excellent aesthetical outcome for the patient. A total of 162 patients suffering from gynecomastia stages I-III (according to Simon) were surgically treated between 2000 and 2010 and these cases were retrospectively evaluated. The results showed a decline in the use of a T-shaped incision in combination with subcutaneous mastectomy with periareolar tightening compared to an increase in the use of subcutaneous mastectomy in combination with liposuction. The excised tissue should always be sent for histological examination to make sure no malignant cells were present.

  2. Surgical manifestations of filariasis

    Directory of Open Access Journals (Sweden)

    Subrahmanyam M

    1978-01-01

    Full Text Available Surgical manifestations of filariasis as seen in 150 cases over a period of three years in the department of Surgery, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha are reviewed. The genital manifestations are more common than the elephantiasis in this endemic zone.

  3. Improving surgical weekend handover.

    Science.gov (United States)

    Culwick, Caroline; Devine, Chris; Coombs, Catherine

    2014-01-01

    Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unified weekend list ordering all surgical patients by ward and bed number was introduced. Discrepancies in the layout of each team's weekday list necessitated the design of a new weekday list to match the weekend list to facilitate the easy transfer of information between the two lists. A colour coding system was also used to highlight specific jobs. Prior to this improvement project only 7.1% of those polled were satisfied with the existing system, after a series of interventions satisfaction increased to 85.7%. The significant increase in overall satisfaction with surgical handover following the introduction of the unified weekend list is promising. Locating patients and identifying jobs is easier and weekend ward rounds can conducted in a more logical and timely fashion. It has also helped facilitate the transition to consultant ward rounds of all surgical inpatients at the weekends with promising feedback from a recent consultants meeting.

  4. [Surgical complications of colostomies].

    Science.gov (United States)

    Ben Ameur, Hazem; Affes, Nejmeddine; Rejab, Haitham; Abid, Bassem; Boujelbene, Salah; Mzali, Rafik; Beyrouti, Mohamed Issam

    2014-07-01

    The colostomy may be terminal or lateral, temporary or permanent. It may have psychological, medical or surgical complications. reporting the incidence of surgical complications of colostomies, their therapeutic management and trying to identify risk factors for their occurrence. A retrospective study for a period of 5 years in general surgery department, Habib Bourguiba hospital, Sfax, including all patients operated with confection of a colostomy. Were then studied patients reoperated for stoma complication. Among the 268 patients who have had a colostomy, 19 patients (7%) developed surgical stoma complications. They had a mean age of 59 years, a sex ratio of 5.3 and a 1-ASA score in 42% of cases. It was a prolapse in 9 cases (reconfection of the colostomy: 6 cases, restoration of digestive continuity: 3 cases), a necrosis in 5 cases (reconfection of the colostomy), a plicature in 2 cases (reconfection of the colostomy) a peristomal abscess in 2 cases (reconfection of the colostomy: 1 case, restoration of digestive continuity: 1 case) and a strangulated parastomal hernia in 1 case (herniorrhaphy). The elective incision and the perineal disease were risk factors for the occurrence of prolapse stomial. Surgical complications of colostomies remain a rare event. Prolapse is the most common complication, and it is mainly related to elective approach. Reoperation is often required especially in cases of early complications, with usually uneventful postoperative course.

  5. Comparison of Maximal Wall Thickness in Hypertrophic Cardiomyopathy Differs Between Magnetic Resonance Imaging and Transthoracic Echocardiography.

    Science.gov (United States)

    Bois, John P; Geske, Jeffrey B; Foley, Thomas A; Ommen, Steve R; Pellikka, Patricia A

    2017-02-15

    Left ventricular (LV) wall thickness is a prognostic marker in hypertrophic cardiomyopathy (HC). LV wall thickness ≥30 mm (massive hypertrophy) is independently associated with sudden cardiac death. Presence of massive hypertrophy is used to guide decision making for cardiac defibrillator implantation. We sought to determine whether measurements of maximal LV wall thickness differ between cardiac magnetic resonance imaging (MRI) and transthoracic echocardiography (TTE). Consecutive patients were studied who had HC without previous septal ablation or myectomy and underwent both cardiac MRI and TTE at a single tertiary referral center. Reported maximal LV wall thickness was compared between the imaging techniques. Patients with ≥1 technique reporting massive hypertrophy received subset analysis. In total, 618 patients were evaluated from January 1, 2003, to December 21, 2012 (mean [SD] age, 53 [15] years; 381 men [62%]). In 75 patients (12%), reported maximal LV wall thickness was identical between MRI and TTE. Median difference in reported maximal LV wall thickness between the techniques was 3 mm (maximum difference, 17 mm). Of the 63 patients with ≥1 technique measuring maximal LV wall thickness ≥30 mm, 44 patients (70%) had discrepant classification regarding massive hypertrophy. MRI identified 52 patients (83%) with massive hypertrophy; TTE, 30 patients (48%). Although guidelines recommend MRI or TTE imaging to assess cardiac anatomy in HC, this study shows discrepancy between the techniques for maximal reported LV wall thickness assessment. In conclusion, because this measure clinically affects prognosis and therapeutic decision making, efforts to resolve these discrepancies are critical. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. [da Vinci surgical system].

    Science.gov (United States)

    Watanabe, Gou; Ishikawa, Norihiro

    2014-07-01

    The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

  7. Value maximizing maintenance policies under general repair

    International Nuclear Information System (INIS)

    Marais, Karen B.

    2013-01-01

    One class of maintenance optimization problems considers the notion of general repair maintenance policies where systems are repaired or replaced on failure. In each case the optimality is based on minimizing the total maintenance cost of the system. These cost-centric optimizations ignore the value dimension of maintenance and can lead to maintenance strategies that do not maximize system value. This paper applies these ideas to the general repair optimization problem using a semi-Markov decision process, discounted cash flow techniques, and dynamic programming to identify the value-optimal actions for any given time and system condition. The impact of several parameters on maintenance strategy, such as operating cost and revenue, system failure characteristics, repair and replacement costs, and the planning time horizon, is explored. This approach provides a quantitative basis on which to base maintenance strategy decisions that contribute to system value. These decisions are different from those suggested by traditional cost-based approaches. The results show (1) how the optimal action for a given time and condition changes as replacement and repair costs change, and identifies the point at which these costs become too high for profitable system operation; (2) that for shorter planning horizons it is better to repair, since there is no time to reap the benefits of increased operating profit and reliability; (3) how the value-optimal maintenance policy is affected by the system's failure characteristics, and hence whether it is worthwhile to invest in higher reliability; and (4) the impact of the repair level on the optimal maintenance policy. -- Highlights: •Provides a quantitative basis for maintenance strategy decisions that contribute to system value. •Shows how the optimal action for a given condition changes as replacement and repair costs change. •Shows how the optimal policy is affected by the system's failure characteristics. •Shows when it is

  8. Measuring collections effort improves cash performance.

    Science.gov (United States)

    Shutts, Joe

    2009-09-01

    Having a satisfied work force can lead to an improved collections effort. Hiring the right people and training them ensures employee engagement. Measuring collections effort and offering incentives is key to revenue cycle success.

  9. [Surgical treatment of prolapse by abdominal route and effort-related urinary incontinence].

    Science.gov (United States)

    Wagner, L; Fatton, B; Delmas, V; Haab, F; Costa, P

    2009-12-01

    Stress urinary incontinence is often associated with prolapse. The suburethral tapes have modified the indication for a preventive treatment of incontinence. The tapes are necessary in case of patent or masked incontinence, discussed in case of potential incontinence. The diagnosis of incontinence is done on questions to the patient, clinical exam, more than in urodynamic study. There is no absolute sign allowing to predict postoperative incontinence after surgery for prolapse. A continent woman can be incontinent postoperatively. If a potential incontinence is treated in the same as the prolapse, the patient must be informed of risk of obstruction and/or urgency.

  10. POLITENESS MAXIM OF MAIN CHARACTER IN SECRET FORGIVEN

    Directory of Open Access Journals (Sweden)

    Sang Ayu Isnu Maharani

    2017-06-01

    Full Text Available Maxim of Politeness is an interesting subject to be discussed, since politeness has been criticized from our childhood. We are obliques to be polite to anyone either in speaking or in acting. Somehow we are manage to show politeness in our spoken expression though our intention might be not so polite. For example we must appriciate others opinion although we feel objection toward the opinion. In this article the analysis of politeness is based on maxim proposes by Leech. He proposed six types of politeness maxim. The discussion shows that the main character (Kristen and Kami use all types of maxim in their conversation. The most commonly used are approbation maxim and agreement maxim

  11. Surgical Safety Training of World Health Organization Initiatives.

    Science.gov (United States)

    Davis, Christopher R; Bates, Anthony S; Toll, Edward C; Cole, Matthew; Smith, Frank C T; Stark, Michael

    2014-01-01

    Undergraduate training in surgical safety is essential to maximize patient safety. This national review quantified undergraduate surgical safety training. Training of 2 international safety initiatives was quantified: (1) World Health Organization (WHO) "Guidelines for Safe Surgery" and (2) Department of Health (DoH) "Principles of the Productive Operating Theatre." Also, 13 additional safety skills were quantified. Data were analyzed using Mann-Whitney U tests. In all, 23 universities entered the study (71.9% response). Safety skills from WHO and DoH documents were formally taught in 4 UK medical schools (17.4%). Individual components of the documents were taught more frequently (47.6%). Half (50.9%) of the additional safety skills identified were taught. Surgical societies supplemented safety training, although the total amount of training provided was less than that in university curricula (P < .0001). Surgical safety training is inadequate in UK medical schools. To protect patients and maximize safety, a national undergraduate safety curriculum is recommended. © 2013 by the American College of Medical Quality.

  12. Virtual Reality Simulator Systems in Robotic Surgical Training.

    Science.gov (United States)

    Mangano, Alberto; Gheza, Federico; Giulianotti, Pier Cristoforo

    2018-06-01

    The number of robotic surgical procedures has been increasing worldwide. It is important to maximize the cost-effectiveness of robotic surgical training and safely reduce the time needed for trainees to reach proficiency. The use of preliminary lab training in robotic skills is a good strategy for the rapid acquisition of further, standardized robotic skills. Such training can be done either by using a simulator or by exercises in a dry or wet lab. While the use of an actual robotic surgical system for training may be problematic (high cost, lack of availability), virtual reality (VR) simulators can overcome many of these obstacles. However, there is still a lack of standardization. Although VR training systems have improved, they cannot yet replace experience in a wet lab. In particular, simulated scenarios are not yet close enough to a real operative experience. Indeed, there is a difference between technical skills (i.e., mechanical ability to perform a simulated task) and surgical competence (i.e., ability to perform a real surgical operation). Thus, while a VR simulator can replace a dry lab, it cannot yet replace training in a wet lab or operative training in actual patients. However, in the near future, it is expected that VR surgical simulators will be able to provide total reality simulation and replace training in a wet lab. More research is needed to produce more wide-ranging, trans-specialty robotic curricula.

  13. Why are junior doctors deterred from choosing a surgical career?

    Science.gov (United States)

    Rogers, Mary E; Creed, Peter A; Searle, Judy

    2012-05-01

    To identify the reasons why interns would not choose a surgical career. This qualitative study used semi-structured telephone interviews to explore the future career choices of 41 junior doctors (14 men, 27 women). Doctors were asked to identify specialties they would not take up, and state why this was the case. Thirty (73.2%) of the 41 interns nominated surgery as a specialty they would not choose. Themes relating to reasons for not wanting to pursue a surgical career included the lifestyle associated with surgery (66.7%), the culture within the surgical work environment (53.3%), the lack of interest in performing surgical work (36.7%), and the training requirements associated with surgery (33.3%). Both sexes had similar reasons for not wanting to choose a surgical career; but additionally, women referred to the male domination of surgery, and the difficulty and inflexibility of the training program as deterrents. Efforts are needed to promote interest in surgery as a career especially for women, to improve the surgical work environment so that medical students and junior doctors have exposure to positive role models and surgical placements, and to provide a more flexible approach to surgical training.

  14. Paediatric Abdominal Surgical Emergencies in a General Surgical ...

    African Journals Online (AJOL)

    ... organized for general surgeons undertaking paediatric surgical emergencies. More paediatric surgeons should be trained and more paediatric surgical units should established in the country. Key Words: Paediatric Abdominal Surgical Emergencies; Paediatric Surgeons, General Surgeons. Journal of College of Medicine ...

  15. Maximizers versus satisficers: Decision-making styles, competence, and outcomes

    OpenAIRE

    Andrew M. Parker; Wändi Bruine de Bruin; Baruch Fischhoff

    2007-01-01

    Our previous research suggests that people reporting a stronger desire to maximize obtain worse life outcomes (Bruine de Bruin et al., 2007). Here, we examine whether this finding may be explained by the decision-making styles of self-reported maximizers. Expanding on Schwartz et al.\\ (2002), we find that self-reported maximizers are more likely to show problematic decision-making styles, as evidenced by self-reports of less behavioral coping, greater dependence on others when making decision...

  16. Measuring cognitive load: performance, mental effort and simulation task complexity.

    Science.gov (United States)

    Haji, Faizal A; Rojas, David; Childs, Ruth; de Ribaupierre, Sandrine; Dubrowski, Adam

    2015-08-01

    Interest in applying cognitive load theory in health care simulation is growing. This line of inquiry requires measures that are sensitive to changes in cognitive load arising from different instructional designs. Recently, mental effort ratings and secondary task performance have shown promise as measures of cognitive load in health care simulation. We investigate the sensitivity of these measures to predicted differences in intrinsic load arising from variations in task complexity and learner expertise during simulation-based surgical skills training. We randomly assigned 28 novice medical students to simulation training on a simple or complex surgical knot-tying task. Participants completed 13 practice trials, interspersed with computer-based video instruction. On trials 1, 5, 9 and 13, knot-tying performance was assessed using time and movement efficiency measures, and cognitive load was assessed using subjective rating of mental effort (SRME) and simple reaction time (SRT) on a vibrotactile stimulus-monitoring secondary task. Significant improvements in knot-tying performance (F(1.04,24.95)  = 41.1, p cognitive load (F(2.3,58.5)  = 57.7, p load among novices engaged in simulation-based learning. These measures can be used to track cognitive load during skills training. Mental effort ratings are also sensitive to small differences in intrinsic load arising from variations in the physical complexity of a simulation task. The complementary nature of these subjective and objective measures suggests their combined use is advantageous in simulation instructional design research. © 2015 John Wiley & Sons Ltd.

  17. Natural maximal νμ-ντ mixing

    International Nuclear Information System (INIS)

    Wetterich, C.

    1999-01-01

    The naturalness of maximal mixing between myon- and tau-neutrinos is investigated. A spontaneously broken nonabelian generation symmetry can explain a small parameter which governs the deviation from maximal mixing. In many cases all three neutrino masses are almost degenerate. Maximal ν μ -ν τ -mixing suggests that the leading contribution to the light neutrino masses arises from the expectation value of a heavy weak triplet rather than from the seesaw mechanism. In this scenario the deviation from maximal mixing is predicted to be less than about 1%. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

  18. On the way towards a generalized entropy maximization procedure

    International Nuclear Information System (INIS)

    Bagci, G. Baris; Tirnakli, Ugur

    2009-01-01

    We propose a generalized entropy maximization procedure, which takes into account the generalized averaging procedures and information gain definitions underlying the generalized entropies. This novel generalized procedure is then applied to Renyi and Tsallis entropies. The generalized entropy maximization procedure for Renyi entropies results in the exponential stationary distribution asymptotically for q element of (0,1] in contrast to the stationary distribution of the inverse power law obtained through the ordinary entropy maximization procedure. Another result of the generalized entropy maximization procedure is that one can naturally obtain all the possible stationary distributions associated with the Tsallis entropies by employing either ordinary or q-generalized Fourier transforms in the averaging procedure.

  19. Violating Bell inequalities maximally for two d-dimensional systems

    International Nuclear Information System (INIS)

    Chen Jingling; Wu Chunfeng; Oh, C. H.; Kwek, L. C.; Ge Molin

    2006-01-01

    We show the maximal violation of Bell inequalities for two d-dimensional systems by using the method of the Bell operator. The maximal violation corresponds to the maximal eigenvalue of the Bell operator matrix. The eigenvectors corresponding to these eigenvalues are described by asymmetric entangled states. We estimate the maximum value of the eigenvalue for large dimension. A family of elegant entangled states |Ψ> app that violate Bell inequality more strongly than the maximally entangled state but are somewhat close to these eigenvectors is presented. These approximate states can potentially be useful for quantum cryptography as well as many other important fields of quantum information

  20. Surgical camps: the Ugandan experience

    African Journals Online (AJOL)

    . The planned visits were advertised locally and in the national media. Screening of the patients was done first by the local medical teams and later by the visiting surgical teams. The surgical teams were comprised of the following personnel:.

  1. Improving surgical weekend handover

    OpenAIRE

    Culwick, Caroline; Devine, Chris; Coombs, Catherine

    2014-01-01

    Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unif...

  2. Acquiring minimally invasive surgical skills

    OpenAIRE

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room. This thesis has led to an enlarged insight in the organization of surgical skills training during residency training of surgical medical specialists.

  3. Robotic surgical training.

    Science.gov (United States)

    Ben-Or, Sharon; Nifong, L Wiley; Chitwood, W Randolph

    2013-01-01

    In July 2000, the da Vinci Surgical System (Intuitive Surgical, Inc) received Food and Drug Administration approval for intracardiac applications, and the first mitral valve repair was done at the East Carolina Heart Institute in May 2000. The system is now approved and used in many surgical specialties. With this disruptive technology and accepted use, surgeons and hospitals are seeking the most efficacious training pathway leading to safe use and responsible credentialing.One of the most important issues related to safe use is assembling the appropriate team of professionals involved with patient care. Moreover, proper patient selection and setting obtainable goals are also important.Creation and maintenance of a successful program are discussed in the article focusing on realistic goals. This begins with a partnership between surgeon leaders, hospital administrators, and industry support. Through this partnership, an appropriate training pathway and clinical pathway for success can be outlined. A timeline can then be created with periods of data analysis and adjustments as necessary. A successful program is attainable by following this pathway and attending to every detail along the journey.

  4. Surgical experts: born or made?

    Science.gov (United States)

    Sadideen, Hazim; Alvand, Abtin; Saadeddin, Munir; Kneebone, Roger

    2013-01-01

    The concept of surgical expertise and the processes involved in its development are topical, and there is a constant drive to identify reliable measures of expert performance in surgery. This review explores the notion of whether surgical experts are "born" or "made", with reference to educational theory and pertinent literature. Peer-reviewed publications, books, and online resources on surgical education, expertise and training were reviewed. Important themes and aspects of expertise acquisition were identified in order to better understand the concept of a surgical expert. The definition of surgical expertise and several important aspects of its development are highlighted. Innate talent plays an important role, but is insufficient on its own to produce a surgical expert. Multiple theories that explore motor skill acquisition and memory are relevant, and Ericsson's theory of the development of competence followed by deliberate self-practice has been especially influential. Psychomotor and non-technical skills are necessary for progression in the current climate in light of our training curricula; surgical experts are adaptive experts who excel in these. The literature suggests that surgical expertise is reached through practice; surgical experts are made, not born. A deeper understanding of the nature of expert performance and its development will ensure that surgical education training programmes are of the highest possible quality. Surgical educators should aim to develop an expertise-based approach, with expert performance as the benchmark. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  5. Surgical navigation with QR codes

    Directory of Open Access Journals (Sweden)

    Katanacho Manuel

    2016-09-01

    Full Text Available The presented work is an alternative to established measurement systems in surgical navigation. The system is based on camera based tracking of QR code markers. The application uses a single video camera, integrated in a surgical lamp, that captures the QR markers attached to surgical instruments and to the patient.

  6. Nigerian Journal of Surgical Research

    African Journals Online (AJOL)

    The Nigerian Journal of Surgical Research is a publication of the Surgical Research Society with main office in Zaria, Nigeria. Zaria is home to Ahmadu Bello University (ABU), a premier university in Nigeria. The aim of The Nigerian Journal of Surgical Research is to cover developments and advances in the broad field of ...

  7. Maximizing the phylogenetic diversity of seed banks.

    Science.gov (United States)

    Griffiths, Kate E; Balding, Sharon T; Dickie, John B; Lewis, Gwilym P; Pearce, Tim R; Grenyer, Richard

    2015-04-01

    Ex situ conservation efforts such as those of zoos, botanical gardens, and seed banks will form a vital complement to in situ conservation actions over the coming decades. It is therefore necessary to pay the same attention to the biological diversity represented in ex situ conservation facilities as is often paid to protected-area networks. Building the phylogenetic diversity of ex situ collections will strengthen our capacity to respond to biodiversity loss. Since 2000, the Millennium Seed Bank Partnership has banked seed from 14% of the world's plant species. We assessed the taxonomic, geographic, and phylogenetic diversity of the Millennium Seed Bank collection of legumes (Leguminosae). We compared the collection with all known legume genera, their known geographic range (at country and regional levels), and a genus-level phylogeny of the legume family constructed for this study. Over half the phylogenetic diversity of legumes at the genus level was represented in the Millennium Seed Bank. However, pragmatic prioritization of species of economic importance and endangerment has led to the banking of a less-than-optimal phylogenetic diversity and prioritization of range-restricted species risks an underdispersed collection. The current state of the phylogenetic diversity of legumes in the Millennium Seed Bank could be substantially improved through the strategic banking of relatively few additional taxa. Our method draws on tools that are widely applied to in situ conservation planning, and it can be used to evaluate and improve the phylogenetic diversity of ex situ collections. © 2014 Society for Conservation Biology.

  8. Evaluation of anti-hyperglycemic effect of Actinidia kolomikta (Maxim. etRur.) Maxim. root extract.

    Science.gov (United States)

    Hu, Xuansheng; Cheng, Delin; Wang, Linbo; Li, Shuhong; Wang, Yuepeng; Li, Kejuan; Yang, Yingnan; Zhang, Zhenya

    2015-05-01

    This study aimed to evaluate the anti-hyperglycemic effect of ethanol extract from Actinidia kolomikta (Maxim. etRur.) Maxim. root (AKE).An in vitro evaluation was performed by using rat intestinal α-glucosidase (maltase and sucrase), the key enzymes linked with type 2 diabetes. And an in vivo evaluation was also performed by loading maltose, sucrose, glucose to normal rats. As a result, AKE showed concentration-dependent inhibition effects on rat intestinal maltase and rat intestinal sucrase with IC(50) values of 1.83 and 1.03mg/mL, respectively. In normal rats, after loaded with maltose, sucrose and glucose, administration of AKE significantly reduced postprandial hyperglycemia, which is similar to acarbose used as an anti-diabetic drug. High contents of total phenolics (80.49 ± 0.05mg GAE/g extract) and total flavonoids (430.69 ± 0.91mg RE/g extract) were detected in AKE. In conclusion, AKE possessed anti-hyperglycemic effects and the possible mechanisms were associated with its inhibition on α-glucosidase and the improvement on insulin release and/or insulin sensitivity as well. The anti-hyperglycemic activity possessed by AKE maybe attributable to its high contents of phenolic and flavonoid compounds.

  9. Approaching maximal performance of longitudinal beam compression in induction accelerator drivers

    International Nuclear Information System (INIS)

    Mark, J.W.K.; Ho, D.D.M.; Brandon, S.T.; Chang, C.L.; Drobot, A.T.; Faltens, A.; Lee, E.P.; Krafft, G.A.

    1986-01-01

    Longitudinal beam compression occurs before final focus and fusion chamber beam transport and is a key process determining initial conditions for final focus hardware. Determining the limits for maximal performance of key accelerator components is an essential element of the effort to reduce driver costs. Studies directed towards defining the limits of final beam compression including considerations such as maximal available compression, effects of longitudinal dispersion and beam emittance, combining pulse-shaping with beam compression to reduce the total number of beam manipulators, etc., are given. Several possible techniques are illustrated for utilizing the beam compression process to provide the pulse shapes required by a number of targets. Without such capabilities to shape the pulse, an additional factor of two or so of beam energy would be required by the targets

  10. Improving the Accuracy of Predicting Maximal Oxygen Consumption (VO2pk)

    Science.gov (United States)

    Downs, Meghan E.; Lee, Stuart M. C.; Ploutz-Snyder, Lori; Feiveson, Alan

    2016-01-01

    Maximal oxygen (VO2pk) is the maximum amount of oxygen that the body can use during intense exercise and is used for benchmarking endurance exercise capacity. The most accurate method to determineVO2pk requires continuous measurements of ventilation and gas exchange during an exercise test to maximal effort, which necessitates expensive equipment, a trained staff, and time to set-up the equipment. For astronauts, accurate VO2pk measures are important to assess mission critical task performance capabilities and to prescribe exercise intensities to optimize performance. Currently, astronauts perform submaximal exercise tests during flight to predict VO2pk; however, while submaximal VO2pk prediction equations provide reliable estimates of mean VO2pk for populations, they can be unacceptably inaccurate for a given individual. The error in current predictions and logistical limitations of measuring VO2pk, particularly during spaceflight, highlights the need for improved estimation methods.

  11. Reconstruction of phylogenetic trees of prokaryotes using maximal common intervals.

    Science.gov (United States)

    Heydari, Mahdi; Marashi, Sayed-Amir; Tusserkani, Ruzbeh; Sadeghi, Mehdi

    2014-10-01

    One of the fundamental problems in bioinformatics is phylogenetic tree reconstruction, which can be used for classifying living organisms into different taxonomic clades. The classical approach to this problem is based on a marker such as 16S ribosomal RNA. Since evolutionary events like genomic rearrangements are not included in reconstructions of phylogenetic trees based on single genes, much effort has been made to find other characteristics for phylogenetic reconstruction in recent years. With the increasing availability of completely sequenced genomes, gene order can be considered as a new solution for this problem. In the present work, we applied maximal common intervals (MCIs) in two or more genomes to infer their distance and to reconstruct their evolutionary relationship. Additionally, measures based on uncommon segments (UCS's), i.e., those genomic segments which are not detected as part of any of the MCIs, are also used for phylogenetic tree reconstruction. We applied these two types of measures for reconstructing the phylogenetic tree of 63 prokaryotes with known COG (clusters of orthologous groups) families. Similarity between the MCI-based (resp. UCS-based) reconstructed phylogenetic trees and the phylogenetic tree obtained from NCBI taxonomy browser is as high as 93.1% (resp. 94.9%). We show that in the case of this diverse dataset of prokaryotes, tree reconstruction based on MCI and UCS outperforms most of the currently available methods based on gene orders, including breakpoint distance and DCJ. We additionally tested our new measures on a dataset of 13 closely-related bacteria from the genus Prochlorococcus. In this case, distances like rearrangement distance, breakpoint distance and DCJ proved to be useful, while our new measures are still appropriate for phylogenetic reconstruction. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Alternative approaches to maximally supersymmetric field theories

    International Nuclear Information System (INIS)

    Broedel, Johannes

    2010-01-01

    The central objective of this work is the exploration and application of alternative possibilities to describe maximally supersymmetric field theories in four dimensions: N=4 super Yang-Mills theory and N=8 supergravity. While twistor string theory has been proven very useful in the context of N=4 SYM, no analogous formulation for N=8 supergravity is available. In addition to the part describing N=4 SYM theory, twistor string theory contains vertex operators corresponding to the states of N=4 conformal supergravity. Those vertex operators have to be altered in order to describe (non-conformal) Einstein supergravity. A modified version of the known open twistor string theory, including a term which breaks the conformal symmetry for the gravitational vertex operators, has been proposed recently. In a first part of the thesis structural aspects and consistency of the modified theory are discussed. Unfortunately, the majority of amplitudes can not be constructed, which can be traced back to the fact that the dimension of the moduli space of algebraic curves in twistor space is reduced in an inconsistent manner. The issue of a possible finiteness of N=8 supergravity is closely related to the question of the existence of valid counterterms in the perturbation expansion of the theory. In particular, the coefficient in front of the so-called R 4 counterterm candidate has been shown to vanish by explicit calculation. This behavior points into the direction of a symmetry not taken into account, for which the hidden on-shell E 7(7) symmetry is the prime candidate. The validity of the so-called double-soft scalar limit relation is a necessary condition for a theory exhibiting E 7(7) symmetry. By calculating the double-soft scalar limit for amplitudes derived from an N=8 supergravity action modified by an additional R 4 counterterm, one can test for possible constraints originating in the E 7(7) symmetry. In a second part of the thesis, the appropriate amplitudes are calculated

  13. The effect of menstruation on chosen physiological and biochemical reactions caused by the physical effort with the submaximal intensity

    Directory of Open Access Journals (Sweden)

    P Zieliński

    2003-03-01

    Full Text Available The aim of this work was to determine the influence of the menstruation phase on changes of respective indicators of the gas exchange and on biochemical parameters of blood during physical efforts with the sub-maximal intensity. Fifteen female students of the Academy of Physical Education took part in the study. Girls were aged from 19 to 22 years old and did not practice sports. The effort tests were conducted in the follicular and luteal phase of two succeeding menstrual cycles. As far the aerobic capacity determination is concerned, one cyclo-ergometric test with graded effort was conducted and it was performed till the “refusal”. It allowed to mark a threshold (TDMA and a maximal level of physiological and biochemical indicators. Basing on the results of the graded test individual loads were determined for every next effort trial (repeated 4 times in every phase of the two succeeding menstrual cycles. The aim of this trial was to evaluate the reaction of women’s constitution on work with the sub-maximal intensity. The above trial consisted on two 10 min efforts divided with the 2 min pause (the first effort with the intensity of 80% of the TDMA threshold, second with the intensity bigger about 30-40% of difference between TDMA and a maximal load established by the graded test. The research did not reveal statistically significant differentiation as considering effort changes of basic physiological and biochemical indicators, determining reaction of women’s organisms on work with the sub- and over- threshold intensity (TDMA. It showed that menstruation has not significant effect on the level of changes of analysed parameters caused by the physical effort with the sub-maximal intensity.

  14. Maximal venous outflow velocity: an index for iliac vein obstruction.

    Science.gov (United States)

    Jones, T Matthew; Cassada, David C; Heidel, R Eric; Grandas, Oscar G; Stevens, Scott L; Freeman, Michael B; Edmondson, James D; Goldman, Mitchell H

    2012-11-01

    Leg swelling is a common cause for vascular surgical evaluation, and iliocaval obstruction due to May-Thurner syndrome (MTS) can be difficult to diagnose. Physical examination and planar radiographic imaging give anatomic information but may miss the fundamental pathophysiology of MTS. Similarly, duplex ultrasonographic examination of the legs gives little information about central impedance of venous return above the inguinal ligament. We have modified the technique of duplex ultrasonography to evaluate the flow characteristics of the leg after tourniquet-induced venous engorgement, with the objective of revealing iliocaval obstruction characteristic of MTS. Twelve patients with signs and symptoms of MTS were compared with healthy control subjects for duplex-derived maximal venous outflow velocity (MVOV) after tourniquet-induced venous engorgement of the leg. The data for healthy control subjects were obtained from a previous study of asymptomatic volunteers using the same MVOV maneuvers. The tourniquet-induced venous engorgement mimics that caused during vigorous exercise. A right-to-left ratio of MVOV was generated for patient comparisons. Patients with clinical evidence of MTS had a mean right-to-left MVOV ratio of 2.0, asymptomatic control subjects had a mean ratio of 1.3, and MTS patients who had undergone endovascular treatment had a poststent mean ratio of 1.2 (P = 0.011). Interestingly, computed tomography and magnetic resonance imaging results, when available, were interpreted as positive in only 53% of the patients with MTS according to both our MVOV criteria and confirmatory venography. After intervention, the right-to-left MVOV ratio in the MTS patients was found to be reduced similar to asymptomatic control subjects, indicating a relief of central venous obstruction by stenting the compressive MTS anatomy. Duplex-derived MVOV measurements are helpful for detection of iliocaval venous obstruction, such as MTS. Right-to-left MVOV ratios and

  15. Experience of collaboration between a Dutch surgical team in a ...

    African Journals Online (AJOL)

    Experience of collaboration between a Dutch surgical team in a Ghanaian Orthopaedic Teaching Hospital. ... medical teams from our hospital were deployed to St. Joseph's Hospital. These teams were completely self-supporting. They were encouraged to work together with the local-staff. Apart from clinical work, effort was

  16. Public policy to maximize tobacco cessation.

    Science.gov (United States)

    McGoldrick, Daniel E; Boonn, Ann V

    2010-03-01

    Tobacco use kills more than 400,000 Americans every year. For smokers, quitting is the biggest step they can take to improve their health, but it is a difficult step. Fortunately, policy-based interventions can both encourage smokers to quit and help them succeed. Evidence shows that tobacco tax increases encourage smokers to quit-recent state and federal increases have created dramatic surges in calls to quitlines. Similarly, smokefree workplace laws not only protect workers and patrons from secondhand smoke but also encourage smokers to quit, help them succeed, and create a social environment less conducive to smoking. The impact of policy changes can be amplified by promoting quitting around the date they are implemented. Outreach to health practitioners can alert them to encourage their patients to quit. Earned and paid media can also be used to motivate smokers to quit when policy changes are put into effect. Although these policies and efforts regarding them can generate great demand for evidence-based cessation services such as counseling and medication, it is important to make these resources available for those wanting to quit. Public and private health insurance plans should provide coverage for cessation services, and states should invest tobacco tax and/or tobacco settlement dollars in smoking-cessation programs as recommended by the CDC. Finally, the Family Smoking Prevention and Tobacco Control Act has given the U.S. Food and Drug Administration new authority to regulate tobacco products and marketing, and to prevent tobacco companies from deceptively marketing new products that discourage smokers from quitting and keep them addicted. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  17. Kinetic theory in maximal-acceleration invariant phase space

    International Nuclear Information System (INIS)

    Brandt, H.E.

    1989-01-01

    A vanishing directional derivative of a scalar field along particle trajectories in maximal acceleration invariant phase space is identical in form to the ordinary covariant Vlasov equation in curved spacetime in the presence of both gravitational and nongravitational forces. A natural foundation is thereby provided for a covariant kinetic theory of particles in maximal-acceleration invariant phase space. (orig.)

  18. IIB solutions with N>28 Killing spinors are maximally supersymmetric

    International Nuclear Information System (INIS)

    Gran, U.; Gutowski, J.; Papadopoulos, G.; Roest, D.

    2007-01-01

    We show that all IIB supergravity backgrounds which admit more than 28 Killing spinors are maximally supersymmetric. In particular, we find that for all N>28 backgrounds the supercovariant curvature vanishes, and that the quotients of maximally supersymmetric backgrounds either preserve all 32 or N<29 supersymmetries

  19. Muscle mitochondrial capacity exceeds maximal oxygen delivery in humans

    DEFF Research Database (Denmark)

    Boushel, Robert Christopher; Gnaiger, Erich; Calbet, Jose A L

    2011-01-01

    Across a wide range of species and body mass a close matching exists between maximal conductive oxygen delivery and mitochondrial respiratory rate. In this study we investigated in humans how closely in-vivo maximal oxygen consumption (VO(2) max) is matched to state 3 muscle mitochondrial respira...

  20. Pace's Maxims for Homegrown Library Projects. Coming Full Circle

    Science.gov (United States)

    Pace, Andrew K.

    2005-01-01

    This article discusses six maxims by which to run library automation. The following maxims are discussed: (1) Solve only known problems; (2) Avoid changing data to fix display problems; (3) Aut viam inveniam aut faciam; (4) If you cannot make it yourself, buy something; (5) Kill the alligator closest to the boat; and (6) Just because yours is…

  1. Pocket money and child effort at school

    OpenAIRE

    François-Charles Wolff; Christine Barnet-Verzat

    2008-01-01

    In this paper, we study the relationship between the provision of parental pocket and the level of effort undertaken by the child at school. Under altruism, an increased amount of parental transfer should reduce the child's effort. Our empirical analysis is based on a French data set including about 1,400 parent-child pairs. We find that children do not undertake less effort when their parents are more generous.

  2. Current Capabilities and Development Potential in Surgical Robotics

    Directory of Open Access Journals (Sweden)

    Mathias Hoeckelmann

    2015-05-01

    Full Text Available Commercial surgical robots have been in clinical use since the mid-1990s, supporting surgeons in various tasks. In the past decades, many systems emerged as research platforms, and a few entered the global market. This paper summarizes the currently available surgical systems and research directions in the broader field of surgical robotics. The widely deployed teleoperated manipulators aim to enhance human cognitive and physical skills and provide smart tools for surgeons, while image-guided robotics focus on surpassing human limitations by introducing automated targeting and treatment delivery methods. Both concepts are discussed based on prototypes and commercial systems. Through concrete examples the possible future development paths of surgical robots are illustrated. While research efforts are taking different approaches to improve the capacity of such systems, the aim of this survey is to assess their maturity from the commercialization point of view.

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

    DEFF Research Database (Denmark)

    Andersen, Steven Arild Wuyts

    2015-01-01

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

  4. Incentive Design and Mis-Allocated Effort

    OpenAIRE

    Schnedler, Wendelin

    2013-01-01

    Incentives often distort behavior: they induce agents to exert effort but this effort is not employed optimally. This paper proposes a theory of incentive design allowing for such distorted behavior. At the heart of the theory is a trade-off between getting the agent to exert effort and ensuring that this effort is used well. The theory covers various moral-hazard models, ranging from traditional single-task to multi-task models. It also provides -for the first time- a formalization and proof...

  5. Surgical management of third nerve palsy

    Directory of Open Access Journals (Sweden)

    Anupam Singh

    2016-01-01

    Full Text Available Third nerve paralysis has been known to be associated with a wide spectrum of presentation and other associated factors such as the presence of ptosis, pupillary involvement, amblyopia, aberrant regeneration, poor bell′s phenomenon, superior oblique (SO overaction, and lateral rectus (LR contracture. Correction of strabismus due to third nerve palsy can be complex as four out of the six extraocular muscles are involved and therefore should be approached differently. Third nerve palsy can be congenital or acquired. The common causes of isolated third nerve palsy in children are congenital (43%, trauma (20%, inflammation (13%, aneurysm (7%, and ophthalmoplegic migraine. Whereas, in adult population, common etiologies are vasculopathic disorders (diabetes mellitus, hypertension, aneurysm, and trauma. Treatment can be both nonsurgical and surgical. As nonsurgical modalities are not of much help, surgery remains the main-stay of treatment. Surgical strategies are different for complete and partial third nerve palsy. Surgery for complete third nerve palsy may involve supra-maximal recession - resection of the recti. This may be combined with SO transposition and augmented by surgery on the other eye. For partial third nerve, palsy surgery is determined according to nature and extent of involvement of extraocular muscles.

  6. Surgical management of third nerve palsy

    Science.gov (United States)

    Singh, Anupam; Bahuguna, Chirag; Nagpal, Ritu; Kumar, Barun

    2016-01-01

    Third nerve paralysis has been known to be associated with a wide spectrum of presentation and other associated factors such as the presence of ptosis, pupillary involvement, amblyopia, aberrant regeneration, poor bell's phenomenon, superior oblique (SO) overaction, and lateral rectus (LR) contracture. Correction of strabismus due to third nerve palsy can be complex as four out of the six extraocular muscles are involved and therefore should be approached differently. Third nerve palsy can be congenital or acquired. The common causes of isolated third nerve palsy in children are congenital (43%), trauma (20%), inflammation (13%), aneurysm (7%), and ophthalmoplegic migraine. Whereas, in adult population, common etiologies are vasculopathic disorders (diabetes mellitus, hypertension), aneurysm, and trauma. Treatment can be both nonsurgical and surgical. As nonsurgical modalities are not of much help, surgery remains the main-stay of treatment. Surgical strategies are different for complete and partial third nerve palsy. Surgery for complete third nerve palsy may involve supra-maximal recession - resection of the recti. This may be combined with SO transposition and augmented by surgery on the other eye. For partial third nerve, palsy surgery is determined according to nature and extent of involvement of extraocular muscles. PMID:27433033

  7. Surgical management of hyperthyroidism.

    Science.gov (United States)

    Quérat, C; Germain, N; Dumollard, J-M; Estour, B; Peoc'h, M; Prades, J-M

    2015-04-01

    Hyperthyroidism includes several clinical and histopathological situations. Surgery is commonly indicated after failure of medical treatment. The aim of this study was to analyze the indications and complications of surgery as well as endocrine results. Patients operated on for hyperthyroidism between 2004 and 2012 were included in a retrospective study. Total thyroidectomy was performed for Graves' disease, toxic multinodular goiter and amiodarone-associated thyrotoxicosis; patients with toxic nodule underwent hemithyroidectomy. Pathologic analysis assessed surgical specimens; postoperative complications and resolution of hyperthyroidism were noted. Two hundred patients from 15 to 83 years old were included. One hundred and eighty-eight underwent primary surgery and 12 were re-operated for recurrent goiter (6 with subtotal thyroidectomy for multinodular goiter 25 years previously; 6 with hemithyroidectomy for solitary nodule 15 years previously). Eighty-two patients suffered from toxic multinodular goiter, 78 from Graves' disease, 35 from solitary toxic nodules and 5 from amiodarone-associated thyrotoxicosis. Fourteen papillary carcinomas (including 11 papillary microcarcinomas) and 34 healthy parathyroid glands (17%) were identified in the pathological specimens. Postoperative complications comprised 4% permanent recurrent laryngeal nerve palsy (1 year follow-up), 9% hematoma requiring surgical revision, and 3% definitive hypocalcemia. Normalization of thyroid hormone levels was observed in 198 patients. Two recurrences occurred due to incomplete resection (1 case of Graves' disease and 1 intrathoracic toxic goiter that occurred respectively 18 and 5 months after resection). Postoperative complications were more frequent in multinodular goiter (23%) than in Graves' disease (13%) (ns: P>0.05). Surgical management of hyperthyroidism enables good endocrinal control if surgery is complete. Patients need to be fully informed of all possible postoperative complications

  8. [Duane vertical surgical treatment].

    Science.gov (United States)

    Merino, M L; Gómez de Liaño, P; Merino, P; Franco, G

    2014-04-01

    We report 3 cases with a vertical incomitance in upgaze, narrowing of palpebral fissure, and pseudo-overaction of both inferior oblique muscles. Surgery consisted of an elevation of both lateral rectus muscles with an asymmetrical weakening. A satisfactory result was achieved in 2 cases, whereas a Lambda syndrome appeared in the other case. The surgical technique of upper-insertion with a recession of both lateral rectus muscles improved vertical incomitance in 2 of the 3 patients; however, a residual deviation remains in the majority of cases. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  9. Ergonomic analysis of primary and assistant surgical roles.

    Science.gov (United States)

    Zihni, Ahmed M; Cavallo, Jaime A; Ray, Shuddhadeb; Ohu, Ikechukwu; Cho, Sohyung; Awad, Michael M

    2016-06-15

    Laparoscopic surgery is associated with a high degree of ergonomic stress. However, the stress associated with surgical assisting is not known. In this study, we compare the ergonomic stress associated with primary and assistant surgical roles during laparoscopic surgery. We hypothesize that higher ergonomic stress will be detected in the primary operating surgeon when compared with the surgical assistant. One right-hand dominant attending surgeon performed 698 min of laparoscopic surgery over 13 procedures (222 min primary and 476 min assisting), whereas electromyography data were collected from bilateral biceps, triceps, deltoids, and trapezius muscles. Data were analyzed in 1-min segments. Average muscle activation as quantified by maximal voluntary contraction (%MVC) was calculated for each muscle group during primary surgery and assisting. We compared mean %MVC values with unpaired t-tests. Activation of right (R) biceps and triceps muscle groups is significantly elevated while operating when compared with assisting (R biceps primary: 5.47 ± 0.21 %MVC, assistant: 3.93 ± 0.11, P ergonomic differences between operating and assisting. Surgical assisting was associated with similar and occasionally higher levels of muscle activation compared with primary operating. These findings suggest that surgical assistants face significant ergonomic stress, just as operating surgeons do. Steps must be taken to recognize and mitigate this stress in both operating surgeons and assistants. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Time preferences, study effort, and academic performance

    NARCIS (Netherlands)

    Non, J.A.; Tempelaar, D.T.

    2014-01-01

    We analyze the relation between time preferences, study effort, and academic performance among first-year Business and Economics students. Time preferences are measured by stated preferences for an immediate payment over larger delayed payments. Data on study efforts are derived from an electronic

  11. Interests, Effort, Achievement and Vocational Preference.

    Science.gov (United States)

    Sjoberg, L.

    1984-01-01

    Relationships between interest in natural sciences and technology and perceived ability, success, and invested effort were studied in Swedish secondary school students. Interests were accounted for by logical orientation and practical value. Interests and grades were strongly correlated, but correlations between interests and effort and vocational…

  12. Dopamine and Effort-Based Decision Making

    Directory of Open Access Journals (Sweden)

    Irma Triasih Kurniawan

    2011-06-01

    Full Text Available Motivational theories of choice focus on the influence of goal values and strength of reinforcement to explain behavior. By contrast relatively little is known concerning how the cost of an action, such as effort expended, contributes to a decision to act. Effort-based decision making addresses how we make an action choice based on an integration of action and goal values. Here we review behavioral and neurobiological data regarding the representation of effort as action cost, and how this impacts on decision making. Although organisms expend effort to obtain a desired reward there is a striking sensitivity to the amount of effort required, such that the net preference for an action decreases as effort cost increases. We discuss the contribution of the neurotransmitter dopamine (DA towards overcoming response costs and in enhancing an animal’s motivation towards effortful actions. We also consider the contribution of brain structures, including the basal ganglia (BG and anterior cingulate cortex (ACC, in the internal generation of action involving a translation of reward expectation into effortful action.

  13. Listening Effort With Cochlear Implant Simulations

    NARCIS (Netherlands)

    Pals, Carina; Sarampalis, Anastasios; Başkent, Deniz

    2013-01-01

    Purpose: Fitting a cochlear implant (CI) for optimal speech perception does not necessarily optimize listening effort. This study aimed to show that listening effort may change between CI processing conditions for which speech intelligibility remains constant. Method: Nineteen normal-hearing

  14. Effort and Selection Effects of Incentive Contracts

    NARCIS (Netherlands)

    Bouwens, J.F.M.G.; van Lent, L.A.G.M.

    2003-01-01

    We show that the improved effort of employees associated with incentive contracts depends on the properties of the performance measures used in the contract.We also find that the power of incentives in the contract is only indirectly related to any improved employee effort.High powered incentive

  15. The Effect of Age on Listening Effort

    Science.gov (United States)

    Degeest, Sofie; Keppler, Hannah; Corthals, Paul

    2015-01-01

    Purpose: The objective of this study was to investigate the effect of age on listening effort. Method: A dual-task paradigm was used to evaluate listening effort in different conditions of background noise. Sixty adults ranging in age from 20 to 77 years were included. A primary speech-recognition task and a secondary memory task were performed…

  16. [Surgical treatment of gynecomastia].

    Science.gov (United States)

    Târcoveanu, E; Lupaşcu, C; Vasilescu, A; Moldovanu, R; Ichim, Mihaela; Georgescu, St; Niculescu, D; Dănilă, N; Dimofte, G; Anton, Raluca; Crumpei, Felicia; Florea, Niculina; Ungureanu, Cristina

    2008-01-01

    Gynecomastia describes a benign increase of the mammary gland in men. When medical treatment fails, the surgical procedure is the treatment of choice. There are two main surgical procedures: subdermal mastectomy and liposuction. To evaluate the results after surgical treatment (mastectomy) performed in a general surgery unit. We performed a retrospective study; all the patients operated for gynecomastia were reviewed. The clinical, imaging, biological, intraoperative and histological data were included into a MS Access database and statistical analyzed. From 1990-2007, 114 patients were admitted in the First Surgical Clinic Iaşi for gynecomastia. Only 12.6% from the patients were with bilateral gynecomastia. The mean age was 40.54 +/- 1.83 years old (range 12-84). Mean body mass was 26.72 +/- 0.46 kg/m2 (range 18.5-41), and about 20% from the patients had a BMI of over 30 kg/m2. We also noted that 46.5% were smokers. Simon classification was used for preoperative staging: 2.6% from the cases (N = 3) were included in stage I, 16.7% (N = 19) in stage IIa, 50% (N = 57) in stage IIb and 30.7% in stage III. The patients included in stages IIa and I are younger then the patients included in stage III (p = 0.024). Mastodynia was noted in 46 cases (40.4%). Ultrasound exam was performed in all the cases, and the larger diameter of the nodule measured was 3.75 +/- 0.18 cm (range 0.5-9.7). Only three cases were preoperatively treated with tamoxifen. Most of the cases were operated using general anesthesia (53.5%). Mastectomy was performed by peri-areolar (70.2%), elliptical (28.9%) or radial (0.9%) incisions. The subdermal mastectomy using peri-areolar approach was performed especially for the cases included in stages I, IIa and IIb--p gynecomastia in 6 cases; the other cases presented dilated ducts. We also noted intraductal papillary hyperplasia in 87 cases and chronic inflammation in 35 cases. The histological exam also revealed intraductal papilloma--9 cases, fibro

  17. Inquiry in bibliography some of the bustan`s maxim

    Directory of Open Access Journals (Sweden)

    sajjad rahmatian

    2016-12-01

    Full Text Available Sa`di is on of those poets who`s has placed a special position to preaching and guiding the people and among his works, allocated throughout the text of bustan to advice and maxim on legal and ethical various subjects. Surely, sa`di on the way of to compose this work and expression of its moral point, direct or indirect have been affected by some previous sources and possibly using their content. The main purpose of this article is that the pay review of basis and sources of bustan`s maxims and show that sa`di when expression the maxims of this work has been affected by which of the texts and works. For this purpose is tried to with search and research on the resources that have been allocated more or less to the aphorisms, to discover and extract traces of influence sa`di from their moral and didactic content. From the most important the finding of this study can be mentioned that indirect effect of some pahlavi books of maxim (like maxims of azarbad marespandan and bozorgmehr book of maxim and also noted sa`di directly influenced of moral and ethical works of poets and writers before him, and of this, sa`di`s influence from abo- shakur balkhi maxims, ferdowsi and keikavus is remarkable and noteworthy.

  18. Can monkeys make investments based on maximized pay-off?

    Directory of Open Access Journals (Sweden)

    Sophie Steelandt

    2011-03-01

    Full Text Available Animals can maximize benefits but it is not known if they adjust their investment according to expected pay-offs. We investigated whether monkeys can use different investment strategies in an exchange task. We tested eight capuchin monkeys (Cebus apella and thirteen macaques (Macaca fascicularis, Macaca tonkeana in an experiment where they could adapt their investment to the food amounts proposed by two different experimenters. One, the doubling partner, returned a reward that was twice the amount given by the subject, whereas the other, the fixed partner, always returned a constant amount regardless of the amount given. To maximize pay-offs, subjects should invest a maximal amount with the first partner and a minimal amount with the second. When tested with the fixed partner only, one third of monkeys learned to remove a maximal amount of food for immediate consumption before investing a minimal one. With both partners, most subjects failed to maximize pay-offs by using different decision rules with each partner' quality. A single Tonkean macaque succeeded in investing a maximal amount to one experimenter and a minimal amount to the other. The fact that only one of over 21 subjects learned to maximize benefits in adapting investment according to experimenters' quality indicates that such a task is difficult for monkeys, albeit not impossible.

  19. Low-effort thought promotes political conservatism.

    Science.gov (United States)

    Eidelman, Scott; Crandall, Christian S; Goodman, Jeffrey A; Blanchar, John C

    2012-06-01

    The authors test the hypothesis that low-effort thought promotes political conservatism. In Study 1, alcohol intoxication was measured among bar patrons; as blood alcohol level increased, so did political conservatism (controlling for sex, education, and political identification). In Study 2, participants under cognitive load reported more conservative attitudes than their no-load counterparts. In Study 3, time pressure increased participants' endorsement of conservative terms. In Study 4, participants considering political terms in a cursory manner endorsed conservative terms more than those asked to cogitate; an indicator of effortful thought (recognition memory) partially mediated the relationship between processing effort and conservatism. Together these data suggest that political conservatism may be a process consequence of low-effort thought; when effortful, deliberate thought is disengaged, endorsement of conservative ideology increases.

  20. Surgical Instrument Sets for Special Operations Expeditionary Surgical Teams.

    Science.gov (United States)

    Hale, Diane F; Sexton, Justin C; Benavides, Linda C; Benavides, Jerry M; Lundy, Jonathan B

    The deployment of surgical assets has been driven by mission demands throughout years of military operations in Iraq and Afghanistan. The transition to the highly expeditious Golden Hour Offset Surgical Transport Team (GHOST- T) now offers highly mobile surgical assets in nontraditional operating rooms; the content of the surgical instrument sets has also transformed to accommodate this change. The 102nd Forward Surgical Team (FST) was attached to Special Operations assigned to southern Afghanistan from June 2015 to March 2016. The focus was to decrease overall size and weight of FST instrument sets without decreasing surgical capability of the GHOST-T. Each instrument set was evaluated and modified to include essential instruments to perform damage control surgery. The overall number of main instrument sets was decreased from eight to four; simplified augmentation sets have been added, which expand the capabilities of any main set. The overall size was decreased by 40% and overall weight decreased by 58%. The cardiothoracic, thoracotomy, and emergency thoracotomy trays were condensed to thoracic set. The orthopedic and amputation sets were replaced with an augmentation set of a prepackaged orthopedic external fixator set). An augmentation set to the major or minor basic sets, specifically for vascular injuries, was created. Through the reorganization of conventional FST surgical instrument sets to maintain damage control capabilities and mobility, the 102nd GHOST-T reduced surgical equipment volume and weight, providing a lesson learned for future surgical teams operating in austere environments. 2017.

  1. Gravitational collapse of charged dust shell and maximal slicing condition

    International Nuclear Information System (INIS)

    Maeda, Keiichi

    1980-01-01

    The maximal slicing condition is a good time coordinate condition qualitatively when pursuing the gravitational collapse by the numerical calculation. The analytic solution of the gravitational collapse under the maximal slicing condition is given in the case of a spherical charged dust shell and the behavior of time slices with this coordinate condition is investigated. It is concluded that under the maximal slicing condition we can pursue the gravitational collapse until the radius of the shell decreases to about 0.7 x (the radius of the event horizon). (author)

  2. Optimal quantum error correcting codes from absolutely maximally entangled states

    Science.gov (United States)

    Raissi, Zahra; Gogolin, Christian; Riera, Arnau; Acín, Antonio

    2018-02-01

    Absolutely maximally entangled (AME) states are pure multi-partite generalizations of the bipartite maximally entangled states with the property that all reduced states of at most half the system size are in the maximally mixed state. AME states are of interest for multipartite teleportation and quantum secret sharing and have recently found new applications in the context of high-energy physics in toy models realizing the AdS/CFT-correspondence. We work out in detail the connection between AME states of minimal support and classical maximum distance separable (MDS) error correcting codes and, in particular, provide explicit closed form expressions for AME states of n parties with local dimension \

  3. Breakdown of maximality conjecture in continuous phase transitions

    International Nuclear Information System (INIS)

    Mukamel, D.; Jaric, M.V.

    1983-04-01

    A Landau-Ginzburg-Wilson model associated with a single irreducible representation which exhibits an ordered phase whose symmetry group is not a maximal isotropy subgroup of the symmetry group of the disordered phase is constructed. This example disproves the maximality conjecture suggested in numerous previous studies. Below the (continuous) transition, the order parameter points along a direction which varies with the temperature and with the other parameters which define the model. An extension of the maximality conjecture to reducible representations was postulated in the context of Higgs symmetry breaking mechanism. Our model can also be extended to provide a counter example in these cases. (author)

  4. Maximizing Efficiency and Reducing Robotic Surgery Costs Using the NASA Task Load Index.

    Science.gov (United States)

    Walters, Carrie; Webb, Paula J

    2017-10-01

    Perioperative leaders at our facility were struggling to meet efficiency targets for robotic surgery procedures while also maintaining the satisfaction of the surgical team. We developed a human resources time and motion study tool and used it in conjunction with the NASA Task Load Index to observe and analyze the required workload of personnel assigned to 25 robotic surgery procedures. The time and motion study identified opportunities to enlist the help of nonlicensed support personnel to ensure safe patient care and improve OR efficiency. Using the NASA Task Load Index demonstrated that high temporal, effort, and physical demands existed for personnel assisting with and performing robotic surgery. We believe that this process could be used to develop cost-effective staffing models, resulting in safe and efficient care for all surgical patients. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  5. Global curriculum in surgical oncology.

    Science.gov (United States)

    Are, C; Berman, R S; Wyld, L; Cummings, C; Lecoq, C; Audisio, R A

    2016-06-01

    The significant global variations in surgical oncology training paradigms can have a detrimental effect on tackling the rising global cancer burden. While some variations in training are essential to account for the differences in types of cancer and biology, the fundamental principles of providing care to a cancer patient remain the same. The development of a global curriculum in surgical oncology with incorporated essential standards could be very useful in building an adequately trained surgical oncology workforce, which in turn could help in tackling the rising global cancer burden. The leaders of the Society of Surgical Oncology and European Society of Surgical Oncology convened a global curriculum committee to develop a global curriculum in surgical oncology. A global curriculum in surgical oncology was developed to incorporate the required domains considered to be essential in training a surgical oncologist. The curriculum was constructed in a modular fashion to permit flexibility to suit the needs of the different regions of the world. Similarly, recognizing the various sociocultural, financial and cultural influences across the world, the proposed curriculum is aspirational and not mandatory in intent. A global curriculum was developed which may be considered as a foundational scaffolding for training surgical oncologists worldwide. It is envisioned that this initial global curriculum will provide a flexible and modular scaffolding that can be tailored by individual countries or regions to train surgical oncologists in a way that is appropriate for practice in their local environment. Copyright © 2016 Society of Surgical Oncology, European Society of Surgical Oncology. Published by Elsevier Ltd.. All rights reserved.

  6. Visual cues and listening effort: individual variability.

    Science.gov (United States)

    Picou, Erin M; Ricketts, Todd A; Hornsby, Benjamin W Y

    2011-10-01

    To investigate the effect of visual cues on listening effort as well as whether predictive variables such as working memory capacity (WMC) and lipreading ability affect the magnitude of listening effort. Twenty participants with normal hearing were tested using a paired-associates recall task in 2 conditions (quiet and noise) and 2 presentation modalities (audio only [AO] and auditory-visual [AV]). Signal-to-noise ratios were adjusted to provide matched speech recognition across audio-only and AV noise conditions. Also measured were subjective perceptions of listening effort and 2 predictive variables: (a) lipreading ability and (b) WMC. Objective and subjective results indicated that listening effort increased in the presence of noise, but on average the addition of visual cues did not significantly affect the magnitude of listening effort. Although there was substantial individual variability, on average participants who were better lipreaders or had larger WMCs demonstrated reduced listening effort in noise in AV conditions. Overall, the results support the hypothesis that integrating auditory and visual cues requires cognitive resources in some participants. The data indicate that low lipreading ability or low WMC is associated with relatively effortful integration of auditory and visual information in noise.

  7. Patient satisfaction and quality of surgical care in US hospitals.

    Science.gov (United States)

    Tsai, Thomas C; Orav, E John; Jha, Ashish K

    2015-01-01

    The relationship between patient satisfaction and surgical quality is unclear for US hospitals. Using national data, we examined if hospitals with high patient satisfaction have lower levels of performance on accepted measures of the quality and efficiency of surgical care. Federal policymakers have made patient satisfaction a core measure for the way hospitals are evaluated and paid through the value-based purchasing program. There is broad concern that performance on patient satisfaction may have little or even a negative correlation with the quality of surgical care, leading to potential trade-offs in efforts to improve patient experience with other surgical quality measures. We used the Hospital Consumer Assessment of Healthcare Providers and Systems survey data from 2010 and 2011 to assess performance on patient experience. We used national Medicare data on 6 common surgical procedures to calculate measures of surgical efficiency and quality: risk-adjusted length of stay, process score, risk-adjusted mortality rate, risk-adjusted readmission rate, and a composite z score across all 4 metrics. Multivariate models adjusting for hospital characteristics were used to assess the independent relationships between patient satisfaction and measures of surgical efficiency and quality. Of the 2953 US hospitals that perform one of these 6 procedures, the median patient satisfaction score was 69.5% (interquartile range, 63%-75.5%). Length of stay was shorter in hospitals with the highest levels of patient satisfaction (7.1 days vs 7.7 days, P patient satisfaction had the higher process of care performance (96.5 vs 95.5, P patient satisfaction also had a higher composite score for quality across all measures (P patient satisfaction provided more efficient care and were associated with higher surgical quality. Our findings suggest there need not be a trade-off between good quality of care for surgical patients and ensuring a positive patient experience.

  8. VEIL Surgical Steps.

    Science.gov (United States)

    Raghunath, S K; Nagaraja, H; Srivatsa, N

    2017-03-01

    Inguinal lymphadenectomy remains the standard of care for metastatic nodal disease in cases of penile, urethral, vulval and vaginal cancers. Outcomes, including cure rates and overall and progression-free survivals, have progressively improved in these diseases with extending criteria to offer inguinal lymph node dissection for patients 'at-risk' for metastasis or loco-regional recurrence. Hence, despite declining incidence of advanced stages of these cancers, many patients will still need to undergo lymphadenectomy for optimal oncological outcomes. Inguinal node dissection is a morbid procedure with operative morbidity noted in almost two third of the patients. Video endoscopic inguinal lymphadenectomy (VEIL) was described and currently practiced with proven equivalent oncological outcomes. We describe our technique of VEIL using laparoscopic and robotic access as well as various new surgical strategies.

  9. Aggressive surgical management of craniopharyngiomas

    Directory of Open Access Journals (Sweden)

    Manmohan Singh

    2013-01-01

    Full Text Available Surgical treatment of craniopharyngiomas is challenging and despite advancements it continues to pose a challenge. Proponents of subtotal resection in conjunction with radiotherapy argue that this less aggressive approach can yield appropriate results with the lower morbidity. On the contrary, other argument is that gross total resection is superior. Though surgical management of craniopharyngioma is challenging due to its location and important surrounding neurovascular structures, optimal surgical results can be expected following radical surgical excision. Radical excision of craniopharyngiomas is associated with excellent long-term recurrence free survival. Radiation induced long-term complications can be altogether avoided by excising these tumors completely.

  10. Surgical treatment of parastomal hernia

    International Nuclear Information System (INIS)

    Basti, Z.; Mayer, A.

    2013-01-01

    Stoma construction is among standard surgical skills and is performed for many indications. Every stoma means huge impact on quality of life for patients even with great improvement in surgical technique and ostomy devices. All patients are very sensitive to complication of stoma and the most frequent complication is parastomal hernia. Incidence reported in literature is very high and unacceptable, it is 30-70%. Surgical approach is very demanding on technical equipment and experiences of surgeon. Authors focus on each surgical approach for treating this complication weather it´s using mesh or laparoscopic or open approach. (author)

  11. Reference Values for Maximal Inspiratory Pressure: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Isabela MB Sclauser Pessoa

    2014-01-01

    Full Text Available BACKGROUND: Maximal inspiratory pressure (MIP is the most commonly used measure to evaluate inspiratory muscle strength. Normative values for MIP vary significantly among studies, which may reflect differences in participant demographics and technique of MIP measurement.

  12. Classification of conformal representations induced from the maximal cuspidal parabolic

    Energy Technology Data Exchange (ETDEWEB)

    Dobrev, V. K., E-mail: dobrev@inrne.bas.bg [Scuola Internazionale Superiore di Studi Avanzati (Italy)

    2017-03-15

    In the present paper we continue the project of systematic construction of invariant differential operators on the example of representations of the conformal algebra induced from the maximal cuspidal parabolic.

  13. Maximizing Your Investment in Building Automation System Technology.

    Science.gov (United States)

    Darnell, Charles

    2001-01-01

    Discusses how organizational issues and system standardization can be important factors that determine an institution's ability to fully exploit contemporary building automation systems (BAS). Further presented is management strategy for maximizing BAS investments. (GR)

  14. Eccentric exercise decreases maximal insulin action in humans

    DEFF Research Database (Denmark)

    Asp, Svend; Daugaard, J R; Kristiansen, S

    1996-01-01

    subjects participated in two euglycaemic clamps, performed in random order. One clamp was preceded 2 days earlier by one-legged eccentric exercise (post-eccentric exercise clamp (PEC)) and one was without the prior exercise (control clamp (CC)). 2. During PEC the maximal insulin-stimulated glucose uptake...... for all three clamp steps used (P maximal activity of glycogen synthase was identical in the two thighs for all clamp steps. 3. The glucose infusion rate (GIR......) necessary to maintain euglycaemia during maximal insulin stimulation was lower during PEC compared with CC (15.7%, 81.3 +/- 3.2 vs. 96.4 +/- 8.8 mumol kg-1 min-1, P maximal...

  15. Maximal slicing of D-dimensional spherically symmetric vacuum spacetime

    International Nuclear Information System (INIS)

    Nakao, Ken-ichi; Abe, Hiroyuki; Yoshino, Hirotaka; Shibata, Masaru

    2009-01-01

    We study the foliation of a D-dimensional spherically symmetric black-hole spacetime with D≥5 by two kinds of one-parameter families of maximal hypersurfaces: a reflection-symmetric foliation with respect to the wormhole slot and a stationary foliation that has an infinitely long trumpetlike shape. As in the four-dimensional case, the foliations by the maximal hypersurfaces avoid the singularity irrespective of the dimensionality. This indicates that the maximal slicing condition will be useful for simulating higher-dimensional black-hole spacetimes in numerical relativity. For the case of D=5, we present analytic solutions of the intrinsic metric, the extrinsic curvature, the lapse function, and the shift vector for the foliation by the stationary maximal hypersurfaces. These data will be useful for checking five-dimensional numerical-relativity codes based on the moving puncture approach.

  16. ICTs and Urban Micro Enterprises : Maximizing Opportunities for ...

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

    ICTs and Urban Micro Enterprises : Maximizing Opportunities for Economic Development ... the use of ICTs in micro enterprises and their role in reducing poverty. ... in its approach to technological connectivity but bottom-up in relation to.

  17. Programming effort analysis of the ELLPACK language

    Science.gov (United States)

    Rice, J. R.

    1978-01-01

    ELLPACK is a problem statement language and system for elliptic partial differential equations which is implemented by a FORTRAN preprocessor. ELLPACK's principal purpose is as a tool for the performance evaluation of software. However, it is used here as an example with which to study the programming effort required for problem solving. It is obvious that problem statement languages can reduce programming effort tremendously; the goal is to quantify this somewhat. This is done by analyzing the lengths and effort (as measured by Halstead's software science technique) of various approaches to solving these problems.

  18. Establishing Maximal Medical Improvement After Arthroscopic Rotator Cuff Repair.

    Science.gov (United States)

    Zuke, William A; Leroux, Timothy S; Gregory, Bonnie P; Black, Austin; Forsythe, Brian; Romeo, Anthony A; Verma, Nikhil N

    2018-03-01

    As health care transitions from a pay-for-service to a pay-for-performance infrastructure, the value of orthopaedic care must be defined accurately. Significant efforts have been made in defining quality and cost in arthroplasty; however, there remains a lag in ambulatory orthopaedic care. Two-year follow-up has been a general requirement for reporting outcomes after rotator cuff repair. However, this time requirement has not been established scientifically and is of increasing importance in the era of value-based health care. Given that arthroscopic rotator cuff repair is a common ambulatory orthopaedic procedure, the purpose of this study was to establish a time frame for maximal medical improvement (the state when improvement has stabilized) after arthroscopic rotator cuff repair. Systematic review. A systematic review of the literature was conducted, identifying studies reporting sequential patient-reported outcomes up to a minimum of 2 years after arthroscopic rotator cuff repair. The primary clinical outcome was patient-reported outcomes at 3-month, 6-month, 1-year, and 2-year follow-up. Secondary clinical outcomes included range of motion, strength, retears, and complications. Clinically significant improvement was determined between various time intervals by use of the minimal clinically important difference. The review included 19 studies including 1370 patients who underwent rotator cuff repair. Clinically significant improvement in patient-reported outcomes was seen up to 1 year after rotator cuff repair, but no clinical significance was noted from 1 year to 2 years. The majority of improvement in strength and range of motion was seen up to 6 months, but no clinically meaningful improvement was seen thereafter. All reported complications and the majority of retears occurred within 6 months after rotator cuff repair. After rotator cuff repair, a clinically significant improvement in patient-reported outcomes, range of motion, and strength was seen up to 1

  19. Nonadditive entropy maximization is inconsistent with Bayesian updating

    Science.gov (United States)

    Pressé, Steve

    2014-11-01

    The maximum entropy method—used to infer probabilistic models from data—is a special case of Bayes's model inference prescription which, in turn, is grounded in basic propositional logic. By contrast to the maximum entropy method, the compatibility of nonadditive entropy maximization with Bayes's model inference prescription has never been established. Here we demonstrate that nonadditive entropy maximization is incompatible with Bayesian updating and discuss the immediate implications of this finding. We focus our attention on special cases as illustrations.

  20. Sex differences in autonomic function following maximal exercise.

    Science.gov (United States)

    Kappus, Rebecca M; Ranadive, Sushant M; Yan, Huimin; Lane-Cordova, Abbi D; Cook, Marc D; Sun, Peng; Harvey, I Shevon; Wilund, Kenneth R; Woods, Jeffrey A; Fernhall, Bo

    2015-01-01

    Heart rate variability (HRV), blood pressure variability, (BPV) and heart rate recovery (HRR) are measures that provide insight regarding autonomic function. Maximal exercise can affect autonomic function, and it is unknown if there are sex differences in autonomic recovery following exercise. Therefore, the purpose of this study was to determine sex differences in several measures of autonomic function and the response following maximal exercise. Seventy-one (31 males and 40 females) healthy, nonsmoking, sedentary normotensive subjects between the ages of 18 and 35 underwent measurements of HRV and BPV at rest and following a maximal exercise bout. HRR was measured at minute one and two following maximal exercise. Males have significantly greater HRR following maximal exercise at both minute one and two; however, the significance between sexes was eliminated when controlling for VO2 peak. Males had significantly higher resting BPV-low-frequency (LF) values compared to females and did not significantly change following exercise, whereas females had significantly increased BPV-LF values following acute maximal exercise. Although males and females exhibited a significant decrease in both HRV-LF and HRV-high frequency (HF) with exercise, females had significantly higher HRV-HF values following exercise. Males had a significantly higher HRV-LF/HF ratio at rest; however, both males and females significantly increased their HRV-LF/HF ratio following exercise. Pre-menopausal females exhibit a cardioprotective autonomic profile compared to age-matched males due to lower resting sympathetic activity and faster vagal reactivation following maximal exercise. Acute maximal exercise is a sufficient autonomic stressor to demonstrate sex differences in the critical post-exercise recovery period.

  1. Power Converters Maximize Outputs Of Solar Cell Strings

    Science.gov (United States)

    Frederick, Martin E.; Jermakian, Joel B.

    1993-01-01

    Microprocessor-controlled dc-to-dc power converters devised to maximize power transferred from solar photovoltaic strings to storage batteries and other electrical loads. Converters help in utilizing large solar photovoltaic arrays most effectively with respect to cost, size, and weight. Main points of invention are: single controller used to control and optimize any number of "dumb" tracker units and strings independently; power maximized out of converters; and controller in system is microprocessor.

  2. Maximally flat radiation patterns of a circular aperture

    Science.gov (United States)

    Minkovich, B. M.; Mints, M. Ia.

    1989-08-01

    The paper presents an explicit solution to the problems of maximizing the area utilization coefficient and of obtaining the best approximation (on the average) of a sectorial Pi-shaped radiation pattern of an antenna with a circular aperture when Butterworth conditions are imposed on the approximating pattern with the aim of flattening it. Constraints on the choice of admissible minimum and maximum antenna dimensions are determined which make possible the synthesis of maximally flat patterns with small sidelobes.

  3. Design of optimal linear antennas with maximally flat radiation patterns

    Science.gov (United States)

    Minkovich, B. M.; Mints, M. Ia.

    1990-02-01

    The paper presents an explicit solution to the problem of maximizing the aperture area utilization coefficient and obtaining the best approximation in the mean of the sectorial U-shaped radiation pattern of a linear antenna, when Butterworth flattening constraints are imposed on the approximating pattern. Constraints are established on the choice of the smallest and large antenna dimensions that make it possible to obtain maximally flat patterns, having a low sidelobe level and free from pulsations within the main lobe.

  4. No Mikheyev-Smirnov-Wolfenstein Effect in Maximal Mixing

    OpenAIRE

    Harrison, P. F.; Perkins, D. H.; Scott, W. G.

    1996-01-01

    We investigate the possible influence of the MSW effect on the expectations for the solar neutrino experiments in the maximal mixing scenario suggested by the atmospheric neutrino data. A direct numerical calculation of matter induced effects in the Sun shows that the naive vacuum predictions are left completely undisturbed in the particular case of maximal mixing, so that the MSW effect turns out to be unobservable. We give a qualitative explanation of this result.

  5. A New Augmentation Based Algorithm for Extracting Maximal Chordal Subgraphs.

    Science.gov (United States)

    Bhowmick, Sanjukta; Chen, Tzu-Yi; Halappanavar, Mahantesh

    2015-02-01

    A graph is chordal if every cycle of length greater than three contains an edge between non-adjacent vertices. Chordal graphs are of interest both theoretically, since they admit polynomial time solutions to a range of NP-hard graph problems, and practically, since they arise in many applications including sparse linear algebra, computer vision, and computational biology. A maximal chordal subgraph is a chordal subgraph that is not a proper subgraph of any other chordal subgraph. Existing algorithms for computing maximal chordal subgraphs depend on dynamically ordering the vertices, which is an inherently sequential process and therefore limits the algorithms' parallelizability. In this paper we explore techniques to develop a scalable parallel algorithm for extracting a maximal chordal subgraph. We demonstrate that an earlier attempt at developing a parallel algorithm may induce a non-optimal vertex ordering and is therefore not guaranteed to terminate with a maximal chordal subgraph. We then give a new algorithm that first computes and then repeatedly augments a spanning chordal subgraph. After proving that the algorithm terminates with a maximal chordal subgraph, we then demonstrate that this algorithm is more amenable to parallelization and that the parallel version also terminates with a maximal chordal subgraph. That said, the complexity of the new algorithm is higher than that of the previous parallel algorithm, although the earlier algorithm computes a chordal subgraph which is not guaranteed to be maximal. We experimented with our augmentation-based algorithm on both synthetic and real-world graphs. We provide scalability results and also explore the effect of different choices for the initial spanning chordal subgraph on both the running time and on the number of edges in the maximal chordal subgraph.

  6. On Maximally Dissipative Shock Waves in Nonlinear Elasticity

    OpenAIRE

    Knowles, James K.

    2010-01-01

    Shock waves in nonlinearly elastic solids are, in general, dissipative. We study the following question: among all plane shock waves that can propagate with a given speed in a given one-dimensional nonlinearly elastic bar, which one—if any—maximizes the rate of dissipation? We find that the answer to this question depends strongly on the qualitative nature of the stress-strain relation characteristic of the given material. When maximally dissipative shocks do occur, they propagate according t...

  7. Maximal near-field radiative heat transfer between two plates

    OpenAIRE

    Nefzaoui, Elyes; Ezzahri, Younès; Drevillon, Jérémie; Joulain, Karl

    2013-01-01

    International audience; Near-field radiative transfer is a promising way to significantly and simultaneously enhance both thermo-photovoltaic (TPV) devices power densities and efficiencies. A parametric study of Drude and Lorentz models performances in maximizing near-field radiative heat transfer between two semi-infinite planes separated by nanometric distances at room temperature is presented in this paper. Optimal parameters of these models that provide optical properties maximizing the r...

  8. Enumerating all maximal frequent subtrees in collections of phylogenetic trees.

    Science.gov (United States)

    Deepak, Akshay; Fernández-Baca, David

    2014-01-01

    A common problem in phylogenetic analysis is to identify frequent patterns in a collection of phylogenetic trees. The goal is, roughly, to find a subset of the species (taxa) on which all or some significant subset of the trees agree. One popular method to do so is through maximum agreement subtrees (MASTs). MASTs are also used, among other things, as a metric for comparing phylogenetic trees, computing congruence indices and to identify horizontal gene transfer events. We give algorithms and experimental results for two approaches to identify common patterns in a collection of phylogenetic trees, one based on agreement subtrees, called maximal agreement subtrees, the other on frequent subtrees, called maximal frequent subtrees. These approaches can return subtrees on larger sets of taxa than MASTs, and can reveal new common phylogenetic relationships not present in either MASTs or the majority rule tree (a popular consensus method). Our current implementation is available on the web at https://code.google.com/p/mfst-miner/. Our computational results confirm that maximal agreement subtrees and all maximal frequent subtrees can reveal a more complete phylogenetic picture of the common patterns in collections of phylogenetic trees than maximum agreement subtrees; they are also often more resolved than the majority rule tree. Further, our experiments show that enumerating maximal frequent subtrees is considerably more practical than enumerating ordinary (not necessarily maximal) frequent subtrees.

  9. Softly Broken Lepton Numbers: an Approach to Maximal Neutrino Mixing

    International Nuclear Information System (INIS)

    Grimus, W.; Lavoura, L.

    2001-01-01

    We discuss models where the U(1) symmetries of lepton numbers are responsible for maximal neutrino mixing. We pay particular attention to an extension of the Standard Model (SM) with three right-handed neutrino singlets in which we require that the three lepton numbers L e , L μ , and L τ be separately conserved in the Yukawa couplings, but assume that they are softly broken by the Majorana mass matrix M R of the neutrino singlets. In this framework, where lepton-number breaking occurs at a scale much higher than the electroweak scale, deviations from family lepton number conservation are calculable, i.e., finite, and lepton mixing stems exclusively from M R . We show that in this framework either maximal atmospheric neutrino mixing or maximal solar neutrino mixing or both can be imposed by invoking symmetries. In this way those maximal mixings are stable against radiative corrections. The model which achieves maximal (or nearly maximal) solar neutrino mixing assumes that there are two different scales in M R and that the lepton number (dash)L=L e -L μ -L τ 1 is conserved in between them. We work out the difference between this model and the conventional scenario where (approximate) (dash)L invariance is imposed directly on the mass matrix of the light neutrinos. (author)

  10. Enumerating all maximal frequent subtrees in collections of phylogenetic trees

    Science.gov (United States)

    2014-01-01

    Background A common problem in phylogenetic analysis is to identify frequent patterns in a collection of phylogenetic trees. The goal is, roughly, to find a subset of the species (taxa) on which all or some significant subset of the trees agree. One popular method to do so is through maximum agreement subtrees (MASTs). MASTs are also used, among other things, as a metric for comparing phylogenetic trees, computing congruence indices and to identify horizontal gene transfer events. Results We give algorithms and experimental results for two approaches to identify common patterns in a collection of phylogenetic trees, one based on agreement subtrees, called maximal agreement subtrees, the other on frequent subtrees, called maximal frequent subtrees. These approaches can return subtrees on larger sets of taxa than MASTs, and can reveal new common phylogenetic relationships not present in either MASTs or the majority rule tree (a popular consensus method). Our current implementation is available on the web at https://code.google.com/p/mfst-miner/. Conclusions Our computational results confirm that maximal agreement subtrees and all maximal frequent subtrees can reveal a more complete phylogenetic picture of the common patterns in collections of phylogenetic trees than maximum agreement subtrees; they are also often more resolved than the majority rule tree. Further, our experiments show that enumerating maximal frequent subtrees is considerably more practical than enumerating ordinary (not necessarily maximal) frequent subtrees. PMID:25061474

  11. Illinois highway materials sustainability efforts of 2015.

    Science.gov (United States)

    2016-08-01

    This report provides a summary of the sustainability efforts of the Illinois Department of Transportation (IDOT) in recycling : reclaimed materials in highway construction during calendar year 2015. This report meets the requirements of Illinois Publ...

  12. EU grid computing effort takes on malaria

    CERN Multimedia

    Lawrence, Stacy

    2006-01-01

    Malaria is the world's most common parasitic infection, affecting more thatn 500 million people annually and killing more than 1 million. In order to help combat malaria, CERN has launched a grid computing effort (1 page)

  13. Illinois highway materials sustainability efforts of 2014.

    Science.gov (United States)

    2015-08-01

    This report presents the 2014 sustainability efforts of the Illinois Department of Transportation (IDOT) in : recycling reclaimed materials in highway construction. This report meets the requirements of Illinois : Public Act 097-0314 by documenting I...

  14. Illinois highway materials sustainability efforts of 2016.

    Science.gov (United States)

    2017-07-04

    This report provides a summary of the sustainability efforts of the Illinois Department of Transportation (IDOT) in recycling : reclaimed materials in highway construction during calendar year 2016. This report meets the requirements of Illinois Publ...

  15. Illinois highway materials sustainability efforts of 2013.

    Science.gov (United States)

    2014-08-01

    This report presents the sustainability efforts of the Illinois Department of Transportation (IDOT) in : recycling and reclaiming materials for use in highway construction. This report meets the requirements of : Illinois Public Act 097-0314 by docum...

  16. Surgical pathology report in the era of desktop publishing.

    Science.gov (United States)

    Pillarisetti, S G

    1993-01-01

    Since it is believed that "a picture is worth a thousand words," incorporation of computer-generated line art was used as a adjunct to gross description in surgical pathology reporting in selected cases. The lack of an integrated software program was overcome by using commercially available graphic and word processing software. A library of drawings was developed over the last few years. Most time-consuming is the development of templates and the graphic library. With some effort it is possible to integrate graphics of high quality into surgical pathology reports.

  17. Approaching maximal performance of longitudinal beam compression in induction accelerator drivers

    International Nuclear Information System (INIS)

    Mark, J.W.K.; Ho, D.D.M.; Brandon, S.T.; Chang, C.L.; Drobot, A.T.; Faltens, A.; Lee, E.P.; Krafft, G.A.

    1986-01-01

    Longitudinal beam compression is an integral part of the US induction accelerator development effort for heavy ion fusion. Producing maximal performance for key accelerator components is an essential element of the effort to reduce driver costs. We outline here initial studies directed towards defining the limits of final beam compression including considerations such as: maximal available compression, effects of longitudinal dispersion and beam emittance, combining pulse-shaping with beam compression to reduce the total number of beam manipulations, etc. The use of higher ion charge state Z greater than or equal to 3 is likely to test the limits of the previously envisaged beam compression and final focus hardware. A more conservative approach is to use additional beamlets in final compression and focus. On the other end of the spectrum of choices, alternate approaches might consider new final focus with greater tolerances for systematic momentum and current variations. Development of such final focus concepts would also allow more compact (and hopefully cheaper) hardware packages where the previously separate processes of beam compression, pulse-shaping and final focus occur as partially combined and nearly concurrent beam manipulations

  18. Optimizing fluorescently tethered Hsp90 inhibitor dose for maximal specific uptake by breast tumors

    Science.gov (United States)

    Crouch, Brian T.; Duer, Joy; Wang, Roujia; Gallagher, Jennifer; Hall, Allison; Soo, Mary Scott; Hughes, Philip; Haystead, Timothy A. J.; Ramanujam, Nirmala

    2018-03-01

    Despite improvements in surgical resection, 20-40% of patients undergoing breast conserving surgery require at least one additional re-excision. Leveraging the unique surface expression of heat shock protein 90 (Hsp90), a chaperone protein involved in several key hallmarks of cancer, in breast cancer provides an exciting opportunity to identify residual disease during surgery. We developed a completely non-destructive strategy using HS-27, a fluorescently-tethered Hsp90 inhibitor, to assay surface Hsp90 expression on intact tissue specimens using a fluorescence microendoscope with a field of view of 750 μm and subcellular resolution of 4 μm. HS-27 consists of an FDA approved Hsp90 inhibitor tethered to fluorescein isothiocyanate (EX 488nm, EM 525nm). Here, we optimized ex vivo HS-27 administration in pre-clinical breast cancer models and validated our approach on 21 patients undergoing standard of care ultrasound guided core needle biopsy. HS-27 administration time was fixed at 1- minute to minimize imaging impact on clinical workflow. HS-27 and HS-217 (non-specific control) doses were modulated from 1 μM up to 100 μM to identify the dose maximizing the ratio of specific uptake (HS-27 fluorescence) to non-specific uptake (HS-217 fluorescence). The specificity ratio was maximized at 100 μM and was significantly greater than all other doses (pcancer makes this technology attractive for assessing tumor margins, as one agent can be used for all subtypes.

  19. Challenges to the development of complex virtual reality surgical simulations.

    Science.gov (United States)

    Seymour, N E; Røtnes, J S

    2006-11-01

    Virtual reality simulation in surgical training has become more widely used and intensely investigated in an effort to develop safer, more efficient, measurable training processes. The development of virtual reality simulation of surgical procedures has begun, but well-described technical obstacles must be overcome to permit varied training in a clinically realistic computer-generated environment. These challenges include development of realistic surgical interfaces and physical objects within the computer-generated environment, modeling of realistic interactions between objects, rendering of the surgical field, and development of signal processing for complex events associated with surgery. Of these, the realistic modeling of tissue objects that are fully responsive to surgical manipulations is the most challenging. Threats to early success include relatively limited resources for development and procurement, as well as smaller potential for return on investment than in other simulation industries that face similar problems. Despite these difficulties, steady progress continues to be made in these areas. If executed properly, virtual reality offers inherent advantages over other training systems in creating a realistic surgical environment and facilitating measurement of surgeon performance. Once developed, complex new virtual reality training devices must be validated for their usefulness in formative training and assessment of skill to be established.

  20. Access to Specialized Surgical Care

    African Journals Online (AJOL)

    The ANNALS of AFRICAN SURGERY. January 2016 Volume 13 Issue 1 1. EDITORIAL. Access to Specialized Surgical Care. Saidi H. University of Nairobi. Correspondence to: Prof Hassan Saidi, P.O Box 30196-00100, Nairobi. Email: hsaid2ke@yahoo.com. Ann Afr Surg. 2016;13(1):1-2. The narrative of surgical disease in ...

  1. Surgical residency: A tenant's view

    African Journals Online (AJOL)

    'To sleep: perchance to dream', is the frequent mantra of the surgical resident. However, unlike. Hamlet, there is no ensuing speculation as to what dreams may come as there are seldom any!! Surgical residency has been both vilified and immortalized, but the fact remains that it is one of the most challenging, provocative ...

  2. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart

    2016-01-01

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

  3. Acquiring minimally invasive surgical skills

    NARCIS (Netherlands)

    Hiemstra, Ellen

    2012-01-01

    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room.

  4. Self-perceived readiness to perform at the attending level following surgical specialist training in Denmark

    DEFF Research Database (Denmark)

    Fabricius, Rasmus; Sillesen, Martin; Hansen, Morten Sejer

    2017-01-01

    INTRODUCTION: Great effort has been invested in improving the educational aspect of the Danish five-year national surgical residency programme. Among other initiatives, an updated logbook containing specific objectives was implemented in 2015. The effect of current and prior educational efforts has...

  5. Combined Surgical Treatment of Gynecomastia

    Directory of Open Access Journals (Sweden)

    Yordanov Y.

    2015-05-01

    Full Text Available Surgical treatment of gynecomastia could present unique challenges for the plastic surgeon. Achieving a good balance between effectiveness of the selected approach and the satisfactory aesthetic outcome often is a difficult endeavor. Optimal surgical treatment involves a combination of liposuction and direct excision. In the present study the charts of 11 patients treated with suction-assisted liposuction and direct surgical excision were retrospectively reviewed; a special emphasis is placed on the surgical technique. The mean follow-up period of the patients was 11.6 months. No infection, hematoma, nipple-areola complex necrosis and nipple retraction was encountered in this series. The combined surgical treatment of gynecomastia has shown to be a reliable technique in both small and moderate breast enlargement including those with skin excess.

  6. Output control of da Vinci surgical system's surgical graspers.

    Science.gov (United States)

    Johnson, Paul J; Schmidt, David E; Duvvuri, Umamaheswar

    2014-01-01

    The number of robot-assisted surgeries performed with the da Vinci surgical system has increased significantly over the past decade. The articulating movements of the robotic surgical grasper are controlled by grip controls at the master console. The user interface has been implicated as one contributing factor in surgical grasping errors. The goal of our study was to characterize and evaluate the user interface of the da Vinci surgical system in controlling surgical graspers. An angular manipulator with force sensors was used to increment the grip control angle as grasper output angles were measured. Input force at the grip control was simultaneously measured throughout the range of motion. Pressure film was used to assess the maximum grasping force achievable with the endoscopic grasping tool. The da Vinci robot's grip control angular input has a nonproportional relationship with the grasper instrument output. The grip control mechanism presents an intrinsic resistant force to the surgeon's fingertips and provides no haptic feedback. The da Vinci Maryland graspers are capable of applying up to 5.1 MPa of local pressure. The angular and force input at the grip control of the da Vinci robot's surgical graspers is nonproportional to the grasper instrument's output. Understanding the true relationship of the grip control input to grasper instrument output may help surgeons understand how to better control the surgical graspers and promote fewer grasping errors. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. The influence of stress responses on surgical performance and outcomes: Literature review and the development of the surgical stress effects (SSE) framework.

    Science.gov (United States)

    Chrouser, Kristin L; Xu, Jie; Hallbeck, Susan; Weinger, Matthew B; Partin, Melissa R

    2018-02-22

    Surgical adverse events persist despite several decades of system-based quality improvement efforts, suggesting the need for alternative strategies. Qualitative studies suggest stress-induced negative intraoperative interpersonal dynamics might contribute to performance errors and undesirable patient outcomes. Understanding the impact of intraoperative stressors may be critical to reducing adverse events and improving outcomes. We searched MEDLINE, psycINFO, EMBASE, Business Source Premier, and CINAHL databases (1996-2016) to assess the relationship between negative (emotional and behavioral) responses to acute intraoperative stressors and provider performance or patient surgical outcomes. Drawing on theory and evidence from reviewed studies, we present the Surgical Stress Effects (SSE) framework. This illustrates how emotional and behavioral responses to stressors can influence individual surgical provider (e.g. surgeon, nurse) performance, team performance, and patient outcomes. It also demonstrates how uncompensated intraoperative threats and errors can lead to adverse events, highlighting evidence gaps for future research efforts. Published by Elsevier Inc.

  8. Disk Density Tuning of a Maximal Random Packing.

    Science.gov (United States)

    Ebeida, Mohamed S; Rushdi, Ahmad A; Awad, Muhammad A; Mahmoud, Ahmed H; Yan, Dong-Ming; English, Shawn A; Owens, John D; Bajaj, Chandrajit L; Mitchell, Scott A

    2016-08-01

    We introduce an algorithmic framework for tuning the spatial density of disks in a maximal random packing, without changing the sizing function or radii of disks. Starting from any maximal random packing such as a Maximal Poisson-disk Sampling (MPS), we iteratively relocate, inject (add), or eject (remove) disks, using a set of three successively more-aggressive local operations. We may achieve a user-defined density, either more dense or more sparse, almost up to the theoretical structured limits. The tuned samples are conflict-free, retain coverage maximality, and, except in the extremes, retain the blue noise randomness properties of the input. We change the density of the packing one disk at a time, maintaining the minimum disk separation distance and the maximum domain coverage distance required of any maximal packing. These properties are local, and we can handle spatially-varying sizing functions. Using fewer points to satisfy a sizing function improves the efficiency of some applications. We apply the framework to improve the quality of meshes, removing non-obtuse angles; and to more accurately model fiber reinforced polymers for elastic and failure simulations.

  9. IMHOTEP: virtual reality framework for surgical applications.

    Science.gov (United States)

    Pfeiffer, Micha; Kenngott, Hannes; Preukschas, Anas; Huber, Matthias; Bettscheider, Lisa; Müller-Stich, Beat; Speidel, Stefanie

    2018-05-01

    The data which is available to surgeons before, during and after surgery is steadily increasing in quantity as well as diversity. When planning a patient's treatment, this large amount of information can be difficult to interpret. To aid in processing the information, new methods need to be found to present multimodal patient data, ideally combining textual, imagery, temporal and 3D data in a holistic and context-aware system. We present an open-source framework which allows handling of patient data in a virtual reality (VR) environment. By using VR technology, the workspace available to the surgeon is maximized and 3D patient data is rendered in stereo, which increases depth perception. The framework organizes the data into workspaces and contains tools which allow users to control, manipulate and enhance the data. Due to the framework's modular design, it can easily be adapted and extended for various clinical applications. The framework was evaluated by clinical personnel (77 participants). The majority of the group stated that a complex surgical situation is easier to comprehend by using the framework, and that it is very well suited for education. Furthermore, the application to various clinical scenarios-including the simulation of excitation propagation in the human atrium-demonstrated the framework's adaptability. As a feasibility study, the framework was used during the planning phase of the surgical removal of a large central carcinoma from a patient's liver. The clinical evaluation showed a large potential and high acceptance for the VR environment in a medical context. The various applications confirmed that the framework is easily extended and can be used in real-time simulation as well as for the manipulation of complex anatomical structures.

  10. Complementary roles of different oscillatory activities in the subthalamic nucleus in coding motor effort in Parkinsonism.

    Science.gov (United States)

    Tan, Huiling; Pogosyan, Alek; Anzak, Anam; Ashkan, Keyoumars; Bogdanovic, Marko; Green, Alexander L; Aziz, Tipu; Foltynie, Thomas; Limousin, Patricia; Zrinzo, Ludvic; Brown, Peter

    2013-10-01

    The basal ganglia may play an important role in the control of motor scaling or effort. Recently local field potential (LFP) recordings from patients with deep brain stimulation electrodes in the basal ganglia have suggested that local increases in the synchronisation of neurons in the gamma frequency band may correlate with force or effort. Whether this feature uniquely codes for effort and whether such a coding mechanism holds true over a range of efforts is unclear. Here we investigated the relationship between frequency-specific oscillatory activities in the subthalamic nucleus (STN) and manual grips made with different efforts. The latter were self-rated using the 10 level Borg scale ranging from 0 (no effort) to 10 (maximal effort). STN LFP activities were recorded in patients with Parkinson's Disease (PD) who had undergone functional surgery. Patients were studied while motor performance was improved by dopaminergic medication. In line with previous studies we observed power increase in the theta/alpha band (4-12 Hz), power suppression in the beta band (13-30 Hz) and power increase in the gamma band (55-90 Hz) and high frequency band (101-375 Hz) during voluntary grips. Beta suppression deepened, and then reached a floor level as effort increased. Conversely, gamma and high frequency power increases were enhanced during grips made with greater effort. Multiple regression models incorporating the four different spectral changes confirmed that the modulation of power in the beta band was the only independent predictor of effort during grips made with efforts rated <5. In contrast, increases in gamma band activity were the only independent predictor of effort during grips made with efforts ≥5. Accordingly, the difference between power changes in the gamma and beta bands correlated with effort across all effort levels. These findings suggest complementary roles for changes in beta and gamma band activities in the STN in motor effort coding. The latter function

  11. Teamwork and Collaboration for Prevention of Surgical Site Infections.

    Science.gov (United States)

    Dellinger, E Patchen

    2016-04-01

    The surgeon has been regarded as the "captain of the ship" in the operating room (OR) for many years, but cannot accomplish successful operative intervention without the rest of the team. Review of the pertinent English-language literature. Many reports demonstrate very different impressions of teamwork and communication in the OR held by different members of the surgical team. Objective measures of teamwork and communication demonstrate a reduction in complications including surgical site infections with improved teamwork and communication, with fewer distractions such as noise, and with effective use of checklists. Efforts to improve teamwork and communication and promote the effective use of checklists promote patient safety and improved outcomes for patients with reduction in surgical site infections.

  12. Quantization with maximally degenerate Poisson brackets: the harmonic oscillator!

    International Nuclear Information System (INIS)

    Nutku, Yavuz

    2003-01-01

    Nambu's construction of multi-linear brackets for super-integrable systems can be thought of as degenerate Poisson brackets with a maximal set of Casimirs in their kernel. By introducing privileged coordinates in phase space these degenerate Poisson brackets are brought to the form of Heisenberg's equations. We propose a definition for constructing quantum operators for classical functions, which enables us to turn the maximally degenerate Poisson brackets into operators. They pose a set of eigenvalue problems for a new state vector. The requirement of the single-valuedness of this eigenfunction leads to quantization. The example of the harmonic oscillator is used to illustrate this general procedure for quantizing a class of maximally super-integrable systems

  13. Quantum speedup in solving the maximal-clique problem

    Science.gov (United States)

    Chang, Weng-Long; Yu, Qi; Li, Zhaokai; Chen, Jiahui; Peng, Xinhua; Feng, Mang

    2018-03-01

    The maximal-clique problem, to find the maximally sized clique in a given graph, is classically an NP-complete computational problem, which has potential applications ranging from electrical engineering, computational chemistry, and bioinformatics to social networks. Here we develop a quantum algorithm to solve the maximal-clique problem for any graph G with n vertices with quadratic speedup over its classical counterparts, where the time and spatial complexities are reduced to, respectively, O (√{2n}) and O (n2) . With respect to oracle-related quantum algorithms for the NP-complete problems, we identify our algorithm as optimal. To justify the feasibility of the proposed quantum algorithm, we successfully solve a typical clique problem for a graph G with two vertices and one edge by carrying out a nuclear magnetic resonance experiment involving four qubits.

  14. Cycle length maximization in PWRs using empirical core models

    International Nuclear Information System (INIS)

    Okafor, K.C.; Aldemir, T.

    1987-01-01

    The problem of maximizing cycle length in nuclear reactors through optimal fuel and poison management has been addressed by many investigators. An often-used neutronic modeling technique is to find correlations between the state and control variables to describe the response of the core to changes in the control variables. In this study, a set of linear correlations, generated by two-dimensional diffusion-depletion calculations, is used to find the enrichment distribution that maximizes cycle length for the initial core of a pressurized water reactor (PWR). These correlations (a) incorporate the effect of composition changes in all the control zones on a given fuel assembly and (b) are valid for a given range of control variables. The advantage of using such correlations is that the cycle length maximization problem can be reduced to a linear programming problem

  15. Maximization of regional probabilities using Optimal Surface Graphs

    DEFF Research Database (Denmark)

    Arias Lorza, Andres M.; Van Engelen, Arna; Petersen, Jens

    2018-01-01

    Purpose: We present a segmentation method that maximizes regional probabilities enclosed by coupled surfaces using an Optimal Surface Graph (OSG) cut approach. This OSG cut determines the globally optimal solution given a graph constructed around an initial surface. While most methods for vessel...... wall segmentation only use edge information, we show that maximizing regional probabilities using an OSG improves the segmentation results. We applied this to automatically segment the vessel wall of the carotid artery in magnetic resonance images. Methods: First, voxel-wise regional probability maps...... were obtained using a Support Vector Machine classifier trained on local image features. Then, the OSG segments the regions which maximizes the regional probabilities considering smoothness and topological constraints. Results: The method was evaluated on 49 carotid arteries from 30 subjects...

  16. El culto de Maximón en Guatemala

    OpenAIRE

    Pédron‑Colombani, Sylvie

    2009-01-01

    Este artículo se enfoca en la figura de Maximón, deidad sincrética de Guatemala, en un contexto de desplazamiento de la religión católica popular por parte de las iglesias protestantes. Esta divinidad híbrida a la cual se agregan santos católicos como Judas Iscariote o el dios maya Mam, permite la apropiación de Maximón por segmentos diferenciados de la población (tanto indígena como mestiza). Permite igualmente ser símbolo de protestas sociales enmascaradas cuando se asocia Maximón con figur...

  17. Maximal Electric Dipole Moments of Nuclei with Enhanced Schiff Moments

    CERN Document Server

    Ellis, John; Pilaftsis, Apostolos

    2011-01-01

    The electric dipole moments (EDMs) of heavy nuclei, such as 199Hg, 225Ra and 211Rn, can be enhanced by the Schiff moments induced by the presence of nearby parity-doublet states. Working within the framework of the maximally CP-violating and minimally flavour-violating (MCPMFV) version of the MSSM, we discuss the maximal values that such EDMs might attain, given the existing experimental constraints on the Thallium, neutron and Mercury EDMs. The maximal EDM values of the heavy nuclei are obtained with the help of a differential-geometrical approach proposed recently that enables the maxima of new CP-violating observables to be calculated exactly in the linear approximation. In the case of 225Ra, we find that its EDM may be as large as 6 to 50 x 10^{-27} e.cm.

  18. Recommendations for processing cardiovascular surgical pathology specimens: a consensus statement from the Standards and Definitions Committee of the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology

    NARCIS (Netherlands)

    Stone, James R.; Basso, Cristina; Baandrup, Ulrik T.; Bruneval, Patrick; Butany, Jagdish; Gallagher, Patrick J.; Halushka, Marc K.; Miller, Dylan V.; Padera, Robert F.; Radio, Stanley J.; Sheppard, Mary N.; Suvarna, Kim; Tan, Carmela D.; Thiene, Gaetano; van der Wal, Allard C.; Veinot, John P.

    2012-01-01

    With the advent of molecular subclassification of diseases, much consideration should be given to the proper processing of cardiovascular surgical pathology specimens to maximize patient care. Such specimens include endomyocardial biopsies, cardiac myectomy specimens, cardiac apical core segments,

  19. Surgical therapy in chronic pancreatitis.

    Science.gov (United States)

    Neal, C P; Dennison, A R; Garcea, G

    2012-12-01

    Chronic pancreatitis (CP) is an inflammatory disease of the pancreas which causes chronic pain, as well as exocrine and endocrine failure in the majority of patients, together producing social and domestic upheaval and a very poor quality of life. At least half of patients will require surgical intervention at some stage in their disease, primarily for the treatment of persistent pain. Available data have now confirmed that surgical intervention may produce superior results to conservative and endoscopic treatment. Comprehensive individual patient assessment is crucial to optimal surgical management, however, in order to determine which morphological disease variant (large duct disease, distal stricture with focal disease, expanded head or small duct/minimal change disease) is present in the individual patient, as a wide and differing range of surgical approaches are possible depending upon the specific abnormality within the gland. This review comprehensively assesses the evidence for these differing approaches to surgical intervention in chronic pancreatitis. Surgical drainage procedures should be limited to a small number of patients with a dilated duct and no pancreatic head mass. Similarly, a small population presenting with a focal stricture and tail only disease may be successfully treated by distal pancreatectomy. Long-term results of both of these procedure types are poor, however. More impressive results have been yielded for the surgical treatment of the expanded head, for which a range of surgical options now exist. Evidence from level I studies and a recent meta-analysis suggests that duodenum-preserving resections offer benefits compared to pancreaticoduodenectomy, though the results of the ongoing, multicentre ChroPac trial are awaited to confirm this. Further data are also needed to determine which of the duodenum-preserving procedures provides optimal results. In relation to small duct/minimal change disease total pancreatectomy represents the only

  20. Surgical Skills Beyond Scientific Management.

    Science.gov (United States)

    Whitfield, Nicholas

    2015-07-01

    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel's attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel-Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice.

  1. Maximal and anaerobic threshold cardiorespiratory responses during deepwater running

    Directory of Open Access Journals (Sweden)

    Ana Carolina Kanitz

    2014-12-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2015v17n1p41   Aquatic exercises provide numerous benefits to the health of their practitioners. To secure these benefits, it is essential to have proper prescriptions to the needs of each individual and, therefore, it is important to study the cardiorespiratory responses of different activities in this environment. Thus, the aim of this study was to compare the cardiorespiratory responses at the anaerobic threshold (AT between maximal deep-water running (DWR and maximal treadmill running (TMR. In addition, two methods of determining the AT (the heart rate deflection point [HRDP] and ventilatory method [VM] are compared in the two evaluated protocols. Twelve young women performed the two maximal protocols. Two-factor ANOVA for repeated measures with a post-hoc Bonferroni test was used (α < 0.05. Significantly higher values of maximal heart rate (TMR: 33.7 ± 3.9; DWR: 22.5 ± 4.1 ml.kg−1.min−1 and maximal oxygen uptake (TMR: 33.7 ± 3.9; DWR: 22.5 ± 4.1 ml.kg−1.min−1 in TMR compared to the DWR were found. Furthermore, no significant differences were found between the methods for determining the AT (TMR: VM: 28.1 ± 5.3, HRDP: 26.6 ± 5.5 ml.kg−1.min−1; DWR: VM: 18.7 ± 4.8, HRDP: 17.8 ± 4.8 ml.kg−1.min−1. The results indicate that a specific maximal test for the trained modality should be conducted and the HRDP can be used as a simple and practical method of determining the AT, based on which the training intensity can be determined

  2. Efficient maximal Poisson-disk sampling and remeshing on surfaces

    KAUST Repository

    Guo, Jianwei; Yan, Dongming; Jia, Xiaohong; Zhang, Xiaopeng

    2015-01-01

    Poisson-disk sampling is one of the fundamental research problems in computer graphics that has many applications. In this paper, we study the problem of maximal Poisson-disk sampling on mesh surfaces. We present a simple approach that generalizes the 2D maximal sampling framework to surfaces. The key observation is to use a subdivided mesh as the sampling domain for conflict checking and void detection. Our approach improves the state-of-the-art approach in efficiency, quality and the memory consumption.

  3. Gap processing for adaptive maximal poisson-disk sampling

    KAUST Repository

    Yan, Dongming

    2013-10-17

    In this article, we study the generation of maximal Poisson-disk sets with varying radii. First, we present a geometric analysis of gaps in such disk sets. This analysis is the basis for maximal and adaptive sampling in Euclidean space and on manifolds. Second, we propose efficient algorithms and data structures to detect gaps and update gaps when disks are inserted, deleted, moved, or when their radii are changed.We build on the concepts of regular triangulations and the power diagram. Third, we show how our analysis contributes to the state-of-the-art in surface remeshing. © 2013 ACM.

  4. On Maximal Non-Disjoint Families of Subsets

    Directory of Open Access Journals (Sweden)

    Yu. A. Zuev

    2017-01-01

    Full Text Available The paper studies maximal non-disjoint families of subsets of a finite set. Non-disjointness means that any two subsets of a family have a nonempty intersection. The maximality is expressed by the fact that adding a new subset to the family cannot increase its power without violating a non-disjointness condition. Studying the properties of such families is an important section of the extreme theory of sets. Along with purely combinatorial interest, the problems considered here play an important role in informatics, anti-noise coding, and cryptography.In 1961 this problem saw the light of day in the Erdos, Ko and Rado paper, which established a maximum power of the non-disjoint family of subsets of equal power. In 1974 the Erdos and Claytman publication estimated the number of maximal non-disjoint families of subsets without involving the equality of their power. These authors failed to establish an asymptotics of the logarithm of the number of such families when the power of a basic finite set tends to infinity. However, they suggested such an asymptotics as a hypothesis. A.D. Korshunov in two publications in 2003 and 2005 established the asymptotics for the number of non-disjoint families of the subsets of arbitrary powers without maximality condition of these families.The basis for the approach used in the paper to study the families of subsets is their description in the language of Boolean functions. A one-to-one correspondence between a family of subsets and a Boolean function is established by the fact that the characteristic vectors of subsets of a family are considered to be the unit sets of a Boolean function. The main theoretical result of the paper is that the maximal non-disjoint families are in one-to-one correspondence with the monotonic self-dual Boolean functions. When estimating the number of maximal non-disjoint families, this allowed us to use the result of A.A. Sapozhenko, who established the asymptotics of the number of the

  5. Gap processing for adaptive maximal poisson-disk sampling

    KAUST Repository

    Yan, Dongming; Wonka, Peter

    2013-01-01

    In this article, we study the generation of maximal Poisson-disk sets with varying radii. First, we present a geometric analysis of gaps in such disk sets. This analysis is the basis for maximal and adaptive sampling in Euclidean space and on manifolds. Second, we propose efficient algorithms and data structures to detect gaps and update gaps when disks are inserted, deleted, moved, or when their radii are changed.We build on the concepts of regular triangulations and the power diagram. Third, we show how our analysis contributes to the state-of-the-art in surface remeshing. © 2013 ACM.

  6. Efficient maximal Poisson-disk sampling and remeshing on surfaces

    KAUST Repository

    Guo, Jianwei

    2015-02-01

    Poisson-disk sampling is one of the fundamental research problems in computer graphics that has many applications. In this paper, we study the problem of maximal Poisson-disk sampling on mesh surfaces. We present a simple approach that generalizes the 2D maximal sampling framework to surfaces. The key observation is to use a subdivided mesh as the sampling domain for conflict checking and void detection. Our approach improves the state-of-the-art approach in efficiency, quality and the memory consumption.

  7. Identities on maximal subgroups of GLn(D)

    International Nuclear Information System (INIS)

    Kiani, D.; Mahdavi-Hezavehi, M.

    2002-04-01

    Let D be a division ring with centre F. Assume that M is a maximal subgroup of GL n (D), n≥1 such that Z(M) is algebraic over F. Group identities on M and polynomial identities on the F-linear hull F[M] are investigated. It is shown that if F[M] is a PI-algebra, then [D:F] n (D) and M is a maximal subgroup of N. If M satisfies a group identity, it is shown that M is abelian-by-finite. (author)

  8. Instantons and Gribov copies in the maximally Abelian gauge

    International Nuclear Information System (INIS)

    Bruckmann, F.; Heinzl, T.; Wipf, A.; Tok, T.

    2000-01-01

    We calculate the Faddeev-Popov operator corresponding to the maximally Abelian gauge for gauge group SU(N). Specializing to SU(2) we look for explicit zero modes of this operator. Within an illuminating toy model (Yang-Mills mechanics) the problem can be completely solved and understood. In the field theory case we are able to find an analytic expression for a normalizable zero mode in the background of a single 't Hooft instanton. Accordingly, such an instanton corresponds to a horizon configuration in the maximally Abelian gauge. Possible physical implications are discussed

  9. Determinants of maximal oxygen uptake in severe acute hypoxia

    DEFF Research Database (Denmark)

    Calbet, J A L; Boushel, Robert Christopher; Rådegran, G

    2003-01-01

    To unravel the mechanisms by which maximal oxygen uptake (VO2 max) is reduced with severe acute hypoxia in humans, nine Danish lowlanders performed incremental cycle ergometer exercise to exhaustion, while breathing room air (normoxia) or 10.5% O2 in N2 (hypoxia, approximately 5,300 m above sea......: 1) reduction of PiO2, 2) impairment of pulmonary gas exchange, and 3) reduction of maximal cardiac output and peak leg blood flow, each explaining about one-third of the loss in VO2 max....

  10. Anatomy of maximal stop mixing in the MSSM

    International Nuclear Information System (INIS)

    Bruemmer, Felix; Kraml, Sabine; Kulkarni, Suchita

    2012-05-01

    A Standard Model-like Higgs near 125 GeV in the MSSM requires multi-TeV stop masses, or a near-maximal contribution to its mass from stop mixing. We investigate the maximal mixing scenario, and in particular its prospects for being realized it in potentially realistic GUT models. We work out constraints on the possible GUT-scale soft terms, which we compare with what can be obtained from some well-known mechanisms of SUSY breaking mediation. Finally, we analyze two promising scenarios in detail, namely gaugino mediation and gravity mediation with non-universal Higgs masses.

  11. Adaptive maximal poisson-disk sampling on surfaces

    KAUST Repository

    Yan, Dongming

    2012-01-01

    In this paper, we study the generation of maximal Poisson-disk sets with varying radii on surfaces. Based on the concepts of power diagram and regular triangulation, we present a geometric analysis of gaps in such disk sets on surfaces, which is the key ingredient of the adaptive maximal Poisson-disk sampling framework. Moreover, we adapt the presented sampling framework for remeshing applications. Several novel and efficient operators are developed for improving the sampling/meshing quality over the state-of-theart. © 2012 ACM.

  12. Maximization of Tsallis entropy in the combinatorial formulation

    International Nuclear Information System (INIS)

    Suyari, Hiroki

    2010-01-01

    This paper presents the mathematical reformulation for maximization of Tsallis entropy S q in the combinatorial sense. More concretely, we generalize the original derivation of Maxwell-Boltzmann distribution law to Tsallis statistics by means of the corresponding generalized multinomial coefficient. Our results reveal that maximization of S 2-q under the usual expectation or S q under q-average using the escort expectation are naturally derived from the combinatorial formulations for Tsallis statistics with respective combinatorial dualities, that is, one for additive duality and the other for multiplicative duality.

  13. Anatomy of maximal stop mixing in the MSSM

    Energy Technology Data Exchange (ETDEWEB)

    Bruemmer, Felix [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Kraml, Sabine; Kulkarni, Suchita [CNRS/IN2P3, INPG, Grenoble (France). Laboratoire de Physique Subatomique et de Cosmologie

    2012-05-15

    A Standard Model-like Higgs near 125 GeV in the MSSM requires multi-TeV stop masses, or a near-maximal contribution to its mass from stop mixing. We investigate the maximal mixing scenario, and in particular its prospects for being realized it in potentially realistic GUT models. We work out constraints on the possible GUT-scale soft terms, which we compare with what can be obtained from some well-known mechanisms of SUSY breaking mediation. Finally, we analyze two promising scenarios in detail, namely gaugino mediation and gravity mediation with non-universal Higgs masses.

  14. The Large Margin Mechanism for Differentially Private Maximization

    OpenAIRE

    Chaudhuri, Kamalika; Hsu, Daniel; Song, Shuang

    2014-01-01

    A basic problem in the design of privacy-preserving algorithms is the private maximization problem: the goal is to pick an item from a universe that (approximately) maximizes a data-dependent function, all under the constraint of differential privacy. This problem has been used as a sub-routine in many privacy-preserving algorithms for statistics and machine-learning. Previous algorithms for this problem are either range-dependent---i.e., their utility diminishes with the size of the universe...

  15. Instruction Emphasizing Effort Improves Physics Problem Solving

    Science.gov (United States)

    Li, Daoquan

    2012-01-01

    Effectively using strategies to solve complex problems is an important educational goal and is implicated in successful academic performance. However, people often do not spontaneously use the effective strategies unless they are motivated to do so. The present study was designed to test whether educating students about the importance of effort in…

  16. Student Effort, Consistency, and Online Performance

    Science.gov (United States)

    Patron, Hilde; Lopez, Salvador

    2011-01-01

    This paper examines how student effort, consistency, motivation, and marginal learning, influence student grades in an online course. We use data from eleven Microeconomics courses taught online for a total of 212 students. Our findings show that consistency, or less time variation, is a statistically significant explanatory variable, whereas…

  17. Net benefits of wildfire prevention education efforts

    Science.gov (United States)

    Jeffrey P. Prestemon; David T. Butry; Karen L. Abt; Ronda Sutphen

    2010-01-01

    Wildfire prevention education efforts involve a variety of methods, including airing public service announcements, distributing brochures, and making presentations, which are intended to reduce the occurrence of certain kinds of wildfires. A Poisson model of preventable Florida wildfires from 2002 to 2007 by fire management region was developed. Controlling for...

  18. Has Malaysia's antidrug effort been effective?

    Science.gov (United States)

    Scorzelli, J F

    1992-01-01

    It is a common belief that a massive effort in law enforcement, preventive education and rehabilitation will result in the elimination of a country's drug problem. Based on this premise. Malaysia in 1983 implemented such a multifaceted anti-drug strategy, and the results of a 1987 study by the author suggested that Malaysia's effort had begun to contribute to a steady decrease in the number of identified drug abusers. Although the number of drug-addicted individuals declined, the country's recidivism rates were still high. Because of this high relapse rate, Malaysia expanded their rehabilitation effort and developed a community transition program. In order to determine the impact of these changes on the country's battle against drug abuse, a follow-up study was conducted in 1990. The results of this study did not clearly demonstrate that the Malaysian effort had been successful in eliminating the problem of drug abuse, and raised some questions concerning the effectiveness of the country's drug treatment programs.

  19. Phase transitions in least-effort communications

    International Nuclear Information System (INIS)

    Prokopenko, Mikhail; Ay, Nihat; Obst, Oliver; Polani, Daniel

    2010-01-01

    We critically examine a model that attempts to explain the emergence of power laws (e.g., Zipf's law) in human language. The model is based on the principle of least effort in communications—specifically, the overall effort is balanced between the speaker effort and listener effort, with some trade-off. It has been shown that an information-theoretic interpretation of this principle is sufficiently rich to explain the emergence of Zipf's law in the vicinity of the transition between referentially useless systems (one signal for all referable objects) and indexical reference systems (one signal per object). The phase transition is defined in the space of communication accuracy (information content) expressed in terms of the trade-off parameter. Our study explicitly solves the continuous optimization problem, subsuming a recent, more specific result obtained within a discrete space. The obtained results contrast Zipf's law found by heuristic search (that attained only local minima) in the vicinity of the transition between referentially useless systems and indexical reference systems, with an inverse-factorial (sub-logarithmic) law found at the transition that corresponds to global minima. The inverse-factorial law is observed to be the most representative frequency distribution among optimal solutions

  20. The Galileo Teacher Training Program Global Efforts

    Science.gov (United States)

    Doran, R.; Pennypacker, C.; Ferlet, R.

    2012-08-01

    The Galileo Teacher Training Program (GTTP) successfully named representatives in nearly 100 nations in 2009, the International Year of Astronomy (IYA2009). The challenge had just begun. The steps ahead are how to reach educators that might benefit from our program and how to help build a more fair and science literate society, a society in which good tools and resources for science education are not the privilege of a few. From 2010 on our efforts have been to strengthen the newly formed network and learn how to equally help educators and students around the globe. New partnerships with other strong programs and institutions are being formed, sponsorship schemes being outlined, new tools and resources being publicized, and on-site and video conference training conducted all over the world. Efforts to officially accredit a GTTP curriculum are on the march and a stronger certification process being outlined. New science topics are being integrated in our effort and we now seek to discuss the path ahead with experts in this field and the community of users, opening the network to all corners of our beautiful blue dot. The main aim of this article is to open the discussion regarding the urgent issue of how to reawaken student interest in science, how to solve the gender inequality in science careers, and how to reach the underprivileged students and open to them the same possibilities. Efforts are in strengthening the newly formed network and learning how to equally help educators and students around the globe.

  1. Effort - Final technical report on task 3

    DEFF Research Database (Denmark)

    Bay, Niels; Henningsen, Poul; Eriksen, Morten

    The present report is documentation for the work carried out at DTU on the Brite/Euram project No. BE96-3340, contract No. BRPR-CT97-0398, with the title Enhanced Framework for forging design using reliable three-dimensional simulation (EFFORTS). The objective of task 3 is to determine data...

  2. Hydrogen economy: a little bit more effort

    International Nuclear Information System (INIS)

    Pauron, M.

    2008-01-01

    In few years, the use of hydrogen in economy has become a credible possibility. Today, billions of euros are invested in the hydrogen industry which is strengthened by technological advances in fuel cells development and by an increasing optimism. However, additional research efforts and more financing will be necessary to make the dream of an hydrogen-based economy a reality

  3. Workplace High Tech Spurs Retraining Efforts.

    Science.gov (United States)

    Davis, Dwight B.

    1984-01-01

    Discusses who should provide training for displaced workers who need new skills. Areas examined include: (1) the need for retraining; (2) current corporate efforts; (3) agreements in the automotive industry; (4) job quality; (5) the federal government's role; and (6) federal legislation related to the problem. (JN)

  4. Testosterone and reproductive effort in male primates.

    Science.gov (United States)

    Muller, Martin N

    2017-05-01

    Considerable evidence suggests that the steroid hormone testosterone mediates major life-history trade-offs in vertebrates, promoting mating effort at the expense of parenting effort or survival. Observations from a range of wild primates support the "Challenge Hypothesis," which posits that variation in male testosterone is more closely associated with aggressive mating competition than with reproductive physiology. In both seasonally and non-seasonally breeding species, males increase testosterone production primarily when competing for fecund females. In species where males compete to maintain long-term access to females, testosterone increases when males are threatened with losing access to females, rather than during mating periods. And when male status is linked to mating success, and dependent on aggression, high-ranking males normally maintain higher testosterone levels than subordinates, particularly when dominance hierarchies are unstable. Trade-offs between parenting effort and mating effort appear to be weak in most primates, because direct investment in the form of infant transport and provisioning is rare. Instead, infant protection is the primary form of paternal investment in the order. Testosterone does not inhibit this form of investment, which relies on male aggression. Testosterone has a wide range of effects in primates that plausibly function to support male competitive behavior. These include psychological effects related to dominance striving, analgesic effects, and effects on the development and maintenance of the armaments and adornments that males employ in mating competition. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Reasonable limits to radiation protection efforts

    International Nuclear Information System (INIS)

    Gonen, Y.G.

    1982-01-01

    It is shown that change in life expectancy (ΔLE) is an improved estimate for risks and safety efforts, reflecting the relevant social goal. A cost-effectiveness index, safety investment/ΔLE, is defined. The harm from low level radiation is seen as a reduction of life expectancy instead of an increased probability of contracting cancer. (author)

  6. Whither surgical quality assurance of breast cancer surgery (surgical margins and local recurrence) after paterson.

    Science.gov (United States)

    Bundred, N J; Thomas, J; Dixon, J M J

    2017-10-01

    The Kennedy report into the actions of the disgraced Breast Surgeon, Paterson focussed on issues of informed consent for mastectomy, management of surgical margins and raised concerns about local recurrence rates and the increasing emphasis on cosmesis after mastectomy for breast cancer. This article assesses whether Kennedy's recommendations apply to the UK as a whole and how to address these issues. New GMC advice on consent and newer nonevidenced innovations in immediate reconstruction have altered the level of informed consent required. Patients deserve a better understanding of the issues of oncological versus cosmetic outcomes on which to base their decisions. Involvement of the whole multidisciplinary team including Oncologists is necessary in surgical planning. Failure to obtain clear microscopic margins at mastectomy leads to an increased local recurrence, yet has received little attention in the UK. Whereas, other countries have used surgical quality assurance audits to reduce local recurrence; local recurrence rates are not available and the extent of variation across the UK in margin involvement after surgery, its management and relationship to local recurrence needs auditing prospectively to reduce unnecessary morbidity. To reassure public, patients and the NHS management, an accreditation system with more rigour than NHSBSP QA and peer review is now required. Resource and efforts to support its introduction will be necessary from the Royal College of Surgeons and the Association of Breast Surgeons. New innovations require careful evaluation before their backdoor introduction to the NHS. Private Hospitals need to have the same standards imposed.

  7. Patient-Specific Surgical Implants Made of 3D Printed PEEK: Material, Technology, and Scope of Surgical Application

    Directory of Open Access Journals (Sweden)

    Philipp Honigmann

    2018-01-01

    Full Text Available Additive manufacturing (AM is rapidly gaining acceptance in the healthcare sector. Three-dimensional (3D virtual surgical planning, fabrication of anatomical models, and patient-specific implants (PSI are well-established processes in the surgical fields. Polyetheretherketone (PEEK has been used, mainly in the reconstructive surgeries as a reliable alternative to other alloplastic materials for the fabrication of PSI. Recently, it has become possible to fabricate PEEK PSI with Fused Filament Fabrication (FFF technology. 3D printing of PEEK using FFF allows construction of almost any complex design geometry, which cannot be manufactured using other technologies. In this study, we fabricated various PEEK PSI by FFF 3D printer in an effort to check the feasibility of manufacturing PEEK with 3D printing. Based on these preliminary results, PEEK can be successfully used as an appropriate biomaterial to reconstruct the surgical defects in a “biomimetic” design.

  8. Patient-Specific Surgical Implants Made of 3D Printed PEEK: Material, Technology, and Scope of Surgical Application.

    Science.gov (United States)

    Honigmann, Philipp; Sharma, Neha; Okolo, Brando; Popp, Uwe; Msallem, Bilal; Thieringer, Florian M

    2018-01-01

    Additive manufacturing (AM) is rapidly gaining acceptance in the healthcare sector. Three-dimensional (3D) virtual surgical planning, fabrication of anatomical models, and patient-specific implants (PSI) are well-established processes in the surgical fields. Polyetheretherketone (PEEK) has been used, mainly in the reconstructive surgeries as a reliable alternative to other alloplastic materials for the fabrication of PSI. Recently, it has become possible to fabricate PEEK PSI with Fused Filament Fabrication (FFF) technology. 3D printing of PEEK using FFF allows construction of almost any complex design geometry, which cannot be manufactured using other technologies. In this study, we fabricated various PEEK PSI by FFF 3D printer in an effort to check the feasibility of manufacturing PEEK with 3D printing. Based on these preliminary results, PEEK can be successfully used as an appropriate biomaterial to reconstruct the surgical defects in a "biomimetic" design.

  9. Optimizing protection efforts for amphibian conservation in Mediterranean landscapes

    Science.gov (United States)

    García-Muñoz, Enrique; Ceacero, Francisco; Carretero, Miguel A.; Pedrajas-Pulido, Luis; Parra, Gema; Guerrero, Francisco

    2013-05-01

    Amphibians epitomize the modern biodiversity crisis, and attract great attention from the scientific community since a complex puzzle of factors has influence on their disappearance. However, these factors are multiple and spatially variable, and declining in each locality is due to a particular combination of causes. This study shows a suitable statistical procedure to determine threats to amphibian species in medium size administrative areas. For our study case, ten biological and ecological variables feasible to affect the survival of 15 amphibian species were categorized and reduced through Principal Component Analysis. The principal components extracted were related to ecological plasticity, reproductive potential, and specificity of breeding habitats. Finally, the factor scores of species were joined in a presence-absence matrix that gives us information to identify where and why conservation management are requires. In summary, this methodology provides the necessary information to maximize benefits of conservation measures in small areas by identifying which ecological factors need management efforts and where should we focus them on.

  10. Acute pain control and accelerated postoperative surgical recovery

    DEFF Research Database (Denmark)

    Kehlet, H

    1999-01-01

    Postoperative pain relief continues to demand our awareness, and surgeons should be fully aware of the potential physiologic benefits of effective dynamic pain relief regimens and the great potential to improve postoperative outcome if such analgesia is used for rehabilitation. To achieve advanta...... to recent knowledge within surgical pathophysiology. Such efforts must be expected to lead to improved quality of care for patients, with less pain and reduced morbidity leading to cost efficiency....

  11. Palliative care and pediatric surgical oncology.

    Science.gov (United States)

    Inserra, Alessandro; Narciso, Alessandra; Paolantonio, Guglielmo; Messina, Raffaella; Crocoli, Alessandro

    2016-10-01

    Survival rate for childhood cancer has increased in recent years, reaching as high as 70% in developed countries compared with 54% for all cancers diagnosed in the 1980s. In the remaining 30%, progression or metastatic disease leads to death and in this framework palliative care has an outstanding role though not well settled in all its facets. In this landscape, surgery has a supportive actor role integrated with other welfare aspects from which are not severable. The definition of surgical palliation has moved from the ancient definition of noncurative surgery to a group of practices performed not to cure but to alleviate an organ dysfunction offering the best quality of life possible in all the aspects of life (pain, dysfunctions, caregivers, psychosocial, etc.). To emphasize this aspect a more modern definition has been introduced: palliative therapy in whose context is comprised not only the care assistance but also the plans of care since the onset of illness, teaching the matter to surgeons in training and share paths. Literature is very poor regarding surgical aspects specifically dedicated and all researches (PubMed, Google Scholar, and Cochrane) with various meshing terms result in a more oncologic and psychosocial effort. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. ANAESTHESIA FOR OPHTHALMIC SURGICAL PROCEDURES

    African Journals Online (AJOL)

    Objective: To review factors influencing the choice of anaesthesia for ophthalmic surgical procedures. ... as risk associated with general anaesthesia (8) they are more .... Wilson ME, Pandey SK, Thakur J. Paediatric cataract blindness in the ...

  13. uniportal vats for surgical repair

    African Journals Online (AJOL)

    2017-03-23

    Mar 23, 2017 ... aDepartamet of Pediatric Surgery, Hospital Teresa Herrera, Complejo Hospitalario. Universitario de A ... Advances in anesthesia, neonatal intensive, surgical, and cardiac care have ... First, these patients are at risk of airway ...

  14. Spinal surgery: non surgical complications

    African Journals Online (AJOL)

    Adele

    surgical procedure). Arterial cannulation ... Acute retinal necrosis syndrome after epidural corticos- teroid injections ... prevented, or respond to early recognition and treatment. ..... drugs should only be administered if there are no alternatives.

  15. Patient-specific surgical simulation.

    Science.gov (United States)

    Soler, Luc; Marescaux, Jacques

    2008-02-01

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

  16. Surface Modification of AISI 440B Stainless Steel and its Influence on Surgical Drill Bits Performance

    Directory of Open Access Journals (Sweden)

    Łępicka M.

    2016-09-01

    Full Text Available The development of modern invasive surgery is highly dependent on the performance of surgical instruments, understood as long-term efficiency arising from high resistance to wear and corrosion. In order to maintain sufficient reliability, surgical cutting instruments are often made of martensitic stainless steels. Nevertheless, the use of ferrous alloys in medical applications is still a concern due to their questionable corrosion and wear resistance. To extend their biocompatibility, improve stability in variable environmental conditions, improve ease of handling, and maximize their performance, diffusion layers and coatings are applied to the surface. The aim of this work was to evaluate the effect of TiN and diamond-like carbon (DLC surface modification on the performance of surgical drill bits, that is, wear and corrosion resistance, measured in model and field tests. Based on the findings presented, DLC layers can be recommended as anti-wear and anti-corrosion coatings for surgical drill bits.

  17. Surgical management of Crohn's disease.

    Science.gov (United States)

    Lu, Kim C; Hunt, Steven R

    2013-02-01

    Although medical management can control symptoms in a recurring incurable disease, such as Crohn's disease, surgical management is reserved for disease complications or those problems refractory to medical management. In this article, we cover general principles for the surgical management of Crohn's disease, ranging from skin tags, abscesses, fistulae, and stenoses to small bowel and extraintestinal disease. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Surgical innovations in canine gonadectomy

    OpenAIRE

    Van Goethem, Bart

    2016-01-01

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

  19. Evolution of surgical skills training

    Science.gov (United States)

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

    2006-01-01

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

  20. Thymoma and minimally invasive surgical treatment

    International Nuclear Information System (INIS)

    Krajc, T.; Spalek, P.; Lucenic, M.; Benej, R.; Harustiak, S.

    2011-01-01

    The authors review the current thymoma classification schemes, diagnosis and surgical treatment options. Many minimally invasive techniques do not provide sufficient extensiveness when compared to complete sternotomy. The Zieliński technique combines transcervical, subxiphoidal and bilateral thoracoscopic approach in a hybrid procedure (MMIT, maximal minimally invasive thymectomy) based on double sternal traction, and allows for removal of the thymus gland, the thymoma and all the relevant mediastinal adipose tissue, thus adhering to principles of oncological radicality. Of the 28 patients undergoing MMIT there were 7 with myasthenia associated thymoma (MGAT) and 5 with a thymoma and no myasthenia, tumors staged Masaoka I-II. Apart from one temporary recurrent nerve palsy there were no postoperative complications. The largest thymoma measured 70 x 65 x 55 mm. Adjuvant radiotherapy was applied in 5 patients. Ectopic thymic tissue was identified in 100 % of patients with thymoma and no myasthenia and in 42.9 % of MGAT patients. Until now there were no recurrences, however, the follow-up median is very short, the longest follow-up period being 30 months. MMIT is a safe technique suitable also for Masaoka I-II thymoma patients and for some specific cases with Masaoka III stage (lung parenchyma invasion). The authors approach all the anterior mediastinal tumors with no mediastinal lymphadenopathy and no myasthenia as a potential thymoma and always attempt the MMIT procedure starting as VATS procedure on the side of tumor. (author)

  1. Maximal saddle solution of a nonlinear elliptic equation involving the ...

    Indian Academy of Sciences (India)

    College of Mathematics and Econometrics, Hunan University, Changsha 410082, China. E-mail: huahuiyan@163.com; duzr@hnu.edu.cn. MS received 3 September 2012; revised 20 December 2012. Abstract. A saddle solution is called maximal saddle solution if its absolute value is not smaller than those absolute values ...

  2. Quantitative approaches for profit maximization in direct marketing

    NARCIS (Netherlands)

    van der Scheer, H.R.

    1998-01-01

    An effective direct marketing campaign aims at selecting those targets, offer and communication elements - at the right time - that maximize the net profits. The list of individuals to be mailed, i.e. the targets, is considered to be the most important component. Therefore, a large amount of direct

  3. An optimal thermal condition for maximal chlorophyll extraction

    Directory of Open Access Journals (Sweden)

    Fu Jia-Jia

    2017-01-01

    Full Text Available This work describes an environmentally friendly process for chlorophyll extraction from bamboo leaves. Shaking water bath and ultrasound cleaner are adopted in this technology, and the influence of temperature of the water bath and ultrasonic cleaner is evaluated. Results indicated that there is an optimal condition for maximal yield of chlorophyll.

  4. Maximal multiplier operators in Lp(·)(Rn) spaces

    Czech Academy of Sciences Publication Activity Database

    Gogatishvili, Amiran; Kopaliani, T.

    2016-01-01

    Roč. 140, č. 4 (2016), s. 86-97 ISSN 0007-4497 R&D Projects: GA ČR GA13-14743S Institutional support: RVO:67985840 Keywords : spherical maximal function * variable Lebesque spaces * boundedness result Subject RIV: BA - General Mathematics Impact factor: 0.750, year: 2016 http://www.sciencedirect.com/science/article/pii/S0007449715000329

  5. Half-maximal supersymmetry from exceptional field theory

    Energy Technology Data Exchange (ETDEWEB)

    Malek, Emanuel [Arnold Sommerfeld Center for Theoretical Physics, Department fuer Physik, Ludwig-Maximilians-Universitaet Muenchen (Germany)

    2017-10-15

    We study D ≥ 4-dimensional half-maximal flux backgrounds using exceptional field theory. We define the relevant generalised structures and also find the integrability conditions which give warped half-maximal Minkowski{sub D} and AdS{sub D} vacua. We then show how to obtain consistent truncations of type II / 11-dimensional SUGRA which break half the supersymmetry. Such truncations can be defined on backgrounds admitting exceptional generalised SO(d - 1 - N) structures, where d = 11 - D, and N is the number of vector multiplets obtained in the lower-dimensional theory. Our procedure yields the most general embedding tensors satisfying the linear constraint of half-maximal gauged SUGRA. We use this to prove that all D ≥ 4 half-maximal warped AdS{sub D} and Minkowski{sub D} vacua of type II / 11-dimensional SUGRA admit a consistent truncation keeping only the gravitational supermultiplet. We also show to obtain heterotic double field theory from exceptional field theory and comment on the M-theory / heterotic duality. In five dimensions, we find a new SO(5, N) double field theory with a (6 + N)-dimensional extended space. Its section condition has one solution corresponding to 10-dimensional N = 1 supergravity and another yielding six-dimensional N = (2, 0) SUGRA. (copyright 2017 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  6. Local Hamiltonians for maximally multipartite-entangled states

    Science.gov (United States)

    Facchi, P.; Florio, G.; Pascazio, S.; Pepe, F.

    2010-10-01

    We study the conditions for obtaining maximally multipartite-entangled states (MMESs) as nondegenerate eigenstates of Hamiltonians that involve only short-range interactions. We investigate small-size systems (with a number of qubits ranging from 3 to 5) and show some example Hamiltonians with MMESs as eigenstates.

  7. Local Hamiltonians for maximally multipartite-entangled states

    International Nuclear Information System (INIS)

    Facchi, P.; Florio, G.; Pascazio, S.; Pepe, F.

    2010-01-01

    We study the conditions for obtaining maximally multipartite-entangled states (MMESs) as nondegenerate eigenstates of Hamiltonians that involve only short-range interactions. We investigate small-size systems (with a number of qubits ranging from 3 to 5) and show some example Hamiltonians with MMESs as eigenstates.

  8. Submaximal exercise capacity and maximal power output in polio subjects

    NARCIS (Netherlands)

    Nollet, F.; Beelen, A.; Sargeant, A. J.; de Visser, M.; Lankhorst, G. J.; de Jong, B. A.

    2001-01-01

    OBJECTIVES: To compare the submaximal exercise capacity of polio subjects with postpoliomyelitis syndrome (PPS) and without (non-PPS) with that of healthy control subjects, to investigate the relationship of this capacity with maximal short-term power and quadriceps strength, and to evaluate

  9. Maximal Regularity of the Discrete Harmonic Oscillator Equation

    Directory of Open Access Journals (Sweden)

    Airton Castro

    2009-01-01

    Full Text Available We give a representation of the solution for the best approximation of the harmonic oscillator equation formulated in a general Banach space setting, and a characterization of lp-maximal regularity—or well posedness—solely in terms of R-boundedness properties of the resolvent operator involved in the equation.

  10. Maximizing car insurance online sales by developing superior webshop

    OpenAIRE

    Pylväs, Paula

    2014-01-01

    The purpose of this thesis work was to investigate what kind of webshop and what kind of improvements would increase customer satisfaction and maximize car insurance online sales by volume and by value. Main measure for this is the conversion rate, percentage of the potential buyers entering the site who actually make a purchase.

  11. Principle of Entropy Maximization for Nonequilibrium Steady States

    DEFF Research Database (Denmark)

    Shapiro, Alexander; Stenby, Erling Halfdan

    2002-01-01

    The goal of this contribution is to find out to what extent the principle of entropy maximization, which serves as a basis for the equilibrium thermodynamics, may be generalized onto non-equilibrium steady states. We prove a theorem that, in the system of thermodynamic coordinates, where entropy...

  12. Transformation of bipartite non-maximally entangled states into a ...

    Indian Academy of Sciences (India)

    We present two schemes for transforming bipartite non-maximally entangled states into a W state in cavity QED system, by using highly detuned interactions and the resonant interactions between two-level atoms and a single-mode cavity field. A tri-atom W state can be generated by adjusting the interaction times between ...

  13. Maximal exercise performance in patients with postcancer fatigue

    NARCIS (Netherlands)

    Prinsen, H.; Hopman, M. T. E.; Zwarts, M. J.; Leer, J. W. H.; Heerschap, A.; Bleijenberg, G.; van Laarhoven, H. W. M.

    2013-01-01

    The aim of this study is to examine whether physical fitness of severely fatigued and non-fatigued cancer survivors, as measured by maximal exercise performance, is different between both groups and, if so, whether this difference can be explained by differences in physical activity, self-efficacy

  14. The Boundary Crossing Theorem and the Maximal Stability Interval

    Directory of Open Access Journals (Sweden)

    Jorge-Antonio López-Renteria

    2011-01-01

    useful tools in the study of the stability of family of polynomials. Although both of these theorem seem intuitively obvious, they can be used for proving important results. In this paper, we give generalizations of these two theorems and we apply such generalizations for finding the maximal stability interval.

  15. An application of the maximal independent set algorithm to course ...

    African Journals Online (AJOL)

    In this paper, we demonstrated one of the many applications of the Maximal Independent Set Algorithm in the area of course allocation. A program was developed in Pascal and used in implementing a modified version of the algorithm to assign teaching courses to available lecturers in any academic environment and it ...

  16. Modifying Softball for Maximizing Learning Outcomes in Physical Education

    Science.gov (United States)

    Brian, Ali; Ward, Phillip; Goodway, Jacqueline D.; Sutherland, Sue

    2014-01-01

    Softball is taught in many physical education programs throughout the United States. This article describes modifications that maximize learning outcomes and that address the National Standards and safety recommendations. The modifications focus on tasks and equipment, developmentally appropriate motor-skill acquisition, increasing number of…

  17. Do Speakers and Listeners Observe the Gricean Maxim of Quantity?

    Science.gov (United States)

    Engelhardt, Paul E.; Bailey, Karl G. D.; Ferreira, Fernanda

    2006-01-01

    The Gricean Maxim of Quantity is believed to govern linguistic performance. Speakers are assumed to provide as much information as required for referent identification and no more, and listeners are believed to expect unambiguous but concise descriptions. In three experiments we examined the extent to which naive participants are sensitive to the…

  18. Extract of Zanthoxylum bungeanum maxim seed oil reduces ...

    African Journals Online (AJOL)

    Purpose: To investigate the anti-hyperlipidaemic effect of extract of Zanthoxylum bungeanum Maxim. seed oil (EZSO) on high-fat diet (HFD)-induced hyperlipidemic hamsters. Methods: Following feeding with HFD for 30 days, hyperlipidemic hamsters were intragastrically treated with EZSO for 60 days. Serum levels of ...

  19. Dynamical generation of maximally entangled states in two identical cavities

    International Nuclear Information System (INIS)

    Alexanian, Moorad

    2011-01-01

    The generation of entanglement between two identical coupled cavities, each containing a single three-level atom, is studied when the cavities exchange two coherent photons and are in the N=2,4 manifolds, where N represents the maximum number of photons possible in either cavity. The atom-photon state of each cavity is described by a qutrit for N=2 and a five-dimensional qudit for N=4. However, the conservation of the total value of N for the interacting two-cavity system limits the total number of states to only 4 states for N=2 and 8 states for N=4, rather than the usual 9 for two qutrits and 25 for two five-dimensional qudits. In the N=2 manifold, two-qutrit states dynamically generate four maximally entangled Bell states from initially unentangled states. In the N=4 manifold, two-qudit states dynamically generate maximally entangled states involving three or four states. The generation of these maximally entangled states occurs rather rapidly for large hopping strengths. The cavities function as a storage of periodically generated maximally entangled states.

  20. MAXIMIZING OPTO-ELASTIC INTERACTION USING TOPOLOGY OPTIMIZATION

    DEFF Research Database (Denmark)

    Gersborg, Allan Roulund; Sigmund, Ole

    . Secondly, there is the photo-elastic effect which changes the refractive index through Pockel's coefficients as the material is strained. For the case of transverse electric modes, we study how the two effects change the material distribution which maximizes the change in the optical transmission...

  1. Influence of Lumber Volume Maximization in Sawing Hardwood Sawlogs

    Science.gov (United States)

    Philip H. Steele; Francis G. Wagner; Lalit Kumar; Philip A. Araman

    1993-01-01

    The Best Opening Face (BOF) technology for volume maximization during sawing has been rapidly adopted by softwood sawmills. Application of this technology in hardwood sawmills has been limited because of their emphasis on sawing for the highest possible grade of lumber. The reason for this emphasis is that there is a relatively large difference in price between the...

  2. Should I Stay or Should I Go? Maximizers versus Satisficers

    Science.gov (United States)

    Buri, John R.; Gunty, Amy; King, Stephanie L.

    2008-01-01

    In the present study, university students were presented a scenario in which a married couple was struggling in their marriage. These students were asked how likely it is that they would stay in a difficult marriage like the one described in the scenario. Each student also completed Schwartz's (2004) Maximization Scale. High scorers on this scale…

  3. Transformation of bipartite non-maximally entangled states into a ...

    Indian Academy of Sciences (India)

    We present two schemes for transforming bipartite non-maximally entangled states into a W state in cavity QED system, by using highly detuned interactions and the resonant interactions between ... Proceedings of the International Workshop/Conference on Computational Condensed Matter Physics and Materials Science

  4. Adaptive maximal poisson-disk sampling on surfaces

    KAUST Repository

    Yan, Dongming; Wonka, Peter

    2012-01-01

    In this paper, we study the generation of maximal Poisson-disk sets with varying radii on surfaces. Based on the concepts of power diagram and regular triangulation, we present a geometric analysis of gaps in such disk sets on surfaces, which

  5. Assessment of maximal handgrip strength : How many attempts are needed?

    NARCIS (Netherlands)

    Reijnierse, Esmee M.; de Jong, Nynke; Trappenburg, Marijke C.; Blauw, Gerard Jan; Butler-Browne, Gillian; Gapeyeva, Helena; Hogrel, Jean Yves; Mcphee, Jamie S.; Narici, Marco V.; Sipilä, Sarianna; Stenroth, Lauri; van Lummel, Rob C.; Pijnappels, Mirjam; Meskers, Carel G M; Maier, Andrea B.

    Background: Handgrip strength (HGS) is used to identify individuals with low muscle strength (dynapenia). The influence of the number of attempts on maximal HGS is not yet known and may differ depending on age and health status. This study aimed to assess how many attempts of HGS are required to

  6. Twitch interpolation technique in testing of maximal muscle strength

    DEFF Research Database (Denmark)

    Bülow, P M; Nørregaard, J; Danneskiold-Samsøe, B

    1993-01-01

    The aim was to study the methodological aspects of the muscle twitch interpolation technique in estimating the maximal force of contraction in the quadriceps muscle utilizing commercial muscle testing equipment. Six healthy subjects participated in seven sets of experiments testing the effects...

  7. Throughput maximization of parcel sorter systems by scheduling inbound containers

    NARCIS (Netherlands)

    Haneyah, S.W.A.; Schutten, Johannes M.J.; Fikse, K.; Clausen, Uwe; ten Hompel, Michael; Meier, J. Fabian

    2013-01-01

    This paper addresses the inbound container scheduling problem for automated sorter systems in express parcel sorting. The purpose is to analyze which container scheduling approaches maximize the throughput of sorter systems. We build on existing literature, particularly on the dynamic load balancing

  8. Prediction of maximal heart rate: comparison using a novel and ...

    African Journals Online (AJOL)

    Prediction of maximal heart rate: comparison using a novel and conventional equation. LR Keytel, E Mukwevho, MA Will, M Lambert. Abstract. No Abstract. African Journal for Physical, Health Education, Recreation and Dance Vol. 11(3) 2005: 269-277. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL ...

  9. Aspects of multiuser MIMO for cell throughput maximization

    DEFF Research Database (Denmark)

    Bauch, Gerhard; Tejera, Pedro; Guthy, Christian

    2007-01-01

    We consider a multiuser MIMO downlink scenario where the resources in time, frequency and space are allocated such that the total cell throughput is maximized. This is achieved by exploiting multiuser diversity, i.e. the physical resources are allocated to the user with the highest SNR. We assume...

  10. PROFIT-MAXIMIZING PRINCIPLES, INSTRUCTIONAL UNITS FOR VOCATIONAL AGRICULTURE.

    Science.gov (United States)

    BARKER, RICHARD L.

    THE PURPOSE OF THIS GUIDE IS TO ASSIST VOCATIONAL AGRICULTURE TEACHERS IN STIMULATING JUNIOR AND SENIOR HIGH SCHOOL STUDENT THINKING, UNDERSTANDING, AND DECISION MAKING AS ASSOCIATED WITH PROFIT-MAXIMIZING PRINCIPLES OF FARM OPERATION FOR USE IN FARM MANAGEMENT. IT WAS DEVELOPED UNDER A U.S. OFFICE OF EDUCATION GRANT BY TEACHER-EDUCATORS, A FARM…

  11. How Managerial Ownership Affects Profit Maximization in Newspaper Firms.

    Science.gov (United States)

    Busterna, John C.

    1989-01-01

    Explores whether different levels of a manager's ownership of a newspaper affects the manager's profit maximizing attitudes and behavior. Finds that owner-managers tend to place less emphasis on profits than non-owner-controlled newspapers, contrary to economic theory and empirical evidence from other industries. (RS)

  12. A note on a profit maximizing location model

    NARCIS (Netherlands)

    S. Zhang (Shuzhong)

    1997-01-01

    textabstractIn this paper we discuss a locational model with a profit-maximizing objective. The model can be illustrated by the following situation. There is a set of potential customers in a given region. A firm enters the market and wants to sell a certain product to this set of customers. The

  13. The Profit-Maximizing Firm: Old Wine in New Bottles.

    Science.gov (United States)

    Felder, Joseph

    1990-01-01

    Explains and illustrates a simplified use of graphical analysis for analyzing the profit-maximizing firm. Believes that graphical analysis helps college students gain a deeper understanding of marginalism and an increased ability to formulate economic problems in marginalist terms. (DB)

  14. Discussion on: "Profit Maximization of a Power Plant"

    DEFF Research Database (Denmark)

    Boomsma (fhv. Kristoffersen), Trine Krogh; Fleten, Stein-Erik

    2012-01-01

    Kragelund et al. provides an interesting contribution to operations scheduling in liberalized electricity markets. They address the problem of profit maximization for a power plant participating in the electricity market. In particular, given that the plant has already been dispatched in a day...

  15. A decision theoretic framework for profit maximization in direct marketing

    NARCIS (Netherlands)

    Muus, L.; van der Scheer, H.; Wansbeek, T.J.; Montgomery, A.; Franses, P.H.B.F.

    2002-01-01

    One of the most important issues facing a firm involved in direct marketing is the selection of addresses from a mailing list. When the parameters of the model describing consumers' reaction to a mailing are known, addresses for a future mailing can be selected in a profit-maximizing way. Usually,

  16. Maximizing profits associated with abandonment decisions and options

    International Nuclear Information System (INIS)

    Antia, D.D.J.

    1994-01-01

    Economic strategies which are designed to maximize profits associated with abandonment decisions and options focus on: extending field life; offsetting of economic risks onto a third party; reuse of facilities and infrastructure; expansion of associated secondary processing and distribution capabilities and usage; and the sale of abandonment units to a third party

  17. Mentoring as Professional Development for Novice Entrepreneurs: Maximizing the Learning

    Science.gov (United States)

    St-Jean, Etienne

    2012-01-01

    Mentoring can be seen as relevant if not essential in the continuing professional development of entrepreneurs. In the present study, we seek to understand how to maximize the learning that occurs through the mentoring process. To achieve this, we consider various elements that the literature suggested are associated with successful mentoring and…

  18. Maximizing plant density affects broccoli yield and quality

    Science.gov (United States)

    Increased demand for fresh market bunch broccoli (Brassica oleracea L. var. italica) has led to increased production along the United States east coast. Maximizing broccoli yields is a primary concern for quickly expanding southeastern commercial markets. This broccoli plant density study was carr...

  19. Off-shell representations of maximally-extended supersymmetry

    International Nuclear Information System (INIS)

    Cox, P.H.

    1985-01-01

    A general theorem on the necessity of off-shell central charges in representations of maximally-extended supersymmetry (number of spinor charges - 4 x largest spin) is presented. A procedure for building larger and higher-N representations is also explored; a (noninteracting) N=8, maximum spin 2, off-shell representation is achieved. Difficulties in adding interactions for this representation are discussed

  20. Maximizing the model for Discounted Stream of Utility from ...

    African Journals Online (AJOL)

    Osagiede et al. (2009) considered an analytic model for maximizing discounted stream of utility from consumption when the rate of production is linear. A solution was provided to a level where methods of solving order differential equations will be applied, but they left off there, as a result of the mathematical complexity ...

  1. Stewart's maxims: eight "do's" for successfully communicating silviculture to policymakers

    Science.gov (United States)

    R. E. Stewart

    1997-01-01

    Technical specialists may experience difficulties in presenting information to non-technical policymakers and having that information used. Eight maxims are discussed that should help the silviculturist successfully provide technical information to non-technical audiences so that it will be considered in the formulation of policy.

  2. The Bianchi classification of maximal D = 8 gauged supergravities

    NARCIS (Netherlands)

    Bergshoeff, Eric; Gran, Ulf; Linares, Román; Nielsen, Mikkel; Ortín, Tomás; Roest, Diederik

    2003-01-01

    We perform the generalized dimensional reduction of D = 11 supergravity over three-dimensional group manifolds as classified by Bianchi. Thus, we construct 11 different maximal D = 8 gauged supergravities, two of which have an additional parameter. One class of group manifolds (class B) leads to

  3. The Bianchi classification of maximal D=8 gauged supergravities

    NARCIS (Netherlands)

    Bergshoeff, E; Gran, U; Linares, R; Nielsen, M; Ortin, T; Roest, D

    2003-01-01

    We perform the generalized dimensional reduction of D = 11 supergravity over three-dimensional group manifolds as classified by Bianchi. Thus, we construct 11 different maximal D = 8 gauged supergravities, two of which have an additional parameter. One class of group manifolds (class B) leads to

  4. Hard-type nonlocality proof for two maximally entangled particles

    International Nuclear Information System (INIS)

    Kalamidas, D.

    2005-01-01

    Full text: We present, for the first time, a Hardy-type proof of nonlocality for two maximally entangled particles in a four-dimensional total Hilbert space. Furthermore, the violation of local realistic predictions occurs for 25 % of trials, exceeding the 9 % maximum obtained by Hardy for nonmaximally entangled states. (author)

  5. Maximal Sharing in the Lambda Calculus with Letrec

    NARCIS (Netherlands)

    Grabmayer, C.A.; Rochel, J.

    2014-01-01

    Increasing sharing in programs is desirable to compactify the code, and to avoid duplication of reduction work at run-time, thereby speeding up execution. We show how a maximal degree of sharing can be obtained for programs expressed as terms in the lambda calculus with letrec. We introduce a notion

  6. Maximal near-field radiative heat transfer between two plates

    Science.gov (United States)

    Nefzaoui, Elyes; Ezzahri, Younès; Drévillon, Jérémie; Joulain, Karl

    2013-09-01

    Near-field radiative transfer is a promising way to significantly and simultaneously enhance both thermo-photovoltaic (TPV) devices power densities and efficiencies. A parametric study of Drude and Lorentz models performances in maximizing near-field radiative heat transfer between two semi-infinite planes separated by nanometric distances at room temperature is presented in this paper. Optimal parameters of these models that provide optical properties maximizing the radiative heat flux are reported and compared to real materials usually considered in similar studies, silicon carbide and heavily doped silicon in this case. Results are obtained by exact and approximate (in the extreme near-field regime and the electrostatic limit hypothesis) calculations. The two methods are compared in terms of accuracy and CPU resources consumption. Their differences are explained according to a mesoscopic description of nearfield radiative heat transfer. Finally, the frequently assumed hypothesis which states a maximal radiative heat transfer when the two semi-infinite planes are of identical materials is numerically confirmed. Its subsequent practical constraints are then discussed. Presented results enlighten relevant paths to follow in order to choose or design materials maximizing nano-TPV devices performances.

  7. Impact of training status on maximal oxygen uptake criteria ...

    African Journals Online (AJOL)

    Peak treadmill running speed was significantly faster and total test time significantly longer in the trained group. In contrast, peak lactate, although maximal for both groups, was significantly higher in the untrained group (13.5 mmol.l-1 compared with 10.3 mmol.l-1). The other responses were not different between the groups ...

  8. Bicarbonate attenuates arterial desaturation during maximal exercise in humans

    DEFF Research Database (Denmark)

    Nielsen, Henning B; Bredmose, Per P; Strømstad, Morten

    2002-01-01

    The contribution of pH to exercise-induced arterial O2 desaturation was evaluated by intravenous infusion of sodium bicarbonate (Bic, 1 M; 200-350 ml) or an equal volume of saline (Sal; 1 M) at a constant infusion rate during a "2,000-m" maximal ergometer row in five male oarsmen. Blood...

  9. Minimizing surgical skin incision scars with a latex surgical glove.

    Science.gov (United States)

    Han, So-Eun; Ryoo, Suk-Tae; Lim, So Young; Pyon, Jai-Kyung; Bang, Sa-Ik; Oh, Kap-Sung; Mun, Goo-Hyun

    2013-04-01

    The current trend in minimally invasive surgery is to make a small surgical incision. However, the excessive tensile stress applied by the retractors to the skin surrounding the incision often results in a long wound healing time and extensive scarring. To minimize these types of wound problems, the authors evaluated a simple and cost-effective method to minimize surgical incision scars based on the use of a latex surgical glove. The tunnel-shaped part of a powder-free latex surgical glove was applied to the incision and the dissection plane. It was fixed to the full layer of the dissection plane with sutures. The glove on the skin surface then was sealed with Ioban (3 M Health Care, St. Paul, MN, USA) to prevent movement. The operation proceeded as usual, with the retractor running through the tunnel of the latex glove. It was possible to complete the operation without any disturbance of the visual field by the surgical glove, and the glove was neither torn nor separated by the retractors. The retractors caused traction and friction during the operation, but the extent of damage to the postoperative skin incision margin was remarkably less than when the operation was performed without a glove. This simple and cost-effective method is based on the use of a latex surgical glove to protect the surgical skin incision site and improve the appearance of the postoperative scar. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  10. Bacterial migration through punctured surgical gloves under real surgical conditions

    Directory of Open Access Journals (Sweden)

    Heidecke Claus-Dieter

    2010-07-01

    Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

  11. [Simulation-based robot-assisted surgical training].

    Science.gov (United States)

    Kolontarev, K B; Govorov, A V; Rasner, P I; Sheptunov, S A; Prilepskaya, E A; Maltsev, E G; Pushkar, D Yu

    2015-12-01

    Since the first use of robotic surgical system in 2000, the robot-assisted technology has gained wide popularity throughout the world. Robot-assisted surgical training is a complex issue that requires significant efforts from students and teacher. During the last two decades, simulation-based training had received active development due to wide-spread occurrence and popularization of laparoscopic and robot-assisted surgical techniques. We performed a systematic review to identify the currently available simulators for robot-assisted surgery. We searched the Medline and Pubmed, English sources of literature data, using the following key words and phrases: "robotics", "robotic surgery", "computer assisted surgery", "simulation", "computer simulation", "virtual reality", "surgical training", and "surgical education". There were identified 565 publications, which meet the key words and phrases; 19 publications were selected for the final analysis. It was established that simulation-based training is the most promising teaching tool that can be used in the training of the next generation robotic surgeons. Today the use of simulators to train surgeons is validated. Price of devices is an obvious barrier for inclusion in the program for training of robotic surgeons, but the lack of this tool will result in a sharp increase in the duration of specialists training.

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

    Directory of Open Access Journals (Sweden)

    Steven Arild Wuyts Andersen

    2015-04-01

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

  13. Maximal isometric strength of the cervical musculature in 100 healthy volunteers

    DEFF Research Database (Denmark)

    Jordan, A; Mehlsen, J; Bülow, P M

    1999-01-01

    A descriptive study involving maximal isometric strength measurements of the cervical musculature.......A descriptive study involving maximal isometric strength measurements of the cervical musculature....

  14. Student Effort, Consistency and Online Performance

    Directory of Open Access Journals (Sweden)

    Hilde Patron

    2011-07-01

    Full Text Available This paper examines how student effort, consistency, motivation, and marginal learning, influence student grades in an online course. We use data from eleven Microeconomics courses taught online for a total of 212 students. Our findings show that consistency, or less time variation, is a statistically significant explanatory variable, whereas effort, or total minutes spent online, is not. Other independent variables include GPA and the difference between a pre-test and a post-test. The GPA is used as a measure of motivation, and the difference between a post-test and pre-test as marginal learning. As expected, the level of motivation is found statistically significant at a 99% confidence level, and marginal learning is also significant at a 95% level.

  15. Summary of process research analysis efforts

    Science.gov (United States)

    Burger, D. R.

    1985-01-01

    A summary of solar-cell process research analysis efforts was presented. Process design and cell design are interactive efforts where technology from integrated circuit processes and other processes are blended. The primary factors that control cell efficiency are: (1) the bulk parameters of the available sheet material, (2) the retention and enhancement of these bulk parameters, and (3) the cell design and the cost to produce versus the finished cells performance. The process sequences need to be tailored to be compatible with the sheet form, the cell shape form, and the processing equipment. New process options that require further evaluation and utilization are lasers, robotics, thermal pulse techniques, and new materials. There are numerous process control techniques that can be adapted and used that will improve product uniformity and reduced costs. Two factors that can lead to longer life modules are the use of solar cell diffusion barriers and improved encapsulation.

  16. Non-proliferation efforts in South Asia

    International Nuclear Information System (INIS)

    Chellaney, B.

    1994-01-01

    Southern Asia is one of the most volatile regions in the world because of inter-State and intra-State conflicts. Security in the region highly depends on the rival capabilities of the involved states, Pakistan, India, China. Increased Confidence building and nuclear transparency are becoming more significant issues in attaining stability in the region, although non-proliferation efforts in this region have attained little headway

  17. Some recent efforts toward high density implosions

    International Nuclear Information System (INIS)

    McClellan, G.E.

    1980-01-01

    Some recent Livermore efforts towards achieving high-density implosions are presented. The implosion dynamics necessary to compress DT fuel to 10 to 100 times liquid density are discussed. Methods of diagnosing the maximum DT density for a specific design are presented along with results to date. The dynamics of the double-shelled target with an exploding outer shell are described, and some preliminary experimental results are presented

  18. Evaluative language, cognitive effort and attitude change.

    OpenAIRE

    van der Pligt, J.; van Schie, E.C.M.; Martijn, C.

    1994-01-01

    Tested the hypotheses that evaluatively biased language influences attitudes and that the magnitude and persistence of attitude change depends on the amount of cognitive effort. 132 undergraduates participated in the experiment, which used material focusing on the issue of restricting adolescent driving over the weekends to reduce the number of fatal traffic accidents. Results indicate that evaluatively biased language can affect attitudes. Using words that evaluate the pro-position positivel...

  19. Efforts to identify spore forming bacillus

    Energy Technology Data Exchange (ETDEWEB)

    Zuleiha, M.S.; Hilmy, N. (National Atomic Energy Agency, Jakarta (Indonesia). Pasar Djumat Research Centre)

    1982-04-01

    Efforts to identify 47 species of radioresistant spore forming bacillus sp. isolated from locally produced medical devices have been carried out. The identifications was conducted using 19 kinds of biochemical tests and compared to species to bacillus subtilis W. T.; bacillus pumilus E 601 and bacillus sphaericus Csub(I)A. The results showed that bacillus sp. examined could be divided into 6 groups, i.e. bacillus cereus; bacillus subtilis; bacillus stearothermophylus; bacillus coagulans; bacillus sphaericus and bacillus circulans.

  20. Efforts to identify spore forming bacillus

    International Nuclear Information System (INIS)

    Zuleiha, M.S.; Hilmy, Nazly

    1982-01-01

    Efforts to identify 47 species of radioresistant spore forming bacillus sp. isolated from locally produced medical devices have been carried out. The identifications was conducted using 19 kinds of biochemical tests and compared to species to bacillus subtilis W. T.; bacillus pumilus E 601 and bacillus sphaericus Csub(I)A. The results showed that bacillus sp. examined could be divided into 6 groups, i.e. bacillus cereus; bacillus subtilis; bacillus stearothermophylus; bacillus coagulans; bacillus sphaericus and bacillus circulans. (author)

  1. Environmental Determinants of Lexical Processing Effort

    OpenAIRE

    McDonald, Scott

    2000-01-01

    Institute for Adaptive and Neural Computation A central concern of psycholinguistic research is explaining the relative ease or difficulty involved in processing words. In this thesis, we explore the connection between lexical processing effort and measurable properties of the linguistic environment. Distributional information (information about a word’s contexts of use) is easily extracted from large language corpora in the form of co-occurrence statistics. We claim that su...

  2. Duke Power's liquid radwaste processing improvement efforts

    International Nuclear Information System (INIS)

    Baker, R.E. Jr.; Bramblett, J.W.

    1995-01-01

    The rising cost of processing liquid radwaste and industry efforts to reduce offsite isotopic contributions has drawn greater attention to the liquid radwaste area. Because of economic pressures to reduce cost and simultaneously improve performance, Duke Power has undertaken a wide ranging effort to cost effectively achieve improvements in the liquid radwaste processing area. Duke Power has achieved significant reductions over recent years in the release of curies to the environment from the Liquid Radwaste Treatmentt systems at its Catawba, McGuire, and Oconee stations. System wide site curie reductions of 78% have been achieved in a 3 year period. These curie reductions have been achieved while simultaneously reducing the amount of media used to accomplish treatment. The curie and media usage reductions have been achieved at low capital cost expenditures. A large number of approaches and projects have been used to achieve these curie and media usage reductions. This paper will describe the various projects and the associated results for Duke Power's processing improvement efforts. The subjects/projects which will be described include: (1) Cooperative philosophy between stations (2) Source Control (3) Processing Improvements (4) Technology Testing

  3. Involving vendors in continuous quality improvement efforts.

    Science.gov (United States)

    McDevitt, M C

    1995-03-01

    In the hospital environment, vendors supply a wide range of items, from surgical sutures to the latest in high-cost technological equipment. Also, many clinical and support services, such as respiratory therapy, transcription, and computer databanks are now outsourced to commercial vendors. Interaction with such vendors is often less than satisfactory, with prolonged timelines and disruption of an important process that is being computerized. Although hospitals deal with very few vendors in long-term relationships, such as those seen in manufacturing, this should not preclude the formation of a supplier-customer relationship that goes beyond management's interaction with the sales representative in response to a request for proposal. This is especially true when a process improvement team has studied an internal process and defined a key quality characteristic.

  4. A model of reward- and effort-based optimal decision making and motor control.

    Directory of Open Access Journals (Sweden)

    Lionel Rigoux

    Full Text Available Costs (e.g. energetic expenditure and benefits (e.g. food are central determinants of behavior. In ecology and economics, they are combined to form a utility function which is maximized to guide choices. This principle is widely used in neuroscience as a normative model of decision and action, but current versions of this model fail to consider how decisions are actually converted into actions (i.e. the formation of trajectories. Here, we describe an approach where decision making and motor control are optimal, iterative processes derived from the maximization of the discounted, weighted difference between expected rewards and foreseeable motor efforts. The model accounts for decision making in cost/benefit situations, and detailed characteristics of control and goal tracking in realistic motor tasks. As a normative construction, the model is relevant to address the neural bases and pathological aspects of decision making and motor control.

  5. The Mediating Role of Maximizer Decision Makin g Approach in Core Self - Evaluations and Entrepreneurial Persona lity Relationship: Konya Sample

    Directory of Open Access Journals (Sweden)

    Aykut Arslan

    2015-09-01

    Full Text Available A lot of effort has been put to increase the number of entrepreneurs, the engines of the countries’ economic progress, and to promote entrepreneurship. In this regard, within the recent years in particular, studies, based on psychology and personality relationship are done to understand the entrepreneurial personality. To contribute to this topic and after searching the relevant literature, variables that might predict entrepreneurship have been incorporated into the model. It has been argued that one ofhese theories, core self-evaluations, may determine the entrepreneurial personality by enhancing their self-perceptions and awareness regarding their skills to utilize the opportunities. Moreover, it has also been investigated if the maximizer decision- making, one of the cognitive psychology theories, play a role as a mediator. Core self-evaluations account for 72% of the variance on entrepreneurship; but when maximizer decision-making is added, the amount of variance decreased to 65%. It may assumed to be an important result that entrepreneurial personality and maximizer decision-making cannot co-exist when the negative but statistical significant relationship between maximizer decision-making and core self-evaluations are considered

  6. RECORDED-ROLE PLAY IN EFL CLASSROOM: A WAY OF MAXIMIZING STUDENTS‟ POTENTIAL IN SPEAKING

    Directory of Open Access Journals (Sweden)

    Krismiyati Krismiyati

    2017-04-01

    Full Text Available Teaching English for non English Department students will be quite a challenge as the students have various background and interest. Handling those students in a big number in a class that requires them to speak is another impending challenge. This is an action research on role-play in English classroom for Information Technology students. This study tries to see whether recorded-role play could maximize students‘ potential in speaking. This study involved 30 students taking English course in Information Technology Faculty. The students were given a situation in which they had to act the role play. They drafted the role -play before they recorded it. The result shows that students felt less tense in acting the role. They also got more time to practice their pronunciation before recording. It even gave students who felt reluctant and shy in the class to actively participate. In addition, students could play around with the supporting background sound to show their creativity. Surprisingly, most students do their best to show their effort in their speaking as the end-product would be played in the classroom, even the most quiet students performed really well. Finally, this recorded-role play proved to be an effective way to maximize students‘ potential in speaking.

  7. Maximized Effective Energy Output of Contact-Separation-Triggered Triboelectric Nanogenerators as Limited by Air Breakdown

    KAUST Repository

    Zi, Yunlong; Wu, Changsheng; Ding, Wenbo; Wang, Zhong Lin

    2017-01-01

    Recent progress in triboelectric nanogenerators (TENGs) has demonstrated their promising potential as a high-efficiency mechanical energy harvesting technology, and plenty of effort has been devoted to improving the power output by maximizing the triboelectric surface charge density. However, due to high-voltage air breakdown, most of the enhanced surface charge density brought by material/surface optimization or external ion injection is not retainable or usable for electricity generation during the operation of contact-separation-triggered TENGs. Here, the existence of the air breakdown effect in a contact-separation mode TENG with a low threshold surface charge density of ≈40–50 µC m−2 is first validated under the high impedance external load, and then followed by the theoretical study of the maximized effective energy output as limited by air breakdown for contact-separation-triggered TENGs. The effects of air pressure and gas composition are also studied and propose promising solutions for reducing the air breakdown effect. This research provides a crucial fundamental study for TENG technology and its further development and applications.

  8. The effect of caffeine on maximal oxygen uptake and vertical jump performance in male basketball players.

    Science.gov (United States)

    Tucker, Matthew A; Hargreaves, Jill M; Clarke, Jenny C; Dale, Darren L; Blackwell, Gavin J

    2013-02-01

    This study investigated whether performance enhancement from caffeine described by other researchers transfers to male basketball players. The effects of caffeine ingestion were studied in a maximal-effort test on a treadmill that was followed by a vertical-jump test. Five elite-level male basketball players completed a graded treadmill test that measured maximal oxygen uptake, blood lactate profiles, respiratory exchange ratio, and rating of perceived exertion at each 3-minute stage. After a 15-minute warm-down, the subjects performed 10 vertical rebound jumps. Each subject completed the test twice--once with a 3 mg·kg(-1) of body weight dose of caffeine and once with a placebo, with the dosage administered 60 minutes before commencement of exercise. The test was thus administered according to a double-blind protocol. No substantial trends were found between caffeine and control trials, regardless of trial order. The study showed that the specified dosage had negligible effects on the players' power and endurance performance and had no efficacy as an ergogenic aid for male basketball players.

  9. Maximized Effective Energy Output of Contact-Separation-Triggered Triboelectric Nanogenerators as Limited by Air Breakdown

    KAUST Repository

    Zi, Yunlong

    2017-05-02

    Recent progress in triboelectric nanogenerators (TENGs) has demonstrated their promising potential as a high-efficiency mechanical energy harvesting technology, and plenty of effort has been devoted to improving the power output by maximizing the triboelectric surface charge density. However, due to high-voltage air breakdown, most of the enhanced surface charge density brought by material/surface optimization or external ion injection is not retainable or usable for electricity generation during the operation of contact-separation-triggered TENGs. Here, the existence of the air breakdown effect in a contact-separation mode TENG with a low threshold surface charge density of ≈40–50 µC m−2 is first validated under the high impedance external load, and then followed by the theoretical study of the maximized effective energy output as limited by air breakdown for contact-separation-triggered TENGs. The effects of air pressure and gas composition are also studied and propose promising solutions for reducing the air breakdown effect. This research provides a crucial fundamental study for TENG technology and its further development and applications.

  10. Maximizing Your Grant Development: A Guide for CEOs.

    Science.gov (United States)

    Snyder, Thomas

    1993-01-01

    Since most private and public sources of external funding generally expect increased effort and accountability, Chief Executive Officers (CEOs) at two-year colleges must inform faculty and staff that if they do not expend extra effort their college will not receive significant grants. The CEO must also work with the college's professional…

  11. Dual Competing Photovoltaic Supply Chains: A Social Welfare Maximization Perspective

    Directory of Open Access Journals (Sweden)

    Zhisong Chen

    2017-11-01

    Full Text Available In the past decades, the inappropriate subsidy policies in many nations have caused problems such as serious oversupply, fierce competition and subpar social welfare in the photovoltaic (PV industry in many nations. There is a clear shortage in the PV industry literature regarding how dual supply chains compete and the key decision issues regarding the competition between dual PV supply chains. It is critical to develop effective subsidy policies for the competing PV supply chains to achieve social welfare maximization. This study has explored the dual PV supply chain competition under the Bertrand competition assumption by three game-theoretical modeling scenarios (or supply chain strategies considering either the public subsidy or no subsidy from a social welfare maximization perspective. A numerical analysis complemented by two sensitivity analyses provides a better understanding of the pricing and quantity decision dynamics in the dual supply chains under three different supply chain strategies and the corresponding outcomes regarding the total supply chain profits, the social welfare and the required total subsidies. The key findings disclose that if there are public subsidies, the dual PV supply chains have the strongest intention to pursue the decentralized strategy to achieve their maximal returns rather than the centralized strategy that would achieve the maximal social welfare; however, the government would need to pay for the maximal subsidy budget. Thus, the best option for the government would be to encourage the dual PV supply chains to adopt a centralized strategy since this will not only maximize the social welfare but also, at the same time, minimize the public subsidy. With a smart subsidy policy, the PV industry can make the best use of the subsidy budget and grow in a sustainable way to support the highly demanded solar power generation in many countries trying very hard to increase the proportion of their clean energy to

  12. Dual Competing Photovoltaic Supply Chains: A Social Welfare Maximization Perspective

    Science.gov (United States)

    Su, Shong-Iee Ivan

    2017-01-01

    In the past decades, the inappropriate subsidy policies in many nations have caused problems such as serious oversupply, fierce competition and subpar social welfare in the photovoltaic (PV) industry in many nations. There is a clear shortage in the PV industry literature regarding how dual supply chains compete and the key decision issues regarding the competition between dual PV supply chains. It is critical to develop effective subsidy policies for the competing PV supply chains to achieve social welfare maximization. This study has explored the dual PV supply chain competition under the Bertrand competition assumption by three game-theoretical modeling scenarios (or supply chain strategies) considering either the public subsidy or no subsidy from a social welfare maximization perspective. A numerical analysis complemented by two sensitivity analyses provides a better understanding of the pricing and quantity decision dynamics in the dual supply chains under three different supply chain strategies and the corresponding outcomes regarding the total supply chain profits, the social welfare and the required total subsidies. The key findings disclose that if there are public subsidies, the dual PV supply chains have the strongest intention to pursue the decentralized strategy to achieve their maximal returns rather than the centralized strategy that would achieve the maximal social welfare; however, the government would need to pay for the maximal subsidy budget. Thus, the best option for the government would be to encourage the dual PV supply chains to adopt a centralized strategy since this will not only maximize the social welfare but also, at the same time, minimize the public subsidy. With a smart subsidy policy, the PV industry can make the best use of the subsidy budget and grow in a sustainable way to support the highly demanded solar power generation in many countries trying very hard to increase the proportion of their clean energy to combat the global

  13. Dual Competing Photovoltaic Supply Chains: A Social Welfare Maximization Perspective.

    Science.gov (United States)

    Chen, Zhisong; Su, Shong-Iee Ivan

    2017-11-20

    In the past decades, the inappropriate subsidy policies in many nations have caused problems such as serious oversupply, fierce competition and subpar social welfare in the photovoltaic (PV) industry in many nations. There is a clear shortage in the PV industry literature regarding how dual supply chains compete and the key decision issues regarding the competition between dual PV supply chains. It is critical to develop effective subsidy policies for the competing PV supply chains to achieve social welfare maximization. This study has explored the dual PV supply chain competition under the Bertrand competition assumption by three game-theoretical modeling scenarios (or supply chain strategies) considering either the public subsidy or no subsidy from a social welfare maximization perspective. A numerical analysis complemented by two sensitivity analyses provides a better understanding of the pricing and quantity decision dynamics in the dual supply chains under three different supply chain strategies and the corresponding outcomes regarding the total supply chain profits, the social welfare and the required total subsidies. The key findings disclose that if there are public subsidies, the dual PV supply chains have the strongest intention to pursue the decentralized strategy to achieve their maximal returns rather than the centralized strategy that would achieve the maximal social welfare; however, the government would need to pay for the maximal subsidy budget. Thus, the best option for the government would be to encourage the dual PV supply chains to adopt a centralized strategy since this will not only maximize the social welfare but also, at the same time, minimize the public subsidy. With a smart subsidy policy, the PV industry can make the best use of the subsidy budget and grow in a sustainable way to support the highly demanded solar power generation in many countries trying very hard to increase the proportion of their clean energy to combat the global

  14. Surgical strategies in childhood craniopharyngioma

    Directory of Open Access Journals (Sweden)

    Jörg eFlitsch

    2011-12-01

    Full Text Available Craniopharyngiomas are biologically benign lesions (WHO Grade 1 of the sellar and suprasellar region, associated with a serious morbidity. About 50% of these tumors become clinically apparent during childhood. Clinical symptoms include headaches, chiasm syndrome, hydrocephalus, pituitary insufficiencies, and obesity. Growth arrest is a typical symptom in children. The treatment of craniopharyngiomas includes surgery as well as radiotherapy. The goal of surgery varies according to the tumor location and extension and may range from complete resection to biopsy. Surgical complications are well known and cause constant evaluation of surgical strategies. Diencephalic obesity is related to surgical manipulation of hypothalamic tissue. Therefore, a classification system for craniopharyngiomas based on preoperative MRI is suggested by the authors, which may help assess the surgical risk. Recurrences are frequent in craniopharyngiomas, even after complete or gross-total resection. Radiotherapy is therefore recommended to patients with incomplete resections. However, the ideal time for radiotherapy after surgery is under discussion.The treatment of craniopharyngiomas requires an interdisciplinary and multimodal approach. Each patient should receive an individually tailored treatment. Surgically, different approaches as well as different degrees of resection can be considered, depending on tumor location and tumor extension.

  15. Surgical Management of Localized Scleroderma.

    Science.gov (United States)

    Lee, Jae Hyun; Lim, Soo Yeon; Lee, Jang Hyun; Ahn, Hee Chang

    2017-09-01

    Localized scleroderma is characterized by a thickening of the skin from excessive collagen deposits. It is not a fatal disease, but quality of life can be adversely affected due to changes in skin appearance, joint contractures, and, rarely, serious deformities of the face and extremities. We present six cases of localized scleroderma in face from our surgical practice. We reviewed six localized scleroderma cases that were initially treated with medication and then received follow-up surgery between April 2003 and February 2015. Six patients had facial lesions. These cases presented with linear dermal sclerosis on the forehead, oval subcutaneous and dermal depression in the cheek. En coup de sabre (n=4), and oval-shaped lesion of the face (n=2) were successfully treated. Surgical methods included resection with or without Z-plasty (n=3), fat graft (n=1), dermofat graft (n=1), and adipofascial free flap (n=1). Deformities of the affected parts were surgically corrected without reoccurrence. We retrospectively reviewed six cases of localized scleroderma that were successfully treated with surgery. And we propose an algorithm for selecting the best surgical approach for individual localized scleroderma cases. Although our cases were limited in number and long-term follow-up will be necessary, we suggest that surgical management should be considered as an option for treating scleroderma patients.

  16. Three-dimensional surgical simulation.

    Science.gov (United States)

    Cevidanes, Lucia H C; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael

    2010-09-01

    In this article, we discuss the development of methods for computer-aided jaw surgery, which allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3-dimensional surface models from cone-beam computed tomography, dynamic cephalometry, semiautomatic mirroring, interactive cutting of bone, and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intraoperative guidance. The system provides further intraoperative assistance with a computer display showing jaw positions and 3-dimensional positioning guides updated in real time during the surgical procedure. The computer-aided surgery system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training, and assessing the difficulties of the surgical procedures before the surgery. Computer-aided surgery can make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  17. Pioneering efforts to control AIDS. Review: IHO.

    Science.gov (United States)

    Chatterji, A; Sehgal, K

    1995-01-01

    The Indian Health Organisation (IHO) is a nongovernmental organization based in Bombay with more than 12 years experience in HIV/AIDS prevention and control efforts. It has attacked ignorance and prejudice via communication efforts. IHO has created a bond with some hospital systems of Bombay. IHO disseminated information about HIV/AIDS in Bombay's red light districts and has bridged the gap between the city's medical establishment and the community most in need. IHO's aggressive street-level fighting in a sector replete with sensitive issues has somewhat isolated it from mainstream national NGOs involved in HIV/AIDS education and control as well as from the medical establishment and potential partners. IHO funds have been reduced, forcing IHO to reduce intervention programs and responses to field demands. It suffers from a high rate of turnover among middle management staff. IHO's chief advantage is its confidence gained over the past 12 years. IHO has clearly delineated the direction it wants to go: care and support programs for persons affected by HIV/AIDS and for commercial sex workers to allow them to quit prostitution, orphan care, and development of training institutions for the education and motivation of medical personnel on HIV/AIDS care and prevention. It plans to build a hospice for AIDS patients and orphans and a training center. Training activities will vary from one-week orientation programs to three-month certificate courses for medical workers, NGOs, and managers from the commercial sector. IHO is prepared to share its experiences in combating HIV/AIDS in Bombay in a team effort. As official and bilateral funding has been decreasing, IHO has targeted industry for funding. Industry has responded, which enables IHO to sustain its core programs and approaches. IHO observations show a decrease in the number of men visiting red-light districts. IHO enjoys a positive relationship with Bombay's media reporting on AIDS.

  18. Economic growth, biodiversity loss and conservation effort.

    Science.gov (United States)

    Dietz, Simon; Adger, W Neil

    2003-05-01

    This paper investigates the relationship between economic growth, biodiversity loss and efforts to conserve biodiversity using a combination of panel and cross section data. If economic growth is a cause of biodiversity loss through habitat transformation and other means, then we would expect an inverse relationship. But if higher levels of income are associated with increasing real demand for biodiversity conservation, then investment to protect remaining diversity should grow and the rate of biodiversity loss should slow with growth. Initially, economic growth and biodiversity loss are examined within the framework of the environmental Kuznets hypothesis. Biodiversity is represented by predicted species richness, generated for tropical terrestrial biodiversity using a species-area relationship. The environmental Kuznets hypothesis is investigated with reference to comparison of fixed and random effects models to allow the relationship to vary for each country. It is concluded that an environmental Kuznets curve between income and rates of loss of habitat and species does not exist in this case. The role of conservation effort in addressing environmental problems is examined through state protection of land and the regulation of trade in endangered species, two important means of biodiversity conservation. This analysis shows that the extent of government environmental policy increases with economic development. We argue that, although the data are problematic, the implications of these models is that conservation effort can only ever result in a partial deceleration of biodiversity decline partly because protected areas serve multiple functions and are not necessarily designated to protect biodiversity. Nevertheless institutional and policy response components of the income biodiversity relationship are important but are not well captured through cross-country regression analysis.

  19. Comparison of changes in the mobility of the pelvic floor muscle on during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction

    OpenAIRE

    Jung, Halim; Jung, Sangwoo; Joo, Sunghee; Song, Changho

    2016-01-01

    [Purpose] The purpose of this study was to compare changes in the mobility of the pelvic floor muscle during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction. [Subjects] Thirty healthy adults participated in this study (15 men and 15 women). [Methods] All participants performed a bridge exercise and abdominal curl-up during the abdominal drawing-in maneuver, maximal expiration, and pelvic floor muscle maximal contraction. Pelvic floor mobility...

  20. Educational Outreach Efforts at the NNDC

    International Nuclear Information System (INIS)

    Holden, N.E.

    2014-01-01

    Isotopes and nuclides are important in our everyday life. The general public and most students are never exposed to the concepts of stable and radioactive isotopes/nuclides. The National Nuclear Data Center (NNDC) is involved in an international project to develop a Periodic Table of the Isotopes for the educational community to illustrate the importance of isotopes and nuclides in understanding the world around us. This effort should aid teachers in introducing these concepts to students from the high school to the graduate school level