WorldWideScience

Sample records for minimal operator intervention

  1. Operation and force analysis of the guide wire in a minimally invasive vascular interventional surgery robot system

    Science.gov (United States)

    Yang, Xue; Wang, Hongbo; Sun, Li; Yu, Hongnian

    2015-03-01

    To develop a robot system for minimally invasive surgery is significant, however the existing minimally invasive surgery robots are not applicable in practical operations, due to their limited functioning and weaker perception. A novel wire feeder is proposed for minimally invasive vascular interventional surgery. It is used for assisting surgeons in delivering a guide wire, balloon and stenting into a specific lesion location. By contrasting those existing wire feeders, the motion methods for delivering and rotating the guide wire in blood vessel are described, and their mechanical realization is presented. A new resistant force detecting method is given in details. The change of the resistance force can help the operator feel the block or embolism existing in front of the guide wire. The driving torque for rotating the guide wire is developed at different positions. Using the CT reconstruction image and extracted vessel paths, the path equation of the blood vessel is obtained. Combining the shapes of the guide wire outside the blood vessel, the whole bending equation of the guide wire is obtained. That is a risk criterion in the delivering process. This process can make operations safer and man-machine interaction more reliable. A novel surgery robot for feeding guide wire is designed, and a risk criterion for the system is given.

  2. Emergency treatment of splenic injury in a novel mobile minimally invasive interventional shelter following disaster: a feasibility study

    Science.gov (United States)

    2014-01-01

    Background There has been an increase in natural disasters in recent years, which leads to a great number of injuries and deaths. It still remains an unsolved problem to treat patients with vascular injury of solid organs effectively following natural disasters, but on-spot emergency interventional transcatheter arterial embolization (TAE) has been highly recommended to cure serious vascular injury of solid organs nowadays. Spleen is the most vulnerable abdominal organ, severe arterial hemorrhage of which can cause death if untreated timely. In this research, we aimed to study the possibility of performing emergency surgical intervention in mobile minimally invasive interventional shelter for splenic injury in the case of natural disasters. Methods First, the mobile minimally invasive interventional shelter was unfolded in the field, and then disinfection and preoperative preparation were performed immediately. Eight large animal models of splenic injury were created, and angiograms were performed using a digital subtraction angiography machine in the mobile minimally invasive interventional shelter, and then the hemostatic embolizations of injured splenic artery were performed following the established convention of rapid intervention therapy. The operating time was recorded, and the survival condition and postoperative complications were observed for two weeks. Results and discussion The average time of unfolding the shelter, and performing disinfection and preoperative preparation was 33 ± 7 min. The number of colonies in the sterilized shelter body was 86 ± 13 cfu/m3. The average TAE time was 31 ± 7 min. All the hemostatic embolizations of splenic injury were performed successfully in the mobile minimally invasive interventional shelter during the operation. A pseudoaneurysm was found in an animal model using angiography two weeks after the operation. The primary clinical success rate of embolization was 87.5%. The two-week survival rate in

  3. Virtual and augmented medical imaging environments: enabling technology for minimally invasive cardiac interventional guidance.

    Science.gov (United States)

    Linte, Cristian A; White, James; Eagleson, Roy; Guiraudon, Gérard M; Peters, Terry M

    2010-01-01

    Virtual and augmented reality environments have been adopted in medicine as a means to enhance the clinician's view of the anatomy and facilitate the performance of minimally invasive procedures. Their value is truly appreciated during interventions where the surgeon cannot directly visualize the targets to be treated, such as during cardiac procedures performed on the beating heart. These environments must accurately represent the real surgical field and require seamless integration of pre- and intra-operative imaging, surgical tracking, and visualization technology in a common framework centered around the patient. This review begins with an overview of minimally invasive cardiac interventions, describes the architecture of a typical surgical guidance platform including imaging, tracking, registration and visualization, highlights both clinical and engineering accuracy limitations in cardiac image guidance, and discusses the translation of the work from the laboratory into the operating room together with typically encountered challenges.

  4. Early and late outcomes of 1000 minimally invasive aortic valve operations.

    Science.gov (United States)

    Tabata, Minoru; Umakanthan, Ramanan; Cohn, Lawrence H; Bolman, Ralph Morton; Shekar, Prem S; Chen, Frederick Y; Couper, Gregory S; Aranki, Sary F

    2008-04-01

    Minimal access cardiac valve surgery is increasingly utilized. We report our 11-year experience with minimally invasive aortic valve surgery. From 07/96 to 12/06, 1005 patients underwent minimally invasive aortic valve surgery. Early and late outcomes were analyzed. Median patient age was 68 years (range: 24-95), 179 patients (18%) were 80 years or older, 130 patients (13%) had reoperative aortic valve surgery, 86 (8.4%) had aortic root replacement, 62 (6.1%) had concomitant ascending aortic replacement, and 26 (2.6%) had percutaneous coronary intervention on the day of surgery (hybrid procedure). Operative mortality was 1.9% (19/1005). The incidences of deep sternal wound infection, pneumonia and reoperation for bleeding were 0.5% (5/1005), 1.3% (13/1005) and 2.4% (25/1005), respectively. Median length of stay was 6 days and 733 patients (72%) were discharged home. Actuarial survival was 91% at 5 years and 88% at 10 years. In the subgroup of the elderly (> or =80 years), operative mortality was 1.7% (3/179), median length of stay was 8 days and 66 patients (37%) were discharged home. Actuarial survival at 5 years was 84%. There was a significant decreasing trend in cardiopulmonary bypass time, the incidence of bleeding, and operative mortality over time. Minimal access approaches in aortic valve surgery are safe and feasible with excellent outcomes. Aortic root replacement, ascending aortic replacement, and reoperative surgery can be performed with these approaches. These procedures are particularly well-tolerated in the elderly.

  5. Guidelines on the facilities required for minor surgical procedures and minimal access interventions.

    LENUS (Irish Health Repository)

    Humphreys, H

    2012-02-01

    There have been many changes in healthcare provision in recent years, including the delivery of some surgical services in primary care or in day surgery centres, which were previously provided by acute hospitals. Developments in the fields of interventional radiology and cardiology have further expanded the range and complexity of procedures undertaken in these settings. In the face of these changes there is a need to define from an infection prevention and control perspective the basic physical requirements for facilities in which such surgical procedures may be carried out. Under the auspices of the Healthcare Infection Society, we have developed the following recommendations for those designing new facilities or upgrading existing facilities. These draw upon best practice, available evidence, other guidelines where appropriate, and expert consensus to provide sensible and feasible advice. An attempt is also made to define minimal access interventions and minor surgical procedures. For minimal access interventions, including interventional radiology, new facilities should be mechanically ventilated to achieve 15 air changes per hour but natural ventilation is satisfactory for minor procedures. All procedures should involve a checklist and operators should be appropriately trained. There is also a need for prospective surveillance to accurately determine the post-procedure infection rate. Finally, there is a requirement for appropriate applied research to develop the evidence base required to support subsequent iterations of this guidance.

  6. Atraumatic restorative treatment and minimal intervention dentistry.

    Science.gov (United States)

    Frencken, J E

    2017-08-11

    Too many people worldwide suffer from the consequences of untreated dentine carious lesions. This finding reflects the inability of the currently used traditional mode of treatments to manage such lesions. A change is needed. Dental training institutions should depart from the traditional 'drill and fill' treatments and embrace the holistic oral healthcare approach that is minimal intervention dentistry (MID) and includes within it minimally invasive operative skills. Dental caries is, after all, a preventable disease. The atraumatic restorative treatment (ART) concept is an example of MID. ART consists of a preventive (ART sealant) and a restorative (ART restoration) component. ART sealants using high-viscosity glass-ionomer (HVGIC) have a very high dentine carious lesion preventive effect. The survival rate of these sealants is not significantly different from that of sealants produced with resin. The survival rate of ART/HVGIC restorations matches those of amalgam and resin composite in single- and multiple-surface cavities in primary teeth and in single-surface cavities in permanent teeth. The principles of carious tissue removal within a cavity recommended by the International Caries Consensus Collaboration are in line with those of treating a cavity using ART. Owing to its good performance and the low levels of discomfort/pain and dental anxiety associated with it, ART and/or other evidence-based atraumatic care procedures should be the first treatment for a primary dentine carious lesion. Only if the use of ART is not indicated should other more invasive and less-atraumatic care procedures be used in both primary and permanent dentitions.

  7. Designing a Minimal Intervention Strategy to Control Taenia solium.

    Science.gov (United States)

    Lightowlers, Marshall W; Donadeu, Meritxell

    2017-06-01

    Neurocysticercosis is an important cause of epilepsy in many developing countries. The disease is a zoonosis caused by the cestode parasite Taenia solium. Many potential intervention strategies are available, however none has been able to be implemented and sustained. Here we predict the impact of some T. solium interventions that could be applied to prevent transmission through pigs, the parasite's natural animal intermediate host. These include minimal intervention strategies that are predicted to be effective and likely to be feasible. Logical models are presented which reflect changes in the risk that age cohorts of animals have for their potential to transmit T. solium. Interventions that include a combined application of vaccination, plus chemotherapy in young animals, are the most effective. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  8. Waste minimization for land-based drilling operations

    International Nuclear Information System (INIS)

    Thurber, N.E.

    1992-01-01

    This paper discusses engineering variables that should be addressed to minimize waste-toxicity and generation while drilling land-based wells. Proper balance of these variables provides both operational and environmental benefits

  9. Minimally invasive or interventional repair of atrial septal defects in children: experience in 171 cases and comparison with conventional strategies.

    Science.gov (United States)

    Formigari, R; Di Donato, R M; Mazzera, E; Carotti, A; Rinelli, G; Parisi, F; Pasquini, L; Ballerini, L

    2001-05-01

    The goal of this study was to evaluate percutaneous interventional and minimally invasive surgical closure of secundum atrial septal defect (ASD) in children. Concern has surrounded abandoning conventional midline sternotomy in favor of the less invasive approaches pursuing a better cosmetic result and a more rational resource utilization. A retrospective analysis was performed on the patients treated from June 1996 to December 1998. One hundred seventy-one children (median age 5.8 years, median weight 22.1 kg) underwent 52 device implants, 72 minimally invasive surgical operations and 50 conventional sternotomy operations. There were no deaths and no residual left to right shunt in any of the groups. The overall complication rate causing delayed discharge was 12.6% for minimally invasive surgery, 12.0% for midline sternotomy and 3.8% for transcatheter device closure (p appeal of the percutaneous and minimally invasive approaches must be weighed against their greater exposure to technical pitfalls. Adequate training is needed if a strategy of surgical or percutaneous minimally invasive closure of ASD in children is planned in place of conventional surgery.

  10. Waste minimization for land-based drilling operations

    International Nuclear Information System (INIS)

    Thurber, N.E.

    1991-01-01

    This paper discusses many of the engineering variables that should be addressed to minimize waste toxicity and generation during the drilling of land-based wells. Proper balance of these variables suggests both operational and environmental benefits

  11. The "Suicide Guard Rail": a minimal structural intervention in hospitals reduces suicide jumps.

    Science.gov (United States)

    Mohl, Andreas; Stulz, Niklaus; Martin, Andrea; Eigenmann, Franz; Hepp, Urs; Hüsler, Jürg; Beer, Jürg H

    2012-08-04

    Jumping from heights is a readily available and lethal method of suicide. This study examined the effectiveness of a minimal structural intervention in preventing suicide jumps at a Swiss general teaching hospital. Following a series of suicide jumps out of the hospital's windows, a metal guard rail was installed at each window of the high-rise building. In the 114 months prior to the installation of the metal guard rail, 10 suicides by jumping out of the hospital's windows occurred among 119,269 inpatients. This figure was significantly reduced to 2 fatal incidents among 104,435 inpatients treated during the 78 months immediately following the installation of the rails at the hospital's windows (χ2 = 4.34, df = 1, p = .037). Even a minimal structural intervention might prevent suicide jumps in a general hospital. Further work is needed to examine the effectiveness of minimal structural interventions in preventing suicide jumps.

  12. Early Success Is Vital in Minimal Worksite Wellness Interventions at Small Worksites

    Science.gov (United States)

    Ablah, Elizabeth; Dong, Frank; Konda, Kurt; Konda, Kelly; Armbruster, Sonja; Tuttle, Becky

    2015-01-01

    Intervention: In an effort to increase physical activity, 15 workplaces participated in a minimal-contact 10,000-steps-a-day program sponsored by the Sedgwick County Health Department in 2007 and 2008. Pedometers were provided to measure participants' weekly steps for the 10-week intervention. Method: Participants were defined as those who…

  13. A Prospective Randomized Study on Operative Treatment for Simple Distal Tibial Fractures-Minimally Invasive Plate Osteosynthesis Versus Minimal Open Reduction and Internal Fixation.

    Science.gov (United States)

    Kim, Ji Wan; Kim, Hyun Uk; Oh, Chang-Wug; Kim, Joon-Woo; Park, Ki Chul

    2018-01-01

    To compare the radiologic and clinical results of minimally invasive plate osteosynthesis (MIPO) and minimal open reduction and internal fixation (ORIF) for simple distal tibial fractures. Randomized prospective study. Three level 1 trauma centers. Fifty-eight patients with simple and distal tibial fractures were randomized into a MIPO group (treatment with MIPO; n = 29) or a minimal group (treatment with minimal ORIF; n = 29). These numbers were designed to define the rate of soft tissue complication; therefore, validation of superiority in union time or determination of differences in rates of delayed union was limited in this study. Simple distal tibial fractures treated with MIPO or minimal ORIF. The clinical outcome measurements included operative time, radiation exposure time, and soft tissue complications. To evaluate a patient's function, the American Orthopedic Foot and Ankle Society ankle score (AOFAS) was used. Radiologic measurements included fracture alignment, delayed union, and union time. All patients acquired bone union without any secondary intervention. The mean union time was 17.4 weeks and 16.3 weeks in the MIPO and minimal groups, respectively. There was 1 case of delayed union and 1 case of superficial infection in each group. The radiation exposure time was shorter in the minimal group than in the MIPO group. Coronal angulation showed a difference between both groups. The American Orthopedic Foot and Ankle Society ankle scores were 86.0 and 86.7 in the MIPO and minimal groups, respectively. Minimal ORIF resulted in similar outcomes, with no increased rate of soft tissue problems compared to MIPO. Both MIPO and minimal ORIF have high union rates and good functional outcomes for simple distal tibial fractures. Minimal ORIF did not result in increased rates of infection and wound dehiscence. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

  14. DMN Operational Synchrony Relates to Self-Consciousness: Evidence from Patients in Vegetative and Minimally Conscious States.

    Science.gov (United States)

    Fingelkurts, Andrew A; Fingelkurts, Alexander A; Bagnato, Sergio; Boccagni, Cristina; Galardi, Giuseppe

    2012-01-01

    The default mode network (DMN) has been consistently activated across a wide variety of self-related tasks, leading to a proposal of the DMN's role in self-related processing. Indeed, there is limited fMRI evidence that the functional connectivity within the DMN may underlie a phenomenon referred to as self-awareness. At the same time, none of the known studies have explicitly investigated neuronal functional interactions among brain areas that comprise the DMN as a function of self-consciousness loss. To fill this gap, EEG operational synchrony analysis [1, 2] was performed in patients with severe brain injuries in vegetative and minimally conscious states to study the strength of DMN operational synchrony as a function of self-consciousness expression. We demonstrated that the strength of DMN EEG operational synchrony was smallest or even absent in patients in vegetative state, intermediate in patients in minimally conscious state and highest in healthy fully self-conscious subjects. At the same time the process of ecoupling of operations performed by neuronal assemblies that comprise the DMN was highest in patients in vegetative state, intermediate in patients in minimally conscious state and minimal in healthy fully self-conscious subjects. The DMN's frontal EEG operational module had the strongest decrease in operational synchrony strength as a function of selfconsciousness loss, when compared with the DMN's posterior modules. Based on these results it is suggested that the strength of DMN functional connectivity could mediate the strength of self-consciousness expression. The observed alterations similarly occurred across EEG alpha, beta1 and beta2 frequency oscillations. Presented results suggest that the EEG operational synchrony within DMN may provide an objective and accurate measure for the assessment of signs of self-(un)consciousness in these challenging patient populations. This method therefore, may complement the current diagnostic procedures for

  15. Evaluation of a School-Based Teen Obesity Prevention Minimal Intervention

    Science.gov (United States)

    Abood, Doris A.; Black, David R.; Coster, Daniel C.

    2008-01-01

    Objective: A school-based nutrition education minimal intervention (MI) was evaluated. Design: The design was experimental, with random assignment at the school level. Setting: Seven schools were randomly assigned as experimental, and 7 as delayed-treatment. Participants: The experimental group included 551 teens, and the delayed treatment group…

  16. On a minimization of the eigenvalues of Schroedinger operator relatively domains

    International Nuclear Information System (INIS)

    Gasymov, Yu.S.; Niftiev, A.A.

    2001-01-01

    Minimization of the eigenvalues plays an important role in the operators spectral theory. The problem on the minimization of the eigenvalues of the Schroedinger operator by areas is considered in this work. The algorithm, analogous to the conditional gradient method, is proposed for the numerical solution of this problem in the common case. The result is generalized for the case of the positively determined completely continuous operator [ru

  17. The “Suicide Guard Rail”: a minimal structural intervention in hospitals reduces suicide jumps

    Directory of Open Access Journals (Sweden)

    Mohl Andreas

    2012-08-01

    Full Text Available Abstract Background Jumping from heights is a readily available and lethal method of suicide. This study examined the effectiveness of a minimal structural intervention in preventing suicide jumps at a Swiss general teaching hospital. Following a series of suicide jumps out of the hospital’s windows, a metal guard rail was installed at each window of the high-rise building. Results In the 114 months prior to the installation of the metal guard rail, 10 suicides by jumping out of the hospital’s windows occurred among 119,269 inpatients. This figure was significantly reduced to 2 fatal incidents among 104,435 inpatients treated during the 78 months immediately following the installation of the rails at the hospital’s windows (χ2 = 4.34, df = 1, p = .037. Conclusions Even a minimal structural intervention might prevent suicide jumps in a general hospital. Further work is needed to examine the effectiveness of minimal structural interventions in preventing suicide jumps.

  18. Insights for Exercise Adherence from a Minimal Planning Intervention to Increase Physical Activity

    Science.gov (United States)

    Chapman, Janine; Campbell, Marianne; Wilson, Carlene

    2015-01-01

    Objective: To test the impact of a minimal, online planning intervention on physical activity in Australian office workers. Method: Employees were randomized to an implementation intention intervention (n = 124) or health information control group (n = 130). Measures of physical activity, past behavior, and motivation were taken at baseline and 6…

  19. Minimal and Maximal Operator Space Structures on Banach Spaces

    OpenAIRE

    P., Vinod Kumar; Balasubramani, M. S.

    2014-01-01

    Given a Banach space $X$, there are many operator space structures possible on $X$, which all have $X$ as their first matrix level. Blecher and Paulsen identified two extreme operator space structures on $X$, namely $Min(X)$ and $Max(X)$ which represents respectively, the smallest and the largest operator space structures admissible on $X$. In this note, we consider the subspace and the quotient space structure of minimal and maximal operator spaces.

  20. Finding the minimal intervention needed for sustained mammography adherence.

    Science.gov (United States)

    Gierisch, Jennifer M; DeFrank, Jessica T; Bowling, J Michael; Rimer, Barbara K; Matuszewski, Jeanine M; Farrell, David; Skinner, Celette Sugg

    2010-10-01

    Regular adherence to mammography screening saves lives, yet few women receive regular mammograms. RCT. Participants were recruited through a state employee health plan. All were women aged 40-75 years and had recent mammograms prior to enrollment (n=3547). Data were collected from 2004 to 2009. Trial tested efficacy of a two-step adaptively-designed intervention to increase mammography adherence over 4 years. The first intervention step consisted of three reminder types: enhanced usual care reminders (EUCR); enhanced letter reminders (ELR); both delivered by mail, and automated telephone reminders (ATR). After delivery of reminders, women who became off-schedule in any of the 4 years received a second step of supplemental interventions. Three supplemental intervention arms contained priming letters and telephone counseling: barriers only (BarriCall); barriers plus positive consequences of getting mammograms (BarriConCall+); and barriers plus negative consequences of not getting mammograms (BarriConCall-). Average cumulative number of days non-adherent to mammography over 4 years based on annual screening guidelines (analyses conducted in 2009). All reminders performed equally well in reducing number of days of non-adherence. Women randomized to receive supplemental interventions had significantly fewer days of non-adherence compared to women who received EUCR (p=0.0003). BarrConCall+ and BarrConCall- conditions did not significantly differ in days non-adherent compared to women in the barriers-only condition (BarriCon). The minimal intervention needed for sustained mammography use is a combination of a reminder followed by a priming letter and barrier-specific telephone counseling for women who become off-schedule. Additional costs associated with supplemental interventions should be considered by organizations deciding which interventions to use. NCT01148875. Copyright © 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Minimization of mixed waste in explosive testing operations

    International Nuclear Information System (INIS)

    Gonzalez, M.A.; Sator, F.E.; Simmons, L.F.

    1993-02-01

    In the 1970s and 1980s, efforts to manage mixed waste and reduce pollution focused largely on post-process measures. In the late 1980s, the approach to waste management and pollution control changed, focusing on minimization and prevention rather than abatement, treatment, and disposal. The new approach, and the formulated guidance from the US Department of Energy, was to take all necessary measures to minimize waste and prevent the release of pollutants to the environment. Two measures emphasized in particular were source reduction (reducing the volume and toxicity of the waste source) and recycling. In 1988, a waste minimization and pollution prevention program was initiated at Site 300, where the Lawrence Livermore National Laboratory (LLNL) conducts explosives testing. LLNL's Defense Systems/Nuclear Design (DS/ND) Program has adopted a variety of conservation techniques to minimize waste generation and cut disposal costs associated with ongoing operations. The techniques include minimizing the generation of depleted uranium and lead mixed waste through inventory control and material substitution measures and through developing a management system to recycle surplus explosives. The changes implemented have reduced annual mixed waste volumes by more than 95% and reduced overall radioactive waste generation (low-level and mixed) by more than 75%. The measures employed were cost-effective and easily implemented

  2. ESTIMATION OF MULTI-MODAL ANALGESIA ADEQUACY IN THE PERIOPERATIVE PERIOD AT LONG-TERMED TRAUMATIZING ABDOMINAL OPERATIVE INTERVENTIONS

    Directory of Open Access Journals (Sweden)

    V. Kh. Sharipova

    2015-01-01

    Full Text Available PURPOSE OF THE STUDY. Improvement of perioperative multimodal analgesia at long­termed traumatizing abdominal interventions with estimation of its effectiveness.MATERIALS AND METHODS. Eighty six patients have been examined and divided into 3 groups depending on anesthesia and postoperative pain relief methods.RESULTS. The effectiveness of perioperative multi­modal analgesia using methods affecting the whole pathogenesis of pain has been revealed. Minimal stress of central and peripheral hemodynamics parameters, less evident pain syndrome in the post­operative period, economic effect shown up by the decrease of the use of narcotic analgesics both in intra­ and post­operative period have been observed.CONCLUSION. Algorithm of perioperative multi­modal analgesia at long­termed and traumatizing abdominal operative interventions has been developed. 

  3. Qualification guideline of the German X-ray association (DRG) und the German association for interventional radiology and minimal invasive therapy (DeGIR) for the performance of interventional-radiological minimal invasive procedures on arteries and veins

    International Nuclear Information System (INIS)

    Buecker, A.; Gross-Fengels, W.; Haage, P.; Huppert, P.; Landwehr, P.; Loose, R.; Reimer, P.; Tacke, J.; Vorwerk, D.; Fischer, J.

    2012-01-01

    The topics covered in the qualification guideline of the German X-ray association (DRG) und the German association for interventional radiology and minimal invasive therapy (DeGIR) for the performance of interventional-radiological minimal invasive procedures on arteries and veins are the following: Practical qualification: aorta iliac vessels and vessels in the upper and lower extremities, kidney and visceral arteries, head and neck arteries, dialysis shunts, veins and pulmonary arteries, aorta aneurysms and peripheral artery aneurysms. Knowledge acquisition concerning radiation protection: legal fundamentals, education and training, knowledge actualization and quality control, definition of the user and the procedure, competence preservation.

  4. Time Management in the Operating Room: An Analysis of the Dedicated Minimally Invasive Surgery Suite

    Science.gov (United States)

    Hsiao, Kenneth C.; Machaidze, Zurab

    2004-01-01

    Background: Dedicated minimally invasive surgery suites are available that contain specialized equipment to facilitate endoscopic surgery. Laparoscopy performed in a general operating room is hampered by the multitude of additional equipment that must be transported into the room. The objective of this study was to compare the preparation times between procedures performed in traditional operating rooms versus dedicated minimally invasive surgery suites to see whether operating room efficiency is improved in the specialized room. Methods: The records of 50 patients who underwent laparoscopic procedures between September 2000 and April 2002 were retrospectively reviewed. Twenty-three patients underwent surgery in a general operating room and 18 patients in an minimally invasive surgery suite. Nine patients were excluded because of cystoscopic procedures undergone prior to laparoscopy. Various time points were recorded from which various time intervals were derived, such as preanesthesia time, anesthesia induction time, and total preparation time. A 2-tailed, unpaired Student t test was used for statistical analysis. Results: The mean preanesthesia time was significantly faster in the minimally invasive surgery suite (12.2 minutes) compared with that in the traditional operating room (17.8 minutes) (P=0.013). Mean anesthesia induction time in the minimally invasive surgery suite (47.5 minutes) was similar to time in the traditional operating room (45.7 minutes) (P=0.734). The average total preparation time for the minimally invasive surgery suite (59.6 minutes) was not significantly faster than that in the general operating room (63.5 minutes) (P=0.481). Conclusion: The amount of time that elapses between the patient entering the room and anesthesia induction is statically shorter in a dedicated minimally invasive surgery suite. Laparoscopic surgery is performed more efficiently in a dedicated minimally invasive surgery suite versus a traditional operating room. PMID

  5. Interventional MRI of the breast: minimally invasive therapy

    International Nuclear Information System (INIS)

    Hall-Craggs, M.A.

    2000-01-01

    In recent years a variety of minimally invasive therapies have been applied to the treatment of breast lesions. These therapies include thermal treatments (interstitial laser coagulation, focused ultrasound, radiofrequency and cryotherapy), percutaneous excision, and interstitial radiotherapy. Magnetic resonance has been used in these treatments to visualize lesions before, during and after therapy and to guide interventions. ''Temperature-sensitive'' sequences have shown changes with thermal ablation which broadly correlate with areas of tumour necrosis. Consequently, MR has the potential to monitor treatment at the time of therapy. To date, experience in the treatment of breast cancer has been restricted to small studies. Large controlled studies are required to validate the efficacy and safety of these therapies in malignant disease. (orig.)

  6. Longitudinal effects of adaptive interventions with a speech-generating devicein minimally verbal children with ASD

    Science.gov (United States)

    Almirall, Daniel; DiStefano, Charlotte; Chang, Ya-Chih; Shire, Stephanie; Kaiser, Ann; Lu, Xi; Nahum-Shani, Inbal; Landa, Rebecca; Mathy, Pamela; Kasari, Connie

    2016-01-01

    Objective There are limited data on the effects of adaptive social communication interventions with a speech-generating device in autism. This study is the first to compare growth in communications outcomes among three adaptive interventions in school-aged children with autism spectrum disorder (ASD) who are minimally verbal. Methods Sixty-one children, aged 5–8 years participated in a sequential, multiple-assignment randomized trial (SMART). All children received a developmental communication intervention: joint attention, symbolic play, engagement and regulation (JASP) with enhanced milieu teaching (EMT). The SMART included three two-stage, 24-week adaptive interventions with different provisions of a speech-generating device (SGD) in the context of JASP+EMT. The first adaptive intervention, with no SGD, initially assigned JASP+EMT alone; then intensified JASP+EMT for slow responders. In the second adaptive intervention, slow responders to JASP+EMT were assigned JASP+EMT+SGD. The third adaptive intervention initially assigned JASP+EMT+SGD; then intensified JASP+EMT+SGD for slow responders. Analyses examined between-group differences in change in outcomes from baseline to week 36. Verbal outcomes included spontaneous communicative utterances and novel words. Non-linguistic communication outcomes included initiating joint attention and behavior regulation, and play. Results The adaptive intervention beginning with JASP+EMT+SGD was estimated as superior. There were significant (Pcommunicative utterances and initiating joint attention. Conclusions School-aged children with ASD who are minimally verbal make significant gains in communication outcomes with an adaptive intervention beginning with JASP+EMT+SGD. Future research should explore mediators and moderators of the adaptive intervention effects and second-stage intervention options that further capitalize on early gains in treatment. PMID:26954267

  7. Gyrokinetic simulations of neoclassical transport using a minimal collision operator

    International Nuclear Information System (INIS)

    Dif-Pradalier, G.; Grandgirard, V.; Sarazin, Y.; Garbet, X.; Ghendrih, Ph.; Angelino, P.

    2008-01-01

    Conventional neoclassical predictions are successfully recovered within a gyrokinetic framework using a minimal Fokker-Planck collision operator. This operator is shown to accurately describe some essential features of neoclassical theory, namely the neoclassical transport, the poloidal rotation and the linear damping of axisymmetric flows while interestingly preserving a high numerical efficiency. Its form makes it especially adapted to Eulerian or Semi-Lagrangian schemes.

  8. Interventional MRI of the breast: minimally invasive therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hall-Craggs, M.A. [MR Unit, Middlesex Hospital, London (United Kingdom)

    2000-01-01

    In recent years a variety of minimally invasive therapies have been applied to the treatment of breast lesions. These therapies include thermal treatments (interstitial laser coagulation, focused ultrasound, radiofrequency and cryotherapy), percutaneous excision, and interstitial radiotherapy. Magnetic resonance has been used in these treatments to visualize lesions before, during and after therapy and to guide interventions. ''Temperature-sensitive'' sequences have shown changes with thermal ablation which broadly correlate with areas of tumour necrosis. Consequently, MR has the potential to monitor treatment at the time of therapy. To date, experience in the treatment of breast cancer has been restricted to small studies. Large controlled studies are required to validate the efficacy and safety of these therapies in malignant disease. (orig.)

  9. Operational tank leak detection and minimization during retrieval

    International Nuclear Information System (INIS)

    Hertzel, J.S.

    1996-03-01

    This report evaluates the activities associated with the retrieval of wastes from the single-shell tanks proposed under the initial Single-Shell Tank Retrieval System. This report focuses on minimizing leakage during retrieval by using effective leak detection and mitigating actions. After reviewing the historical data available on single-shell leakage, and evaluating current leak detection technology, this report concludes that the only currently available leak detection method which can function within the most probable leakage range is the mass balance system. If utilized after each sluicing campaign, this method should allow detection at a leakage value well below the leakage value where significant health effects occur which is calculated for each tank. Furthermore, this report concludes that the planned sequence or sluicing activities will serve to further minimize the probability and volume of leaks by keeping liquid away from areas with the greatest potential for leaking. Finally, this report identifies a series of operational responses which when used in conjunction with the recommended sluicing sequence and leak detection methods will minimize worker exposure and environmental safety health risks

  10. Operating envelope to minimize probability of fractures in Zircaloy-2 pressure tubes

    International Nuclear Information System (INIS)

    Azer, N.; Wong, H.

    1994-01-01

    The failure mode of primary concern with Candu pressure tubes is fast fracture of a through-wall axial crack, resulting from delayed hydride crack growth. The application of operating envelopes is demonstrated to minimize the probability of fracture in Zircaloy-2 pressure tubes based on Zr-2.5%Nb pressure tube experience. The technical basis for the development of the operating envelopes is also summarized. The operating envelope represents an area on the pressure versus temperature diagram within which the reactor may be operated without undue concern for pressure tube fracture. The envelopes presented address both normal operating conditions and the condition where a pressure tube leak has been detected. The examples in this paper are prepared to illustrate the methodology, and are not intended to be directly applicable to the operation of any specific reactor. The application of operating envelopes to minimized the probability of fracture in 80 mm diameter Zircaloy-2 pressure tubes has been discussed. Both normal operating and leaking pressure tube conditions have been considered. 3 refs., 4 figs

  11. Minimally invasive neurosurgery with interventional magnetic resonance. Its present and future

    International Nuclear Information System (INIS)

    Hashimoto, Takuo

    2000-01-01

    We have used X-ray fluoroscopy, ultrasonography, and computed tomography in treatment. However, these methods do not provide precise image. Since magnetic resonance (MR) provides high-resolution images, it is more suitable in treatment. Recently open-type MR has been introduced for clinical diagnosis and treatment. Interventional MR provides a real-time images, high-resolutional images, and thermal distribution. Open MR can be used for minimally invasive neurosurgery. Interventional MR (I-MR) can be used in treatment and is extremely useful for minimally invasive surgery of the brain and spinal cord. We have used an open-type permanent MR scanner (Airis, Hitachi), for minimally invasive neurosurgery. Stereotactic brain tumor biopsy, aspiration of intracerebral hematoma, and percutaneous laser disc hernia ablation under MR guidance has been performed in our department. I-MR provided precise, and less-invasive treatment. Stereotactic biopsy was done in 12 patients with brain tumors. Precise, accurate biopsy is possible with MR fluoroscopic guidance. Hematomas were also aspirated safely and precisely by monitoring real-time image. Percutaneous laser disc hernia ablation (PLDA) was done in 201 patients with lumbar disc herniation (127 at L4/5 and 48 at L5/S1). Patients ranged in age from 17 to 72 years. A MR-compatible 18-gauge 15-cm-long titanium needle was clearly visualized and safety and accurately inserted into the disc herniation from multiple directions. Laser ablation was done (mean, 1,000 J). Signs and symptoms improved immediately after ablation. The overall success rate was 90.5% (MacNab's criteria). Two patients (1.0%) had discitis after PLDA. I-MR and fluoroscopy provide near-real-time images for treatment of brain tumors and hematoma. Precise treatment can be performed with the Patil MR-compatible stereotactic system. PLDA was performed safety and accurately with I-MR. The results were satisfactory. I-MR-PLDA is a safe, precise, and minimally invasive

  12. Minimally invasive neurosurgery with interventional magnetic resonance. Its present and future

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Takuo [Jikei Univ., Tokyo (Japan). School of Medicine

    2000-01-01

    We have used X-ray fluoroscopy, ultrasonography, and computed tomography in treatment. However, these methods do not provide precise image. Since magnetic resonance (MR) provides high-resolution images, it is more suitable in treatment. Recently open-type MR has been introduced for clinical diagnosis and treatment. Interventional MR provides a real-time images, high-resolutional images, and thermal distribution. Open MR can be used for minimally invasive neurosurgery. Interventional MR (I-MR) can be used in treatment and is extremely useful for minimally invasive surgery of the brain and spinal cord. We have used an open-type permanent MR scanner (Airis, Hitachi), for minimally invasive neurosurgery. Stereotactic brain tumor biopsy, aspiration of intracerebral hematoma, and percutaneous laser disc hernia ablation under MR guidance has been performed in our department. I-MR provided precise, and less-invasive treatment. Stereotactic biopsy was done in 12 patients with brain tumors. Precise, accurate biopsy is possible with MR fluoroscopic guidance. Hematomas were also aspirated safely and precisely by monitoring real-time image. Percutaneous laser disc hernia ablation (PLDA) was done in 201 patients with lumbar disc herniation (127 at L4/5 and 48 at L5/S1). Patients ranged in age from 17 to 72 years. A MR-compatible 18-gauge 15-cm-long titanium needle was clearly visualized and safety and accurately inserted into the disc herniation from multiple directions. Laser ablation was done (mean, 1,000 J). Signs and symptoms improved immediately after ablation. The overall success rate was 90.5% (MacNab's criteria). Two patients (1.0%) had discitis after PLDA. I-MR and fluoroscopy provide near-real-time images for treatment of brain tumors and hematoma. Precise treatment can be performed with the Patil MR-compatible stereotactic system. PLDA was performed safety and accurately with I-MR. The results were satisfactory. I-MR-PLDA is a safe, precise, and minimally

  13. Minimization of Illness Absenteeism in Primary School Students Using Low-Cost Hygiene Interventions

    Directory of Open Access Journals (Sweden)

    Tambekar DH

    2012-07-01

    Full Text Available Objective: Safe water and hygiene intervention was evaluated to assess its impact on students’ health, hygiene practices and reduction in illness absenteeism in primary school students. Method: After evaluatingprimary schools of Amravati district; 50 students with high enteric illness absenteeism were selected for study. Families with problem of in-house water contamination were provided earthen pot with tap for water storage and soap for hand washing at school and home. Household drinking waters (before and after intervention were analyzed for potability. Results: By adopting correct water storage (water container with tap, handling and hand washing practices found to improve health and reduction in 20% illness absenteeism in school. Promoting these interventions and improvement in water-behavioral practices prevented in-house-water contamination. Conclusion: These low cost intervention (water storage container with tap promises to reducing school absenteeism by minimizing risk of transmission of enteric infections by promoting water and student hygiene.

  14. Experience in minimally invasive Nuss operation for 406 children with pectus excavatum.

    Science.gov (United States)

    Shu, Qiang; Shi, Zhuo; Xu, Wei-Ze; Li, Jian-Hua; Zhang, Ze-Wei; Lin, Ru; Zhu, Xiong-Kai; Yu, Jian-Gen

    2011-08-01

    This study was to investigate the advantages of thoracoscopy-assisted minimally invasive Nuss operation for the treatment of pectus excavatum (PE) in children. A total of 406 patients with PE (female: 93; male: 313) with an average age of 6.8 years (range: 3.5-17.5 years) were included in this study. Associated diseases included congenital heart disease in 9 patients and congenital pulmonary cyst in 2. The Haller index of the patients ranged from 3.35 to 7.23, with an average of 5.17±1.64. Minimally invasive Nuss operation was performed for all the patients. The operations were performed successfully and no operative mortality occurred. The average blood loss during the operation was less than 10 mL and the operating time ranged from 30 to 85 minutes with an average of 45 minutes. The length of hospital stay ranged from 5 to 9 days with an average of 7 days. Struts were implanted in 12 (3.0%) of the 406 patients. Injury of the pericardium occurred in 1 patient during the operation. Early post-operative complications occurred in 9 patients with pneumothorax and 6 patients with pleural effusion, which were cured by puncture or drainage. Poor wound healing occurred in 4 patients (1.0%) and was cured by nutritional support. During a 3-month to 6-year follow-up, 2 patients had scoliosis and 3 patients had displacement of the strut, which was cured by a second Nuss operation. Allergy occurred in 2 patients: the symptoms were improved in 1 patient after conservative treatment, but the strut was removed in advance due to allergy in the other patient. Totally 154 patients (40.0%) underwent operation for strut removal. Excellent repair results were achieved in 387 (95.3%) patients, good repair results in 12 (3.0%), and fair results in 7 (1.7%). Thoracoscopy-assisted Nuss operation has many advantages including small and masked incision, short operative time, minimal blood loss, fast recovery, less trauma, and satisfactory outcomes of repair. Nuss is a safe and reliable

  15. Operational cost minimization in cooling water systems

    Directory of Open Access Journals (Sweden)

    Castro M.M.

    2000-01-01

    Full Text Available In this work, an optimization model that considers thermal and hydraulic interactions is developed for a cooling water system. It is a closed loop consisting of a cooling tower unit, circulation pump, blower and heat exchanger-pipe network. Aside from process disturbances, climatic fluctuations are considered. Model constraints include relations concerning tower performance, air flowrate requirement, make-up flowrate, circulating pump performance, heat load in each cooler, pressure drop constraints and climatic conditions. The objective function is operating cost minimization. Optimization variables are air flowrate, forced water withdrawal upstream the tower, and valve adjustment in each branch. It is found that the most significant operating cost is related to electricity. However, for cooled water temperatures lower than a specific target, there must be a forced withdrawal of circulating water and further makeup to enhance the cooling tower capacity. Additionally, the system is optimized along the months. The results corroborate the fact that the most important variable on cooling tower performance is not the air temperature itself, but its humidity.

  16. Self-management interventions : Proposal and validation of a new operational definition

    NARCIS (Netherlands)

    Jonkman, Nini H; Schuurmans, Marieke J; Jaarsma, Tiny; Shortridge-Baggett, Lillie M; Hoes, Arno W; Trappenburg, Jaap C A

    2016-01-01

    OBJECTIVES: Systematic reviews on complex interventions like self-management interventions often do not explicitly state an operational definition of the intervention studied, which may impact the review's conclusions. This study aimed to propose an operational definition of self-management

  17. Self-management interventions: Proposal and validation of a new operational definition

    NARCIS (Netherlands)

    Jonkman, N.H.; Schuurmans, Marieke J.; Jaarsma, Tiny; Shortbridge-Baggett, Lillie M.; Hoes, Arno W.; Trappenburg, Jaap C A

    2016-01-01

    Objectives: Systematic reviews on complex interventions like self-management interventions often do not explicitly state an operational definition of the intervention studied, which may impact the review's conclusions. This study aimed to propose an operational definition of self-management

  18. Structure of N = 2 superconformally invariant unitary ''minimal'' theories: Operator algebra and correlation functions

    International Nuclear Information System (INIS)

    Kiritsis, E.B.

    1987-01-01

    N = 2 superconformal-invariant theories are studied and their general structure is analyzed. The geometry of N = 2 complex superspace is developed as a tool to study the correlation functions of the theories above. The Ward identities of the global N = 2 superconformal symmetry are solved, to restrict the form of correlation functions. Advantage is taken of the existence of the degenerate operators to derive the ''fusion'' rules for the unitary minimal systems with c<1. In particular, the closure of the operator algebra for such systems is shown. The c = (1/3 minimal system is analyzed and its two-, three-, and four-point functions as well as its operator algebra are calculated explicitly

  19. Ionizing radiation exposure in interventional cardiology: current radiation protection practice of invasive cardiology operators in Lithuania.

    Science.gov (United States)

    Valuckiene, Zivile; Jurenas, Martynas; Cibulskaite, Inga

    2016-09-01

    Ionizing radiation management is among the most important safety issues in interventional cardiology. Multiple radiation protection measures allow the minimization of x-ray exposure during interventional procedures. Our purpose was to assess the utilization and effectiveness of radiation protection and optimization techniques among interventional cardiologists in Lithuania. Interventional cardiologists of five cardiac centres were interviewed by anonymized questionnaire, addressing personal use of protective garments, shielding, table/detector positioning, frame rate (FR), resolution, field of view adjustment and collimation. Effective patient doses were compared between operators who work with and without x-ray optimization. Thirty one (68.9%) out of 45 Lithuanian interventional cardiologists participated in the survey. Protective aprons were universally used, but not the thyroid collars; 35.5% (n  =  11) operators use protective eyewear and 12.9% (n  =  4) wear radio-protective caps; 83.9% (n  =  26) use overhanging shields, 58.1% (n  =  18)-portable barriers; 12.9% (n  =  4)-abdominal patient's shielding; 35.5% (n  =  11) work at a high table position; 87.1% (n  =  27) keep an image intensifier/receiver close to the patient; 58.1% (n  =  18) reduce the fluoroscopy FR; 6.5% (n  =  2) reduce the fluoro image detail resolution; 83.9% (n  =  26) use a 'store fluoro' option; 41.9% (N  =  13) reduce magnification for catheter transit; 51.6% (n  =  16) limit image magnification; and 35.5% (n  =  11) use image collimation. Median effective patient doses were significantly lower with x-ray optimization techniques in both diagnostic and therapeutic interventions. Many of the ionizing radiation exposure reduction tools and techniques are underused by a considerable proportion of interventional cardiology operators. The application of basic radiation protection tools and

  20. Application of the Non-Intervention Principle to Low-Intensity Cyber Operations

    OpenAIRE

    Adamson, Liisi

    2015-01-01

    Present work focuses on the non-intervention principle and low-intensity cyber operations. More specifically, its main question is, whether the principle of non-intervention applies to low-intensity cyber operations and if it does, is the legal framework of non-intervention principle an effective way to regulate peacetime low-intensity cyber operations. Information Age and the rapid development of ICTs have provided hostile actors the opportunity to exploit the advantages cyberspace offe...

  1. Kinetic changes during a six-week minimal footwear and gait-retraining intervention in runners.

    Science.gov (United States)

    Warne, Joe P; Smyth, Barry P; Fagan, John O'C; Hone, Michelle E; Richter, Chris; Nevill, Alan M; Moran, Kieran A; Warrington, Giles D

    2017-08-01

    An evaluation of a six-week Combined minimal footwear transition and gait-retraining combination vs. gait retraining only on impact characteristics and leg stiffness. Twenty-four trained male runners were randomly assigned to either (1) Minimalist footwear transition Combined with gait-retraining over a six-week period ("Combined" group; n = 12) examined in both footwear, or (2) a gait-retraining group only with no minimalist footwear exposure ("Control"; n = 12). Participants were assessed for loading rate, impact peak, vertical, knee and ankle stiffness, and foot-strike using 3D and kinetic analysis. Loading rate was significantly higher in the Combined group in minimal shoes in pre-tests compared to a Control (P ≤ 0.001), reduced significantly in the Combined group over time (P ≤ 0.001), and was not different to the Control group in post-tests (P = 0.16). The impact peak (P = 0.056) and ankle stiffness reduced in both groups (P = 0.006). Loading rate and vertical stiffness was higher in minimalist footwear than conventional running shoes both pre (P ≤ 0.001) and post (P = 0.046) the intervention. There has a higher tendency to non-rearfoot strike in both interventions, but more acute changes in the minimalist footwear. A Combined intervention can potentially reduce impact variables. However, higher loading rate initially in minimalist footwear may increase the risk of injury in this condition.

  2. Manual of extravascular minimally invasive interventional procedures of the liver and biliary tract

    International Nuclear Information System (INIS)

    Miranda Mena, Shirley

    2011-01-01

    The use of interventional radiology and image-guided surgery has increased. Interventional radiologists are involved in patient treatment, well as in the diagnosis of the disease carrying his knowledge to the tumor treatment and procedures more invasive. Large amount of didactic material there are available, but the country lacks a manual to standardize interventional radiological techniques carried out. Also, those that could be instituted and adapted effectively in the management of hepatobiliary pathology of the Sistema de Salud Publica in Costa Rica, that covers the main procedures and adopt guidelines in a standardized way. A manual of procedures minimally invasive radiologic extravascular of the liver and biliary tract, is presented with broad bibliographic support that directs, standardizes and is adaptable to the needs and own resources of Costa Rica. Interventional radiology has been a non surgical alternative of a low index of complications, useful for the management of some health problems, avoids surgery and certainly lower costs. An alternative to surgical treatment of many conditions is offered, thereby reducing complications (morbidity) and can eliminate the need for hospitalization, in some cases. The development of new materials has allowed the most common working tools of the medical field are improved and become increasingly more efficient in the diagnosis and treatment of diseases, improving the training of radiologists in the interventional field. (author) [es

  3. Operating cost minimization of a radial distribution system in a deregulated electricity market through reconfiguration using NSGA method

    International Nuclear Information System (INIS)

    Chandramohan, S.; Atturulu, Naresh; Devi, R.P. Kumudini; Venkatesh, B.

    2010-01-01

    In the future, mechanisms for trade in ancillary services such as reactive power will be implemented in many deregulated power systems. In such an operating framework, a Distribution Corporation (DisCo) would have to purchase reactive power along with real power from the connected transmission corporation. A DisCo would want to minimize its operating costs by minimizing the total amount of real and reactive power drawn from the connected transmission system. Optimally reconfiguring the network will achieve such a goal. In this work, we use a non-dominated sorting genetic algorithm (NSGA) for reconfiguring a radial DisCo to minimize its operating costs considering real and reactive power costs while maximizing its operating reliability and satisfying the regular operating constraints. This method is tested on sample test systems and reported. (author)

  4. Self-management interventions: Proposal and validation of a new operational definition.

    Science.gov (United States)

    Jonkman, Nini H; Schuurmans, Marieke J; Jaarsma, Tiny; Shortridge-Baggett, Lillie M; Hoes, Arno W; Trappenburg, Jaap C A

    2016-12-01

    Systematic reviews on complex interventions like self-management interventions often do not explicitly state an operational definition of the intervention studied, which may impact the review's conclusions. This study aimed to propose an operational definition of self-management interventions and determine its discriminative performance compared with other operational definitions. Systematic review of definitions of self-management interventions and consensus meetings with self-management research experts and practitioners. Self-management interventions were defined as interventions that aim to equip patients with skills to actively participate and take responsibility in the management of their chronic condition in order to function optimally through at least knowledge acquisition and a combination of at least two of the following: stimulation of independent sign/symptom monitoring, medication management, enhancing problem-solving and decision-making skills for medical treatment management, and changing their physical activity, dietary, and/or smoking behavior. This definition substantially reduced the number of selected studies (255 of 750). In two preliminary expert meetings (n = 6), the proposed definition was identifiable for self-management research experts and practitioners (80% and 60% agreement, respectively). Future systematic reviews must carefully consider the operational definition of the intervention studied because the definition influences the selection of studies on which conclusions and recommendations for clinical practice are based. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. The establishment of enteral nutrition with minimally-invasive interventional procedure under endoscopic or imaging guidance

    International Nuclear Information System (INIS)

    Li Feng; Cheng Yingsheng

    2010-01-01

    For patients unable to get the necessary nutrition orally, a variety of techniques,including surgical way, to make gastrostomy with tube placement have been employed. For recent years, gastrostomy and tube placement with the help of endoscopic guidance or percutaneous interventional management has been developed, which is superior to surgical procedure in minimizing injuries, decreasing cost and reducing complications. In certain clinical situations, both endoscopic method and interventional method can be employed. This paper aims to make a comprehensive review of the indications, techniques and skills, advantages and disadvantages of both the endoscopy-guided and the imaging-guided percutaneous gastrojejunostomy for the establishment of enteral nutrition. (authors)

  6. First Robotic SPECT for Minimally Invasive Sentinel Lymph Node Mapping.

    Science.gov (United States)

    Fuerst, Bernhard; Sprung, Julian; Pinto, Francisco; Frisch, Benjamin; Wendler, Thomas; Simon, Hervé; Mengus, Laurent; van den Berg, Nynke S; van der Poel, Henk G; van Leeuwen, Fijs W B; Navab, Nassir

    2016-03-01

    In this paper we present the usage of a drop-in gamma probe for intra-operative Single-Photon Emission Computed Tomography (SPECT) imaging in the scope of minimally invasive robot-assisted interventions. The probe is designed to be inserted and reside inside the abdominal cavity during the intervention. It is grasped during the procedure using a robotic laparoscopic gripper enabling full six degrees of freedom handling by the surgeon. We demonstrate the first deployment of the tracked probe for intra-operative in-patient robotic SPECT enabling augmented-reality image guidance. The hybrid mechanical- and image-based in-patient probe tracking is shown to have an accuracy of 0.2 mm. The overall system performance is evaluated and tested with a phantom for gynecological sentinel lymph node interventions and compared to ground-truth data yielding a mean reconstruction accuracy of 0.67 mm.

  7. Manned underwater intervention during deep-water operations

    Energy Technology Data Exchange (ETDEWEB)

    Lothe, Mikal Sjur

    2010-07-01

    The focus for deep and remote areas operations are Remote Operated systems. Manned intervention is generally first choice when looking for intervention methods in most areas of the world. As an industry we need to focus on the most cost effective and safe method for construction, Maintenance and Repair. The focus is on advances in diving methods related to surface oriented and saturation diving, such as shallow water tie-ins of risers and umbilicals, inspection and evaluations of FPSOs including thruster change-out and wet docking. Also, the options for efficient repair scenarios utilizing man's ability to work in low visibility areas by feel etc. Finally the presentation will show new technology in Saturation Diving based on the 24 man saturation systems onboard the 3rd generation Divex systems used by Technip and Subsea 7. (Author)

  8. Development of a minimization instrument for allocation of a hospital-level performance improvement intervention to reduce waiting times in Ontario emergency departments.

    Science.gov (United States)

    Leaver, Chad Andrew; Guttmann, Astrid; Zwarenstein, Merrick; Rowe, Brian H; Anderson, Geoff; Stukel, Therese; Golden, Brian; Bell, Robert; Morra, Dante; Abrams, Howard; Schull, Michael J

    2009-06-08

    Rigorous evaluation of an intervention requires that its allocation be unbiased with respect to confounders; this is especially difficult in complex, system-wide healthcare interventions. We developed a short survey instrument to identify factors for a minimization algorithm for the allocation of a hospital-level intervention to reduce emergency department (ED) waiting times in Ontario, Canada. Potential confounders influencing the intervention's success were identified by literature review, and grouped by healthcare setting specific change stages. An international multi-disciplinary (clinical, administrative, decision maker, management) panel evaluated these factors in a two-stage modified-delphi and nominal group process based on four domains: change readiness, evidence base, face validity, and clarity of definition. An original set of 33 factors were identified from the literature. The panel reduced the list to 12 in the first round survey. In the second survey, experts scored each factor according to the four domains; summary scores and consensus discussion resulted in the final selection and measurement of four hospital-level factors to be used in the minimization algorithm: improved patient flow as a hospital's leadership priority; physicians' receptiveness to organizational change; efficiency of bed management; and physician incentives supporting the change goal. We developed a simple tool designed to gather data from senior hospital administrators on factors likely to affect the success of a hospital patient flow improvement intervention. A minimization algorithm will ensure balanced allocation of the intervention with respect to these factors in study hospitals.

  9. Applying interactive control to waste processing operations

    International Nuclear Information System (INIS)

    Grasz, E.L.; Merrill, R.D.; Couture, S.A.

    1992-08-01

    At present waste and residue processing includes steps that require human interaction. The risk of exposure to unknown hazardous materials and the potential for radiation contamination motivates the desire to remove operators from these processes. Technologies that facilitate this include glove box robotics, modular systems for remote and automated servicing, and interactive controls that minimize human intervention. LLNL is developing an automated system which is designed to supplant the operator for glove box tasks, thus protecting the operator from the risk of radiation exposure and minimizing operator-associated waste. Although most of the processing can be automated with minimal human interaction, there are some tasks where intelligent intervention is both desirable and necessary to adapt to Enexpected circumstances and events. These activities require that the operator interact with the process using a remote manipulator which provides or reflects a natural feel to the operator. The remote manipulation system which was developed incorporates sensor fusion and interactive control, and provides the operator with an effective means of controlling the robot in a potentially unknown environment. This paper describes recent accomplishments in technology development and integration, and outlines the future goals of Lawrence Livermore National Laboratory for achieving this integrated interactive control capability

  10. Anesthetic management of minimally invasive intervention in pediatric oncohematology: possibilities and limitations of inhalation and intravenous anesthesia

    Directory of Open Access Journals (Sweden)

    V. V. Shchukin

    2013-01-01

    Full Text Available In contrast to the "adult" medicine, pediatric oncology and hematology requires considerably more anesthesiologist participation in diagnosticsand treatment. According to data of Federal Research Center of Pediatric Hematology, Oncology and Immunology more than 70 % of indications for general anesthesia are minimally invasive interventions. The purpose of general anesthesia for small interventions is to provide patient safety and comfort during painful and fear-inducing manipulations. Protocols of inhalation and intravenous anesthesia recommended for widespread use in pediatric patients are presented.

  11. Anesthetic management of minimally invasive intervention in pediatric oncohematology: possibilities and limitations of inhalation and intravenous anesthesia

    Directory of Open Access Journals (Sweden)

    V. V. Shchukin

    2014-07-01

    Full Text Available In contrast to the "adult" medicine, pediatric oncology and hematology requires considerably more anesthesiologist participation in diagnosticsand treatment. According to data of Federal Research Center of Pediatric Hematology, Oncology and Immunology more than 70 % of indications for general anesthesia are minimally invasive interventions. The purpose of general anesthesia for small interventions is to provide patient safety and comfort during painful and fear-inducing manipulations. Protocols of inhalation and intravenous anesthesia recommended for widespread use in pediatric patients are presented.

  12. Potential pollution prevention and waste minimization for Department of Energy operations

    International Nuclear Information System (INIS)

    Griffin, J.; Ischay, C.; Kennicott, M.; Pemberton, S.; Tull, D.

    1995-10-01

    With the tightening of budgets and limited resources, it is important to ensure operations are carried out in a cost-effective and productive manner. Implementing an effective Pollution Prevention strategy can help to reduce the costs of waste management and prevent harmful releases to the environment. This document provides an estimate of the Department of Energy's waste reduction potential from the implementation of Pollution Prevention opportunities. A team of Waste Minimization and Pollution Prevention professionals was formed to collect the data and make the estimates. The report includes a list of specific reduction opportunities for various waste generating operations and waste types. A generic set of recommendations to achieve these reduction opportunities is also provided as well as a general discussion of the approach and assumptions made for each waste generating operation

  13. Minimally traumatic stapes surgery for otosclerosis: Risk reduction of post-operative vertigo

    Directory of Open Access Journals (Sweden)

    An-Suey Shiao

    2018-06-01

    Full Text Available Background: The author (Dr. Shiao modified traditional stapes surgery (TSS specifically for patients with otosclerosis. The proposed technique, referred to as minimally traumatic stapes surgery (MTSS, reduces the risk of subjective discomfort (i.e. vertigo and tinnitus following surgery. This paper compares the effectiveness of MTSS with that of TSS. Methods: The medical records of patients with otosclerosis after stapes surgery (TSS or MTSS were analyzed. Outcome variables included post-operative vertigo, tinnitus, and hearing success. Multivariate logistic regression analysis was used to determine the correlation between surgical technique and outcome variables. Results: TSS was performed in 23 otosclerosis ears and MTSS was performed in 33 otosclerosis ears. The risk of post-operative vertigo was significantly lower among patients that underwent MTSS (27% than among those that underwent TSS (83%, p < 0.001. No differences in the incidence of tinnitus were observed between the two groups. Post-operative audiometric outcomes were also equivalent between the two groups. However, multivariate logistic regression analysis revealed a correlation between post-operative vertigo and surgical technique (p < 0.001. Conclusion: MTSS involves a lower risk of vertigo than does TSS. MTSS helps to prevent damage to the footplate, thereby reducing the risk of footplate floating. Therefore, MTSS provides a means to overcome some of the limitations associated with the narrow surgical field in Asian patients. Keywords: Footplate floating, Minimally traumatic, Otosclerosis, Stapes surgery, Vertigo

  14. The “Suicide Guard Rail”: a minimal structural intervention in hospitals reduces suicide jumps

    OpenAIRE

    Mohl, Andreas; Stulz, Niklaus; Martin, Andrea; Eigenmann, Franz; Hepp, Urs; Hüsler, Jürg; Beer, Jürg H

    2012-01-01

    Abstract Background Jumping from heights is a readily available and lethal method of suicide. This study examined the effectiveness of a minimal structural intervention in preventing suicide jumps at a Swiss general teaching hospital. Following a series of suicide jumps out of the hospital’s windows, a metal guard rail was installed at each window of the high-rise building. Results In the 114 months prior to the installation of the metal guard rail, 10 suicides by jumping out of the hospital’...

  15. Efficacy of a telerehabilitation intervention programme using biofeedback among computer operators.

    Science.gov (United States)

    Golebowicz, Merav; Levanon, Yafa; Palti, Ram; Ratzon, Navah Z

    2015-01-01

    Computer operators spend long periods of time sitting in a static posture at computer workstations and therefore have an increased exposure to work-related musculoskeletal disorders (WRMSD). The present study is aimed at investigating the feasibility and effectiveness of a tele-biofeedback ergonomic intervention programme among computer operators suffering from WRMSD. Twelve subjects with WRMSD were assigned an ergonomic intervention accompanied by remote tele-biofeedback training, which was practised at their workstations. Evaluations of pain symptoms and locations, body posture and psychosocial characteristics were carried out before and after the intervention in the workplace. The hypothesis was partially verified as it showed improved body position at the workstation and decreased pain in some body parts. Tele-biofeedback, as part of an intervention, appears to be feasible and efficient for computer operators who suffer from WRMSD. This study encourages further research on tele-health within the scope of occupational therapy practice. Practitioner summary: Research concerning tele-health using biofeedback is scarce. The present study analyses the feasibility and partial effectiveness of a tele-biofeedback ergonomic intervention programme for computer operators suffering from WRMSD. The uniqueness and singularity of this study is the usage of remote communication between participants and practitioners through the Internet.

  16. Development of a minimization instrument for allocation of a hospital-level performance improvement intervention to reduce waiting times in Ontario emergency departments

    Directory of Open Access Journals (Sweden)

    Anderson Geoff

    2009-06-01

    Full Text Available Abstract Background Rigorous evaluation of an intervention requires that its allocation be unbiased with respect to confounders; this is especially difficult in complex, system-wide healthcare interventions. We developed a short survey instrument to identify factors for a minimization algorithm for the allocation of a hospital-level intervention to reduce emergency department (ED waiting times in Ontario, Canada. Methods Potential confounders influencing the intervention's success were identified by literature review, and grouped by healthcare setting specific change stages. An international multi-disciplinary (clinical, administrative, decision maker, management panel evaluated these factors in a two-stage modified-delphi and nominal group process based on four domains: change readiness, evidence base, face validity, and clarity of definition. Results An original set of 33 factors were identified from the literature. The panel reduced the list to 12 in the first round survey. In the second survey, experts scored each factor according to the four domains; summary scores and consensus discussion resulted in the final selection and measurement of four hospital-level factors to be used in the minimization algorithm: improved patient flow as a hospital's leadership priority; physicians' receptiveness to organizational change; efficiency of bed management; and physician incentives supporting the change goal. Conclusion We developed a simple tool designed to gather data from senior hospital administrators on factors likely to affect the success of a hospital patient flow improvement intervention. A minimization algorithm will ensure balanced allocation of the intervention with respect to these factors in study hospitals.

  17. Minimal intervention dentistry II: part 6. Microscope and microsurgical techniques in periodontics.

    Science.gov (United States)

    Sitbon, Y; Attathom, T

    2014-05-01

    Different aspects of treatment for periodontal diseases or gingival problems require rigorous diagnostics. Magnification tools and microsurgical instruments, combined with minimally invasive techniques can provide the best solutions in such cases. Relevance of treatments, duration of healing, reduction of pain and post-operative scarring have the potential to be improved for patients through such techniques. This article presents an overview of the use of microscopy in periodontics, still in the early stages of development.

  18. Robotics in percutaneous cardiovascular interventions.

    Science.gov (United States)

    Pourdjabbar, Ali; Ang, Lawrence; Behnamfar, Omid; Patel, Mitul P; Reeves, Ryan R; Campbell, Paul T; Madder, Ryan D; Mahmud, Ehtisham

    2017-11-01

    The fundamental technique of performing percutaneous cardiovascular (CV) interventions has remained unchanged and requires operators to wear heavy lead aprons to minimize exposure to ionizing radiation. Robotic technology is now being utilized in interventional cardiology partially as a direct result of the increasing appreciation of the long-term occupational hazards of the field. This review was undertaken to report the clinical outcomes of percutaneous robotic coronary and peripheral vascular interventions. Areas covered: A systematic literature review of percutaneous robotic CV interventions was undertaken. The safety and feasibility of percutaneous robotically-assisted CV interventions has been validated in simple to complex coronary disease, and iliofemoral disease. Studies have shown that robotically-assisted PCI significantly reduces operator exposure to harmful ionizing radiation without compromising procedural success or clinical efficacy. In addition to the operator benefits, robotically-assisted intervention has the potential for patient advantages by allowing more accurate lesion length measurement, precise stent placement and lower patient radiation exposure. However, further investigation is required to fully elucidate these potential benefits. Expert commentary: Incremental improvement in robotic technology and telecommunications would enable treatment of an even broader patient population, and potentially provide remote robotic PCI.

  19. Intervention levels for protective action in the radiological emergency

    International Nuclear Information System (INIS)

    Lee, G.Y.; Khang, B.O.; Lee, M.; Lee, J.T.

    1998-09-01

    In the event of nuclear accident or radiological emergency, the protective action based on intervention levels prepared in advance should be implemented in order to minimize the public hazard. There are several protective measures such as sheltering, evacuation, iodine prophylaxis, foodstuff restrictions, temporary relocation, permanent resettlement, etc. for protecting the public. The protective measures should be implemented on the basis of operational intervention level of action level. This report describes the basic principles of intervention and the methodology for deriving intervention levels, and also recommendations for the intervention levels suggested from IAEA, ICRP, WHO and EU are summarized to apply to the domestic radiological emergency. This report also contains a revision procedure of operational intervention levels to meet a difference accident condition. Therefore, it can be usefully applied to establish revised operational intervention levels considering or the regional characteristics of our country. (author). 20 refs

  20. New heuristics for planning operating rooms.

    NARCIS (Netherlands)

    Molina-Pariente, J.M.; Hans, Elias W.; Framinan, J.M.; Gomez-Cia, T.

    2015-01-01

    We tackle the operating room planning problem of the Plastic Surgery and Major Burns Specialty of the University Hospital “Virgen del Rocio” in Seville (Spain). The decision problem is to assign an intervention date and an operating room to a set of surgeries on the waiting list, minimizing access

  1. Patient safety in the operating room: an intervention study on latent risk factors

    Directory of Open Access Journals (Sweden)

    van Beuzekom Martie

    2012-06-01

    Full Text Available Abstract Background Patient safety is one of the greatest challenges in healthcare. In the operating room errors are frequent and often consequential. This article describes an approach to a successful implementation of a patient safety program in the operating room, focussing on latent risk factors that influence patient safety. We performed an intervention to improve these latent risk factors (LRFs and increase awareness of patient safety issues amongst OR staff. Methods Latent risk factors were studied using a validated questionnaire applied to the OR staff before and after an intervention. A pre-test/post-test control group design with repeated measures was used to evaluate the effects of the interventions. The staff from one operating room of an university hospital acted as the intervention group. Controls consisted of the staff of the operating room in another university hospital. The outcomes were the changes in LRF scores, perceived incident rate, and changes in incident reports between pre- and post-intervention. Results Based on pre-test scores and participants’ key concerns about organizational factors affecting patient safety in their department the intervention focused on the following LRFs: Material Resources, Training and Staffing Recourses. After the intervention, the intervention operating room - compared to the control operating room - reported significantly fewer problems on Material Resources and Staffing Resources and a significantly lower score on perceived incident rate. The contribution of technical factors to incident causation decreased significantly in the intervention group after the intervention. Conclusion The change of state of latent risk factors can be measured using a patient safety questionnaire aimed at these factors. The change of the relevant risk factors (Material and Staffing resources concurred with a decrease in perceived and reported incident rates in the relevant categories. We conclude that

  2. Waste minimization, recycling and reuse in operations support services fleet maintenance

    International Nuclear Information System (INIS)

    Trego, A.L.

    1994-01-01

    Government regulations and smart business practices demand that organizations dramatically reduce both the type and volume of waste generated by their operations. This article describes successful waste minimization and recycling programs created by the Fleet Maintenance, Operations Support Services Division, Westinghouse Hanford Company. These comprehensive programs have greatly reduced waste formerly produced in maintaining 3,528 government-owned vehicles and nearly 200 emergency power generators at the Hanford Site. The actions are integral to preventing future contamination of the Site as well as to cleaning up the complexity of wastes from almost 50 years of defense production. The results of the Fleet Maintenance programs are impressive, recording cost savings of $290,000 in fiscal year 1993 and $965,000 since 1988

  3. Anesthetic management of minimally invasive intervention in children's oncohematology: preoperative patient management protocol

    Directory of Open Access Journals (Sweden)

    V. V. Shchukin

    2013-01-01

    Full Text Available Preoperative patient management protocol in the complex anesthetic support of minimally invasive interventions in pediatric oncology is described. Choice of general anesthesia method was determined by the specific clinical situation by analyzing all of the following factors: airway management, necessity and anticipated duration of unconsciousness, the need for analgesia, necessity and duration of immobilization, prevention of hypothermia, the presence and severity of disturbances in the hemostatic system, comfort for the child and his representatives (parents. Basic techniques of child preoperative examination, as well as the methodology for predicting the risk of perioperative adverse events are described.

  4. Anesthetic management of minimally invasive intervention in children's oncohematology: preoperative patient management protocol

    Directory of Open Access Journals (Sweden)

    V. V. Shchukin

    2014-07-01

    Full Text Available Preoperative patient management protocol in the complex anesthetic support of minimally invasive interventions in pediatric oncology is described. Choice of general anesthesia method was determined by the specific clinical situation by analyzing all of the following factors: airway management, necessity and anticipated duration of unconsciousness, the need for analgesia, necessity and duration of immobilization, prevention of hypothermia, the presence and severity of disturbances in the hemostatic system, comfort for the child and his representatives (parents. Basic techniques of child preoperative examination, as well as the methodology for predicting the risk of perioperative adverse events are described.

  5. Parents' Adoption of Social Communication Intervention Strategies: Families Including Children with Autism Spectrum Disorder Who Are Minimally Verbal

    Science.gov (United States)

    Shire, Stephanie Y.; Goods, Kelly; Shih, Wendy; Distefano, Charlotte; Kaiser, Ann; Wright, Courtney; Mathy, Pamela; Landa, Rebecca; Kasari, Connie

    2015-01-01

    Notably absent from the intervention literature are parent training programs targeting school-aged children with autism who have limited communication skills (Tager-Flusberg and Kasari in "Autism Res" 6:468-478, 2013). Sixty-one children with autism age 5-8 with minimal spontaneous communication received a 6-month social communication…

  6. Operator expansions in the minimal subtraction scheme. II. Explicit formulas for coefficient functions

    International Nuclear Information System (INIS)

    Chetyrkin, K.G.

    1989-01-01

    It is shown in an arbitrary model that the coefficient functions of the operator expansion (renormalized in the minimal subtraction scheme) are finite. Explicit formulas convenient for calculating them in practice are obtained. The gluing method and the formalism of the R* operation are used to transform the formulas in such a way that the coefficient functions can be expressed in terms of ordinary diagrams containing neither nonstandard propagators nor an additional loop integration. An important feature of the representation for the coefficient functions is that the R* operation, which subtracts simultaneously the ultraviolet and infrared divergences, guarantees the existence of the coefficient functions in the limit when the dimensional regularization is lifted without any restrictions

  7. Completion plug design provides improved operational efficiency and safety while minimizing environmental risks

    Energy Technology Data Exchange (ETDEWEB)

    Dum, Frank [T.D. Williamson, Inc., Tulsa, OK (United States)

    2012-07-01

    Pipeline repair standards have been raised with recent improvements for completion plugs when used with a brand new setting tool, resulting in lower environmental risks, improved operational efficiency and safety. The design changes were originally made to serve in an offshore environment in order to minimize the diver's time in the water and simplify steps by the diver to execute pipeline repair operations in cold, dark conditions. Enhancements in the design include fewer number of fittings, plugs, o-rings and gaskets isolating the pipeline product found inside the pipe. The new design is a step toward meeting strict operational and safety standards demanded in the field of pipeline maintenance and repair. (author)

  8. Minimal open strings

    International Nuclear Information System (INIS)

    Hosomichi, Kazuo

    2008-01-01

    We study FZZT-branes and open string amplitudes in (p, q) minimal string theory. We focus on the simplest boundary changing operators in two-matrix models, and identify the corresponding operators in worldsheet theory through the comparison of amplitudes. Along the way, we find a novel linear relation among FZZT boundary states in minimal string theory. We also show that the boundary ground ring is realized on physical open string operators in a very simple manner, and discuss its use for perturbative computation of higher open string amplitudes.

  9. Minimally Processed Functional Foods: Technological and Operational Pathways.

    Science.gov (United States)

    Rodgers, Svetlana

    2016-10-01

    This paper offers a concise review of technical and operational concepts underpinning commercialization of minimally processed functional foods (FFs), foods with fresh-like qualities commanding premium prices. The growing number of permitted nutritional content/health claims, many of which relate to well-being, coupled with emerging extraction and food processing technologies offers new exciting opportunities for small and medium size enterprises (SMEs) specializing in fresh produce to play an active role in the health market. Supporting SMEs, governments could benefit from savings in healthcare costs and value creation in the economy. Consumers could benefit from novel FF formats such as refrigerated RTE (ready-to-eat) meals, a variety of fresh-like meat-, fish-, and egg-based products, fresh-cut fruits and vegetables, cereal-based fermented foods and beverages. To preserve these valuable commodities, mild biological (enzymatic treatment, fermentation and, bio-preservation) and engineering solutions are needed. The latter include nonthermal techniques such as high-pressure treatment, cook-chill, sous-vide, mirco-encapsulation, vacuum impregnation and others. "De-constructive" culinary techniques such as 3D food printing and molecular gastronomy as well as developments in nutrigenomics and digital technologies facilitate novel product formats, personalization and access to niche markets. In the operational sense, moving from nourishment to health improvement demands a shift from defensive market-oriented to offensive market-developing strategies including collaborative networks with research organizations. © 2016 Institute of Food Technologists®.

  10. Operational intervention levels (OILs): a tool to overcome differences in intervention levels?

    International Nuclear Information System (INIS)

    Kirchner, Gerald; Wirth, Erich

    2008-01-01

    The intervention levels for evacuation, sheltering and iodine blockade still differ in many countries, although international organisation like IAEA, NEA or ICRP aspire to harmonise them on an international level. Even if the dose values of the limits are in agreement, they are not necessarily comparable because the type of dose (projected dose, averted dose), the respected exposure pathways (external dose, inhalation, ingestion) or the integration time might differ significantly. The question is raised, how can harmonisation being achieved? International organisations recommend 'operational intervention levels' (OILs) for promptly assessing the results of environmental monitoring and to decide on protective actions. OILs are measurable values derived from dose limits. Best examples are the derived intervention levels for food and feed in the codex alimentarius or by the EC, which limit the ingestion dose to about 5 mSv/a. This paper discusses the properties and potential use of OILs, identifies and derives useful OILs and addresses their benefit in practise both for early and later countermeasures. Furthermore it is discussed whether OILs might be a useful tool to overcome national differences in intervention levels because an OIL value covers a relative wide range of the projected dose due to the uncertainty of the parameters needed for derivation. (author)

  11. An Optical Multicast Routing with Minimal Network Coding Operations in WDM Networks

    Directory of Open Access Journals (Sweden)

    Huanlin Liu

    2014-01-01

    Full Text Available Network coding can improve the optical multicast routing performance in terms of network throughput, bandwidth utilization, and traffic load balance. But network coding needs high encoding operations costs in all-optical WDM networks due to shortage of optical RAM. In the paper, the network coding operation is defined to evaluate the number of network coding operation cost in the paper. An optical multicast routing algorithm based on minimal number of network coding operations is proposed to improve the multicast capacity. Two heuristic criteria are designed to establish the multicast routing with low network coding cost and high multicast capacity. One is to select one path from the former K shortest paths with the least probability of dropping the multicast maximal capacity. The other is to select the path with lowest potential coding operations with the highest link shared degree among the multiple wavelength disjoint paths cluster from source to each destination. Comparing with the other multicast routing based on network coding, simulation results show that the proposed multicast routing algorithm can effectively reduce the times of network coding operations, can improve the probability of reaching multicast maximal capacity, and can keep the less multicast routing link cost for optical WDM networks.

  12. Design of an Intervention to Minimize Ingestion of Fecal Microbes by Young Children in Rural Zimbabwe.

    Science.gov (United States)

    Mbuya, Mduduzi N N; Tavengwa, Naume V; Stoltzfus, Rebecca J; Curtis, Valerie; Pelto, Gretel H; Ntozini, Robert; Kambarami, Rukundo A; Fundira, Dadirai; Malaba, Thokozile R; Maunze, Diana; Morgan, Peter; Mangwadu, Goldberg; Humphrey, Jean H

    2015-12-15

    We sought to develop a water, sanitation, and hygiene (WASH) intervention to minimize fecal-oral transmission among children aged 0-18 months in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial. We undertook 4 phases of formative research, comprising in-depth interviews, focus group discussions, behavior trials, and a combination of observations and microbiological sampling methods. The resulting WASH intervention comprises material inputs and behavior change communication to promote stool disposal, handwashing with soap, water treatment, protected exploratory play, and hygienic infant feeding. Nurture and disgust were found to be key motivators, and are used as emotional triggers. The concept of a safe play space for young children was particularly novel, and families were eager to implement this after learning about the risks of unprotected exploratory play. An iterative process of formative research was essential to create a sequenced and integrated longitudinal intervention for a SHINE household as it expects (during pregnancy) and then cares for a new child. © The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America.

  13. Early post-operative pulmonary function tests after mitral valve replacement: Minimally invasive versus conventional approach. Which is better?

    Directory of Open Access Journals (Sweden)

    Magdy Gomaa

    2016-12-01

    Conclusion: Minimally invasive right anterolateral mini-thoracotomy is as safe as median sternotomy for mitral valve surgery, with fewer complications and postoperative pain, less ICU and hospital stay, fast recovery to work with no movement restriction after surgery. There was a highly significant difference denoting better post operative pulmonary function of the minimally invasive approach.

  14. Operation Cost Minimization of Droop-Controlled AC Microgrids Using Multiagent-Based Distributed Control

    DEFF Research Database (Denmark)

    Li, Chendan; Savaghebi, Mehdi; Guerrero, Josep M.

    2016-01-01

    on the power rating of the power converters. With various primary source for the distributed generator (DG), factors that are closely related to the operation cost, such as fuel cost of the generators and losses should be taken into account in order to improve the efficiency of the whole system. In this paper......, a multiagent-based distributed method is proposed to minimize the operation cost in AC microgrids. In the microgrid, each DG is acting as an agent which regulates the power individually using a novel power regulation method based on frequency scheduling. An optimal power command is obtained through carefully...... designed consensus algorithm by using sparse communication links only among neighbouring agents. Experimental results for different cases verified that the proposed control strategy can effectively reduce the operation cost....

  15. Quantification of Operational Learning in Minimal Invasive Extracorporeal Circulation.

    Science.gov (United States)

    Anastasiadis, Kyriakos; Antonitsis, Polychronis; Asteriou, Christos; Argiriadou, Helena; Deliopoulos, Apostolos; Konstantinou, Dimitrios; Grosomanidis, Vassilios; Tossios, Paschalis

    2017-07-01

    Minimal invasive extracorporeal circulation (MiECC) has initiated important new efforts within science and technology towards a more physiologic perfusion. In this study, we aim to investigate the learning curve of our center regarding MiECC. We studied a series of 150 consecutive patients who underwent elective coronary artery bypass grafting by the same surgical team during the initial phase of MiECC application. Patients were randomly assigned into two groups. Group A (n = 75) included patients operated on MiECC, while group B (n = 75) included patients operated with conventional cardiopulmonary bypass (cCPB). The primary end-point of the study was to identify whether there is a learning curve when operating on MiECC. The following parameters were unrelated with increasing experience, even though the results favored MiECC use: reduced CPB duration (102.9 ± 25 vs. 122.2 ± 33 min, P learning applied to postoperative hematocrit and hemoglobin levels (R 2  = 0.098, P = 0.006). We identified that advantages of MiECC technology in terms of reduced hemodilution and improved end-organ protection and clinical outcome are evident from the first patient. Optimal results are obtained with 50 cases; this refers mainly to significant reduction in the need for intraoperative blood transfusion. Teamwork from surgeons, anesthesiologists, and perfusionists is of paramount importance in order to maximize the clinical benefits from this technology. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  16. Efficacy of a minimal home-based psychoeducative intervention versus usual care for managing anxiety and dyspnoea in patients with severe chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Bove, Dorthe Gaby; Overgaard, Dorthe; Lomborg, Kirsten

    2015-01-01

    investigates the efficacy of a minimal home-based psychoeducative intervention versus usual care for patients with severe chronic obstructive pulmonary disease. METHODS AND ANALYSIS: The trial is a randomised controlled trial with a 4-week and 3-month follow-up. 66 patients with severe chronic obstructive...... pulmonary disease and associated anxiety will be randomised 1:1 to either an intervention or control group. The intervention consists of a single psychoeducative session in the patient's home in combination with a telephone booster session. The intervention is based on a manual, with a theoretical...

  17. Loss Minimizing Operation of Doubly Fed Induction Generator Based Wind Generation Systems Considering Reactive Power Provision

    DEFF Research Database (Denmark)

    Baohua, Zhang; Hu, Weihao; Chen, Zhe

    2014-01-01

    The paper deals with control techniques for minimizing the operating loss of doubly fed induction generator based wind generation systems when providing reactive power. The proposed method achieves its goal through controlling the rotor side q-axis current in the synchronous reference frame...

  18. Prevention of upper limb symptoms and signs of nerve afflictions in computer operators: The effect of intervention by stretching

    Directory of Open Access Journals (Sweden)

    Thomsen Gert

    2008-01-01

    Full Text Available Abstract Background In a previous study of computer operators we have demonstrated the relation of upper limb pain to individual and patterns of neurological findings (reduced function of muscles, sensory deviations from normal and mechanical allodynia of nerve trunks. The identified patterns were in accordance with neural afflictions at three specific locations (brachial plexus at chord level, posterior interosseous and median nerve on elbow level. We have introduced an intervention program aiming to mobilize nerves at these locations and tested its efficacy. Methods 125 and 59, respectively, computer operators in two divisions of an engineering consultancy company were invited to answer a questionnaire on upper limb symptoms and to undergo a blinded neurological examination. Participants in one division were subsequently instructed to participate in an upper limb stretching course at least three times during workdays in a six month period. Subjects from the other division served as controls. At the end of the intervention both groups were invited to a second identical evaluation by questionnaire and physical examination. Symptoms and findings were studied in the right upper limb. Perceived changes of pain were recorded and individual and patterns of physical findings assessed for both groups at baseline and at follow-up. In subjects with no or minimal preceding pain we additionally studied the relation of incident pain to the summarized findings for parameters contained in the definition of nerve affliction at the three locations. Results Summarized pain was significantly reduced in the intervention group but unchanged in controls. After the intervention, fewer neurological abnormalities in accordance with nerve affliction were recorded for the whole material but no conclusion could be drawn regarding the relation to the intervention of this reduction. Incident pain correlated to findings in accordance with the three locations of nerve

  19. An operational waste minimization chargeback system at Sandia National Laboratories, New Mexico

    International Nuclear Information System (INIS)

    Horak, K.; Peek, D.W.; Stermer, D.; Dailleboust, L.; Reilly, H.

    1993-01-01

    Sandia National Laboratories, New Mexico, (SNL/NM) has made a commitment to achieve significant reductions in the amount of hazardous wastes generated throughout its operations. The success of the SNL/NM Waste Minimization/Pollution Prevention Program depends primarily on: (1) adequate program funding, and (2) comprehensive collection and dissemination of information pertaining to SNL/NM's waste. This paper describes the chargeback system that SNL/NM has chosen for funding the implementation of the Waste Minimization/Pollution Prevention program, as well as the waste reporting system that follows naturally from the chargeback system. Both the chargeback and reporting systems have been fully implemented. The details of implementation are discussed, including: the physical means by which waste is managed and data collected; the database systems which have been linked; the flow of data through both human hands and electronic systems; the quality assurance of that data; and the waste report format now in use. Also discussed are intended improvements in the system that are currently planned for the coming years

  20. Design of a magnetic-tunnel-junction-oriented nonvolatile lookup table circuit with write-operation-minimized data shifting

    Science.gov (United States)

    Suzuki, Daisuke; Hanyu, Takahiro

    2018-04-01

    A magnetic-tunnel-junction (MTJ)-oriented nonvolatile lookup table (LUT) circuit, in which a low-power data-shift function is performed by minimizing the number of write operations in MTJ devices is proposed. The permutation of the configuration memory cell for read/write access is performed as opposed to conventional direct data shifting to minimize the number of write operations, which results in significant write energy savings in the data-shift function. Moreover, the hardware cost of the proposed LUT circuit is small since the selector is shared between read access and write access. In fact, the power consumption in the data-shift function and the transistor count are reduced by 82 and 52%, respectively, compared with those in a conventional static random-access memory-based implementation using a 90 nm CMOS technology.

  1. [Research on fuzzy proportional-integral-derivative control of master-slave minimally invasive operation robot driver].

    Science.gov (United States)

    Zhao, Ximei; Ren, Chengyi; Liu, Hao; Li, Haogyi

    2014-12-01

    Robotic catheter minimally invasive operation requires that the driver control system has the advantages of quick response, strong anti-jamming and real-time tracking of target trajectory. Since the catheter parameters of itself and movement environment and other factors continuously change, when the driver is controlled using traditional proportional-integral-derivative (PID), the controller gain becomes fixed once the PID parameters are set. It can not change with the change of the parameters of the object and environmental disturbance so that its change affects the position tracking accuracy, and may bring a large overshoot endangering patients' vessel. Therefore, this paper adopts fuzzy PID control method to adjust PID gain parameters in the tracking process in order to improve the system anti-interference ability, dynamic performance and tracking accuracy. The simulation results showed that the fuzzy PID control method had a fast tracking performance and a strong robustness. Compared with those of traditional PID control, the feasibility and practicability of fuzzy PID control are verified in a robotic catheter minimally invasive operation.

  2. Radiation protection cabin for catheter-directed liver interventions: operator dose assessment

    International Nuclear Information System (INIS)

    Maleux, Geert; Bosmans, Hilde; Bergans, Niki; Bogaerts, Ria

    2016-01-01

    The number and complexity of interventional radiological procedures and in particular catheter-directed liver interventions have increased substantially. The current study investigates the reduction of personal doses when using a dedicated radiation protection cabin (RPC) for these procedures. Operator and assistant doses were assessed for 3 series of 20 chemo-infusion/chemoembolisation interventions, including an equal number of procedures with and without RPC. Whole body doses, finger doses and doses at the level of knees and eyes were evaluated with different types of TLD-100 Harshaw dosemeters. Dosemeters were also attached on the three walls of the RPC. The operator doses were significantly reduced by the RPC, but also without RPC, the doses appear to be limited as a result of thorough optimisation with existing radiation protection tools. The added value of the RPC should thus be determined by the outcome of balancing dose reduction and other aspects such as ergonomic benefits. (authors)

  3. Minimal Invasive Urologic Surgery and Postoperative Ileus

    Directory of Open Access Journals (Sweden)

    Fouad Aoun

    2015-07-01

    Full Text Available Postoperative ileus (POI is the most common cause of prolonged length of hospital stays (LOS and associated healthcare costs. The advent of minimal invasive technique was a major breakthrough in the urologic landscape with great potential to progress in the future. In the field of gastrointestinal surgery, several studies had reported lower incidence rates for POI following minimal invasive surgery compared to conventional open procedures. In contrast, little is known about the effect of minimal invasive approach on the recovery of bowel motility after urologic surgery. We performed an overview of the potential benefit of minimal invasive approach on POI for urologic procedures. The mechanisms and risk factors responsible for the onset of POI are discussed with emphasis on the advantages of minimal invasive approach. In the urologic field, POI is the main complication following radical cystectomy but it is rarely of clinical significance for other minimal invasive interventions. Laparoscopy or robotic assisted laparoscopic techniques when studied individually may reduce to their own the duration and prevent the onset of POI in a subset of procedures. The potential influence of age and urinary diversion type on postoperative ileus is contradictory in the literature. There is some evidence suggesting that BMI, blood loss, urinary extravasation, existence of a major complication, bowel resection, operative time and transperitoneal approach are independent risk factors for POI. Treatment of POI remains elusive. One of the most important and effective management strategies for patients undergoing radical cystectomy has been the development and use of enhanced recovery programs. An optimal rational strategy to shorten the duration of POI should incorporate minimal invasive approach when appropriate into multimodal fast track programs designed to reduce POI and shorten LOS.

  4. Operator agency in process intervention: tampering versus application of tacit knowledge

    Science.gov (United States)

    Van Gestel, P.; Pons, D. J.; Pulakanam, V.

    2015-09-01

    Statistical process control (SPC) theory takes a negative view of adjustment of process settings, which is termed tampering. In contrast, quality and lean programmes actively encourage operators to acts of intervention and personal agency in the improvement of production outcomes. This creates a conflict that requires operator judgement: How does one differentiate between unnecessary tampering and needful intervention? Also, difficult is that operators apply tacit knowledge to such judgements. There is a need to determine where in a given production process the operators are applying tacit knowledge, and whether this is hindering or aiding quality outcomes. The work involved the conjoint application of systems engineering, statistics, and knowledge management principles, in the context of a case study. Systems engineering was used to create a functional model of a real plant. Actual plant data were analysed with the statistical methods of ANOVA, feature selection, and link analysis. This identified the variables to which the output quality was most sensitive. These key variables were mapped back to the functional model. Fieldwork was then directed to those areas to prospect for operator judgement activities. A natural conversational approach was used to determine where and how operators were applying judgement. This contrasts to the interrogative approach of conventional knowledge management. Data are presented for a case study of a meat rendering plant. The results identify specific areas where operators' tacit knowledge and mental model contribute to quality outcomes and untangles the motivations behind their agency. Also evident is how novice and expert operators apply their knowledge differently. Novices were focussed on meeting throughput objectives, and their incomplete understanding of the plant characteristics led them to inadvertently sacrifice quality in the pursuit of productivity in certain situations. Operators' responses to the plant are affected by

  5. Interactive Visual Intervention Planning: Interactive Visualization for Intervention Planning in Particle Accelerator Environments with Ionizing Radiation

    CERN Document Server

    Fabry, Thomas; Feral, Bruno

    2013-01-01

    Intervention planning is crucial for maintenance operations in particle accelerator environments with ionizing radiation, during which the radiation dose contracted by maintenance workers should be reduced to a minimum. In this context, we discuss the visualization aspects of a new software tool, which integrates interactive exploration of a scene depicting an accelerator facility augmented with residual radiation level simulations, with the visualization of intervention data such as the followed trajectory and maintenance tasks. The visualization of each of these aspects has its effect on the final predicted contracted radiation dose. In this context, we explore the possible benefits of a user study, with the goal of enhancing the visual conditions in which the intervention planner using the software tool is minimizing the radiation dose.

  6. Target Registration Error minimization involving deformable organs using elastic body splines and Particle Swarm Optimization approach.

    Science.gov (United States)

    Spinczyk, Dominik; Fabian, Sylwester

    2017-12-01

    In minimally invasive surgery one of the main challenges is the precise location of the target during the intervention. The aim of the study is to present usability of elastic body splines (EBS) to minimize TRE error. The method to find the desired EBS parameters values is presented with usage of Particle Swarm optimization approach. This ability of TRE minimization has been achieved for the respiratory phases corresponding to minimum FRE for abdominal (especially liver) surgery. The proposed methodology was verified during experiments conducted on 21 patients diagnosed with liver tumors. This method has been developed to perform operations in real-time on a standard workstation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Waste minimization handbook, Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Boing, L.E.; Coffey, M.J.

    1995-12-01

    This technical guide presents various methods used by industry to minimize low-level radioactive waste (LLW) generated during decommissioning and decontamination (D and D) activities. Such activities generate significant amounts of LLW during their operations. Waste minimization refers to any measure, procedure, or technique that reduces the amount of waste generated during a specific operation or project. Preventive waste minimization techniques implemented when a project is initiated can significantly reduce waste. Techniques implemented during decontamination activities reduce the cost of decommissioning. The application of waste minimization techniques is not limited to D and D activities; it is also useful during any phase of a facility`s life cycle. This compendium will be supplemented with a second volume of abstracts of hundreds of papers related to minimizing low-level nuclear waste. This second volume is expected to be released in late 1996.

  8. Waste minimization handbook, Volume 1

    International Nuclear Information System (INIS)

    Boing, L.E.; Coffey, M.J.

    1995-12-01

    This technical guide presents various methods used by industry to minimize low-level radioactive waste (LLW) generated during decommissioning and decontamination (D and D) activities. Such activities generate significant amounts of LLW during their operations. Waste minimization refers to any measure, procedure, or technique that reduces the amount of waste generated during a specific operation or project. Preventive waste minimization techniques implemented when a project is initiated can significantly reduce waste. Techniques implemented during decontamination activities reduce the cost of decommissioning. The application of waste minimization techniques is not limited to D and D activities; it is also useful during any phase of a facility's life cycle. This compendium will be supplemented with a second volume of abstracts of hundreds of papers related to minimizing low-level nuclear waste. This second volume is expected to be released in late 1996

  9. Qualification guideline of the German X-ray association (DRG) und the German association for interventional radiology and minimal invasive therapy (DeGIR) for the performance of interventional-radiological minimal invasive procedures on arteries and veins; Qualifizierungsleitlinie der Deutschen Roentgengesellschaft (DRG) und der Deutschen Gesellschaft fuer Interventionelle Radiologie und minimalinvasive Therapie (DeGIR) zur Durchfuehrung interventionell-radiologischer minimalinvasiver Verfahren an Arterien und Venen

    Energy Technology Data Exchange (ETDEWEB)

    Buecker, A. [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany); Gross-Fengels, W. [Asklepiosklinik, Hamburg-Harburg (Germany); Haage, P. [Helios-Kliniken, Wuppertal (Germany); Huppert, P. [Klinikum Darmstadt (Germany); Landwehr, P. [Henriettenstiftung, Hannover (Germany); Loose, R. [Klinikum Nuernberg-Nord (Germany); Reimer, P. [Klinikum Karlsruhe (Germany); Tacke, J. [Klinikum Passau (Germany); Vorwerk, D. [Klinikum Ingolstadt (Germany); Fischer, J.

    2012-06-15

    The topics covered in the qualification guideline of the German X-ray association (DRG) und the German association for interventional radiology and minimal invasive therapy (DeGIR) for the performance of interventional-radiological minimal invasive procedures on arteries and veins are the following: Practical qualification: aorta iliac vessels and vessels in the upper and lower extremities, kidney and visceral arteries, head and neck arteries, dialysis shunts, veins and pulmonary arteries, aorta aneurysms and peripheral artery aneurysms. Knowledge acquisition concerning radiation protection: legal fundamentals, education and training, knowledge actualization and quality control, definition of the user and the procedure, competence preservation.

  10. Evaluation of timing and dosage of a parent-based intervention to minimize college students' alcohol consumption.

    Science.gov (United States)

    Turrisi, Rob; Mallett, Kimberly A; Cleveland, Michael J; Varvil-Weld, Lindsey; Abar, Caitlin; Scaglione, Nichole; Hultgren, Brittney

    2013-01-01

    The study evaluated the timing and dosage of a parent-based intervention to minimize alcohol consumption for students with varying drinking histories. First-year students (N = 1,900) completed Web assessments during the summer before college (baseline) and two follow-ups (fall of first and second years). Students were randomized to one of four conditions (pre-college matriculation [PCM], pre-college matriculation plus boosters [PCM+B], after college matriculation [ACM], and control conditions). Seven indicators of drinking (drink in past month, been drunk in past month, weekday [Sunday to Wednesday] drinking, Thursday drinking, weekend [Friday, Saturday] drinking, heavy episodic drinking in past 2 weeks, and peak blood alcohol concentration students.

  11. Operation Cost Minimization of Droop-Controlled AC Microgrids Using Multiagent-Based Distributed Control

    Directory of Open Access Journals (Sweden)

    Chendan Li

    2016-09-01

    Full Text Available Recently, microgrids are attracting increasing research interest as promising technologies to integrate renewable energy resources into the distribution system. Although many works have been done on droop control applied to microgrids, they mainly focus on achieving proportional power sharing based on the power rating of the power converters. With various primary source for the distributed generator (DG, factors that are closely related to the operation cost, such as fuel cost of the generators and losses should be taken into account in order to improve the efficiency of the whole system. In this paper, a multiagent-based distributed method is proposed to minimize the operation cost in AC microgrids. In the microgrid, each DG is acting as an agent which regulates the power individually using a novel power regulation method based on frequency scheduling. An optimal power command is obtained through carefully designed consensus algorithm by using sparse communication links only among neighbouring agents. Experimental results for different cases verified that the proposed control strategy can effectively reduce the operation cost.

  12. Minimally invasive orthognathic surgery.

    Science.gov (United States)

    Resnick, Cory M; Kaban, Leonard B; Troulis, Maria J

    2009-02-01

    Minimally invasive surgery is defined as the discipline in which operative procedures are performed in novel ways to diminish the sequelae of standard surgical dissections. The goals of minimally invasive surgery are to reduce tissue trauma and to minimize bleeding, edema, and injury, thereby improving the rate and quality of healing. In orthognathic surgery, there are two minimally invasive techniques that can be used separately or in combination: (1) endoscopic exposure and (2) distraction osteogenesis. This article describes the historical developments of the fields of orthognathic surgery and minimally invasive surgery, as well as the integration of the two disciplines. Indications, techniques, and the most current outcome data for specific minimally invasive orthognathic surgical procedures are presented.

  13. Exercise intervention for patients diagnosed with operable non-small cell lung cancer

    DEFF Research Database (Denmark)

    Missel, Malene; Pedersen, Jesper Holst; Hendriksen, Carsten

    2015-01-01

    PURPOSE: The purpose was to explore operable lung cancer patient experiences with an exercise intervention from a longitudinal perspective according to patient motivation and patient perceived benefits and barriers of exercise. METHODS: Nineteen patients enrolled in an exercise intervention 2 weeks...... study dropped out of the intervention due to side effects of chemotherapy (n = 3) and external circumstances (n = 5). The mean attendance rate for the eleven participants who completed the intervention was 82 %. No patients experienced severe adverse events. Motivation for participation included...... patients' expectations of physical benefits and the security of having professionals present. Patients experienced physical and emotional benefits and affirmed their social identity. Barriers were primarily related to side effects of chemotherapy. CONCLUSION: The exercise intervention was undertaken safely...

  14. The development of control technologies applied to waste processing operations

    International Nuclear Information System (INIS)

    Grasz, E.; Baker, S.; Couture, S.; Dennison, D.; Holliday, M.; Hurd, R.; Kettering, B.; Merrill, R.; Wilhelmson, K.

    1993-02-01

    Typical waste and residue processes involve some level of human interaction. The risk of exposure to unknown hazardous materials and the potential for radiation contamination provide the impetus for physically separating or removing operators from such processing steps. Technologies that facilitate separation of the operator from potential contamination include glove box robotics; modular systems for remote and automated servicing; and interactive controls that minimize human intervention. Lawrence Livermore National Laboratory (LLNL) is developing an automated system which by design will supplant the operator for glove box tasks, thus affording protection from the risk of radiation exposure and minimizing operator associated waste.This paper describes recent accomplishments in technology development and integration, and outlines the future goals at LLNL for achieving this integrated, interactive control capability

  15. Parents' Adoption of Social Communication Intervention Strategies: Families Including Children with Autism Spectrum Disorder Who are Minimally Verbal.

    Science.gov (United States)

    Shire, Stephanie Y; Goods, Kelly; Shih, Wendy; Distefano, Charlotte; Kaiser, Ann; Wright, Courtney; Mathy, Pamela; Landa, Rebecca; Kasari, Connie

    2015-06-01

    Notably absent from the intervention literature are parent training programs targeting school-aged children with autism who have limited communication skills (Tager-Flusberg and Kasari in Autism Res 6:468-478, 2013). Sixty-one children with autism age 5-8 with minimal spontaneous communication received a 6-month social communication intervention including parent training. Parent-child play interactions were coded for parents' strategy implementation and children's time jointly engaged (Adamson et al. in J Autism Dev Disord 39:84-96, 2009). Parents mastered an average of 70% of the strategies. Further analyses indicated some gains in implementation occurred from mere observation of sessions, while the greatest gains occurred in the first month of active coaching and workshops. Children's joint engagement was associated with parents' implementation success across time demonstrating parents' implementation was relevant to children's social engagement.

  16. Measurement of spatial dose distribution for evaluation operator dose during nero-interventional procedures

    International Nuclear Information System (INIS)

    Han, Su Chul; Hong, Dong Hee

    2016-01-01

    The spatial dose distribution was measured with ionization chamber as preliminary study to evaluate operator dose and to study dose reduction during neuro-interventional procedures. The zone of operators was divided into four area (45, 135, 225, and 315 degree).We supposed that operator exist on the four area and indicated location of critical organs(eyes, breast, gonad). The spatial doses were measured depending on distance( 80, 100, 120, and 140 cm) and location of critical organs. The spatial doses of area of 225 degree were 114.5 mR/h (eyes location), 143.1 mR/h (breast location) and 147 mR/h (gonad location) in 80 cm. When changed location of x-ray generator, spatial dose increased in 18.1±10.5%, averagely. We certified spatial dose in the operator locations, Using the results of this study, It is feasible to protect operator from radiation in neuro-interventional procedures

  17. Measurement of spatial dose distribution for evaluation operator dose during nero-interventional procedures

    Energy Technology Data Exchange (ETDEWEB)

    Han, Su Chul [Division of Medical Radiation Equipment, Korea Institute of Radiological and Medical Sciences, Seoul (Korea, Republic of); Hong, Dong Hee [Dept. of Radiology Science, Far East University, Eumseong (Korea, Republic of)

    2016-09-15

    The spatial dose distribution was measured with ionization chamber as preliminary study to evaluate operator dose and to study dose reduction during neuro-interventional procedures. The zone of operators was divided into four area (45, 135, 225, and 315 degree).We supposed that operator exist on the four area and indicated location of critical organs(eyes, breast, gonad). The spatial doses were measured depending on distance( 80, 100, 120, and 140 cm) and location of critical organs. The spatial doses of area of 225 degree were 114.5 mR/h (eyes location), 143.1 mR/h (breast location) and 147 mR/h (gonad location) in 80 cm. When changed location of x-ray generator, spatial dose increased in 18.1±10.5%, averagely. We certified spatial dose in the operator locations, Using the results of this study, It is feasible to protect operator from radiation in neuro-interventional procedures.

  18. Radiation exposure of operator during various interventional procedures

    International Nuclear Information System (INIS)

    Yu, In Kyu; Chung, Jin Wook; Han, Joon Koo; Park, Jae Hyung; Kang, Wee Saing

    1994-01-01

    To investigate the levels of radiation exposure of an operator which may be influenced by the wearing an apron, type of procedure, duration of fluoroscopy and operator's skill during various interventional procedures. Radiation doses were measured both inside and outside the apron(0.5 mm lead equivalent) of the operator by a film badge monitoring method and the duration of fluoroscopy was measured in 96 procedures prospectively. The procedures were 30 transcatheter arterial embolization (TAE), 25 percutaneous transhepatic biliary drainages (PTBD), 16 stone removals (SR), 15 percutaneous needle aspirations (PNCA) and 10 percutaneous nephrostomies(PCN). To assess the difference of exposure by the operator's skill, the procedures of TAE and PTBD were done separately by groups of staffs and residents. Average protective effect of the apron was 72.8%. Average radiation exposure(unit: μ Sv/procedure was 23.3 in PTBD by residents, 10.0 in PTBD by staffs, 10.0 in SR, 8.7 in TAE by residents, 7.3 in TAE by staffs, 9.0 in PCN and 6.0 in PCNA. Average radiation exposure of residents were 1.9 times greater than those of staffs. Radiation exposure was not proportionally related to the duration of fluoroscopy, but influenced by wearing an apron, various types of procedure and operator's skills

  19. Topological gravity with minimal matter

    International Nuclear Information System (INIS)

    Li Keke

    1991-01-01

    Topological minimal matter, obtained by twisting the minimal N = 2 supeconformal field theory, is coupled to two-dimensional topological gravity. The free field formulation of the coupled system allows explicit representations of BRST charge, physical operators and their correlation functions. The contact terms of the physical operators may be evaluated by extending the argument used in a recent solution of topological gravity without matter. The consistency of the contact terms in correlation functions implies recursion relations which coincide with the Virasoro constraints derived from the multi-matrix models. Topological gravity with minimal matter thus provides the field theoretic description for the multi-matrix models of two-dimensional quantum gravity. (orig.)

  20. Evaluation of Timing and Dosage of a Parent-Based Intervention to Minimize College Students’ Alcohol Consumption

    Science.gov (United States)

    Turrisi, Rob; Mallett, Kimberly A.; Cleveland, Michael J.; Varvil-Weld, Lindsey; Abar, Caitlin; Scaglione, Nichole; Hultgren, Brittney

    2013-01-01

    Objective: The study evaluated the timing and dosage of a parent-based intervention to minimize alcohol consumption for students with varying drinking histories. Method: First-year students (N = 1,900) completed Web assessments during the summer before college (baseline) and two follow-ups (fall of first and second years). Students were randomized to one of four conditions (pre-college matriculation [PCM], pre-college matriculation plus boosters [PCM+B], after college matriculation [ACM], and control conditions). Seven indicators of drinking (drink in past month, been drunk in past month, weekday [Sunday to Wednesday] drinking, Thursday drinking, weekend [Friday, Saturday] drinking, heavy episodic drinking in past 2 weeks, and peak blood alcohol concentration students. PMID:23200148

  1. MO-DE-202-03: Image-Guided Surgery and Interventions in the Advanced Multimodality Image-Guided Operating (AMIGO) Suite

    Energy Technology Data Exchange (ETDEWEB)

    Kapur, T. [Brigham & Women’s Hospital (United States)

    2016-06-15

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

  2. MO-DE-202-03: Image-Guided Surgery and Interventions in the Advanced Multimodality Image-Guided Operating (AMIGO) Suite

    International Nuclear Information System (INIS)

    Kapur, T.

    2016-01-01

    At least three major trends in surgical intervention have emerged over the last decade: a move toward more minimally invasive (or non-invasive) approach to the surgical target; the development of high-precision treatment delivery techniques; and the increasing role of multi-modality intraoperative imaging in support of such procedures. This symposium includes invited presentations on recent advances in each of these areas and the emerging role for medical physics research in the development and translation of high-precision interventional techniques. The four speakers are: Keyvan Farahani, “Image-guided focused ultrasound surgery and therapy” Jeffrey H. Siewerdsen, “Advances in image registration and reconstruction for image-guided neurosurgery” Tina Kapur, “Image-guided surgery and interventions in the advanced multimodality image-guided operating (AMIGO) suite” Raj Shekhar, “Multimodality image-guided interventions: Multimodality for the rest of us” Learning Objectives: Understand the principles and applications of HIFU in surgical ablation. Learn about recent advances in 3D–2D and 3D deformable image registration in support of surgical safety and precision. Learn about recent advances in model-based 3D image reconstruction in application to intraoperative 3D imaging. Understand the multi-modality imaging technologies and clinical applications investigated in the AMIGO suite. Understand the emerging need and techniques to implement multi-modality image guidance in surgical applications such as neurosurgery, orthopaedic surgery, vascular surgery, and interventional radiology. Research supported by the NIH and Siemens Healthcare.; J. Siewerdsen; Grant Support - National Institutes of Health; Grant Support - Siemens Healthcare; Grant Support - Carestream Health; Advisory Board - Carestream Health; Licensing Agreement - Carestream Health; Licensing Agreement - Elekta Oncology.; T. Kapur, P41EB015898; R. Shekhar, Funding: R42CA137886 and R41CA192504

  3. Operator dependency of the radiation exposure in cardiac interventions: feasibility of ultra low dose levels

    International Nuclear Information System (INIS)

    Emre Ozpelit, Mehmet; Ercan, Ertugrul; Pekel, Nihat; Tengiz, Istemihan; Yilmaz, Akar; Ozpelit, Ebru; Ozyurtlu, Ferhat

    2017-01-01

    Introduction: Mean radiation exposure in invasive cardiology varies greatly between different centres and interventionists. The International Commission on Radiological Protection and the EURATOM Council stipulate that, despite reference values, 'All medical exposure for radiodiagnostic purposes shall be kept as low as reasonably achievable' (ALARA). The purpose of this study is to establish the effects of the routine application of ALARA principles and to determine operator and procedure impact on radiation exposure in interventional cardiology. Materials and methods: A total of 240 consecutive cardiac interventional procedures were analysed. Five operators performed the procedures, two of whom were working in accordance with ALARA principles (Group 1 operators) with the remaining three working in a standard manner (Group 2 operators). Radiation exposure levels of these two groups were compared. Results: Total fluoroscopy time and the number of radiographic runs were similar between groups. However, dose area product and cumulative dose were significantly lower in Group 1 when compared with Group 2. Radiation levels of Group 1 were far below even the reference levels in the literature, thus representing an ultra-low-dose radiation exposure in interventional cardiology. Conclusion: By use of simple radiation reducing techniques, ultra-low-dose radiation exposure is feasible in interventional cardiology. Achievability of such levels depends greatly on operator awareness, desire, knowledge and experience of radiation protection. (authors)

  4. Towards Clinically Optimized MRI-guided Surgical Manipulator for Minimally Invasive Prostate Percutaneous Interventions: Constructive Design*

    Science.gov (United States)

    Eslami, Sohrab; Fischer, Gregory S.; Song, Sang-Eun; Tokuda, Junichi; Hata, Nobuhiko; Tempany, Clare M.; Iordachita, Iulian

    2013-01-01

    This paper undertakes the modular design and development of a minimally invasive surgical manipulator for MRI-guided transperineal prostate interventions. Severe constraints for the MRI-compatibility to hold the minimum artifact on the image quality and dimensions restraint of the bore scanner shadow the design procedure. Regarding the constructive design, the manipulator kinematics has been optimized and the effective analytical needle workspace is developed and followed by proposing the workflow for the manual needle insertion. A study of the finite element analysis is established and utilized to improve the mechanism weaknesses under some inevitable external forces to ensure the minimum structure deformation. The procedure for attaching a sterile plastic drape on the robot manipulator is discussed. The introduced robotic manipulator herein is aimed for the clinically prostate biopsy and brachytherapy applications. PMID:24683502

  5. Benefit from the minimally invasive sinus technique.

    Science.gov (United States)

    Salama, N; Oakley, R J; Skilbeck, C J; Choudhury, N; Jacob, A

    2009-02-01

    Sinus drainage is impeded by the transition spaces that the anterior paranasal sinuses drain into, not the ostia themselves. Addressing the transition spaces and leaving the ostia intact, using the minimally invasive sinus technique, should reverse chronic rhinosinusitis. To assess patient benefit following use of the minimally invasive sinus technique for chronic rhinosinusitis. One hundred and forty-three consecutive patients underwent the minimally invasive sinus technique for chronic rhinosinusitis. Symptoms (i.e. blocked nose, poor sense of smell, rhinorrhoea, post-nasal drip, facial pain and sneezing) were recorded using a visual analogue scale, pre-operatively and at six and 12 weeks post-operatively. Patients were also surveyed using the Glasgow benefit inventory, one and three years post-operatively. We found a significant reduction in all nasal symptom scores at six and 12 weeks post-operatively, and increased total quality of life scores at one and three years post-operatively (25.2 and 14.8, respectively). The patient benefits of treatment with the minimally invasive sinus technique compare with the published patient benefits for functional endoscopic sinus surgery.

  6. Minimally invasive surgical treatment options for patients with degenerative lumbar spine disease

    International Nuclear Information System (INIS)

    Durny, P.

    2014-01-01

    The most common cause of reduced activity in working people is degenerative disc disease and spondylosis of lumbar spine. The variety of clinical findings such as segmental lumbago or severe form of mixed radicular compression syndromes can be occurred. Neurosurgical intervention is indicated in case of failure of conservative treatment and graphical findings correlating with a clinical picture. Large decompressive surgical procedures can destabilize segments previously affected. Recommendations from recent years suggested the functional reconstruction of damaged parts of the vertebrae, intervertebral discs and joints. Continuously improving surgical procedures and instrumentations, intended for operative treatment of lumbar spine degenerative diseases is primarily an effort to improve the properties of implants while minimizing tissue damage during the approach to the target structure. To protect functions of active spine stabilizer and paraspinal muscles is an important factor for the final outcome of the operation. Depend on the nature and extent of the disease the approaches to the spine can be an anterior, lateral and posterior as open surgery or minimally invasive procedures. (author)

  7. Influence of unit operations on the levels of polyacetylenes in minimally processed carrots and parsnips: An industrial trial.

    Science.gov (United States)

    Koidis, Anastasios; Rawson, Ashish; Tuohy, Maria; Brunton, Nigel

    2012-06-01

    Carrots and parsnips are often consumed as minimally processed ready-to-eat convenient foods and contain in minor quantities, bioactive aliphatic C17-polyacetylenes (falcarinol, falcarindiol, falcarindiol-3-acetate). Their retention during minimal processing in an industrial trial was evaluated. Carrot and parsnips were prepared in four different forms (disc cutting, baton cutting, cubing and shredding) and samples were taken in every point of their processing line. The unit operations were: peeling, cutting and washing with chlorinated water and also retention during 7days storage was evaluated. The results showed that the initial unit operations (mainly peeling) influence the polyacetylene retention. This was attributed to the high polyacetylene content of their peels. In most cases, when washing was performed after cutting, less retention was observed possibly due to leakage during tissue damage occurred in the cutting step. The relatively high retention during storage indicates high plant matrix stability. Comparing the behaviour of polyacetylenes in the two vegetables during storage, the results showed that they were slightly more retained in parsnips than in carrots. Unit operations and especially abrasive peeling might need further optimisation to make them gentler and minimise bioactive losses. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Minimal Intervention Dentistry (MID) for managing dental caries – a review

    Science.gov (United States)

    Frencken, Jo E.; Peters, Mathilde C.; Manton, David J.; Leal, Soraya C.; Gordan, Valeria V.; Eden, Ece

    2012-01-01

    This publication describes the history of Minimal Intervention Dentistry (MID) for managing dental caries and presents evidence for various carious lesion detection devices, for preventive measures, for restorative and non-restorative therapies as well as for repairing rather than replacing defective restorations. It is a follow-up to the FDI World Dental Federation publication on MID, of 2000. The dental profession currently is faced with an enormous task of how to manage the high burden of consequences of the caries process amongst the world population. If it is to manage carious lesion development and its progression, it should move away from the ‘surgical’ care approach and fully embrace the MID approach. The chance for MID to be successful is thought to be increased tremendously if dental caries is not considered an infectious but instead a behavioural disease with a bacterial component. Controlling the two main carious lesion development related behaviours, i.e. intake and frequency of fermentable sugars, to not more than five times daily and removing/disturbing dental plaque from all tooth surfaces using an effective fluoridated toothpaste twice daily, are the ingredients for reducing the burden of dental caries in many communities in the world. FDI’s policy of reducing the need for restorative therapy by placing an even greater emphasis on caries prevention than is currently done, is therefore, worth pursuing. PMID:23106836

  9. Multiagent-based Distributed Control for Operation Cost Minimization of Droop Controlled DC Microgrid Using Incremental Cost Consensus

    DEFF Research Database (Denmark)

    Li, Chendan; Quintero, Juan Carlos Vasquez; Guerrero, Josep M.

    2015-01-01

    In this paper, a multiagent based distributed control is proposed for DC microgrid to minimize the operation cost. The power of each distributed generator (DG) is dispatched in a distributed manner in a multiagent system by means of voltage scheduling. Every DG unit is taken as an agent......, and they share the load corresponding to the operation cost of all the units in the system with only communication with direct neighbors through incremental cost consensus. The power regulation according to the power reference generated by consensus is implemented through voltage scheduling in local primary...... controllers. Simulation verification shows that total operation cost of the DC microgrid is successfully reduced though the proposed method....

  10. Multiagent based Distributed Control for Operation Cost Minimization of Droop Controlled AC Microgrid Using Incremental Cost Consensus

    DEFF Research Database (Denmark)

    Li, Chendan; Firoozabadi, Mehdi Savaghebi; Quintero, Juan Carlos Vasquez

    2015-01-01

    sharing based on the power rating. With various types of distributed generator (DG) units in the system, factors that closely related to the operation cost, such as fuel cost and efficiencies of the generator should be taken into account in order to improve the efficiency of the whole system....... In this paper, a multiagent based distributed method is proposed to minimize operation cost of the AC microgrid. Each DG is acting as an agent which regulates the power individually using proposed frequency scheduling method. Optimal power command is obtained through carefully designed consensus algorithm...... with only light communication between neighboring agents. Case studies verified that the proposed control strategy can effectively reduce the operation cost....

  11. Interventional MRI

    Energy Technology Data Exchange (ETDEWEB)

    Harada, Junta; Dohi, Michiko; Yoshihiro, Akiko; Mogami, Takuji; Kuwada, Tomoko; Nakata, Norio [Jikei Univ., Chiba (Japan). Kashiwa Hospital

    2000-06-01

    Open type MR system and fast sequence is now available and MRI becomes a new modality for interventional Radiology, including biopsy, drainage operation, and monitoring for minimally invasive therapy. Experimental studies of temperature monitoring were performed under hot and cold status. Signal changes of porcine disc and meat under microwave and laser ablation were observed as low signal area by signal intensity method. Using proton chemical shift method, signal change by laser ablation was displaced color imaging and correlated with thermometric temperature measurement. The very T2 relaxation time of ice affords excellent contrast between ice and surrounding gelatin tissue allowing acute depiction of the extent of the iceball under MRI. (author)

  12. The role of interventional radiology in obstetric and gynaecology practice

    International Nuclear Information System (INIS)

    Ganeshan, Arul; Nazir, Sarfraz Ahmed; Hon, Lye Quen; Upponi, Sara S.; Foley, Peter; Warakaulle, Dinuke R.; Uberoi, Raman

    2010-01-01

    Interventional radiology is continuing to reshape current practice in many specialties of clinical care. It is a relatively new and innovative branch of medicine in which physicians treat diseases non-operatively through small catheters guided to the target by fluoroscopic and other imaging modalities. The aim is to provide image-guided, minimally invasive alternatives to traditional surgical and medical procedures in suitable cohorts of patients. Procedures which previously required major surgery can now be performed by interventional radiologists, sometimes on an outpatient basis, with little patient discomfort. In this review, we highlight the importance of interventional radiology in treating a comprehensive range of obstetric and gynaecological pathologies.

  13. The continuous reaction time test for minimal hepatic encephalopathy validated by a randomized controlled multi-modal intervention-A pilot study

    DEFF Research Database (Denmark)

    Lauridsen, M M; Mikkelsen, S; Svensson, T

    2017-01-01

    Background: Minimal hepatic encephalopathy (MHE) is clinically undetectable and the diagnosis requires psychometric tests. However, a lack of clarity exists as to whether the tests are in fact able to detect changes in cognition. Aim: To examine if the continuous reaction time test (CRT) can detect...... changes in cognition with anti-HE intervention in patients with cirrhosis and without clinically manifest hepatic encephalopathy (HE). Methods: Firstly, we conducted a reproducibility analysis and secondly measured change in CRT induced by anti-HE treatment in a randomized controlled pilot study: We...... stratified 44 patients with liver cirrhosis and without clinically manifest HE according to a normal (n = 22) or abnormal (n = 22) CRT. Each stratum was then block randomized to receive multimodal anti-HE intervention (lactulose+branched-chain amino acids+rifaximin) or triple placebos for 3 months...

  14. Rationale and design of a multicenter randomized controlled trial on a 'minimal intervention' in Dutch army personnel with nonspecific low back pain [ISRCTN19334317

    Directory of Open Access Journals (Sweden)

    Staal J Bart

    2004-11-01

    Full Text Available Abstract Background Researchers from the Royal Netherlands Army are studying the potential of isolated lumbar extensor training in low back pain in their working population. Currently, a randomized controlled trial is carried out in five military health centers in The Netherlands and Germany, in which a 10-week program of not more than 2 training sessions (10–15 minutes per week is studied in soldiers with nonspecific low back pain for more than 4 weeks. The purpose of the study is to investigate the efficacy of this 'minimal intervention program', compared to usual care. Moreover, attempts are made to identify subgroups of different responders to the intervention. Methods Besides a baseline measurement, follow-up data are gathered at two short-term intervals (5 and 10 weeks after randomization and two long-term intervals (6 months and one year after the end of the intervention, respectively. At every test moment, participants fill out a compound questionnaire on a stand-alone PC, and they undergo an isometric back strength measurement on a lower back machine. Primary outcome measures in this study are: self-assessed degree of complaints and degree of handicap in daily activities due to back pain. In addition, our secondary measurements focus on: fear of movement/(re- injury, mental and social health perception, individual back extension strength, and satisfaction of the patient with the treatment perceived. Finally, we assess a number of potential prognostic factors: demographic and job characteristics, overall health, the degree of physical activity, and the attitudes and beliefs of the physiotherapist towards chronic low back pain. Discussion Although a substantial number of trials have been conducted that included lumbar extension training in low back pain patients, hardly any study has emphasized a minimal intervention approach comparable to ours. For reasons of time efficiency and patient preferences, this minimal sports medicine

  15. Minimal algorithm for running an internal combustion engine

    Science.gov (United States)

    Stoica, V.; Borborean, A.; Ciocan, A.; Manciu, C.

    2018-01-01

    The internal combustion engine control is a well-known topic within automotive industry and is widely used. However, in research laboratories and universities the use of a control system trading is not the best solution because of predetermined operating algorithms, and calibrations (accessible only by the manufacturer) without allowing massive intervention from outside. Laboratory solutions on the market are very expensive. Consequently, in the paper we present a minimal algorithm required to start-up and run an internal combustion engine. The presented solution can be adapted to function on performance microcontrollers available on the market at the present time and at an affordable price. The presented algorithm was implemented in LabView and runs on a CompactRIO hardware platform.

  16. Energy Hub’s Structural and Operational Optimization for Minimal Energy Usage Costs in Energy Systems

    Directory of Open Access Journals (Sweden)

    Thanh Tung Ha

    2018-03-01

    Full Text Available The structural and optimal operation of an Energy Hub (EH has a tremendous influence on the hub’s performance and reliability. This paper envisions an innovative methodology that prominently increases the synergy between structural and operational optimization and targets system cost affordability. The generalized energy system structure is presented theoretically with all selective hub sub-modules, including electric heater (EHe and solar sources block sub-modules. To minimize energy usage cost, an energy hub is proposed that consists of 12 kinds of elements (i.e., energy resources, conversion, and storage functions and is modeled mathematically in a General Algebraic Modeling System (GAMS, which indicates the optimal hub structure’s corresponding elements with binary variables (0, 1. Simulation results contrast with 144 various scenarios established in all 144 categories of hub structures, in which for each scenario the corresponding optimal operation cost is previously calculated. These case studies demonstrate the effectiveness of the suggested model and methodology. Finally, avenues for future research are also prospected.

  17. Caregiver Coaching Strategies for Early Intervention Providers: Moving toward Operational Definitions

    Science.gov (United States)

    Friedman, Mollie; Woods, Juliann; Salisbury, Christine

    2012-01-01

    Early intervention (EI) providers increasingly coach and collaborate with caregivers to strengthen and support caregiver-child interactions. The EI providers learning to coach other adults benefit from knowing what, exactly, they should do to support caregivers. This article serves two purposes. First, it proposes an operationally defined,…

  18. Laparoscopic colonic resection in inflammatory bowel disease: minimal surgery, minimal access and minimal hospital stay.

    LENUS (Irish Health Repository)

    Boyle, E

    2008-11-01

    Laparoscopic surgery for inflammatory bowel disease (IBD) is technically demanding but can offer improved short-term outcomes. The introduction of minimally invasive surgery (MIS) as the default operative approach for IBD, however, may have inherent learning curve-associated disadvantages. We hypothesise that the establishment of MIS as the standard operative approach does not increase patient morbidity as assessed in the initial period of its introduction into a specialised unit, and that it confers earlier postoperative gastrointestinal recovery and reduced hospitalisation compared with conventional open resection.

  19. Operational intervention levels for reactor emergencies IAEA recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Aguiar, Laís A. de; Reis, Arlene A. dos; Santos, Raul dos, E-mail: laguiar@ird.gov.br, E-mail: arlene@ird.gov.br, E-mail: raul@ird.gov.br [Instituto de Radioproteção e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2017-07-01

    The IAEA publication EPR-NPP-OILs-2017, Operational Intervention Levels for Reactor Emergences and Methodology for their Derivation, provides selected default OIL values, describing a methodology for their derivation, as well as practical tools and recommendations for their use. IAEA recommends that tools and default OIL values be directly integrated into national emergency arrangements or reviewed and modified as necessary to meet the specific emergency preparedness and response arrangements. The Institute of Radiation Protection and Dosimetry (IRD) has a Radiological Assessment TEAM (EAR) as pare of its Radiation Emergency Response System. Brazilian regulatory standards address actions for radiation emergencies encompassing necessary measures to assess public exposures, intervention levels to protect the public and recommendations for protective actions as, evacuation, relocation, sheltering and food restrictions. The objective of this paper is to present a discussion the use these OILs, to compare those ones established by the Brazilian standards and to propose a methodology on how OILs can be used by EAR/IRD in case of an emergency at the Brazilian NPP. (author)

  20. Operational intervention levels for reactor emergencies IAEA recommendations

    International Nuclear Information System (INIS)

    Aguiar, Laís A. de; Reis, Arlene A. dos; Santos, Raul dos

    2017-01-01

    The IAEA publication EPR-NPP-OILs-2017, Operational Intervention Levels for Reactor Emergences and Methodology for their Derivation, provides selected default OIL values, describing a methodology for their derivation, as well as practical tools and recommendations for their use. IAEA recommends that tools and default OIL values be directly integrated into national emergency arrangements or reviewed and modified as necessary to meet the specific emergency preparedness and response arrangements. The Institute of Radiation Protection and Dosimetry (IRD) has a Radiological Assessment TEAM (EAR) as pare of its Radiation Emergency Response System. Brazilian regulatory standards address actions for radiation emergencies encompassing necessary measures to assess public exposures, intervention levels to protect the public and recommendations for protective actions as, evacuation, relocation, sheltering and food restrictions. The objective of this paper is to present a discussion the use these OILs, to compare those ones established by the Brazilian standards and to propose a methodology on how OILs can be used by EAR/IRD in case of an emergency at the Brazilian NPP. (author)

  1. Operation Cost Minimization of Droop-Controlled DC Microgrids Based on Real-Time Pricing and Optimal Power Flow

    DEFF Research Database (Denmark)

    Li, Chendan; de Bosio, Federico; Chaudhary, Sanjay Kumar

    2015-01-01

    In this paper, an optimal power flow problem is formulated in order to minimize the total operation cost by considering real-time pricing in DC microgrids. Each generation resource in the system, including the utility grid, is modeled in terms of operation cost, which combines the cost...... problem is solved in a heuristic way by using genetic algorithms. In order to test the proposed algorithm, a six-bus droop-controlled DC microgrid is used as a case-study. The obtained simulation results show that under variable renewable generation, load, and electricity prices, the proposed method can...

  2. Analysis of operators' surface doses in the common endovascular and on-vascular interventional diagnosis and treatment

    International Nuclear Information System (INIS)

    Zhang Lin; Zhu Jianguo; Min Nan; Lu Feng

    2011-01-01

    Objective: To contrast the level of radiation doses of Lead protective clothing both inside and outside in different parts of the body of the first and second operators and touring nurse in common endovascular and non-vascular interventional diagnosis and treatment. Methods: We choose the common endovascular interventional diagnosis and treatment in the head, thorax, abdomen, such as Cerebral angiography, Coronary angiography, Transcatheter arterial chemoembolization and non-vascular interventional diagnosis and treatment such as Endoscopic Retrograde Cholangio-Pancreatography and Percutaneous transhepatic cholangial drainage as experiment objects. Put the thermoluminescence dosimeter on the different spots of Lead protective clothing of subjects (Inside and outside the lead cap and the lead collar, inside and outside of the lead protective clothing in chest and abdomen, left upper arm outside of lead protective clothing, back of the left hand) and X-ray machine outgoing port when the operation was going on. After that, measure the thermoluminescence dosimeter, calculate and analyze exposure doses inside and outside of the lead protective clothing. Results: The skin doses of operators in different types of interventional diagnosis and treatment are listed in Table 1to Table 4; exposure doses of touring nurses are very low; the doses of X-ray machine outgoing port are mostly over the measuring range. Conclusion: The protection of Lead clothes plays a significant role in these two types of interventional diagnosis and treatment based on the conclusion that the dose of inside of Lead clothes is less than that of outside. We should enhance the operators' protection and administration in the process of intervention and arise the conscious of self-protection, to avoid the unnecessary radiation exposure. (authors)

  3. Experiência inicial com operações cardíacas minimamente invasivas Initial experience with minimally invasive cardiac operations

    Directory of Open Access Journals (Sweden)

    Francisco Costa

    2012-09-01

    Full Text Available INTRODUÇÃO: Operações cardíacas minimamente invasivas têm sido propostas como uma alternativa para a correção de diversas cardiopatias congênitas e adquiridas, com o intuito de reduzir a morbimortalidade. OBJETIVOS: Descrever a experiência inicial de dois anos com operações cardíacas minimamente invasivas, com ênfase nos aspectos técnicos e na curva de aprendizado. MÉTODOS: Entre julho de 2009 a março de 2012, 95 pacientes foram operados com técnicas minimamente invasivas. A média de idade foi de 55±15 anos e 53% pacientes eram do sexo feminino. As operações foram fechamento de comunicação interatrial (25, substituição valvar aórtica (32, plastia mitral (23, substituição valvar mitral (12, ressecção de mixoma de átrio esquerdo (2 e ressecção de membrana subaórtica (1. A incisão consistiu de minitoracotomia lateral direita em 87 casos e de miniesternotomia em oito. RESULTADOS: A mortalidade imediata foi de 4,2%, e o tamanho médio da incisão foi de 6,3 ± 1,2 cm. A extensão da toracotomia só foi necessária em um caso. Dois pacientes apresentaram acidente vascular cerebral, e a quantidade total de sangramento foi de 470 ± 277 ml. Nenhum paciente teve infecção de ferida operatória, e 67% dos casos não apresentaram morbidade pós-operatória significativa. CONCLUSÕES: Os resultados iniciais com operações minimamente invasivas demonstraram que elas podem ser realizadas de forma segura e com resultados iniciais satisfatórios. O índice de satisfação dos pacientes foi elevado. Uma vez ultrapassada a curva de aprendizado, as operações minimamente invasivas podem ser uma excelente alternativa para muitos pacientes com cardiopatias valvares e congênitas.BACKGROUND: Minimally invasive cardiovascular operations have been proposed as an alternative method to correct several cardiac congenital and acquired heart diseases, with the aim to reduce morbidity and mortality. OBJECTIVES: Describe the two years

  4. Preliminary Results and Learning Curve of the Minimally Invasive Chevron Akin Operation for Hallux Valgus.

    Science.gov (United States)

    Jowett, Charlie R J; Bedi, Harvinder S

    Minimally invasive surgery is increasing in popularity. It is relevant in hallux valgus surgery owing to the potential for reduced disruption of the soft tissues and improved wound healing. We present our results and assess the learning curve of the minimally invasive Chevron Akin operation for hallux valgus. A total of 120 consecutive feet underwent minimally invasive Chevron Akin for symptomatic hallux valgus, of which 14 were excluded. They were followed up for a mean of 25 (range 18 to 38) months. The patients were clinically assessed using the American Orthopaedic Foot and Ankle Society score. Complications and patient satisfaction were recorded. The radiographs were analyzed and measurements recorded for hallux valgus and intermetatarsal angle correction. The mean age of the patients undergoing surgery was 55 (range 25 to 81) years. Of the 78 patients, 76 (97.4%) were female and 2 (2.6%) were male; 28 (35.9%) cases were bilateral. The mean American Orthopaedic Foot and Ankle Society score improved from 56 (range 23 to 76) preoperatively to 87 (range 50 to 100) postoperatively (p technique. They display a steep associated learning curve. However, the results are promising, and the learning curve is comparable to that for open hallux valgus surgery. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  5. 10 CFR 20.1406 - Minimization of contamination.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Minimization of contamination. 20.1406 Section 20.1406... License Termination § 20.1406 Minimization of contamination. (a) Applicants for licenses, other than early... procedures for operation will minimize, to the extent practicable, contamination of the facility and the...

  6. [Minimal invasive esophageal resection with anastomosis on the neck [McKeown]. Our experiences after 20 cases].

    Science.gov (United States)

    Mohos, Elemér; Nagy, Attila; Szabados, György; Réti, György; Kovács, Tamás; Jánó, Zoltán; Berki, Csaba; Mohay, József; Szabó, Lóránt; Bene, Krisztina; Bognár, Gábor; Horzov, Myroslav; Mohos, Petra; Sándor, Gábor; Tornai, Gábor; Szenkovits, Péter; Nagy, Tibor; Orbán, Csaba; Herpai, Vivien

    2016-12-01

    Esophageal resection is a traumatic intervention usually performed on patients with poor condition, resulting high mortality and morbidity. To improve the high incidence of complications, minimal invasive interventions were introduced. The results of the thoracoscopically and laparoscopically performed esophageal resection (McKeown) was investigated after 20 cases and the technical details of the surgical intervention are presented. 20 thoracoscopic esophageal resection with laparoscopic gastric tube formation (sec. Akiyama) preparing the esophago-gastric anastomosis on the neck were performed in our department in the last four years. 1 patient with stricture and the other 19 patients with esophageal cancer were operated on, among them11 had T4 stage. 17 patient received neoadjuvant chemo-radiotherapy because of advanced disease. Regular follow up examinations were performed in the oncological outpatient department. 8 patients are alive after a mean follow up period of 25 months, 2 of them are treated oncologically because of recurrent disease. 19 patients were extubated within 12 hours after the intervention and the time spent in the intensive care unit were reduced to 1 or 2 days. The mean duration of the intervention was 320 minutes. Thoracoscopic dissection was performed in 8 patients without ventilation of the right lung using double lumen tracheal tube, among them 3 patients developed pneumonia in the postoperative period. The remaining 12 patients were operated with ventilated right lung, among them one patient developed pneumonia. One patient was converted because of injury of the thoracic aorta, after urgent thoracotomy we managed to suture the aortic wall. 1 patient died in 30 days after the operation, caused by leakage of the anastomosis, resulting mediastinitis and esophago-tracheal fistula. In two patients re-thoracoscopy and ligation of the thoracic duct was performed because of chylothorax refractory for conservative treatment. According to our

  7. Convergence Analysis of Distributed Control for Operation Cost Minimization of Droop Controlled DC Microgrid Based on Multiagent

    DEFF Research Database (Denmark)

    Li, Chendan; Quintero, Juan Carlos Vasquez; Guerrero, Josep M.

    2016-01-01

    In this paper we present a distributed control method for minimizing the operation cost in DC microgrid based on multiagent system. Each agent is autonomous and controls the local converter in a hierarchical way through droop control, voltage scheduling and collective decision making....... The collective decision for the whole system is made by proposed incremental cost consensus, and only nearest-neighbor communication is needed. The convergence characteristics of the consensus algorithm are analyzed considering different communication topologies and control parameters. Case studies verified...... the proposed method by comparing it without traditional methods. The robustness of system is tested under different communication latency and plug and play operation....

  8. On minimizing the influence of the noise tail of correlation functions in operational modal analysis

    DEFF Research Database (Denmark)

    Tarpø, Marius; Olsen, Peter; Amador, Sandro

    2017-01-01

    on the identification results (random errors) when the noise tail is included in the identification. On the other hand, if the correlation function is truncated too much, then important information is lost. In other to minimize this error, a suitable truncation based on manual inspection of the correlation function......In operational modal analysis (OMA) correlation functions are used by all classical time-domain modal identification techniques that uses the impulse response function (free decays) as primary data. However, the main difference between the impulse response and the correlation functions estimated...... from the operational responses is that the latter present a higher noise level. This is due to statistical errors in the estimation of the correlation function and it causes random noise in the end of the function and this is called the noise tail. This noise might have significant influence...

  9. Economic Dispatch for Operating Cost Minimization under Real Time Pricing in Droop Controlled DC Microgrid

    DEFF Research Database (Denmark)

    Li, Chendan; Federico, de Bosio; Chen, Fang

    2017-01-01

    In this paper, an economic dispatch problem for total operation cost minimization in DC microgrids is formulated. An operating cost is associated with each generator in the microgrid, including the utility grid, combining the cost-efficiency of the system with demand response requirements...... achieving higher control accuracy and faster response. The optimization problem is solved in a heuristic method. In order to test the proposed algorithm, a six-bus droop-controlled DC microgrid is used in the case studies. Simulation results show that under variable renewable energy generation, load...... of the utility. The power flow model is included in the optimization problem, thus the transmission losses can be considered for generation dispatch. By considering the primary (local) control of the grid-forming converters of a microgrid, optimal parameters can be directly applied to this control level, thus...

  10. Mixed waste and waste minimization: The effect of regulations and waste minimization on the laboratory

    International Nuclear Information System (INIS)

    Dagan, E.B.; Selby, K.B.

    1993-08-01

    The Hanford Site is located in the State of Washington and is subject to state and federal environmental regulations that hamper waste minimization efforts. This paper addresses the negative effect of these regulations on waste minimization and mixed waste issues related to the Hanford Site. Also, issues are addressed concerning the regulations becoming more lenient. In addition to field operations, the Hanford Site is home to the Pacific Northwest Laboratory which has many ongoing waste minimization activities of particular interest to laboratories

  11. A novel approach for a 2D/3D image registration routine for medical tool navigation in minimally invasive vascular interventions

    Energy Technology Data Exchange (ETDEWEB)

    Schwerter, Michael [Forschungszentrum Juelich (Germany). Inst. of Neuroscience and Medicine (INM-4) - Medical Imaging Physics; Lietzmann, Florian; Schad, Lothar R. [Heidelberg Univ., Medical Faculty Mannheim (Germany). Computer Assisted Clinical Medicine

    2016-11-01

    Minimally invasive interventions are frequently aided by 2D projective image guidance. To facilitate the navigation of medical tools within the patient, information from preoperative 3D images can supplement interventional data. This work describes a novel approach to perform a 3D CT data registration to a single interventional native fluoroscopic frame. The goal of this procedure is to recover and visualize a current 2D interventional tool position in its corresponding 3D dataset. A dedicated routine was developed and tested on a phantom. The 3D position of a guidewire inserted into the phantom could successfully be reconstructed for varying 2D image acquisition geometries. The scope of the routine includes projecting the CT data into the plane of the fluoroscopy. A subsequent registration of the real and virtual projections is performed with an accuracy within the range of 1.16 ± 0.17 mm for fixed landmarks. The interventional tool is extracted from the fluoroscopy and matched to the corresponding part of the projected and transformed arterial vasculature. A root mean square error of up to 0.56 mm for matched point pairs is reached. The desired 3D view is provided by backprojecting the matched guidewire through the CT array. Due to its potential to reduce patient dose and treatment times, the proposed routine has the capability of reducing patient stress at lower overall treatment costs.

  12. Effects of functional taping compared with sham taping and minimal intervention on pain intensity and static postural control for patients with non-specific chronic low back pain: a randomised clinical trial protocol.

    Science.gov (United States)

    Jassi, F J; Del Antônio, T; Moraes, R; George, S Z; Chaves, T C

    2017-06-01

    To investigate the immediate and 1-month effects of functional taping to lumbar spine for pain intensity and postural control in patients with chronic non-specific low back pain. Randomised clinical trial. One hundred and twenty participants aged 18 to 50 years. Participants will be allocated at random to receive one of three interventions: functional star-shape taping for 7 days, sham functional taping for 7 days or minimal intervention, one session. The primary outcomes will be pain intensity and postural control. Four measurements of static posturography will be conducted: pre-intervention, immediately after application of the tape, 7 days post-intervention (after removal of the tape) and 1-month follow-up. The secondary outcomes will be low-back-pain-related disability, global perceived effect of treatment and fear avoidance beliefs. Primary and secondary outcomes will be assessed on three occasions: pre-intervention, 7 days post-intervention and at 1-month follow-up. All statistical analyses will be conducted following intention-to-treat principles, and the treatment effects will be calculated using linear mixed models. The results of this study will determine the effects of functional taping on pain intensity and postural control compared with sham taping and minimal intervention. NCT02546466. Copyright © 2016 Chartered Society of Physiotherapy. All rights reserved.

  13. Randomized comparison of operator radiation exposure comparing transradial and transfemoral approach for percutaneous coronary procedures: rationale and design of the minimizing adverse haemorrhagic events by TRansradial access site and systemic implementation of angioX - RAdiation Dose study (RAD-MATRIX).

    Science.gov (United States)

    Sciahbasi, Alessandro; Calabrò, Paolo; Sarandrea, Alessandro; Rigattieri, Stefano; Tomassini, Francesco; Sardella, Gennaro; Zavalloni, Dennis; Cortese, Bernardo; Limbruno, Ugo; Tebaldi, Matteo; Gagnor, Andrea; Rubartelli, Paolo; Zingarelli, Antonio; Valgimigli, Marco

    2014-06-01

    Radiation absorbed by interventional cardiologists is a frequently under-evaluated important issue. Aim is to compare radiation dose absorbed by interventional cardiologists during percutaneous coronary procedures for acute coronary syndromes comparing transradial and transfemoral access. The randomized multicentre MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) trial has been designed to compare the clinical outcome of patients with acute coronary syndromes treated invasively according to the access site (transfemoral vs. transradial) and to the anticoagulant therapy (bivalirudin vs. heparin). Selected experienced interventional cardiologists involved in this study have been equipped with dedicated thermoluminescent dosimeters to evaluate the radiation dose absorbed during transfemoral or right transradial or left transradial access. For each access we evaluate the radiation dose absorbed at wrist, at thorax and at eye level. Consequently the operator is equipped with three sets (transfemoral, right transradial or left transradial access) of three different dosimeters (wrist, thorax and eye dosimeter). Primary end-point of the study is the procedural radiation dose absorbed by operators at thorax. An important secondary end-point is the procedural radiation dose absorbed by operators comparing the right or left radial approach. Patient randomization is performed according to the MATRIX protocol for the femoral or radial approach. A further randomization for the radial approach is performed to compare right and left transradial access. The RAD-MATRIX study will probably consent to clarify the radiation issue for interventional cardiologist comparing transradial and transfemoral access in the setting of acute coronary syndromes. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Automatic classification of minimally invasive instruments based on endoscopic image sequences

    Science.gov (United States)

    Speidel, Stefanie; Benzko, Julia; Krappe, Sebastian; Sudra, Gunther; Azad, Pedram; Müller-Stich, Beat Peter; Gutt, Carsten; Dillmann, Rüdiger

    2009-02-01

    Minimally invasive surgery is nowadays a frequently applied technique and can be regarded as a major breakthrough in surgery. The surgeon has to adopt special operation-techniques and deal with difficulties like the complex hand-eye coordination and restricted mobility. To alleviate these constraints we propose to enhance the surgeon's capabilities by providing a context-aware assistance using augmented reality techniques. To analyze the current situation for context-aware assistance, we need intraoperatively gained sensor data and a model of the intervention. A situation consists of information about the performed activity, the used instruments, the surgical objects, the anatomical structures and defines the state of an intervention for a given moment in time. The endoscopic images provide a rich source of information which can be used for an image-based analysis. Different visual cues are observed in order to perform an image-based analysis with the objective to gain as much information as possible about the current situation. An important visual cue is the automatic recognition of the instruments which appear in the scene. In this paper we present the classification of minimally invasive instruments using the endoscopic images. The instruments are not modified by markers. The system segments the instruments in the current image and recognizes the instrument type based on three-dimensional instrument models.

  15. Design, operation, and safety of single-room interventional MRI suites: practical experience from two centers.

    Science.gov (United States)

    White, Mark J; Thornton, John S; Hawkes, David J; Hill, Derek L G; Kitchen, Neil; Mancini, Laura; McEvoy, Andrew W; Razavi, Reza; Wilson, Sally; Yousry, Tarek; Keevil, Stephen F

    2015-01-01

    The design and operation of a facility in which a magnetic resonance imaging (MRI) scanner is incorporated into a room used for surgical or endovascular cardiac interventions presents several challenges. MR safety must be maintained in the presence of a much wider variety of equipment than is found in a diagnostic unit, and of staff unfamiliar with the MRI environment, without compromising the safety and practicality of the interventional procedure. Both the MR-guided cardiac interventional unit at Kings College London and the intraoperative imaging suite at the National Hospital for Neurology and Neurosurgery are single-room interventional facilities incorporating 1.5 T cylindrical-bore MRI scanners. The two units employ similar strategies to maintain MR safety, both in original design and day-to-day operational workflows, and between them over a decade of incident-free practice has been accumulated. This article outlines these strategies, highlighting both similarities and differences between the units, as well as some lessons learned and resulting procedural changes made in both units since installation. © 2014 Wiley Periodicals, Inc.

  16. Model-based minimization algorithm of a supercritical helium loop consumption subject to operational constraints

    Science.gov (United States)

    Bonne, F.; Bonnay, P.; Girard, A.; Hoa, C.; Lacroix, B.; Le Coz, Q.; Nicollet, S.; Poncet, J.-M.; Zani, L.

    2017-12-01

    Supercritical helium loops at 4.2 K are the baseline cooling strategy of tokamaks superconducting magnets (JT-60SA, ITER, DEMO, etc.). This loops work with cryogenic circulators that force a supercritical helium flow through the superconducting magnets in order that the temperature stay below the working range all along their length. This paper shows that a supercritical helium loop associated with a saturated liquid helium bath can satisfy temperature constraints in different ways (playing on bath temperature and on the supercritical flow), but that only one is optimal from an energy point of view (every Watt consumed at 4.2 K consumes at least 220 W of electrical power). To find the optimal operational conditions, an algorithm capable of minimizing an objective function (energy consumption at 5 bar, 5 K) subject to constraints has been written. This algorithm works with a supercritical loop model realized with the Simcryogenics [2] library. This article describes the model used and the results of constrained optimization. It will be possible to see that the changes in operating point on the temperature of the magnet (e.g. in case of a change in the plasma configuration) involves large changes on the cryodistribution optimal operating point. Recommendations will be made to ensure that the energetic consumption is kept as low as possible despite the changing operating point. This work is partially supported by EUROfusion Consortium through the Euratom Research and Training Program 20142018 under Grant 633053.

  17. Types of Motivating Operations in Interventions with Problem Behavior: A Systematic Review

    Science.gov (United States)

    Simo-Pinatella, David; Font-Roura, Josep; Planella-Morato, Joaquima; McGill, Peter; Alomar-Kurz, Elisabeth; Gine, Climent

    2013-01-01

    A motivating operation (MO) alters both the effectiveness of a stimulus as a reinforcer and the current frequency of all behavior that has been reinforced by that particular stimulus. This article reviews studies that have manipulated a MO during interventions with school-age participants with intellectual disabilities and problem behavior. A…

  18. Attention to the application of vein anaesthesia in interventional radiology

    International Nuclear Information System (INIS)

    Xie Zonggui; Cheng Yongde

    2006-01-01

    Interventional radiology is mostly carried out under local anesthesia with micro invasive characteristics. However, the questions of patient's pain, nerve intense, change of blood pressure and heart rate always influence the performance of operation. General anaesthesia in interventional radiology is a comparatively simple venous anaesthesia modality with a controlled dose of anesthetics injecting via periphery vein through persistent minimally injecting pump to keep the patient in dormancy under electrocardiographic monitoring. It doesn't require a tube insertion of trachea. The anaesthesia depth and time are under control. The half-life of the anaesthesia drugs is short with less side-effect. It is necessary to introduce the advanced anaesthesia into common interventional radiological therapy with attentions of promoting the development through new modalities. (authors)

  19. Randomized comparison of operator radiation exposure comparing transradial and transfemoral approach for percutaneous coronary procedures: rationale and design of the minimizing adverse haemorrhagic events by TRansradial access site and systemic implementation of angioX – RAdiation Dose study (RAD-MATRIX)

    International Nuclear Information System (INIS)

    Sciahbasi, Alessandro; Calabrò, Paolo; Sarandrea, Alessandro; Rigattieri, Stefano; Tomassini, Francesco; Sardella, Gennaro; Zavalloni, Dennis; Cortese, Bernardo; Limbruno, Ugo; Tebaldi, Matteo; Gagnor, Andrea; Rubartelli, Paolo; Zingarelli, Antonio; Valgimigli, Marco

    2014-01-01

    Background: Radiation absorbed by interventional cardiologists is a frequently under-evaluated important issue. Aim is to compare radiation dose absorbed by interventional cardiologists during percutaneous coronary procedures for acute coronary syndromes comparing transradial and transfemoral access. Methods: The randomized multicentre MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) trial has been designed to compare the clinical outcome of patients with acute coronary syndromes treated invasively according to the access site (transfemoral vs. transradial) and to the anticoagulant therapy (bivalirudin vs. heparin). Selected experienced interventional cardiologists involved in this study have been equipped with dedicated thermoluminescent dosimeters to evaluate the radiation dose absorbed during transfemoral or right transradial or left transradial access. For each access we evaluate the radiation dose absorbed at wrist, at thorax and at eye level. Consequently the operator is equipped with three sets (transfemoral, right transradial or left transradial access) of three different dosimeters (wrist, thorax and eye dosimeter). Primary end-point of the study is the procedural radiation dose absorbed by operators at thorax. An important secondary end-point is the procedural radiation dose absorbed by operators comparing the right or left radial approach. Patient randomization is performed according to the MATRIX protocol for the femoral or radial approach. A further randomization for the radial approach is performed to compare right and left transradial access. Conclusions: The RAD-MATRIX study will probably consent to clarify the radiation issue for interventional cardiologist comparing transradial and transfemoral access in the setting of acute coronary syndromes

  20. Randomized comparison of operator radiation exposure comparing transradial and transfemoral approach for percutaneous coronary procedures: rationale and design of the minimizing adverse haemorrhagic events by TRansradial access site and systemic implementation of angioX – RAdiation Dose study (RAD-MATRIX)

    Energy Technology Data Exchange (ETDEWEB)

    Sciahbasi, Alessandro, E-mail: alessandro.sciahbasi@fastwebnet.it [Interventional Cardiology, Sandro Pertini Hospital – ASL RMB, Rome (Italy); Calabrò, Paolo [Division of Cardiology - Department of Cardio-Thoracic Sciences - Second University of Naples (Italy); Sarandrea, Alessandro [HSE Management, Rome (Italy); Rigattieri, Stefano [Interventional Cardiology, Sandro Pertini Hospital – ASL RMB, Rome (Italy); Tomassini, Francesco [Department of Cardiology, Infermi Hospital, Rivoli (Italy); Sardella, Gennaro [La Sapienza University, Rome (Italy); Zavalloni, Dennis [UO Emodinamica e Cardiologia Invasiva, IRCCS, Istituto Clinico Humanitas, Rozzano (Italy); Cortese, Bernardo [Interventional Cardiology, Fatebenefratelli Hospital, Milan (Italy); Limbruno, Ugo [Cardiology Unit, Misericordia Hospital, Grosseto (Italy); Tebaldi, Matteo [Cardiology Department, University of Ferrara, Department of Cardiology (Italy); Gagnor, Andrea [Department of Cardiology, Infermi Hospital, Rivoli (Italy); Rubartelli, Paolo [Villa Scassi Hospital, Genova (Italy); Zingarelli, Antonio [San Martino Hospital, Genova (Italy); Valgimigli, Marco [Thoraxcenter, Rotterdam (Netherlands)

    2014-06-15

    Background: Radiation absorbed by interventional cardiologists is a frequently under-evaluated important issue. Aim is to compare radiation dose absorbed by interventional cardiologists during percutaneous coronary procedures for acute coronary syndromes comparing transradial and transfemoral access. Methods: The randomized multicentre MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) trial has been designed to compare the clinical outcome of patients with acute coronary syndromes treated invasively according to the access site (transfemoral vs. transradial) and to the anticoagulant therapy (bivalirudin vs. heparin). Selected experienced interventional cardiologists involved in this study have been equipped with dedicated thermoluminescent dosimeters to evaluate the radiation dose absorbed during transfemoral or right transradial or left transradial access. For each access we evaluate the radiation dose absorbed at wrist, at thorax and at eye level. Consequently the operator is equipped with three sets (transfemoral, right transradial or left transradial access) of three different dosimeters (wrist, thorax and eye dosimeter). Primary end-point of the study is the procedural radiation dose absorbed by operators at thorax. An important secondary end-point is the procedural radiation dose absorbed by operators comparing the right or left radial approach. Patient randomization is performed according to the MATRIX protocol for the femoral or radial approach. A further randomization for the radial approach is performed to compare right and left transradial access. Conclusions: The RAD-MATRIX study will probably consent to clarify the radiation issue for interventional cardiologist comparing transradial and transfemoral access in the setting of acute coronary syndromes.

  1. Applicable value of real time interventional ultrasound guidance in family planning reproduction operation

    International Nuclear Information System (INIS)

    Wu Guoping; Zou Dongfang; Sun Jian; Dong Weihua

    2007-01-01

    Objective: To determine the clinical value of real time interventional ultrasound guidance in family planning reproduction operation. Methods: Under the guidance of ultrasound monitoring, 522 cases with high risk and difficult uterine operation were undertaken in our department. Results: The abdominal endoscopic contraceptive uterine operation under real time ultrasound monitoring was carried out for 522 cases in 4 years, with successful rates for high risk pregnancy as 287/289 cases, high risk troublesome withdrawal of contraceptive ring as 129/130 cases and puzzling uterine operation as 103/103 cases. The total successful rate reached 99.42%, without uterine rupture and other complications. Conclusion: The former complex, blind and difficult uterine operations turn to be simple, safe and reliable under the guidance of real time ultrasound. (authors)

  2. Chances of cryosurgery in the minimal invasive therapy; Chancen der Kryochirurgie in der Minimal Invasiven Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Haensgen, H. [Institut fuer Luft- und Kaeltetechnik GmbH, Dresden (Germany). Fachbereich Klimatechnik; Binneberg, A. [Institut fuer Luft- und Kaeltetechnik GmbH, Dresden (Germany). Fachbereich Klimatechnik; Herzog, R. [Institut fuer Luft- und Kaeltetechnik GmbH, Dresden (Germany). Fachbereich Klimatechnik; Schumann, B. [Institut fuer Luft- und Kaeltetechnik GmbH, Dresden (Germany). Fachbereich Klimatechnik

    1995-01-01

    Object in view of the minimal invasive therapy is to substitute the traditional open and therefore invasive surgically interventions through fewer invasive surgery. Additional to preponderantly in MIT used microsurgery and laser-therapy also cryotherapy may be used. Clinical results in therapy of trigeminalneuralgia are present. Application of endoscopic cryotip are possible. (orig.)

  3. Recommendations to designers aimed at minimizing radiation dose incurred in operation, maintenance, inspection and repair of light-water reactors

    International Nuclear Information System (INIS)

    1978-01-01

    In the framework of the exchange of experience between nuclear power plant operators organized by the services of the Commission of the European Communities an ad-hoc working party elaborated recommendations particularly directed to those concerned with design of light water reactor plants. The necessary design measures which should be followed to minimize radiation dose incurred in operation, maintenance, inspection and repair of such reactors are listed. The recommendations are based on recent views expressed by operating utilities within the Community. It is intended to revise these recommendations at suitable intervals in order to make use of the most recent experience and to keep the report up to date with the actual state of art in nuclear technology

  4. Pediatric interventional radiology: vascular interventions

    International Nuclear Information System (INIS)

    Kandasamy, Devasenathipathy; Gamanagatti, Shivanand; Gupta, Arun Kumar

    2016-01-01

    Pediatric interventional radiology (PIR) comprises a range of minimally invasive diagnostic and therapeutic procedures that are performed using image guidance. PIR has emerged as an essential adjunct to various surgical and medical conditions. Over the years, technology has undergone dramatic and continuous evolution, making this speciality grow. In this review, the authors will discuss various vascular interventional procedures undertaken in pediatric patients. It is challenging for the interventional radiologist to accomplish a successful interventional procedure. There are many vascular interventional radiology procedures which are being performed and have changed the way the diseases are managed. Some of the procedures are life saving and have become the treatment of choice in those patients. The future is indeed bright for the practice and practitioners of pediatric vascular and non-vascular interventions. As more and more of the procedures that are currently being performed in adults get gradually adapted for use in the pediatric population, it may be possible to perform safe and successful interventions in many of the pediatric vascular lesions that are otherwise being referred for surgery. (author)

  5. Minimally invasive surgery in the era of step-up approach for treatment of severe acute pancreatitis.

    Science.gov (United States)

    Morató, Olga; Poves, Ignasi; Ilzarbe, Lucas; Radosevic, Aleksandar; Vázquez-Sánchez, Antonia; Sánchez-Parrilla, Juan; Burdío, Fernando; Grande, Luís

    2018-03-01

    To assess the minimally invasive surgery into the step-up approach procedures as a standard treatment for severe acute pancreatitis and comparing its results with those obtained by classical management. Retrospective cohort study comparative with two groups treated over two consecutive, equal periods of time were defined: group A, classic management with open necrosectomy from January 2006 to June 2010; and group B, management with the step-up approach with minimally invasive surgery from July 2010 to December 2014. In group A, 83 patients with severe acute pancreatitis were treated, of whom 19 underwent at least one laparotomy, and in 5 any minimally invasive surgery. In group B, 81 patients were treated: minimally invasive surgery was necessary in 17 cases and laparotomy in 3. Among operated patients, the time from admission to first interventional procedures was significantly longer in group B (9 days vs. 18.5 days; p = 0.042). There were no significant differences in Intensive Care Unit stay or overall stay: 9.5 and 27 days (group A) vs. 8.5 and 21 days (group B). Mortality in operated patients and mortality overall were 50% and 18.1% in group A vs 0% and 6.2% in group B (p < 0.001 and p = 0.030). The combination of the step-up approach and minimally invasive surgery algorithm is feasible and could be considered as the standard of treatment for severe acute pancreatitis. The mortality rate deliberately descends when it is used. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  6. Minimal DBM Substraction

    DEFF Research Database (Denmark)

    David, Alexandre; Håkansson, John; G. Larsen, Kim

    In this paper we present an algorithm to compute DBM substractions with a guaranteed minimal number of splits and disjoint DBMs to avoid any redundance. The substraction is one of the few operations that result in a non-convex zone, and thus, requires splitting. It is of prime importance to reduce...

  7. Impact of regulatory guidances and drug regulation on risk minimization interventions in drug safety: a systematic review.

    Science.gov (United States)

    Nkeng, Lenhangmbong; Cloutier, Anne-Marie; Craig, Camille; Lelorier, Jacques; Moride, Yola

    2012-07-01

    Therapeutic risk management has received growing interest in recent years, particularly since the publication of regulatory guidances in 2005 and 2006, paralleled with a change in drug regulation. The characteristics of risk minimization interventions (RMIs) that have been implemented or approved remain inadequately explored. The aim of this study was to review RMIs published in the literature or posted on regulatory agency websites over the past 10 years, and to assess whether publication of regulatory guidances on risk management is associated with changes in the number and types of interventions. Sources were searched for RMIs published/posted between 1 January 2000 and 31 December 2009. For the literature search, MEDLINE and EMBASE databases were used using key words related to drug safety (i.e. 'drug toxicity') and the individual RMI names. The website review involved searches of major regulatory authority websites such as the European Medicines Agency, US FDA, Health Canada, the UK's Medicines and Healthcare products Regulatory Agency, Japan's Pharmaceutical and Medical Devices Agency and Australia's Therapeutic Goods Administration. The following eligibility criteria were applied for inclusion in the review: published/posted between the years 2000 and 2009, inclusive; involving drug products; use in humans; and involving RMIs, or tools used to increase the reporting of adverse events (AEs). Natural healthcare products, devices, diagnostic chemicals, pregnancy registries without follow-up, medication errors and products not used as therapy for illness were not retained. For each source, the following characteristics were extracted: nature of the intervention, target population, therapeutic area, AE(s) of special interest, country/regulatory agency and year of publication. A total of 119 unique interventions were identified in the literature (54 published in 2000-4 and 65 published in 2005-9). Interventions included educational material (n = 37; 31%), black

  8. Constraining N=1 supergravity inflation with non-minimal Kähler operators using δN formalism

    International Nuclear Information System (INIS)

    Choudhury, Sayantan

    2014-01-01

    In this paper I provide a general framework based on δN formalism to study the features of unavoidable higher dimensional non-renormalizable Kähler operators for N=1 supergravity (SUGRA) during primordial inflation from the combined constraint on non-Gaussianity, sound speed and CMB dipolar asymmetry as obtained from the recent Planck data. In particular I study the nonlinear evolution of cosmological perturbations on large scales which enables us to compute the curvature perturbation, ζ, without solving the exact perturbed field equations. Further I compute the non-Gaussian parameters f NL , τ NL and g NL for local type of non-Gaussianities and CMB dipolar asymmetry parameter, A CMB , using the δN formalism for a generic class of sub-Planckian models induced by the Hubble-induced corrections for a minimal supersymmetric D-flat direction where inflation occurs at the point of inflection within the visible sector. Hence by using multi parameter scan I constrain the non-minimal couplings appearing in non-renormalizable Kähler operators within, O(1), for the speed of sound, 0.02≤c s ≤1, and tensor to scalar, 10 −22 ≤r ⋆ ≤0.12. Finally applying all of these constraints I will fix the lower as well as the upper bound of the non-Gaussian parameters within, O(1−5)≤f NL ≤8.5, O(75−150)≤τ NL ≤2800 and O(17.4−34.7)≤g NL ≤648.2, and CMB dipolar asymmetry parameter within the range, 0.05≤A CMB ≤0.09

  9. Constraining N=1 supergravity inflation with non-minimal Kähler operators using δN formalism

    Energy Technology Data Exchange (ETDEWEB)

    Choudhury, Sayantan [Physics and Applied Mathematics Unit, Indian Statistical Institute, 203 B.T. Road, Kolkata 700 108 (India)

    2014-04-15

    In this paper I provide a general framework based on δN formalism to study the features of unavoidable higher dimensional non-renormalizable Kähler operators for N=1 supergravity (SUGRA) during primordial inflation from the combined constraint on non-Gaussianity, sound speed and CMB dipolar asymmetry as obtained from the recent Planck data. In particular I study the nonlinear evolution of cosmological perturbations on large scales which enables us to compute the curvature perturbation, ζ, without solving the exact perturbed field equations. Further I compute the non-Gaussian parameters f{sub NL} , τ{sub NL} and g{sub NL} for local type of non-Gaussianities and CMB dipolar asymmetry parameter, A{sub CMB}, using the δN formalism for a generic class of sub-Planckian models induced by the Hubble-induced corrections for a minimal supersymmetric D-flat direction where inflation occurs at the point of inflection within the visible sector. Hence by using multi parameter scan I constrain the non-minimal couplings appearing in non-renormalizable Kähler operators within, O(1), for the speed of sound, 0.02≤c{sub s}≤1, and tensor to scalar, 10{sup −22}≤r{sub ⋆}≤0.12. Finally applying all of these constraints I will fix the lower as well as the upper bound of the non-Gaussian parameters within, O(1−5)≤f{sub NL}≤8.5, O(75−150)≤τ{sub NL}≤2800 and O(17.4−34.7)≤g{sub NL}≤648.2, and CMB dipolar asymmetry parameter within the range, 0.05≤A{sub CMB}≤0.09.

  10. Effectiveness of a minimal intervention for stress-related mental disorders with sick leave (MISS): study protocol of a cluster randomised controlled trial in general practice [ISRCTN43779641

    NARCIS (Netherlands)

    Bakker, I.M.; Terluin, B.; van Marwijk, H.W.J.; Cundy, C.M.; Smit, J.H.; van Mechelen, W.; Stalman, W.A.B.

    2006-01-01

    Background: The main aims of this paper are to describe the setting and design of a Minimal Intervention in general practice for Stress-related mental disorders in patients on Sick leave (MISS), as well as to ascertain the study complies with the requirements for a cluster randomised controlled

  11. Hydrocolloid dressing in pediatric burns may decrease operative intervention rates.

    LENUS (Irish Health Repository)

    Martin, Fiachra T

    2010-03-01

    Partial-thickness scalds are the most common pediatric burn injury, and primary management consists of wound dressings to optimize the environment for reepithelialization. Operative intervention is reserved for burns that fail to heal using conservative methods. Worldwide, paraffin-based gauze (Jelonet) is the most common burn dressing; but literature suggests that it adheres to wounds and requires more frequent dressing change that may traumatize newly epithelialized surfaces. Hydrocolloid dressings (DuoDERM) provide an occlusive moist environment to optimize healing and are associated with less frequent dressing changes.

  12. Achieving shift work excellence: maximizing health, safety and operating efficiency in round-the-clock operations

    Energy Technology Data Exchange (ETDEWEB)

    Sirois, W. G. (circadian Technologies Ltd., Cambridge, MA (United States))

    1999-01-01

    Alertness Assurance techniques, Lifestyle Training and Shift Scheduling practices are described as weapons in the fight against the consequences of sleep deprivation and fatigue, higher operating risks , the adverse health, safety and quality of life effects on workers. Fatigue is a fundamental problem for all round-the-clock industries. The central message of this paper is that by making appropriate interventions and taking counter-measures to fatigue, the risks and liabilities of human error can be dramatically minimized through increased employee alertness, vigilance and cognitive reasoning skills around-the-clock. 12 refs., 1 fig.

  13. Ozone impact minimization through coordinated scheduling of turnaround operations from multiple olefin plants in an ozone nonattainment area

    Science.gov (United States)

    Ge, Sijie; Wang, Sujing; Xu, Qiang; Ho, Thomas

    2018-03-01

    Turnaround operations (start-up and shutdown) are critical operations in olefin plants, which emit large quantities of VOCs, NOx and CO. The emission has great potentials to impact the ozone level in ozone nonattainment areas. This study demonstrates a novel practice to minimize the ozone impact through coordinated scheduling of turnaround operations from multiple olefin plants located in Houston, Texas, an ozone nonattainment area. The study considered two olefin plants scheduled to conduct turnaround operations: one start-up and one shutdown, simultaneously on the same day within a five-hour window. Through dynamic simulations of the turnaround operations using ASPEN Plus Dynamics and air quality simulations using CAMx, the study predicts the ozone impact from the combined effect of the two turnaround operations under different starting-time scenarios. The simulations predict that the ozone impact from planned turnaround operations ranges from a maximum of 11.4 ppb to a minimum of 1.4 ppb. Hence, a reduction of up to 10.0 ppb can be achieved on a single day based on the selected two simulation days. This study demonstrates a cost-effective and environmentally benign ozone control practice for relevant stakeholders, including environmental agencies, regional plant operators, and local communities.

  14. Ke konceptu minimální intervence

    Czech Academy of Sciences Publication Activity Database

    Beneš, Martin; Prošek, Martin

    2011-01-01

    Roč. 72, č. 1 (2011), s. 39-55 ISSN 0037-7031 Institutional research plan: CEZ:AV0Z90610518 Keywords : language cultivation * language counselling * codification * Concept of Minimal Intervention * language norm * literary language Subject RIV: AI - Linguistics Impact factor: 0.158, year: 2011

  15. Legionellosis prevention in building water and HVAC systems a practical guide for design, operation and maintenance to minimize the risk

    CERN Document Server

    Joppolo, Cesare Maria; Pitera, Luca Alberto; Angermann, Jean Pierre; Izard, Mark

    2013-01-01

    This Guidebook is a practical guide for design, operation and maintenance to minimize the risk of legionellosis in building water and HVAC systmes. It is devided into several themes such as: Air conditioning of the air (by water – humidification), Production of hot water for washing (fundamentally but not only hot water for washing) and Evaporative cooling tower.

  16. Computed Tomography Helps to Plan Minimally Invasive Aortic Valve Replacement Operations.

    Science.gov (United States)

    Stoliński, Jarosław; Plicner, Dariusz; Grudzień, Grzegorz; Kruszec, Paweł; Fijorek, Kamil; Musiał, Robert; Andres, Janusz

    2016-05-01

    This study evaluated the role of multidetector computed tomography (MDCT) in preparation for minimally invasive aortic valve replacement (MIAVR). An analysis of 187 patients scheduled for MIAVR between June 2009 and December 2014 was conducted. In the study group (n = 86), MDCT of the thorax, aorta, and femoral arteries was performed before the operation. In the control group (n = 101), patients qualified for MIAVR without receiving preoperative MDCT. The surgical strategy was changed preoperatively in 12.8% of patients from the study group and in 2.0% of patients from the control group (p = 0.010) and intraoperatively in 9.9% of patients from the control group and in none from the study group (p = 0.002). No conversion to median sternotomy was necessary in the study group; among the controls, there were 4.0% conversions. On the basis of the MDCT measurements, optimal access to the aortic valve was achieved when the angle between the aortic valve plane and the line to the second intercostal space was 91.9 ± 10.0 degrees and to the third intercostal space was 94.0 ± 1.4 degrees, with the distance to the valve being 94.8 ± 13.8 mm and 84.5 ± 9.9 mm for the second and third intercostal spaces, respectively. The right atrium covering the site of the aortotomy was present in 42.9% of cases when MIAVR had been performed through the third intercostal space and in 1.3% when through the second intercostal space (p = 0.001). Preoperative MDCT of the thorax, aorta, and femoral arteries makes it possible to plan MIAVR operations. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  17. [INTERVENTIONAL AND SURGICAL TREATMENT OF THE ANGINA PECTORIS RECURRENCE AFTER CORONARY SHUNTING OPERATION].

    Science.gov (United States)

    Fanta, S M

    2015-12-01

    There were examined 134 patients, in whom in the clinic in 2005-2014 yrs a coronary shunting operation was performed. In patients with the angina pectoris recurrence a reoperation is indicated. The data of repeated coronaroventriculography and shuntography were analyzed. Efficacy of the surgical and interventional methods application in the patients was proved.

  18. The Quest for Minimal Quotients for Probabilistic Automata

    DEFF Research Database (Denmark)

    Eisentraut, Christian; Hermanns, Holger; Schuster, Johann

    2013-01-01

    One of the prevailing ideas in applied concurrency theory and verification is the concept of automata minimization with respect to strong or weak bisimilarity. The minimal automata can be seen as canonical representations of the behaviour modulo the bisimilarity considered. Together with congruence...... results wrt. process algebraic operators, this can be exploited to alleviate the notorious state space explosion problem. In this paper, we aim at identifying minimal automata and canonical representations for concurrent probabilistic models. We present minimality and canonicity results for probabilistic...... automata wrt. strong and weak bisimilarity, together with polynomial time minimization algorithms....

  19. Minimization of rad waste production in NPP Dukovany

    International Nuclear Information System (INIS)

    Kulovany, J.

    2001-01-01

    A whole range of measures has been taken in the power plant in connection with the minimization of radioactive waste. It will lead to the set goals. The procedures that prevent possible endangering of the operation take precedence during introduction of the minimization measures. Further economically undemanding procedures are implemented that bring about minimization in an effective way. In accordance with the EMS principles it can be expected that the minimizing measures will be implemented also in areas where their greatest contribution will be for the environment

  20. Operant Conditioning: A Minimal Components Requirement in Artificial Spiking Neurons Designed for Bio-Inspired Robot’s Controller

    Directory of Open Access Journals (Sweden)

    André eCyr

    2014-07-01

    Full Text Available We demonstrate the operant conditioning (OC learning process within a basic bio-inspired robot controller paradigm, using an artificial spiking neural network (ASNN with minimal component count as artificial brain. In biological agents, OC results in behavioral changes that are learned from the consequences of previous actions, using progressive prediction adjustment triggered by reinforcers. In a robotics context, virtual and physical robots may benefit from a similar learning skill when facing unknown environments with no supervision. In this work, we demonstrate that a simple ASNN can efficiently realise many OC scenarios. The elementary learning kernel that we describe relies on a few critical neurons, synaptic links and the integration of habituation and spike-timing dependent plasticity (STDP as learning rules. Using four tasks of incremental complexity, our experimental results show that such minimal neural component set may be sufficient to implement many OC procedures. Hence, with the described bio-inspired module, OC can be implemented in a wide range of robot controllers, including those with limited computational resources.

  1. Pre-operative Screening and Manual Drilling Strategies to Reduce the Risk of Thermal Injury During Minimally Invasive Cochlear Implantation Surgery.

    Science.gov (United States)

    Dillon, Neal P; Fichera, Loris; Kesler, Kyle; Zuniga, M Geraldine; Mitchell, Jason E; Webster, Robert J; Labadie, Robert F

    2017-09-01

    This article presents the development and experimental validation of a methodology to reduce the risk of thermal injury to the facial nerve during minimally invasive cochlear implantation surgery. The first step in this methodology is a pre-operative screening process, in which medical imaging is used to identify those patients that present a significant risk of developing high temperatures at the facial nerve during the drilling phase of the procedure. Such a risk is calculated based on the density of the bone along the drilling path and the thermal conductance between the drilling path and the nerve, and provides a criterion to exclude high-risk patients from receiving the minimally invasive procedure. The second component of the methodology is a drilling strategy for manually-guided drilling near the facial nerve. The strategy utilizes interval drilling and mechanical constraints to enable better control over the procedure and the resulting generation of heat. The approach is tested in fresh cadaver temporal bones using a thermal camera to monitor temperature near the facial nerve. Results indicate that pre-operative screening may successfully exclude high-risk patients and that the proposed drilling strategy enables safe drilling for low-to-moderate risk patients.

  2. Adoption of waste minimization technology to benefit electroplaters

    Energy Technology Data Exchange (ETDEWEB)

    Ching, E.M.K.; Li, C.P.H.; Yu, C.M.K. [Hong Kong Productivity Council, Kowloon (Hong Kong)

    1996-12-31

    Because of increasingly stringent environmental legislation and enhanced environmental awareness, electroplaters in Hong Kong are paying more heed to protect the environment. To comply with the array of environmental controls, electroplaters can no longer rely solely on the end-of-pipe approach as a means for abating their pollution problems under the particular local industrial environment. The preferred approach is to adopt waste minimization measures that yield both economic and environmental benefits. This paper gives an overview of electroplating activities in Hong Kong, highlights their characteristics, and describes the pollution problems associated with conventional electroplating operations. The constraints of using pollution control measures to achieve regulatory compliance are also discussed. Examples and case studies are given on some low-cost waste minimization techniques readily available to electroplaters, including dragout minimization and water conservation techniques. Recommendations are given as to how electroplaters can adopt and exercise waste minimization techniques in their operations. 1 tab.

  3. Toda theories, W-algebras, and minimal models

    International Nuclear Information System (INIS)

    Mansfield, P.; Spence, B.

    1991-01-01

    We discuss the classical W-algebra symmetries of Toda field theories in terms of the pseudo-differential Lax operator associated with the Toda Lax pair. We then show how the W-algebra transformations can be understood as the non-abelian gauge transformations which preserve the form of the Lax pair. This provides a new understanding of the W-algebras, and we discuss their closure and co-cycle structure using this approach. The quantum Lax operator is investigated, and we show that this operator, which generates the quantum W-algebra currents, is conserved in the conformally extended Toda theories. The W-algebra minimal model primary fields are shown to arise naturally in these theories, leading to the conjecture that the conformally extended Toda theories provide a lagrangian formulation of the W-algebra minimal models. (orig.)

  4. Wilson loops in minimal surfaces

    International Nuclear Information System (INIS)

    Drukker, Nadav; Gross, David J.; Ooguri, Hirosi

    1999-01-01

    The AdS/CFT correspondence suggests that the Wilson loop of the large N gauge theory with N = 4 supersymmetry in 4 dimensions is described by a minimal surface in AdS 5 x S 5 . The authors examine various aspects of this proposal, comparing gauge theory expectations with computations of minimal surfaces. There is a distinguished class of loops, which the authors call BPS loops, whose expectation values are free from ultra-violet divergence. They formulate the loop equation for such loops. To the extent that they have checked, the minimal surface in AdS 5 x S 5 gives a solution of the equation. The authors also discuss the zig-zag symmetry of the loop operator. In the N = 4 gauge theory, they expect the zig-zag symmetry to hold when the loop does not couple the scalar fields in the supermultiplet. They will show how this is realized for the minimal surface

  5. Wilson loops and minimal surfaces

    International Nuclear Information System (INIS)

    Drukker, Nadav; Gross, David J.; Ooguri, Hirosi

    1999-01-01

    The AdS-CFT correspondence suggests that the Wilson loop of the large N gauge theory with N=4 supersymmetry in four dimensions is described by a minimal surface in AdS 5 xS 5 . We examine various aspects of this proposal, comparing gauge theory expectations with computations of minimal surfaces. There is a distinguished class of loops, which we call BPS loops, whose expectation values are free from ultraviolet divergence. We formulate the loop equation for such loops. To the extent that we have checked, the minimal surface in AdS 5 xS 5 gives a solution of the equation. We also discuss the zigzag symmetry of the loop operator. In the N=4 gauge theory, we expect the zigzag symmetry to hold when the loop does not couple the scalar fields in the supermultiplet. We will show how this is realized for the minimal surface. (c) 1999 The American Physical Society

  6. [The hybrid operating room. Home of high-end intraoperative imaging].

    Science.gov (United States)

    Gebhard, F; Riepl, C; Richter, P; Liebold, A; Gorki, H; Wirtz, R; König, R; Wilde, F; Schramm, A; Kraus, M

    2012-02-01

    A hybrid operating room must serve the medical needs of different highly specialized disciplines. It integrates interventional techniques for cardiovascular procedures and allows operations in the field of orthopaedic surgery, neurosurgery and maxillofacial surgery. The integration of all steps such as planning, documentation and the procedure itself saves time and precious resources. The best available imaging devices and user interfaces reduce the need for extensive personnel in the OR and facilitate new minimally invasive procedures. The immediate possibility of postoperative control images in CT-like quality enables the surgeon to react to problems during the same procedure without the need for later revision.

  7. Effects of "minimally invasive curricular surgery" - a pilot intervention study to improve the quality of bedside teaching in medical education.

    Science.gov (United States)

    Raupach, Tobias; Anders, Sven; Pukrop, Tobias; Hasenfuss, Gerd; Harendza, Sigrid

    2009-09-01

    Bedside teaching is an important element of undergraduate medical education. However, the impact of curricular course structure on student outcome needs to be determined. This study assessed changes in fourth-year medical students' evaluations of clinical teaching sessions before and after the introduction of a new course format. The curricular structure of bedside teaching sessions in cardiology was modified without changing the amount of teaching time. Clinical teachers were instructed about the new teaching format and learning objectives. The new format implemented for adult but not paediatric cardiology sessions was piloted with 143 students in winter 2007/08. By computing effect sizes, evaluation results were compared to data obtained from 185 students before the intervention. Significant rating increases were observed for adult cardiology teaching sessions (Cohen's d = 0.66) but not paediatric cardiology sessions (d = 0.22). In addition to improving the structure and organization of the course, the intervention significantly impacted on students' perceptions of their learning outcome regarding practical skills (d = 0.69). Minimal curricular changes combined with basic faculty development measures significantly increase students' perception of learning outcome. Curricular structure needs to be considered when planning bedside teaching sessions in medical undergraduate training.

  8. Efficacy of the RADPAD Protection Drape in Reducing Operators' Radiation Exposure in the Catheterization Laboratory: A Sham-Controlled Randomized Trial

    NARCIS (Netherlands)

    Vlastra, Wieneke; Delewi, Ronak; Sjauw, Krischan D.; Beijk, Marcel A.; Claessen, Bimmer E.; Streekstra, Geert J.; Bekker, Robbert J.; van Hattum, Juliette C.; Wykrzykowska, Joanna J.; Vis, Marije M.; Koch, Karel T.; de Winter, Robbert J.; Piek, Jan J.; Henriques, José P. S.

    2017-01-01

    Background Interventional cardiologists are increasingly exposed to radiation-induced diseases like cataract and the stochastic risk of left-sided brain tumors. The RADPAD is a sterile, disposable, lead-free shield placed on the patient with the aim to minimize operator-received scatter radiation.

  9. Protection of staff in interventional radiology

    International Nuclear Information System (INIS)

    Melkamu, M. A.

    2013-04-01

    This project focuses on the interventional radiology. The main objective of this project work was to provide a guidance and advice for occupational exposure and hospital management to optimize radiation protection safety and endorse safety culture. It provides practical information on how to minimize occupational exposure in interventional radiology. In the literature review all considerable parameters to reduce dose to the occupationally exposed are well discussed. These parameters include dose limit, risk estimation, use of dosimeter, personal dose record keeping, analysis of surveillance of occupational dose, investigation levels, and proper use of radiation protection tools and finally about scatter radiation dose rate. In addition the project discusses the ways to reduce occupational exposure in interventional radiology. The methods for dose reduction are minimizing fluoroscopic time, minimizing the number of fluoroscopic image, use of patient dose reduction technologies, use of collimation, planning interventional procedures, positioning in low scattered areas, use of protective shielding, use of appropriate fluoroscopic imaging equipment, giving training for the staff, wearing the dosimeters and know their own dose regularly, and management commitment to quality assurance and quality control system and optimization of radiation protection of safety. (author)

  10. Implementing primary health care-based PMTCT interventions: operational perspectives from Muhima cohort analysis (Rwanda)

    Science.gov (United States)

    Bucagu, Maurice; Muganda, John

    2014-01-01

    Introduction In countries with high burden of HIV, major programmatic challenges have been identified to preventing new infections among children and scaling up of treatment for pregnant mothers. We initiated this study to examine operational approaches that were used to enhance implementation of PMTCT interventions in Muhima health Centre (Kigali/Rwanda) from 2007 to 2010. Methods The prospective cohort study was conducted at Muhima health centre. A sample size of 656 was the minimum number required for the study. The main outcome was cumulative incidence of mother - to - child transmission of HIV-1 measured at 6 weeks of life among live born children. Results Among the 679 live born babies and followed up in this study, the overall cumulative rate of HIV-1 mother - to - child transmission observed was 3.2% at 6 weeks of age after birth. Disclosure of HIV status to partner was significantly associated with HIV-1 status of infants at 6 weeks of age (non-disclosure of HIV status adjusted odds ratio [AOR] 4.68, CI 1.39 to 15.77, p. Conclusion The Muhima type of decentralized health facility offered an appropriate platform for implementation of PMTCT interventions, with the following operational features: family - centered approach; integrated service delivery for PMTCT/MCH interventions, task shifting; subsidized membership fees for people living with HIV, allowing for access to the community-based health insurance benefits. PMID:26113893

  11. Minimally invasive spine surgery: Hurdles to be crossed

    Directory of Open Access Journals (Sweden)

    Mahesh Bijjawara

    2014-01-01

    Full Text Available MISS as a concept is noble and all surgeons need to address and minimize the surgical morbidity for better results. However, we need to be cautions and not fall prey into accepting that minimally invasive spine surgery can be done only when certain metal access systems are used. Minimally invasive spine surgery (MISS has come a long way since the description of endoscopic discectomy in 1997 and minimally invasive TLIF (mTLIF in 2003. Today there is credible evidence (though not level-I that MISS has comparable results to open spine surgery with the advantage of early postoperative recovery and decreased blood loss and infection rates. However, apart from decreasing the muscle trauma and decreasing the muscle dissection during multilevel open spinal instrumentation, there has been little contribution to address the other morbidity parameters like operative time , blood loss , access to decompression and atraumatic neural tissue handling with the existing MISS technologies. Since all these parameters contribute to a greater degree than posterior muscle trauma for the overall surgical morbidity, we as surgeons need to introspect before we accept the concept of minimally invasive spine surgery being reduced to surgeries performed with a few tubular retractors. A spine surgeon needs to constantly improve his skills and techniques so that he can minimize blood loss, minimize traumatic neural tissue handling and minimizing operative time without compromising on the surgical goals. These measures actually contribute far more, to decrease the morbidity than approach related muscle damage alone. Minimally invasine spine surgery , though has come a long way, needs to provide technical solutions to minimize all the morbidity parameters involved in spine surgery, before it can replace most of the open spine surgeries, as in the case of laparoscopic surgery or arthroscopic surgery.

  12. Operating force information on-line acquisition of a novel slave manipulator for vascular interventional surgery.

    Science.gov (United States)

    Zhao, Yan; Guo, Shuxiang; Xiao, Nan; Wang, Yuxin; Li, Youxiang; Jiang, Yuhua

    2018-04-02

    Vascular interventional surgery has its advantages compared to traditional operation. Master-slave robotic technology can further improve the operation accuracy, efficiency and safety of this complicated and high risk surgery. However, on-line acquisition of operating force information of catheter and guidewire remains to be a significant obstacle on the path to enhancing robotic surgery safety. Thus, a novel slave manipulator is proposed in this paper to realize on-line sensing of guidewire torsional operating torque and axial operation force during robotic assisted operations. A strain sensor is specially designed to detect the small scale torsional operation torque with low rotational frequency. Additionally, the axial operating force is detected via a load cell, which is incorporated into a sliding mechanism to eliminate the influence of friction. For validation, calibration and performance evaluation experiments are conducted. The results indicate that the proposed operation torque and force detection device is effective. Thus, it can provide the foundation for enabling accurate haptic feedback to the surgeon to improve surgical safety.

  13. Image-guided therapy and minimally invasive surgery in children: a merging future

    International Nuclear Information System (INIS)

    Shlomovitz, Eran; Amaral, Joao G.; Chait, Peter G.

    2006-01-01

    Minimally invasive image-guided therapy for children, also known as pediatric interventional radiology (PIR), is a new and exciting field of medicine. Two key elements that helped the rapid evolution and dissemination of this specialty were the creation of devices appropriate for the pediatric population and the development of more cost-effective and minimally invasive techniques. Despite its clear advantages to children, many questions are raised regarding who should be performing these procedures. Unfortunately, this is a gray zone with no clear answer. Surgeons fear that interventional radiologists will take over additional aspects of the surgical/procedural spectrum. Interventional radiologists, on the other hand, struggle to avoid becoming highly specialized technicians rather than physicians who are responsible for complete care of their patients. In this article, we briefly discuss some of the current aspects of minimally invasive image-guided therapy in children and innovations that are expected to be incorporated into clinical practice in the near future. Then, we approach the current interspecialty battles over the control of this field and suggest some solutions to these issues. Finally, we propose the development of a generation of physicians with both surgical and imaging skills. (orig.)

  14. Minimizing TLD-DRD differences

    International Nuclear Information System (INIS)

    Riley, D.L.; McCoy, R.A.; Connell, W.D.

    1987-01-01

    When substantial differences exist in exposures recorded by TLD's and DRD's, it is often necessary to perform an exposure investigation to reconcile the difference. In working with several operating plants, the authors have observed a number of causes for these differences. This paper outlines these observations and discusses procedures that can be used to minimize them

  15. Procedures minimally invasive image-guided

    International Nuclear Information System (INIS)

    Mora Guevara, Alejandro

    2011-01-01

    A literature review focused on minimally invasive procedures, has been performed at the Department of Radiology at the Hospital Calderon Guardia. A multidisciplinary team has been raised for decision making. The materials, possible complications and the available imaging technique such as ultrasound, computed tomography, magnetic resonance imaging, have been determined according to the procedure to be performed. The revision has supported medical interventions didactically enjoying the best materials, resources and conditions for a successful implementation of procedures and results [es

  16. Self-Averaging Property of Minimal Investment Risk of Mean-Variance Model.

    Science.gov (United States)

    Shinzato, Takashi

    2015-01-01

    In portfolio optimization problems, the minimum expected investment risk is not always smaller than the expected minimal investment risk. That is, using a well-known approach from operations research, it is possible to derive a strategy that minimizes the expected investment risk, but this strategy does not always result in the best rate of return on assets. Prior to making investment decisions, it is important to an investor to know the potential minimal investment risk (or the expected minimal investment risk) and to determine the strategy that will maximize the return on assets. We use the self-averaging property to analyze the potential minimal investment risk and the concentrated investment level for the strategy that gives the best rate of return. We compare the results from our method with the results obtained by the operations research approach and with those obtained by a numerical simulation using the optimal portfolio. The results of our method and the numerical simulation are in agreement, but they differ from that of the operations research approach.

  17. Self-Averaging Property of Minimal Investment Risk of Mean-Variance Model.

    Directory of Open Access Journals (Sweden)

    Takashi Shinzato

    Full Text Available In portfolio optimization problems, the minimum expected investment risk is not always smaller than the expected minimal investment risk. That is, using a well-known approach from operations research, it is possible to derive a strategy that minimizes the expected investment risk, but this strategy does not always result in the best rate of return on assets. Prior to making investment decisions, it is important to an investor to know the potential minimal investment risk (or the expected minimal investment risk and to determine the strategy that will maximize the return on assets. We use the self-averaging property to analyze the potential minimal investment risk and the concentrated investment level for the strategy that gives the best rate of return. We compare the results from our method with the results obtained by the operations research approach and with those obtained by a numerical simulation using the optimal portfolio. The results of our method and the numerical simulation are in agreement, but they differ from that of the operations research approach.

  18. Null-polygonal minimal surfaces in AdS4 from perturbed W minimal models

    International Nuclear Information System (INIS)

    Hatsuda, Yasuyuki; Ito, Katsushi; Satoh, Yuji

    2012-11-01

    We study the null-polygonal minimal surfaces in AdS 4 , which correspond to the gluon scattering amplitudes/Wilson loops in N=4 super Yang-Mills theory at strong coupling. The area of the minimal surfaces with n cusps is characterized by the thermodynamic Bethe ansatz (TBA) integral equations or the Y-system of the homogeneous sine-Gordon model, which is regarded as the SU(n-4) 4 /U(1) n-5 generalized parafermion theory perturbed by the weight-zero adjoint operators. Based on the relation to the TBA systems of the perturbed W minimal models, we solve the TBA equations by using the conformal perturbation theory, and obtain the analytic expansion of the remainder function around the UV/regular-polygonal limit for n = 6 and 7. We compare the rescaled remainder function for n=6 with the two-loop one, to observe that they are close to each other similarly to the AdS 3 case.

  19. Changes in safety climate and teamwork in the operating room after implementation of a revised WHO checklist: a prospective interventional study.

    Science.gov (United States)

    Erestam, Sofia; Haglind, Eva; Bock, David; Andersson, Annette Erichsen; Angenete, Eva

    2017-01-01

    Inter-professional teamwork in the operating room is important for patient safety. The World Health Organization (WHO) checklist was introduced to improve intraoperative teamwork. The aim of this study was to evaluate the safety climate in a Swedish operating room setting before and after an intervention, using a revised version of the WHO checklist to improve teamwork. This study is a single center prospective interventional study. Participants were personnel working in operating room teams including surgeons, anesthesiologists, scrub nurses, nurse anaesthetists and nurse assistants. The study started with pre-interventional observations of the WHO checklist use followed by education on safety climate, the WHO checklist, and non-technical skills in the operating room. Thereafter a revised version of the WHO checklist was introduced. Post-interventional observations regarding the performance of the WHO checklist were carried out. The Safety Attitude Questionnaire was used to assess safety climate at baseline and post-intervention. At baseline we discovered a need for improved teamwork and communication. The participants considered teamwork to be important for patient safety, but had different perceptions of good teamwork between professions. The intervention, a revised version of the WHO checklist, did not affect teamwork climate. Adherence to the revision of the checklist was insufficient, dominated by a lack of structure. There was no significant change in teamwork climate by use of the revised WHO checklist, which may be due to insufficient implementation, as a lack of adherence to the WHO checklist was detected. We found deficiencies in teamwork and communication. Further studies exploring how to improve safety climate are needed. NCT02329691.

  20. Attach importance to intervention therapy of acute abdomen

    International Nuclear Information System (INIS)

    Li Xuan

    2006-01-01

    Acute abdomen means a set of clinical emergency with acute abdominalgia as the primary characteristic symptom of onset, including others as the acute onset, quick symptom changes, severe illness, and oftenly need surgical treatment; therefore, acute abdomen ought to be designated within surgery domain. As interventional therapy is extensively applied in clinical medicine, now a days many victims of acute abdomen, especially those with ambiguous clinical diagnosis requiring an initial invasive examination (angiography, PTC, etc), should be referred to interventional therapy before taking an item of invasive measures. This new concept management has achieved good clinical curative effect and become one of the remarkable achievements in acute abdomen therapeutics. Such predominance finds proper expression in the following two aspects: (1) The evolution of contemporary medical iconography has made it possible to duly and accurately diagnose acute abdomen, and thus created a diagnostic predominance for us-interventionalists; (2) Intervention therapy is featured with its unique minimal invasion and massive effectiveness, and thus provides high leading edge than conventional surgical operation. The authors believe that intervention management ought to become the first-choice for treating the above mentioned acute abdomen. (authors)

  1. Optimization of PHEV Power Split Gear Ratio to Minimize Fuel Consumption and Operation Cost

    Science.gov (United States)

    Li, Yanhe

    A Plug-in Hybrid Electric Vehicle (PHEV) is a vehicle powered by a combination of an internal combustion engine and an electric motor with a battery pack. The battery pack can be charged by plugging the vehicle to the electric grid and from using excess engine power. The research activity performed in this thesis focused on the development of an innovative optimization approach of PHEV Power Split Device (PSD) gear ratio with the aim to minimize the vehicle operation costs. Three research activity lines have been followed: • Activity 1: The PHEV control strategy optimization by using the Dynamic Programming (DP) and the development of PHEV rule-based control strategy based on the DP results. • Activity 2: The PHEV rule-based control strategy parameter optimization by using the Non-dominated Sorting Genetic Algorithm (NSGA-II). • Activity 3: The comprehensive analysis of the single mode PHEV architecture to offer the innovative approach to optimize the PHEV PSD gear ratio.

  2. Minimization In Digital Design As A Meta-Planning Problem

    Science.gov (United States)

    Ho, William P. C.; Wu, Jung-Gen

    1987-05-01

    In our model-based expert system for automatic digital system design, we formalize the design process into three sub-processes - compiling high-level behavioral specifications into primitive behavioral operations, grouping primitive operations into behavioral functions, and grouping functions into modules. Consideration of design minimization explicitly controls decision-making in the last two subprocesses. Design minimization, a key task in the automatic design of digital systems, is complicated by the high degree of interaction among the time sequence and content of design decisions. In this paper, we present an AI approach which directly addresses these interactions and their consequences by modeling the minimization prob-lem as a planning problem, and the management of design decision-making as a meta-planning problem.

  3. Minimally Invasive Surgery (MIS) Approaches to Thoracolumbar Trauma.

    Science.gov (United States)

    Kaye, Ian David; Passias, Peter

    2018-03-01

    Minimally invasive surgical (MIS) techniques offer promising improvements in the management of thoracolumbar trauma. Recent advances in MIS techniques and instrumentation for degenerative conditions have heralded a growing interest in employing these techniques for thoracolumbar trauma. Specifically, surgeons have applied these techniques to help manage flexion- and extension-distraction injuries, neurologically intact burst fractures, and cases of damage control. Minimally invasive surgical techniques offer a means to decrease blood loss, shorten operative time, reduce infection risk, and shorten hospital stays. Herein, we review thoracolumbar minimally invasive surgery with an emphasis on thoracolumbar trauma classification, minimally invasive spinal stabilization, surgical indications, patient outcomes, technical considerations, and potential complications.

  4. 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.

  5. The Effects of an Abolishing Operation Intervention Component on Play Skills, Challenging Behavior, and Stereotypy

    Science.gov (United States)

    Lang, Russell; O'Reilly, Mark; Sigafoos, Jeff; Machalicek, Wendy; Rispoli, Mandy; Lancioni, Giulio E.; Aguilar, Jeannie; Fragale, Christina

    2010-01-01

    The purpose of this study was to reduce stereotypy and challenging behavior during play skills instruction by adding an abolishing operation component (AOC) to the intervention strategy. An alternating treatments design compared one condition in which participants were allowed to engage in stereotypy freely before beginning the play skills…

  6. The WEST programme: Minimizing technology and operational risks of a full actively cooled tungsten divertor on ITER

    Energy Technology Data Exchange (ETDEWEB)

    Grosman, André, E-mail: andre.grosman@cea.fr [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France); Bucalossi, Jérôme; Doceul, Louis [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France); Escourbiac, Frédéric [ITER Organization, Cadarache, 13115 St. Paul-lez-Durance (France); Lipa, Manfred [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France); Merola, Mario [ITER Organization, Cadarache, 13115 St. Paul-lez-Durance (France); Missirlian, Marc [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France); Pitts, Richard A. [ITER Organization, Cadarache, 13115 St. Paul-lez-Durance (France); Samaille, Franck; Tsitrone, Emmanuelle [CEA, IRFM, F-13108 Saint-Paul-Lez-Durance (France)

    2013-10-15

    Highlights: ► The WEST programme is a unique opportunity to experience the industrial scale manufacture of tungsten plasma-facing components similar to the ITER divertor ones. ► In Tore Supra, it will bring important know how for actively cooled W divertor operation. ► This can be done by a reasonable modification of the Tore Supra tokamak. ► A fast implementation of the project would make this information available in due time. ► This allows a significant contribution to the W ITER divertor risk minimization in its manufacturing and operation phase. -- Abstract: The WEST programme consists in transforming the Tore Supra tokamak into an X point divertor device, while taking advantage of its long discharge capability. This is obtained by inserting in vessel coils to create the X point while adapting the in-vessel elements to this new geometry. This will allow the full tungsten divertor technology to be used on ITER to be tested in anticipation of its use on ITER under relevant heat loading conditions and pulse duration. The early manufacturing of a significant industrial series of ITER-similar W plasma-facing units will contribute to the ITER divertor manufacturing risk mitigation and to that associated with early W divertor plasma operation on ITER.

  7. Modeling Optimal Scheduling for Pumping System to Minimize Operation Cost and Enhance Operation Reliability

    Directory of Open Access Journals (Sweden)

    Yin Luo

    2012-01-01

    Full Text Available Traditional pump scheduling models neglect the operation reliability which directly relates with the unscheduled maintenance cost and the wear cost during the operation. Just for this, based on the assumption that the vibration directly relates with the operation reliability and the degree of wear, it could express the operation reliability as the normalization of the vibration level. The characteristic of the vibration with the operation point was studied, it could be concluded that idealized flow versus vibration plot should be a distinct bathtub shape. There is a narrow sweet spot (80 to 100 percent BEP to obtain low vibration levels in this shape, and the vibration also follows similar law with the square of the rotation speed without resonance phenomena. Then, the operation reliability could be modeled as the function of the capacity and rotation speed of the pump and add this function to the traditional model to form the new. And contrast with the tradition method, the result shown that the new model could fix the result produced by the traditional, make the pump operate in low vibration, then the operation reliability could increase and the maintenance cost could decrease.

  8. Waste Minimization Policy at the Romanian Nuclear Power Plant

    International Nuclear Information System (INIS)

    Andrei, V.; Daian, I.

    2002-01-01

    The radioactive waste management system at Cernavoda Nuclear Power Plant (NPP) in Romania was designed to maintain acceptable levels of safety for workers and to protect human health and the environment from exposure to unacceptable levels of radiation. In accordance with terminology of the International Atomic Energy Agency (IAEA), this system consists of the ''pretreatment'' of solid and organic liquid radioactive waste, which may include part or all of the following activities: collection, handling, volume reduction (by an in-drum compactor, if appropriate), and storage. Gaseous and aqueous liquid wastes are managed according to the ''dilute and discharge'' strategy. Taking into account the fact that treatment/conditioning and disposal technologies are still not established, waste minimization at the source is a priority environmental management objective, while waste minimization at the disposal stage is presently just a theoretical requirement for future adopted technologies . The necessary operational and maintenance procedures are in place at Cernavoda to minimize the production and contamination of waste. Administrative and technical measures are established to minimize waste volumes. Thus, an annual environmental target of a maximum 30 m3 of radioactive waste volume arising from operation and maintenance has been established. Within the first five years of operations at Cernavoda NPP, this target has been met. The successful implementation of the waste minimization policy has been accompanied by a cost reduction while the occupational doses for plant workers have been maintained at as low as reasonably practicable levels. This paper will describe key features of the waste management system along with the actual experience that has been realized with respect to minimizing the waste volumes at the Cernavoda NPP

  9. White Paper: Curriculum in Interventional Radiology.

    Science.gov (United States)

    Mahnken, Andreas H; Bücker, Arno; Hohl, Christian; Berlis, Ansgar

    2017-04-01

    Purpose  Scope and clinical importance of interventional radiology markedly evolved over the last decades. Consequently it was acknowledged as independent subspecialty by the "European Union of Medical Specialists" (UEMS). Based on radiological imaging techniques Interventional Radiology is an integral part of Radiology. Materials und Methods  In 2009 the German Society for Interventional Radiology and minimally-invasive therapy (DeGIR) developed a structured training in Interventional Radiology. In cooperation with the German Society of Neuroradiology (DGNR) this training was extended to also cover Interventional Neuroradiology in 2012. Tailored for this training in Interventional Radiology a structured curriculum was developed, covering the scope of this modular training. Results  The curriculum is based on the DeGIR/DGNR modular training concept in Interventional Radiology. There is also an European Curriculum and Syllabus for Interventional Radiology developed by the "Cardiovascular and Interventional Radiological Society of Europe" (CIRSE). The presented curriculum in Interventional Radiology is designed to provide a uniform base for the training in Interventional Radiology in Germany, based on the competencies obtained during residency. Conclusion  This curriculum can be used as a basis for training in Interventional Radiology by all training sites. Key Points: · Interventional Radiology is an integral part of clinical radiology. · The German Society for Interventional Radiology and minimally-invasive therapy (DeGIR) developed a curriculum in Interventional Radiology. · This curriculum is an integrative basis for the training in interventional. Citation Format · Mahnken AH, Bücker A, Hohl C et al. White Paper: Curriculum in Interventional Radiology. Fortschr Röntgenstr 2017; 189: 309 - 311. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Null-polygonal minimal surfaces in AdS{sub 4} from perturbed W minimal models

    Energy Technology Data Exchange (ETDEWEB)

    Hatsuda, Yasuyuki [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Ito, Katsushi [Tokyo Institute of Technology (Japan). Dept. of Physics; Satoh, Yuji [Tsukuba Univ., Sakura, Ibaraki (Japan). Inst. of Physics

    2012-11-15

    We study the null-polygonal minimal surfaces in AdS{sub 4}, which correspond to the gluon scattering amplitudes/Wilson loops in N=4 super Yang-Mills theory at strong coupling. The area of the minimal surfaces with n cusps is characterized by the thermodynamic Bethe ansatz (TBA) integral equations or the Y-system of the homogeneous sine-Gordon model, which is regarded as the SU(n-4){sub 4}/U(1){sup n-5} generalized parafermion theory perturbed by the weight-zero adjoint operators. Based on the relation to the TBA systems of the perturbed W minimal models, we solve the TBA equations by using the conformal perturbation theory, and obtain the analytic expansion of the remainder function around the UV/regular-polygonal limit for n = 6 and 7. We compare the rescaled remainder function for n=6 with the two-loop one, to observe that they are close to each other similarly to the AdS{sub 3} case.

  11. The practical use of an interactive visualization and planning tool for intervention planning in particle accelerator environments with ionizing radiation

    CERN Document Server

    Fabry, Thomas; Vanherpe, Liesbeth; Braesch, Christian; Tabourot, Laurent; Feral, Bruno

    2014-01-01

    A core issue during the planning of a maintenance intervention in a facility with ionizing radiation is the minimization of the integrated equivalent dose contracted by the maintenance workers during the intervention. In this work, we explore the use of a technical-scientific software program facilitating the intervention planning in irradiated environments using sound mathematical concepts. We show how the software can be used in planning future operations using a case studies: the decommissioning of a beam dump for a linear 160 MeV H− accelerator. Interactive visualization of the facilities and radiation levels, as well as tools for interactive trajectory planning are explored, as well as automatic calculation of the expected integrated individual dose contracted during an intervention.

  12. Autonomous calibration of single spin qubit operations

    Science.gov (United States)

    Frank, Florian; Unden, Thomas; Zoller, Jonathan; Said, Ressa S.; Calarco, Tommaso; Montangero, Simone; Naydenov, Boris; Jelezko, Fedor

    2017-12-01

    Fully autonomous precise control of qubits is crucial for quantum information processing, quantum communication, and quantum sensing applications. It requires minimal human intervention on the ability to model, to predict, and to anticipate the quantum dynamics, as well as to precisely control and calibrate single qubit operations. Here, we demonstrate single qubit autonomous calibrations via closed-loop optimisations of electron spin quantum operations in diamond. The operations are examined by quantum state and process tomographic measurements at room temperature, and their performances against systematic errors are iteratively rectified by an optimal pulse engineering algorithm. We achieve an autonomous calibrated fidelity up to 1.00 on a time scale of minutes for a spin population inversion and up to 0.98 on a time scale of hours for a single qubit π/2 -rotation within the experimental error of 2%. These results manifest a full potential for versatile quantum technologies.

  13. Minimally invasive approaches in pancreatic pseudocyst: a Case report

    Directory of Open Access Journals (Sweden)

    Rohollah Y

    2009-09-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: According to importance of post operative period, admission duration, post operative pain, and acceptable rate of complications, minimally invasive approaches with endoscope in pancreatic pseudocyst management becomes more popular, but the best choice of procedure and patient selection is currently not completely established. During past decade endoscopic procedures are become first choice in most authors' therapeutic plans, however, open surgery remains gold standard in pancreatic pseudocyst treatment."n"nMethods: we present here a patient with pancreatic pseudocyst unresponsive to conservative management that is intervened endoscopically before 6th week, and review current literatures to depict a schema to management navigation."n"nResults: A 16 year old male patient presented with two episodes of acute pancreatitis with abdominal pain, nausea and vomiting. Hyperamilasemia, pancreatic ascites and a pseudocyst were found in our preliminary investigation. Despite optimal conservative management, including NPO (nil per os and total parentral nutrition, after four weeks, clinical and para-clinical findings deteriorated. Therefore, ERCP and trans-papillary cannulation with placement of 7Fr stent was

  14. A deep learning approach for the analysis of masses in mammograms with minimal user intervention.

    Science.gov (United States)

    Dhungel, Neeraj; Carneiro, Gustavo; Bradley, Andrew P

    2017-04-01

    We present an integrated methodology for detecting, segmenting and classifying breast masses from mammograms with minimal user intervention. This is a long standing problem due to low signal-to-noise ratio in the visualisation of breast masses, combined with their large variability in terms of shape, size, appearance and location. We break the problem down into three stages: mass detection, mass segmentation, and mass classification. For the detection, we propose a cascade of deep learning methods to select hypotheses that are refined based on Bayesian optimisation. For the segmentation, we propose the use of deep structured output learning that is subsequently refined by a level set method. Finally, for the classification, we propose the use of a deep learning classifier, which is pre-trained with a regression to hand-crafted feature values and fine-tuned based on the annotations of the breast mass classification dataset. We test our proposed system on the publicly available INbreast dataset and compare the results with the current state-of-the-art methodologies. This evaluation shows that our system detects 90% of masses at 1 false positive per image, has a segmentation accuracy of around 0.85 (Dice index) on the correctly detected masses, and overall classifies masses as malignant or benign with sensitivity (Se) of 0.98 and specificity (Sp) of 0.7. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Vascular Complications of Pancreatitis: Role of Interventional Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Barge, Jaideep U.; Lopera, Jorge E. [University of Texas Health Science Center, San Antonio (United States)

    2012-02-15

    Major vascular complications related to pancreatitis can cause life-threatening hemorrhage and have to be dealt with as an emergency, utilizing a multidisciplinary approach of angiography, endoscopy or surgery. These may occur secondary to direct vascular injuries, which result in the formation of splanchnic pseudoaneurysms, gastrointestinal etiologies such as peptic ulcer disease and gastroesophageal varices, and post-operative bleeding related to pancreatic surgery. In this review article, we discuss the pathophysiologic mechanisms, diagnostic modalities, and treatment of pancreatic vascular complications, with a focus on the role of minimally-invasive interventional therapies such as angioembolization, endovascular stenting, and ultrasound-guided percutaneous thrombin injection in their management.

  16. Operations and maintenance philosophy

    International Nuclear Information System (INIS)

    DUNCAN, G.P.

    1999-01-01

    This Operations and Maintenance (O and M) Philosophy document is intended to establish a future O and M vision, with an increased focus on minimizing worker exposure, ensuring uninterrupted retrieval operations, and minimizing operation life-cycle cost. It is intended that this document would incorporate O and M lessons learned into on-going and future project upgrades

  17. Meta-Analysis of Single-Case Design Research on Self-Regulatory Interventions for Academic Performance

    Science.gov (United States)

    Perry, Valerie; Albeg, Loren; Tung, Catherine

    2012-01-01

    The current study examined the effects of self-regulatory interventions on reading, writing, and math by conducting a meta-analysis of single-case design research. Self-regulatory interventions have promise as an effective approach that is both minimally invasive and involves minimal resources. Effects of the interventions were analyzed by…

  18. Biocontrol interventions for inactivation of foodborne pathogens on produce

    Science.gov (United States)

    Post-harvest interventions for control of foodborne pathogens on minimally processed foods are crucial for food safety. Biocontrol interventions have the primary objective of developing novel antagonists in combinations with physical and chemical interventions to inactivate pathogenic microbes. Ther...

  19. Minimization and segregation of radioactive wastes

    International Nuclear Information System (INIS)

    1992-07-01

    The report will serve as one of a series of technical manuals providing reference material and direct know-how to staff in radioisotope user establishments and research centres in Member States without nuclear power and the associated range of complex waste management operations. Considerations are limited to the minimization and segregation of wastes, these being initial steps on which the efficiency of the whole waste management system depends. The minimization and segregation operations are examined in the context of the restricted quantities and predominantly shorter lived activities of wastes from nuclear research, production and usage of radioisotopes. Liquid and solid wastes only are considered in the report. Gaseous waste minimization and treatment are specialized subjects and are not examined in this document. Gaseous effluent treatment in facilities handling low and intermediate level radioactive materials has been already the subject of a detailed IAEA report. Management of spent sealed sources has specifically been covered in a previous manual. Conditioned sealed sources must be taken into account in segregation arrangements for interim storage and disposal where there are exceptional long lived highly radiotoxic isotopes, particularly radium or americium. These are unlikely ever to be suitable for shallow land burial along with the remaining wastes. 30 refs, 5 figs, 8 tabs

  20. A radioisotope production cyclotron designed to minimize dose

    International Nuclear Information System (INIS)

    Szlavik, F.F.; Moritz, L.E.

    1992-01-01

    This paper describes a radioisotope production cyclotron which has been designed to minimize the dose to personnel during operation and maintenance. The design incorporates lessons learned from the operation of a CP42 cyclotron and has resulted in a reduction of the dose by a factor of more than 10. (author)

  1. Minimally invasive aortic valve replacement

    DEFF Research Database (Denmark)

    Foghsgaard, Signe; Schmidt, Thomas Andersen; Kjaergard, Henrik K

    2009-01-01

    In this descriptive prospective study, we evaluate the outcomes of surgery in 98 patients who were scheduled to undergo minimally invasive aortic valve replacement. These patients were compared with a group of 50 patients who underwent scheduled aortic valve replacement through a full sternotomy...... operations were completed as mini-sternotomies, 4 died later of noncardiac causes. The aortic cross-clamp and perfusion times were significantly different across all groups (P replacement...... is an excellent operation in selected patients, but its true advantages over conventional aortic valve replacement (other than a smaller scar) await evaluation by means of randomized clinical trial. The "extended mini-aortic valve replacement" operation, on the other hand, is a risky procedure that should...

  2. Effect of an Ergonomics-Based Educational Intervention Based on Transtheoretical Model in Adopting Correct Body Posture Among Operating Room Nurses.

    Science.gov (United States)

    Moazzami, Zeinab; Dehdari, Tahere; Taghdisi, Mohammad Hosein; Soltanian, Alireza

    2015-11-03

    One of the preventive strategies for chronic low back pain among operating room nurses is instructing proper body mechanics and postural behavior, for which the use of the Transtheoretical Model (TTM) has been recommended. Eighty two nurses who were in the contemplation and preparation stages for adopting correct body posture were randomly selected (control group = 40, intervention group = 42). TTM variables and body posture were measured at baseline and again after 1 and 6 months after the intervention. A four-week ergonomics educational intervention based on TTM variables was designed and conducted for the nurses in the intervention group. Following the intervention, a higher proportion of nurses in the intervention group moved into the action stage (p 0.05) after the intervention. The TTM provides a suitable framework for developing stage-based ergonomics interventions for postural behavior.

  3. Opportunity of interventional radiology: advantages and application of interventional technique in biological target therapy

    International Nuclear Information System (INIS)

    Teng Gaojun; Lu Qin

    2007-01-01

    Interventional techniques not only provide opportunity of treatment for many diseases, but also alter the traditional therapeutic pattern. With the new century of wide application of biological therapies, interventional technique also shows extensive roles. The current biological therapy, including gene therapy, cell transplantation therapy, immunobiologic molecule therapy containing cell factors, tumor antibody or vaccine, recombined proteins, radioactive-particles and targeting materials therapy, can be locally administrated by interventional techniques. The combination of targeting biological therapies and high-targeted interventional technique holds advantages of minimal invasion, accurate delivery, vigorous local effect, and less systemic adverse reactions. Authors believe that the biological therapy may arise a great opportunity for interventional radiology, therefore interventional colleagues should grasp firmly and promptly for the development and extension in this field. (authors)

  4. Electric dipole moment constraints on minimal electroweak baryogenesis

    CERN Document Server

    Huber, S J; Ritz, A; Huber, Stephan J.; Pospelov, Maxim; Ritz, Adam

    2007-01-01

    We study the simplest generic extension of the Standard Model which allows for conventional electroweak baryogenesis, through the addition of dimension six operators in the Higgs sector. At least one such operator is required to be CP-odd, and we study the constraints on such a minimal setup, and related scenarios with minimal flavor violation, from the null results of searches for electric dipole moments (EDMs), utilizing the full set of two-loop contributions to the EDMs. The results indicate that the current bounds are stringent, particularly that of the recently updated neutron EDM, but fall short of ruling out these scenarios. The next generation of EDM experiments should be sufficiently sensitive to provide a conclusive test.

  5. Impact of pharmacist intervention on antibiotic use and prophylactic antibiotic use in urology clean operations.

    Science.gov (United States)

    Zhou, Y; Ma, L-Y; Zhao, X; Tian, S-H; Sun, L-Y; Cui, Y-M

    2015-08-01

    The use of prophylactic antibiotics in clean operations was routine in China before 2011. Along with the appeal for using antibiotics rationally by WHO in 2011, China launched a national special rectification scheme on clinical use of antibiotics from April that year. The scheme, aimed at achieving rational use of antibiotics, made pharmacists part of the responsible medical team. Our objective was to describe the impacts of pharmacist intervention on the use of antibiotics, particularly in urology clean operations. Pharmacists participated in antibiotic stewardship programmes of the hospital and urological clinical work and conducted real-time interventions at the same time from 2011 to 2013. Data on the use of antibiotics between 2010 and 2013 in urology were collected. Comparison of the 2013 data with those of 2010 showed that antibiotic use density [AUD= DDDs*100/(The number of patients who were treated the same period*Average days in hospital). DDDs = Total drug consumption (g)/DDD. DDD is the Defined Daily Dose] decreased by 57·8(58·8%); average antibiotic cost decreased by 246·94 dollars; the cost of antibiotics as a percentage of total drug cost decreased by 27·7%; the rate of use of antibiotics decreased from 100% to 7·3%. The study illustrates how an antibiotic stewardship programme with pharmacist participation including real-time interventions can promote improved antibiotic-prescribing and significantly decrease costs. © 2015 John Wiley & Sons Ltd.

  6. The practical use of an interactive visualization and planning tool for intervention planning in particle accelerator environments with ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    Fabry, Thomas, E-mail: thomas.fabry@cern.ch [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland); Blaha, Jan; Vanherpe, Liesbeth [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland); Braesch, Christian; Tabourot, Laurent [SYMME, Université de Savoie, Polytech Annecy-Chambéry, 5 Chemin de Bellevue, 74944 Annecy le Vieux (France); Feral, Bruno [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland)

    2014-04-11

    A core issue during the planning of a maintenance intervention in a facility with ionizing radiation is the minimization of the integrated equivalent dose contracted by the maintenance workers during the intervention. In this work, we explore the use of a technical-scientific software program facilitating the intervention planning in irradiated environments using sound mathematical concepts. We show how the software can be used in planning future operations using a case studies: the decommissioning of a beam dump for a linear 160 MeV H{sup −} accelerator. Interactive visualization of the facilities and radiation levels, as well as tools for interactive trajectory planning are explored, as well as automatic calculation of the expected integrated individual dose contracted during an intervention.

  7. The practical use of an interactive visualization and planning tool for intervention planning in particle accelerator environments with ionizing radiation

    International Nuclear Information System (INIS)

    Fabry, Thomas; Blaha, Jan; Vanherpe, Liesbeth; Braesch, Christian; Tabourot, Laurent; Feral, Bruno

    2014-01-01

    A core issue during the planning of a maintenance intervention in a facility with ionizing radiation is the minimization of the integrated equivalent dose contracted by the maintenance workers during the intervention. In this work, we explore the use of a technical-scientific software program facilitating the intervention planning in irradiated environments using sound mathematical concepts. We show how the software can be used in planning future operations using a case studies: the decommissioning of a beam dump for a linear 160 MeV H − accelerator. Interactive visualization of the facilities and radiation levels, as well as tools for interactive trajectory planning are explored, as well as automatic calculation of the expected integrated individual dose contracted during an intervention

  8. The minimally tuned minimal supersymmetric standard model

    International Nuclear Information System (INIS)

    Essig, Rouven; Fortin, Jean-Francois

    2008-01-01

    The regions in the Minimal Supersymmetric Standard Model with the minimal amount of fine-tuning of electroweak symmetry breaking are presented for general messenger scale. No a priori relations among the soft supersymmetry breaking parameters are assumed and fine-tuning is minimized with respect to all the important parameters which affect electroweak symmetry breaking. The superpartner spectra in the minimally tuned region of parameter space are quite distinctive with large stop mixing at the low scale and negative squark soft masses at the high scale. The minimal amount of tuning increases enormously for a Higgs mass beyond roughly 120 GeV

  9. NLP model of a LiBr–H2O absorption refrigeration system for the minimization of the annual operating cost

    International Nuclear Information System (INIS)

    Rubio-Maya, Carlos; Pacheco-Ibarra, J. Jesús; Belman-Flores, Juan M.; Galván-González, Sergio R.; Mendoza-Covarrubias, Crisanto

    2012-01-01

    In this paper the optimization of a LiBr–H 2 O absorption refrigeration system with the annual operating cost as the objective function to be minimized is presented. The optimization problem is established as a Non-Linear Programming (NLP) model allowing a formulation of the problem in a simple and structured way, and reducing the typical complexity of the thermal systems. The model is composed of three main parts: the thermodynamic model based on the exergy concept including also the proper formulation for the thermodynamic properties of the LiBr–H 2 O mixture, the second is the economic model and the third part composed by inequality constraints. The solution of the model is obtained using the CONOPT solver suitable for NLP problems (code is available on request). The results show the values of the decision variables that minimize the annual cost under the set of assumptions considered in the model and agree well with those reported in other works using different optimization approaches. - Highlights: ► The optimization of an ARS is presented using the annual operating cost as the objective function. ► The problem is established as an NLP model allowing a formulation in a simple and structured way. ► Several formulations for the thermodynamic properties were tested to implement the simpler ones. ► The results obtained agree well with those reported in the work being in comparison.

  10. Minimally Invasive Parathyroidectomy

    Directory of Open Access Journals (Sweden)

    Lee F. Starker

    2011-01-01

    Full Text Available Minimally invasive parathyroidectomy (MIP is an operative approach for the treatment of primary hyperparathyroidism (pHPT. Currently, routine use of improved preoperative localization studies, cervical block anesthesia in the conscious patient, and intraoperative parathyroid hormone analyses aid in guiding surgical therapy. MIP requires less surgical dissection causing decreased trauma to tissues, can be performed safely in the ambulatory setting, and is at least as effective as standard cervical exploration. This paper reviews advances in preoperative localization, anesthetic techniques, and intraoperative management of patients undergoing MIP for the treatment of pHPT.

  11. Medical interventional procedures--reducing the radiation risks

    International Nuclear Information System (INIS)

    Cousins, C.; Sharp, C.

    2004-01-01

    Over the last 40 years, the number of percutaneous interventional procedures using radiation has increased significantly, with many secondary care clinicians using fluoroscopically guided techniques. Many procedures can deliver high radiation doses to patients and staff, with the potential to cause immediate and delayed radiation effects. The challenge for interventionists is to maximize benefit, whilst minimizing radiation risk to patients and staff. Non-radiologist clinicians are often inadequately trained in radiation safety and radiobiology. However, clinical governance and legislation now requires a more rigorous approach to protecting patients and staff. Protection can be ensured, and risks can be controlled, by appropriate design, procurement and commissioning of equipment; quality assurance; and optimal operational technique, backed by audit. Interventionists need knowledge and skills to reduce the risks. Appropriate training should include awareness of the potential for radiation injury, equipment operational parameters, doses measurement and recording methods and dose reduction techniques. Clinical governance requires informed consent, appropriate patient counselling and follow-up

  12. Medical interventional procedures--reducing the radiation risks

    Energy Technology Data Exchange (ETDEWEB)

    Cousins, C. E-mail: claire.cousins@addenbrookes.nhs.uk; Sharp, C

    2004-06-01

    Over the last 40 years, the number of percutaneous interventional procedures using radiation has increased significantly, with many secondary care clinicians using fluoroscopically guided techniques. Many procedures can deliver high radiation doses to patients and staff, with the potential to cause immediate and delayed radiation effects. The challenge for interventionists is to maximize benefit, whilst minimizing radiation risk to patients and staff. Non-radiologist clinicians are often inadequately trained in radiation safety and radiobiology. However, clinical governance and legislation now requires a more rigorous approach to protecting patients and staff. Protection can be ensured, and risks can be controlled, by appropriate design, procurement and commissioning of equipment; quality assurance; and optimal operational technique, backed by audit. Interventionists need knowledge and skills to reduce the risks. Appropriate training should include awareness of the potential for radiation injury, equipment operational parameters, doses measurement and recording methods and dose reduction techniques. Clinical governance requires informed consent, appropriate patient counselling and follow-up.

  13. DSA diagnosis and interventional management of postoperative bleeding

    International Nuclear Information System (INIS)

    Li Yuwei; Zhang Fuqiang; Li Yunhui; Yuan Liang; Si Guangyan; Liu Lili

    2009-01-01

    Objective: To discuss the clinical application of DSA and interventional management in diagnosing and treating the bleeding after surgery. Methods: The clinical data and the interventional management of 14 patients with DSA-proved postoperative bleeding, encountered during the period of Aug. 2005-Jan. 2008, were retrospectively analyzed. The surgeries included subtotal gastrectomy (n=4), pancreatoduodenectomy (n=3), cesarean section (n=2), nephrolithotomy (n=3), heminephrectomy (n=1), internal hemorrhoidectomy (n=1). Results: Seventeen arterial bleeding sites were demonstrated, including gastroduodenal (n=2), left gastric (n=4), phrenic (n=1), short gastric (n=1), superior mesenteric (n=2), renal (n=4), uterine (n=2) and internal pudendal (n=1) artery. The diagnosis was confirmed with DSA in all 14 patients, of which embolization was successfully carried out in 13 in one session (92.8%). The remaining one case had to be operated again to stop the bleeding because of the failure of the superselective catheterization. No serious complications, such as organ necrosis or visceral dysfunction, occurred. Conclusion: As a safe, minimally-invasive and effective technique, DSA and interventional management are very helpful in diagnosing and treating the bleeding after surgery. (authors)

  14. An environment for operation planning of electrical energy distribution systems; Um ambiente para planejamento da operacao de sistemas de distribuicao de energia eletrica

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Kleber

    1997-07-01

    The aim of operation planning of electrical energy distribution systems is to define a group of interventions in the distribution network in a way to reach a global optimization. Both normal operation and emergency conditions are considered including scheduled interventions in the network. Under normal conditions, some aspects as voltage drop and loss minimization, for example, are considered; under emergency conditions, the minimization of non-distributed energy and interruption time are taken into account. This proposes the development of a computer environment for operation planning studies. The design and implementation of a specific operation planning database, based on a relational database model, was carried out so that new information modules could be easily included. A statistical approach has been applied to the load model including consumption habits and seasonal information, for each consumer category. A group of operation planning functions is proposed, which includes simulation modules responsible for system analysis. These functions and the database should be designed together. The developed computer environment allows the inclusion of new functions, due to the standardized query language used to access the database. Two functions have been implemented for illustration. The development of the proposed environment constitutes a step towards an open operation planning system, an integration with other information systems and an easy-to-use system based on graphical interface. (author)

  15. Hydrogen atom in momentum space with a minimal length

    International Nuclear Information System (INIS)

    Bouaziz, Djamil; Ferkous, Nourredine

    2010-01-01

    A momentum representation treatment of the hydrogen atom problem with a generalized uncertainty relation, which leads to a minimal length ΔX imin =(ℎ/2π)√(3β+β ' ), is presented. We show that the distance squared operator can be factorized in the case β ' =2β. We analytically solve the s-wave bound-state equation. The leading correction to the energy spectrum caused by the minimal length depends on √(β). An upper bound for the minimal length is found to be about 10 -9 fm.

  16. The minimal non-minimal standard model

    International Nuclear Information System (INIS)

    Bij, J.J. van der

    2006-01-01

    In this Letter I discuss a class of extensions of the standard model that have a minimal number of possible parameters, but can in principle explain dark matter and inflation. It is pointed out that the so-called new minimal standard model contains a large number of parameters that can be put to zero, without affecting the renormalizability of the model. With the extra restrictions one might call it the minimal (new) non-minimal standard model (MNMSM). A few hidden discrete variables are present. It is argued that the inflaton should be higher-dimensional. Experimental consequences for the LHC and the ILC are discussed

  17. A combined teamwork training and work standardisation intervention in operating theatres: controlled interrupted time series study.

    Science.gov (United States)

    Morgan, Lauren; Pickering, Sharon P; Hadi, Mohammed; Robertson, Eleanor; New, Steve; Griffin, Damian; Collins, Gary; Rivero-Arias, Oliver; Catchpole, Ken; McCulloch, Peter

    2015-02-01

    Teamwork training and system standardisation have both been proposed to reduce error and harm in surgery. Since the approaches differ markedly, there is potential for synergy between them. Controlled interrupted time series with a 3 month intervention and observation phases before and after. Operating theatres conducting elective orthopaedic surgery in a single hospital system (UK Hospital Trust). Teamwork training based on crew resource management plus training and follow-up support in developing standardised operating procedures. Focus of subsequent standardisation efforts decided by theatre staff. Paired observers watched whole procedures together. We assessed non-technical skills using NOTECHS II, technical performance using glitch rate and compliance with WHO checklist using a simple quality tool. We measured complication and readmission rates and hospital stay using hospital administrative records. Before/after change was compared in the active and control groups using two-way ANOVA and regression models. 1121 patients were operated on before and 1100 after intervention. 44 operations were observed before and 50 afterwards. Non-technical skills (p=0.002) and WHO compliance (pteamwork and system improvement causes marked improvements in team behaviour and WHO performance, but not technical performance or outcome. These findings are consistent with the synergistic hypothesis, but larger controlled studies with a strong implementation strategy are required to test potential outcome effects. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Importance of imaging diagnostics and interventional therapy for diseases of the lacrimal drainage canals

    International Nuclear Information System (INIS)

    Bink, A.; Berkefeld, J.; Luechtenberg, M.

    2008-01-01

    Epiphora (continuous watering of the eyes) is frequently caused by obstruction of the lacrimal draining system. Radiographic imaging of the tear ducts after contrast injection with the DSA (digital subtraction angiography) dacryocystography technique is still the gold standard in patients with severe epiphora which does not respond to conservative therapy. Recent techniques, such as 3D rotational dacryocystography, MRI and CT are able to show the anatomic surroundings in addition to the ductal structures and are especially useful for planning endoscopic operations. Dacryocystographically assisted interventions, such as balloon dilatation or stenting of tear duct stenoses are technically feasible. Balloon dacryocystoplasty is especially successful in patients with incomplete or short distance obstructions of the nasolacrimal duct. Stenting may improve procedural success and patency rates. Minimally invasive interventional therapy is useful as an initial treatment in selected cases, however, long-term success rates may be limited and operative dacryocystorhinostomy still plays an important role. Comparative studies for evaluation of different therapeutic options are necessary. (orig.) [de

  19. Minimization over randomly selected lines

    Directory of Open Access Journals (Sweden)

    Ismet Sahin

    2013-07-01

    Full Text Available This paper presents a population-based evolutionary optimization method for minimizing a given cost function. The mutation operator of this method selects randomly oriented lines in the cost function domain, constructs quadratic functions interpolating the cost function at three different points over each line, and uses extrema of the quadratics as mutated points. The crossover operator modifies each mutated point based on components of two points in population, instead of one point as is usually performed in other evolutionary algorithms. The stopping criterion of this method depends on the number of almost degenerate quadratics. We demonstrate that the proposed method with these mutation and crossover operations achieves faster and more robust convergence than the well-known Differential Evolution and Particle Swarm algorithms.

  20. Claus sulphur recovery potential approaches 99% while minimizing cost

    Energy Technology Data Exchange (ETDEWEB)

    Berlie, E M

    1974-01-21

    In a summary of a paper presented to the fourth joint engineering conference of the American Institute of Chemical Engineers and the Canadian Society for Chemical Engineering, the Claus process is discussed in a modern setting. Some problems faced in the operation of sulfur recovery plants include (1) strict pollution control regulations; (2) design and operation of existing plants; (3) knowledge of process fundamentals; (4) performance testing; (5) specification of feed gas; (6) catalyst life; (7) instrumentation and process control; and (8) quality of feed gas. Some of the factors which must be considered in order to achieve the ultimate capability of the Claus process are listed. There is strong evidence to support the contention that plant operators are reluctant to accept new fundamental knowledge of the Claus sulfur recovery process and are not taking advantage of its inherent potential to achieve the emission standards required, to minimize cost of tail gas cleanup systems and to minimize operating costs.

  1. Randomization in clinical trials: stratification or minimization? The HERMES free simulation software.

    Science.gov (United States)

    Fron Chabouis, Hélène; Chabouis, Francis; Gillaizeau, Florence; Durieux, Pierre; Chatellier, Gilles; Ruse, N Dorin; Attal, Jean-Pierre

    2014-01-01

    Operative clinical trials are often small and open-label. Randomization is therefore very important. Stratification and minimization are two randomization options in such trials. The first aim of this study was to compare stratification and minimization in terms of predictability and balance in order to help investigators choose the most appropriate allocation method. Our second aim was to evaluate the influence of various parameters on the performance of these techniques. The created software generated patients according to chosen trial parameters (e.g., number of important prognostic factors, number of operators or centers, etc.) and computed predictability and balance indicators for several stratification and minimization methods over a given number of simulations. Block size and proportion of random allocations could be chosen. A reference trial was chosen (50 patients, 1 prognostic factor, and 2 operators) and eight other trials derived from this reference trial were modeled. Predictability and balance indicators were calculated from 10,000 simulations per trial. Minimization performed better with complex trials (e.g., smaller sample size, increasing number of prognostic factors, and operators); stratification imbalance increased when the number of strata increased. An inverse correlation between imbalance and predictability was observed. A compromise between predictability and imbalance still has to be found by the investigator but our software (HERMES) gives concrete reasons for choosing between stratification and minimization; it can be downloaded free of charge. This software will help investigators choose the appropriate randomization method in future two-arm trials.

  2. Clinical application of an improved utero-operator in the interventional treatment of infertility

    International Nuclear Information System (INIS)

    Huang Yaoming; Zhang Guangfu; Li Detai

    2002-01-01

    Objective: To evaluate the effectiveness of an improved utero-operator in the interventional treatment of tube obstruction infertility, and to make a comparison with other methods. Methods: One hundred cases of infertile women with tubal obstruction were divided into 3 groups and treated separately under TV fluoroscopy with 3 different methods and follow-up examination was made up to 24 months. Among the 100 cases, 60 cases were treated with improved utero-operator (109 tubes), 20 with Cook cupped coaxial catheter (36 tubes), and 20 with emulsoid double-cavity tube (20 tubes). Result: Among the improved utero-operator group, Cook cupped coaxial catheter group, and emulsoid double-cavity tube group, the successful rate of selective catheterization was 92.7%, 80.6% and 80.0%, respectively. The successful rate of recanalization was 72.3%, 72.4% and 71.4%, respectively. The pregnancy rate was 36.4%, 35.7% and 36.4%, respectively. Improved utero-operator has the highest successful rate in selective catheterization (x 2 = 4.275, P < 0.05). Conclusion: Improved utero-operator has a high successful rate of selective catheterization in selective salpingography and treatment of tube obstruction infertility, and it is an easy and stable method which spends less time and received less X-ray. It is an ideal treating method at the moment

  3. Operative interventions for failed heller myotomy: a single institution experience.

    Science.gov (United States)

    Pallati, Pradeep K; Mittal, Sumeet K

    2011-03-01

    Recurrent dysphagia and/or gastroesophageal reflux (GER) are failures of treatment after Heller myotomy for achalasia. We present our single center experience with surgical interventions for these failures. We did a retrospective analysis of a prospectively collected database. Based on preoperative symptoms and endoscopy, esophagogram, and manometry results, patients were divided into three groups to guide management. Telephone follow-up was done using a structured foregut questionnaire. Between December 2003 and June 2009, 16 patients underwent operative interventions for disabling symptoms after previous Heller myotomy. Eight patients presented primarily with recurrent dysphagia and underwent transabdominal Heller myotomy with partial fundoplication. Seven patients reported good to excellent symptom relief at mean follow-up of 42 months. One patient reported no relief and eventually required esophageal bypass with retrosternal gastric pull-up. Four patients presented with uncontrolled GER. Two patients who underwent redo partial fundoplication reported poor symptomatic outcome and one patient has since undergone short limb Roux-en-y gastric bypass (SLRNYGB) with excellent symptom relief. The other two patients underwent SLRNYGB with excellent relief at 10 months. Four patients had end stage achalasia and underwent esophageal resection with reconstruction. All reported excellent symptom relief at mean follow-up of 36 months. Transabdominal redo Heller myotomy for dysphagia has good outcomes. Redo fundoplication for GER after previous myotomy has poor results and SLRNYGB is an effective option in these patients. Esophageal resection remains an effective, albeit morbid, option for end-stage achalasia.

  4. New trends in minimally invasive urological surgery

    Directory of Open Access Journals (Sweden)

    Prabhakar Rajan

    2009-10-01

    Full Text Available Purpose: The perceived benefits of minimally-invasive surgery include less postoperative pain, shorter hospitalization, reduced morbidity and better cosmesis while maintaining diagnostic accuracy and therapeutic outcome. We review the new trends in minimally-invasive urological surgery. Materials and method: We reviewed the English language literature using the National Library of Medicine database to identify the latest technological advances in minimally-invasive surgery with particular reference to urology. Results: Amongst other advances, studies incorporating needlescopic surgery, laparoendoscopic single-site surgery , magnetic anchoring and guidance systems, natural orifice transluminal endoscopic surgery and flexible robots were considered of interest. The results from initial animal and human studies are also outlined. Conclusion: Minimally-invasive surgery continues to evolve to meet the demands of the operators and patients. Many novel technologies are still in the testing phase, whilst others have entered clinical practice. Further evaluation is required to confirm the safety and efficacy of these techniques and validate the published reports.

  5. [Clinical use of interventional MR imaging].

    Science.gov (United States)

    Kahn, Thomas; Schulz, Thomas; Moche, Michael; Prothmann, Sascha; Schneider, Jens-Peter

    2003-01-01

    The integration of diagnostic and therapeutic procedures by MRI is based on the combination of excellent morphologic and functional imaging. The spectrum of MR-guided interventions includes biopsies, thermal ablation procedures, vascular applications, and intraoperative MRI. In all these applications, different scientific groups have obtained convincing results in basic developments as well as in clinical use. Interventional MRI (iMRI) is expected to attain an important role in interventional radiology, minimal invasive therapy, and monitoring of surgical procedures.

  6. Minimalism

    CERN Document Server

    Obendorf, Hartmut

    2009-01-01

    The notion of Minimalism is proposed as a theoretical tool supporting a more differentiated understanding of reduction and thus forms a standpoint that allows definition of aspects of simplicity. This book traces the development of minimalism, defines the four types of minimalism in interaction design, and looks at how to apply it.

  7. GPU-based RFA simulation for minimally invasive cancer treatment of liver tumours

    NARCIS (Netherlands)

    Mariappan, P.; Weir, P.; Flanagan, R.; Voglreiter, P.; Alhonnoro, T.; Pollari, M.; Moche, M.; Busse, H.; Futterer, J.J.; Portugaller, H.R.; Sequeiros, R.B.; Kolesnik, M.

    2017-01-01

    PURPOSE: Radiofrequency ablation (RFA) is one of the most popular and well-standardized minimally invasive cancer treatments (MICT) for liver tumours, employed where surgical resection has been contraindicated. Less-experienced interventional radiologists (IRs) require an appropriate planning tool

  8. Cardiac surgery or interventional cardiology? Why not both? Let's go hybrid.

    Science.gov (United States)

    Papakonstantinou, Nikolaos A; Baikoussis, Nikolaos G; Dedeilias, Panagiotis; Argiriou, Michalis; Charitos, Christos

    2017-01-01

    A hybrid strategy, firstly performed in the 1990s, is a combination of tools available only in the catheterization laboratory with those available only in the operating room in order to minimize surgical morbidity and face with any cardiovascular lesion. The continuous evolution of stent technology along with the adoption of minimally invasive surgical approaches, make hybrid approaches an attractive alternative to standard surgical or transcatheter techniques for any given set of cardiovascular lesions. Examples include hybrid coronary revascularization, when an open surgical anastomosis of the left internal mammary artery to the left anterior descending coronary artery is performed along with stent implantation in non-left anterior descending coronary vessels, open heart valve surgery combined with percutaneous coronary interventions to coronary lesions, hybrid aortic arch debranching combined with endovascular grafting for thoracic aortic aneurysms, hybrid endocardial and epicardial atrial fibrillation procedures, and carotid artery stenting along with coronary artery bypass grafting. The cornerstone of success for all of these methods is the productive collaboration between cardiac surgeons and interventional cardiologists. The indications and patient selection of these procedures are still to be defined. However, high-risk patients have already been shown to benefit from hybrid approaches. Copyright © 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  9. Recent advances in pediatric interventional cardiology.

    Science.gov (United States)

    Kim, Seong-Ho

    2017-08-01

    During the last 10 years, there have been major technological achievements in pediatric interventional cardiology. In addition, there have been several advances in cardiac imaging, especially in 3-dimensional imaging of echocardiography, computed tomography, magnetic resonance imaging, and cineangiography. Therefore, more types of congenital heart diseases can be treated in the cardiac catheter laboratory today than ever before. Furthermore, lesions previously considered resistant to interventional therapies can now be managed with high success rates. The hybrid approach has enabled the overcoming of limitations inherent to percutaneous access, expanding the application of endovascular therapies as adjunct to surgical interventions to improve patient outcomes and minimize invasiveness. Percutaneous pulmonary valve implantation has become a successful alternative therapy. However, most of the current recommendations about pediatric cardiac interventions (including class I recommendations) refer to off-label use of devices, because it is difficult to study the safety and efficacy of catheterization and transcatheter therapy in pediatric cardiac patients. This difficulty arises from the challenge of identifying a control population and the relatively small number of pediatric patients with congenital heart disease. Nevertheless, the pediatric interventional cardiology community has continued to develop less invasive solutions for congenital heart defects to minimize the need for open heart surgery and optimize overall outcomes. In this review, various interventional procedures in patients with congenital heart disease are explored.

  10. Interventional Cardiology for Congenital Heart Disease.

    Science.gov (United States)

    Kenny, Damien

    2018-05-01

    Congenital heart interventions are now replacing surgical palliation and correction in an evolving number of congenital heart defects. Right ventricular outflow tract and ductus arteriosus stenting have demonstrated favorable outcomes compared to surgical systemic to pulmonary artery shunting, and it is likely surgical pulmonary valve replacement will become an uncommon procedure within the next decade, mirroring current practices in the treatment of atrial septal defects. Challenges remain, including the lack of device design focused on smaller infants and the inevitable consequences of somatic growth. Increasing parental and physician expectancy has inevitably lead to higher risk interventions on smaller infants and appreciation of the consequences of these interventions on departmental outcome data needs to be considered. Registry data evaluating congenital heart interventions remain less robust than surgical registries, leading to a lack of insight into the longer-term consequences of our interventions. Increasing collaboration with surgical colleagues has not been met with necessary development of dedicated equipment for hybrid interventions aimed at minimizing the longer-term consequences of scar to the heart. Therefore, great challenges remain to ensure children and adults with congenital heart disease continue to benefit from an exponential growth in minimally invasive interventions and technology. This can only be achieved through a concerted collaborative approach from physicians, industry, academia and regulatory bodies supporting great innovators to continue the philosophy of thinking beyond the limits that has been the foundation of our specialty for the past 50 years. Copyright © 2018. The Korean Society of Cardiology.

  11. Laboratory waste minimization during the operation startup phase

    International Nuclear Information System (INIS)

    Morrison, J.A.

    1995-05-01

    The Waste Sampling and Characterization Facility (WSCF) Laboratory was opened for occupancy in October, 1994. It is the first of its kind on the Hanford Site, a low level lab located in an area of high level radiological material. The mission of the facility is to analyze process samples from two on-line effluent treatment plants. One of these plants is operating and the other is due to begin operations by the end of 1995. The VSCF also performs air sampling analysis for routine radiological surveillance filter papers drawn from around the Hanford Site. Because this type of laboratory had not been in operation before, there was only speculation about the types and amounts of waste that would be generated. The laboratory personnel assigned to WSCF were assembled from existing labs on the Hanford Site and from outside the Hanford Site community. For some, it was a first time experience working on a site where a twenty mile drive is sometimes required to visit another building. For others, it was a change in the way business is conducted using state-of-the-art equipment, a new building, and a chance to approach issues as a team from the beginning. It is how this team came together and the issues that were discussed, sometimes uncomfortably, that lead to the current success. The outcome of this process is discussed in this paper

  12. Operation and maintenance results from ISFOC CPV plants

    Science.gov (United States)

    Gil, Eduardo; Martinez, María; de la Rubia, Oscar

    2017-09-01

    The analysis of field operation and maintenance data collected during a period of over eight years, from CPV installations consisting of three different CPV technologies (including second generation of one of these technologies), has allowed us to get valuable information about the long-term degradation of the CPV systems. Through the study of the maintenance control ratio previously defined and by applying the root cause analysis methodology, the components responsible for the most unplanned interventions for each technology were identified. Focusing maintenance efforts on these components, a reduction of the unplanned interventions and the total cost of maintenance has been achieved over the years. Therefore, the deployment of an effective maintenance plan, identifying critical components, is essential to minimize the risk for investors and maximize the CPV power plants lifetime and energy output, increasing the availability of CPV installations, boosting market confidence in CPV systems.

  13. Generalized bi-quasi-variational inequalities for quasi-semi-monotone and bi-quasi-semi-monotone operators with applications in non-compact settings and minimization problems

    Directory of Open Access Journals (Sweden)

    Chowdhury Molhammad SR

    2000-01-01

    Full Text Available Results are obtained on existence theorems of generalized bi-quasi-variational inequalities for quasi-semi-monotone and bi-quasi-semi-monotone operators in both compact and non-compact settings. We shall use the concept of escaping sequences introduced by Border (Fixed Point Theorem with Applications to Economics and Game Theory, Cambridge University Press, Cambridge, 1985 to obtain results in non-compact settings. Existence theorems on non-compact generalized bi-complementarity problems for quasi-semi-monotone and bi-quasi-semi-monotone operators are also obtained. Moreover, as applications of some results of this paper on generalized bi-quasi-variational inequalities, we shall obtain existence of solutions for some kind of minimization problems with quasi- semi-monotone and bi-quasi-semi-monotone operators.

  14. Minimizing hydride cracking in zirconium alloys

    International Nuclear Information System (INIS)

    Coleman, C.E.; Cheadle, B.A.; Ambler, J.F.R.; Eadie, R.L.

    1985-01-01

    Zirconium alloy components can fail by hydride cracking if they contain large flaws and are highly stressed. If cracking in such components is suspected, crack growth can be minimized by following two simple operating rules: components should be heated up from at least 30K below any operating temperature above 450K, and when the component requires cooling to room temperature from a high temperature, any tensile stress should be reduced as much and as quickly as is practical during cooling. This paper describes the physical basis for these rules

  15. Waste Minimization Measurement and Progress Reporting

    International Nuclear Information System (INIS)

    Stone, K.A.

    1995-01-01

    Westinghouse Savannah River Company is implementing productivity improvement concepts into the Waste Minimization Program by focusing on the positive initiatives taken to reduce waste generation at the Savannah River Site. Previous performance measures, based only on waste generation rates, proved to be an ineffective metric for measuring performance and promoting continuous improvements within the Program. Impacts of mission changes and non-routine operations impeded development of baseline waste generation rates and often negated waste generation trending reports. A system was developed to quantify, document and track innovative activities that impact waste volume and radioactivity/toxicity reductions. This system coupled with Management-driven waste disposal avoidance goals is proving to be a powerful tool to promote waste minimization awareness and the implementation of waste reduction initiatives. Measurement of waste not generated, in addition to waste generated, increases the credibility of the Waste Minimization Program, improves sharing of success stories, and supports development of regulatory and management reports

  16. Study of the Operational Safety of a Vascular Interventional Surgical Robotic System

    Directory of Open Access Journals (Sweden)

    Jian Guo

    2018-03-01

    Full Text Available This paper proposes an operation safety early warning system based on LabView (2014, National Instruments Corporation, Austin, TX, USA for vascular interventional surgery (VIS robotic system. The system not only provides intuitive visual feedback information for the surgeon, but also has a safety early warning function. It is well known that blood vessels differ in their ability to withstand stress in different age groups, therefore, the operation safety early warning system based on LabView has a vascular safety threshold function that changes in real-time, which can be oriented to different age groups of patients and a broader applicable scope. In addition, the tracing performance of the slave manipulator to the master manipulator is also an important index for operation safety. Therefore, we also transformed the slave manipulator and integrated the displacement error compensation algorithm in order to improve the tracking ability of the slave manipulator to the master manipulator and reduce master–slave tracking errors. We performed experiments “in vitro” to validate the proposed system. According to previous studies, 0.12 N is the maximum force when the blood vessel wall has been penetrated. Experimental results showed that the proposed operation safety early warning system based on LabView combined with operating force feedback can effectively avoid excessive collisions between the surgical catheter and vessel wall to avoid vascular puncture. The force feedback error of the proposed system is maintained between ±20 mN, which is within the allowable safety range and meets our design requirements. Therefore, the proposed system can ensure the safety of surgery.

  17. Exposition of the operator's eye lens and efficacy of radiation shielding in fluoroscopically guided interventions

    International Nuclear Information System (INIS)

    Galster, M.; Adamus, R.; Guhl, C.; Uder, M.

    2013-01-01

    Purpose: Efficacy of radiation protection tools for the eye lens dose of the radiologist in fluoroscopic interventions. Materials and Methods: A patient phantom was exposed using a fluoroscopic system. Dose measurements were made at the eye location of the radiologist using an ionization chamber. The setting followed typical fluoroscopic interventions. The reduction of scattered radiation by the equipment-mounted shielding (undercouch drapes and overcouch top) was evaluated. The ceiling-suspended lead acrylic glass screen was tested in scattered radiation generated by a slab phantom. The protective properties of different lead glass goggles and lead acrylic visors were evaluated by thermoluminescence measurements on a head phantom in the primary beam. Results: The exposition of the lens of about 110 to 550 μSv during radiologic interventions is only slightly reduced by the undercouch drapes. Applying the top in addition to the drapes reduces the lens dose by a factor of 2 for PA projections. In 25 LAO the dose is reduced by a factor between 1.2 and 5. The highest doses were measured for AP angulations furthermore the efficacy of the equipment-mounted shielding is minimal. The ceiling-suspended lead screen reduced scatter by a factor of about 30. The lead glass goggles and visors reduced the lens dose up to a factor of 8 to 10. Depending on the specific design, the tested models are less effective especially for radiation from lateral with cranial angulation of the beam. Occasionally the visors even caused an increase of dose. Conclusion: The exposition of the eye lens can be kept below the new occupational limit recommended by the ICRP if the radiation shielding equipment is used consistently. (orig.)

  18. Minimal changes in health status questionnaires: distinction between minimally detectable change and minimally important change

    Directory of Open Access Journals (Sweden)

    Knol Dirk L

    2006-08-01

    Full Text Available Abstract Changes in scores on health status questionnaires are difficult to interpret. Several methods to determine minimally important changes (MICs have been proposed which can broadly be divided in distribution-based and anchor-based methods. Comparisons of these methods have led to insight into essential differences between these approaches. Some authors have tried to come to a uniform measure for the MIC, such as 0.5 standard deviation and the value of one standard error of measurement (SEM. Others have emphasized the diversity of MIC values, depending on the type of anchor, the definition of minimal importance on the anchor, and characteristics of the disease under study. A closer look makes clear that some distribution-based methods have been merely focused on minimally detectable changes. For assessing minimally important changes, anchor-based methods are preferred, as they include a definition of what is minimally important. Acknowledging the distinction between minimally detectable and minimally important changes is useful, not only to avoid confusion among MIC methods, but also to gain information on two important benchmarks on the scale of a health status measurement instrument. Appreciating the distinction, it becomes possible to judge whether the minimally detectable change of a measurement instrument is sufficiently small to detect minimally important changes.

  19. Optimizing Processes to Minimize Risk

    Science.gov (United States)

    Loyd, David

    2017-01-01

    NASA, like the other hazardous industries, has suffered very catastrophic losses. Human error will likely never be completely eliminated as a factor in our failures. When you can't eliminate risk, focus on mitigating the worst consequences and recovering operations. Bolstering processes to emphasize the role of integration and problem solving is key to success. Building an effective Safety Culture bolsters skill-based performance that minimizes risk and encourages successful engagement.

  20. 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.

  1. FNAL Booster intensity, extraction, and synchronization control for collider operation

    International Nuclear Information System (INIS)

    Ducar, R.J.; Lackey, J.R.; Tawzer, S.R.

    1987-03-01

    Booster operation for collider physics is considerably different than for fixed target operation. Various scenarios for collider physics, machine studies, and P-Bar targeting may require that the intensity vary from 5E10 PPP to 3E12 PPP at a 15 Hertz machine cycle rate. In addition to the normal Booster single turn extraction mode, collider operations require that the Booster inject into the Main Ring a small number of beam bunches for coalescing into a single high intensity bunch. These bunches must be synchronized such that the center bunch arrives in the RF bucket which corresponds to the zero phase of the coalescing cavity. The system implemented has the ability to deliver a precise fraction of the available 84 Booster beam bunches to Main Ring or to the P-Bar Debuncher via the newly installed AP-4 beam line for tune-up and studies. It is required that all of the various intensity and extraction scenarios be accommodated with minimal operator intervention

  2. French Reed Bed as a Solution to Minimize the Operational and Maintenance Costs of Wastewater Treatment from a Small Settlement: An Italian Example

    Directory of Open Access Journals (Sweden)

    Anacleto Rizzo

    2018-02-01

    Full Text Available French Reed Bed (FRB is a particular constructed wetland (CW solution which receives raw wastewater. Data from the full-scale FRB wastewater treatment plant of Castelluccio di Norcia (center of Italy were collected to show the FRB capability to minimize the operational and management (O&M costs. The system was designed to treat wastewater variable from 200 person equivalent (PE in off-season up to 1000 PE. Data from 2014 up to 2016 showed high removal efficiency in line with French experiences with FRBs. An interview was conducted with the Water Utility to estimate the operational and maintenance (O&M costs faced by the WWTP, which allowed us to detail the O&M costs for energy consumption, water quality samples, and personnel for inspection. Other O&M expenditure items were estimated on the basis of parametric costs from the executive design. The FRB O&M costs in euro for 500–1000 PE (6–11 € PE−1 year−1 resulted from 5 to 13 lower in comparison to those reported for classical activated sludge systems in an Italian context (45–90 € year−1. The low O&M costs are mainly due to the limited energy consumed and to the minimized costs of sludge management.

  3. Operational scale entomological intervention for malaria control: strategies, achievements and challenges in Zambia

    Directory of Open Access Journals (Sweden)

    Chanda Emmanuel

    2013-01-01

    Full Text Available Abstract Background While consensus on malaria vector control policy and strategy has stimulated unprecedented political-will, backed by international funding organizations and donors, vector control interventions are expansively being implemented based on assumptions with unequaled successes. This manuscript reports on the strategies, achievements and challenges of the past and contemporary malaria vector control efforts in Zambia. Case description All available information and accessible archived documentary records on malaria vector control in Zambia were reviewed. Retrospective analysis of routine surveillance data from the Health Management Information System (HMIS, data from population-based household surveys and various operations research reports was conducted to assess the status in implementing policies and strategies. Discussion and evaluation Empirical evidence is critical for informing policy decisions and tailoring interventions to local settings. Thus, the World Health Organization (WHO encourages the adoption of the integrated vector management (IVM strategy which is a rational decision making process for optimal use of available resources. One of the key features of IVM is capacity building at the operational level to plan, implement, monitor and evaluate vector control and its epidemiological and entomological impact. In Zambia, great progress has been made in implementing WHO-recommended vector control policies and strategies within the context of the IVM Global Strategic framework with strong adherence to its five key attributes. Conclusions The country has solid, consistent and coordinated policies, strategies and guidelines for malaria vector control. The Zambian experience demonstrates the significance of a coordinated multi-pronged IVM approach effectively operationalized within the context of a national health system.

  4. Active pixel as dosimetric device for interventional radiology

    International Nuclear Information System (INIS)

    Servoli, L.; Baldaccini, F.; Biasini, M.; Checcucci, B.; Chiocchini, S.; Cicioni, R.; Conti, E.; Di Lorenzo, R.; Dipilato, A.C.; Esposito, A.; Fanó, L.; Paolucci, M.; Passeri, D.; Pentiricci, A.

    2013-01-01

    Interventional Radiology (IR) is a subspecialty of radiology comprehensive of all minimally invasive diagnostic and therapeutic procedures performed using radiological devices to obtain image guidance. The interventional procedures are potentially harmful for interventional radiologists and medical staff due to the X-ray diffusion by the patient's body. The characteristic energy range of the diffused photons spans few tens of keV. In this work we will present a proposal for a new X-ray sensing element in the energy range of interest for IR procedures. The sensing element will then be assembled in a dosimeter prototype, capable of real-time measurement, packaged in a small form-factor, with wireless communication and no external power supply to be used for individual operators dosimetry for IR procedures. For the sensor, which is the heart of the system, we considered three different Active Pixel Sensors (APS). They have shown a good capability as single X-ray photon detectors, up to several tens keV photon energy. Two dosimetric quantities have been considered, the number of detected photons and the measured energy deposition. Both observables have a linear dependence with the dose, as measured by commercial dosimeters. The uncertainties in the measurement are dominated by statistic and can be pushed at ∼5% for all the sensors under test

  5. Hazardous waste minimization tracking system

    International Nuclear Information System (INIS)

    Railan, R.

    1994-01-01

    Under RCRA section 3002 9(b) and 3005f(h), hazardous waste generators and owners/operators of treatment, storage, and disposal facilities (TSDFs) are required to certify that they have a program in place to reduce the volume or quantity and toxicity of hazardous waste to the degree determined to be economically practicable. In many cases, there are environmental, as well as, economic benefits, for agencies that pursue pollution prevention options. Several state governments have already enacted waste minimization legislation (e.g., Massachusetts Toxic Use Reduction Act of 1989, and Oregon Toxic Use Reduction Act and Hazardous Waste Reduction Act, July 2, 1989). About twenty six other states have established legislation that will mandate some type of waste minimization program and/or facility planning. The need to address the HAZMIN (Hazardous Waste Minimization) Program at government agencies and private industries has prompted us to identify the importance of managing The HAZMIN Program, and tracking various aspects of the program, as well as the progress made in this area. The open-quotes WASTEclose quotes is a tracking system, which can be used and modified in maintaining the information related to Hazardous Waste Minimization Program, in a manageable fashion. This program maintains, modifies, and retrieves information related to hazardous waste minimization and recycling, and provides automated report generating capabilities. It has a built-in menu, which can be printed either in part or in full. There are instructions on preparing The Annual Waste Report, and The Annual Recycling Report. The program is very user friendly. This program is available in 3.5 inch or 5 1/4 inch floppy disks. A computer with 640K memory is required

  6. Use of MRI in interventions in head and neck surgery

    International Nuclear Information System (INIS)

    Schulz, T.; Schneider, J.P.; Schmidt, F.; Kahn, T.; Bootz, F.; Weber, A.; Weidenbach, H.; Heinke, W.; Koehler-Brock, A.

    2001-01-01

    Presentation of new concepts and applications of MR-guided head and neck surgery are presented. Examples of diagnostic and therapeutic procedures such as evaluation of transseptal tumor biopsies, placement of afterloading catheters for brachytherapy, and microscopic surgery of paranasal sinuses in the open MRI are discussed. Material and Methods: 24 MRI-guided ENT-procedures (14 transsphenoidal biopsies, one transnasal biopsy, 6 placements of brachytherapy catheters, and 3 operations of the paranasal sinuses) were performed in an open 0.5 T MR system. Results: localisation and/or extension of all lesions as well as the placement of biopsy needles or catheters were determined with great precision during the interventions. Conclusions: surgical risk and postoperative morbidity are significantly reduced in MR-guided surgery of the petroclival region and the region of head and neck compared to other, conventional methods. Thus, interventional MRI-guidance optimizes minimal invasive surgery and catheter placement in difficult anatomical regions like the petroclival region. (orig.) [de

  7. Minimal surfaces

    CERN Document Server

    Dierkes, Ulrich; Sauvigny, Friedrich; Jakob, Ruben; Kuster, Albrecht

    2010-01-01

    Minimal Surfaces is the first volume of a three volume treatise on minimal surfaces (Grundlehren Nr. 339-341). Each volume can be read and studied independently of the others. The central theme is boundary value problems for minimal surfaces. The treatise is a substantially revised and extended version of the monograph Minimal Surfaces I, II (Grundlehren Nr. 295 & 296). The first volume begins with an exposition of basic ideas of the theory of surfaces in three-dimensional Euclidean space, followed by an introduction of minimal surfaces as stationary points of area, or equivalently

  8. Hybrid genetic algorithm for minimizing non productive machining ...

    African Journals Online (AJOL)

    user

    The movement of tool is synchronized with the help of these CNC codes. Total ... Lot of work has been reported for minimizing the productive time by ..... Optimal path for automated drilling operations by a new heuristic approach using particle.

  9. Determining minimally important score differences in scales of the Copenhagen Psychosocial Questionnaire

    DEFF Research Database (Denmark)

    Pejtersen, Jan Hyld; Bjorner, Jakob Bue; Hasle, Peter

    2010-01-01

    AIM: To determine minimally important differences (MIDs) for scales in the first version of the Copenhagen Psychosocial Questionnaire (COPSOQ). METHODS: Data were taken from two separate studies: a national population survey (N = 1062), and an intervention study at 14 workplaces (N = 1505). On th...

  10. Waste minimization activity report for 1991

    International Nuclear Information System (INIS)

    Shoemaker, J.D.

    1992-01-01

    This is a waste reduction report for the Lawrence Livermore National Laboratory (LLNL) for 1991. The report covers the Main Site at Livermore and Site 300. Each research program at LLNL is described by its operation, administrative procedures, and waste minimization. Examples of the programs at LLNL are biomedical and environmental research, chemistry and materials science, and energy program and earth sciences. (MB)

  11. Application of minimally invasive technique in surgical treatment of pancreatic diseases

    Directory of Open Access Journals (Sweden)

    ZHANG Yixi

    2015-05-01

    Full Text Available In recent years, with the rapid development of minimally invasive concept, from laparoscopic operation to three-dimension laparoscopic technique and to robotic surgical system, treatment modalities have changed a lot. Pancreatic diseases, including multiple lesions, have different prognoses. An appropriate surgical procedure should be selected while ensuring the radical treatment of disease, so as to minimize the injury to patients and the impairment of organ function. Minimally invasive technique is of great significance in the surgical treatment of pancreatic diseases.

  12. Minimally Invasive Subcortical Parafascicular Transsulcal Access for Clot Evacuation (Mi SPACE for Intracerebral Hemorrhage

    Directory of Open Access Journals (Sweden)

    Benjamin Ritsma

    2014-01-01

    Full Text Available Background. Spontaneous intracerebral hemorrhage (ICH is common and causes significant mortality and morbidity. To date, optimal medical and surgical intervention remains uncertain. A lack of definitive benefit for operative management may be attributable to adverse surgical effect, collateral tissue injury. This is particularly relevant for ICH in dominant, eloquent cortex. Minimally invasive surgery (MIS offers the potential advantage of reduced collateral damage. MIS utilizing a parafascicular approach has demonstrated such benefit for intracranial tumor resection. Methods. We present a case of dominant hemisphere spontaneous ICH evacuated via the minimally invasive subcortical parafascicular transsulcal access clot evacuation (Mi SPACE model. We use this report to introduce Mi SPACE and to examine the application of this novel MIS paradigm. Case Presentation. The featured patient presented with a left temporal ICH and severe global aphasia. The hematoma was evacuated via the Mi SPACE approach. Postoperative reassessments showed significant improvement. At two months, bedside language testing was normal. MRI tractography confirmed limited collateral injury. Conclusions. This case illustrates successful application of the Mi SPACE model to ICH in dominant, eloquent cortex and subcortical regions. MRI tractography illustrates collateral tissue preservation. Safety and feasibility studies are required to further assess this promising new therapeutic paradigm.

  13. Advanced pyrochemical technologies for minimizing nuclear waste

    International Nuclear Information System (INIS)

    Bronson, M.C.; Dodson, K.E.; Riley, D.C.

    1994-01-01

    The Department of Energy (DOE) is seeking to reduce the size of the current nuclear weapons complex and consequently minimize operating costs. To meet this DOE objective, the national laboratories have been asked to develop advanced technologies that take uranium and plutonium, from retired weapons and prepare it for new weapons, long-term storage, and/or final disposition. Current pyrochemical processes generate residue salts and ceramic wastes that require aqueous processing to remove and recover the actinides. However, the aqueous treatment of these residues generates an estimated 100 liters of acidic transuranic (TRU) waste per kilogram of plutonium in the residue. Lawrence Livermore National Laboratory (LLNL) is developing pyrochemical techniques to eliminate, minimize, or more efficiently treat these residue streams. This paper will present technologies being developed at LLNL on advanced materials for actinide containment, reactors that minimize residues, and pyrochemical processes that remove actinides from waste salts

  14. [Exposition of the operator's eye lens and efficacy of radiation shielding in fluoroscopically guided interventions].

    Science.gov (United States)

    Galster, M; Guhl, C; Uder, M; Adamus, R

    2013-05-01

    Efficacy of radiation protection tools for the eye lens dose of the radiologist in fluoroscopic interventions. A patient phantom was exposed using a fluoroscopic system. Dose measurements were made at the eye location of the radiologist using an ionization chamber. The setting followed typical fluoroscopic interventions. The reduction of scattered radiation by the equipment-mounted shielding (undercouch drapes and overcouch top) was evaluated. The ceiling-suspended lead acrylic glass screen was tested in scattered radiation generated by a slab phantom. The protective properties of different lead glass goggles and lead acrylic visors were evaluated by thermoluminescence measurements on a head phantom in the primary beam. The exposition of the lens of about 110 to 550 μSv during radiologic interventions is only slightly reduced by the undercouch drapes. Applying the top in addition to the drapes reduces the lens dose by a factor of 2 for PA projections. In 25°LAO the dose is reduced by a factor between 1.2 and 5. The highest doses were measured for AP angulations furthermore the efficacy of the equipment-mounted shielding is minimal. The ceiling-suspended lead screen reduced scatter by a factor of about 30. The lead glass goggles and visors reduced the lens dose up to a factor of 8 to 10. Depending on the specific design, the tested models are less effective especially for radiation from lateral with cranial angulation of the beam. Occasionally the visors even caused an increase of dose. The exposition of the eye lens can be kept below the new occupational limit recommended by the ICRP if the radiation shielding equipment is used consistently. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Minimally invasive strabismus surgery versus paralimbal approach: A randomized, parallel design study is minimally invasive strabismus surgery worth the effort?

    Directory of Open Access Journals (Sweden)

    Richa Sharma

    2014-01-01

    Full Text Available Introduction : Minimal access surgery is common in all fields of medicine. We compared a new minimally invasive strabismus surgery (MISS approach with a standard paralimbal strabismus surgery (SPSS approach in terms of post-operative course. Materials and Methods: This parallel design study was done on 28 eyes of 14 patients, in which one eye was randomized to MISS and the other to SPSS. MISS was performed by giving two conjunctival incisions parallel to the horizontal rectus muscles; performing recession or resection below the conjunctival strip so obtained. We compared post-operative redness, congestion, chemosis, foreign body sensation (FBS, and drop intolerance (DI on a graded scale of 0 to 3 on post-operative day 1, at 2-3 weeks, and 6 weeks. In addition, all scores were added to obtain a total inflammatory score (TIS. Statistical Analysis: Inflammatory scores were analyzed using Wilcoxon′s signed rank test. Results: On the first post-operative day, only FBS (P = 0.01 and TIS (P = 0.04 showed significant difference favoring MISS. At 2-3 weeks, redness (P = 0.04, congestion (P = 0.04, FBS (P = 0.02, and TIS (P = 0.04 were significantly less in MISS eye. At 6 weeks, only redness (P = 0.04 and TIS (P = 0.05 were significantly less. Conclusion: MISS is more comfortable in the immediate post-operative period and provides better cosmesis in the intermediate period.

  16. Hybrid operating room concept for combined diagnostics, intervention and surgery in acute type A dissection.

    Science.gov (United States)

    Tsagakis, Konstantinos; Konorza, Thomas; Dohle, Daniel Sebastian; Kottenberg, Eva; Buck, Thomas; Thielmann, Matthias; Erbel, Raimund; Jakob, Heinz

    2013-02-01

    In acute type A dissection (AAAD), it is commonly decided to carry out immediate surgical repair without invasive diagnostics. The hybrid operating room (Hybrid OR) concept encompasses simultaneous haemodynamic control, non-invasive and invasive diagnostics and immediate surgical and/or interventional treatment. Results over a seven-year period are presented here. From March 2004 to March 2011, 1883 cardiological and surgical patients were treated in a Hybrid OR. Of these, 124 patients (age 60 ± 13, 64% male) diagnosed with AAAD were operated upon. External computed tomography (CT) was available for 87% (108/124) of cases and angiography in 15% (19/124). Preoperative transoesophageal echocardiography (TEE) was done in all patients and angiography in 57% (71/124). Surgery was performed without angiography in 27% (34/124), of which 14% (17/124) was due to shock. Postoperative control angiography followed in 18% (22/124) due to suspected ongoing malperfusion. Preoperative angiography was performed in 71 patients, and no angiography related complications were observed during the procedure. A total of 32% (23/71) of these underwent coronary artery bypass graft (CABG)--for newly-diagnosed coronary artery disease in 21% of cases and for coronary malperfusion in 11%. Visceral/peripheral malperfusion syndromes, necessitating primary endovascular intervention, were detected in 23% (16/71). Ascending aorta replacement was performed in 100% (124/124) of patients, arch replacement in 88% (109/124) and descending aorta repair in 35% (44/124). Five postoperative endovascular interventions became necessary due to persistent malperfusion. In-hospital mortality was 13% (12/90) in patients who had undergone preoperative invasive diagnostics and 24% (8/34) in patients who had not. The Hybrid OR concept enables the exact diagnosis of coronary status and downstream malperfusion sites and influences the design of surgical and/or endovascular treatment, without time delay and at

  17. Interventional techniques in medicine and radioprotection

    International Nuclear Information System (INIS)

    Le Guen, B.; Bar, O.; Benderitter, M.; Bourguignon, M.; Chevillard, S.; Gauron, Ch.; Lallemand, J.; Lombard, J.; Maccia, C.; Sapoval, M.; Bernier, M.O.; Pirard, Ph.; Jacob, S.; Donadille, L.; Aubert, B.; Clairand, I.; Mozziconacci, J.G.; Brot, A.M.; Jarrige, V.; Huet, Ch.; Marchal, C.; Martin, M.; Bar, O.; Degrange, J.P.; Livarek, B.; Menechal, Ph.; Sapoval, M.; Pellerin, O.

    2009-01-01

    This document gathers the slides of the available presentations given during this conference day. Nineteen presentations are assembled in the document and deal with: 1 - Interventional radiology: why is it developing? (M. Sapoval); 2 - exposure particularities in interventional radiology (O. Bar); 3 - doses received by organs in interventional cardiology (C. Maccia); 4 - Patients exposure: description of cumulated exposure of patients treated in interventional cardiology (M.O. Bernier); 5 - 2004 inquiry to dermatologists about post-interventional radiology radio-dermatitis (P. Pirard); 6 - exposure and risks to operators (S. Jacob); 7 - dosimetric evaluation techniques and results about interventional imaging operators' extremities (L. Donadille and F. Merat); 8 - bibliographic study of doses received by operators with non-protected organs (B. Aubert); 9 - ORAMED European project: optimization of operational dosimeter uses in interventional radiology (I. Clairand); 10 - reference levels and dosimetric evaluation of patients (C. Maccia); 11 - optimization in coronary angioplasty (J.G. Mozziconacci, A.M. Brot and V. Jarrige); 12 - dosimetry in medical over-exposure situation (C. Huet); 13 - significant radioprotection events in interventional radiology declared to the Nuclear Safety Authority (ASN) - status and experience feedback (C. Marchal); 14 - interventional radiology and unwanted effects (M. Benderitter); 15 - global analyses and new exposure indicators in human epidermis cells (M. Martin); 16 - radioprotection regulations and training (O. Bar); 17 - zoning and workplace analysis in interventional cardiology (J.P. Degrange); 18 - guide of good clinical practices: example of interventional cardiology (B. Livarek); 19 - how to encourage the radioprotection optimization in interventional radiology: the ASN's point of view (P. Menechal). (J.S.)

  18. The revised program for measurements in intense operation mode according to AVV-IMIS

    International Nuclear Information System (INIS)

    Bieringer, J.; Wirth, E.; Buehling, A.; Mueller-Neumann, M.; Haase, G.; Heinrich, T.; Steinkopff, T.; Wiezorek, C.

    2007-01-01

    The monitoring program for measurements in intense operation mode has been revised recently by a working group at the Federal Ministry for Environment, Nature Conservation and Reactor Safety (BMU). The major issues of the revision are reported in this contribution. Measurements in intense operation must be appropriate for fast assessment of the radiological situation, for estimating the dose to the population and for decisions on countermeasures to minimize the dose. In order to meet these requirements the structure of the measurement program in intense operation mode was divided into three phases when different exposition paths are relevant: before and during dispersion of radioactive material, immediately after dispersion of radioactive material has ended and a late phase when contamination values have decreased in different environmental media. For each of these phases a special measurement program was defined that is tailored to achieve the above mentioned objectives. Minimum detectable activity concentrations were introduced similar to the measurement program in routine operation mode. They follow the intervention levels in the catalogue of countermeasures and maximum permitted values given by the European Union (EU) for food and animal feed. The minimum detectable activity concentrations were defined such that the detection of 1/10 of the intervention levels for countermeasures is ensured. (orig.)

  19. 21 CFR 50.53 - Clinical investigations involving greater than minimal risk and no prospect of direct benefit to...

    Science.gov (United States)

    2010-04-01

    ... minimal risk and no prospect of direct benefit to individual subjects, but likely to yield generalizable... minimal risk and no prospect of direct benefit to individual subjects, but likely to yield generalizable... intervention or procedure that does not hold out the prospect of direct benefit for the individual subject, or...

  20. Optimal design method to minimize users' thinking mapping load in human-machine interactions.

    Science.gov (United States)

    Huang, Yanqun; Li, Xu; Zhang, Jie

    2015-01-01

    The discrepancy between human cognition and machine requirements/behaviors usually results in serious mental thinking mapping loads or even disasters in product operating. It is important to help people avoid human-machine interaction confusions and difficulties in today's mental work mastered society. Improving the usability of a product and minimizing user's thinking mapping and interpreting load in human-machine interactions. An optimal human-machine interface design method is introduced, which is based on the purpose of minimizing the mental load in thinking mapping process between users' intentions and affordance of product interface states. By analyzing the users' thinking mapping problem, an operating action model is constructed. According to human natural instincts and acquired knowledge, an expected ideal design with minimized thinking loads is uniquely determined at first. Then, creative alternatives, in terms of the way human obtains operational information, are provided as digital interface states datasets. In the last, using the cluster analysis method, an optimum solution is picked out from alternatives, by calculating the distances between two datasets. Considering multiple factors to minimize users' thinking mapping loads, a solution nearest to the ideal value is found in the human-car interaction design case. The clustering results show its effectiveness in finding an optimum solution to the mental load minimizing problems in human-machine interaction design.

  1. Clinical Efficacy of Simulated Vitreoretinal Surgery to Prepare Surgeons for the Upcoming Intervention in the Operating Room.

    Science.gov (United States)

    Deuchler, Svenja; Wagner, Clemens; Singh, Pankaj; Müller, Michael; Al-Dwairi, Rami; Benjilali, Rachid; Schill, Markus; Ackermann, Hanns; Bon, Dimitra; Kohnen, Thomas; Schoene, Benjamin; Koss, Michael; Koch, Frank

    2016-01-01

    To evaluate the efficacy of the virtual reality training simulator Eyesi to prepare surgeons for performing pars plana vitrectomies and its potential to predict the surgeons' performance. In a preparation phase, four participating vitreoretinal surgeons performed repeated simulator training with predefined tasks. If a surgeon was assigned to perform a vitrectomy for the management of complex retinal detachment after a surgical break of at least 60 hours it was randomly decided whether a warmup training on the simulator was required (n = 9) or not (n = 12). Performance at the simulator was measured using the built-in scoring metrics. The surgical performance was determined by two blinded observers who analyzed the video-recorded interventions. One of them repeated the analysis to check for intra-observer consistency. The surgical performance of the interventions with and without simulator training was compared. In addition, for the surgeries with simulator training, the simulator performance was compared to the performance in the operating room. Comparing each surgeon's performance with and without warmup trainingshowed a significant effect of warmup training onto the final outcome in the operating room. For the surgeries that were preceeded by the warmup procedure, the performance at the simulator was compared with the operating room performance. We found that there is a significant relation. The governing factor of low scores in the simulator were iatrogenic retinal holes, bleedings and lens damage. Surgeons who caused minor damage in the simulation also performed well in the operating room. Despite the large variation of conditions, the effect of a warmup training as well as a relation between the performance at the simulator and in the operating room was found with statistical significance. Simulator training is able to serve as a warmup to increase the average performance.

  2. Clinical Efficacy of Simulated Vitreoretinal Surgery to Prepare Surgeons for the Upcoming Intervention in the Operating Room.

    Directory of Open Access Journals (Sweden)

    Svenja Deuchler

    Full Text Available To evaluate the efficacy of the virtual reality training simulator Eyesi to prepare surgeons for performing pars plana vitrectomies and its potential to predict the surgeons' performance.In a preparation phase, four participating vitreoretinal surgeons performed repeated simulator training with predefined tasks. If a surgeon was assigned to perform a vitrectomy for the management of complex retinal detachment after a surgical break of at least 60 hours it was randomly decided whether a warmup training on the simulator was required (n = 9 or not (n = 12. Performance at the simulator was measured using the built-in scoring metrics. The surgical performance was determined by two blinded observers who analyzed the video-recorded interventions. One of them repeated the analysis to check for intra-observer consistency. The surgical performance of the interventions with and without simulator training was compared. In addition, for the surgeries with simulator training, the simulator performance was compared to the performance in the operating room.Comparing each surgeon's performance with and without warmup trainingshowed a significant effect of warmup training onto the final outcome in the operating room. For the surgeries that were preceeded by the warmup procedure, the performance at the simulator was compared with the operating room performance. We found that there is a significant relation. The governing factor of low scores in the simulator were iatrogenic retinal holes, bleedings and lens damage. Surgeons who caused minor damage in the simulation also performed well in the operating room.Despite the large variation of conditions, the effect of a warmup training as well as a relation between the performance at the simulator and in the operating room was found with statistical significance. Simulator training is able to serve as a warmup to increase the average performance.

  3. Bootstrap regularity for integro-differential operators and its application to nonlocal minimal surfaces

    OpenAIRE

    Barrera, Begoña Barrios; Figalli, Alessio; Valdinoci, Enrico

    2012-01-01

    We prove that $C^{1,\\alpha}$ $s$-minimal surfaces are automatically $C^\\infty$. For this, we develop a new bootstrap regularity theory for solutions of integro-differential equations of very general type, which we believe is of independent interest.

  4. Minimal contact psychotherapy for sub-threshold depression in primary care: a randomised trial.

    NARCIS (Netherlands)

    Willemse, G.R.W.M.; Smit, F.; Cuijpers, W.J.M.J.; Tiemens, B.G.

    2004-01-01

    Background: Sub-threshold depression is a prognostic variable for major depression. Interventions in sub-threshold depression may prevent the onset of new cases of major depression. Aims: To examine the effects of minimal-contact psychotherapy in primary care patients with sub-threshold depression

  5. Waste minimization at Chalk River Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Kranz, P.; Wong, P.C.F. [Atomic Energy of Canada Limited, Chalk River, ON (Canada)

    2011-07-01

    Waste minimization supports Atomic Energy of Canada Limited (AECL) Environment Policy with regard to pollution prevention and has positive impacts on the environment, human health and safety, and economy. In accordance with the principle of pollution prevention, the quantities and degree of hazard of wastes requiring storage or disposition at facilities within or external to AECL sites shall be minimized, following the principles of Prevent, Reduce, Reuse, and Recycle, to the extent practical. Waste minimization is an important element in the Waste Management Program. The Waste Management Program has implemented various initiatives for waste minimization since 2007. The key initiatives have focused on waste reduction, segregation and recycling, and included: 1) developed waste minimization requirements and recycling procedure to establish the framework for applying the Waste Minimization Hierarchy; 2) performed waste minimization assessments for the facilities, which generate significant amounts of waste, to identify the opportunities for waste reduction and assist the waste generators to develop waste reduction targets and action plans to achieve the targets; 3) implemented the colour-coded, standardized waste and recycling containers to enhance waste segregation; 4) established partnership with external agents for recycling; 5) extended the likely clean waste and recyclables collection to selected active areas; 6) provided on-going communications to promote waste reduction and increase awareness for recycling; and 7) continually monitored performance, with respect to waste minimization, to identify opportunities for improvement and to communicate these improvements. After implementation of waste minimization initiatives at CRL, the solid waste volume generated from routine operations at CRL has significantly decreased, while the amount of recyclables diverted from the onsite landfill has significantly increased since 2007. The overall refuse volume generated at

  6. Waste minimization at Chalk River Laboratories

    International Nuclear Information System (INIS)

    Kranz, P.; Wong, P.C.F.

    2011-01-01

    Waste minimization supports Atomic Energy of Canada Limited (AECL) Environment Policy with regard to pollution prevention and has positive impacts on the environment, human health and safety, and economy. In accordance with the principle of pollution prevention, the quantities and degree of hazard of wastes requiring storage or disposition at facilities within or external to AECL sites shall be minimized, following the principles of Prevent, Reduce, Reuse, and Recycle, to the extent practical. Waste minimization is an important element in the Waste Management Program. The Waste Management Program has implemented various initiatives for waste minimization since 2007. The key initiatives have focused on waste reduction, segregation and recycling, and included: 1) developed waste minimization requirements and recycling procedure to establish the framework for applying the Waste Minimization Hierarchy; 2) performed waste minimization assessments for the facilities, which generate significant amounts of waste, to identify the opportunities for waste reduction and assist the waste generators to develop waste reduction targets and action plans to achieve the targets; 3) implemented the colour-coded, standardized waste and recycling containers to enhance waste segregation; 4) established partnership with external agents for recycling; 5) extended the likely clean waste and recyclables collection to selected active areas; 6) provided on-going communications to promote waste reduction and increase awareness for recycling; and 7) continually monitored performance, with respect to waste minimization, to identify opportunities for improvement and to communicate these improvements. After implementation of waste minimization initiatives at CRL, the solid waste volume generated from routine operations at CRL has significantly decreased, while the amount of recyclables diverted from the onsite landfill has significantly increased since 2007. The overall refuse volume generated at

  7. Optimization at different loads by minimization of irreversibilities

    International Nuclear Information System (INIS)

    Wong, K.F.V.; Niu, Z.

    1991-01-01

    This paper reports that the irreversibility of the power cycle was chosen as the objective function as this function can successfully measure both the quality and quantity of energy flow in the cycle. Minimization of the irreversibility ensures that the power cycle will operate more efficiently. One feature of the present work is that the boiler, turbine, condenser and heaters are treated as one system for the purpose of optimization. In the optimization model, nine regression formulae are used, which are obtained from the measured test data. From the results of the present work, it can be seen that the optimization model developed can represent the effect of operational parameters on the power plant first and second law efficiency. Some of the results can be used to provide guidance for the optimal operation of the power plant. When the power cycle works at full load, the main steam temperature and pressure should be at the upper limit for minimal irreversibility of the system. If the load is less than 65% of its design capacity, the steam temperature and pressure should be decreased for a lower irreversibility of the system

  8. Minimizing the health and climate impacts of emissions from heavy-duty public transportation bus fleets through operational optimization.

    Science.gov (United States)

    Gouge, Brian; Dowlatabadi, Hadi; Ries, Francis J

    2013-04-16

    In contrast to capital control strategies (i.e., investments in new technology), the potential of operational control strategies (e.g., vehicle scheduling optimization) to reduce the health and climate impacts of the emissions from public transportation bus fleets has not been widely considered. This case study demonstrates that heterogeneity in the emission levels of different bus technologies and the exposure potential of bus routes can be exploited though optimization (e.g., how vehicles are assigned to routes) to minimize these impacts as well as operating costs. The magnitude of the benefits of the optimization depend on the specific transit system and region. Health impacts were found to be particularly sensitive to different vehicle assignments and ranged from worst to best case assignment by more than a factor of 2, suggesting there is significant potential to reduce health impacts. Trade-offs between climate, health, and cost objectives were also found. Transit agencies that do not consider these objectives in an integrated framework and, for example, optimize for costs and/or climate impacts alone, risk inadvertently increasing health impacts by as much as 49%. Cost-benefit analysis was used to evaluate trade-offs between objectives, but large uncertainties make identifying an optimal solution challenging.

  9. Current status of pediatric minimal access surgery at Sultan Qaboos ...

    African Journals Online (AJOL)

    Keywords: current status, laparoscopy, minimal access surgery, thoracoscopy. Departments of ... Materials and methods ... procedures, the open technique was used for the creation ... operated for bilateral inguinal herniotomy had recurrence.

  10. Minimal cut-set methodology for artificial intelligence applications

    International Nuclear Information System (INIS)

    Weisbin, C.R.; de Saussure, G.; Barhen, J.; Oblow, E.M.; White, J.C.

    1984-01-01

    This paper reviews minimal cut-set theory and illustrates its application with an example. The minimal cut-set approach uses disjunctive normal form in Boolean algebra and various Boolean operators to simplify very complicated tree structures composed of AND/OR gates. The simplification process is automated and performed off-line using existing computer codes to implement the Boolean reduction on the finite, but large tree structure. With this approach, on-line expert diagnostic systems whose response time is critical, could determine directly whether a goal is achievable by comparing the actual system state to a concisely stored set of preprocessed critical state elements

  11. Minimally verbal school-aged children with autism spectrum disorder: the neglected end of the spectrum.

    Science.gov (United States)

    Tager-Flusberg, Helen; Kasari, Connie

    2013-12-01

    It is currently estimated that about 30% of children with autism spectrum disorder remain minimally verbal, even after receiving years of interventions and a range of educational opportunities. Very little is known about the individuals at this end of the autism spectrum, in part because this is a highly variable population with no single set of defining characteristics or patterns of skills or deficits, and in part because it is extremely challenging to provide reliable or valid assessments of their developmental functioning. In this paper, we summarize current knowledge based on research including minimally verbal children. We review promising new novel methods for assessing the verbal and nonverbal abilities of minimally verbal school-aged children, including eye-tracking and brain-imaging methods that do not require overt responses. We then review what is known about interventions that may be effective in improving language and communication skills, including discussion of both nonaugmentative and augmentative methods. In the final section of the paper, we discuss the gaps in the literature and needs for future research. © 2013 International Society for Autism Research, Wiley Periodicals, Inc.

  12. Interventional magnetic resonance imaging

    International Nuclear Information System (INIS)

    Debatin, J.F.; Adam, G.

    1998-01-01

    With the advent of open configuration MR imaging systems, the vision of MRI-based guidance, control, and monitoring of minimally invasive interventions has evolved from a hypothetical concept to a practical possibility. This book provides a comprehensive overview of the very exciting emerging field of interventional MRI. The international authorship provides firsthand experience of all relevant topics. This book will familiarize the reader with the basic principles underlying currently available hardware and software configurations. In addition, technical aspects of thermosensitive imaging, techniques for instrument visualization, and safety aspects are covered. Finally, the book emphasizes both existing and future clinical applications. (orig.)

  13. Manually operated pile driver for use in the south Iraqi Marshlands

    Directory of Open Access Journals (Sweden)

    Massimo Monti

    2013-09-01

    Full Text Available Anthropizations are necessary to implement the maintenance, recovery and utilization of wetlands. These interventions should be sustainable in every sense, in particular they should be marked by a low environmental impact. In general this aim can be achieved by using natural materials and carrying out procedures minimally invasive. In Developing Countries the latter point is often supported by the lack of equipment and energy availability, normally obtainable in Industrialized Countries. In practice, to build micro-infrastructures with the above said characteristics, it is normally necessary to drive poles, in our case in wood, in marshland’s soil. In order to accomplish this task a manually operated pile driver was designed and built. To operate in the water, a floating pier consisting of removable modular elements was also designed.

  14. Real-time integration of 3-D multimodality data in interventional neuroangiography

    NARCIS (Netherlands)

    Ruijters, D.; Babic, D.; Homan, R.; Mielekamp, P.; Haar Romenij, ter B.M.; Suetens, P.

    2009-01-01

    We describe a novel approach to using soft-tissue data sets, such as computer tomography on magnetic resonance, in the minimally invasive image guidance of intra-arterial and intravenous endovascular devices in neuroangiography interventions. Minimally invasive x-ray angiography procedures rely on

  15. Minimally Invasive Spine Metastatic Tumor Resection and Stabilization: New Technology Yield Improved Outcome

    Directory of Open Access Journals (Sweden)

    Ran Harel

    2015-01-01

    Full Text Available Spinal metastases compressing the spinal cord are a medical emergency and should be operated on if possible; however, patients’ medical condition is often poor and surgical complications are common. Minimizing surgical extant, operative time, and blood loss can potentially reduce postoperative complications. This is a retrospective study describing the patients operated on in our department utilizing a minimally invasive surgery (MIS approach to decompress and instrument the spine from November 2013 to November 2014. Five patients were operated on for thoracic or lumbar metastases. In all cases a unilateral decompression with expandable tubular retractor was followed by instrumentation of one level above and below the index level and additional screw at the index level contralateral to the decompression side. Cannulated fenestrated screws were used (Longitude FNS and cement was injected to increase pullout resistance. Mean operative time was 134 minutes and estimated blood loss was minimal in all cases. Improvement was noticeable in neurological status, function, and pain scores. No complications were observed. Technological improvements in spinal instruments facilitate shorter and safer surgeries in oncologic patient population and thus reduce the complication rate. These technologies improve patients’ quality of life and enable the treatment of patients with comorbidities.

  16. Installations of in-vivo nuclear medicine: Minimal technical rules of design, operation and maintenance. Guide Nr 32 - Release of the 2017/05/24

    International Nuclear Information System (INIS)

    2017-01-01

    After having evoked the regulatory context, this document details the different articles contained by a decision taken by the ASN in October 2014 to define the minimal technical rules of design, operation and maintenance of installations dedicated to in-vivo nuclear medicine. It is therefore written for the different professions involved in nuclear medicine, and its content is to be reflected by modifications introduced in the French labour code and public health code. The following issues and aspects are addressed: general principles adopted for the decision, design rules (for premises, for equipments and for premises ventilation), operation rules (general and specific rules), and various and transient measures. For each of these issues, the texts of concerned articles are indicated and their content is then explained in a detailed way

  17. Estimation and Minimization of Embodied Carbon of Buildings: A Review

    Directory of Open Access Journals (Sweden)

    Ali Akbarnezhad

    2017-01-01

    Full Text Available Building and construction is responsible for up to 30% of annual global greenhouse gas (GHG emissions, commonly reported in carbon equivalent unit. Carbon emissions are incurred in all stages of a building’s life cycle and are generally categorised into operating carbon and embodied carbon, each making varying contributions to the life cycle carbon depending on the building’s characteristics. With recent advances in reducing the operating carbon of buildings, the available literature indicates a clear shift in attention towards investigating strategies to minimize embodied carbon. However, minimizing the embodied carbon of buildings is challenging and requires evaluating the effects of embodied carbon reduction strategies on the emissions incurred in different life cycle phases, as well as the operating carbon of the building. In this paper, the available literature on strategies for reducing the embodied carbon of buildings, as well as methods for estimating the embodied carbon of buildings, is reviewed and the strengths and weaknesses of each method are highlighted.

  18. Minimally invasive oesophagectomy more expensive than open despite shorter length of stay.

    Science.gov (United States)

    Dhamija, Anish; Dhamija, Ankit; Hancock, Jacquelyn; McCloskey, Barbara; Kim, Anthony W; Detterbeck, Frank C; Boffa, Daniel J

    2014-05-01

    The minimally invasive oesophagectomy (MIO) approach offers a number of advantages over open approaches including reduced discomfort, shorter length of stay and a faster recovery to baseline status. On the other hand, minimally invasive procedures typically are longer and consume greater disposable instrumentation, potentially resulting in a greater overall cost. The objective of this study was to compare costs associated with various oesophagectomy approaches for oesophageal cancer. An institutional Resource Information Management System (RIMS) was queried for cost data relating to hospital expenditures (as opposed to billings or collections). The RIMS was searched for patients undergoing oesophagectomy for oesophageal cancer between 2003 and 2012 via minimally invasive, open transthoracic (OTT) (including Ivor Lewis, modified McKeown or thoracoabdominal) or transhiatal approaches. Patients that were converted from minimally invasive to open, or involved hybrid procedures, were excluded. A total of 160 oesophagectomies were identified, including 61 minimally invasive, 35 open transthoracic and 64 transhiatal. Costs on the day of surgery averaged higher in the MIO group ($12 476 ± 2190) compared with the open groups, OTT ($8202 ± 2512, P < 0.0001) or OTH ($5809 ± 2575, P < 0.0001). The median costs associated with the entire hospitalization also appear to be higher in the MIO group ($25 935) compared with OTT ($24 440) and OTH ($15 248). The average length of stay was lowest in the MIO group (11 ± 9 days) compared with OTT (19 ± 18 days, P = 0.006) and OTH (18 ± 28 days P = 0.07). The operative mortality was similar in the three groups (MIO = 3%, OTT = 9% and OTH = 3%). The operating theatre costs associated with minimally invasive oesophagectomy are significantly higher than OTT or OTH approaches. Unfortunately, a shorter hospital stay after MIO does not consistently offset higher surgical expense, as total hospital costs trend higher in the MIO patients. In

  19. Techniques for Interventional MRI Guidance in Closed-Bore Systems.

    Science.gov (United States)

    Busse, Harald; Kahn, Thomas; Moche, Michael

    2018-02-01

    Efficient image guidance is the basis for minimally invasive interventions. In comparison with X-ray, computed tomography (CT), or ultrasound imaging, magnetic resonance imaging (MRI) provides the best soft tissue contrast without ionizing radiation and is therefore predestined for procedural control. But MRI is also characterized by spatial constraints, electromagnetic interactions, long imaging times, and resulting workflow issues. Although many technical requirements have been met over the years-most notably magnetic resonance (MR) compatibility of tools, interventional pulse sequences, and powerful processing hardware and software-there is still a large variety of stand-alone devices and systems for specific procedures only.Stereotactic guidance with the table outside the magnet is common and relies on proper registration of the guiding grids or manipulators to the MR images. Instrument tracking, often by optical sensing, can be added to provide the physicians with proper eye-hand coordination during their navigated approach. Only in very short wide-bore systems, needles can be advanced at the extended arm under near real-time imaging. In standard magnets, control and workflow may be improved by remote operation using robotic or manual driving elements.This work highlights a number of devices and techniques for different interventional settings with a focus on percutaneous, interstitial procedures in different organ regions. The goal is to identify technical and procedural elements that might be relevant for interventional guidance in a broader context, independent of the clinical application given here. Key challenges remain the seamless integration into the interventional workflow, safe clinical translation, and proper cost effectiveness.

  20. Treatment of Pseudoarthrosis After Minimally Invasive Hallux Valgus ...

    African Journals Online (AJOL)

    access techniques enable correction of 80-90% of hallux valgus deformities solely via hallux manipulation without removal of the eminence or open lateral release yielding more than 90% excellent and good results.[2,4,5] Nonunion is rarely reported. We describe our operative technique for nonunion following minimally ...

  1. Laparoscopic subtotal hysterectomy in the era of minimally invasive surgery

    Directory of Open Access Journals (Sweden)

    Chia-Jen Wu

    2015-02-01

    Full Text Available According to a nation-wide population-based study in Taiwan, along with the expanding concepts and surgical techniques of minimally invasive surgery, laparoscopic supracervical/subtotal hysterectomy (LSH has been blooming. Despite this, the role of LSH in the era of minimally invasive surgery remains uncertain. In this review, we tried to evaluate the perioperative and postoperative outcomes of LSH compared to other types of hysterectomy, including total abdominal hysterectomy (TAH, vaginal hysterectomy, laparoscopic-assisted vaginal hysterectomy, and total laparoscopic hysterectomy (TLH. From the literature, LSH has a better perioperative outcome than TAH, and comparable perioperative complications compared with laparoscopic-assisted vaginal hysterectomy. LSH had less bladder injury, vaginal cuff bleeding, hematoma, infection, and dehiscence requiring re-operation compared with TLH. Despite this, LSH has more postoperative cyclic menstrual bleeding and re-operations with extirpations of the cervical stump. LSH does, however, have a shorter recovery time than TAH due to the minimally invasive approach; and there is quicker resumption of coitus than TLH, due to cervical preservation and the avoidance of vaginal cuff dehiscence. LSH is therefore an alternative option when the removal of the cervix is not strictly necessary or desired. Nevertheless, the risk of further cervical malignancy, postoperative cyclic menstrual bleeding, and re-operations with extirpations of the cervical stump is a concern when discussing the advantages and disadvantages of LSH with patients.

  2. Westinghouse Hanford Company waste minimization and pollution prevention awareness program plan

    International Nuclear Information System (INIS)

    Craig, P.A.; Nichols, D.H.; Lindsey, D.W.

    1991-08-01

    The purpose of this plan is to establish the Westinghouse Hanford Company's Waste Minimization Program. The plan specifies activities and methods that will be employed to reduce the quantity and toxicity of waste generated at Westinghouse Hanford Company (Westinghouse Hanford). It is designed to satisfy the US Department of Energy (DOE) and other legal requirements that are discussed in Subsection C of the section. The Pollution Prevention Awareness Program is included with the Waste Minimization Program as permitted by DOE Order 5400.1 (DOE 1988a). This plan is based on the Hanford Site Waste Minimization and Pollution Prevention Awareness Program Plan, which directs DOE Field Office, Richland contractors to develop and maintain a waste minimization program. This waste minimization program is an organized, comprehensive, and continual effort to systematically reduce waste generation. The Westinghouse Hanford Waste Minimization Program is designed to prevent or minimize pollutant releases to all environmental media from all aspects of Westinghouse Hanford operations and offers increased protection of public health and the environment. 14 refs., 2 figs., 1 tab

  3. Minimally Invasive Catheter Procedures to Assist Complicated Pacemaker Lead Extraction and Implantation in the Operating Room

    International Nuclear Information System (INIS)

    Kröpil, Patric; Lanzman, Rotem S.; Miese, Falk R.; Blondin, Dirk; Winter, Joachim; Scherer, Axel; Fürst, Günter

    2011-01-01

    We report on percutaneous catheter procedures in the operating room (OR) to assist complicated manual extraction or insertion of pacemaker (PM) and implantable cardioverter defibrillator leads. We retrospectively reviewed complicated PM revisions and implantations performed between 2004 and 2009 that required percutaneous catheter procedures performed in the OR. The type of interventional procedure, catheter and retrieval system used, venous access, success rates, and procedural complications were analyzed. In 41 (12 female and 29 male [mean age 62 ± 17 years]) of 3021 (1.4%) patients, standard manual retrieval of old leads or insertion of new leads was not achievable and thus required percutaneous catheter intervention for retrieval of misplaced leads and/or recanalisation of occluded central veins. Thirteen of 18 (72.2%) catheter-guided retrieval procedures for misplaced (right atrium [RA] or ventricle [RV; n = 3], superior vena cava [n = 2], brachiocephalic vein [n = 5], and subclavian vein [n = 3]) lead fragments in 16 patients were successful. Percutaneous catheter retrieval failed in five patients because there were extremely fixed or adhered lead fragments. Percutaneous transluminal angiography (PTA) of central veins for occlusion or high-grade stenosis was performed in 25 patients. In 22 of 25 patients (88%), recanalization of central veins was successful, thus enabling subsequent lead replacement. Major periprocedural complications were not observed. In the case of complicated manual PM lead implantation or revision, percutaneous catheter-guided extraction of misplaced lead fragments or recanalisation of central veins can be performed safely in the OR, thus enabling subsequent implantation or revision of PM systems in the majority of patients.

  4. 8. The operational processes.

    Science.gov (United States)

    2014-05-01

    There are two principal directions that disaster studies pursue: (1) interventional; and (2) noninterventional. Interventional studies are used to evaluate specific responses as to their effectiveness in meeting their respective objectives, their contribution to the overarching goal, the efficiency with which they are able to achieve their objectives, other effects created, and their respective costs. On the other hand, noninterventional studies examine the epidemiology of disasters and for the most part are observational. Both interventional and noninterventional studies require data/information obtained from assessments. This section of these Guidelines examines the operational framework used to study interventions/responses and includes the following processes: (1) assessments, (2) identification of needs; (3) strategic planning; (4) selection of intervention(s); (5) operational planning; (6) execution of interventions; and (7) monitoring and evaluation of effects and changes in levels of functions resulting from the intervention(s) being studied.

  5. Promoting interventional radiology in clinical practice of emergency medicine

    International Nuclear Information System (INIS)

    Zhou Bing; Yuan Jianhua

    2009-01-01

    Interventional radiology has lot of advantages in dealing with various emergencies. The technique is minimally-invasive, highly-effective and immediately-efficient, moreover, it integrates the diagnosis with the therapy perfectly. Besides, the interventional techniques applied in emergency medicine include not only the vascular interventions,such as embolization, embolectomy, etc, but also the nonvascular interventions, such as tracheal s tent implantation, percutaneous vertebroplasty and so forth. However, importance has not been attached to the clinical use of interventional therapy in emergency medicine so far. It is imperative for us to promote the acceptance of interventional therapy in emergency medicine as well as to popularize the technique in clinical practice. (authors)

  6. On the non-minimal character of the SMEFT

    DEFF Research Database (Denmark)

    Jiang, Yun; Trott, Michael Robert

    2017-01-01

    When integrating out unknown new physics sectors, what is the minimal character of the Standard Model Effective Field Theory (SMEFT) that can result? In this paper we focus on a particular aspect of this question: “How can one obtain only one dimension six operator in the SMEFT from a consistent...

  7. Occupational radiation exposure at the Eurochemic reprocessing plant during normal operation and intervention periods

    International Nuclear Information System (INIS)

    Osipenco, A.

    1980-01-01

    The Eurochemic reprocessing plant is a direct-maintenance, demonstration facility. From 1966 to 1974 it has processed about 180 tonnes of natural or low-enriched uranium, mainly as oxide, and about 30 tonnes of alloys of aluminium and highly enriched uranium. In this period, the operation was stopped for the time necessary to build and connect a new unit for the separation and purification of plutonium. As from 1975, all equipment was rinsed in order to put the plant in standby, some particular equipment was dismantled and a campaign of systematic decontamination was started. Simultaneously, the necessary steps were taken for the solidification and conditioning for storage or disposal of the wastes produced during the operation of the plant. The methods used to determine the individual doses due to external or internal irradiation are shortly described, as well as the rules set up for limiting these doses or for authorizing planned exposures. For the period 1966-1978 the paper shows the distribution of yearly individual and collective doses recorded for the permanent staff and for workers occupied for limited times. Correlations are shown between the absorbed doses and the nature of the work (normal operation, intervention, etc.) or the function in the enterprise (operation, maintenance, health physics, etc.). A small number of incidents leading to intakes or doses higher than normal did occur. However, experience has shown that careful planning and close collaboration between operational and health physics staff have resulted in keeping the doses within the authorized limits. (author)

  8. Radiological protection optimization derived from radiation induced lesions in interventional cardiology finding

    International Nuclear Information System (INIS)

    Vano, E.; Arranz, L.; Sastre, J.M.; Ferrer, N.

    1997-01-01

    Interventional Cardiology is one of the specialties in which patients are submitted to the greatest radiation doses with x ray systems used for diagnostic purposes and then, it is also a specialty of high occupational radiation risk. In the last years, several cases of radiation induced lesions produced on patients derived of new complex interventional procedures have been described. As consequence, different rules for avoiding this kind of incidents have been recommended by International Organisations and regulatory Bodies. Nevertheless it has been devoted relatively few attention to the evaluation of the occupational risks that inevitably are also high in these facilities. In this work, some cases of radioinduced skin lesions produced on patients submitted to cardiac ablation procedures are described. Radiological protection considerations of interest for the regulatory Bodies are made, that permit to minimize the probability of these incidents, in what to the X-rays equipment is referred as well as to the operation procedures and level of radiation protection training of the medical specialists. (author)

  9. Hyperparathyroidism in octogenarians: A plea for ambulatory minimally invasive surgery under local anesthesia.

    Science.gov (United States)

    Fui, Stéphanie Li Sun; Bonnichon, Philippe; Bonni, Nicolas; Delbot, Thierry; André, Jean Pascal; Pion-Graff, Joëlle; Berrod, Jean-Louis; Fontaine, Marine; Brunaud, Catherine; Cocagne, Nicolas

    2016-10-01

    With the current aging of the world's population, diagnosis of primary hyperparathyroidism is being reported in increasingly older patients, with the associated functional symptomatology exacerbating the vicissitudes of age. This retrospective study was designed to establish functional improvements in older patients following parathyroid adenomectomy under local anesthesia as outpatient surgery. Data were collected from 53 patients aged 80 years or older who underwent a minimally invasive parathyroid adenomectomy. All patients underwent a preoperative ultrasound, scintigraphy, and were monitored for the effectiveness of the procedure according to intra- and postdosage of parathyroid hormone (PTH) at 5min, 2h and 4h. Mean preoperative serum calcium level was 2.8mmol/L (112mg/L) and mean PTH was 180pg/ml. Thirty-eight patients were operated under local anesthesia using minimally invasive surgery and 18 patients were operated under general anesthesia. In 26 cases, the procedure was planned on an outpatient basis but could only be carried out in 21 patients. Fifty-one patients had normal serum calcium and PTH levels during the immediate postoperative period. Two patients were reoperated under general anesthesia, since immediate postoperative PTH did not return to normal. Four patients died due to reasons unrelated to hyperparathyroidism. Five patients were lost to follow-up six months to two years postsurgery. Of the 44 patients (83%) with long-term monitoring for PTH, none had recurrence of biological hyperparathyroidism. Excluding the three asymptomatic patients, 38 of the 41 symptomatic patients (93%) with long-term follow-up were considering themselves as "improved" or "strongly improved" after the intervention, notably with respect to fatigue, muscle and bone pain. Two patients (4.9%) reported no difference and one patient (2.4%) said her condition had worsened and regretted having undergone surgery. In patients 80 years or older, minimally invasive surgery as an

  10. minimal pairs of polytopes and their number of vertices

    African Journals Online (AJOL)

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    Using this operation we give a new algorithm to reduce and find a minimal pair of polytopes from the given ... Key words/phrases: Pairs of compact convex sets, Blaschke addition, Minkowski sum, mnimality ... product K(X)×K(X) by K2. (X).

  11. Exploring the minimal 4D N=1 SCFT

    Energy Technology Data Exchange (ETDEWEB)

    Poland, David [Department of Physics, Yale University,New Haven, CT 06520 (United States); School of Natural Sciences, Institute for Advanced Study,Princeton, NJ 08540 (United States); Stergiou, Andreas [Department of Physics, Yale University,New Haven, CT 06520 (United States)

    2015-12-17

    We study the conformal bootstrap constraints for 4D N=1 superconformal field theories containing a chiral operator ϕ and the chiral ring relation ϕ{sup 2}=0. Hints for a minimal interacting SCFT in this class have appeared in previous numerical bootstrap studies. We perform a detailed study of the properties of this conjectured theory, establishing that the corresponding solution to the bootstrap constraints contains a U(1){sub R} current multiplet and estimating the central charge and low-lying operator spectrum of this theory.

  12. Navigation concepts for MR image-guided interventions.

    Science.gov (United States)

    Moche, Michael; Trampel, Robert; Kahn, Thomas; Busse, Harald

    2008-02-01

    The ongoing development of powerful magnetic resonance imaging techniques also allows for advanced possibilities to guide and control minimally invasive interventions. Various navigation concepts have been described for practically all regions of the body. The specific advantages and limitations of these concepts largely depend on the magnet design of the MR scanner and the interventional environment. Open MR scanners involve minimal patient transfer, which improves the interventional workflow and reduces the need for coregistration, ie, the mapping of spatial coordinates between imaging and intervention position. Most diagnostic scanners, in contrast, do not allow the physician to guide his instrument inside the magnet and, consequently, the patient needs to be moved out of the bore. Although adequate coregistration and navigation concepts for closed-bore scanners are technically more challenging, many developments are driven by the well-known capabilities of high-field systems and their better economic value. Advanced concepts such as multimodal overlays, augmented reality displays, and robotic assistance devices are still in their infancy but might propel the use of intraoperative navigation. The goal of this work is to give an update on MRI-based navigation and related techniques and to briefly discuss the clinical experience and limitations of some selected systems. (Copyright) 2008 Wiley-Liss, Inc.

  13. Automated economic analysis model for hazardous waste minimization

    International Nuclear Information System (INIS)

    Dharmavaram, S.; Mount, J.B.; Donahue, B.A.

    1990-01-01

    The US Army has established a policy of achieving a 50 percent reduction in hazardous waste generation by the end of 1992. To assist the Army in reaching this goal, the Environmental Division of the US Army Construction Engineering Research Laboratory (USACERL) designed the Economic Analysis Model for Hazardous Waste Minimization (EAHWM). The EAHWM was designed to allow the user to evaluate the life cycle costs for various techniques used in hazardous waste minimization and to compare them to the life cycle costs of current operating practices. The program was developed in C language on an IBM compatible PC and is consistent with other pertinent models for performing economic analyses. The potential hierarchical minimization categories used in EAHWM include source reduction, recovery and/or reuse, and treatment. Although treatment is no longer an acceptable minimization option, its use is widespread and has therefore been addressed in the model. The model allows for economic analysis for minimization of the Army's six most important hazardous waste streams. These include, solvents, paint stripping wastes, metal plating wastes, industrial waste-sludges, used oils, and batteries and battery electrolytes. The EAHWM also includes a general application which can be used to calculate and compare the life cycle costs for minimization alternatives of any waste stream, hazardous or non-hazardous. The EAHWM has been fully tested and implemented in more than 60 Army installations in the United States

  14. Session: Avoiding, minimizing, and mitigating avian and bat impacts

    Energy Technology Data Exchange (ETDEWEB)

    Thelander, Carl; Kerlinger, Paul

    2004-09-01

    This session at the Wind Energy and Birds/Bats workshop consisted of two presentations followed by a discussion/question answer period. The session addressed a variety of questions related to avoiding, minimizing, and mitigating the avian and bat impacts of wind power development including: what has been learned from operating turbines and mitigating impacts where they are unavoidable, such as at Altamont Pass WRA, and should there be mitigation measures such as habitat creation or land conservation where impacts occur. Other impact minimization and mitigation approaches discussed included: location and siting evaluations; options for construction and operation of wind facilities; turbine lighting; and the physical alignment/orientation. Titles and authors of the presentations were: 'Bird Fatalities in the Altamont Pass Wind Resource Area: A Case Study, Part II' by Carl Thelander and 'Prevention and Mitigation of Avian Impacts at Wind Power Facilities' by Paul Kerlinger.

  15. Session: Avoiding, minimizing, and mitigating avian and bat impacts

    International Nuclear Information System (INIS)

    Thelander, Carl; Kerlinger, Paul

    2004-01-01

    This session at the Wind Energy and Birds/Bats workshop consisted of two presentations followed by a discussion/question answer period. The session addressed a variety of questions related to avoiding, minimizing, and mitigating the avian and bat impacts of wind power development including: what has been learned from operating turbines and mitigating impacts where they are unavoidable, such as at Altamont Pass WRA, and should there be mitigation measures such as habitat creation or land conservation where impacts occur. Other impact minimization and mitigation approaches discussed included: location and siting evaluations; options for construction and operation of wind facilities; turbine lighting; and the physical alignment/orientation. Titles and authors of the presentations were: 'Bird Fatalities in the Altamont Pass Wind Resource Area: A Case Study, Part II' by Carl Thelander and 'Prevention and Mitigation of Avian Impacts at Wind Power Facilities' by Paul Kerlinger

  16. Navicular stress fractures treated with minimally invasive fixation

    Directory of Open Access Journals (Sweden)

    Korula Mani Jacob

    2013-01-01

    Early intervention with minimally invasive surgery has significantly less morbidity and a reliable early return to active sports and is therefore the best option in high-performance athletes. Materials and Methods: Nine athletes with ten stress fractures of the navicular treated at our institution between April 1991 and October 2000. The mean age of the patients was 22.8 years (range 18-50 years. All patients were treated by minimally invasive screw fixation and early weight bearing mobilization without a cast. The average followup was 7 years (range 2-11 years. Results: Seven of the nine patients returned to their pre-fracture level of sporting activity at an average of 5 months (range 3-9 months. One patient returned to full sporting activity following a delay of 2 years due to an associated tibial stress fracture and one patient had an unsatisfactory result. Long term review at an average of 7 years showed that six of these eight patients who returned to sports remained symptom free with two patients experiencing minimal intermittent discomfort after prolonged activity. Conclusions: We recommend percutaneous screw fixation as a reliable, low morbidity procedure allowing early return to full sporting activity without long term complications or recurrences.

  17. Interactive intervention planning in particle accelerator environments with ionizing radiation

    CERN Document Server

    Fabry, Thomas; Baudin, Mathieu; Theis, Chris; Braesch, Christian; Feral, Bruno

    2013-01-01

    A core issue during the planning of a maintenance intervention in a facility with ionizing radiation is the minimization of the integrated equivalent dose contracted by the maintenance workers during the intervention. In this work, we lay down the concepts for intervention planning in an irradiated environment and present a new software program for intervention planning, which provides interactive visualization of facilities and radiation levels, as well as tools for interactive trajectory planning. The software includes automatic calculation of the expected integrated equivalent radiation dose contracted during an intervention.

  18. Interactive intervention planning in particle accelerator environments with ionizing radiation

    Energy Technology Data Exchange (ETDEWEB)

    Fabry, Thomas, E-mail: thomas.fabry@cern.ch [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland); Vanherpe, Liesbeth [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland); Baudin, Mathieu [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland); LCPI, ENSAM ParisTech, 151 Boulevard de l' Hôpital, 75013 Paris (France); Theis, Chris [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland); Braesch, Christian [SYMME, Université de Savoie, Polytech Annecy-Chambry, 5 chemin de Bellevue, 74944 Annecy le Vieux (France); Feral, Bruno [European Organization for Nuclear Research, CERN, CH-1211 Genève 23 (Switzerland)

    2013-04-21

    A core issue during the planning of a maintenance intervention in a facility with ionizing radiation is the minimization of the integrated equivalent dose contracted by the maintenance workers during the intervention. In this work, we lay down the concepts for intervention planning in an irradiated environment and present a new software program for intervention planning, which provides interactive visualization of facilities and radiation levels, as well as tools for interactive trajectory planning. The software includes automatic calculation of the expected integrated equivalent radiation dose contracted during an intervention.

  19. Interactive intervention planning in particle accelerator environments with ionizing radiation

    International Nuclear Information System (INIS)

    Fabry, Thomas; Vanherpe, Liesbeth; Baudin, Mathieu; Theis, Chris; Braesch, Christian; Feral, Bruno

    2013-01-01

    A core issue during the planning of a maintenance intervention in a facility with ionizing radiation is the minimization of the integrated equivalent dose contracted by the maintenance workers during the intervention. In this work, we lay down the concepts for intervention planning in an irradiated environment and present a new software program for intervention planning, which provides interactive visualization of facilities and radiation levels, as well as tools for interactive trajectory planning. The software includes automatic calculation of the expected integrated equivalent radiation dose contracted during an intervention

  20. Optimization for a fuel cell/battery/capacity tram with equivalent consumption minimization strategy

    International Nuclear Information System (INIS)

    Zhang, Wenbin; Li, Jianqiu; Xu, Liangfei; Ouyang, Minggao

    2017-01-01

    Highlights: • The hybridization of the fuel cell with the energy storage systems is realized for the tram. • A protype tram is tested based on an operation mode switching method. • An equivalent consumption minimization strategy is proposed and verified for optimization. - Abstract: This paper describes a hybrid tram powered by a Proton Exchange Membrane (PEM) fuel cell (FC) stack supported by an energy storage system (ESS) composed of a Li-ion battery (LB) pack and an ultra-capacitor (UC) pack. This configuration allows the tram to operate without grid connection. The hybrid tram with its full load is tested in the CRRC Qingdao Sifang Co.; Ltd. It firstly works on the operation mode switching method (OPMS) without energy regenerative and proper power management. Therefore, an equivalent consumption minimization strategy (ECMS) aimed at minimizing the hydrogen consumption is proposed to improve the characteristics of the tram. The results show that the proposed control system enhances drivability and economy, and is effective for application to this hybrid system.

  1. [Minimal emotional dysfunction and first impression formation in personality disorders].

    Science.gov (United States)

    Linden, M; Vilain, M

    2011-01-01

    "Minimal cerebral dysfunctions" are isolated impairments of basic mental functions, which are elements of complex functions like speech. The best described are cognitive dysfunctions such as reading and writing problems, dyscalculia, attention deficits, but also motor dysfunctions such as problems with articulation, hyperactivity or impulsivity. Personality disorders can be characterized by isolated emotional dysfunctions in relation to emotional adequacy, intensity and responsivity. For example, paranoid personality disorders can be characterized by continuous and inadequate distrust, as a disorder of emotional adequacy. Schizoid personality disorders can be characterized by low expressive emotionality, as a disorder of effect intensity, or dissocial personality disorders can be characterized by emotional non-responsivity. Minimal emotional dysfunctions cause interactional misunderstandings because of the psychology of "first impression formation". Studies have shown that in 100 ms persons build up complex and lasting emotional judgements about other persons. Therefore, minimal emotional dysfunctions result in interactional problems and adjustment disorders and in corresponding cognitive schemata.From the concept of minimal emotional dysfunctions specific psychotherapeutic interventions in respect to the patient-therapist relationship, the diagnostic process, the clarification of emotions and reality testing, and especially an understanding of personality disorders as impairment and "selection, optimization, and compensation" as a way of coping can be derived.

  2. An Equivalent Emission Minimization Strategy for Causal Optimal Control of Diesel Engines

    Directory of Open Access Journals (Sweden)

    Stephan Zentner

    2014-02-01

    Full Text Available One of the main challenges during the development of operating strategies for modern diesel engines is the reduction of the CO2 emissions, while complying with ever more stringent limits for the pollutant emissions. The inherent trade-off between the emissions of CO2 and pollutants renders a simultaneous reduction difficult. Therefore, an optimal operating strategy is sought that yields minimal CO2 emissions, while holding the cumulative pollutant emissions at the allowed level. Such an operating strategy can be obtained offline by solving a constrained optimal control problem. However, the final-value constraint on the cumulated pollutant emissions prevents this approach from being adopted for causal control. This paper proposes a framework for causal optimal control of diesel engines. The optimization problem can be solved online when the constrained minimization of the CO2 emissions is reformulated as an unconstrained minimization of the CO2 emissions and the weighted pollutant emissions (i.e., equivalent emissions. However, the weighting factors are not known a priori. A method for the online calculation of these weighting factors is proposed. It is based on the Hamilton–Jacobi–Bellman (HJB equation and a physically motivated approximation of the optimal cost-to-go. A case study shows that the causal control strategy defined by the online calculation of the equivalence factor and the minimization of the equivalent emissions is only slightly inferior to the non-causal offline optimization, while being applicable to online control.

  3. Interventional MR imaging: state of the art and future perspectives

    International Nuclear Information System (INIS)

    Kahn, T.; Moedder, U.

    1998-01-01

    The concept of MR guidance of invasive diagnostic and minimally invasive therapeutic procedures is based on the excellent morphologic and functional properties of MR imaging. Prerequisites are adequate patient monitoring and adherence to safety guidelines. Fast and ultrafast sequences, temperature quantification, visualization of intravascular devices, thermal stability of contrast media and thermosensitive contrast media are discussed. The spectrum of clinical applications includes biopsies, thermal ablation modalities, vascular applications, MR endoscopy and intraoperative MR imaging. The development of interventional MR imaging is still in its infancy. In the future, MR imaging may play an important role in interventional radiology and minimally invasive therapy. (orig.) [de

  4. 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 .

  5. Minimally Invasive Spinal Surgery with Intraoperative Image-Guided Navigation

    Directory of Open Access Journals (Sweden)

    Terrence T. Kim

    2016-01-01

    Full Text Available We present our perioperative minimally invasive spine surgery technique using intraoperative computed tomography image-guided navigation for the treatment of various lumbar spine pathologies. We present an illustrative case of a patient undergoing minimally invasive percutaneous posterior spinal fusion assisted by the O-arm system with navigation. We discuss the literature and the advantages of the technique over fluoroscopic imaging methods: lower occupational radiation exposure for operative room personnel, reduced need for postoperative imaging, and decreased revision rates. Most importantly, we demonstrate that use of intraoperative cone beam CT image-guided navigation has been reported to increase accuracy.

  6. Wilson expansion in the minimal subtraction scheme

    International Nuclear Information System (INIS)

    Smirnov, V.A.

    1989-01-01

    The small distance expansion of the product of composite fields is constructed for an arbitrary renormalization procedure of the type of minimal subtraction scheme. Coefficient functions of the expansion are expressed explicitly through the Green functions of composite fields. The expansion has the explicity finite form: the ultraviolet (UV) divergences of the coefficient functions and composite fields are removed by the initial renormalization procedure while the infrared (IR) divergences in massless diagrams with nonvanishing contribution into the coefficient functions are removed by the R-operation which is the IR part of the R-operation. The latter is the generalization of the dimensional renormalization in the case when both UV and IR divergences are present. To derive the expansion, a ''pre-subtracting operator'' is introduced and formulas of the counter-term technique are exploited

  7. Study of the parameters affecting operator doses in interventional radiology using Monte Carlo simulations

    International Nuclear Information System (INIS)

    Koukorava, C.; Carinou, E.; Ferrari, P.; Krim, S.; Struelens, L.

    2011-01-01

    Measurements performed within the ORAMED project helped to evaluate the dose levels to the operators’ hands, wrists, legs and eye lenses, during several types of interventional radiology (IR) and cardiology (IC) procedures, and also to determine the parameters that affect the doses. However, the study of the effect of each parameter separately, was possible only through Monte Carlo (MC) simulations, as in clinical practice many of those parameters change simultaneously. The influence of the protective equipment, the beam projections, the beam quality, the field size and the position of the operator according to the position of access of the catheter was investigated, using anthropomorphic phantoms in setups that represent realistic IR/IC procedures. The proper use of protective shields was found to be the most important way of reducing extremity and eye lens exposure during such examinations. Ceiling suspended shields can reduce the doses to the eye lenses up to 97%, but they can also reduce hand doses about 70% when placed correctly. The highest exposure to the operator is observed for left anterior oblique (LAO) and cranial projections. Additionally, for overcouch irradiations the eyes and the hands are about 6 times more exposed compared to the cases where the tube is below the operating table. For the lateral LAO projection, placing the ceiling suspended shield at the left side of the operator is twice more effective for the protection of the eyes compared to the cases where it is placed above the patient. Finally, beam collimation was found to play an important role in the reduction of the hands and wrists doses, especially when the operator is close to the irradiation field.

  8. Television Violence: An Intervention to Reduce Its Impact on Children

    Science.gov (United States)

    Rosenkoetter, Lawrence I.; Rosenkoetter, Sharon E.; Acock, Alan C.

    2008-01-01

    In an attempt to minimize the adverse effects of television violence, the authors implemented a classroom-based intervention with 496 children in 32 classrooms (grades 1 to 4). The intervention consisted of 28 brief lessons conducted by university staff over the course of 7 months. Participants were individually interviewed prior to the…

  9. Accelerated Desensitization and Adaptive Attitudes Interventions and Test Gains with Academic Probation Students

    Science.gov (United States)

    Driscoll, Richard; Holt, Bruce; Hunter, Lori

    2005-01-01

    The study evaluates the test-gain benefits of an accelerated desensitization and adaptive attitudes intervention for test-anxious students. College students were screened for high test anxiety. Twenty anxious students, half of them on academic probation, were assigned to an Intervention or to a minimal treatment Control group. The Intervention was…

  10. Minimal Liouville gravity correlation numbers from Douglas string equation

    International Nuclear Information System (INIS)

    Belavin, Alexander; Dubrovin, Boris; Mukhametzhanov, Baur

    2014-01-01

    We continue the study of (q,p) Minimal Liouville Gravity with the help of Douglas string equation. We generalize the results of http://dx.doi.org/10.1016/0550-3213(91)90548-Chttp://dx.doi.org/10.1088/1751-8113/42/30/304004, where Lee-Yang series (2,2s+1) was studied, to (3,3s+p 0 ) Minimal Liouville Gravity, where p 0 =1,2. We demonstrate that there exist such coordinates τ m,n on the space of the perturbed Minimal Liouville Gravity theories, in which the partition function of the theory is determined by the Douglas string equation. The coordinates τ m,n are related in a non-linear fashion to the natural coupling constants λ m,n of the perturbations of Minimal Lioville Gravity by the physical operators O m,n . We find this relation from the requirement that the correlation numbers in Minimal Liouville Gravity must satisfy the conformal and fusion selection rules. After fixing this relation we compute three- and four-point correlation numbers when they are not zero. The results are in agreement with the direct calculations in Minimal Liouville Gravity available in the literature http://dx.doi.org/10.1103/PhysRevLett.66.2051http://dx.doi.org/10.1007/s11232-005-0003-3http://dx.doi.org/10.1007/s11232-006-0075-8

  11. First Consensus on Primary Prevention and Early Intervention in Aesthetic Medicine.

    Science.gov (United States)

    Landau, Marina; Anand, Chytra V; Besins, Thierry; Chao, Yates Yen Yu; Fabi, Sabrina Guillen; Gout, Uliana; Kerscher, Martina; Pavicic, Tatjana; Peng, Peter Hsien Li; Rzany, Berthold; Sattler, Gerhard; Tiryaki, Tunk; Waldorf, Heidi A; Braz, Andre

    2017-09-01

    Facial aging is a complex interplay of extrinsic and intrinsic factors leading to progressive changes in the skin, subcutaneous tissue, and bone. Clinical experience suggests that early aesthetic intervention may slow the signs of aging, but treatment in the absence of symptoms or with minimal signs of aging has not yet been properly addressed. To provide treatment recommendations for primary prevention and early intervention in individuals with no or minimal signs of aging. Fourteen specialists in aesthetic medicine convened over a full-day meeting under the guidance of a certified moderator. Tailored treatment recommendations have been provided for prevention and early intervention of fine wrinkles, static lines and folds, irregular pigmentation, laxity, and subcutaneous volume loss by protecting the epidermis, stimulating neocollagenesis, reducing hyperkinetic musculature, and reinforcing supporting structures. Preventive measures and early therapeutic interventions that may alter the course of facial aging were defined. Further studies are needed to support these recommendations with the best possible evidence. J Drugs Dermatol. 2017;16(9):846-854..

  12. Computers and the Environment: Minimizing the Carbon Footprint

    Science.gov (United States)

    Kaestner, Rich

    2009-01-01

    Computers can be good and bad for the environment; one can maximize the good and minimize the bad. When dealing with environmental issues, it's difficult to ignore the computing infrastructure. With an operations carbon footprint equal to the airline industry's, computer energy use is only part of the problem; everyone is also dealing with the use…

  13. Opportunity Loss Minimization and Newsvendor Behavior

    Directory of Open Access Journals (Sweden)

    Xinsheng Xu

    2017-01-01

    Full Text Available To study the decision bias in newsvendor behavior, this paper introduces an opportunity loss minimization criterion into the newsvendor model with backordering. We apply the Conditional Value-at-Risk (CVaR measure to hedge against the potential risks from newsvendor’s order decision. We obtain the optimal order quantities for a newsvendor to minimize the expected opportunity loss and CVaR of opportunity loss. It is proven that the newsvendor’s optimal order quantity is related to the density function of market demand when the newsvendor exhibits risk-averse preference, which is inconsistent with the results in Schweitzer and Cachon (2000. The numerical example shows that the optimal order quantity that minimizes CVaR of opportunity loss is bigger than expected profit maximization (EPM order quantity for high-profit products and smaller than EPM order quantity for low-profit products, which is different from the experimental results in Schweitzer and Cachon (2000. A sensitivity analysis of changing the operation parameters of the two optimal order quantities is discussed. Our results confirm that high return implies high risk, while low risk comes with low return. Based on the results, some managerial insights are suggested for the risk management of the newsvendor model with backordering.

  14. [Minimally invasive coronary artery surgery].

    Science.gov (United States)

    Zalaquett, R; Howard, M; Irarrázaval, M J; Morán, S; Maturana, G; Becker, P; Medel, J; Sacco, C; Lema, G; Canessa, R; Cruz, F

    1999-01-01

    There is a growing interest to perform a left internal mammary artery (LIMA) graft to the left anterior descending coronary artery (LAD) on a beating heart through a minimally invasive access to the chest cavity. To report the experience with minimally invasive coronary artery surgery. Analysis of 11 patients aged 48 to 79 years old with single vessel disease that, between 1996 and 1997, had a LIMA graft to the LAD performed through a minimally invasive left anterior mediastinotomy, without cardiopulmonary bypass. A 6 to 10 cm left parasternal incision was done. The LIMA to the LAD anastomosis was done after pharmacological heart rate and blood pressure control and a period of ischemic pre conditioning. Graft patency was confirmed intraoperatively by standard Doppler techniques. Patients were followed for a mean of 11.6 months (7-15 months). All patients were extubated in the operating room and transferred out of the intensive care unit on the next morning. Seven patients were discharged on the third postoperative day. Duplex scanning confirmed graft patency in all patients before discharge; in two patients, it was confirmed additionally by arteriography. There was no hospital mortality, no perioperative myocardial infarction and no bleeding problems. After follow up, ten patients were free of angina, in functional class I and pleased with the surgical and cosmetic results. One patient developed atypical angina on the seventh postoperative month and a selective arteriography confirmed stenosis of the anastomosis. A successful angioplasty of the original LAD lesion was carried out. A minimally invasive left anterior mediastinotomy is a good surgical access to perform a successful LIMA to LAD graft without cardiopulmonary bypass, allowing a shorter hospital stay and earlier postoperative recovery. However, a larger experience and a longer follow up is required to define its role in the treatment of coronary artery disease.

  15. The effect of pre-operative optimization on post-operative outcome in Crohn's disease resections

    DEFF Research Database (Denmark)

    El-Hussuna, Alaa; Iesalnieks, Igors; Horesh, Nir

    2017-01-01

    BACKGROUND: The timing of surgical intervention in Crohn's disease (CD) may depend on pre-operative optimization (PO) which includes different interventions to decrease the risk for unfavourable post-operative outcome. The objective of this study was to investigate the effect of multi-model PO on...

  16. ROV: improving remotely operated vehicle (ROV) intervention capabilities for blowout preventer override systems

    Energy Technology Data Exchange (ETDEWEB)

    Lazar, Stephen [Christopher S. Mancini, Tomball, TX (United States)

    2012-07-01

    Events during 2010 have focused attention on increased ROV/BOP Intervention capabilities and standardization of BOP/ROV interfaces in the oil and gas offshore industry. Currently no enforced set standards for ROV intervention panels or manifold types for use on BOP Override systems are specified. The industry offers multiple configurations at present. This abstract will discuss the advantages and disadvantages of the various configurations in existence, trending toward suggested industry standards taking shape as requirements in the near term. Standards for the offshore industry or a set specification must be made to increase safety and functionality of BOP control systems. To date, ROV override capabilities have been added to existing engineered BOP systems. BOP designed closing times were not a critical consideration, only that the access was there to allow for ROV override. Increased ROV flow and pressure capabilities: no current minimum flow requirements for Emergency BOP Override pumps are established. Based on stack valving and configuration, a minimum, 7 gpm may be required to shift valving fully to allow BOP operator function. IADC/API minimum requirements may be proposed at 10 gpm at 3000psi. Based on shear pressures exceeding 3000psi, pressures of 5000psi should be considered. Current intervention skids/pump capabilities will be required if ROVs must achieve API 16D BOP minimum closing times. Remote or isolated accumulation for increased intervention capabilities offers possibilities when ANY ROV of opportunity can trigger a function (such as small inspection type ROVs). Increased volumes will be required. This is critical in functioning stack rams with an ROV of opportunity to achieve API 16D closing times. We now understand that higher flows and pressures are required along with standardization of stab types. Current recommendations: API 17H Hi-Flow manifolds should be added to essential ROV overrides. ROV skids will have a minimum requirement of 10gpm

  17. Communication growth in minimally verbal children with ASD: The importance of interaction.

    Science.gov (United States)

    DiStefano, Charlotte; Shih, Wendy; Kaiser, Ann; Landa, Rebecca; Kasari, Connie

    2016-10-01

    Little is known about language development in children with Autism Spectrum Disorders (ASD) who remain minimally verbal past age 5. While there is evidence that children can develop language after age 5, we lack detailed information. Studies of this population generally focus on discrete language skills without addressing broader social-communication abilities. As communication and social deficits are both inherent to ASD, an examination of not only what language skills are acquired, but how those skills are used in interactions is relevant. Research in typical development has examined how communication interchanges (unbroken back-and-forth exchanges around a unified purpose) develop, which can be used as a framework for studying minimally verbal children. This study examined the interchange use by 55 children with ASD over the course of a 6-month play and engagement-based communication intervention. Half of the children received intervention sessions that also incorporated a speech-generating device (SGD). Interchanges were coded by: frequency, length, function, and initiator (child or adult). Results indicated that children initiated a large proportion of interchanges and this proportion increased over time. The average length and number of interchanges increased over time, with children in the SGD group showing even greater growth. Finally, children's total number of interchanges at baseline was positively associated with their spoken language gains over the course of intervention. This study supports the crucial relationship between social engagement and expressive language development, and highlights the need to include sustained communication interchanges as a target for intervention with this population. Autism Res 2016, 9: 1093-1102. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

  18. Types of motivating operations in interventions with problem behavior: a systematic review.

    Science.gov (United States)

    Simó-Pinatella, David; Font-Roura, Josep; Planella-Morató, Joaquima; McGill, Peter; Alomar-Kurz, Elisabeth; Giné, Climent

    2013-01-01

    A motivating operation (MO) alters both the effectiveness of a stimulus as a reinforcer and the current frequency of all behavior that has been reinforced by that particular stimulus. This article reviews studies that have manipulated a MO during interventions with school-age participants with intellectual disabilities and problem behavior. A systematic review was conducted using the following major electronic databases: PsychInfo, Education Resources Information Center, Science Direct, Blackwell, SAGE, and Medline. A total of 31 published articles representing 55 participants was examined. Findings from this study suggest that the modification of a MO usually has an effect on the problem behavior by either establishing or abolishing its motivation. Furthermore, a relationship was found between the type of MO and the behavioral function identified. The theoretical and practical implications of these findings, limitations of this study and potential issues for future research are discussed.

  19. A minimal collision operator for implementing neoclassical transport in gyrokinetic simulations

    International Nuclear Information System (INIS)

    Garbet, X.; Dif-Pradalier, G.; Nguyen, C.; Angelino, P.; Sarazin, Y.; Grandgirard, V.; Ghendrih, P.; Samain, A.

    2008-01-01

    This paper presents a class of collision operators, which reproduce neoclassical transport and comply with the constraints of a full-f global gyrokinetic code. The assessment of these operators is based on a variational entropy method, which allows a fast calculation of the neoclassical diffusivity and poloidal velocity.

  20. Cognitive-Behavioral and Pharmacologic Interventions for Children's Distress during Painful Medical Procedures.

    Science.gov (United States)

    Jay, Susan M.; And Others

    1987-01-01

    Evaluated efficacy of cognitive-behavioral intervention package and low-risk pharmacologic intervention (oral Valium) as compared with minimal treatment-attention control condition, in reducing children leukemia patients' distress during bone marrow aspirations. The cognitive-behavioral therapy reduced behavioral distress, pain ratings and pulse…

  1. Efficacy of a minimal home-based psychoeducative intervention in patients with advanced COPD

    DEFF Research Database (Denmark)

    Bove, D. G.; Lomborg, K.; Jensen, A. K.

    2016-01-01

    -based psychoeducative intervention versus usual care for reducing symptoms of anxiety in patients with advanced COPD. METHODS: The trial included 66 participants with advanced COPD and symptoms of anxiety. The primary outcome was anxiety assessed by the Hospital Anxiety and Depression scale (HADS) subscale for anxiety...

  2. MINIMALLY INVASIVE OPEN THYROIDECTOMY IN THYROID CANCER WITH COEXISTENT HASHIMOTO THYROIDITIS

    Directory of Open Access Journals (Sweden)

    Rumen Nenkov

    2013-06-01

    Full Text Available One of the minimally invasive thyroidectomy challenges is the application of this technique in the surgical treatment of thyroid cancer. The use of minimally invasive open approach in co-existence of thyroid cancer with Hashimoto thyroiditis is well known provocation to the skills of the surgeon working in the field of thyroid surgery.Aim: To report our results and to present the possibilities of minimally invasive open approach in the surgical treatment of thyroid carcinoma and coexistent Hashimoto thyroiditis. Patients and methods: For the period from 2008 to 2011, 641 patients were operated on in our clinic using minimally invasive open approach. In 32 of these patients presence of Hashimoto thyroiditis was found in combination with thyroid cancer. All patients were females, 26 to 46 years age. Patients were selected according to designed and accepted for our institution criteria. The procedures were performed using ultrasound (harmonic shears (Harmonic Focus® and Harmonic Ace®, Ethicon Endo-Surgery. The operative time, incidence, type and severity of complications, length of hospital stay, safety and reliability of the surgical procedure were analyzed. Results: The operative incision length in all cases was between 2.0-2.5 cm. In 27 patients papillary thyroid carcinoma and in 5 patients – follicular variant of the neoplasm were found. The tumor size ranged between 0.5 and 1.5 cm. In all patients total thyroidectomy using harmonic scalpel was performed. Lymph node metastases in the central neck compartment were not found in any of the cases. The rate, type and severity of complications did not exceed those for patients who underwent conventional thyroidectomy. All patients leaved the hospital in the first 24 postoperative hours. The follow-up did not reveal remnant thyroid tissue in thyroid gland bed or recurrence of the disease.Conclusions: Our results demonstrate the feasibility and reliability of minimally invasive open approach with

  3. Determining Minimal Clinically Important Differences in Japanese Cedar/Cypress Pollinosis Patients

    OpenAIRE

    Takaya Higaki; Mitsuhiro Okano; Shin Kariya; Tazuko Fujiwara; Takenori Haruna; Haruka Hirai; Aya Murai; Minoru Gotoh; Kimihiro Okubo; Shuji Yonekura; Yoshitaka Okamoto; Kazunori Nishizaki

    2013-01-01

    Background: Statistically significant results of medical intervention trials are not always clinically meaningful. We sought to estimate the minimal clinically important difference (MCID) (the smallest change in a given endpoint that is meaningful to a patient) during seasonal alteration of Japanese cedar/cypress pollinosis (JCCP). Methods: Results of a double-blinded, placebo-controlled trial of JCCP patients conducted between 2008 and 2010 were analyzed using an anchor-based method in wh...

  4. Occupational exposure in interventional radiology

    International Nuclear Information System (INIS)

    Oh, H.J.; Lee, K.Y.; Cha, S.H.; Kang, Y.K.; Kim, H.J.; Oh, H.J.

    2003-01-01

    This study was conducted to survey of radiation safety control and to measure occupational radiation exposure dose of staff in interventional radiology in Korea. Interventioanl radiology requires the operator and assisting personnel to remain close to the patient, and thus close to primary beams of radiation. Therefore exposure doses of these personnel are significant from a radiological protection point of view. We surveyed the status of radiation safety on interventional radiology of 72 hospitals. The result were that 119 radiation equipments are using in interventional radiology and 744 staffs are composed of 307 radiologists, 116 residents of radiology, 5 general physicians, 171 radiologic technologists and 145 nurses. 81.4% and 20.2 % of operating physicians are using neck collar protector and goggle respectively. The average radiation dose was measured 0.46±0.15 mSv/10 hours fluoroscopy inside examination room in radiation protection facilities. Occupational radiation exposure data on the staff were assessed in interventional radiology procedures from 8 interventional radiology equipments of 6 university hospitals. The dose measurements were made by placing a thermoluminesent dosimeter(TLD) on various body surface of operation and assistant staff during actual interventional radiology. The measured points were the corner of the eyes, neck(on the thyroid) , wrists, chest(outside and inside of the protector), and back. Average radiation equivalent dose of the corner of left eye and left wrist of operating physicians were 1.19 mSv(0.11∼4.13 mSv)/100 minutes fluoroscopy and 4.32 mSv(0.16∼11.0 mSv)/100 minutes fluoroscopy respectively. Average exposure dose may vary depending on the type of procedure, personal skills and the quality of equipment. These results will be contributed to prepare the guide line in interventional radiology in Korea

  5. Application of TEMPPC code to the IEA-R1 nuclear reactor core hydrothermal calculations operating at 2 MW for determining the minimal coolant flow

    International Nuclear Information System (INIS)

    Frajndlich, R.; Sousa, J.A. de.

    1985-01-01

    A thermohydraulic study of the IEA-R1 nuclear reactor core on steady-state operating condition and forced convection, is presented. The objective of this calculation is to obtain the minimal flow rate of coolant necessary at the reactor core, limited by the temperature associated to the beginning of nucleate boiling over the fuel plates at a normal operating power (2MW) for a certain inlet coolant temperature. The coolant system safety level is also calculated in this paper, which is divided in three steps: thermohydraulic calculation, without using the uncertainty factors and, after that, considering these factor by two methods: the statistical and the conventional ones. Whichever the method accepted, the results obtained by the program TEMPPC show a great safety margin with respect to the termohydraulic parameters from the IEA-R1 nuclear reactor. (Author) [pt

  6. Methods for the minimization of radioactive waste from decontamination and decommissioning of nuclear facilities

    International Nuclear Information System (INIS)

    2001-01-01

    The objective of this report is to provide Member States and their decision makers (ranging from regulators, strategists, planners and designers, to operators) with relevant information on opportunities for minimizing radioactive wastes arising from the D and D of nuclear facilities. This will allow waste minimization options to be properly planned and assessed as part of national, site and plant waste management policies. This objective will be achieved by: reviewing the sources and characteristics of radioactive materials arising from D and D activities; reviewing waste minimization principles and current practical applications, together with regulatory, technical, financial and political factors influencing waste minimization practices; and reviewing current trends in improving waste minimization practices during D and D

  7. Endovascular interventional magnetic resonance imaging

    International Nuclear Information System (INIS)

    Bartels, L W; Bakker, C J G

    2003-01-01

    Minimally invasive interventional radiological procedures, such as balloon angioplasty, stent placement or coiling of aneurysms, play an increasingly important role in the treatment of patients suffering from vascular disease. The non-destructive nature of magnetic resonance imaging (MRI), its ability to combine the acquisition of high quality anatomical images and functional information, such as blood flow velocities, perfusion and diffusion, together with its inherent three dimensionality and tomographic imaging capacities, have been advocated as advantages of using the MRI technique for guidance of endovascular radiological interventions. Within this light, endovascular interventional MRI has emerged as an interesting and promising new branch of interventional radiology. In this review article, the authors will give an overview of the most important issues related to this field. In this context, we will focus on the prerequisites for endovascular interventional MRI to come to maturity. In particular, the various approaches for device tracking that were proposed will be discussed and categorized. Furthermore, dedicated MRI systems, safety and compatibility issues and promising applications that could become clinical practice in the future will be discussed. (topical review)

  8. The anchor-based minimal important change, based on receiver operating characteristic analysis or predictive modeling, may need to be adjusted for the proportion of improved patients.

    Science.gov (United States)

    Terluin, Berend; Eekhout, Iris; Terwee, Caroline B

    2017-03-01

    Patients have their individual minimal important changes (iMICs) as their personal benchmarks to determine whether a perceived health-related quality of life (HRQOL) change constitutes a (minimally) important change for them. We denote the mean iMIC in a group of patients as the "genuine MIC" (gMIC). The aims of this paper are (1) to examine the relationship between the gMIC and the anchor-based minimal important change (MIC), determined by receiver operating characteristic analysis or by predictive modeling; (2) to examine the impact of the proportion of improved patients on these MICs; and (3) to explore the possibility to adjust the MIC for the influence of the proportion of improved patients. Multiple simulations of patient samples involved in anchor-based MIC studies with different characteristics of HRQOL (change) scores and distributions of iMICs. In addition, a real data set is analyzed for illustration. The receiver operating characteristic-based and predictive modeling MICs equal the gMIC when the proportion of improved patients equals 0.5. The MIC is estimated higher than the gMIC when the proportion improved is greater than 0.5, and the MIC is estimated lower than the gMIC when the proportion improved is less than 0.5. Using an equation including the predictive modeling MIC, the log-odds of improvement, the standard deviation of the HRQOL change score, and the correlation between the HRQOL change score and the anchor results in an adjusted MIC reflecting the gMIC irrespective of the proportion of improved patients. Adjusting the predictive modeling MIC for the proportion of improved patients assures that the adjusted MIC reflects the gMIC. We assumed normal distributions and global perceived change scores that were independent on the follow-up score. Additionally, floor and ceiling effects were not taken into account. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Effect of pre-operative octenidine nasal ointment and showering on surgical site infections in patients undergoing cardiac surgery.

    Science.gov (United States)

    Reiser, M; Scherag, A; Forstner, C; Brunkhorst, F M; Harbarth, S; Doenst, T; Pletz, M W; Hagel, S

    2017-02-01

    To evaluate the effect of pre-operative octenidine (OCT) decolonization on surgical site infection (SSI) rates. Before-and-after cohort study. Patients undergoing an elective isolated coronary artery bypass graft (CABG) procedure: control group (1 st January to 31 st December 2013), N=475; intervention group (1 st January to 31 st December 2014), N=428. The intervention consisted of nasal application of OCT ointment three times daily, beginning on the day before surgery, and showering the night before and on the day of surgery with OCT soap. A median sternotomy was performed in 805 (89.1%) patients and a minimally invasive direct coronary artery bypass procedure was performed in 98 (10.9%) patients. Overall, there was no difference in SSI rates between the control and intervention groups (15.4% vs 13.3%, P=0.39). The rate of harvest site SSIs was significantly lower in patients in the intervention group (2.5% vs 0.5%, P=0.01). Patients who had undergone a median sternotomy in the intervention group had a significantly lower rate of organ/space sternal SSIs (1.9% vs 0.3%, P=0.04). However, there was a trend towards an increased rate of deep incisional sternal SSIs (1.2% vs 2.9%, P=0.08). Multi-variate analysis did not identify a significant protective effect of the intervention (odds ratio 0.79, 95% confidence interval 0.53-1.15, P=0.27). Pre-operative decolonization with OCT did not reduce overall SSI rates in patients undergoing an elective isolated CABG procedure, but significantly decreased harvest site and organ/space sternal SSIs. Randomized controlled trials, including controlled patient adherence to the intervention, are required to confirm these observations and to determine the clinical utility of OCT in pre-operative decolonization. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  10. Pre-operative Functional Cardiovascular Reserve Is Associated with Acute Kidney Injury after Intervention.

    Science.gov (United States)

    Saratzis, A; Shakespeare, J; Jones, O; Bown, M J; Mahmood, A; Imray, C H E

    2017-05-01

    Acute kidney injury (AKI) is a common complication after endovascular intervention, associated with poor short and long-term outcomes. However, the mechanisms underlying AKI development remain poorly understood. The impact of pre-existing cardiovascular disease and low cardiovascular reserve (CVR) in AKI is unclear; it remains unknown whether AKI is primarily related to pre-existing comorbidity or to procedural parameters. The association between CVR and AKI after EVAR was therefore assessed. This is a case control study. From a database of 484 patients, 292 undergoing elective endovascular aneurysm repair (EVAR) of an infrarenal abdominal aortic aneurysm (AAA) in two tertiary centres were included. Of these, 73 patients who had developed AKI after EVAR were case matched, based on pre-operative estimated glomerular filtration rate (eGFR; within 5 mL/min/1.73 m 2 ) and age, with patients who had not developed AKI. Cardiopulmonary exercise testing (CPET) was used to assess CVR using the anaerobic threshold (AT). Development of AKI was defined using the Kidney Disease Improving Outcomes (KDIGO) guidance. Associations between CVR (based on AT levels) and AKI development were then analysed. Pre-operative AT levels were significantly different between those who did and did not develop AKI (12.1±2.9 SD vs. 14.8±3.0 mL/min/kg, p < .001). In multivariate analysis, a higher level of AT (per 1 mL/min/kg) was associated with a lower odds ratio (OR) of 0.72 (95% CI, 0.63-0.82, p < .001), relative to AKI development. A pre-operative AT level of < 11 mL/min/kg was associated with post-operative AKI development in adjusted analysis, with an OR of 7.8 (95% CI, 3.75-16.51, p < .001). The area under the curve (receiver operating characteristic) for AT as a predictor of post-operative AKI was 0.81 (standard error, 0.06, 95% CI, 0.69-0.93, p < .001). Poor CVR was strongly associated with the development of AKI. This provides pathophysiological insights into the

  11. Endovascular image-guided interventions (EIGIs)

    International Nuclear Information System (INIS)

    Rudin, Stephen; Bednarek, Daniel R.; Hoffmann, Kenneth R.

    2008-01-01

    Minimally invasive interventions are rapidly replacing invasive surgical procedures for the most prevalent human disease conditions. X-ray image-guided interventions carried out using the insertion and navigation of catheters through the vasculature are increasing in number and sophistication. In this article, we offer our vision for the future of this dynamic field of endovascular image-guided interventions in the form of predictions about (1) improvements in high-resolution detectors for more accurate guidance, (2) the implementation of high-resolution region of interest computed tomography for evaluation and planning, (3) the implementation of dose tracking systems to control patient radiation risk, (4) the development of increasingly sophisticated interventional devices, (5) the use of quantitative treatment planning with patient-specific computer fluid dynamic simulations, and (6) the new expanding role of the medical physicist. We discuss how we envision our predictions will come to fruition and result in the universal goal of improved patient care.

  12. Minimally invasive thyroidectomy (MIT): indications and results.

    Science.gov (United States)

    Docimo, Giovanni; Salvatore Tolone, Salvatore; Gili, Simona; d'Alessandro, A; Casalino, G; Brusciano, L; Ruggiero, Roberto; Docimo, Ludovico

    2013-01-01

    To establish if the indication for different approaches for thyroidectomy and the incision length provided by means of pre-operative assessment of gland volume and size of nodules resulted in safe and effective outcomes and in any notable aesthetic or quality-of-life impact on patients. Ninehundred eightytwo consecutive patients, undergoing total thyroidectomy, were enrolled. The thyroid volume and maximal nodule diameter were measured by means of ultrasounds. Based on ultrasounds findings, patients were divided into three groups: minimally invasive video assisted thyroidectomy (MIVAT), minimally invasive thyroidectomy (MIT) and conventional thyroidectomy (CT) groups. The data concerning the following parameters were collected: operative time, postoperative complications, postoperative pain and cosmetic results. The MIVAT group included 179 patients, MIT group included 592 patients and CT group included 211 patients. Incidence of complications did not differ significantly in each group. In MIVAT and MIT group, the perception of postoperative pain was less intense than CT group. The patients in the MIVAT (7±1.5) and MIT (8±2) groups were more satisfied with the cosmetic results than those in CT group (5±1.3) (p= MIT is a technique totally reproducible, and easily convertible to perform surgical procedures in respect of the patient, without additional complications, increased costs, and with better aesthetic results.

  13. Lumbar Spinal Stenosis Minimally Invasive Treatment with Bilateral Transpedicular Facet Augmentation System

    Energy Technology Data Exchange (ETDEWEB)

    Masala, Salvatore, E-mail: salva.masala@tiscali.it [Interventional Radiology and Radiotherapy, University of Rome ' Tor Vergata' , Department of Diagnostic and Molecular Imaging (Italy); Tarantino, Umberto [University of Rome ' Tor Vergata' , Department of Orthopaedics and Traumatology (Italy); Nano, Giovanni, E-mail: gionano@gmail.com [Interventional Radiology and Radiotherapy, University of Rome ' Tor Vergata' , Department of Diagnostic and Molecular Imaging (Italy); Iundusi, Riccardo [University of Rome ' Tor Vergata' , Department of Orthopaedics and Traumatology (Italy); Fiori, Roberto, E-mail: fiori.r@libero.it; Da Ros, Valerio, E-mail: valeriodaros@hotmail.com; Simonetti, Giovanni [Interventional Radiology and Radiotherapy, University of Rome ' Tor Vergata' , Department of Diagnostic and Molecular Imaging (Italy)

    2013-06-15

    Purpose. The purpose of this study was to evaluate the effectiveness of a new pedicle screw-based posterior dynamic stabilization device PDS Percudyn System Trade-Mark-Sign Anchor and Stabilizer (Interventional Spine Inc., Irvine, CA) as alternative minimally invasive treatment for patients with lumbar spine stenosis. Methods. Twenty-four consecutive patients (8 women, 16 men; mean age 61.8 yr) with lumbar spinal stenosis underwent implantation of the minimally invasive pedicle screw-based device for posterior dynamic stabilization. Inclusion criteria were lumbar stenosis without signs of instability, resistant to conservative treatment, and eligible to traditional surgical posterior decompression. Results. Twenty patients (83 %) progressively improved during the 1-year follow-up. Four (17 %) patients did not show any improvement and opted for surgical posterior decompression. For both responder and nonresponder patients, no device-related complications were reported. Conclusions. Minimally invasive PDS Percudyn System Trade-Mark-Sign has effectively improved the clinical setting of 83 % of highly selected patients treated, delaying the need for traditional surgical therapy.

  14. Lumbar Spinal Stenosis Minimally Invasive Treatment with Bilateral Transpedicular Facet Augmentation System

    International Nuclear Information System (INIS)

    Masala, Salvatore; Tarantino, Umberto; Nano, Giovanni; Iundusi, Riccardo; Fiori, Roberto; Da Ros, Valerio; Simonetti, Giovanni

    2013-01-01

    Purpose. The purpose of this study was to evaluate the effectiveness of a new pedicle screw-based posterior dynamic stabilization device PDS Percudyn System™ Anchor and Stabilizer (Interventional Spine Inc., Irvine, CA) as alternative minimally invasive treatment for patients with lumbar spine stenosis. Methods. Twenty-four consecutive patients (8 women, 16 men; mean age 61.8 yr) with lumbar spinal stenosis underwent implantation of the minimally invasive pedicle screw-based device for posterior dynamic stabilization. Inclusion criteria were lumbar stenosis without signs of instability, resistant to conservative treatment, and eligible to traditional surgical posterior decompression. Results. Twenty patients (83 %) progressively improved during the 1-year follow-up. Four (17 %) patients did not show any improvement and opted for surgical posterior decompression. For both responder and nonresponder patients, no device-related complications were reported. Conclusions. Minimally invasive PDS Percudyn System™ has effectively improved the clinical setting of 83 % of highly selected patients treated, delaying the need for traditional surgical therapy.

  15. Investigations on quantum mechanics with minimal length

    International Nuclear Information System (INIS)

    Chargui, Yassine

    2009-01-01

    We consider a modified quantum mechanics where the coordinates and momenta are assumed to satisfy a non-standard commutation relation of the form( X i , P j ) = iℎ(δ ij (1+βP 2 )+β'P i P j ). Such an algebra results in a generalized uncertainty relation which leads to the existence of a minimal observable length. Moreover, it incorporates an UV/IR mixing and non commutative position space. We analyse the possible representations in terms of differential operators. The latter are used to study the low energy effects of the minimal length by considering different quantum systems : the harmonic oscillator, the Klein-Gordon oscillator, the spinless Salpeter Coulomb problem, and the Dirac equation with a linear confining potential. We also discuss whether such effects are observable in precision measurements on a relativistic electron trapped in strong magnetic field.

  16. The production of audiovisual teaching tools in minimally invasive surgery.

    Science.gov (United States)

    Tolerton, Sarah K; Hugh, Thomas J; Cosman, Peter H

    2012-01-01

    Audiovisual learning resources have become valuable adjuncts to formal teaching in surgical training. This report discusses the process and challenges of preparing an audiovisual teaching tool for laparoscopic cholecystectomy. The relative value in surgical education and training, for both the creator and viewer are addressed. This audiovisual teaching resource was prepared as part of the Master of Surgery program at the University of Sydney, Australia. The different methods of video production used to create operative teaching tools are discussed. Collating and editing material for an audiovisual teaching resource can be a time-consuming and technically challenging process. However, quality learning resources can now be produced even with limited prior video editing experience. With minimal cost and suitable guidance to ensure clinically relevant content, most surgeons should be able to produce short, high-quality education videos of both open and minimally invasive surgery. Despite the challenges faced during production of audiovisual teaching tools, these resources are now relatively easy to produce using readily available software. These resources are particularly attractive to surgical trainees when real time operative footage is used. They serve as valuable adjuncts to formal teaching, particularly in the setting of minimally invasive surgery. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  17. INTELLIGENT DECISION SUPPORT FOR WASTE MINIMIZATION IN ELECTROPLATING PLANTS. (R824732)

    Science.gov (United States)

    AbstractWastewater, spent solvent, spent process solutions, and sludge are the major waste streams generated in large volumes daily in electroplating plants. These waste streams can be significantly minimized through process modification and operational improvement. I...

  18. Minimally invasive mini open split-muscular percutaneous pedicle screw fixation of the thoracolumbar spine

    Directory of Open Access Journals (Sweden)

    Murat Ulutaş

    2015-03-01

    Full Text Available We prospectively assessed the feasibility and safety of a new percutaneous pedicle screw (PPS fixation technique for instrumentation of the thoracic and lumbar spine in this study. All patients were operated in the prone position under general anesthesia. A 6 to 8 cm midline skin incision was made and wide sub-cutaneous dissection was performed. The paravertebral muscles were first dissected subperiosteally into the midline incision of the fascia for lumbar microdiscectomy with transforaminal lumbar interbody fusion cage implantation. After the secondary paramedian incisions on the fascia, the PPSs were inserted via cleavage of the multifidus muscles directly into the pedicles under fluoroscopy visualization. A total of 35 patients underwent surgery with this new surgical technique. The control group for operative time, blood loss and analgesic usage consisted of 35 randomly selected cases from our department. The control group underwent surgery via conventional pedicle screw instrumentation with paramedian fusion. All patients in the minimal invasive surgery series were ambulatory with minimal pain on the first postoperative day. The operation time and blood loss and the postoperative analgesic consumption were significantly less with this new technique. In conclusion, the minimal invasive mini open split-muscular percutaneous pedicle screw fixation technique is safe and feasible. It can be performed via a short midline skin incision and can also be combined with interbody fusion, causing minimal pain without severe muscle damage.

  19. Use of Minimally Invasive Distal Metatarsal Osteotomy for Correction of Hallux Valgus

    Directory of Open Access Journals (Sweden)

    Chun-Kit Tong

    2012-06-01

    Conclusion: Good clinical and radiographic results have been achieved with minimally invasive techniques for treatment of hallux valgus. This is an acceptable alternative operation for mild-to-moderate hallux valgus.

  20. Minimally-invasive treatment of high velocity intra-articular fractures of the distal tibia.

    LENUS (Irish Health Repository)

    Leonard, M

    2012-02-01

    The pilon fracture is a complex injury. The purpose of this study was to evaluate the outcome of minimally invasive techniques in management of these injuries. This was a prospective study of closed AO type C2 and C3 fractures managed by early (<36 hours) minimally invasive surgical intervention and physiotherapist led rehabilitation. Thirty patients with 32 intra-articular distal tibial fractures were treated by the senior surgeon (GK). Our aim was to record the outcome and all complications with a minimum two year follow-up. There were two superficial wound infections. One patient developed a non-union which required a formal open procedure. Another patient was symptomatic from a palpable plate inferiorly. An excellent AOFAS result was obtained in 83% (20\\/24) of the patients. Early minimally invasive reduction and fixation of complex high velocity pilon fractures gave very satisfactory results at a minimum of two years follow-up.

  1. Technology-based Intervention Programs to Promote Stimulation Control and Communication in Post-coma Persons with Different Levels of Disability

    Directory of Open Access Journals (Sweden)

    Giulio E. Lancioni

    2014-02-01

    Full Text Available Post-coma persons in a minimally conscious state and with extensive motor impairment or emerging/emerged from such a state, but affected by lack of speech and motor impairment, tend to be passive and isolated. A way to help them develop functional responding to control environmental events and communication involves the use of intervention programs relying on assistive technology. This paper provides an overview of technology-based intervention programs for enabling the participants to (a access brief periods of stimulation through one or two microswitches, (b pursue stimulation and social contact through the combination of a microswitch and a sensor connected to a speech generating device (SGD or through two SGD-related sensors, (c control stimulation options through computer or radio systems and a microswitch, (d communicate through modified messaging or telephone systems operated via microswitch, and (e control combinations of leisure and communication options through computer systems operated via microswitch. Twenty-six studies, involving a total of 52 participants, were included in this paper. The intervention programs were carried out using single-subject methodology, and their outcomes were generally considered positive from the standpoint of the participants and their context. Practical implications of the programs are discussed.

  2. Minimal investment risk of a portfolio optimization problem with budget and investment concentration constraints

    Science.gov (United States)

    Shinzato, Takashi

    2017-02-01

    In the present paper, the minimal investment risk for a portfolio optimization problem with imposed budget and investment concentration constraints is considered using replica analysis. Since the minimal investment risk is influenced by the investment concentration constraint (as well as the budget constraint), it is intuitive that the minimal investment risk for the problem with an investment concentration constraint can be larger than that without the constraint (that is, with only the budget constraint). Moreover, a numerical experiment shows the effectiveness of our proposed analysis. In contrast, the standard operations research approach failed to identify accurately the minimal investment risk of the portfolio optimization problem.

  3. Use of an Automated Suture Fastening Device in Minimally Invasive Aortic Valve Replacement.

    Science.gov (United States)

    Beute, Tyler J; Orem, Matthew D; Schiller, Timothy M; Goehler, Matthew; Parker, Jessica; Willekes, Charles L; Timek, Tomasz

    2018-03-01

    Minimally invasive aortic valve replacement (mAVR) is gaining clinical acceptance, however, it is associated with increased operative times due to limited surgical field and access. The Cor-Knot is an automated fastening device designed to facilitate suture fastening, but clinical data in mAVR are lacking. From May 2014 to February 2017, 92 patients underwent mAVR at our center with 39 valves secured with manually-tied (MT) sutures and 53 valves entirely secured with the Cor-Knot (CK). Pre-operative characteristics and 30-day outcomes data were extracted from our local Society of Thoracic Surgeons database and the electronic medical record. Survival data were obtained from the Michigan State Social Security Death Index. No significant difference in pre-operative characteristics were noted between the two groups. Aortic cross-clamp time (72±12 min vs 82±15 min, p=0.001) was significantly shorter with CK. There was no difference in post-operative mortality (0% vs 0%), stroke (0% vs 1.9%), atrial fibrillation (28% vs 33%), renal failure (0% vs 3.8%), or pacemaker implantation (5.1% vs 5.7%) between MT and CK. Valve function on post-operative echocardiography and 1-year patient survival were similar. In minimally invasive aortic valve replacement, the Cor-Knot device was associated with reduced aortic cross-clamp time while providing equivalent clinical outcomes. Larger studies are needed to confirm efficacy, safety, and cost-effectiveness of the Cor-Knot device in minimally invasive aortic valve surgery. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  4. Image-guided interventions and computer-integrated therapy: Quo vadis?

    Science.gov (United States)

    Peters, Terry M; Linte, Cristian A

    2016-10-01

    Significant efforts have been dedicated to minimizing invasiveness associated with surgical interventions, most of which have been possible thanks to the developments in medical imaging, surgical navigation, visualization and display technologies. Image-guided interventions have promised to dramatically change the way therapies are delivered to many organs. However, in spite of the development of many sophisticated technologies over the past two decades, other than some isolated examples of successful implementations, minimally invasive therapy is far from enjoying the wide acceptance once envisioned. This paper provides a large-scale overview of the state-of-the-art developments, identifies several barriers thought to have hampered the wider adoption of image-guided navigation, and suggests areas of research that may potentially advance the field. Copyright © 2016. Published by Elsevier B.V.

  5. Y-formalism and b ghost in the non-minimal pure spinor formalism of superstrings

    International Nuclear Information System (INIS)

    Oda, Ichiro; Tonin, Mario

    2007-01-01

    We present the Y-formalism for the non-minimal pure spinor quantization of superstrings. In the framework of this formalism we compute, at the quantum level, the explicit form of the compound operators involved in the construction of the b ghost, their normal-ordering contributions and the relevant relations among them. We use these results to construct the quantum-mechanical b ghost in the non-minimal pure spinor formalism. Moreover we show that this non-minimal b ghost is cohomologically equivalent to the non-covariant b ghost

  6. Evaluation of Kerma rate in the skin entrance in interventional procedures guided by fluoroscopy

    International Nuclear Information System (INIS)

    Medeiros, Regina Bitelli; Alves, Fatima Faloppa Rodrigues; Ruberti Filha, Eny M.

    2005-01-01

    Interventional therapeutic procedures guided by fluoroscopy are responsible for delayed exposure to radiation of professionals and patients. The technology employed on generation of the pulsed fluoroscopy can be an important tool of protection used for reducing the exposure time. It generates constant width and varied frequency pulse or width pulse or varied frequency for a constant frequency. The typical doses into the skin and its relationship with the quality of the images in the various technical and operational conditions should be known by the professionals so that they can optimize them. Generated radiation doses were evaluated using the Toshiba Infinitix equipment used in invasive cardiology procedures and electrophysiological studies through the Kerma rate at the entrance of the patient's skin measured throughout the year of 2004. With these information shall be set out the criteria for the decision of the technical-operational conditions that allow minimizing of dose

  7. Operating experience with a VMEbus multiprocessor system for data acquisition and reduction in nuclear physics

    International Nuclear Information System (INIS)

    Kutt, P.H.; Balamuth, D.P.

    1989-01-01

    A multiprocessor system based on commercially available VMEbus components has been developed for the acquisition and reduction of event-mode data in nuclear physics experiments. The system contains seven 68000 CPU's and 14 MB of memory. A minimal operating system handles data transfer and task allocation, and a compiler for a specially designed event analysis language produces code for the processors. The system has been in operation for four years at the University of Pennsylvania Tandem Accelerator Laboratory. Computation rates over 3 times that of a MicroVAX II have been achieved at a fraction of the cost. The use of WORM optical disks for event recording allows the processing for gigabyte data sets without operator intervention. A more powerful system is being planned which will make use of recently developed RISC processors to obtain an order of magnitude increase in computing power per node

  8. 3D object reconstruction in image-guided interventions using multi-view X-ray

    NARCIS (Netherlands)

    Papalazarou, C.

    2012-01-01

    In the last two decades, minimally-invasive interventions have replaced traditional surgery in many clinical scenarios. In these interventions, the doctor manipulates small devices inside the patient through a small incision, while guided by live imaging. In many cases, this guidance is provided by

  9. Recent developments in the DOE Waste Minimization Pollution Prevention Program

    International Nuclear Information System (INIS)

    Hancock, J.K.

    1993-01-01

    The U.S. Department of Energy (DOE) is involved in a wide variety of research and development, remediation, and production activities at more than 100 sites throughout the United States. The wastes generated cover a diverse spectrum of sanitary, hazardous, and radioactive waste streams, including typical office environments, power generation facilities, laboratories, remediation sites, production facilities, and defense facilities. The DOE's initial waste minimization activities pre-date the Pollution Prevention Act of 1990 and focused on the defense program. Little emphasis was placed on nonproduction activities. In 1991 the Office of Waste Management Operations developed the Waste Minimization Division with the intention of coordinating and expanding the waste minimization pollution prevention approach to the entire complex. The diverse nature of DOE activities has led to several unique problems in addressing the needs of waste minimization and pollution prevention. The first problem is developing a program that addresses the geographical and institutional hurdles that exist; the second is developing a monitoring and reporting mechanism that one can use to assess the overall performance of the program

  10. Minimally invasive surgery in the treatment of esophageal cancer

    International Nuclear Information System (INIS)

    Janik, M.; Lucenic, M.; Juhos, P.; Harustiak, S.

    2016-01-01

    Esophageal cancer represents the sixth most common cause of the death caused by malignant diseases. The incidence is 11.5/100 000 in men population and 4.7/100 000 in women. It is the eighth most common malignancy. The incidence grows up, it doubled in Slovakia in last period and 5-year survival is only 18 %. Esophagectomy is a huge burden for organism. Mortality varies from 8.1 % to 23 % in low-volume departments in comparison with high-volume centres, where it is lower then 5 %. Complications range after operations is 30 – 80 %. Minimally invasive approach leads to the reduction of mortality and morbidity according to lot of studies. We performed 121 esophagectomies in cancer in period 2010 – 2015 and in 2015 it was 32 operations. We performed 29 totally minimally invasive esophagectomies, 16 hybrid MIE and 66 open esophagectomies. The chylothorax occurs twice, we managed it by surgery. The anastomotic dehiscence represents 9.09 %. Cardiovascular system complications occur in 43 %, need for vasopressors caused by hypotensia was in 44 %. It concluded from that we started with restrictive management of patients during the operation and need for vasopressors last only for two days after the operation and did not cause renal failure or any other complications.30 days mortality was related to MODS evolved by sepsis caused by pneumonia, most common in cirrhotic patients in very poor condition. Tracheoneoesophageal fistula occur in three patients, they all underwent operation, one of them died because of severe pneumonia. We recorded grow number of patient in our institution, which is probably related to better cooperation with gastroenterologists all over Slovakia. (author)

  11. The Contingency of Success: Operations for Deep Impact's Planet Hunt

    Science.gov (United States)

    Rieber, Richard R.; Sharrow, Robert F.

    2009-01-01

    The Deep Impact Flyby spacecraft completed its prime mission in August 2005. It was reactivated for a mission of opportunity add-on called EPOXI on September 25, 2007. The first portion of EPOXI, called EPOCh (Extra-solar Planetary Observation & CHaracterization), occurred from January 21, 2008 through August 31, 2008. Its purpose was to characterize transiting hot-Jupiters by measuring the effects the planet has on the luminosity of its parent star. These observations entailed using the spacecraft in ways it was never intended. A new green-light, success-oriented operational strategy was devised that entailed high amounts of automation and minimal intervention from the ground. The specifics, techniques, and key challenges to obtaining the 172,209 usable science images from EPOCh are discussed in detail.

  12. Activity recognition from minimal distinguishing subsequence mining

    Science.gov (United States)

    Iqbal, Mohammad; Pao, Hsing-Kuo

    2017-08-01

    Human activity recognition is one of the most important research topics in the era of Internet of Things. To separate different activities given sensory data, we utilize a Minimal Distinguishing Subsequence (MDS) mining approach to efficiently find distinguishing patterns among different activities. We first transform the sensory data into a series of sensor triggering events and operate the MDS mining procedure afterwards. The gap constraints are also considered in the MDS mining. Given the multi-class nature of most activity recognition tasks, we modify the MDS mining approach from a binary case to a multi-class one to fit the need for multiple activity recognition. We also study how to select the best parameter set including the minimal and the maximal support thresholds in finding the MDSs for effective activity recognition. Overall, the prediction accuracy is 86.59% on the van Kasteren dataset which consists of four different activities for recognition.

  13. Operational validation - current status and opportunities for improvement

    International Nuclear Information System (INIS)

    Davey, E.

    2002-01-01

    The design of nuclear plant systems and operational practices is based on the application of multiple defenses to minimize the risk of occurrence of safety and production challenges and upsets. With such an approach, the effectiveness of individual or combinations of design and operational features in preventing upset challenges should be known. A longstanding industry concern is the adverse impact errors in human performance can have on plant safety and production. To minimize the risk of error occurrence, designers and operations staff routinely employ multiple design and operational defenses. However, the effectiveness of individual or combinations of defensive features in minimizing error occurrence are generally only known in a qualitative sense. More importantly, the margins to error or upset occurrence provided by combinations of design or operational features are generally not characterized during design or operational validation. This paper provides some observations and comments on current validation practice as it relates to operational human performance concerns. The paper also discusses opportunities for future improvement in validation practice in terms of the resilience of validation results to operating changes and characterization of margins to safety or production challenge. (author)

  14. Waste minimization applications at a remediation site

    International Nuclear Information System (INIS)

    Allmon, L.A.

    1995-01-01

    The Fernald Environmental Management Project (FEMP) owned by the Department of Energy was used for the processing of uranium. In 1989 Fernald suspended production of uranium metals and was placed on the National Priorities List (NPL). The site's mission has changed from one of production to environmental restoration. Many groups necessary for producing a product were deemed irrelevant for remediation work, including Waste Minimization. Waste Minimization does not readily appear to be applicable to remediation work. Environmental remediation is designed to correct adverse impacts to the environment from past operations and generates significant amounts of waste requiring management. The premise of pollution prevention is to avoid waste generation, thus remediation is in direct conflict with this premise. Although greater amounts of waste will be generated during environmental remediation, treatment capacities are not always available and disposal is becoming more difficult and costly. This creates the need for pollution prevention and waste minimization. Applying waste minimization principles at a remediation site is an enormous challenge. If the remediation site is also radiologically contaminated it is even a bigger challenge. Innovative techniques and ideas must be utilized to achieve reductions in the amount of waste that must be managed or dispositioned. At Fernald the waste minimization paradigm was shifted from focusing efforts on source reduction to focusing efforts on recycle/reuse by inverting the EPA waste management hierarchy. A fundamental difference at remediation sites is that source reduction has limited applicability to legacy wastes but can be applied successfully on secondary waste generation. The bulk of measurable waste reduction will be achieved by the recycle/reuse of primary wastes and by segregation and decontamination of secondary wastestreams. Each effort must be measured in terms of being economically and ecologically beneficial

  15. Regularity of Minimal Surfaces

    CERN Document Server

    Dierkes, Ulrich; Tromba, Anthony J; Kuster, Albrecht

    2010-01-01

    "Regularity of Minimal Surfaces" begins with a survey of minimal surfaces with free boundaries. Following this, the basic results concerning the boundary behaviour of minimal surfaces and H-surfaces with fixed or free boundaries are studied. In particular, the asymptotic expansions at interior and boundary branch points are derived, leading to general Gauss-Bonnet formulas. Furthermore, gradient estimates and asymptotic expansions for minimal surfaces with only piecewise smooth boundaries are obtained. One of the main features of free boundary value problems for minimal surfaces is t

  16. Endovascular interventions for multiple trauma

    International Nuclear Information System (INIS)

    Kinstner, C.; Funovics, M.

    2014-01-01

    In recent years interventional radiology has significantly changed the management of injured patients with multiple trauma. Currently nearly all vessels can be reached within a reasonably short time with the help of specially preshaped catheters and guide wires to achieve bleeding control of arterial und venous bleeding. Whereas bleeding control formerly required extensive open surgery, current interventional methods allow temporary vessel occlusion (occlusion balloons), permanent embolization and stenting. In injured patients with multiple trauma preinterventional procedural planning is performed with the help of multidetector computed tomography whenever possible. Interventional radiology not only allows minimization of therapeutic trauma but also a considerably shorter treatment time. Interventional bleeding control has developed into a standard method in the management of vascular trauma of the chest and abdomen as well as in vascular injuries of the upper and lower extremities when open surgical access is associated with increased risk. Additionally, pelvic trauma, vascular trauma of the superior thoracic aperture and parenchymal arterial lacerations of organs that can be at least partially preserved are primarily managed by interventional methods. In an interdisciplinary setting interventional radiology provides a safe and efficient means of rapid bleeding control in nearly all vascular territories in addition to open surgical access. (orig.) [de

  17. Contribution to computer aided design of digital circuits - Minimization of alphanumeric expressions - Program CHOPIN

    International Nuclear Information System (INIS)

    Blanca, Ernest

    1974-10-01

    Alpha-numeric boolean expressions, written in the form of sums of products and/or products of sums with many brackets, may be minimized in two steps: syntaxic recognition analysis using precedence operator grammar, syntaxic reduction analysis. These two phases of execution and the different programs of the corresponding machine algorithm are described. Examples of minimization of alpha-numeric boolean expressions written with the help of brackets, utilisation note of the program CHOPIN and theoretical considerations related to language, grammar, precedence operator grammar, sequential systems, boolean sets, boolean representations and treatments of boolean expressions, boolean matrices and their use in grammar theory, are discussed and described. (author) [fr

  18. Minimally coupled N-particle scattering integral equations

    International Nuclear Information System (INIS)

    Kowalski, K.L.

    1977-01-01

    A concise formalism is developed which permits the efficient representation and generalization of several known techniques for deriving connected-kernel N-particle scattering integral equations. The methods of Kouri, Levin, and Tobocman and Bencze and Redish which lead to minimally coupled integral equations are of special interest. The introduction of channel coupling arrays is characterized in a general manner and the common base of this technique and that of the so-called channel coupling scheme is clarified. It is found that in the Bencze-Redish formalism a particular coupling array has a crucial function but one different from that of the arrays employed by Kouri, Levin, and Tobocman. The apparent dependence of the proof of the minimality of the Bencze-Redish integral equations upon the form of the inhomogeneous term in these equations is eliminated. This is achieved by an investigation of the full (nonminimal) Bencze-Redish kernel. It is shown that the second power of this operator is connected, a result which is needed for the full applicability of the Bencze-Redish formalism. This is used to establish the relationship between the existence of solutions to the homogeneous form of the minimal equations and eigenvalues of the full Bencze-Redish kernel

  19. Study of design parameters for minimizing the cost of electricity of tokamak fusion power reactors

    International Nuclear Information System (INIS)

    Tokimatsu, K.; Yamaji, K.; Katsurai, M.; Okano, K.; Yoshida, T.

    1998-01-01

    The impact of the design parameters on the cost of electricity (COE) is studied through a parameter survey in order to minimize the COE. Three kinds of operating modes are considered; first stability (FS), second stability (SS) and reversed shear (RS). The COE is calculated by a coupled physics-engineering-cost computer system code. Deuterium-tritium type, 1000 MW(e) at electric bus bar, steady state tokamak reactors with aspect ratios A from 3 to 4.5 are assumed. Several criteria are used for the parameter survey; for example, (a) the thermal to electrical conversion efficiency is assumed to be 34.5% using water as a coolant; (b) the average neutron wall load must not exceed 5 MW/m 2 for plasma major radius R p >5 m; (c) a 2 MeV neutral beam injector (NBI) is applied. It is found that the RS operating mode most minimizes the COE among the three operating modes by reducing the cost of the current drive and the coils and structures. The cost-minimized RS reactor can attain high f bs , high β N and low q 95 at the same time, which results in a short R p of 5.1 m, a low B max of the maximum magnetic toroidal field (TF) of the TF coils of 13 T and a low A of 3.0. It can be concluded that this cost-minimized RS reactor is the most cost-minimized within the frameworks of this study. This cost-minimized RS reactor has two advantages: one is that a B max =13 T TF coil can be made by use of ITER coil technology and the other is that the same cooling technology as that of ITER (water cooling) can be used. (author)

  20. Metronome Use for Coordination of Breaths and Cardiac Compressions Delivered by Minimally-Trained Caregivers During Two-Person CPR

    Science.gov (United States)

    Hurst, Victor, IV; West, Sarah; Austin, Paul; Branson, Richard; Beck, George

    2005-01-01

    Astronaut crew medical officers (CMO) aboard the International Space Station (ISS) receive 40 hours of medical training over 18 months before each mission, including two-person cardiopulmonary resuscitation (2CPR) as recommended by the American Heart Association (AHA). Recent studies have concluded that the use of metronomic tones improves the coordination of 2CPR by trained clinicians. 2CPR performance data for minimally-trained caregivers has been limited. The goal of this study was to determine whether use of a metronome by minimally-trained caregivers (CMO analogues) would improve 2CPR performance. 20 pairs of minimally-trained caregivers certified in 2CPR via AHA guidelines performed 2CPR for 4 minutes on an instrumented manikin using 3 interventions: 1) Standard 2CPR without a metronome [NONE], 2) Standard 2CPR plus a metronome for coordinating compression rate only [MET], 3) Standard 2CPR plus a metronome for coordinating both the compression rate and ventilation rate [BOTH]. Caregivers were evaluated for their ability to meet the AHA guideline of 32 breaths-240 compressions in 4 minutes. All (100%) caregivers using the BOTH intervention provided the required number of ventilation breaths as compared with the NONE caregivers (10%) and MET caregivers (0%). For compressions, 97.5% of the BOTH caregivers were not successful in meeting the AHA compression guideline; however, an average of 238 compressions of the desired 240 were completed. None of the caregivers were successful in meeting the compression guideline using the NONE and MET interventions. This study demonstrates that use of metronomic tones by minimally-trained caregivers for coordinating both compressions and breaths improves 2CPR performance. Meeting the breath guideline is important to minimize air entering the stomach, thus decreasing the likelihood of gastric aspiration. These results suggest that manifesting a metronome for the ISS may augment the performance of 2CPR on orbit and thus may

  1. Operational intervention levels in a nuclear emergency, general concepts and a probabilistic approach

    International Nuclear Information System (INIS)

    Lauritzen, B.; Baeverstam, U.; Naadland Holo, E.; Sinkko, K.

    1997-12-01

    This report deals with Operational Intervention Levels (OILs) in a nuclear or radiation emergency. OILs are defined as the values of environmental measurements, in particular dose rate measurements, above which specific protective actions should be carried out in emergency exposure situations. The derivation and the application of OILs are discussed, and an overview of the presently adopted values is provided, with emphasis on the situation in the Nordic countries. A new, probabilistic approach to derive OILs is presented and the method is illustrated by calculating dose rate OILs in a simplified setting. Contrary to the standard approach, the probabilistic approach allows for optimization of OILs. It is argued, that optimized OILs may be much larger than the presently adopted or suggested values. It is recommended, that the probabilistic approach is further developed and employed in determining site specific OILs and in optimizing environmental measuring strategies. (au)

  2. Minimal Poems Written in 1979 Minimal Poems Written in 1979

    Directory of Open Access Journals (Sweden)

    Sandra Sirangelo Maggio

    2008-04-01

    Full Text Available The reading of M. van der Slice's Minimal Poems Written in 1979 (the work, actually, has no title reminded me of a book I have seen a long time ago. called Truth, which had not even a single word printed inside. In either case we have a sample of how often excentricities can prove efficient means of artistic creativity, in this new literary trend known as Minimalism. The reading of M. van der Slice's Minimal Poems Written in 1979 (the work, actually, has no title reminded me of a book I have seen a long time ago. called Truth, which had not even a single word printed inside. In either case we have a sample of how often excentricities can prove efficient means of artistic creativity, in this new literary trend known as Minimalism.

  3. Minimal access surgery for mitral valve endocarditis.

    Science.gov (United States)

    Barbero, Cristina; Marchetto, Giovanni; Ricci, Davide; Mancuso, Samuel; Boffini, Massimo; Cecchi, Enrico; De Rosa, Francesco Giuseppe; Rinaldi, Mauro

    2017-08-01

    Minimal access mitral valve surgery (MVS) has already proved to be feasible and effective with low perioperative mortality and excellent long-term outcomes. However, experience in more complex valve diseases such as infective endocarditis (IE) still remains limited. The aim of this retrospective study was to evaluate early and long-term results of minimal access MVS for IE. Data were entered into a dedicated database. Analysis was performed retrospectively for the 8-year period between January 2007 and April 2015. During the study period, 35 consecutive patients underwent minimal access MVS for IE at our department. Twenty-four had diagnosis of native MV endocarditis (68.6%) and 11 of mitral prosthesis endocarditis (31.4%).Thirty patients underwent early MVS (85.7%), and 5 patients were operated after the completion of antibiotic treatment (14.3%). Seven patients underwent MV repair (20%), 17 patients underwent MV replacement (48.6%), and 11 patients underwent mitral prosthesis replacement (31.4%). Thirty-day mortality was 11.4% (4 patients). No neurological or vascular complications were reported. One patient underwent reoperation for prosthesis IE relapse after 37 days. Overall actuarial survival rate at 1 and 5 years was 83%; freedom from MV reoperation and/or recurrence of IE at 1 and 5 years was 97%. Minimally invasive MVS for IE is feasible and associated with good early and long-term results. Preoperative accurate patient selection and transoesophageal echocardiography evaluation is mandatory for surgical planning. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  4. Long-term effectiveness and cost-effectiveness of smoking cessation interventions in patients with COPD.

    Science.gov (United States)

    Hoogendoorn, Martine; Feenstra, Talitha L; Hoogenveen, Rudolf T; Rutten-van Mölken, Maureen P M H

    2010-08-01

    The aim of this study was to estimate the long-term (cost-) effectiveness of smoking cessation interventions for patients with chronic obstructive pulmonary disease (COPD). A systematic review was performed of randomised controlled trials on smoking cessation interventions in patients with COPD reporting 12-month biochemical validated abstinence rates. The different interventions were grouped into four categories: usual care, minimal counselling, intensive counselling and intensive counselling + pharmacotherapy ('pharmacotherapy'). For each category the average 12-month continuous abstinence rate and intervention costs were estimated. A dynamic population model for COPD was used to project the long-term (cost-) effectiveness (25 years) of 1-year implementation of the interventions for 50% of the patients with COPD who smoked compared with usual care. Uncertainty and one-way sensitivity analyses were performed for variations in the calculation of the abstinence rates, the type of projection, intervention costs and discount rates. Nine studies were selected. The average 12-month continuous abstinence rates were estimated to be 1.4% for usual care, 2.6% for minimal counselling, 6.0% for intensive counselling and 12.3% for pharmacotherapy. Compared with usual care, the costs per quality-adjusted life year (QALY) gained for minimal counselling, intensive counselling and pharmacotherapy were euro 16 900, euro 8200 and euro 2400, respectively. The results were most sensitive to variations in the estimation of the abstinence rates and discount rates. Compared with usual care, intensive counselling and pharmacotherapy resulted in low costs per QALY gained with ratios comparable to results for smoking cessation in the general population. Compared with intensive counselling, pharmacotherapy was cost saving and dominated the other interventions.

  5. Correlates of minimal dating.

    Science.gov (United States)

    Leck, Kira

    2006-10-01

    Researchers have associated minimal dating with numerous factors. The present author tested shyness, introversion, physical attractiveness, performance evaluation, anxiety, social skill, social self-esteem, and loneliness to determine the nature of their relationships with 2 measures of self-reported minimal dating in a sample of 175 college students. For women, shyness, introversion, physical attractiveness, self-rated anxiety, social self-esteem, and loneliness correlated with 1 or both measures of minimal dating. For men, physical attractiveness, observer-rated social skill, social self-esteem, and loneliness correlated with 1 or both measures of minimal dating. The patterns of relationships were not identical for the 2 indicators of minimal dating, indicating the possibility that minimal dating is not a single construct as researchers previously believed. The present author discussed implications and suggestions for future researchers.

  6. Dry cooling tower operating experience in the LOFT reactor

    International Nuclear Information System (INIS)

    Hunter, J.A.

    1980-01-01

    A dry cooling tower has been uniquely utilized to dissipate heat generated in a small experimental pressurized water nuclear reactor. Operational experience revealed that dry cooling towers can be intermittently operated with minimal wind susceptibility and water hammer occurrences by cooling potential steam sources after a reactor scram, by isolating idle tubes from the external atmosphere, and by operating at relatively high pressures. Operating experience has also revealed that tube freezing can be minimized by incorporating the proper heating and heat loss prevention features

  7. [Robotic-assisted minimally invasive abdominothoracal oesophageal resection with intrathoracic anastomosis].

    Science.gov (United States)

    Egberts, J-H; Aselmann, H; Schafmayer, C; Jünemann, K-P; Becker, T

    2014-02-01

    Ivor Lewis oesophagectomy is one of the approaches used worldwide for treating oesophageal cancer. The adoption of minimally invasive oesophagectomy has increased worldwide since its first description more than 15 years ago. However, minimally invasive oesophagectomy with a chest anastomosis has advantages. By using a four-arm robotic platform, not only the preparation of the gastric tube and mobilisation of the oesophagus but also the intrathoracic anastomosis of the oesophagogastrostomy can be performed in a comfortable and safe way. The indication for oesophageal resection is oesophageal cancer. The operative procedure comprises robotic-assisted abdominothoracal oesophageal resection with reconstruction by a gastric tube and intrathoracic anastomosis (Ivor Lewis procedure). Robotic abdominal and thoracic minimally invasive esophagectomy is feasible, and safe with a complete lymph node dissection. Especially the intrathoracic anastomosis of the oesophagogastrostomy can be performed in a comfortable and safe way. Georg Thieme Verlag KG Stuttgart · New York.

  8. Minimally Invasive Cochlear Implantation Assisted by Bi-planar Device: An Exploratory Feasibility Study in vitro

    Directory of Open Access Journals (Sweden)

    Jia Ke

    2016-01-01

    Conclusions: This exploratory study demonstrated the safety of the newly developed image-guided minimally invasive cochlear implantation assisted by the bi-planar device and established the operational procedures. Further, more in vitro experiments are needed to improve the system operation and its safety.

  9. Complex intravenous anesthesia in interventional procedures

    International Nuclear Information System (INIS)

    Xie Zonggui; Hu Yuanming; Huang Yunlong; You Yong; Wu Juan; Huang Zengping; Li Jian

    2006-01-01

    Objective: To evaluate the value and safety of Diprivan and Fentany intravenous administration of analgesia in interventional procedures. Methods: Diprivan with Fentany intravenous administration for analgesia was used in eighty interventional procedures of sixty-five patients, without tracheal tube insertion. Vital signs including HR, BP, arterial oxygen saturation (SpO 2 ) and patients' reaction to operating were recorded. Results: Intravenous anesthesia was cared out successfully in eighty interventional procedures, with patients under sleeping condition during the operation, together with no pain and no agony memory of the procedure. The amount of Diprivan was 500±100 mg and Fentany was 0.2±0.025 mg. Mean arterial pressure and SpO 2 were 11.4±2.2 kPa, 10.6±2.1 kPa and 98±1.0, 96±1.5 respectively before and after ten minutes of the operation, with no significant difference. Conclusions: Diprivan with Fentany intravenous administration for interventional procedure analgesia possess good safety, painless and no agony memory of the procedure; therefor ought to be recommended. (authors)

  10. Minimal Super Technicolor

    DEFF Research Database (Denmark)

    Antola, M.; Di Chiara, S.; Sannino, F.

    2011-01-01

    We introduce novel extensions of the Standard Model featuring a supersymmetric technicolor sector (supertechnicolor). As the first minimal conformal supertechnicolor model we consider N=4 Super Yang-Mills which breaks to N=1 via the electroweak interactions. This is a well defined, economical......, between unparticle physics and Minimal Walking Technicolor. We consider also other N =1 extensions of the Minimal Walking Technicolor model. The new models allow all the standard model matter fields to acquire a mass....

  11. Infant Operant Conditioning and Its Implications for Early Intervention.

    Science.gov (United States)

    Lancioni, Giullo E.

    1980-01-01

    In this article infant operant conditioning studies are grouped according to distinct procedures: free operant; discrete trial with one discriminative stimulus; discrete trial with two or more discriminative stimuli; controlled operant with two or more discriminative stimuli; and unrestricted operant with two or more discriminative stimuli.…

  12. [Theory and practice of minimally invasive endodontics].

    Science.gov (United States)

    Jiang, H W

    2016-08-01

    The primary goal of modern endodontic therapy is to achieve the long-term retention of a functional tooth by preventing or treating pulpitis or apical periodontitis is. The long-term retention of endodontically treated tooth is correlated with the remaining amount of tooth tissue and the quality of the restoration after root canal filling. In recent years, there has been rapid progress and development in the basic research of endodontic biology, instrument and applied materials, making treatment procedures safer, more accurate, and more efficient. Thus, minimally invasive endodontics(MIE)has received increasing attention at present. MIE aims to preserve the maximum of tooth structure during root canal therapy, and the concept covers the whole process of diagnosis and treatment of teeth. This review article focuses on describing the minimally invasive concepts and operating essentials in endodontics, from diagnosis and treatment planning to the access opening, pulp cavity finishing, root canal cleaning and shaping, 3-dimensional root canal filling and restoration after root canal treatment.

  13. Nutrition in peri-operative esophageal cancer management.

    Science.gov (United States)

    Steenhagen, Elles; van Vulpen, Jonna K; van Hillegersberg, Richard; May, Anne M; Siersema, Peter D

    2017-07-01

    Nutritional status and dietary intake are increasingly recognized as essential areas in esophageal cancer management. Nutritional management of esophageal cancer is a continuously evolving field and comprises an interesting area for scientific research. Areas covered: This review encompasses the current literature on nutrition in the pre-operative, peri-operative, and post-operative phases of esophageal cancer. Both established interventions and potential novel targets for nutritional management are discussed. Expert commentary: To ensure an optimal pre-operative status and to reduce peri-operative complications, it is key to assess nutritional status in all pre-operative esophageal cancer patients and to apply nutritional interventions accordingly. Since esophagectomy results in a permanent anatomical change, a special focus on nutritional strategies is needed in the post-operative phase, including early initiation of enteral feeding, nutritional interventions for post-operative complications, and attention to long-term nutritional intake and status. Nutritional aspects of pre-optimization and peri-operative management should be incorporated in novel Enhanced Recovery After Surgery programs for esophageal cancer.

  14. On SW-minimal models and N=1 supersymmetric quantum Toda-field theories

    International Nuclear Information System (INIS)

    Mallwitz, S.

    1994-04-01

    Integrable N=1 supersymmetric Toda-field theories are determined by a contragredient simple Super-Lie-Algebra (SSLS) with purely fermionic lowering and raising operators. For the SSLA's Osp(3/2) and D(2/1;α) we construct explicitly the higher spin conserved currents and obtain free field representations of the super W-algebras SW(3/2,2) and SW(3/2,3/2,2). In constructing the corresponding series of minimal models using covariant vertex operators, we find a necessary restriction on the Cartan matrix of the SSLA, also for the general case. Within this framework, this restriction claims that there be a minimum of one non-vanishing element on the diagonal of the Cartan matrix. This condition is without parallel in bosonic conformal field theory. As a consequence only two series of SSLA's yield minimal models, namely Osp(2n/2n-1) and Osp(2n/2n+1). Subsequently some general aspects of degenerate representations of SW-algebras, notably the fusion rules, are investigated. As an application we discuss minimal models of SW(3/2, 2), which were constructed with independent methods, in this framework. Covariant formulation is used throughout this paper. (orig.)

  15. An optimization based method for line planning to minimize travel time

    DEFF Research Database (Denmark)

    Bull, Simon Henry; Lusby, Richard Martin; Larsen, Jesper

    2015-01-01

    The line planning problem is to select a number of lines from a potential pool which provides sufficient passenger capacity and meets operational requirements, with some objective measure of solution line quality. We model the problem of minimizing the average passenger system time, including...

  16. Minimally extended SILH

    International Nuclear Information System (INIS)

    Chala, Mikael; Grojean, Christophe; Humboldt-Univ. Berlin; Lima, Leonardo de; Univ. Estadual Paulista, Sao Paulo

    2017-03-01

    Higgs boson compositeness is a phenomenologically viable scenario addressing the hierarchy problem. In minimal models, the Higgs boson is the only degree of freedom of the strong sector below the strong interaction scale. We present here the simplest extension of such a framework with an additional composite spin-zero singlet. To this end, we adopt an effective field theory approach and develop a set of rules to estimate the size of the various operator coefficients, relating them to the parameters of the strong sector and its structural features. As a result, we obtain the patterns of new interactions affecting both the new singlet and the Higgs boson's physics. We identify the characteristics of the singlet field which cause its effects on Higgs physics to dominate over the ones inherited from the composite nature of the Higgs boson. Our effective field theory construction is supported by comparisons with explicit UV models.

  17. Minimally extended SILH

    Energy Technology Data Exchange (ETDEWEB)

    Chala, Mikael [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Valencia Univ. (Spain). Dept. de Fisica Teorica y IFIC; Durieux, Gauthier; Matsedonskyi, Oleksii [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Grojean, Christophe [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Humboldt-Univ. Berlin (Germany). Inst. fuer Physik; Lima, Leonardo de [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Univ. Estadual Paulista, Sao Paulo (Brazil). Inst. de Fisica Teorica

    2017-03-15

    Higgs boson compositeness is a phenomenologically viable scenario addressing the hierarchy problem. In minimal models, the Higgs boson is the only degree of freedom of the strong sector below the strong interaction scale. We present here the simplest extension of such a framework with an additional composite spin-zero singlet. To this end, we adopt an effective field theory approach and develop a set of rules to estimate the size of the various operator coefficients, relating them to the parameters of the strong sector and its structural features. As a result, we obtain the patterns of new interactions affecting both the new singlet and the Higgs boson's physics. We identify the characteristics of the singlet field which cause its effects on Higgs physics to dominate over the ones inherited from the composite nature of the Higgs boson. Our effective field theory construction is supported by comparisons with explicit UV models.

  18. Review and Analysis of Literature on Self-Management Interventions to Promote Appropriate Classroom Behaviors (1988-2008)

    Science.gov (United States)

    Briesch, Amy M.; Chafouleas, Sandra M.

    2009-01-01

    In the late 1980s, J. W. Fantuzzo and colleagues conducted a review of the self-management literature in order to better define the characteristics of this class of interventions. Results indicated that many interventions were minimally student-directed despite the title "self-managed" and that student-managed interventions demonstrated…

  19. The Cycle of Reciprocity: A Social Capital Intervention Strategy for SSTR Operations

    National Research Council Canada - National Science Library

    Tolle, Glenn A

    2007-01-01

    ...? The author postulates that an intervention strategy based on fostering "bridging social capital" between two or more competing parties stands a greater probability of success than an intervention...

  20. [Evaluation of the results of high-speed handpiece and minimally invasive extraction in impacted mandibular third molar extraction].

    Science.gov (United States)

    Yang, Ying-yang; DU, Sheng-nan; Lv, Zong-kai

    2015-08-01

    To compare the results of high-speed handpiece and minimally invasive extraction in impacted mandibular third molar extraction. From May 2011 to May 2014, 83 patients undergoing impacted mandibular third molar extraction were enrolled into the study and randomly divided into 2 groups: 42 patients in group A (experimental group) and 41 patients in group B (control group). Group B underwent extraction with traditional method and group A underwent high-speed handpiece and minimally invasive extraction of the impacted mandibular third molar. The occurrences of the root fracture, gingival laceration, tooth mobility, lingual bone plate fracture, jaw fracture and dislocation of temporomandibular joint during operation and lower lip numbness, dry socket, facial swelling and limitation of mouth opening after operation were observed and compared between 2 groups. The operation time, integrity of extraction sockets, VAS pain score and satisfaction from patients were collected and compared. SPSS 19.0 software package was used for statistical analysis. The occurrences of root fracture, gingival laceration, tooth mobility, lingual bone plate fracture, jaw fracture, and dislocation of temporomandibular joint during operation in group A significantly decreased compared with group B (Pextraction sockets, VAS pain scores and satisfaction scores in group A improved significantly compared with group B (Phandpiece and minimally invasive extraction should be widely used in impacted mandibular third molar extraction, due to the advantages of simple operation, high efficiency, minimal trauma, and few perioperative complications.

  1. BRST cohomology ring in 2D gravity coupled to minimal models

    International Nuclear Information System (INIS)

    Kanno, H.; Sarmadi, M.H.

    1992-08-01

    The ring structure of Lian-Zuckerman states for (q,p) minimal models coupled to gravity is shown to be R=R 0 xC[w,w -1 ] where R 0 is the ring of ghost number zero operators generated by two elements and w is an operator of ghost number -1. Some examples are discussed in detail. For these models the currents are also discussed and their algebra is shown to contain the Virasoro algebra. (author). 21 refs

  2. Uniportal thoracoscopy combined with laparoscopy as minimally invasive treatment of esophageal cancer.

    Science.gov (United States)

    Caronia, Francesco Paolo; Arrigo, Ettore; Failla, Andrea Valentino; Sgalambro, Francesco; Giannone, Giorgio; Lo Monte, Attilio Ignazio; Cajozzo, Massimo; Santini, Mario; Fiorelli, Alfonso

    2018-04-01

    A 67-year-old man was referred to our attention for management of esophageal adenocarcinoma, localized at the level of the esophagogastric junction and obstructed the 1/3 of the esophageal lumen. Due to the extension of the disease (T3N1M0-Stage IIIA), the patient underwent neo-adjuvant chemo-radiation therapy and he was then scheduled for a minimally invasive surgical procedure including laparoscopic gastroplasty, uniportal thoracoscopic esophageal dissection and intrathoracic end-to-end esophago-gastric anastomosis. No intraoperative and post-operative complications were seen. The patient was discharged in post-operative day 9. Pathological study confirmed the diagnosis of adenocarcinoma (T2N1M0-Stage IIB) and he underwent adjuvant chemotherapy. At the time of present paper, patient is alive and well without signs of recurrence or metastasis. Our minimally approach compared to standard open procedure would help reduce post-operative pain and favours early return to normal activity. However, future experiences with a control group are required before our strategy can be widely used.

  3. The minimal curvaton-Higgs model

    International Nuclear Information System (INIS)

    Enqvist, Kari; Lerner, Rose N.; Helsinki Univ. and Helsinki Institute of Physics; Takahashi, Tomo

    2013-10-01

    We present the first full study of the minimal curvaton-Higgs (MCH) model, which is a minimal interpretation of the curvaton scenario with one real scalar coupled to the standard model Higgs boson. The standard model coupling allows the dynamics of the model to be determined in detail, including effects from the thermal background and from radiative corrections to the potential. The relevant mechanisms for curvaton decay are incomplete non-perturbative decay (delayed by thermal blocking), followed by decay via a dimension-5 non-renormalisable operator. To avoid spoiling the predictions of big bang nucleosynthesis, we find the ''bare'' curvaton mass to be m σ ≥8 x 10 4 GeV. To match observational data from Planck there is an upper limit on the curvaton-higgs coupling g, between 10 -3 and 10 -2 , depending on the mass. This is due to interactions with the thermal background. We find that typically non-Gaussianities are small but that if f NL is observed in the near future then m σ 9 GeV, depending on Hubble scale during inflation. In a thermal dark matter model, the lower bound on m σ can increase substantially. The parameter space may also be affected once the baryogenesis mechanism is specified.

  4. Scattering matrices for Φ1,2 perturbed conformal minimal models in absence of kink states

    International Nuclear Information System (INIS)

    Koubek, A.; Martins, M.J.; Mussardo, G.

    1991-05-01

    We determine the spectrum and the factorizable S-matrices of the massive excitations of the nonunitary minimal models M 2,2n+1 perturbed by the operator Φ 1,2 . These models present no kinks as asymptotic states, as follows from the reduction of the Zhiber-Mikhailov-Shabat model with respect to the quantum group SL(2) q found by Smirnov. We also give the whole set of S-matrices of the nonunitary minimal model M 2,9 perturbed by the operator Φ 1,4 , which is related to a RSOS reduction for the Φ 1.2 operator of the unitary model M 8,9 . The thermodynamical Bethe ansatz and the truncated conformal space approach are applied to these scattering theories in order to support their interpretation. (orig.)

  5. Proceedings of the Department of Energy Defense Programs hazardous and mixed waste minimization workshop: Hazardous Waste Remedial Actions Program

    International Nuclear Information System (INIS)

    1988-09-01

    The first workshop on hazardous and mixed waste minimization was held in Las Vegas, Nevada, on July 26--28, 1988. The objective of this workshop was to establish an interchange between DOE headquarters (DOE-HQ) DP, Operations Offices, and contractors of waste minimization strategies and successes. The first day of the workshop began with presentations stressing the importance of establishing a waste minimization program at each site as required by RCRA, the land ban restrictions, and the decrease in potential liabilities associated with waste disposal. Discussions were also centered on pending legislation which would create an Office of Waste Reduction in the Environmental Protection Agency (EPA). The Waste Minimization and Avoidance Study was initiated by DOE as an addition to the long-term productivity study to address the issues of evolving requirements facing RCRA waste management activities at the DP sites, to determine how major operations will be affected by these requirements, and to determine the available strategies and options for waste minimization and avoidance. Waste minimization was defined in this study as source reduction and recycling

  6. Minimally Invasive Treatment of Giant Haemangiomas of the Liver: Embolisation With Bleomycin

    Energy Technology Data Exchange (ETDEWEB)

    Bozkaya, Halil, E-mail: halilbozkaya@yahoo.com; Cinar, Celal, E-mail: celalcinar@hotmail.com [Ege University, Division of Interventional Radiology, Department of Radiology, School of Medicine (Turkey); Besir, Fahri Halit, E-mail: drfhbesir@gmail.com [Duzce University, Department of Radiology, School of Medicine (Turkey); Parıldar, Mustafa, E-mail: mparildar@yahoo.com; Oran, Ismail, E-mail: ismailoran@gmail.com [Ege University, Division of Interventional Radiology, Department of Radiology, School of Medicine (Turkey)

    2013-04-12

    PurposeThe management of patients with giant haemangioma of the liver remains controversial. Although the usual treatment method for symptomatic giant haemangioma is surgery, the classical paradigm of operative resection remains. In this study, we evaluated the symptomatic improvement and size-reduction effect of embolisation with bleomycin mixed with lipiodol for the treatment of symptomatic giant hepatic haemangioma.MethodsThis study included 26 patients [21 female, five male; age 41–65 years (mean 49.83 ± 1.53)] with symptomatic giant haemangioma unfit for surgery and treated with selective embolisation by bleomycin mixed with lipiodol. The patients were followed-up (mean 7.4 ± 0.81 months) clinically and using imaging methods. Statistical analysis was performed using SPSS version 16.0, and p < 0.05 was considered to indicate statistical significance.ResultsEmbolisation of 32 lesions in 26 patients was performed. The mean volume of the haemangiomas was 446.28 ± 88 cm{sup 3} (range 3.39–1559 cm{sup 3}) before intervention and 244.43 ± 54.38 cm{sup 3} (range 94–967 cm{sup 3}) after intervention. No mortality or morbidity related to the treatment was identified. Symptomatic improvement was observed in all patients, and significant volume reduction was achieved (p = 0.001).ConclusionThe morbidity of surgical treatment in patients with giant liver hemangioma were similar to those obtained in patients followed-up without treatment. Therefore, follow-up without treatment is preferred in most patients. Thus, minimally invasive embolisation is an alternative and effective treatment for giant symptomatic haemangioma of the liver.

  7. Process optimized minimally invasive total hip replacement

    Directory of Open Access Journals (Sweden)

    Philipp Gebel

    2012-02-01

    Full Text Available The purpose of this study was to analyse a new concept of using the the minimally invasive direct anterior approach (DAA in total hip replacement (THR in combination with the leg positioner (Rotex- Table and a modified retractor system (Condor. We evaluated retrospectively the first 100 primary THR operated with the new concept between 2009 and 2010, regarding operation data, radiological and clinical outcome (HOOS. All surgeries were perfomed in a standardized operation technique including navigation. The average age of the patients was 68 years (37 to 92 years, with a mean BMI of 26.5 (17 to 43. The mean time of surgery was 80 min. (55 to 130 min. The blood loss showed an average of 511.5 mL (200 to 1000 mL. No intra-operative complications occurred. The postoperative complication rate was 6%. The HOOS increased from 43 points pre-operatively to 90 (max 100 points 3 months after surgery. The radiological analysis showed an average cup inclination of 43° and a leg length discrepancy in a range of +/- 5 mm in 99%. The presented technique led to excellent clinic results, showed low complication rates and allowed correct implant positions although manpower was saved.

  8. Intervention Integrity in the Low Countries: Interventions Targeting Social-Emotional Behaviors in the School

    Science.gov (United States)

    Taal, Margot; Ekels, Elles; van der Valk, Cindel; van der Molen, Maurits

    2017-01-01

    The current study presents a review of intervention studies conducted in the Low Countries (i.e., The Netherlands and Flanders) focusing on social-emotional behaviors in the school. The primary purpose of this review was to assess whether studies included an operational definition of the intervention under study and reported data on the…

  9. Entropy Generation Minimization in Dimethyl Ether Synthesis: A Case Study

    Science.gov (United States)

    Kingston, Diego; Razzitte, Adrián César

    2018-04-01

    Entropy generation minimization is a method that helps improve the efficiency of real processes and devices. In this article, we study the entropy production (due to chemical reactions, heat exchange and friction) in a conventional reactor that synthesizes dimethyl ether and minimize it by modifying different operating variables of the reactor, such as composition, temperature and pressure, while aiming at a fixed production of dimethyl ether. Our results indicate that it is possible to reduce the entropy production rate by nearly 70 % and that, by changing only the inlet composition, it is possible to cut it by nearly 40 %, though this comes at the expense of greater dissipation due to heat transfer. We also study the alternative of coupling the reactor with another, where dehydrogenation of methylcyclohexane takes place. In that case, entropy generation can be reduced by 54 %, when pressure, temperature and inlet molar flows are varied. These examples show that entropy generation analysis can be a valuable tool in engineering design and applications aiming at process intensification and efficient operation of plant equipment.

  10. Crisis Intervention in Early Adolescence. First Annual Report.

    Science.gov (United States)

    Adolescence Resources Center, Sumter, SC.

    The basic premise under investigation is that systematic intervention in a predictable, natural occurring stress situation for population groups: (1) can promote acquisition of competence and coping skills; and (2) minimize pathological response to stress and eventual need for treatment. This study is an exploration of preadolescent development of…

  11. Hanford Site waste minimization and pollution prevention awareness program plan

    International Nuclear Information System (INIS)

    1994-05-01

    The Hanford Site WMin/P2 program is an organized, comprehensive, and continual effort to systematically reduce the quantity and toxicity of hazardous, radioactive, mixed, and sanitary wastes; conserve resources; and prevent or minimize pollutant releases to all environmental media from all Site activities. The Hanford Site WMin/P2 program plan reflects national and DOE waste minimization and pollution prevention goals and policies, and represents an ongoing effort to make WMin/P2 part of the Site operating philosophy. In accordance with these policies, a hierarchical approach to environmental management has been adopted and is applied to all types of polluting and waste generating activities. Pollution prevention and waste minimization through source reduction are first priority in the Hanford WMin/P2 program, followed by environmentally safe recycling. Treatment to reduce the quantity, toxicity, and/or mobility will be considered only when prevention or recycling are not possible or practical. Environmentally safe disposal is the last option

  12. Minimally invasive lateral trans-psoas approach for tuberculosis of lumbar spine

    Directory of Open Access Journals (Sweden)

    Nitin Garg

    2014-01-01

    Full Text Available Anterior, posterolateral and posterior approaches are used for managing lumbar tuberculosis. Minimally invasive methods are being used increasingly for various disorders of the spine. This report presents the utility of lateral trans-psoas approach to the lumbar spine (LS using minimal access techniques, also known as direct lateral lumbar interbody fusion in 2 cases with tuberculosis of LS. Two patients with tuberculosis at L2-3 and L4-5 presented with back pain. Both had destruction and deformity of the vertebral body. The whole procedure comprising debridement and placement of iliac crest graft was performed using tubular retractors and was augmented by posterior fixation using percutaneous transpedicular screws. Both patients recovered well with no significant procedure related morbidity. Post-operative computed tomography scans showed appropriate position of the graft and instrumentation. At follow-up, both patients are ambulant with no progression of the deformity. Minimal access direct lateral transpsoas approach can be used for debridement and reconstruction of ventral column in tuberculous of Lumbar spine. This paper highlights the growing applications of minimal access surgery for spine.

  13. Minimally invasive plating osteosynthesis for mid-distal third humeral shaft fractures.

    Science.gov (United States)

    Lian, Kejian; Wang, Lei; Lin, Dasheng; Chen, Zhiwen

    2013-08-01

    Mid-distal third humeral shaft fractures can be effectively treated with minimally invasive plating osteosynthesis and intramedullary nailing (IMN). However, these 2 treatments have not been adequately compared. Forty-seven patients (47 fractures) with mid-distal third humeral shaft fractures were randomly allocated to undergo either minimally invasive plating osteosynthesis (n=24) or IMN (n=23). The 2 groups were similar in terms of fracture patterns, fracture location, age, and associated injuries. Intraoperative measurements included blood loss and operative time. Clinical outcome measurements included fracture healing, radial nerve recovery, and elbow and shoulder discomfort. Radiographic measurements included fracture alignment, time to healing, delayed union, and nonunion. Functional outcome was satisfactory in both groups. Mean American Shoulder and Elbow Surgeons score and Mayo score were both better for the minimally invasive plating osteosynthesis group than for the IMN group (98.2 vs 97.6, respectively, and 93.5 vs 94.1, respectively; Pshaft fractures. Minimally invasive plating osteosynthesis is more suitable for complex fractures, especially for radial protection and motion recovery of adjacent joints, compared with IMN for simple fractures. Copyright 2013, SLACK Incorporated.

  14. Reducing musculoskeletal disorders among computer operators: comparison between ergonomics interventions at the workplace.

    Science.gov (United States)

    Levanon, Yafa; Gefen, Amit; Lerman, Yehuda; Givon, Uri; Ratzon, Navah Z

    2012-01-01

    Typing is associated with musculoskeletal disorders (MSDs) caused by multiple risk factors. This control study aimed to evaluate the efficacy of a workplace intervention for reducing MSDs among computer workers. Sixty-six subjects with and without MSD were assigned consecutively to one of three groups: ergonomics intervention (work site and body posture adjustments, muscle activity training and exercises) accompanied with biofeedback training, the same ergonomics intervention without biofeedback and a control group. Evaluation of MSDs, body posture, psychosocial status, upper extremity (UE) kinematics and muscle surface electromyography were carried out before and after the intervention in the workplace and the motion lab. Our main hypothesis that significant differences in the reduction of MSDs will exist between subjects in the study groups and controls was confirmed (χ(2) = 13.3; p = 0.001). Significant changes were found in UE kinematics and posture as well. Both ergonomics interventions effectively reduced MSD and improved body posture. This study aimed to test the efficacy of an individual workplace intervention programme among computer workers by evaluating musculoskeletal disorders (MSDs), body posture, upper extremity kinematics, muscle activity and psychosocial factors were tested. The proposed ergonomics interventions effectively reduced MSDs and improved body posture.

  15. Internet-based interventions for cancer-related distress: exploring the experiences of those whose needs are not met.

    Science.gov (United States)

    Gorlick, Amanda; Bantum, Erin O'Carroll; Owen, Jason E

    2014-04-01

    Low levels of engagement in Internet-based interventions are common. Understanding users' experiences with these interventions is a key to improving efficacy. Although qualitative methods are well-suited for this purpose, few qualitative studies have been conducted in this area. In the present study, we assessed experiences with an Internet-based intervention among cancer survivors who made minimal use of the intervention. Semi-structured interviews were conducted with 25 cancer survivors who were minimally engaged (i.e., spent around 1 h total on website) with the online intervention, health-space.net. The intervention was a 12-week, facilitated support group with social and informational components. Interviews were analyzed using an interpretive descriptive design. Three broad categories, consisting of 18 specific themes, were identified from the interviews, which included connecting with similar others, individual expectations, and problems with the site (Κ = 0.88). The 'similar others' category reflected the significance of interacting with relatable survivors (i.e., same cancer type), the 'individual expectations' category reflected the significance of participants' expectations about using online interventions (i.e., personally relevant information), and the 'problems with the site' category reflected the significance of study procedures (i.e., website structure). The data indicate that minimally engaged participants have high variability regarding their needs and preferences for Internet-based interventions. Using qualitative methodologies to identify and incorporate these needs into the next generation of interventions has the potential to increase engagement and outcomes. The current study provides a foundation for future research to characterize survivors' needs and offer suggestions for better meeting these needs. Copyright © 2013 John Wiley & Sons, Ltd.

  16. A prospective randomized peri- and post-operative comparison of the minimally invasive anterolateral approach versus the lateral approach

    OpenAIRE

    Stefan Landgraeber; Henning Quitmann; Sebastian Güth; Marcel Haversath; Wojciech Kowalczyk; Andrés Kecskeméthy; Hansjörg Heep; Marcus Jäger

    2013-01-01

    There is still controversy as to whether minimally invasive total hip arthroplasty enhances the postoperative outcome. The aim of this study was to compare the outcome of patients who underwent total hip replacement through an anterolateral minimally invasive (MIS) or a conventional lateral approach (CON). We performed a randomized, prospective study of 75 patients with primary hip arthritis, who underwent hip replacement through the MIS (n=36) or CON (n=39) approach. The Western Ontario and ...

  17. Minimal Nasolabial Incision Technique for Nasolabial Fold Modification in Patients With Facial Paralysis.

    Science.gov (United States)

    Faris, Callum; Heiser, Alyssa; Jowett, Nate; Hadlock, Tessa

    2018-03-01

    Creation of symmetrical nasolabial folds (NLFs) is important in the management of the paralyzed face. Established techniques use a linear incision in the NLF, and technical refinements now allow the linear incision to be omitted. This retrospective case series was conducted in a tertiary care setting from February 2, 2017, to June 7, 2017. Participants were all patients (N = 21) with peripheral facial paralysis who underwent NLF modification that used the minimal nasolabial incision technique at the Massachusetts Eye and Ear Infirmary Facial Nerve Center from February 1, 2015, through August 31, 2016. Patient-reported outcome measures using the validated, quality-of-life Facial Clinimetric Evaluation (FaCE) Scale; clinician-reported facial function outcomes using a validated electronic clinician-graded facial paralysis assessment (eFACE); layperson assessment of the overall aesthetic outcome of the NLF; and expert-clinician scar assessment of the NLF. Of the 21 patients who underwent NLF modification that used the minimal nasolabial incision technique, 9 patients (43%) were female and 12 (57%) were male. The mean age was 41 (range, 9-90) years; 17 patients (81%) were adults (≥18 years) and 4 (19%) were children (<18 years). Overall, significant improvements were observed after NLF modification in all outcome measures as graded by both clinicians and patients. The mean (SD) scores for total eFACE were 60.7 (14.9) before the operation and 77.2 (8.9) after the operation (mean difference, 16.5 [95% CI, 8.5-24.2]; P < .001). The mean (SD) static eFACE scores were 61.4 (20.6) before the operation and 82.7 (12.4) after the operation (mean difference, 21.3 [95% CI, 10.7-31.9]; P < .001). The mean (SD) FaCE quality-of-life scores were 51.3 (20.1) before the operation and 70.3 (12.6) after the operation (mean difference, 19.0 [95% CI, 6.5-31.6]; P  =  .001). The layperson self-assessment of the overall aesthetic outcome of the NLF modification was

  18. Minimizing Mutual Couping

    DEFF Research Database (Denmark)

    2010-01-01

    Disclosed herein are techniques, systems, and methods relating to minimizing mutual coupling between a first antenna and a second antenna.......Disclosed herein are techniques, systems, and methods relating to minimizing mutual coupling between a first antenna and a second antenna....

  19. Operation auxiliary system (SAO)

    International Nuclear Information System (INIS)

    Lolich, J.; Santome, D.; Drexler, J.

    1990-01-01

    This work presents an auxiliary system for nuclear power plants operation (SAO). The development purpose consisted in a computing supervision system to be installed at different sites of a reactor, mainly in the control room. The inclusion of this system to a nuclear power plant minimizes the possibility of human error for the facility operation. (Author) [es

  20. Ergonomic assessment of neck posture in the minimally invasive surgery suite during laparoscopic cholecystectomy.

    Science.gov (United States)

    van Det, M J; Meijerink, W J H J; Hoff, C; van Veelen, M A; Pierie, J P E N

    2008-11-01

    With the expanding implementation of minimally invasive surgery, the operating team is confronted with challenges in the field of ergonomics. Visual feedback is derived from a monitor placed outside the operating field. This crossover trial was conducted to evaluate and compare neck posture in relation to monitor position in a dedicated minimally invasive surgery (MIS) suite and a conventional operating room. Assessment of the neck was conducted for 16 surgeons, assisting surgeons, and scrub nurses performing a laparoscopic cholecystectomy in both types of operating room. Flexion and rotation of the cervical spine were measured intraoperatively using a video analysis system. A two-question visual analog scale (VAS) questionnaire was used to evaluate posture in relation to the monitor position. Neck rotation was significantly reduced in the MIS suite for the surgeon (p = 0.018) and the assisting surgeon (p < 0.001). Neck flexion was significantly improved in the MIS suite for the surgeon (p < 0.001) and the scrub nurse (p = 0.018). On the questionnaire, the operating room team scored their posture significantly higher in the MIS suite and also indicated fewer musculoskeletal complaints. The ergonomic quality of the neck posture is significantly improved in the MIS suite for the entire operating room team.

  1. 2013 Los Alamos National Laboratory Hazardous Waste Minimization Report

    Energy Technology Data Exchange (ETDEWEB)

    Salzman, Sonja L. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); English, Charles J. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-08-24

    Waste minimization and pollution prevention are inherent goals within the operating procedures of Los Alamos National Security, LLC (LANS). The US Department of Energy (DOE) and LANS are required to submit an annual hazardous waste minimization report to the New Mexico Environment Department (NMED) in accordance with the Los Alamos National Laboratory (LANL or the Laboratory) Hazardous Waste Facility Permit. The report was prepared pursuant to the requirements of Section 2.9 of the LANL Hazardous Waste Facility Permit. This report describes the hazardous waste minimization program (a component of the overall Waste Minimization/Pollution Prevention [WMin/PP] Program) administered by the Environmental Stewardship Group (ENV-ES). This report also supports the waste minimization and pollution prevention goals of the Environmental Programs Directorate (EP) organizations that are responsible for implementing remediation activities and describes its programs to incorporate waste reduction practices into remediation activities and procedures. LANS was very successful in fiscal year (FY) 2013 (October 1-September 30) in WMin/PP efforts. Staff funded four projects specifically related to reduction of waste with hazardous constituents, and LANS won four national awards for pollution prevention efforts from the National Nuclear Security Administration (NNSA). In FY13, there was no hazardous, mixedtransuranic (MTRU), or mixed low-level (MLLW) remediation waste generated at the Laboratory. More hazardous waste, MTRU waste, and MLLW was generated in FY13 than in FY12, and the majority of the increase was related to MTRU processing or lab cleanouts. These accomplishments and analysis of the waste streams are discussed in much more detail within this report.

  2. Psychosocial interventions in attention-deficit/hyperactivity disorder: update.

    Science.gov (United States)

    Antshel, Kevin M

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is the most common reason for referral to child and adolescent psychiatry clinics. Although stimulant medications represent an evidence-based approach to managing ADHD, psychosocial interventions for child/adolescent ADHD target functional impairments as the intervention goal, and rely heavily on behavioral therapy techniques and operant conditioning principles. Evidence-based psychosocial interventions for managing pediatric ADHD include behavioral parent training, school-based interventions relying on behavioral modification, teaching skills, and operant conditioning principles, and intensive summer treatment programs. The use of conjoint psychosocial treatments with ADHD medications may enable lower doses of each form of treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Claims of operators, non-operators and third parties arising from oil and gas operations

    International Nuclear Information System (INIS)

    Block, R.W.; Semadeni, T.

    1999-01-01

    There has come a resurgence in the number of companies involved in the oil and gas industry seeking protection from their creditors because of the recent weakness in commodity prices. Because most operations in this industry are conducted jointly, a single insolvency can lead to a toppling of other participants in the joint venture and beyond. The problem is to minimize one's losses if other members of the joint venture become insolvent. An examination is included of some remedies which may be available to operators, non-operators and third parties when faced with an insolvent oil and gas participant. The remedies which may be available to the non-operator that is owed moneys by its operator are discussed. The remedies that the operator has against its non-operators, with an emphasis on the nature of the operator's lien and the right of set-off, are described. A brief review is included of some of the remedies that might be available to a third party as against the operators and non-operators. Some s uggestions are included for directors, bankers, third parties, non-operators and operators

  4. Waste minimization successes at McGuire Nuclear Station

    International Nuclear Information System (INIS)

    Correll, J.C.; Johnson, G.T.

    1995-01-01

    McGuire Nuclear Station is a two unit, 1125 MWe PWR located 25 miles north of Charlotte, North Carolina. It is a Westinghouse Ice Condenser plant that is owned and operated by Duke Power Company. At Duke Power, open-quotes Culture Changeclose quotes is a common term that we have used to describe the incredible transformation that we are making to become a cost conscious, customer driven, highly competitive business. Nowhere has this change been more evident then in the way we process and disposed of our solid radioactive waste. With top-down management support, we have used team-based, formalized, problem solving methods and have implemented many successful waste minimization programs. Through these programs, we have dramatically increased employees close-quote awareness of the importance of waste minimization. As a result, we have been able to reduce both our burial volumes and our waste processing and disposal costs

  5. Minimally invasive surgical procedures for the treatment of lumbar disc herniation

    Directory of Open Access Journals (Sweden)

    Raspe, Heiner

    2005-11-01

    there is no dependable evidence-base to recommend their use in routine clinical practice. 2. To create such a dependable evidence-base further research in two directions is needed: a The studies need to include adequate patient populations, use realistic controls (e.g. standard operative procedures or continued conservative care and use standardised measurements of meaningful outcomes after adequate periods of time. b Studies that are able to report effectiveness of the procedures under everyday practice conditions and furthermore have the potential to detect rare adverse effects are needed. In Sweden this type of data is yielded by national quality registries. On the one hand their data are used for quality improvement measures and on the other hand they allow comprehensive scientific evaluations. 3. Since the year of 2000 a continuous rise in utilisation of minimally-invasive lumbar disc surgery is observed among statutory health insurers. Examples from other areas of innovative surgical technologies (e.g. robot assisted total hip replacement indicate that the rise will probably continue - especially because there are no legal barriers to hinder introduction of innovative treatments into routine hospital care. Upon request by payers or providers the "Gemeinsamer Bundesausschuss" may assess a treatments benefit, its necessity and cost-effectiveness as a prerequisite for coverage by the statutory health insurance. In the case of minimally-invasive disc surgery it would be advisable to examine the legal framework for covering procedures only if they are provided under evaluation conditions. While in Germany coverage under evaluation conditions is established practice in ambulatory health care only (“Modellvorhaben" examples from other European countries (Great Britain, Switzerland demonstrate that it is also feasible for hospital based interventions. In order to assure patient protection and at the same time not hinder the further development of new and promising

  6. Creation of a mobile intervention group; Creation d'un groupe mobile d'intervention

    Energy Technology Data Exchange (ETDEWEB)

    Cerre, P.; Mestre, E.

    1961-11-30

    This document presents the different missions and equipment of the Mobile Intervention Group which is supposed to intervene on a site of accident involving radioactive products. The authors indicate the various missions inside and outside a nuclear centre, the vehicles (with a laboratory, a decontamination set, an intervention vehicle for four persons, a liaison vehicle), the intervention equipment, the control and sampling equipment (samplers, counters), the analysis equipment, and the personnel (engineer, chemist, electronics technician, drivers, decontamination agents, sampling agents). They describe the alert procedure and the successive operations.

  7. Symptomatic portal vein occlusion: treated by interventional radiological techniques

    International Nuclear Information System (INIS)

    Wang Maoqiang; Gu Xiaofang; Guan Jun; Wang Zhongpu; Liu Fengyong; Wang Zhiqiang

    2004-01-01

    Objective: To evaluate the efficacy and safety of the interventional radiological techniques for management of symptomatic portal vein (PV) occlusion. Methods: Nine patients with PV trunk occlusion were treated using interventional procedures. Four patients presented with abdominal pain, distention, and malabsorption; five presented with portal hypertension and repeated bleeding from esophagogastric varices. The etiologic factors were identified in all 9 patients, including post-transplantation of the liver in 2, hepatocellular carcinoma (HCC) associated with PV tumor thrombus in 3, post abdominal operative state in 1, and PV thrombosis in 3 cases. The portal access was established via a percutaneous transhepatic route in 4, and via a transjugular intrahepatic portosystemic shunt ( TIPS) approach in 5 patients. The interventional procedures included stent placement in 4, balloon angioplasty in 6, and catheter directed pharmacologic and mechanical thrombolysis in 7 patients. Results: The technical success was achieved in all cases. No complications related to the procedure occurred. Portal flow was reestablished in all patients after the procedures. Clinical improvement was seen in 3 patients with symptomatic PV thrombosis, characterized by progressive reduction of abdominal pain, distention, and diarrhea. Follow-up time ranged from 4 to 36 months. One patient with HCC died of multiple organs metastases at 11 months after the treatment . One patient died of intraabdominal sepsis and multiple organs failure 12 days after the procedure even though the antegrade flow was re-established in the main trunk of the PV. Patency of the PV trunk was confirmed by follow-up color Doppler ultrasound scan in the rest 7 patients, without recurrence of variceal bleeding or PV thrombus. Conclusions: Interventional minimally invasive procedures, including balloon angioplasty, stent placement, catheter directed local pharmacologic and mechanical thrombolysis, are safe and effective in

  8. Minimally invasive surgical treatment for temporomandibular joint in patients with various rheumatic diseases

    Directory of Open Access Journals (Sweden)

    A. Yu. Drobyshev

    2017-01-01

    Full Text Available Temporomandibular joint (TMJ involvement occurs in patients with different rheumatic diseases (RDs. Pain, limitation of mouth opening can lead to significant problems in both oral hygiene and when eating. Conservative treatments for TMJ lesions are not always effective. Objective: to evaluate the efficiency of minimally invasive surgical interventions (TMJ arthrocentesis and arthroscopy in patients with RDs. Patients and methods. The investigation enrolled 64 patients with different RDs (43 with rheumatoid arthritis, 11 with psoriatic arthritis, 8 with systemic lupus erythematosus, and 2 with ankylosing spondylitis who were divided into three groups in relation to the severity of TMJ involvement in accordance with the Wilkes classification. All the patients underwent TMJ magnetic resonance imaging at baseline and 6 months after treatment. Also at baseline, 14 days, and 1, 6, and 12 months after surgery, the investigators assessed TMJ pain intensity by visual analogue scale and the parameters of mandibular movements. Patients with Wilkes stages IV and V TMJ involvement underwent arthroscopic intervention into the TMJ and those with III stage received TMJ arthrocentesis with arthrolavage. Results and discussion. After surgical treatment, all the groups were noted to have a significant decrease in TMJ pain intensity compared with the baseline level; moreover, the severity of TMJ pain most significantly decreased on day 7 after surgery. Later on, positive changes remained within subsequent follow-up months. There were data similar in the higher degree of mouth opening. The results of surgical treatment in patients with Wilkes stage V TMJ involvement were worse than in those with stages III and IV. Conclusion. Minimally invasive TMJ surgery in patients with RDs is effective and associated with the low frequency of postoperative complications and exacerbations of RDs. The efficiency of minimally invasive TMJ surgery is higher in patients with the

  9. New special operators in W-gravity theories

    International Nuclear Information System (INIS)

    Rama, S.K.

    1991-01-01

    This paper reports on special physical operators of W 3 -gravity having non-trivial ghost sectors. Some of these operators may be viewed as the Liouville dressings of the energy operator of the Ising model coupled to two-dimensional (2D) gravity and this fills in the gap in the connection between pure W 3 -gravity and Ising model coupled to 2D gravity found in the authors' previous work. The authors formulate a selection rule required for the calculation of correlators in W-gravity theories. Using this rule, the authors construct the non-ghost part of the new operators of W N -gravity and find that they represent the (N,N + 1) minimal model operators from both inside and outside the minimal table. Along the way the authors obtain the canonical spectrum of W N -gravity for all N

  10. Operational Performance Risk Assessment in Support of A Supervisory Control System

    Energy Technology Data Exchange (ETDEWEB)

    Denning, Richard S. [Self Employed; Muhlheim, Michael David [ORNL; Cetiner, Sacit M. [ORNL; Guler Yigitoglu, Askin [ORNL

    2017-06-01

    Supervisory control system (SCS) is developed for multi-unit advanced small modular reactors to minimize human interventions in both normal and abnormal operations. In SCS, control action decisions made based on probabilistic risk assessment approach via Event Trees/Fault Trees. Although traditional PRA tools are implemented, their scope is extended to normal operations and application is reversed; success of non-safety related system instead failure of safety systems this extended PRA approach called as operational performance risk assessment (OPRA). OPRA helps to identify success paths, combination of control actions for transients and to quantify these success paths to provide possible actions without activating plant protection system. In this paper, a case study of the OPRA in supervisory control system is demonstrated within the context of the ALMR PRISM design, specifically power conversion system. The scenario investigated involved a condition that the feed water control valve is observed to be drifting to the closed position. Alternative plant configurations were identified via OPRA that would allow the plant to continue to operate at full or reduced power. Dynamic analyses were performed with a thermal-hydraulic model of the ALMR PRISM system using Modelica to evaluate remained safety margins. Successful recovery paths for the selected scenario are identified and quantified via SCS.

  11. Intervention program efficacy for spelling difficulties.

    Science.gov (United States)

    Sampaio, Maria Nobre; Capellini, Simone Aparecida

    2014-01-01

    To develop an intervention procedure for spelling difficulties and to verify the effectiveness of the intervention program in students with lower spelling performance. We developed an intervention program for spelling difficulties, according to the semiology of the errors. The program consisted of three modules totaling 16 sessions. The study included 40 students of the third to fifth grade of public elementary education of the city of Marilia (SP), of both genders, in aged of eight to 12 years old, being distributed in the following groups: GI (20 students with lower spelling performance) and GII (20 students with higher spelling performance). In situation of pre and post-testing, all groups were submitted to the Pro-Orthography. The results statistically analyzed showed that, in general, all groups had average of right that has higher in post-testing, reducing the types of errors second semiologycal classification, mainly related to natural spelling errors. However, the results also showed that the groups submitted to the intervention program showed better performance on spelling tests in relation to not submitted. The intervention program developed was effective once the groups submitted showed better performance on spelling tests in relation to not submitted. Therefore, the intervention program can help professionals in the Health and Education to minimize the problems related to spelling, giving students an intervention that is effective for the development of the spelling knowledge.

  12. Unambiguous discrimination among oracle operators

    International Nuclear Information System (INIS)

    Chefles, Anthony; Kitagawa, Akira; Takeoka, Masahiro; Sasaki, Masahide; Twamley, Jason

    2007-01-01

    We address the problem of unambiguous discrimination among oracle operators. The general theory of unambiguous discrimination among unitary operators is extended with this application in mind. We prove that entanglement with an ancilla cannot assist any discrimination strategy for commuting unitary operators. We also obtain a simple, practical test for the unambiguous distinguishability of an arbitrary set of unitary operators on a given system. Using this result, we prove that the unambiguous distinguishability criterion is the same for both standard and minimal oracle operators. We then show that, except in certain trivial cases, unambiguous discrimination among all standard oracle operators corresponding to integer functions with fixed domain and range is impossible. However, we find that it is possible to unambiguously discriminate among the Grover oracle operators corresponding to an arbitrarily large unsorted database. The unambiguous distinguishability of standard oracle operators corresponding to totally indistinguishable functions, which possess a strong form of classical indistinguishability, is analysed. We prove that these operators are not unambiguously distinguishable for any finite set of totally indistinguishable functions on a Boolean domain and with arbitrary fixed range. Sets of such functions on a larger domain can have unambiguously distinguishable standard oracle operators, and we provide a complete analysis of the simplest case, that of four functions. We also examine the possibility of unambiguous oracle operator discrimination with multiple parallel calls and investigate an intriguing unitary superoperator transformation between standard and entanglement-assisted minimal oracle operators

  13. Continuous spinal anaesthesia with minimally invasive haemodynamic monitoring for surgical hip repair in two patients with severe aortic stenosis

    Directory of Open Access Journals (Sweden)

    María Mercedes López

    2016-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: Aortic stenosis increases perioperative morbidity and mortality, perioperative invasive monitoring is advised for patients with an aortic valve area 30 mm Hg and it is important to avoid hypotension and arrhythmias. We report the anaesthetic management with continuous spinal anaesthesia and minimally invasive haemodynamic monitoring of two patients with severe aortic stenosis undergoing surgical hip repair. CASE REPORT: Two women with severe aortic stenosis were scheduled for hip fracture repair. Continuous spinal anaesthesia with minimally invasive haemodynamic monitoring was used for anaesthetic management of both. Surgery was performed successfully after two consecutive doses of 2 mg of isobaric bupivacaine 0.5% in one of them and four consecutive doses in the other. Haemodynamic conditions remained stable throughout the intervention. Vital signs and haemodynamic parameters remained stable throughout the two interventions. CONCLUSION: Our report illustrates the use of continuous spinal anaesthesia with minimally invasive haemodynamic monitoring as a valid alternative to general or epidural anaesthesia in two patients with severe aortic stenosis who are undergoing lower limb surgery. However, controlled clinical trials would be required to establish that this technique is safe and effective in these type or patients.

  14. Minimally invasive surgery for esophageal achalasia.

    Science.gov (United States)

    Chen, Huan-Wen; Du, Ming

    2016-07-01

    Esophageal achalasia is due to the esophagus of neuromuscular dysfunction caused by esophageal functional disease. Its main feature is the lack of esophageal peristalsis, the lower esophageal sphincter pressure and to reduce the swallow's relaxation response. Lower esophageal muscular dissection is one of the main ways to treat esophageal achalasia. At present, the period of muscular layer under the thoracoscope esophagus dissection is one of the treatment of esophageal achalasia. Combined with our experience in minimally invasive esophageal surgery, to improved incision and operation procedure, and adopts the model of the complete period of muscular layer under the thoracoscope esophagus dissection in the treatment of esophageal achalasia.

  15. Regulatory interventions necessitated by non-conservative operator decisions

    International Nuclear Information System (INIS)

    Ojha, D.; Chande, S.K.; Sharma, S.K.

    2005-01-01

    Presently, India has 15 nuclear power units in operation and 8 units under construction. Though the safety performance of the Nuclear Power Plants (NPPs) in India has been excellent, a few recent events indicate that conservative decision making process can possibly get affected by perceived production goals. In one of the events, a need for some maintenance work arose while reactor start-up was in progress. After it was realized that the maintenance would require considerable time, the proper course of action would have been to shutdown the reactor and add neutron poison to moderator to ensure sufficient sub criticality. This was not done, as it would have delayed the start up of the reactor on completion of maintenance. In another incident, an unintended slow increase in reactor power occurred due to the adjuster rods becoming inoperable on account of blowing-off of fuses in their power supply. Under this condition, the reactor should have been tripped which was not done. Further, the automatic addition of boron poison to the reactor was inhibited. Regulatory review showed that both the incidents were indicative of degradation in safety culture and reflected operator's overriding concern for keeping the units in operation. Appropriate corrective actions were taken to prevent recurrence of such events in the respective units as also in all other operating units of similar type. In the wake of improved production performance operators may develop a tendency to create new operational records and compete with other units. This aspect points out to a need for careful study of events to check the presence of any element of non-conservative decision-making and to identify leading indicators of degradation in safety performance. (author)

  16. Minimally invasive cardiac surgery and transesophageal echocardiography

    Directory of Open Access Journals (Sweden)

    Ajay Kumar Jha

    2014-01-01

    Full Text Available Improved cosmetic appearance, reduced pain and duration of post-operative stay have intensified the popularity of minimally invasive cardiac surgery (MICS; however, the increased risk of stroke remains a concern. In conventional cardiac surgery, surgeons can visualize and feel the cardiac structures directly, which is not possible with MICS. Transesophageal echocardiography (TEE is essential during MICS in detecting problems that require immediate correction. Comprehensive evaluation of the cardiac structures and function helps in the confirmation of not only the definitive diagnosis, but also the success of surgical treatment. Venous and aortic cannulations are not under the direct vision of the surgeon and appropriate positioning of the cannulae is not possible during MICS without the aid of TEE. Intra-operative TEE helps in the navigation of the guide wire and correct placement of the cannulae and allows real-time assessment of valvular pathologies, ventricular filling, ventricular function, intracardiac air, weaning from cardiopulmonary bypass and adequacy of the surgical procedure. Early detection of perioperative complications by TEE potentially enhances the post-operative outcome of patients managed with MICS.

  17. Minimal lepton flavor violation implications of the b→s anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chao-Jung; Tandean, Jusak [Department of Physics and Center for Theoretical Sciences, National Taiwan University, Taipei 106, Taiwan (China)

    2015-08-25

    The latest measurements of rare b→s decays in the LHCb experiment have led to results in tension with the predictions of the standard model (SM), including a tentative indication of the violation of lepton flavor universality. Assuming that this situation will persist because of new physics, we explore some of the potential consequences in the context of the SM extended with the seesaw mechanism involving right-handed neutrinos plus effective dimension-six lepton-quark operators under the framework of minimal flavor violation. We focus on a couple of such operators which can accommodate the LHCb anomalies and conform to the minimal flavor violation hypothesis in both their lepton and quark parts. We examine specifically the lepton-flavor-violating decays B→K{sup (∗)}ℓℓ{sup ′}, B{sub s}→ϕℓℓ{sup ′}, B→(π,ρ)ℓℓ{sup ′}, and B{sub d,s}→ℓℓ{sup ′}, as well as K{sub L}→eμ and K→πeμ, induced by such operators. The estimated branching fractions of some of these decay modes with μτ in the final states are allowed by the pertinent experimental constraints to reach a few times 10{sup −7} if other operators do not yield competitive effects. We also look at the implications for B→K{sup (∗)}νν and K→πνν, finding that their rates can be a few times larger than their SM values. These results are testable in future experiments.

  18. Minimization for conditional simulation: Relationship to optimal transport

    Science.gov (United States)

    Oliver, Dean S.

    2014-05-01

    In this paper, we consider the problem of generating independent samples from a conditional distribution when independent samples from the prior distribution are available. Although there are exact methods for sampling from the posterior (e.g. Markov chain Monte Carlo or acceptance/rejection), these methods tend to be computationally demanding when evaluation of the likelihood function is expensive, as it is for most geoscience applications. As an alternative, in this paper we discuss deterministic mappings of variables distributed according to the prior to variables distributed according to the posterior. Although any deterministic mappings might be equally useful, we will focus our discussion on a class of algorithms that obtain implicit mappings by minimization of a cost function that includes measures of data mismatch and model variable mismatch. Algorithms of this type include quasi-linear estimation, randomized maximum likelihood, perturbed observation ensemble Kalman filter, and ensemble of perturbed analyses (4D-Var). When the prior pdf is Gaussian and the observation operators are linear, we show that these minimization-based simulation methods solve an optimal transport problem with a nonstandard cost function. When the observation operators are nonlinear, however, the mapping of variables from the prior to the posterior obtained from those methods is only approximate. Errors arise from neglect of the Jacobian determinant of the transformation and from the possibility of discontinuous mappings.

  19. Minimization and parameter estimation for seminorm regularization models with I-divergence constraints

    International Nuclear Information System (INIS)

    Teuber, T; Steidl, G; Chan, R H

    2013-01-01

    In this paper, we analyze the minimization of seminorms ‖L · ‖ on R n under the constraint of a bounded I-divergence D(b, H · ) for rather general linear operators H and L. The I-divergence is also known as Kullback–Leibler divergence and appears in many models in imaging science, in particular when dealing with Poisson data but also in the case of multiplicative Gamma noise. Often H represents, e.g., a linear blur operator and L is some discrete derivative or frame analysis operator. A central part of this paper consists in proving relations between the parameters of I-divergence constrained and penalized problems. To solve the I-divergence constrained problem, we consider various first-order primal–dual algorithms which reduce the problem to the solution of certain proximal minimization problems in each iteration step. One of these proximation problems is an I-divergence constrained least-squares problem which can be solved based on Morozov’s discrepancy principle by a Newton method. We prove that these algorithms produce not only a sequence of vectors which converges to a minimizer of the constrained problem but also a sequence of parameters which converges to a regularization parameter so that the corresponding penalized problem has the same solution. Furthermore, we derive a rule for automatically setting the constraint parameter for data corrupted by multiplicative Gamma noise. The performance of the various algorithms is finally demonstrated for different image restoration tasks both for images corrupted by Poisson noise and multiplicative Gamma noise. (paper)

  20. Six-year success rates of occlusal amalgam and glass-ionomer restorations placed using three minimal intervention approaches.

    NARCIS (Netherlands)

    Mandari, G.J.; Frencken, J.E.F.M.; Hof, M.A. van 't

    2003-01-01

    The present randomised clinical trial was aimed at comparing three minimally invasive restorative treatment approaches for managing dental caries in occlusal surfaces using a non-gamma-2 amalgam and a low-viscosity glass-ionomer as the restorative material. The treatment approaches tested in

  1. Technology-supported dietary and lifestyle interventions in healthy pregnant women: a systematic review.

    Science.gov (United States)

    O'Brien, O A; McCarthy, M; Gibney, E R; McAuliffe, F M

    2014-07-01

    Overweight and obesity are associated with increased risk of adverse maternal and fetal outcomes. However, the actuality of delivering effective lifestyle interventions in clinical practice is hampered by a high demand for resources. The use of technology to assist lifestyle interventions needs to be explored as a valid method of reducing strain on resources, and enhancing the effectiveness and population reach of interventions. The aim was to systematically review the literature on the use of technology-supported lifestyle interventions for healthy pregnant women and their impact on maternal outcomes. Online databases and registries were searched in March 2013. Primary outcomes of selected English language studies were fasting maternal glucose, incidence of gestational diabetes mellitus (GDM) and maternal gestational weight gain. Secondary outcomes were intervention uptake and acceptance, and dietary or physical activity modification. Studies whose subjects were diagnosed with GDM prior to intervention were excluded. The minimal number of eligible studies and varying outcomes precluded formal meta-analysis of the data. Initially, 203 articles were identified and screened. Seven articles, including five randomised controlled trials, met inclusion criteria for the current review. Results demonstrate several potential benefits associated with technology-supported interventions in pregnancy, despite minimal search results. Although communication technology holds potential as a safe therapeutic tool for the support of lifestyle interventions in pregnancy, there is a paucity of data on its effectiveness. Further RCTs examining the effectiveness of communication technology are required, particularly among those most likely to benefit from lifestyle interventions, such as overweight and obese pregnant women.

  2. A New Framework to Minimize Insider Threats in Nuclear Power Operations

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Young A; Yim, Man-Sung [KAIST, Daejeon (Korea, Republic of)

    2016-10-15

    In a 2008 report, IAEA presented preventive and protective measures against such threat. These are summarized as : (1) Exclude potential insiders by identifying undesirable behavior or characteristics, which may indicate motivation, prior to allowing them access; (2) Exclude further potential insiders by identifying undesirable behavior or characteristics, which may indicate motivation, after they have access; (3) Minimize opportunities for malicious acts by limiting access, authority and knowledge, and by other measures; (4) Detect, delay and respond to malicious acts. The nuclear security risk, i.e. insider threat, has concerned continuously because the existing physical protection system is only for outsider threats. In addition, with high possibility of use of multicultural workforce in newcomers' NPPs, the detection and prediction of insider threat is a hot potato. Thus, this paper suggested a new framework for predicting and detecting the insider threat. This framework integrates the behavioral indicators, stimulus monitoring and cognitive monitoring. This framework open a chance to detect and predict the insider before commits a crime accurately. This model can be direct application to reduce the security risks in multicultural environment.

  3. A New Framework to Minimize Insider Threats in Nuclear Power Operations

    International Nuclear Information System (INIS)

    Suh, Young A; Yim, Man-Sung

    2016-01-01

    In a 2008 report, IAEA presented preventive and protective measures against such threat. These are summarized as : (1) Exclude potential insiders by identifying undesirable behavior or characteristics, which may indicate motivation, prior to allowing them access; (2) Exclude further potential insiders by identifying undesirable behavior or characteristics, which may indicate motivation, after they have access; (3) Minimize opportunities for malicious acts by limiting access, authority and knowledge, and by other measures; (4) Detect, delay and respond to malicious acts. The nuclear security risk, i.e. insider threat, has concerned continuously because the existing physical protection system is only for outsider threats. In addition, with high possibility of use of multicultural workforce in newcomers' NPPs, the detection and prediction of insider threat is a hot potato. Thus, this paper suggested a new framework for predicting and detecting the insider threat. This framework integrates the behavioral indicators, stimulus monitoring and cognitive monitoring. This framework open a chance to detect and predict the insider before commits a crime accurately. This model can be direct application to reduce the security risks in multicultural environment

  4. A simultaneous minimally invasive approach to treat a patient with coronary artery disease and metastatic lung cancer.

    Science.gov (United States)

    Fu, Yuanhao; Zhang, Lufeng; Ji, Ling; Xu, Chenyang

    2016-01-01

    Concurrent lung cancer and coronary artery disease requiring treatment with percutaneous coronary intervention or coronary artery bypass grafting is not rare. An individualized perioperative anticoagulation regimen and minimal surgical trauma will benefit the patient's postoperative recovery. We successfully treated a 68-year-old female patient with a lesion in the left anterior descending artery and metastatic right lung carcinoma by simultaneous minimally invasive direct coronary artery bypass grafting via a small left thoracotomy and thoracoscopic wedge resection of the lung lesion. She recovered and was discharged on the eighth postoperative day. The patient showed no symptoms of myocardial ischemia postoperatively. Computed tomography scan did not indicate metastatic lesion of lung carcinoma at 1-year follow-up. In conclusion, minimally invasive direct coronary artery bypass grafting combined with thoracoscopic wedge resection is an effective minimally invasive treatment for concurrent lung cancer and coronary artery disease. This technique eliminates the risk of perioperative bleeding and provides satisfactory mid-term follow-up results.

  5. Front end power dissipation minimization and optimal transmission rate for wireless receivers

    NARCIS (Netherlands)

    Heuvel, van den J.H.C.; Wu, Y.; Baltus, P.G.M.; Linnartz, J.P.M.G.; Roermund, van A.H.M.

    2014-01-01

    Most wireless battery-operated devices spend more energy receiving than transmitting. Hence, minimizing the power dissipation in the receiver front end, which, in many cases, is the prominent power consuming part of the receiver, is an important challenge. This paper addresses this challenge by

  6. Legal incentives for minimizing waste

    International Nuclear Information System (INIS)

    Clearwater, S.W.; Scanlon, J.M.

    1991-01-01

    Waste minimization, or pollution prevention, has become an integral component of federal and state environmental regulation. Minimizing waste offers many economic and public relations benefits. In addition, waste minimization efforts can also dramatically reduce potential criminal requirements. This paper addresses the legal incentives for minimizing waste under current and proposed environmental laws and regulations

  7. NEUROGATE: a new MR-compatible device for realizing minimally invasive treatment of intracerebral tumors.

    Science.gov (United States)

    Vitzthum, Hans Ekkehart; Winkler, Dirk; Strauss, Gero; Lindner, Dirk; Krupp, Wolfgang; Schneider, Jens Peter; Schober, Ralf; Meixensberger, Jürgen

    2004-01-01

    The authors report on the handling and the practicability of a newly developed MR-compatible device, the NEUROGATE (Daum GmbH, Germany), which allows precise planning, simulation and control of stereotactic biopsy in patients with suspect intracranial lesions, and which allows minimally invasive maneuvers to be performed in a comfortable way. Twenty-eight patients were examined stereotactically in the Signa SP interventional 0.5 Tesla MRI (General Electric Medical Systems, USA), including 15 patients with malignant intracerebral tumors and poor general medical conditions (8 gliomas, 7 metastases) who were treated by laser-induced interstitial thermotherapy (LITT) after definite intraoperative neuropathological diagnosis. As a special stereotactic holding device, the NEUROGATE was favored as a reliable tool for stereotaxy and minimally invasive procedures.

  8. On relevant boundary perturbations of unitary minimal models

    International Nuclear Information System (INIS)

    Recknagel, A.; Roggenkamp, D.; Schomerus, V.

    2000-01-01

    We consider unitary Virasoro minimal models on the disk with Cardy boundary conditions and discuss deformations by certain relevant boundary operators, analogous to tachyon condensation in string theory. Concentrating on the least relevant boundary field, we can perform a perturbative analysis of renormalization group fixed points. We find that the systems always flow towards stable fixed points which admit no further (non-trivial) relevant perturbations. The new conformal boundary conditions are in general given by superpositions of 'pure' Cardy boundary conditions

  9. 40 CFR 26.405 - Observational research involving greater than minimal risk but presenting the prospect of direct...

    Science.gov (United States)

    2010-07-01

    ... greater than minimal risk but presenting the prospect of direct benefit to the individual subjects. 26.405... but presenting the prospect of direct benefit to the individual subjects. If the IRB finds that an...: (a) The intervention or procedure holds out the prospect of direct benefit to the individual subject...

  10. The minimal curvaton-Higgs model

    Energy Technology Data Exchange (ETDEWEB)

    Enqvist, Kari [Helsinki Univ. and Helsinki Institute of Physics (Finland). Physics Dept.; Lerner, Rose N. [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Helsinki Univ. and Helsinki Institute of Physics (Finland). Physics Dept.; Takahashi, Tomo [Saga Univ. (Japan). Dept. of Physics

    2013-10-15

    We present the first full study of the minimal curvaton-Higgs (MCH) model, which is a minimal interpretation of the curvaton scenario with one real scalar coupled to the standard model Higgs boson. The standard model coupling allows the dynamics of the model to be determined in detail, including effects from the thermal background and from radiative corrections to the potential. The relevant mechanisms for curvaton decay are incomplete non-perturbative decay (delayed by thermal blocking), followed by decay via a dimension-5 non-renormalisable operator. To avoid spoiling the predictions of big bang nucleosynthesis, we find the ''bare'' curvaton mass to be m{sub {sigma}}{>=}8 x 10{sup 4} GeV. To match observational data from Planck there is an upper limit on the curvaton-higgs coupling g, between 10{sup -3} and 10{sup -2}, depending on the mass. This is due to interactions with the thermal background. We find that typically non-Gaussianities are small but that if f{sub NL} is observed in the near future then m{sub {sigma}}

  11. MOCUS, Minimal Cut Sets and Minimal Path Sets from Fault Tree Analysis

    International Nuclear Information System (INIS)

    Fussell, J.B.; Henry, E.B.; Marshall, N.H.

    1976-01-01

    1 - Description of problem or function: From a description of the Boolean failure logic of a system, called a fault tree, and control parameters specifying the minimal cut set length to be obtained MOCUS determines the system failure modes, or minimal cut sets, and the system success modes, or minimal path sets. 2 - Method of solution: MOCUS uses direct resolution of the fault tree into the cut and path sets. The algorithm used starts with the main failure of interest, the top event, and proceeds to basic independent component failures, called primary events, to resolve the fault tree to obtain the minimal sets. A key point of the algorithm is that an and gate alone always increases the number of path sets; an or gate alone always increases the number of cut sets and increases the size of path sets. Other types of logic gates must be described in terms of and and or logic gates. 3 - Restrictions on the complexity of the problem: Output from MOCUS can include minimal cut and path sets for up to 20 gates

  12. The Development of Robotic Technology in Cardiac and Vascular Interventions

    Directory of Open Access Journals (Sweden)

    Ali Pourdjabbar

    2017-07-01

    Full Text Available Robotic technology has been used in cardiovascular medicine for over a decade, and over that period its use has been expanded to interventional cardiology and percutaneous coronary and peripheral vascular interventions. The safety and feasibility of robotically assisted interventions has been demonstrated in multiple studies ranging from simple to complex coronary lesions, and in the treatment of iliofemoral and infrapopliteal disease. These studies have shown a reduction in operator exposure to harmful ionizing radiation, and the use of robotics has the intuitive benefit of alleviating the occupational hazard of operator orthopedic injuries. In addition to the interventional operator benefits, robotically assisted intervention has the potential to also be beneficial for patients by allowing more accurate lesion length measurement, stent placement, and patient radiation exposure; however, more investigation is required to elucidate these benefits fully.

  13. Radwaste minimization successes at Duke Power Company

    International Nuclear Information System (INIS)

    Lan, C.D.; Johnson, G.T.; Groves, D.C.; Smith, T.A.

    1996-01-01

    At Duke Power Company, open-quotes Culture Changeclose quotes is a common term that we have used to describe the incredible transformation. We are becoming a cost conscious, customer driven, highly competitive business. Nowhere has this change been more evident then in the way we process and dispose of our solid radioactive waste. With top-down management support, we have used team-based, formalized problem solving methods and have implemented many successful waste minimization programs. Through these programs, we have dramatically increased employees' awareness of the importance of waste minimization. As a result, we have been able to reduce both our burial volumes and our waste processing and disposal costs. In June, 1994, we invited EPRI to conduct assessments of our waste minimization programs at Oconee and Catawba nuclear stations. Included in the assessments were in-depth looks at contamination control, an inventory of items in the plant, the volume of waste generated in the plant and how it was processed, laundry reject data, site waste-handling operations, and plant open-quotes housekeepingclose quotes routines and process. One of the most important aspects of the assessment is the open-quotes dumpster dive,close quotes which is an evaluation of site dry active waste composition by sorting through approximately fifteen bags of radioactive waste. Finally, there was an evaluation of consumable used at each site in order to gain knowledge of items that could be standardized at all stations. With EPRI recommendations, we made several changes and standardized the items used. We have made significant progress in waste reduction. We realize, however, that we are aiming at a moving target and we still have room for improvement. As the price of processing and disposal (or storage) increases, we will continue to evaluate our waste minimization programs

  14. Effect of an Ergonomics-Based Educational Intervention Based on Transtheoretical Model in Adopting Correct Body Posture Among Operating Room Nurses

    OpenAIRE

    Moazzami, Zeinab; Dehdari, Tahere; Taghdisi, Mohammad Hosein; Soltanian, Alireza

    2015-01-01

    Background: One of the preventive strategies for chronic low back pain among operating room nurses is instructing proper body mechanics and postural behavior, for which the use of the Transtheoretical Model (TTM) has been recommended. Methods: Eighty two nurses who were in the contemplation and preparation stages for adopting correct body posture were randomly selected (control group = 40, intervention group = 42). TTM variables and body posture were measured at baseline and again after 1 and...

  15. A workplace feasibility study of the effect of a minimal fruit intervention on fruit intake

    DEFF Research Database (Denmark)

    Alinia, Sevil; Lassen, Anne Dahl; Krogholm, Kirstine Suszkiewicz

    2011-01-01

    intake would affect vegetable, total energy and nutrient intake. Design: A 5-month, controlled, workplace study where workplaces were divided into an intervention group (IG) and a control group (CG). At least one piece of free fruit was available per person per day in the IG. Total fruit and dietary...... intake was assessed, using two 24 h dietary recalls at baseline and at endpoint. Setting: Eight Danish workplaces were enrolled in the study. Five workplaces were in the IG and three were in the CG. Subjects: One hundred and twenty-four (IG, n 68; CG, n 56) healthy, mainly normal-weight participants were....... Vegetable, total energy and macronutrient intake remained unchanged through the intervention period for both groups. Conclusions: The present study showed that it is feasible to increase the average fruit intake at workplaces by simply increasing fruit availability and accessibility. Increased fruit intake...

  16. A multicenter prospective cohort study on camera navigation training for key user groups in minimally invasive surgery

    NARCIS (Netherlands)

    Graafland, Maurits; Bok, Kiki; Schreuder, Henk W. R.; Schijven, Marlies P.

    2014-01-01

    Untrained laparoscopic camera assistants in minimally invasive surgery (MIS) may cause suboptimal view of the operating field, thereby increasing risk for errors. Camera navigation is often performed by the least experienced member of the operating team, such as inexperienced surgical residents,

  17. Effects of an iPad-Supported Phonics Intervention on Decoding Performance and Time On-Task

    Science.gov (United States)

    Larabee, Kaitlyn M.; Burns, Matthew K.; McComas, Jennifer J.

    2014-01-01

    Despite their recent popularity in schools, there is minimal consensus in the educational literature regarding the use of mobile devices for reading intervention. The word box intervention (Joseph "Read Teach" 52:348-356, 1998) has been consistently associated with improvements in student decoding performance. This early efficacy study…

  18. Is non-minimal inflation eternal?

    International Nuclear Information System (INIS)

    Feng, Chao-Jun; Li, Xin-Zhou

    2010-01-01

    The possibility that the non-minimal coupling inflation could be eternal is investigated. We calculate the quantum fluctuation of the inflaton in a Hubble time and find that it has the same value as that in the minimal case in the slow-roll limit. Armed with this result, we have studied some concrete non-minimal inflationary models including the chaotic inflation and the natural inflation, in which the inflaton is non-minimally coupled to the gravity. We find that the non-minimal coupling inflation could be eternal in some parameter spaces.

  19. Minimization of waste from uranium purification, enrichment and fuel fabrication

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-10-01

    As any industry, nuclear industry generates a diverse range of waste which has to be managed in a safe manner to be acceptable to the public and the environment. The cost of waste management, the risks to the public and employees, and the detriment to the environment are dependent on the quantity and radioactive content of the waste generated. Waste minimization is a necessary activity needed to reduce the impact from nuclear fuel cycle operations and it is included in the national policy of some countries. In recognition of the importance of the subject, the IAEA has decided to review the current status of the work aimed at waste minimization in the nuclear fuel cycle. The waste minimization issues related to the back end of the nuclear fuel cycle are covered in Technical Reports Series No. 377 'Minimization of Radioactive Waste from Nuclear Power Plants and the Back End of the Nuclear Fuel Cycle' published in 1995. The present report deals with the front end of the nuclear fuel cycle, including existing options, approaches, developments and some specific considerations to be taken into account in decision making on waste minimization. It has been recognized that, in comparison with the back end of the nuclear fuel cycle, much less information is available, and this report should be considered as a first attempt to analyse waste minimization practices and opportunities in uranium purification, conversion, enrichment and fuel fabrication. Although mining and milling is an important part of the front end of the nuclear fuel cycle, these activities are excluded from consideration since relevant activities are covered in other IAEA publications.

  20. Minimization of waste from uranium purification, enrichment and fuel fabrication

    International Nuclear Information System (INIS)

    1999-10-01

    As any industry, nuclear industry generates a diverse range of waste which has to be managed in a safe manner to be acceptable to the public and the environment. The cost of waste management, the risks to the public and employees, and the detriment to the environment are dependent on the quantity and radioactive content of the waste generated. Waste minimization is a necessary activity needed to reduce the impact from nuclear fuel cycle operations and it is included in the national policy of some countries. In recognition of the importance of the subject, the IAEA has decided to review the current status of the work aimed at waste minimization in the nuclear fuel cycle. The waste minimization issues related to the back end of the nuclear fuel cycle are covered in Technical Reports Series No. 377 'Minimization of Radioactive Waste from Nuclear Power Plants and the Back End of the Nuclear Fuel Cycle' published in 1995. The present report deals with the front end of the nuclear fuel cycle, including existing options, approaches, developments and some specific considerations to be taken into account in decision making on waste minimization. It has been recognized that, in comparison with the back end of the nuclear fuel cycle, much less information is available, and this report should be considered as a first attempt to analyse waste minimization practices and opportunities in uranium purification, conversion, enrichment and fuel fabrication. Although mining and milling is an important part of the front end of the nuclear fuel cycle, these activities are excluded from consideration since relevant activities are covered in other IAEA publications

  1. The OTD Robotics Waste Minimization Program

    International Nuclear Information System (INIS)

    Couture, S.A.

    1992-04-01

    The danger to human health and safety posed by exposure to transuranic (TRU) and Pu contaminated materials necessitates remote processing in confined environments. Currently these operations are carried out in gloveboxes and hot-cells by human operators using lead- lined gloves or teleoperated manipulators. Protective clothing worn by operators during gloved operations has contributed significantly to the waste problems currently facing site remediators. The DOE Environmental Restoration and Waste Management (ER/WM) Program is in the process of developing and demonstrating technologies to assist in the remediation of sites that have accumulated wastes generated using these processes over the past five decades. Recognizing that continued use of existing production, recovery and waste treatment systems will compound the remediation problem, DOE has made a commitment to waste minimization. To reduce waste generation during weapons production and waste processing operations, automated processes are being developed and demonstrated for use in future DOE processing facilities as part of OTD's Robotics Technology Development Program. These technologies are currently being applied to pyrochemical processing systems to demonstrate conversion of plutonium oxide to metal. However, these technologies are expected to have applications in a variety of waste processing systems including those used to treat high-level tank wastes, buried wastes requiring remote processing, mixed wastes, and unknown hazardous materials. In addition to reducing the future waste burden of DOE, automated processes are an effective way to comply with existing and anticipated federal, state, and local regulations related to personal health and safety and the health of the environment

  2. Random defect lines in conformal minimal models

    International Nuclear Information System (INIS)

    Jeng, M.; Ludwig, A.W.W.

    2001-01-01

    We analyze the effect of adding quenched disorder along a defect line in the 2D conformal minimal models using replicas. The disorder is realized by a random applied magnetic field in the Ising model, by fluctuations in the ferromagnetic bond coupling in the tricritical Ising model and tricritical three-state Potts model (the phi 12 operator), etc. We find that for the Ising model, the defect renormalizes to two decoupled half-planes without disorder, but that for all other models, the defect renormalizes to a disorder-dominated fixed point. Its critical properties are studied with an expansion in ε∝1/m for the mth Virasoro minimal model. The decay exponents X N =((N)/(2))1-((9(3N-4))/(4(m+1) 2 ))+O((3)/(m+1)) 3 of the Nth moment of the two-point function of phi 12 along the defect are obtained to 2-loop order, exhibiting multifractal behavior. This leads to a typical decay exponent X typ =((1)/(2))1+((9)/((m+1) 2 ))+O((3)/(m+1)) 3 . One-point functions are seen to have a non-self-averaging amplitude. The boundary entropy is larger than that of the pure system by order 1/m 3 . As a byproduct of our calculations, we also obtain to 2-loop order the exponent X-tilde N =N1-((2)/(9π 2 ))(3N-4)(q-2) 2 +O(q-2) 3 of the Nth moment of the energy operator in the q-state Potts model with bulk bond disorder

  3. 2016 Los Alamos National Laboratory Hazardous Waste Minimization Report

    Energy Technology Data Exchange (ETDEWEB)

    Salzman, Sonja L. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); English, Charles Joe [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-12-02

    Waste minimization and pollution prevention are goals within the operating procedures of Los Alamos National Security, LLC (LANS). The US Department of Energy (DOE), inclusive of the National Nuclear Security Administration (NNSA) and the Office of Environmental Management, and LANS are required to submit an annual hazardous waste minimization report to the New Mexico Environment Department (NMED) in accordance with the Los Alamos National Laboratory (LANL or the Laboratory) Hazardous Waste Facility Permit. The report was prepared pursuant to the requirements of Section 2.9 of the LANL Hazardous Waste Facility Permit. This report describes the hazardous waste minimization program, which is a component of the overall Pollution Prevention (P2) Program, administered by the Environmental Stewardship Group (EPC-ES). This report also supports the waste minimization and P2 goals of the Associate Directorate of Environmental Management (ADEM) organizations that are responsible for implementing remediation activities and describes its programs to incorporate waste reduction practices into remediation activities and procedures. This report includes data for all waste shipped offsite from LANL during fiscal year (FY) 2016 (October 1, 2015 – September 30, 2016). LANS was active during FY2016 in waste minimization and P2 efforts. Multiple projects were funded that specifically related to reduction of hazardous waste. In FY2016, there was no hazardous, mixed-transuranic (MTRU), or mixed low-level (MLLW) remediation waste shipped offsite from the Laboratory. More non-remediation hazardous waste and MLLW was shipped offsite from the Laboratory in FY2016 compared to FY2015. Non-remediation MTRU waste was not shipped offsite during FY2016. These accomplishments and analysis of the waste streams are discussed in much more detail within this report.

  4. Management of Port Operations

    OpenAIRE

    Gheorghe BASANU; Georgiana NUKINA

    2011-01-01

    The Management of port operation requires the proper and efficient use of port facility, equipment for cargo handling, berth facilities, waterways and roads. It also entails the use of effective communications system, storage facilities, and dockworkers. The whole activities mentioned above form the bulk of port operations. The aspiration of port operator is to get cargo through the gateway of ports as fast as possible on to other modes of transport (rail or road) with a minimal cost to them ...

  5. Minimal families of curves on surfaces

    KAUST Repository

    Lubbes, Niels

    2014-11-01

    A minimal family of curves on an embedded surface is defined as a 1-dimensional family of rational curves of minimal degree, which cover the surface. We classify such minimal families using constructive methods. This allows us to compute the minimal families of a given surface.The classification of minimal families of curves can be reduced to the classification of minimal families which cover weak Del Pezzo surfaces. We classify the minimal families of weak Del Pezzo surfaces and present a table with the number of minimal families of each weak Del Pezzo surface up to Weyl equivalence.As an application of this classification we generalize some results of Schicho. We classify algebraic surfaces that carry a family of conics. We determine the minimal lexicographic degree for the parametrization of a surface that carries at least 2 minimal families. © 2014 Elsevier B.V.

  6. Operationally efficient propulsion system study (OEPSS) data book. Volume 6; Space Transfer Propulsion Operational Efficiency Study Task of OEPSS

    Science.gov (United States)

    Harmon, Timothy J.

    1992-01-01

    This document is the final report for the Space Transfer Propulsion Operational Efficiency Study Task of the Operationally Efficient Propulsion System Study (OEPSS) conducted by the Rocketdyne Division of Rockwell International. This Study task studied, evaluated and identified design concepts and technologies which minimized launch and in-space operations and optimized in-space vehicle propulsion system operability.

  7. Hexavalent Chromium Minimization Strategy

    Science.gov (United States)

    2011-05-01

    Logistics 4 Initiative - DoD Hexavalent Chromium Minimization Non- Chrome Primer IIEXAVAJ ENT CHRO:M I~UMI CHROMIUM (VII Oil CrfVli.J CANCEfl HAnRD CD...Management Office of the Secretary of Defense Hexavalent Chromium Minimization Strategy Report Documentation Page Form ApprovedOMB No. 0704-0188...00-2011 4. TITLE AND SUBTITLE Hexavalent Chromium Minimization Strategy 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6

  8. Inner strategies of coping with operational work amongst SAPS officers

    Directory of Open Access Journals (Sweden)

    Masefako A. Gumani

    2013-11-01

    Research purpose: The objective of this study was to describe inner coping strategies used by officers in the Vhembe district (South Africa to reconstruct stressful and traumatic experiences at work. Motivation for the study: Most studies on coping amongst SAPS officers focus on organisational stress and not on the impact of the officers’ operational work. Research design, approach and method: An exploratory design was used and 20 SAPS officers were selected through purposive sampling. In-depth face-to-face and telephone interviews, as well as diaries were used to collect data, which were analysed using content thematic data analysis. Main findings: The results showed that the main categories of coping strategies that led to management of the impact of operational work amongst the selected sample were centred around problem-focused and emotion-focused strategies, with some use of reappraisal and minimal use of avoidance. Considering the context of the officers’ work, the list of dimensions of inner coping strategies amongst SAPS officers should be extended. Practical/managerial implications: Intervention programmes designed for the SAPS, including critical incident stress debriefing, should take the operational officers’ inner strategies into account to improve the management of the impact of their work. Contribution/value-add: This study contributes to the body of knowledge on the inner coping strategies amongst SAPS officers, with special reference to operational work in a specific setting.

  9. Minimal average consumption downlink base station power control strategy

    OpenAIRE

    Holtkamp H.; Auer G.; Haas H.

    2011-01-01

    We consider single cell multi-user OFDMA downlink resource allocation on a flat-fading channel such that average supply power is minimized while fulfilling a set of target rates. Available degrees of freedom are transmission power and duration. This paper extends our previous work on power optimal resource allocation in the mobile downlink by detailing the optimal power control strategy investigation and extracting fundamental characteristics of power optimal operation in cellular downlink. W...

  10. [Management of patients with bronchial asthma received general anesthesia and surgical intervention].

    Science.gov (United States)

    To, Masako; Tajima, Makoto; Ogawa, Cyuhei; Otomo, Mamoru; Suzuki, Naohito; Sano, Yasuyuki

    2002-01-01

    Stimulation to bronchial mucosa is one of the major risk factor of asthma attack. When patients receive surgical intervention and general anesthesia, they are always exposed to stimulation to bronchial mucosa. Prevention method of bronchial asthma attack during surgical intervention is not established yet. We investigated that clinical course of patients with bronchial asthma who received general anesthesia and surgical intervention. Seventy-six patients with bronchial asthma were received general anesthesia and surgical intervention from 1993 to 1998. Twenty-four patients were mild asthmatic patients, 39 were moderate asthmatic patients and 13 were severe asthmatic patients. Preoperative treatment for preventing asthma attack was as follows; Eight patients were given intravenous infusion of aminophylline before operation. Fifty-two patients were given intravenous infusion of aminophylline and hydrocortisone before operation. Three patients were given intravenous infusion of hydrocortisone for consecutive 3 days before operation. Thirteen patients were given no treatment for preventing asthma attack. One patient was suffered from asthma attack during operation. She was given no preventing treatment for asthma attack before operation. Three patients were suffered from asthma attack after operation. No wound dehiscence was observed in all patients. To prevent asthma attack during operation, intravenous infusion of steroid before operation is recommended, when patients with asthma receive general anesthesia and surgical intervention.

  11. A Variance Minimization Criterion to Feature Selection Using Laplacian Regularization.

    Science.gov (United States)

    He, Xiaofei; Ji, Ming; Zhang, Chiyuan; Bao, Hujun

    2011-10-01

    In many information processing tasks, one is often confronted with very high-dimensional data. Feature selection techniques are designed to find the meaningful feature subset of the original features which can facilitate clustering, classification, and retrieval. In this paper, we consider the feature selection problem in unsupervised learning scenarios, which is particularly difficult due to the absence of class labels that would guide the search for relevant information. Based on Laplacian regularized least squares, which finds a smooth function on the data manifold and minimizes the empirical loss, we propose two novel feature selection algorithms which aim to minimize the expected prediction error of the regularized regression model. Specifically, we select those features such that the size of the parameter covariance matrix of the regularized regression model is minimized. Motivated from experimental design, we use trace and determinant operators to measure the size of the covariance matrix. Efficient computational schemes are also introduced to solve the corresponding optimization problems. Extensive experimental results over various real-life data sets have demonstrated the superiority of the proposed algorithms.

  12. Incidence of cerebrovascular accidents in patients undergoing minimally invasive valve surgery.

    Science.gov (United States)

    LaPietra, Angelo; Santana, Orlando; Mihos, Christos G; DeBeer, Steven; Rosen, Gerald P; Lamas, Gervasio A; Lamelas, Joseph

    2014-07-01

    Minimally invasive valve surgery has been associated with increased cerebrovascular complications. Our objective was to evaluate the incidence of cerebrovascular accidents in patients undergoing minimally invasive valve surgery. We retrospectively reviewed all the minimally invasive valve surgery performed at our institution from January 2009 to June 2012. The operative times, lengths of stay, postoperative complications, and mortality were analyzed. A total of 1501 consecutive patients were identified. The mean age was 73 ± 13 years, and 808 patients (54%) were male. Of the 1501 patients, 206 (13.7%) had a history of a cerebrovascular accident, and 225 (15%) had undergone previous heart surgery. The procedures performed were 617 isolated aortic valve replacements (41.1%), 658 isolated mitral valve operations (43.8%), 6 tricuspid valve repairs (0.4%), 216 double valve surgery (14.4%), and 4 triple valve surgery (0.3%). Femoral cannulation was used in 1359 patients (90.5%) and central cannulation in 142 (9.5%). In 1392 patients (92.7%), the aorta was clamped, and in 109 (7.3%), the surgery was performed with the heart fibrillating. The median aortic crossclamp and cardiopulmonary bypass times were 86 minutes (interquartile range [IQR], 70-107) minutes and 116 minutes (IQR, 96-143), respectively. The median intensive care unit length of stay was 47 hours (IQR, 29-74), and the median postoperative hospital length of stay was 7 days (IQR, 5-10). A total of 23 cerebrovascular accidents (1.53%) and 38 deaths (2.53%) had occurred at 30 days postoperatively. Minimally invasive valve surgery was associated with an acceptable stroke rate, regardless of the cannulation technique. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  13. Advanced Tele-operation

    International Nuclear Information System (INIS)

    Decreton, M.

    1998-01-01

    Maintenance, repair, and dismantling operations in nuclear facilities have to be performed remotely when high radiation doses exclude hands-on operation, but also to minimize contamination risks and occupational doses to the operators. Computer-aided and sensor-based tele-operation enhances safety, reliability, and performance by helping the operator in difficult tasks with poor remote environmental perception. The objectives of work in this domain are to increase the scientific knowledge of the studied phenomena, to improve the interpretation of data, to improve the piloting og experimental devices during irradiation, to reveal and to understand possible unexpected phenomena occurring during irradiation. This scientific report describes the achievements for 1997 in the area of radiation tolerance for of remote-sensing, optical fibres and optical fibre sensors

  14. Minimization of PWR reactor control rods wear

    International Nuclear Information System (INIS)

    Ponzoni Filho, Pedro; Moura Angelkorte, Gunther de

    1995-01-01

    The Rod Cluster Control Assemblies (RCCA's) of Pressurized Water Reactors (PWR's) have experienced a continuously wall cladding wear when Reactor Coolant Pumps (RCP's) are running. Fretting wear is a result of vibrational contact between RCCA rodlets and the guide cards which provide lateral support for the rodlets when RCCA's are withdrawn from the core. A procedure is developed to minimize the rodlets wear, by the shuffling and axial reposition of RCCA's every operating cycle. These shuffling and repositions are based on measurement of the rodlet cladding thickness of all RCCA's. (author). 3 refs, 2 figs, 2 tabs

  15. Using Self-Management Interventions to Address General Education Behavioral Needs: Assessment of Effectiveness and Feasibility

    Science.gov (United States)

    Briesch, Amy M.; Daniels, Brian

    2013-01-01

    A comprehensive self-management intervention was utilized to increase the on-task behavior of three African American students within an urban middle-school setting. The intervention was designed to necessitate minimal management on the part of the general education classroom teacher by utilizing an electronic prompting device, as well as a…

  16. Entropy Minimization Design Approach of Supersonic Internal Passages

    Directory of Open Access Journals (Sweden)

    Jorge Sousa

    2015-08-01

    Full Text Available Fluid machinery operating in the supersonic regime unveil avenues towards more compact technology. However, internal supersonic flows are associated with high aerodynamic and thermal penalties, which usually prevent their practical implementation. Indeed, both shock losses and the limited operational range represent particular challenges to aerodynamic designers that should be taken into account at the initial phase of the design process. This paper presents a design methodology for supersonic passages based on direct evaluations of the velocity field using the method of characteristics and computation of entropy generation across shock waves. This meshless function evaluation tool is then coupled to an optimization scheme, based on evolutionary algorithms that minimize the entropy generation across the supersonic passage. Finally, we assessed the results with 3D Reynolds Averaged Navier Stokes calculations.

  17. New real-time MR image-guided surgical robotic system for minimally invasive precision surgery

    Energy Technology Data Exchange (ETDEWEB)

    Hashizume, M.; Yasunaga, T.; Konishi, K. [Kyushu University, Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Fukuoka (Japan); Tanoue, K.; Ieiri, S. [Kyushu University Hospital, Department of Advanced Medicine and Innovative Technology, Fukuoka (Japan); Kishi, K. [Hitachi Ltd, Mechanical Engineering Research Laboratory, Hitachinaka-Shi, Ibaraki (Japan); Nakamoto, H. [Hitachi Medical Corporation, Application Development Office, Kashiwa-Shi, Chiba (Japan); Ikeda, D. [Mizuho Ikakogyo Co. Ltd, Tokyo (Japan); Sakuma, I. [The University of Tokyo, Graduate School of Engineering, Bunkyo-Ku, Tokyo (Japan); Fujie, M. [Waseda University, Graduate School of Science and Engineering, Shinjuku-Ku, Tokyo (Japan); Dohi, T. [The University of Tokyo, Graduate School of Information Science and Technology, Bunkyo-Ku, Tokyo (Japan)

    2008-04-15

    To investigate the usefulness of a newly developed magnetic resonance (MR) image-guided surgical robotic system for minimally invasive laparoscopic surgery. The system consists of MR image guidance [interactive scan control (ISC) imaging, three-dimensional (3-D) navigation, and preoperative planning], an MR-compatible operating table, and an MR-compatible master-slave surgical manipulator that can enter the MR gantry. Using this system, we performed in vivo experiments with MR image-guided laparoscopic puncture on three pigs. We used a mimic tumor made of agarose gel and with a diameter of approximately 2 cm. All procedures were successfully performed. The operator only advanced the probe along the guidance device of the manipulator, which was adjusted on the basis of the preoperative plan, and punctured the target while maintaining the operative field using robotic forceps. The position of the probe was monitored continuously with 3-D navigation and 2-D ISC images, as well as the MR-compatible laparoscope. The ISC image was updated every 4 s; no artifact was detected. A newly developed MR image-guided surgical robotic system is feasible for an operator to perform safe and precise minimally invasive procedures. (orig.)

  18. New real-time MR image-guided surgical robotic system for minimally invasive precision surgery

    International Nuclear Information System (INIS)

    Hashizume, M.; Yasunaga, T.; Konishi, K.; Tanoue, K.; Ieiri, S.; Kishi, K.; Nakamoto, H.; Ikeda, D.; Sakuma, I.; Fujie, M.; Dohi, T.

    2008-01-01

    To investigate the usefulness of a newly developed magnetic resonance (MR) image-guided surgical robotic system for minimally invasive laparoscopic surgery. The system consists of MR image guidance [interactive scan control (ISC) imaging, three-dimensional (3-D) navigation, and preoperative planning], an MR-compatible operating table, and an MR-compatible master-slave surgical manipulator that can enter the MR gantry. Using this system, we performed in vivo experiments with MR image-guided laparoscopic puncture on three pigs. We used a mimic tumor made of agarose gel and with a diameter of approximately 2 cm. All procedures were successfully performed. The operator only advanced the probe along the guidance device of the manipulator, which was adjusted on the basis of the preoperative plan, and punctured the target while maintaining the operative field using robotic forceps. The position of the probe was monitored continuously with 3-D navigation and 2-D ISC images, as well as the MR-compatible laparoscope. The ISC image was updated every 4 s; no artifact was detected. A newly developed MR image-guided surgical robotic system is feasible for an operator to perform safe and precise minimally invasive procedures. (orig.)

  19. The Innovative Socio-economic Interventions Against Tuberculosis (ISIAT) project: an operational assessment.

    Science.gov (United States)

    Rocha, C; Montoya, R; Zevallos, K; Curatola, A; Ynga, W; Franco, J; Fernandez, F; Becerra, N; Sabaduche, M; Tovar, M A; Ramos, E; Tapley, A; Allen, N R; Onifade, D A; Acosta, C D; Maritz, M; Concha, D F; Schumacher, S G; Evans, C A

    2011-06-01

    Tuberculosis (TB) affected households in impoverished shantytowns, Lima, Peru. To evaluate socio-economic interventions for strengthening TB control by improving uptake of TB care and prevention services. Barriers to TB control were characterised by interviews with TB-affected families. To reduce these barriers, a multidisciplinary team offered integrated community and household socio-economic interventions aiming to: 1) enhance uptake of TB care by education, community mobilisation and psychosocial support; and 2) reduce poverty through food and cash transfers, microcredit, microenterprise and vocational training. An interim analysis was performed after the socio-economic interventions had been provided for 2078 people in 311 households of newly diagnosed TB patients for up to 34 months. Poverty (46% earned microcredit; poverty;social determinants.

  20. Performance analysis for minimally nonlinear irreversible refrigerators at finite cooling power

    Science.gov (United States)

    Long, Rui; Liu, Zhichun; Liu, Wei

    2018-04-01

    The coefficient of performance (COP) for general refrigerators at finite cooling power have been systematically researched through the minimally nonlinear irreversible model, and its lower and upper bounds in different operating regions have been proposed. Under the tight coupling conditions, we have calculated the universal COP bounds under the χ figure of merit in different operating regions. When the refrigerator operates in the region with lower external flux, we obtained the general bounds (0 present large values, compared to a relative small loss from the maximum cooling power. If the cooling power is the main objective, it is desirable to operate the refrigerator at a slightly lower cooling power than at the maximum one, where a small loss in the cooling power induces a much larger COP enhancement.

  1. Analytical guide wire motion algorithm for simulation of endovascular interventions

    NARCIS (Netherlands)

    Konings, M. K.; van de Kraats, E. B.; Alderliesten, T.; Niessen, W. J.

    2003-01-01

    Performing minimally invasive vascular interventions requires proper training, as a guide wire needs to be manipulated, by the tail, under fluoroscopic guidance. To provide a training environment, the motion of the guide wire inside the human vasculature can be simulated by computer. Such a

  2. No Vacation from Bullying: A Summer Camp Intervention Pilot Study

    Science.gov (United States)

    Carney, Amy G.; Nottis, Kathryn E. K.

    2008-01-01

    Within school environments, where bullying interventions are usually studied, the preponderance of bullying incidents generally occur in less structured settings (Hazler, 1996; Leff, Power, Costigan, & Manz, 2003; Olweus, 1997). Outside of school, children spend time in relatively unstructured community environments, with minimally trained staff.…

  3. The positive effect on determinants of physical activity of a tailored, general practice-based physical activity intervention

    NARCIS (Netherlands)

    van Sluijs, E.M.F.; van Poppel-Bruinvels, M.N.M.; Twisk, J.W.R.; Brug, J.; van Mechelen, W.

    2005-01-01

    PACE (Physician-based Assessment and Counseling for Exercise) is an individualized theory-based minimal intervention strategy aimed at the enhancement of regular physical activity. The aim of this study was to evaluate the effectiveness of a PACE intervention applied by general practitioners (GPs)

  4. Minimal and non-minimal standard models: Universality of radiative corrections

    International Nuclear Information System (INIS)

    Passarino, G.

    1991-01-01

    The possibility of describing electroweak processes by means of models with a non-minimal Higgs sector is analyzed. The renormalization procedure which leads to a set of fitting equations for the bare parameters of the lagrangian is first reviewed for the minimal standard model. A solution of the fitting equations is obtained, which correctly includes large higher-order corrections. Predictions for physical observables, notably the W boson mass and the Z O partial widths, are discussed in detail. Finally the extension to non-minimal models is described under the assumption that new physics will appear only inside the vector boson self-energies and the concept of universality of radiative corrections is introduced, showing that to a large extent they are insensitive to the details of the enlarged Higgs sector. Consequences for the bounds on the top quark mass are also discussed. (orig.)

  5. Importance of training on clinical thinking and clinical competence to interventional radiologists

    International Nuclear Information System (INIS)

    Xu Ke; Zhong Hongshan

    2010-01-01

    Although the history of Interventional Radiology is no longer than 50 years, interventional techniques have been dramatically developed. Interventional radiologists have been responsible for much of the medical innovations and development of the minimally invasive procedures that are commonplace today to treat many complicated diseases as physicians. But the education backgrounds of interventional radiologist in China are different. Therefore, we should be aware that the job of an interventional radiologist is totally different from that of a diagnostic radiologist. It is very important to train interventional radiologists for improving their clinical thinking and clinical competence. Herein, we propose our suggestions on how to improve the clinical thinking and clinical competence of interventional radiologists. In this paper we also systemically introduce the accurate and proper treatment procedures which should be strictly followed in clinical work and,meanwhile, the perioperative patients care is emphasized. (authors)

  6. Improved scores for observed teamwork in the clinical environment following a multidisciplinary operating room simulation intervention.

    Science.gov (United States)

    Weller, Jennifer M; Cumin, David; Civil, Ian D; Torrie, Jane; Garden, Alexander; MacCormick, Andrew D; Gurusinghe, Nishanthi; Boyd, Matthew J; Frampton, Christopher; Cokorilo, Martina; Tranvik, Magnus; Carlsson, Lisa; Lee, Tracey; Ng, Wai Leap; Crossan, Michael; Merry, Alan F

    2016-08-05

    We ran a Multidisciplinary Operating Room Simulation (MORSim) course for 20 complete general surgical teams from two large metropolitan hospitals. Our goal was to improve teamwork and communication in the operating room (OR). We hypothesised that scores for teamwork and communication in the OR would improve back in the workplace following MORSim. We used an extended Behavioural Marker Risk Index (BMRI) to measure teamwork and communication, because a relationship has previously been documented between BMRI scores and surgical patient outcomes. Trained observers scored general surgical teams in the OR at the two study hospitals before and after MORSim, using the BMRI. Analysis of BMRI scores for the 224 general surgical cases before and 213 cases after MORSim showed BMRI scores improved by more than 20% (0.41 v 0.32, pteamwork score would translate into a clinically important reduction in complications and mortality in surgical patients. We demonstrated an improvement in scores for teamwork and communication in general surgical ORs following our intervention. These results support the use of simulation-based multidisciplinary team training for OR staff to promote better teamwork and communication, and potentially improve outcomes for general surgical patients.

  7. Perioperative outcomes of minimally invasive versus open radical cystectomy: A single-center experience

    Directory of Open Access Journals (Sweden)

    Pankaj Panwar

    2018-01-01

    Conclusions: MIS is associated with significantly longer operative time than open RC. Robotic RC has significantly higher lymph node yield than open or laparoscopic RC. Minimally invasive RC is equivalent to open surgery in terms of perioperative morbidity, mortality, and blood loss.

  8. Multivariate dynamic linear models for estimating the effect of experimental interventions in an evolutionary operations setup in dairy herds

    DEFF Research Database (Denmark)

    Stygar, Anna Helena; Krogh, Mogens Agerbo; Kristensen, Troels

    2017-01-01

    Evolutionary operations is a method to exploit the association of often small changes in process variables, planned during systematic experimentation and occurring during the normal production flow, to production characteristics to find a way to alter the production process to be more efficient....... The objective of this study was to construct a tool to assess the intervention effect on milk production in an evolutionary operations setup. The method used for this purpose was a dynamic linear model (DLM) with Kalman filtering. The DLM consisted of parameters describing milk yield in a herd, individual cows...... bulk tank records. The presented model proved to be a flexible and dynamic tool, and it was successfully applied for systematic experimentation in dairy herds. The model can serve as a decision support tool for on-farm process optimization exploiting planned changes in process variables...

  9. Correlation Functions in Holographic Minimal Models

    CERN Document Server

    Papadodimas, Kyriakos

    2012-01-01

    We compute exact three and four point functions in the W_N minimal models that were recently conjectured to be dual to a higher spin theory in AdS_3. The boundary theory has a large number of light operators that are not only invisible in the bulk but grow exponentially with N even at small conformal dimensions. Nevertheless, we provide evidence that this theory can be understood in a 1/N expansion since our correlators look like free-field correlators corrected by a power series in 1/N . However, on examining these corrections we find that the four point function of the two bulk scalar fields is corrected at leading order in 1/N through the contribution of one of the additional light operators in an OPE channel. This suggests that, to correctly reproduce even tree-level correlators on the boundary, the bulk theory needs to be modified by the inclusion of additional fields. As a technical by-product of our analysis, we describe two separate methods -- including a Coulomb gas type free-field formalism -- that ...

  10. [Minimally invasive therapy for hallux valgus with deformity of little toe varus].

    Science.gov (United States)

    Gu, Shi-Wei; Yang, Ke; Zhao, Si-Qiao; Gao, Zhan-Ao; Ma, Shun-Qian; Zhang, Wen-Qing

    2018-03-25

    To explore clinical effect of minimally corrective osteotomy for the treatment of hallux valgus with deformity of little toe varus through small incision. From January 2013 to June 2016, 168 hallux valgus patients with deformity of little toe varus were treated by minimally corrective osteotomy through small incision. Among them, 7 males and 161 females were aged from 22 to 75 years old with an average of(59.3±3.5) years old. Preoperative clinical manifestation mainly focus on red and swollen of bunion, pain around with metatarsal bones, and diagnosed as hallux valgus with deformity of little toe varus through small incision. Operative time, postoperative complications, pre and post-operative IMA(angle between the first and the second metatarsal bones), HVA (hallux valgus angle), LDA(valgus angle of the fifth metatarsal bones), MPA(valgus angle of little toe), IM4-5 (angle between the forth and the fifth metatarsal bones) and PASA(fixed angle of proximal joint), postoperative AOFAS score were used to evaluate foot function. One hundred and sixty-eight patients were followed up for 6 to 48 months with an average of (28.6±3.2) months. All wounds were healed well without infection, sinus tract and other complications. Operative time ranged from 16 to 28 min with an average of (18.3±2.1) min. IMA, HVA, LDA, MPA and IM A 4-5 were (10.1±2.1)°, (32.6±4.2)°, (6.9±2.3)°, (18.5±5.2)°, (15.1±2.9)°preoperatively, improved to (8.3±2.2)°, (10.9±2.9)°, (2.7±0.4)°, (6.5±1.6)°, (8.9±1.8)° postoperatively, and had significant differences before and after operation. While there was no difference in PASA before (9.1±2.1)°and after operation(8.7±1.9)°. AOFAS score were improved from (31.6±3.9) before operation to(83.7±5.2) after operation, but no significant difference( P >0.05). According to AOFAS score, 147 patients obtained excellent results, 13 good, 6 moderate and 2 poor. Minimally corrective osteotomy for the treatment of hallux valgus with deformity

  11. Non-surgical treatment of hip osteoarthritis. Hip school, with or without the addition of manual therapy, in comparison to a minimal control intervention: Protocol for a three-armed randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Vach Werner

    2011-05-01

    Full Text Available Abstract Background Hip osteoarthritis is a common and chronic condition resulting in pain, functional disability and reduced quality of life. In the early stages of the disease, a combination of non-pharmacological and pharmacological treatment is recommended. There is evidence from several trials that exercise therapy is effective. In addition, single trials suggest that patient education in the form of a hip school is a promising intervention and that manual therapy is superior to exercise. Methods/Design This is a randomized clinical trial. Patients with clinical and radiological hip osteoarthritis, 40-80 years of age, and without indication for hip surgery were randomized into 3 groups. The active intervention groups A and B received six weeks of hip school, taught by a physiotherapist, for a total of 5 sessions. In addition, group B received manual therapy consisting of joint manipulation and soft-tissue therapy twice a week for six weeks. Group C received a self-care information leaflet containing advice on "live as usual" and stretching exercises from the hip school. The primary time point for assessing relative effectiveness is at the end of the six weeks intervention period with follow-ups after three and 12 months. Primary outcome measure is pain measured on an eleven-point numeric rating scale. Secondary outcome measures are the hip dysfunction and osteoarthritis outcome score, patient's global perceived effect, patient specific functional scale, general quality of life and hip range of motion. Discussion To our knowledge this is the first randomized clinical trial comparing a patient education program with or without the addition of manual therapy to a minimal intervention for patients with hip osteoarthritis. Trial registration ClinicalTrials NCT01039337

  12. [Thymomectomy by minimally invasive surgery. Comparative study videosurgery versus robot-assisted surgery].

    Science.gov (United States)

    Witte Pfister, A; Baste, J-M; Piton, N; Bubenheim, M; Melki, J; Wurtz, A; Peillon, C

    2017-05-01

    To report the results of minimally invasive surgery in patients with stage I or II thymoma in the Masaoka classification. The reference technique is partial or complete thymectomy by sternotonomy. A retrospective single-center study of a prospective database including all cases of thymoma operated from April 2009 to February 2015 by minimally invasive techniques: either videosurgery (VATS) or robot-assisted surgery (RATS). The surgical technique, type of resection, length of hospital stay, postoperative complications and recurrences were analysed. Our series consisted of 22 patients (15 women and 7 men). The average age was 53 years. Myasthenia gravis was present in 12 patients. Eight patients were operated on by VATS and 14 patiens by RATS. There were no conversions to sternotomy and no perioperative deaths. The mean operating time was 92min for VATS and 137min for RATS (P<0.001). The average hospital stay was 5 days. The mean weight of the specimen for the VATS group was 13.2 and 45.7mg for the RATS group. Twelve patients were classified Masaoka stage I and 10 were stage II. According to the WHO classification there were 7 patients type A, 5 type AB, 4 type B1, 4 type B2 4 and 2 type B3. As proposed by the Group ITMIG-IASLC in 2015 all patients corresponded to group I. The mean follow-up period was 36 months. We noted 3 major perioperative complications according to the Clavien-Dindo classification: one pneumonia, one phrenic nerve paralysis and one recurrent laryngeal nerve palsy. We observed one case of local recurrence at 22 months. Following surgery 4 patients were treated with radiotherapy and 2 patients with chemotherapy. The minimally invasive route is safe, relatively atraumatic and may be incorporated in the therapeutic arsenal for the treatment of Masaoka stage I and II thymoma as an alternative to conventional sternotomy. RATS and VATS are two minimally invasive techniques and the results in the short and medium term are

  13. Minimally Invasive Implantation of HeartWare Assist Device and Simultaneous Tricuspid Valve Reconstruction Through Partial Upper Sternotomy.

    Science.gov (United States)

    Hillebrand, Julia; Hoffmeier, Andreas; Djie Tiong Tjan, Tonny; Sindermann, Juergen R; Schmidt, Christoph; Martens, Sven; Scherer, Mirela

    2017-05-01

    Left ventricular assist device (LVAD) implantation is a well-established therapy to support patients with end-stage heart failure. However, the operative procedure is associated with severe trauma. Third generation LVADs like the HeartWare assist device (HeartWare, Inc., Framingham, MA, USA) are characterized by enhanced technology despite smaller size. These devices offer new minimally invasive surgical options. Tricuspid regurgitation requiring valve repair is frequent in patients with the need for mechanical circulatory support as it is strongly associated with ischemic and nonischemic cardiomyopathy. We report on HeartWare LVAD implantation and simultaneous tricuspid valve reconstruction through minimally invasive access by partial upper sternotomy to the fifth left intercostal space. Four male patients (mean age 51.72 ± 11.95 years) suffering from chronic heart failure due to dilative (three patients) and ischemic (one patient) cardiomyopathy and also exhibiting concomitant tricuspid valve insufficiency due to annular dilation underwent VAD implantation and tricuspid valve annuloplasty. Extracorporeal circulation was established via the ascending aorta, superior vena cava, and right atrium. In all four cases the LVAD implantation and tricuspid valve repair via partial median sternotomy was successful. During the operative procedure, no conversion to full sternotomy was necessary. One patient needed postoperative re-exploration because of pericardial effusion. No postoperative focal neurologic injury was observed. New generation VADs are advantageous because of the possibility of minimally invasive implantation procedure which can therefore minimize surgical trauma. Concomitant tricuspid valve reconstruction can also be performed simultaneously through partial upper sternotomy. Nevertheless, minimally invasive LVAD implantation is a challenging operative technique. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals

  14. Microswitch- and VOCA-Assisted Programs for Two Post-Coma Persons with Minimally Conscious State and Pervasive Motor Disabilities

    Science.gov (United States)

    Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Buonocunto, Francesca; Sacco, Valentina; Colonna, Fabio; Navarro, Jorge; Oliva, Doretta; Signorino, Mario; Megna, Gianfranco

    2009-01-01

    Intervention programs, based on learning principles and assistive technology, were assessed in two studies with two post-coma men with minimally conscious state and pervasive motor disabilities. Study I assessed a program that included (a) an optic microswitch, activated via double blinking, which allowed a man direct access to brief music…

  15. Development and evaluation of a mobile intervention for heavy drinking and smoking among college students.

    Science.gov (United States)

    Witkiewitz, Katie; Desai, Sruti A; Bowen, Sarah; Leigh, Barbara C; Kirouac, Megan; Larimer, Mary E

    2014-09-01

    Nearly all college student smokers also drink alcohol, and smoking and heavy episodic drinking (HED) commonly co-occur. However, few studies have examined the factors that concurrently influence smoking and HED among college students and, to date, no interventions have been developed that target both HED and smoking in this population. The objective of the current study was to develop and evaluate a mobile feedback intervention that targets HED and smoking. Participants (N = 94) were non-treatment-seeking college students (M(age) = 20.5 years, SD = 1.7) who engaged in at least a single HED episode in the past 2 weeks and reported concurrent smoking and drinking at least once a week. Participants were randomized to receive either the mobile intervention for 14 days, complete mobile assessments (without intervention) for 14 days, or complete minimal assessments (without intervention or mobile assessments). At a 1-month follow-up, compared with the minimal assessment condition, we observed significant reductions in the number of cigarettes per smoking day in both the mobile intervention (d = 0.55) and mobile assessment (d = 0.45) conditions. Among those randomized to the mobile intervention, receiving more modules of the intervention was significantly associated with a lower likelihood of any drinking during the 14-day assessment period and significant reductions in smoking at 1-month follow-up. The mobile intervention did not result in significant reductions in HED or concurrent smoking and drinking. Future research should continue to examine ways of using technology and the real-time environment to improve interventions for HED and smoking.

  16. Comparison of femoral neck fracture healing and affected limb pain after anterolateral-approach minimally invasive total hip replacement and hemiarthroplasty

    Directory of Open Access Journals (Sweden)

    Xiao-Dong Cao

    2017-04-01

    Full Text Available Objective: To study the differences in femoral neck fracture healing and affected limb pain after anterolateral-approach minimally invasive total hip replacement and hemiarthroplasty. Methods: A total of 92 patients with femoral neck fracture who received hip replacement in our hospital between May 2013 and December 2015 were selected and randomly divided into total hip and half hip group, total hip group received anterolateral-approach minimally invasive total hip replacement, half hip group received anterolateral-approach minimally invasive hemiarthroplasty, and 1 month after operation, serum was collected to detect the levels of bone metabolism markers, osteocyte cytokines, SP and CGRP. Results: 1 month after operation, serum PINP, PICP, BMP, TGF-β, FGF, IGF-I and IGF-II levels of total hip group were significantly higher than those of half hip group while TRAP5b and CatK levels were significantly lower than those of half hip group; the day after operation, serum pain media SP and CGRP levels were not significantly different between the two groups of patients; 36 h after operation, serum SP and CGRP levels of total hip group were significantly lower than those of half hip group. Conclusion: The bone metabolism after anterolateral-approach minimally invasive total hip replacement is better than that after hemiarthroplasty, and the degree of pain is less than that after hemiarthroplasty.

  17. Seeley-Gilkey coefficients for fourth-order operators on Riemannian manifold

    International Nuclear Information System (INIS)

    Gusynin, V.P.

    1990-01-01

    The covariant pseudodifferential-operator method of Widom is developed for computing the coefficients in the heat kernel expansion. It allows one to calculate Seeley-Gilkey coefficients for both minimal and nonminimal differential operators acting on a vector bundle over a riemannian manifold. The coefficients for the fourth-order minimal operators in arbitrary dimensions of space are calculated. In contrast to the second-order operators the coefficients for the fourth-order (and higher) operators turn out to be essentially dependent on the space dimension. The algorithmic character of the method allows one to calculate the coefficients by computer using an analytical calculation system. The method also permits a simple generalization to manifolds with torsion and supermanifolds. (orig.)

  18. PET/CT-guided Interventions: Personnel Radiation Dose

    Energy Technology Data Exchange (ETDEWEB)

    Ryan, E. Ronan, E-mail: ronan@ronanryan.com; Thornton, Raymond; Sofocleous, Constantinos T.; Erinjeri, Joseph P. [Memorial Sloan-Kettering Cancer Center, Department of Radiology (United States); Hsu, Meier [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics (United States); Quinn, Brian; Dauer, Lawrence T. [Memorial Sloan-Kettering Cancer Center, Department of Medical Physics (United States); Solomon, Stephen B. [Memorial Sloan-Kettering Cancer Center, Department of Radiology (United States)

    2013-08-01

    PurposeTo quantify radiation exposure to the primary operator and staff during PET/CT-guided interventional procedures.MethodsIn this prospective study, 12 patients underwent PET/CT-guided interventions over a 6 month period. Radiation exposure was measured for the primary operator, the radiology technologist, and the nurse anesthetist by means of optically stimulated luminescence dosimeters. Radiation exposure was correlated with the procedure time and the use of in-room image guidance (CT fluoroscopy or ultrasound).ResultsThe median effective dose was 0.02 (range 0-0.13) mSv for the primary operator, 0.01 (range 0-0.05) mSv for the nurse anesthetist, and 0.02 (range 0-0.05) mSv for the radiology technologist. The median extremity dose equivalent for the operator was 0.05 (range 0-0.62) mSv. Radiation exposure correlated with procedure duration and with the use of in-room image guidance. The median operator effective dose for the procedure was 0.015 mSv when conventional biopsy mode CT was used, compared to 0.06 mSv for in-room image guidance, although this did not achieve statistical significance as a result of the small sample size (p = 0.06).ConclusionThe operator dose from PET/CT-guided procedures is not significantly different than typical doses from fluoroscopically guided procedures. The major determinant of radiation exposure to the operator from PET/CT-guided interventional procedures is time spent in close proximity to the patient.

  19. Minimal Gromov-Witten rings

    International Nuclear Information System (INIS)

    Przyjalkowski, V V

    2008-01-01

    We construct an abstract theory of Gromov-Witten invariants of genus 0 for quantum minimal Fano varieties (a minimal class of varieties which is natural from the quantum cohomological viewpoint). Namely, we consider the minimal Gromov-Witten ring: a commutative algebra whose generators and relations are of the form used in the Gromov-Witten theory of Fano varieties (of unspecified dimension). The Gromov-Witten theory of any quantum minimal variety is a homomorphism from this ring to C. We prove an abstract reconstruction theorem which says that this ring is isomorphic to the free commutative ring generated by 'prime two-pointed invariants'. We also find solutions of the differential equation of type DN for a Fano variety of dimension N in terms of the generating series of one-pointed Gromov-Witten invariants

  20. Minimal Marking: A Success Story

    Science.gov (United States)

    McNeilly, Anne

    2014-01-01

    The minimal-marking project conducted in Ryerson's School of Journalism throughout 2012 and early 2013 resulted in significantly higher grammar scores in two first-year classes of minimally marked university students when compared to two traditionally marked classes. The "minimal-marking" concept (Haswell, 1983), which requires…

  1. Thoracoscopic management of volvulus of the gastric conduit following minimally invasive Ivor-Lewis esophagectomy.

    Science.gov (United States)

    Linson, Jeremy; Latzko, Michael; Ahmed, Bestoun; Awad, Ziad

    2016-07-01

    We present a case of emergent thoracoscopic management of volvulus of the gastric conduit following minimally invasive Ivor-Lewis esophagectomy. The patient is a 69-year-old Caucasian male with a history of adenocarcinoma of the lower third of the esophagus. Initial presentation was dysphagia with solid foods, which progressed in severity until he was unable to swallow anything. EUS demonstrated a partially obstructing mass at 33 cm; biopsy revealed poorly differentiated adenocarcinoma, stage T3N2Mx. PET scan did not reveal any metastatic disease. Preoperative management included neo-adjuvant chemoradiation therapy (5-FU and cisplatin) and early placement of a jejunal feeding tube. Intra-operative leak test was performed as a matter of routine following completion of the esophagogastric anastomosis. A nasogastric tube was placed intra-operatively and removed on POD2 according to our standard pathway. Postoperatively, the patient progressed without difficulty to POD4, when we routinely obtain an upper GI swallow study. This demonstrated a lack of transit of contrast through the distal neo-esophagus. Follow-up endoscopy revealed volvulus of the gastric conduit with obliteration of the lumen. We immediately took the patient to the OR for thoracoscopic detorsion, which we accomplished successfully by entering the existing trochar sites and using blunt dissection.␣Upon entering the thoracic cavity, the staple line that had been oriented anteriorly was now posterior. Attachments were gently teased away from the chest wall and the conduit was detorsed and anchored to the chest wall in the correct orientation with silk suture. Intra-operative endoscopy demonstrated a patent conduit. Postoperative upper GI fluoroscopy now showed good transit of contrast. The patient continued to improve and was eventually advanced to mechanical soft diet and discharged on postoperative day 9. Early intervention is indicated in cases of volvulus of the gastric conduit following Ivor

  2. Cost and radiation exposure optimization of demineralizer operation

    International Nuclear Information System (INIS)

    Bernal, F.E.; Burn, R.R.; Cook, G.M.; Simonetti, L.; Simpson, P.A.

    1985-01-01

    A pool water demineralizer is utilized at a research reactor to minimize impurities that become radioactive; to minimize impurities that react chemically with reactor components; to maintain optical clarity of the pool water; and to minimize aluminum fuel cladding corrosion by maintaining a slightly acidic pH. Balanced against these advantages are the dollar costs of equipment, resins, recharging chemicals, and maintenance; the man-rem costs of radiation exposure during maintenance, demineralizer recharges, and resin replacement; and hazardous chemical exposure. At the Ford Nuclear Reactor (FNR), maintenance of the demineralizer system is the second largest source of radiation exposure to operators. Theoretical and practical aspects of demineralizer operation are discussed. The most obvious way to reduce radiation exposure due to demineralizer system operation is to perform recharges after the reactor has been shut down for the maximum possible time. Setting a higher depletion limit and operating with the optimum system lineup reduce the frequency between recharges, saving both exposure and cost. Recharge frequency and resin lifetime seem to be relatively independent of the quality of the chemicals used and the personnel performing recharges, provided consistent procedures are followed

  3. [Localization Establishment of an Interdisciplinary Intervention Model to Prevent Post-Operative Delirium in Older Patients Based on 'Hospital Elder Life Program'].

    Science.gov (United States)

    Wang, Yan-Yan; Liao, Yu-Lin; Gao, Lang-Li; Hu, Xiu-Ying; Yue, Ji-Rong

    2017-06-01

    Postoperative delirium is a significant complication in elderly patients. The occurrence of delirium may increase the related physical and psychological risks, delay the length of hospital stays, and even lead to death. According to the current evidence-based model, the application of interdisciplinary intervention may effectively prevent delirium, shorten the length of hospital stays, and save costs. To establish a culturally appropriate interdisciplinary intervention model for preventing postoperative delirium in older Chinese patients. The authors adapted the original version of the Hospital Elder Life Program (HELP©) from the Hebrew Senior Life Institute for Aging Research of Harvard University by localizing the content using additional medical resources and translating the modified instrument into Chinese. Furthermore, the final version of this interdisciplinary intervention model for postoperative delirium was developed in accordance with the "guideline of delirium: diagnosis, prevention and management produced by the National Institute for Health and Clinical Excellence in 2010" and the "clinical practice guideline for postoperative delirium in older adults" produced by American geriatrics society in 2014. Finally, the translated instrument was revised and improved using discussions, consultations, and pilot study. The abovementioned procedure generated an interdisciplinary intervention model for preventing postoperative delirium that is applicable to the Chinese medical environment. The content addresses personnel structure and assignment of responsibility; details of interdisciplinary intervention protocols and implementation procedures; and required personnel training. The revised model is expected to decrease the occurrence of post-operative delirium and other complications in elderly patients, to help them maintain and improve their function, to shorten the length of their hospital stays, and to facilitate recovery.

  4. Minimal families of curves on surfaces

    KAUST Repository

    Lubbes, Niels

    2014-01-01

    A minimal family of curves on an embedded surface is defined as a 1-dimensional family of rational curves of minimal degree, which cover the surface. We classify such minimal families using constructive methods. This allows us to compute the minimal

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

    African Journals Online (AJOL)

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

  6. The investigation of the design of hybrid operating room

    International Nuclear Information System (INIS)

    Jiang Weihao; Li Jun

    2011-01-01

    Objective: To investigate the design of the interventional operating room that can meet the needs of modern DSA operation, and the overall arrangement of the hybrid operating room should be reasonable, practical and perspective. Methods: The experience and understanding obtained from the designing and planning of the new Building of Radiology and Surgery in authors' hospital were summarized. In order to meet the requirements of aseptic surgical practices and a full-featured hybrid operating room the following factors should be carefully and synthetically taken into account: the room size, the functional sub-areas, the operational procedures, the aseptic specification, etc. Results: The sufficient verification and scientific design were the important link for building a hybrid operating room. It could provide the surgeons and interventional physicians with more alternative operating methods and it could represent the development trend of medical technology. Conclusion: When planning and designing a new DSA operating room, various factors related to the interventional procedures, such as the room size, the functional sub-areas, the operational procedures and the aseptic specification, should be carefully and synthetically taken into account. The standard of aseptic procedure must be strictly complied with and the various functional sub-areas need to be rationally distributed. The design of hybrid operating room, which joins the functions of both open surgery and interventional management together, should be scientific, practical and perspective. (authors)

  7. Cognitive-behavioral Intervention for Older Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    René García Roche

    2016-03-01

    Full Text Available Background: aging-associated diseases contribute to morbidity and mortality in the population; therefore, it is necessary to develop intervention strategies to prevent and/or minimize their consequences. Objectives: to evaluate the effectiveness of a cognitive-behavioral intervention aimed at older hypertensive patients treated in primary care in Cardenas and Santiago de Cuba municipalities during 2011-2013. Methods: an intervention study of older adults with hypertension was conducted in two municipalities: Santiago de Cuba and Cárdenas. The intervention group was composed of 399 older patients living in the catchment areas of the Carlos Juan Finlay and Héroes del Moncada polyclinics while the control group included 377 older adults served by the Julian Grimau and Jose Antonio Echeverría polyclinics. The intervention consisted of a systematic strategy to increase knowledge of the disease in order to change lifestyles. Results: in the intervention group, there were more patients with sufficient knowledge of the disease (OR: 1.82, greater control of hypertension (OR: 1.51 and better adherence to treatment (OR: 1.70. By modeling the explanatory variables with hypertension control, being in the intervention group (OR: 0.695 and adhering to treatment (OR: 0.543 were found to be health protective factors. Conclusion: the congnitive-behavioral intervention for older adults treated in primary care of the municipalities studied was effective in improving blood pressure control since it contributed to a greater adherence to treatment.

  8. ER-E3 regulation. Minimal instrumentation that must operate nuclear medicine in Cuba

    International Nuclear Information System (INIS)

    2015-01-01

    The purpose of this regulation is to define the instrumentation that must exist in any institution conducting the practice of nuclear medicine in Cuba. This regulation emphasizes two aspects: The minimum equipment necessary to operate a nuclear medicine laboratory for use 'in vitro' and the minimum equipment required to operate a Nuclear Medicine use 'in vivo'

  9. Waste Minimization/Pollution Prevention Crosscut Plan, 1994

    International Nuclear Information System (INIS)

    1994-01-01

    This plan establishes a Department-wide goal to reduce total releases of toxic chemicals to the environment and off-site transfers of such toxic chemicals by 50 percent by December 31, 1999, in compliance with Executive Order 12856. Each site that meets the threshold quantities of toxic chemicals established in the Emergency Planning and Community Right-to-Know Act (EPCRA) will participate in this goal. In addition, each DOE site will establish site-specific goals to reduce generation of hazardous, radioactive, radioactive mixed, and sanitary wastes and pollutants, as applicable. Implementation of this plan will represent a major step toward the environmental risks and costs associated with DOE operations and increasing the Department's use of preventive environmental management practices. Investing in Waste Minimization Pollution Prevention (WMin/PP) steadily reduce hazardous and radioactive waste generation and will reduce the need for waste management and unnecessary expenditures for waste treatment, storage, and disposal. A preventive approach to waste management will help solve current environmental and regulatory issues and reduce the need for costly future corrective actions. The purpose of this plan is to establish the strategic framework for integrating WMin/PP into all DOE internal activities. This program includes setting DOE policy and goals for reducing the generation of wastes and pollutants, increasing recycling activities, and establishing an infrastructure to achieve and measure the goals throughout the DOE complex. Waste Minimization and Pollution Prevention Awareness Plans, submitted to Headquarters by DOE field sites, will incorporate the WMin/PP activities and goals outlined in this plan. Success of the DOE WMin/PP program is dependent upon each field operation becoming accountable for resources used, wastes and pollutants generated, and wastes recycled

  10. Non-technical skills in minimally invasive surgery teams

    DEFF Research Database (Denmark)

    Gjeraa, Kirsten; Spanager, Lene; Konge, Lars

    2016-01-01

    BACKGROUND: Root cause analyses show that up to 70 % of adverse events are caused by human error. Strong non-technical skills (NTS) can prevent or reduce these errors, considerable numbers of which occur in the operating theatre. Minimally invasive surgery (MIS) requires manipulation of more...... complex equipment than open procedures, likely requiring a different set of NTS for each kind of team. The aims of this study were to identify the MIS teams' key NTS and investigate the effect of training and assessment of NTS on MIS teams. METHODS: The databases of PubMed, Cochrane Library, Embase, Psyc...... were included. All were observational studies without blinding, and they differed in aims, types of evaluation, and outcomes. Only two studies evaluated patient outcomes other than operative time, and overall, the studies' quality of evidence was low. Different communication types were encountered...

  11. Gas cylinder disposal pit remediation waste minimization and management

    International Nuclear Information System (INIS)

    Alas, C.A.; Solow, A.; Criswell, C.W.; Spengler, D.; Brannon, R.; Schwender, J.M.; Eckman, C.K.; Rusthoven, T.

    1995-01-01

    A remediation of a gas cylinder disposal pit at Sandia National Laboratories, New Mexico has recently been completed. The cleanup prevented possible spontaneous releases of hazardous gases from corroded cylinders that may have affected nearby active test areas at Sandia's Technical Area III. Special waste management, safety, and quality plans were developed and strictly implemented for this project. The project was conceived from a waste management perspective, and waste minimization and management were built into the planning and implementation phases. The site layout was planned to accommodate light and heavy equipment, storage of large quantities of suspect soil, and special areas to stage and treat gases and reactive chemicals removed from the pit, as well as radiation protection areas. Excavation was a tightly controlled activity using experienced gas cylinder and reactive chemical specialists. Hazardous operations were conducted at night under lights, to allow nearby daytime operations to function unhindered. The quality assurance plan provided specific control of, and documentation for, critical decisions, as well as the record of daily operations. Both hand and heavy equipment excavation techniques were utilized. Hand excavation techniques were utilized. Hand excavation techniques allows sealed glass containers to be exhumed unharmed. In the end, several dozen thermal batteries; 5 pounds (2.3 kg) of lithium metal; 6.6 pounds (3.0 kg) of rubidium metal; several kilograms of unknown chemicals; 140 cubic yards (107 cubic meters) of thorium-contaminated soil; 270 cubic yards (205 cubic meters) of chromium-contaminated soil; and 450 gas cylinders, including 97 intact cylinders containing inert, flammable, toxic, corrosive, or oxidizing gases were removed and effectively managed to minimize waste

  12. Waste minimization assessment procedure

    International Nuclear Information System (INIS)

    Kellythorne, L.L.

    1993-01-01

    Perry Nuclear Power Plant began developing a waste minimization plan early in 1991. In March of 1991 the plan was documented following a similar format to that described in the EPA Waste Minimization Opportunity Assessment Manual. Initial implementation involved obtaining management's commitment to support a waste minimization effort. The primary assessment goal was to identify all hazardous waste streams and to evaluate those streams for minimization opportunities. As implementation of the plan proceeded, non-hazardous waste streams routinely generated in large volumes were also evaluated for minimization opportunities. The next step included collection of process and facility data which would be useful in helping the facility accomplish its assessment goals. This paper describes the resources that were used and which were most valuable in identifying both the hazardous and non-hazardous waste streams that existed on site. For each material identified as a waste stream, additional information regarding the materials use, manufacturer, EPA hazardous waste number and DOT hazard class was also gathered. Once waste streams were evaluated for potential source reduction, recycling, re-use, re-sale, or burning for heat recovery, with disposal as the last viable alternative

  13. Westinghouse Hanford Company waste minimization actions

    International Nuclear Information System (INIS)

    Greenhalgh, W.O.

    1988-09-01

    Companies that generate hazardous waste materials are now required by national regulations to establish a waste minimization program. Accordingly, in FY88 the Westinghouse Hanford Company formed a waste minimization team organization. The purpose of the team is to assist the company in its efforts to minimize the generation of waste, train personnel on waste minimization techniques, document successful waste minimization effects, track dollar savings realized, and to publicize and administer an employee incentive program. A number of significant actions have been successful, resulting in the savings of materials and dollars. The team itself has been successful in establishing some worthwhile minimization projects. This document briefly describes the waste minimization actions that have been successful to date. 2 refs., 26 figs., 3 tabs

  14. 40 CFR 264.273 - Design and operating requirements.

    Science.gov (United States)

    2010-07-01

    ... the facility permit how the owner or operator will design, construct, operate, and maintain the land..., construct, operate, and maintain the treatment zone to minimize run-off of hazardous constituents during the... maintain a run-on control system capable of preventing flow onto the treatment zone during peak discharge...

  15. Responsiveness, minimal detectable change, and minimal clinically important difference of the Nottingham Extended Activities of Daily Living Scale in patients with improved performance after stroke rehabilitation.

    Science.gov (United States)

    Wu, Ching-yi; Chuang, Li-ling; Lin, Keh-chung; Lee, Shin-da; Hong, Wei-hsien

    2011-08-01

    To determine the responsiveness, minimal detectable change (MDC), and minimal clinically important differences (MCIDs) of the Nottingham Extended Activities of Daily Living (NEADL) scale and to assess percentages of patients' change scores exceeding the MDC and MCID after stroke rehabilitation. Secondary analyses of patients who received stroke rehabilitation therapy. Medical centers. Patients with stroke (N=78). Secondary analyses of patients who received 1 of 4 rehabilitation interventions. Responsiveness (standardized response mean [SRM]), 90% confidence that a change score at this threshold or higher is true and reliable rather than measurement error (MDC(90)), and MCID on the NEADL score and percentages of patients exceeding the MDC(90) and MCID. The SRM of the total NEADL scale was 1.3. The MDC(90) value for the total NEADL scale was 4.9, whereas minima and maxima of the MCID for total NEADL score were 2.4 and 6.1 points, respectively. Percentages of patients exceeding the MDC(90) and MCID of the total NEADL score were 50.0%, 73.1%, and 32.1%, respectively. The NEADL is a responsive instrument relevant for measuring change in instrumental activities of daily living after stroke rehabilitation. A patient's change score has to reach 4.9 points on the total to indicate a true change. The mean change score of a stroke group on the total NEADL scale should achieve 6.1 points to be regarded as clinically important. Our findings are based on patients with improved NEADL performance after they received specific interventions. Future research with larger sample sizes is warranted to validate these estimates. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  16. A cyclotron isotope production facility designed to maximize production and minimize radiation dose

    International Nuclear Information System (INIS)

    Dickie, W.J.; Stevenson, N.R.; Szlavik, F.F.

    1993-01-01

    Continuing increases in requirements from the nuclear medicine industry for cyclotron isotopes is increasing the demands being put on an aging stock of machines. In addition, with the 1990 recommendations of the ICRP publication in place, strict dose limits will be required and this will have an effect on the way these machines are being operated. Recent advances in cyclotron design combined with lessons learned from two decades of commercial production mean that new facilities can result in a substantial charge on target, low personnel dose, and minimal residual activation. An optimal facility would utilize a well engineered variable energy/high current H - cyclotron design, multiple beam extraction, and individual target caves. Materials would be selected to minimize activation and absorb neutrons. Equipment would be designed to minimize maintenance activities performed in high radiation fields. (orig.)

  17. Waste Minimization Improvements Achieved Through Six Sigma Analysis Result In Significant Cost Savings

    International Nuclear Information System (INIS)

    Mousseau, Jeffrey D.; Jansen, John R.; Janke, David H.; Plowman, Catherine M.

    2003-01-01

    Improved waste minimization practices at the Department of Energy's (DOE) Idaho National Engineering and Environmental Laboratory (INEEL) are leading to a 15% reduction in the generation of hazardous and radioactive waste. Bechtel, BWXT Idaho, LLC (BBWI), the prime management and operations contractor at the INEEL, applied the Six Sigma improvement process to the INEEL Waste Minimization Program to review existing processes and define opportunities for improvement. Our Six Sigma analysis team: composed of an executive champion, process owner, a black belt and yellow belt, and technical and business team members used this statistical based process approach to analyze work processes and produced ten recommendations for improvement. Recommendations ranged from waste generator financial accountability for newly generated waste to enhanced employee recognition programs for waste minimization efforts. These improvements have now been implemented to reduce waste generation rates and are producing positive results

  18. Waste minimization for commercial radioactive materials users generating low-level radioactive waste

    International Nuclear Information System (INIS)

    Fischer, D.K.; Gitt, M.; Williams, G.A.; Branch, S.; Otis, M.D.; McKenzie-Carter, M.A.; Schurman, D.L.

    1991-07-01

    The objective of this document is to provide a resource for all states and compact regions interested in promoting the minimization of low-level radioactive waste (LLW). This project was initiated by the Commonwealth of Massachusetts, and Massachusetts waste streams have been used as examples; however, the methods of analysis presented here are applicable to similar waste streams generated elsewhere. This document is a guide for states/compact regions to use in developing a system to evaluate and prioritize various waste minimization techniques in order to encourage individual radioactive materials users (LLW generators) to consider these techniques in their own independent evaluations. This review discusses the application of specific waste minimization techniques to waste streams characteristic of three categories of radioactive materials users: (1) industrial operations using radioactive materials in the manufacture of commercial products, (2) health care institutions, including hospitals and clinics, and (3) educational and research institutions. Massachusetts waste stream characterization data from key radioactive materials users in each category are used to illustrate the applicability of various minimization techniques. The utility group is not included because extensive information specific to this category of LLW generators is available in the literature

  19. Minimal but non-minimal inflation and electroweak symmetry breaking

    Energy Technology Data Exchange (ETDEWEB)

    Marzola, Luca [National Institute of Chemical Physics and Biophysics,Rävala 10, 10143 Tallinn (Estonia); Institute of Physics, University of Tartu,Ravila 14c, 50411 Tartu (Estonia); Racioppi, Antonio [National Institute of Chemical Physics and Biophysics,Rävala 10, 10143 Tallinn (Estonia)

    2016-10-07

    We consider the most minimal scale invariant extension of the standard model that allows for successful radiative electroweak symmetry breaking and inflation. The framework involves an extra scalar singlet, that plays the rôle of the inflaton, and is compatibile with current experimental bounds owing to the non-minimal coupling of the latter to gravity. This inflationary scenario predicts a very low tensor-to-scalar ratio r≈10{sup −3}, typical of Higgs-inflation models, but in contrast yields a scalar spectral index n{sub s}≃0.97 which departs from the Starobinsky limit. We briefly discuss the collider phenomenology of the framework.

  20. Minimally Invasive Procedures - Direct and Video-Assisted Forms in the Treatment of Heart Diseases

    International Nuclear Information System (INIS)

    Castro, Josué Viana Neto; Melo, Emanuel Carvalho; Silva, Juliana Fernandes; Rebouças, Leonardo Lemos; Corrêa, Larissa Chagas; Germano, Amanda de Queiroz; Machado, João José Aquino

    2014-01-01

    Minimally invasive cardiovascular procedures have been progressively used in heart surgery. To describe the techniques and immediate results of minimally invasive procedures in 5 years. Prospective and descriptive study in which 102 patients were submitted to minimally invasive procedures in direct and video-assisted forms. Clinical and surgical variables were evaluated as well as the in hospital follow-up of the patients. Fourteen patients were operated through the direct form and 88 through the video-assisted form. Between minimally invasive procedures in direct form, 13 had aortic valve disease. Between minimally invasive procedures in video-assisted forms, 43 had mitral valve disease, 41 atrial septal defect and four tumors. In relation to mitral valve disease, we replaced 26 and reconstructed 17 valves. Aortic clamp, extracorporeal and procedure times were, respectively, 91,6 ± 21,8, 112,7 ± 27,9 e 247,1 ± 20,3 minutes in minimally invasive procedures in direct form. Between minimally invasive procedures in video-assisted forms, 71,6 ± 29, 99,7 ± 32,6 e 226,1 ± 42,7 minutes. Considering intensive care and hospitalization times, these were 41,1 ± 14,7 hours and 4,6 ± 2 days in minimally invasive procedures in direct and 36,8 ± 16,3 hours and 4,3 ± 1,9 days in minimally invasive procedures in video-assisted forms procedures. Minimally invasive procedures were used in two forms - direct and video-assisted - with safety in the surgical treatment of video-assisted, atrial septal defect and tumors of the heart. These procedures seem to result in longer surgical variables. However, hospital recuperation was faster, independent of the access or pathology