Surgical instrument biocontaminant fluorescence detection in ambient lighting conditions for hospital reprocessing and sterilization department (Conference Presentation)

Science.gov (United States)

Baribeau, François; Bubel, Annie; Dumont, Guillaume; Vachon, Carl; Lépine, André; Rochefort, Stéphane; Massicotte, Martin; Buteau-Vaillancourt, Louis; Gallant, Pascal; Mermut, Ozzy

2017-03-01

Hospitals currently rely on simple human visual inspection for assessing cleanliness of surgical instruments. Studies showed that surgical site infections are in part attributed to inadequate cleaning of medical devices. Standards groups recognize the need to objectively quantify the amount of residues on surgical instruments and establish guidelines. We developed a portable technology for the detection of contaminants on surgical instruments through fluorescence following cleaning. Weak fluorescence signals are usually detected in the obscurity only with the lighting of the excitation source. The key element of this system is that it works in ambient lighting conditions, a requirement to not disturb the normal workflow of hospital reprocessing facilities. A biocompatible fluorescent dye is added to the detergent and labels the proteins of organic residues. It is resistant to the harsh environment in a washer-disinfector. Two inspection devices have been developed with a 488nm laser as the excitation source: a handheld scanner and a tabletop station using spectral-domain and time-domain ambient light cancellation schemes. The systems are eye safe and equipped with image processing and interfacing software to provide visual or audible warnings to the operator based on a set of adjustable signal thresholds. Micron-scale residues are detected by the system which can also evaluate soil size and mass. Unlike swabbing, it can inspect whole tools in real-time. The technology has been validated in an independent hospital decontamination research laboratory. It also has potential applications in the forensics, agro-food, and space fields. Technical aspects and results will be presented and discussed.

Varying ultrasound power level to distinguish surgical instruments and tissue.

Science.gov (United States)

Ren, Hongliang; Anuraj, Banani; Dupont, Pierre E

2018-03-01

We investigate a new framework of surgical instrument detection based on power-varying ultrasound images with simple and efficient pixel-wise intensity processing. Without using complicated feature extraction methods, we identified the instrument with an estimated optimal power level and by comparing pixel values of varying transducer power level images. The proposed framework exploits the physics of ultrasound imaging system by varying the transducer power level to effectively distinguish metallic surgical instruments from tissue. This power-varying image-guidance is motivated from our observations that ultrasound imaging at different power levels exhibit different contrast enhancement capabilities between tissue and instruments in ultrasound-guided robotic beating-heart surgery. Using lower transducer power levels (ranging from 40 to 75% of the rated lowest ultrasound power levels of the two tested ultrasound scanners) can effectively suppress the strong imaging artifacts from metallic instruments and thus, can be utilized together with the images from normal transducer power levels to enhance the separability between instrument and tissue, improving intraoperative instrument tracking accuracy from the acquired noisy ultrasound volumetric images. We performed experiments in phantoms and ex vivo hearts in water tank environments. The proposed multi-level power-varying ultrasound imaging approach can identify robotic instruments of high acoustic impedance from low-signal-to-noise-ratio ultrasound images by power adjustments.

Robotic-surgical instrument wrist pose estimation.

Science.gov (United States)

Fabel, Stephan; Baek, Kyungim; Berkelman, Peter

2010-01-01

The Compact Lightweight Surgery Robot from the University of Hawaii includes two teleoperated instruments and one endoscope manipulator which act in accord to perform assisted interventional medicine. The relative positions and orientations of the robotic instruments and endoscope must be known to the teleoperation system so that the directions of the instrument motions can be controlled to correspond closely to the directions of the motions of the master manipulators, as seen by the the endoscope and displayed to the surgeon. If the manipulator bases are mounted in known locations and all manipulator joint variables are known, then the necessary coordinate transformations between the master and slave manipulators can be easily computed. The versatility and ease of use of the system can be increased, however, by allowing the endoscope or instrument manipulator bases to be moved to arbitrary positions and orientations without reinitializing each manipulator or remeasuring their relative positions. The aim of this work is to find the pose of the instrument end effectors using the video image from the endoscope camera. The P3P pose estimation algorithm is used with a Levenberg-Marquardt optimization to ensure convergence. The correct transformations between the master and slave coordinate frames can then be calculated and updated when the bases of the endoscope or instrument manipulators are moved to new, unknown, positions at any time before or during surgical procedures.

21 CFR 886.4350 - Manual ophthalmic surgical instrument.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual ophthalmic surgical instrument. 886.4350 Section 886.4350 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... suturing needle, lachrymal probe, trabeculotomy probe, cornea-sclera punch, ophthalmic retractor...

Surgical robotics beyond enhanced dexterity instrumentation: a survey of machine learning techniques and their role in intelligent and autonomous surgical actions.

Science.gov (United States)

Kassahun, Yohannes; Yu, Bingbin; Tibebu, Abraham Temesgen; Stoyanov, Danail; Giannarou, Stamatia; Metzen, Jan Hendrik; Vander Poorten, Emmanuel

2016-04-01

Advances in technology and computing play an increasingly important role in the evolution of modern surgical techniques and paradigms. This article reviews the current role of machine learning (ML) techniques in the context of surgery with a focus on surgical robotics (SR). Also, we provide a perspective on the future possibilities for enhancing the effectiveness of procedures by integrating ML in the operating room. The review is focused on ML techniques directly applied to surgery, surgical robotics, surgical training and assessment. The widespread use of ML methods in diagnosis and medical image computing is beyond the scope of the review. Searches were performed on PubMed and IEEE Explore using combinations of keywords: ML, surgery, robotics, surgical and medical robotics, skill learning, skill analysis and learning to perceive. Studies making use of ML methods in the context of surgery are increasingly being reported. In particular, there is an increasing interest in using ML for developing tools to understand and model surgical skill and competence or to extract surgical workflow. Many researchers begin to integrate this understanding into the control of recent surgical robots and devices. ML is an expanding field. It is popular as it allows efficient processing of vast amounts of data for interpreting and real-time decision making. Already widely used in imaging and diagnosis, it is believed that ML will also play an important role in surgery and interventional treatments. In particular, ML could become a game changer into the conception of cognitive surgical robots. Such robots endowed with cognitive skills would assist the surgical team also on a cognitive level, such as possibly lowering the mental load of the team. For example, ML could help extracting surgical skill, learned through demonstration by human experts, and could transfer this to robotic skills. Such intelligent surgical assistance would significantly surpass the state of the art in surgical

3D printing of surgical instruments for long-duration space missions.

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Wong, Julielynn Y; Pfahnl, Andreas C

2014-07-01

The first off-Earth fused deposition modeling (FDM) 3D printer will explore thermoplastic manufacturing capabilities in microgravity. This study evaluated the feasibility of FDM 3D printing 10 acrylonitrile butadiene styrene (ABS) thermoplastic surgical instruments on Earth. Three-point bending tests compared stiffness and yield strength between FDM 3D printed and conventionally manufactured ABS thermoplastic. To evaluate the relative speed of using four printed instruments compared to conventional instruments, 13 surgeons completed simulated prepping, draping, incising, and suturing tasks. Each surgeon ranked the performance of six printed instruments using a 5-point Likert scale. At a thickness of 5.75 mm or more, the FDM printing process had a less than 10% detrimental effect on the tested yield strength and stiffness of horizontally printed ABS thermoplastic relative to conventional ABS thermoplastic. Significant weakness was observed when a bending load was applied transversely to a 3D printed layer. All timed tasks were successfully performed using a printed sponge stick, towel clamp, scalpel handle, and toothed forceps. There was no substantial difference in time to completion of simulated surgical tasks with control vs. 3D printed instruments. Of the surgeons, 100%, 92%, 85%, 77%, 77%, and 69% agreed that the printed smooth and tissue forceps, curved and straight hemostats, tissue and right angle clamps, respectively, would perform adequately. It is feasible to 3D print ABS thermoplastic surgical instruments on Earth. Loadbearing structures were designed to be thicker, when possible. Printing orientations were selected so that the printing layering direction of critical structures would not be transverse to bending loads.

Research on seamless development of surgical instruments based on biological mechanisms using CAD and 3D printer.

Science.gov (United States)

Yamamoto, Ikuo; Ota, Ren; Zhu, Rui; Lawn, Murray; Ishimatsu, Takakazu; Nagayasu, Takeshi; Yamasaki, Naoya; Takagi, Katsunori; Koji, Takehiko

2015-01-01

In the area of manufacturing surgical instruments, the ability to rapidly design, prototype and test surgical instruments is critical. This paper provides a simple case study of the rapid development of two bio-mechanism based surgical instruments which are ergonomic, aesthetic and were successfully designed, prototyped and conceptually tested in a very short period of time.

The history of thoracic surgical instruments and instrumentation.

Science.gov (United States)

Hagopian, E J; Mann, C; Galibert, L A; Steichen, F M

2000-02-01

Thoracic surgical practice has evolved from the innovations of its pioneers. Beginning with the stethoscope discovered by Laënnec with his system of auscultation, to the tools we use in the dissection and control of the hilum of the lung for resection, our practice of thoracic surgery has been entwined with the development of instruments and instrumentation. The development of strategies to prevent death from the open pneumothorax began with manual control of the mediastinum and progressed through differential pressure to, finally, the technique of intubation and the methods of positive-pressure and insufflation anesthesia. The instruments we place in our hands are not enough to define our art. Entry into the chest would not be possible without the use of rib retractors, rib shears, and even periosteal elevators. Finally, to the present day of minimally invasive techniques and the application of thoracoscopy for therapeutic purposes, we find the efforts of our predecessors well developed. For the progression from the fear of the open pneumothorax to the present-day state of the ease of thoracotomy for lung resection we are indebted to those who gave so much of their time and, for some, their lives to death from tuberculosis, to allow the advancement of our practice of surgery. These great people should be remembered not only for their acceptance of novel ideas but also, more importantly, for their lack of fear of testing them.

Factors determining the potential for onward transmission of variant Creutzfeldt–Jakob disease via surgical instruments

Science.gov (United States)

Garske, Tini; Ward, Hester J.T; Clarke, Paul; Will, Robert G; Ghani, Azra C

2006-01-01

While the number of variant Creutzfeldt–Jakob disease (vCJD) cases continues to decline, concern has been raised that transmission could occur directly from one person to another through routes including the transfer of blood and shared use of surgical instruments. Here we firstly present data on the surgical procedures undertaken on vCJD patients prior to onset of clinical symptoms, which supports the hypothesis that cases via this route are possible. We then apply a mathematical framework to assess the potential for self-sustaining epidemics via surgical procedures. Data from hospital episode statistics on the rates of high- and medium-risk procedures in the UK were used to estimate model parameters, and sensitivity to other unknown parameters about surgically transmitted vCJD was assessed. Our results demonstrate that a key uncertainty determining the scale of an epidemic and whether it is self-sustaining is the number of times a single instrument is re-used, alongside the infectivity of contaminated instruments and the effectiveness of cleaning. A survey into the frequency of re-use of surgical instruments would help reduce these uncertainties. PMID:17015298

Automatic localization of the da Vinci surgical instrument tips in 3-D transrectal ultrasound.

Science.gov (United States)

Mohareri, Omid; Ramezani, Mahdi; Adebar, Troy K; Abolmaesumi, Purang; Salcudean, Septimiu E

2013-09-01

Robot-assisted laparoscopic radical prostatectomy (RALRP) using the da Vinci surgical system is the current state-of-the-art treatment option for clinically confined prostate cancer. Given the limited field of view of the surgical site in RALRP, several groups have proposed the integration of transrectal ultrasound (TRUS) imaging in the surgical workflow to assist with accurate resection of the prostate and the sparing of the neurovascular bundles (NVBs). We previously introduced a robotic TRUS manipulator and a method for automatically tracking da Vinci surgical instruments with the TRUS imaging plane, in order to facilitate the integration of intraoperative TRUS in RALRP. Rapid and automatic registration of the kinematic frames of the da Vinci surgical system and the robotic TRUS probe manipulator is a critical component of the instrument tracking system. In this paper, we propose a fully automatic registration technique based on automatic 3-D TRUS localization of robot instrument tips pressed against the air-tissue boundary anterior to the prostate. The detection approach uses a multiscale filtering technique to identify and localize surgical instrument tips in the TRUS volume, and could also be used to detect other surface fiducials in 3-D ultrasound. Experiments have been performed using a tissue phantom and two ex vivo tissue samples to show the feasibility of the proposed methods. Also, an initial in vivo evaluation of the system has been carried out on a live anaesthetized dog with a da Vinci Si surgical system and a target registration error (defined as the root mean square distance of corresponding points after registration) of 2.68 mm has been achieved. Results show this method's accuracy and consistency for automatic registration of TRUS images to the da Vinci surgical system.

Development of Real-Time Coal Monitoring Instrument

Energy Technology Data Exchange (ETDEWEB)

Rajan Gurjar, Ph.D.

2010-06-17

Relying on coal for energy requires optimizing the extraction of heat content from various blends of coal fuel and reducing harmful constituents and byproducts. Having a real-time measurement instrument provides relevant information about toxic constituents released in the atmosphere from burning coal and optimizes the performance of a power plant. A few commercial instruments exist and have been in operation for more than a decade. However, most of these instruments are based on radioactive sources and are bulky, expensive and time-consuming. The proposed instrument is based on the Laser Induced Breakdown Spectroscopy (LIBS). The advantage of LIBS is that it is a standoff instrument, does not require sample preparation and provides precise information about sample constituents.

Femoral Test Bed for Impedance Controlled Surgical Instrumentation

Directory of Open Access Journals (Sweden)

Christian Brendle

2012-01-01

Full Text Available The risk for patients during the standard procedure of revision of cemented artificial hip joints is unsatisfactorily highdue to its high level of invasiveness and limited access to the operative field. To reduce this risk we are developing anImpedance Controlled Surgical Instrumentation (ICOS system, which aims to establish real-time control during a BoneCement (BC milling process. For this, the relationship between the thickness of the BC and its frequency-dependentelectrical impedance is used to estimate the residual BC thickness. The aim is to avoid unintended cutting of boneby detecting the passage of the BC/bone boundary layer by the milling head. In a second step, an estimation of theresidual BC thickness will be used to improve process control. As a first step towards demonstrating the feasibility ofour approach, presented here are experimental studies to characterize the BC permittivity and to describe the process indetail. The results show that the permittivity properties of BC are dominated by its polymethyl methacrylate (PMMAfraction. Thus, PMMA can be used as a substitute for future experiments. Furthermore, a Femoral Test Bed (FTB wasdesigned. Using this setup we show it is feasible to accurately distinguish between slightly different thicknesses of BC.

Surgical site infections following instrumented stabilization of the spine

Directory of Open Access Journals (Sweden)

Dapunt U

2017-09-01

Full Text Available Ulrike Dapunt,1 Caroline Bürkle,1 Frank Günther,2 Wojciech Pepke,1 Stefan Hemmer,1 Michael Akbar1 1Clinic for Orthopedics and Trauma Surgery, Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, Heidelberg University Hospital, 2Department for Infectious Diseases, Medical Microbiology and Hygiene, Heidelberg University, Heidelberg, Germany Background: Implant-associated infections are still a feared complication in the field of orthopedics. Bacteria attach to the implant surface and form so-called biofilm colonies that are often difficult to diagnose and treat. Since the majority of studies focus on prosthetic joint infections (PJIs of the hip and knee, current treatment options (eg, antibiotic prophylaxis of implant-associated infections have mostly been adapted according to these results. Objective: The aim of this study was to evaluate patients with surgical site infections following instrumented stabilization of the spine with regard to detected bacteria species and the course of the disease. Patients and methods: We performed a retrospective single-center analysis of implant-associated infections of the spine from 2010 to 2014. A total of 138 patients were included in the study. The following parameters were evaluated: C-reactive protein serum concentration, microbiological evaluation of tissue samples, the time course of the disease, indication for instrumented stabilization of the spine, localization of the infection, and the number of revision surgeries required until cessation of symptoms. Results: Coagulase-negative Staphylococcus spp. were most commonly detected (n=69, 50%, followed by fecal bacteria (n=46, 33.3%. In 23.2% of cases, no bacteria were detected despite clinical suspicion of an infection. Most patients suffered from degenerative spine disorders (44.9%, followed by spinal fractures (23.9%, non-degenerative scoliosis (20.3%, and spinal tumors (10.1%. Surgical site infections occurred predominantly within 3

Endoscopic vision-based tracking of multiple surgical instruments during robot-assisted surgery.

Science.gov (United States)

Ryu, Jiwon; Choi, Jaesoon; Kim, Hee Chan

2013-01-01

Robot-assisted minimally invasive surgery is effective for operations in limited space. Enhancing safety based on automatic tracking of surgical instrument position to prevent inadvertent harmful events such as tissue perforation or instrument collisions could be a meaningful augmentation to current robotic surgical systems. A vision-based instrument tracking scheme as a core algorithm to implement such functions was developed in this study. An automatic tracking scheme is proposed as a chain of computer vision techniques, including classification of metallic properties using k-means clustering and instrument movement tracking using similarity measures, Euclidean distance calculations, and a Kalman filter algorithm. The implemented system showed satisfactory performance in tests using actual robot-assisted surgery videos. Trajectory comparisons of automatically detected data and ground truth data obtained by manually locating the center of mass of each instrument were used to quantitatively validate the system. Instruments and collisions could be well tracked through the proposed methods. The developed collision warning system could provide valuable information to clinicians for safer procedures. © 2012, Copyright the Authors. Artificial Organs © 2012, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Instrument-mounted displays for reducing cognitive load during surgical navigation.

Science.gov (United States)

Herrlich, Marc; Tavakol, Parnian; Black, David; Wenig, Dirk; Rieder, Christian; Malaka, Rainer; Kikinis, Ron

2017-09-01

Surgical navigation systems rely on a monitor placed in the operating room to relay information. Optimal monitor placement can be challenging in crowded rooms, and it is often not possible to place the monitor directly beside the situs. The operator must split attention between the navigation system and the situs. We present an approach for needle-based interventions to provide navigational feedback directly on the instrument and close to the situs by mounting a small display onto the needle. By mounting a small and lightweight smartwatch display directly onto the instrument, we are able to provide navigational guidance close to the situs and directly in the operator's field of view, thereby reducing the need to switch the focus of view between the situs and the navigation system. We devise a specific variant of the established crosshair metaphor suitable for the very limited screen space. We conduct an empirical user study comparing our approach to using a monitor and a combination of both. Results from the empirical user study show significant benefits for cognitive load, user preference, and general usability for the instrument-mounted display, while achieving the same level of performance in terms of time and accuracy compared to using a monitor. We successfully demonstrate the feasibility of our approach and potential benefits. With ongoing technological advancements, instrument-mounted displays might complement standard monitor setups for surgical navigation in order to lower cognitive demands and for improved usability of such systems.

Real-time simulation of ex-core nuclear instrumentation system

International Nuclear Information System (INIS)

Zhao Qiang; Zhang Zhijian; Cao Xinrong

2005-01-01

Real-time simulation of ex-core nuclear instrumentation system is an indispensable part of nuclear power plant (NPP) full-scope training simulator. The simulation method, which is based upon the theory of measurement, is introduced in the paper. The fitting formula between the measured data and the three-dimensional neutron flux distribution in the core is established. The fitting parameter is adjusted according to the reactor physical calculation or the experiment of power calibration. The simulation result shows that the method can simulate the ex-core neutron instrumentation system accurately in real-time and meets the needs of NPP full-scope training simulator. (authors)

Pneumatic-type surgical robot end-effector for laparoscopic surgical-operation-by-wire.

Science.gov (United States)

Lee, Chiwon; Park, Woo Jung; Kim, Myungjoon; Noh, Seungwoo; Yoon, Chiyul; Lee, Choonghee; Kim, Youdan; Kim, Hyeon Hoe; Kim, Hee Chan; Kim, Sungwan

2014-09-05

Although minimally invasive surgery (MIS) affords several advantages compared to conventional open surgery, robotic MIS systems still have many limitations. One of the limitations is the non-uniform gripping force due to mechanical strings of the existing systems. To overcome this limitation, a surgical instrument with a pneumatic gripping system consisting of a compressor, catheter balloon, micro motor, and other parts is developed. This study aims to implement a surgical instrument with a pneumatic gripping system and pitching/yawing joints using micro motors and without mechanical strings based on the surgical-operation-by-wire (SOBW) concept. A 6-axis external arm for increasing degrees of freedom (DOFs) is integrated with the surgical instrument using LabVIEW® for laparoscopic procedures. The gripping force is measured over a wide range of pressures and compared with the simulated ideal step function. Furthermore, a kinematic analysis is conducted. To validate and evaluate the system's clinical applicability, a simple peg task experiment and workspace identification experiment are performed with five novice volunteers using the fundamentals of laparoscopic surgery (FLS) board kit. The master interface of the proposed system employs the hands-on-throttle-and-stick (HOTAS) controller used in aerospace engineering. To develop an improved HOTAS (iHOTAS) controller, 6-axis force/torque sensor was integrated in the special housing. The mean gripping force (after 1,000 repetitions) at a pressure of 0.3 MPa was measured to be 5.8 N. The reaction time was found to be 0.4 s, which is almost real-time. All novice volunteers could complete the simple peg task within a mean time of 176 s, and none of them exceeded the 300 s cut-off time. The system's workspace was calculated to be 11,157.0 cm3. The proposed pneumatic gripping system provides a force consistent with that of other robotic MIS systems. It provides near real-time control. It is more durable than the

Teaching Surgical Hysteroscopy with a Computer

Science.gov (United States)

Lefebvre; Cote; Lefebvre

1996-08-01

Using a hysteroscope can be simulated on a computer. It will improve physician training by measuring basic knowledge and abilities, allow different interventions and anatomic variations, minimize the trauma of surgical intervention, and reduce operative casualties. An integrated questionnaire covers instrumentation, fluid infusion, power source, indications and preparation for endometrial ablation, surgical techniques, and complications to evaluate the user's knowledge. The operation simulation then proceeds. In the endometrial cavity, by virtual simulation, the operating field should appear in real time to allow physicians to adapt the trajectory of the instruments. The computer is an IBM PC compatible. We use a modified joystick with optical encoders to know the instrument position. The simulation can be repeated as desired. An evaluation system is integrated in the software to keep the user informed on the amount of burn area(s) that have been completed. This prototype model is available.

Influence of usage history, instrument complexity, and different cleaning procedures on the cleanliness of blood-contaminated dental surgical instruments

NARCIS (Netherlands)

Wu, G.; Yu, X.F.

2009-01-01

Our study assessed the factors that influence the resistance of blood residues on dental surgical instruments to washer‐disinfector-based cleaning procedures in a clinical setting. The use of 2 additional cleaning methods—presoaking and scrubbing by hand—and the use of newer and/or less structurally

Protein adsorption on low temperature alpha alumina films for surgical instruments

Energy Technology Data Exchange (ETDEWEB)

Cloud, A.N., E-mail: acloud@uark.ed [University of Arkansas, Fayetteville, AR 72701 (United States); Kumar, S. [Ian Wark Research Institute, University of South Australia, Mawson Lakes, Adelaide, SA 5095 (Australia); Kavdia, M.; Abu-Safe, H.H.; Gordon, M.H. [University of Arkansas, Fayetteville, AR 72701 (United States)

2009-08-31

Bulk alumina has been shown to exhibit reduced protein adsorption, a property that can be exploited for developing alumina-coated surgical instruments and devices. Alpha alumina thin films were deposited on surgical stainless steel substrates to investigate the adsorption of a model protein (BSA, bovine serum albumin). The films were deposited at 480 {sup o}C by AC inverted cylindrical magnetron sputtering. Films were obtained at 6 kW and 50% oxygen partial pressure by volume. The presence of alpha-phase alumina has been shown by transmission electron microscopy. Results indicate that there was a 50% reduction in protein adsorption for samples with the alumina coating compared to those with no coating.

Highly sensitive rapid fluorescence detection of protein residues on surgical instruments

International Nuclear Information System (INIS)

Kovalev, Valeri I; Bartona, James S; Richardson, Patricia R; Jones, Anita C

2006-01-01

There is a risk of contamination of surgical instruments by infectious protein residues, in particular, prions which are the agents for Creutzfeldt-Jakob Disease in humans. They are exceptionally resistant to conventional sterilization, therefore it is important to detect their presence as contaminants so that alternative cleaning procedures can be applied. We describe the development of an optimized detection system for fluorescently labelled protein, suitable for in-hospital use. We show that under optimum conditions the technique can detect ∼10 attomole/cm 2 with a scan speed of ∼3-10 cm 2 /s of the test instrument's surface. A theoretical analysis and experimental measurements will be discussed

Intrasurgical Human Retinal Imaging With Manual Instrument Tracking Using a Microscope-Integrated Spectral-Domain Optical Coherence Tomography Device.

Science.gov (United States)

Hahn, Paul; Carrasco-Zevallos, Oscar; Cunefare, David; Migacz, Justin; Farsiu, Sina; Izatt, Joseph A; Toth, Cynthia A

2015-07-01

To characterize the first in-human intraoperative imaging using a custom prototype spectral-domain microscope-integrated optical coherence tomography (MIOCT) device during vitreoretinal surgery with instruments in the eye. Under institutional review board approval for a prospective intraoperative study, MIOCT images were obtained at surgical pauses with instruments held static in the vitreous cavity and then concurrently with surgical maneuvers. Postoperatively, MIOCT images obtained at surgical pauses were compared with images obtained with a high-resolution handheld spectral-domain OCT (HHOCT) system with objective endpoints, including acquisition of images acceptable for analysis and identification of predefined macular morphologic or pathologic features. Human MIOCT images were successfully obtained before incision and during pauses in surgical maneuvers. MIOCT imaging confirmed preoperative diagnoses, such as epiretinal membrane, full-thickness macular hole, and vitreomacular traction and demonstrated successful achievement of surgical goals. MIOCT and HHOCT images obtained at surgical pauses in two cohorts of five patients were comparable with greater than or equal to 80% correlation in 80% of patients. Real-time video-imaging concurrent with surgical manipulations enabled, for the first time using this device, visualization of dynamic instrument-retina interaction with targeted OCT tracking. MIOCT is successful for imaging at surgical pauses and for real-time image guidance with implementation of targeted OCT tracking. Even faster acquisition speeds are currently being developed with incorporation of a swept-source MIOCT engine. Further refinements and investigations will be directed toward continued integration for real-time volumetric imaging of surgical maneuvers. Ongoing development of seamless MIOCT systems will likely transform surgical visualization, approaches, and decision-making.

Instrument for Real-Time Digital Nucleic Acid Amplification on Custom Microfluidic Devices.

Directory of Open Access Journals (Sweden)

David A Selck

Full Text Available Nucleic acid amplification tests that are coupled with a digital readout enable the absolute quantification of single molecules, even at ultralow concentrations. Digital methods are robust, versatile and compatible with many amplification chemistries including isothermal amplification, making them particularly invaluable to assays that require sensitive detection, such as the quantification of viral load in occult infections or detection of sparse amounts of DNA from forensic samples. A number of microfluidic platforms are being developed for carrying out digital amplification. However, the mechanistic investigation and optimization of digital assays has been limited by the lack of real-time kinetic information about which factors affect the digital efficiency and analytical sensitivity of a reaction. Commercially available instruments that are capable of tracking digital reactions in real-time are restricted to only a small number of device types and sample-preparation strategies. Thus, most researchers who wish to develop, study, or optimize digital assays rely on the rate of the amplification reaction when performed in a bulk experiment, which is now recognized as an unreliable predictor of digital efficiency. To expand our ability to study how digital reactions proceed in real-time and enable us to optimize both the digital efficiency and analytical sensitivity of digital assays, we built a custom large-format digital real-time amplification instrument that can accommodate a wide variety of devices, amplification chemistries and sample-handling conditions. Herein, we validate this instrument, we provide detailed schematics that will enable others to build their own custom instruments, and we include a complete custom software suite to collect and analyze the data retrieved from the instrument. We believe assay optimizations enabled by this instrument will improve the current limits of nucleic acid detection and quantification, improving our

Surgical infection in a videolaparoscopic cholecystectomy when using peracetic acid for the sterilization of instruments.

Science.gov (United States)

de Melo, Edluza Maria Viana Bezerra; Leão, Cristiano de Souza; Andreto, Luciana Marques; de Mello, Maria Júlia Gonçalves

2013-01-01

To determine the frequency of surgical site infection in patients undergoing laparoscopic cholecystectomy with instruments sterilized by peracetic acid. We conducted a retrospective, cohort, descriptive, cross-sectional study. Peracetic acid has been used for sterilization following the protocol recommended by the manufacturer. We observed the criteria and indicators of process and structure for preventing surgical site infection pre and intraoperatively. For epidemiological surveillance, outpatient visits were scheduled for the 15th and between the 30th and 45th days after discharge. Among the 247 patients, there were two cases of surgical site infection (0.8%). One patient was readmitted to systemic antibiotic therapy and percutaneous puncture; in the other the infection was superficial and followed at the clinic. Ethical issues prevent the conduction of a prospective study because of peracetic acid have been banned for the sterilization of instruments that penetrate organs and cavities. Nevertheless, these results encourage prospective case-control studies comparing its use (historical control) with ethylene oxide sterilization.

[Design and implementation of real-time continuous glucose monitoring instrument].

Science.gov (United States)

Huang, Yonghong; Liu, Hongying; Tian, Senfu; Jia, Ziru; Wang, Zi; Pi, Xitian

2017-12-01

Real-time continuous glucose monitoring can help diabetics to control blood sugar levels within the normal range. However, in the process of practical monitoring, the output of real-time continuous glucose monitoring system is susceptible to glucose sensor and environment noise, which will influence the measurement accuracy of the system. Aiming at this problem, a dual-calibration algorithm for the moving-window double-layer filtering algorithm combined with real-time self-compensation calibration algorithm is proposed in this paper, which can realize the signal drift compensation for current data. And a real-time continuous glucose monitoring instrument based on this study was designed. This real-time continuous glucose monitoring instrument consisted of an adjustable excitation voltage module, a current-voltage converter module, a microprocessor and a wireless transceiver module. For portability, the size of the device was only 40 mm × 30 mm × 5 mm and its weight was only 30 g. In addition, a communication command code algorithm was designed to ensure the security and integrity of data transmission in this study. Results of experiments in vitro showed that current detection of the device worked effectively. A 5-hour monitoring of blood glucose level in vivo showed that the device could continuously monitor blood glucose in real time. The relative error of monitoring results of the designed device ranged from 2.22% to 7.17% when comparing to a portable blood meter.

Highly sensitive rapid fluorescence detection of protein residues on surgical instruments

Energy Technology Data Exchange (ETDEWEB)

Kovalev, Valeri I [School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS (United Kingdom); Bartona, James S [School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS (United Kingdom); Richardson, Patricia R [School of Chemistry, University of Edinburgh, Edinburgh, EH9 3JJ (United Kingdom); Jones, Anita C [School of Chemistry, University of Edinburgh, Edinburgh, EH9 3JJ (United Kingdom)

2006-07-15

There is a risk of contamination of surgical instruments by infectious protein residues, in particular, prions which are the agents for Creutzfeldt-Jakob Disease in humans. They are exceptionally resistant to conventional sterilization, therefore it is important to detect their presence as contaminants so that alternative cleaning procedures can be applied. We describe the development of an optimized detection system for fluorescently labelled protein, suitable for in-hospital use. We show that under optimum conditions the technique can detect {approx}10 attomole/cm{sup 2} with a scan speed of {approx}3-10 cm{sup 2}/s of the test instrument's surface. A theoretical analysis and experimental measurements will be discussed.

Real time analysis of brain tissue by direct combination of ultrasonic surgical aspiration and sonic spray mass spectrometry.

Science.gov (United States)

Schäfer, Karl-Christian; Balog, Júlia; Szaniszló, Tamás; Szalay, Dániel; Mezey, Géza; Dénes, Júlia; Bognár, László; Oertel, Matthias; Takáts, Zoltán

2011-10-15

Direct combination of cavitron ultrasonic surgical aspirator (CUSA) and sonic spray ionization mass spectrometry is presented. A commercially available ultrasonic surgical device was coupled to a Venturi easy ambient sonic-spray ionization (V-EASI) source by directly introducing liquified tissue debris into the Venturi air jet pump. The Venturi air jet pump was found to efficiently nebulize the suspended tissue material for gas phase ion production. The ionization mechanism involving solely pneumatic spraying was associated with that of sonic spray ionization. Positive and negative ionization spectra were obtained from brain and liver samples reflecting the primary application areas of the surgical device. Mass spectra were found to feature predominantly complex lipid-type constituents of tissues in both ion polarity modes. Multiply charged peptide anions were also detected. The influence of instrumental settings was characterized in detail. Venturi pump geometry and flow parameters were found to be critically important in ionization efficiency. Standard solutions of phospholipids and peptides were analyzed in order to test the dynamic range, sensitivity, and suppression effects. The spectra of the intact tissue specimens were found to be highly specific to the histological tissue type. The principal component analysis (PCA) and linear discriminant analysis (LDA) based data analysis method was developed for real-time tissue identification in a surgical environment. The method has been successfully tested on post-mortem and ex vivo human samples including astrocytomas, meningeomas, metastatic brain tumors, and healthy brain tissue. © 2011 American Chemical Society

Real time noninvasive assessment of external trunk geometry during surgical correction of adolescent idiopathic scoliosis

Directory of Open Access Journals (Sweden)

Mac-Thiong Jean-Marc

2009-02-01

Full Text Available Abstract Background The correction of trunk deformity is crucial in scoliosis surgery, especially for the patient's self-image. However, direct visualization of external scoliotic trunk deformity during surgical correction is difficult due to the covering draping sheets. Methods An optoelectronic camera system with 10 passive markers is used to track the trunk geometry of 5 scoliotic patients during corrective surgery. The position of 10 anatomical landmarks and 5 trunk indices computed from the position of the passive markers are compared during and after instrumentation of the spine. Results Internal validation of the accuracy of tracking was evaluated at 0.41 +/- 0.05 mm RMS. Intra operative tracking during surgical maneuvers shows improvement of the shoulder balance during and after correction of the spine. Improvement of the overall patient balance is observed. At last, a minor increase of the spinal length can be noticed. Conclusion Tracking of the external geometry of the trunk during surgical correction is useful to monitor changes occurring under the sterile draping sheets. Moreover, this technique can used be used to reach the optimal configuration on the operating frame before proceeding to surgery. The current tracking technique was able to detect significant changes in trunk geometry caused by posterior instrumentation of the spine despite significant correction of the spinal curvature. It could therefore become relevant for computer-assisted guidance of surgical maneuvers when performing posterior instrumentation of the scoliotic spine, provide important insights during positioning of patients.

Real-time stereo generation for surgical vision during minimal invasive robotic surgery

Science.gov (United States)

Laddi, Amit; Bhardwaj, Vijay; Mahapatra, Prasant; Pankaj, Dinesh; Kumar, Amod

2016-03-01

This paper proposes a framework for 3D surgical vision for minimal invasive robotic surgery. It presents an approach for generating the three dimensional view of the in-vivo live surgical procedures from two images captured by very small sized, full resolution camera sensor rig. A pre-processing scheme is employed to enhance the image quality and equalizing the color profile of two images. Polarized Projection using interlacing two images give a smooth and strain free three dimensional view. The algorithm runs in real time with good speed at full HD resolution.

Real-time instrument-failure detection in the LOFT pressurizer using functional redundancy

International Nuclear Information System (INIS)

Tylee, J.L.

1982-07-01

The functional redundancy approach to detecting instrument failures in a pressurized water reactor (PWR) pressurizer is described and evaluated. This real-time method uses a bank of Kalman filters (one for each instrument) to generate optimal estimates of the pressurizer state. By performing consistency checks between the output of each filter, failed instruments can be identified. Simulation results and actual pressurizer data are used to demonstrate the capabilities of the technique

[Surgical Roman instruments in the Museum of History of Medicine of the University of Rome "La Sapienza"].

Science.gov (United States)

Gazzaniga, V; Serarcangeli, C

1999-01-01

The Museum of History of Medicine at the University of Rome "La Sapienza" keeps numerous roman surgical instruments, dating from the 1st century A.D. This article offers a short review of the critical literature existing on the topic, together with a temporary catalogue of the instruments.

Real-time surgical simulation for deformable soft-tissue objects with a tumour using Boundary Element techniques

Science.gov (United States)

Wang, P.; Becker, A. A.; Jones, I. A.; Glover, A. T.; Benford, S. D.; Vloeberghs, M.

2009-08-01

A virtual-reality real-time simulation of surgical operations that incorporates the inclusion of a hard tumour is presented. The software is based on Boundary Element (BE) technique. A review of the BE formulation for real-time analysis of two-domain deformable objects, using the pre-solution technique, is presented. The two-domain BE software is incorporated into a surgical simulation system called VIRS to simulate the initiation of a cut on the surface of the soft tissue and extending the cut deeper until the tumour is reached.

Real-time surgical simulation for deformable soft-tissue objects with a tumour using Boundary Element techniques

International Nuclear Information System (INIS)

Wang, P; Becker, A A; Jones, I A; Glover, A T; Benford, S D; Vloeberghs, M

2009-01-01

A virtual-reality real-time simulation of surgical operations that incorporates the inclusion of a hard tumour is presented. The software is based on Boundary Element (BE) technique. A review of the BE formulation for real-time analysis of two-domain deformable objects, using the pre-solution technique, is presented. The two-domain BE software is incorporated into a surgical simulation system called VIRS to simulate the initiation of a cut on the surface of the soft tissue and extending the cut deeper until the tumour is reached.

Surgeons' and surgical trainees' acute stress in real operations or simulation: A systematic review.

Science.gov (United States)

Georgiou, Konstantinos; Larentzakis, Andreas; Papavassiliou, Athanasios G

2017-12-01

Acute stress in surgery is ubiquitous and has an immediate impact on surgical performance and patient safety. Surgeons react with several coping strategies; however, they recognise the necessity of formal stress management training. Thus, stress assessment is a direct need. Surgical simulation is a validated standardised training milieu designed to replicate real-life situations. It replicates stress, prevents biases, and provides objective metrics. The complexity of stress mechanisms makes stress measurement difficult to quantify and interpret. This systematic review aims to identify studies that have used acute stress estimation measurements in surgeons or surgical trainees during real operations or surgical simulation, and to collectively present the rationale of these tools, with special emphasis in salivary markers. A search strategy was implemented to retrieve relevant articles from MEDLINE and SCOPUS databases. The 738 articles retrieved were reviewed for further evaluation according to the predetermined inclusion/exclusion criteria. Thirty-three studies were included in this systematic review. The methods for acute stress assessment varied greatly among studies with the non-invasive techniques being the most commonly used. Subjective and objective tests for surgeons' acute stress assessment are being presented. There is a broad spectrum of acute mental stress assessment tools in the surgical field and simulation and salivary biomarkers have recently gained popularity. There is a need to maintain a consistent methodology in future research, towards a deeper understanding of acute stress in the surgical field. Copyright © 2017 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Analysis of risk factors for loss of lumbar lordosis in patients who had surgical treatment with segmental instrumentation for adolescent idiopathic scoliosis.

Science.gov (United States)

Trobisch, Per D; Samdani, Amer F; Betz, Randal R; Bastrom, Tracey; Pahys, Joshua M; Cahill, Patrick J

2013-06-01

Iatrogenic flattening of lumbar lordosis in patients with adolescent idiopathic scoliosis (AIS) was a major downside of first generation instrumentation. Current instrumentation systems allow a three-dimensional scoliosis correction, but flattening of lumbar lordosis remains a significant problem which is associated with decreased health-related quality of life. This study sought to identify risk factors for loss of lumbar lordosis in patients who had surgical correction of AIS with the use of segmental instrumentation. Patients were included if they had surgical correction for AIS with segmental pedicle screw instrumentation Lenke type 1 or 2 and if they had a minimum follow-up of 24 months. Two groups were created, based on the average loss of lumbar lordosis. The two groups were then compared and multivariate analysis was performed to identify parameters that correlated to loss of lumbar lordosis. Four hundred and seventeen patients were analyzed for this study. The average loss of lumbar lordosis at 24 months follow-up was an increase of 10° lordosis for group 1 and a decrease of 15° for group 2. Risk factors for loss of lumbar lordosis included a high preoperative lumbar lordosis, surgical decrease of thoracic kyphosis, and the particular operating surgeon. The lowest instrumented vertebra or spinopelvic parameters were two of many parameters that did not seem to influence loss of lumbar lordosis. This study identified important risk factors for decrease of lumbar lordosis in patients who had surgical treatment for AIS with segmental pedicle screw instrumentation, including a high preoperative lumbar lordosis, surgical decrease of thoracic kyphosis, and factors attributable to a particular operating surgeon that were not quantified in this study.

Management of Surgical Instruments Package in the Operating Room%手术室器械包的管理

Institute of Scientific and Technical Information of China (English)

刘萍; 张娟; 潘文琴; 戴榕娟

2017-01-01

Objective Cleaning, maintenance, disinfection and preoperative preparation of surgical instruments in the past are done by the operation room, but with the development of China's hospitals and national new surgical management practices, certain progress has been achieved in the integrated management of surgical instruments for the operating rooms.Practical experiences in the management were discussed in this article.MethodsIn order to improve work quality and work efficiency and to reduce cost in the management of instruments in operation room, we analyzed the current situation of the management of equipment in the operation room based on the reality and tried to find out the method of surgical instrument package innovation, including the production of classification photo album for the surgical instrument package, paper list of all equipments, and production of marking cards for the instruments that can stand the sterilization under high pressure.Results and Conclusion From the implementation point of view, the total loss rate is reduced from the original 0.43% to 0.14%,and the loss rate of the micro device from 0.725% to 0.23%, effectively reducing the device losses.Great progress has been made in the use of the new methods, the quality of the personnel, in charge of the surgical instruments, classification management and the mapping and marking of cards.%目的 手术器械包的清洗、保养、消毒灭菌和术前准备工作以往均由手术室自行完成,随着我国医院洁净手术室的发展和国家新手术管理规范的实施,手术器械管理实施手供一体化相关工作逐步取得一定的效果.方法 分析手术器械包的管理及成效,改善工作品质,提高工作效率,降低成本等情况;找出手术器械包新的管理方法,包括制作手术器械包分类相册,以及手术器械包中加入纸质的器械清单、制作能够高压灭菌的金属器械牌等手段.结果与结论 �

Tracking-by-detection of surgical instruments in minimally invasive surgery via the convolutional neural network deep learning-based method.

Science.gov (United States)

Zhao, Zijian; Voros, Sandrine; Weng, Ying; Chang, Faliang; Li, Ruijian

2017-12-01

Worldwide propagation of minimally invasive surgeries (MIS) is hindered by their drawback of indirect observation and manipulation, while monitoring of surgical instruments moving in the operated body required by surgeons is a challenging problem. Tracking of surgical instruments by vision-based methods is quite lucrative, due to its flexible implementation via software-based control with no need to modify instruments or surgical workflow. A MIS instrument is conventionally split into a shaft and end-effector portions, while a 2D/3D tracking-by-detection framework is proposed, which performs the shaft tracking followed by the end-effector one. The former portion is described by line features via the RANSAC scheme, while the latter is depicted by special image features based on deep learning through a well-trained convolutional neural network. The method verification in 2D and 3D formulation is performed through the experiments on ex-vivo video sequences, while qualitative validation on in-vivo video sequences is obtained. The proposed method provides robust and accurate tracking, which is confirmed by the experimental results: its 3D performance in ex-vivo video sequences exceeds those of the available state-of -the-art methods. Moreover, the experiments on in-vivo sequences demonstrate that the proposed method can tackle the difficult condition of tracking with unknown camera parameters. Further refinements of the method will refer to the occlusion and multi-instrumental MIS applications.

A multimodal instrument for real-time in situ study of ultrasound and cavitation mediated drug delivery

OpenAIRE

Bian, S; Seth, A; Daly, D; Carlisle, R; Stride, E

2017-01-01

The development of a multimodal instrument capable of real-time in situ measurements of cavitation activity and effect in tissue mimicking phantoms during ultrasound and cavitation mediated drug delivery experiments is described here. The instrument features an acoustic arm that can expose phantoms to high-intensity focused-ultrasound while measuring cavitation activity and an optical arm that monitors cavitation effect using confocal microscopy. This combination of modalities allows real-tim...

An integrated approach to endoscopic instrument tracking for augmented reality applications in surgical simulation training.

Science.gov (United States)

Loukas, Constantinos; Lahanas, Vasileios; Georgiou, Evangelos

2013-12-01

Despite the popular use of virtual and physical reality simulators in laparoscopic training, the educational potential of augmented reality (AR) has not received much attention. A major challenge is the robust tracking and three-dimensional (3D) pose estimation of the endoscopic instrument, which are essential for achieving interaction with the virtual world and for realistic rendering when the virtual scene is occluded by the instrument. In this paper we propose a method that addresses these issues, based solely on visual information obtained from the endoscopic camera. Two different tracking algorithms are combined for estimating the 3D pose of the surgical instrument with respect to the camera. The first tracker creates an adaptive model of a colour strip attached to the distal part of the tool (close to the tip). The second algorithm tracks the endoscopic shaft, using a combined Hough-Kalman approach. The 3D pose is estimated with perspective geometry, using appropriate measurements extracted by the two trackers. The method has been validated on several complex image sequences for its tracking efficiency, pose estimation accuracy and applicability in AR-based training. Using a standard endoscopic camera, the absolute average error of the tip position was 2.5 mm for working distances commonly found in laparoscopic training. The average error of the instrument's angle with respect to the camera plane was approximately 2°. The results are also supplemented by video segments of laparoscopic training tasks performed in a physical and an AR environment. The experiments yielded promising results regarding the potential of applying AR technologies for laparoscopic skills training, based on a computer vision framework. The issue of occlusion handling was adequately addressed. The estimated trajectory of the instruments may also be used for surgical gesture interpretation and assessment. Copyright © 2013 John Wiley & Sons, Ltd.

Multimodality instrument for tissue characterization

Science.gov (United States)

Mah, Robert W. (Inventor); Andrews, Russell J. (Inventor)

2004-01-01

A system with multimodality instrument for tissue identification includes a computer-controlled motor driven heuristic probe with a multisensory tip. For neurosurgical applications, the instrument is mounted on a stereotactic frame for the probe to penetrate the brain in a precisely controlled fashion. The resistance of the brain tissue being penetrated is continually monitored by a miniaturized strain gauge attached to the probe tip. Other modality sensors may be mounted near the probe tip to provide real-time tissue characterizations and the ability to detect the proximity of blood vessels, thus eliminating errors normally associated with registration of pre-operative scans, tissue swelling, elastic tissue deformation, human judgement, etc., and rendering surgical procedures safer, more accurate, and efficient. A neural network program adaptively learns the information on resistance and other characteristic features of normal brain tissue during the surgery and provides near real-time modeling. A fuzzy logic interface to the neural network program incorporates expert medical knowledge in the learning process. Identification of abnormal brain tissue is determined by the detection of change and comparison with previously learned models of abnormal brain tissues. The operation of the instrument is controlled through a user friendly graphical interface. Patient data is presented in a 3D stereographics display. Acoustic feedback of selected information may optionally be provided. Upon detection of the close proximity to blood vessels or abnormal brain tissue, the computer-controlled motor immediately stops probe penetration. The use of this system will make surgical procedures safer, more accurate, and more efficient. Other applications of this system include the detection, prognosis and treatment of breast cancer, prostate cancer, spinal diseases, and use in general exploratory surgery.

Can surgical simulation be used to train detection and classification of neural networks?

Science.gov (United States)

Zisimopoulos, Odysseas; Flouty, Evangello; Stacey, Mark; Muscroft, Sam; Giataganas, Petros; Nehme, Jean; Chow, Andre; Stoyanov, Danail

2017-10-01

Computer-assisted interventions (CAI) aim to increase the effectiveness, precision and repeatability of procedures to improve surgical outcomes. The presence and motion of surgical tools is a key information input for CAI surgical phase recognition algorithms. Vision-based tool detection and recognition approaches are an attractive solution and can be designed to take advantage of the powerful deep learning paradigm that is rapidly advancing image recognition and classification. The challenge for such algorithms is the availability and quality of labelled data used for training. In this Letter, surgical simulation is used to train tool detection and segmentation based on deep convolutional neural networks and generative adversarial networks. The authors experiment with two network architectures for image segmentation in tool classes commonly encountered during cataract surgery. A commercially-available simulator is used to create a simulated cataract dataset for training models prior to performing transfer learning on real surgical data. To the best of authors' knowledge, this is the first attempt to train deep learning models for surgical instrument detection on simulated data while demonstrating promising results to generalise on real data. Results indicate that simulated data does have some potential for training advanced classification methods for CAI systems.

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

Science.gov (United States)

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

2014-01-01

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

A multimodal instrument for real-time in situ study of ultrasound and cavitation mediated drug delivery.

Science.gov (United States)

Bian, Shuning; Seth, Anjali; Daly, Dan; Carlisle, Robert; Stride, Eleanor

2017-03-01

The development of a multimodal instrument capable of real-time in situ measurements of cavitation activity and effect in tissue mimicking phantoms during ultrasound and cavitation mediated drug delivery experiments is described here. The instrument features an acoustic arm that can expose phantoms to high-intensity focused-ultrasound while measuring cavitation activity and an optical arm that monitors cavitation effect using confocal microscopy. This combination of modalities allows real-time in situ characterisation of drug delivery in tissue and tissue mimicking phantoms during ultrasound and cavitation mediated drug delivery experiments. A representative result, obtained with a tissue mimicking phantom and acoustically activated droplets, is presented here as a demonstration of the instrument's capabilities and potential applications.

Augmented reality in laparoscopic surgical oncology.

Science.gov (United States)

Nicolau, Stéphane; Soler, Luc; Mutter, Didier; Marescaux, Jacques

2011-09-01

Minimally invasive surgery represents one of the main evolutions of surgical techniques aimed at providing a greater benefit to the patient. However, minimally invasive surgery increases the operative difficulty since the depth perception is usually dramatically reduced, the field of view is limited and the sense of touch is transmitted by an instrument. However, these drawbacks can currently be reduced by computer technology guiding the surgical gesture. Indeed, from a patient's medical image (US, CT or MRI), Augmented Reality (AR) can increase the surgeon's intra-operative vision by providing a virtual transparency of the patient. AR is based on two main processes: the 3D visualization of the anatomical or pathological structures appearing in the medical image, and the registration of this visualization on the real patient. 3D visualization can be performed directly from the medical image without the need for a pre-processing step thanks to volume rendering. But better results are obtained with surface rendering after organ and pathology delineations and 3D modelling. Registration can be performed interactively or automatically. Several interactive systems have been developed and applied to humans, demonstrating the benefit of AR in surgical oncology. It also shows the current limited interactivity due to soft organ movements and interaction between surgeon instruments and organs. If the current automatic AR systems show the feasibility of such system, it is still relying on specific and expensive equipment which is not available in clinical routine. Moreover, they are not robust enough due to the high complexity of developing a real-time registration taking organ deformation and human movement into account. However, the latest results of automatic AR systems are extremely encouraging and show that it will become a standard requirement for future computer-assisted surgical oncology. In this article, we will explain the concept of AR and its principles. Then, we

Real-time operation without a real-time operating system for instrument control and data acquisition

Science.gov (United States)

Klein, Randolf; Poglitsch, Albrecht; Fumi, Fabio; Geis, Norbert; Hamidouche, Murad; Hoenle, Rainer; Looney, Leslie; Raab, Walfried; Viehhauser, Werner

2004-09-01

We are building the Field-Imaging Far-Infrared Line Spectrometer (FIFI LS) for the US-German airborne observatory SOFIA. The detector read-out system is driven by a clock signal at a certain frequency. This signal has to be provided and all other sub-systems have to work synchronously to this clock. The data generated by the instrument has to be received by a computer in a timely manner. Usually these requirements are met with a real-time operating system (RTOS). In this presentation we want to show how we meet these demands differently avoiding the stiffness of an RTOS. Digital I/O-cards with a large buffer separate the asynchronous working computers and the synchronous working instrument. The advantage is that the data processing computers do not need to process the data in real-time. It is sufficient that the computer can process the incoming data stream on average. But since the data is read-in synchronously, problems of relating commands and responses (data) have to be solved: The data is arriving at a fixed rate. The receiving I/O-card buffers the data in its buffer until the computer can access it. To relate the data to commands sent previously, the data is tagged by counters in the read-out electronics. These counters count the system's heartbeat and signals derived from that. The heartbeat and control signals synchronous with the heartbeat are sent by an I/O-card working as pattern generator. Its buffer gets continously programmed with a pattern which is clocked out on the control lines. A counter in the I/O-card keeps track of the amount of pattern words clocked out. By reading this counter, the computer knows the state of the instrument or knows the meaning of the data that will arrive with a certain time-tag.

Design and implementation of a PC-based image-guided surgical system.

Science.gov (United States)

Stefansic, James D; Bass, W Andrew; Hartmann, Steven L; Beasley, Ryan A; Sinha, Tuhin K; Cash, David M; Herline, Alan J; Galloway, Robert L

2002-11-01

In interactive, image-guided surgery, current physical space position in the operating room is displayed on various sets of medical images used for surgical navigation. We have developed a PC-based surgical guidance system (ORION) which synchronously displays surgical position on up to four image sets and updates them in real time. There are three essential components which must be developed for this system: (1) accurately tracked instruments; (2) accurate registration techniques to map physical space to image space; and (3) methods to display and update the image sets on a computer monitor. For each of these components, we have developed a set of dynamic link libraries in MS Visual C++ 6.0 supporting various hardware tools and software techniques. Surgical instruments are tracked in physical space using an active optical tracking system. Several of the different registration algorithms were developed with a library of robust math kernel functions, and the accuracy of all registration techniques was thoroughly investigated. Our display was developed using the Win32 API for windows management and tomographic visualization, a frame grabber for live video capture, and OpenGL for visualization of surface renderings. We have begun to use this current implementation of our system for several surgical procedures, including open and minimally invasive liver surgery.

A case study on the design of a modular surgical instrument for removing metastases using engineering design tools

OpenAIRE

Preca, George; Farrugia, Philip; Casha, Aaron; International Conference on Engineering and Product Design Education

2014-01-01

Metastatic cancer is a form of cancer stemming from a primary tumour that propagates to different organs and/or to different sites within the same organ. Studies have indicated that the chances of survival improve upon surgical removal of metastases. The overall goal of this research was to develop a modular surgical instrument that would be easy to use and manipulate and hence facilitate resection of metastases. This research forms part of a final year project carried out by a mechanical eng...

Systems for tracking minimally invasive surgical instruments

NARCIS (Netherlands)

Chmarra, M. K.; Grimbergen, C. A.; Dankelman, J.

2007-01-01

Minimally invasive surgery (e.g. laparoscopy) requires special surgical skills, which should be objectively assessed. Several studies have shown that motion analysis is a valuable assessment tool of basic surgical skills in laparoscopy. However, to use motion analysis as the assessment tool, it is

Surgical risks and perioperative complications of instrumented lumbar surgery in patients with liver cirrhosis

Directory of Open Access Journals (Sweden)

Tung-Yi Lin

2014-02-01

Full Text Available Background: Patients with liver cirrhosis have high surgical risks due to malnutrition, impaired immunity, coagulopathy, and encephalopathy. However, there is no information in English literature about the results of liver cirrhotic patients who underwent instrumented lumbar surgery. The purpose of this study is to report the perioperative complications, clinical outcomes and determine the surgical risk factors in cirrhotic patients. Methods: We retrospectively reviewed 29 patients with liver cirrhosis who underwent instrumented lumbar surgery between 1997 and 2009. The hepatic functional reserves of the patients were recorded according to the Child-Turcotte-Pugh scoring system. Besides, fourteen other variables and perioperative complications were also collected. To determine the risks, we divided the patients into two groups according to whether or not perioperative complications developed. Results: Of the 29 patients, 22 (76% belonged to Child class A and 7 (24% belonged to Child class B. Twelve patients developed one or more complications. Patients with Child class B carried a significantly higher incidence of complications than those with Child class A (p = 0.011. In the Child class A group, patients with 6 points had a significantly higher incidence of complications than those with 5 points (p = 0.025. A low level of albumin was significantly associated with higher risk, and a similar trend was also noted for the presence of ascites although statistical difference was not reached. Conclusion: The study concludes that patients with liver cirrhosis who have undergone instrumented lumbar surgery carry a high risk of developing perioperative complications, especially in those with a Child-Turcotte-Pugh score of 6 or more.

Achieving a predictable 24-hour return to normal activities after breast augmentation: part II. Patient preparation, refined surgical techniques, and instrumentation.

Science.gov (United States)

Tebbetts, John B

2006-12-01

The goal of this study was to develop practices that would allow patients undergoing subpectoral augmentation to predictably return to full normal activities within 24 hours after the operation, free of postoperative adjuncts. Part I of this study used motion and time study principles to reduce operative times, medication dosages, perioperative morbidity, and recovery times in augmentation mammaplasty. Part II of the study focuses on details of patient education, preoperative planning, instrumentation, and surgical technique modifications that were identified, modified, and implemented to achieve the results reported in part I. Two groups of 16 patients each (groups 1 and 2) were studied retrospectively for comparison to a third group of 627 patients (group 3) studied prospectively. Patients in group 1 had axillary partial retropectoral breast augmentations in 1982-1983, using dissociative anesthesia, blunt instrument implant pocket dissection, and Dow Corning, double-lumen implants containing 20 mg of methylprednisolone and 20 cc of saline in the outer lumen of the implants. Patients in group 2 (1990) had inframammary, retromammary augmentations by using a combination of blunt and electrocautery dissection, Surgitek Replicon polyurethane-covered, silicone gel-filled implants, and general endotracheal anesthesia. Patients in group 3 (1998 to 2001, n = 627) had inframammary partial retropectoral, inframammary retromammary, and axillary partial retropectoral augmentations under general endotracheal anesthesia. Refined practices and surgical techniques from studies of groups 1 and 2 were applied in group 3. Videotapes from operative procedures of groups 1 and 2 were analyzed with macromotion and micromotion study principles, and tables of events were formulated for each move during the operation for all personnel in the operating room. Extensive details of surgical technique were examined and reexamined in 13 different stages by using principles of motion and time

Evolution of surgical skills training

Science.gov (United States)

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

2006-01-01

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

Comparison of real-time instruments and gravimetric method when measuring particulate matter in a residential building.

Science.gov (United States)

Wang, Zuocheng; Calderón, Leonardo; Patton, Allison P; Sorensen Allacci, MaryAnn; Senick, Jennifer; Wener, Richard; Andrews, Clinton J; Mainelis, Gediminas

2016-11-01

This study used several real-time and filter-based aerosol instruments to measure PM 2.5 levels in a high-rise residential green building in the Northeastern US and compared performance of those instruments. PM 2.5 24-hr average concentrations were determined using a Personal Modular Impactor (PMI) with 2.5 µm cut (SKC Inc., Eighty Four, PA) and a direct reading pDR-1500 (Thermo Scientific, Franklin, MA) as well as its filter. 1-hr average PM 2.5 concentrations were measured in the same apartments with an Aerotrak Optical Particle Counter (OPC) (model 8220, TSI, Inc., Shoreview, MN) and a DustTrak DRX mass monitor (model 8534, TSI, Inc., Shoreview, MN). OPC and DRX measurements were compared with concurrent 1-hr mass concentration from the pDR-1500. The pDR-1500 direct reading showed approximately 40% higher particle mass concentration compared to its own filter (n = 41), and 25% higher PM 2.5 mass concentration compared to the PMI 2.5 filter. The pDR-1500 direct reading and PMI 2.5 in non-smoking homes (self-reported) were not significantly different (n = 10, R 2 = 0.937), while the difference between measurements for smoking homes was 44% (n = 31, R 2 = 0.773). Both OPC and DRX data had substantial and significant systematic and proportional biases compared with pDR-1500 readings. However, these methods were highly correlated: R 2 = 0.936 for OPC versus pDR-1500 reading and R 2 = 0.863 for DRX versus pDR-1500 reading. The data suggest that accuracy of aerosol mass concentrations from direct-reading instruments in indoor environments depends on the instrument, and that correction factors can be used to reduce biases of these real-time monitors in residential green buildings with similar aerosol properties. This study used several real-time and filter-based aerosol instruments to measure PM 2.5 levels in a high-rise residential green building in the northeastern United States and compared performance of those instruments. The data show that while the use of real

DEVELOPMENT OF AN ON-LINE, REAL-TIME ALPHA RADIATION MEASURING INSTRUMENT FOR LIQUID STREAMS

International Nuclear Information System (INIS)

Unknown

1999-01-01

Thermo Power Corporation has proven the technical viability of an on-line, real-time alpha radionuclide instrument for aqueous sample analysis through laboratory and initial field tests of the instrument. The instrument has been shown to be isotonically sensitive to extremely low (ten parts per trillion, or femto Curies per liter) levels of a broad range of radioisotopes. Performance enhancement and other scaling data obtained during the course of this investigation have shown that on-line, real-time operation is possible, with a sub 30-minute response time analyzing 20 ppb (30 pCi/1) natural uranium. Now that these initial field tests in Oak Ridge, Tennessee have been successfully completed, Thermo Power plans to conduct comprehensive field tests of the instrument. The purpose of these endurance tests will be to determine the endurance characteristics of the Thermo Alpha Monitor for Water when it is used by non-Thermo Power personnel in a series of one or more extended field tests. Such endurance testing is the vital next step towards the commercialization of the Alpha Monitor. Subsequently, it will be possible to provide the DOE with an instrument that has the capability of obtaining rapid feedback about the concentrations of alpha-emitting isotope contamination in effluent water streams (Subsurface Contaminants Focus Area). It will also be useful for process control of remediation and D and D operations such as monitoring scrubber/rinse water radioactivity levels (Mixed Waste, Plutonium and D and D Focus Areas)

Microscope-integrated optical coherence tomography: A new surgical tool in vitreoretinal surgery.

Science.gov (United States)

Jayadev, Chaitra; Dabir, Supriya; Vinekar, Anand; Shah, Urmil; Vaid, Tania; Yadav, Naresh Kumar

2015-05-01

Optical coherence tomography (OCT) has revolutionized imaging of ocular structures and various disease conditions. Though it has been used in the clinic for some decades, the OCT has only recently found its way into the operating theater. Early attempts at intraoperative OCT, hand-held and microscope mounted, have already improved our understanding of the surgical pathology and the role it might play in surgical decision-making. The microscope-integrated OCT now allows seamless, high-resolution, real-time imaging of surgical maneuvers from the incision to wound closure. Visualization of instruments and intraoperative tissue manipulation are possible with this in vivo modality and, therefore, help improve the outcome of surgery. In this article, we describe the advantages it offers during various vitreoretinal procedures.

Surgical Outcome of Reduction and Instrumented Fusion in Lumbar Degenerative Spondylolisthesis

Directory of Open Access Journals (Sweden)

Farzad Omidi-Kashani

2016-02-01

Full Text Available Background: Lumbar degenerative spondylolisthesis (LDS is a degenerative slippage of the lumbar vertebrae. We aimed to evaluate the surgical outcome of degenerative spondylolisthesis with neural decompression, pedicular screw fixation, reduction, and posterolateral fusion. Methods: This before-after study was carried out on 45 patients (37 female and 8 male with LDS operated from August 2008 to January 2011. The patients’ pain and disability were assessed by visual analogue scale (VAS and Oswestry disability index (ODI questionnaire. In surgery, we applied distraction force to facilitate slip reduction. All the intra- and postoperative complications were recorded. The paired t-test and Pearson correlation coefficient were used for statistical analysis. Results: The mean age of patients and mean follow-up period were 58.3±3.5 years and 31.2±4.8 months, respectively. The mean slip correction rate was 52.2% with a mean correction loss of 4.8%. Preoperative VAS and ODI improved from 8.8 and 71.6 to postoperative 2.1 and 28.7, respectively. Clinical improvement was more prominent in more reduced patients, but Pearson coefficient could not find a significant correlation. Conclusion: Although spinal decompression with fusion and posterior instrumentation in surgical treatment of the patients with LDS result in satisfactory outcome, vertebral reduction cannot significantly enhance the clinical improvement.

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

Science.gov (United States)

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

2012-06-15

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

FY1995 development of a endoscopic surgical system utilizing multi-modal functional images; 1995 nendo tashu kino gazo wo mochiiru teishinshu naishikyo shujutsu system no kaihatsu

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-05-01

The purpose of this study is to develop an endoscope system for neurosurgery that can provide not only conventional endoscopic images but also ultraviolet-visible spectra, fluorescence spectra, near infrared spectra, and ultra-soundimages of tissue aiming for real-time identification of pathological tissue. The system also incorporates surgical manipulator and devices such as micro forceps and laser surgical instruments for endoscopic image guided surgery. Surgical Manipulator should be a high performance and easy to operate surgical instrument as well as conventional surgical tools such as scissors and knife. Since living tissue deforms during surgical operation, pre-operative three dimensional information for registration of pathological tissue should be modified based on information obtained during surgery. Thus surgical manipulator should be operated under guidance of surgeon's observation. Consequently, surgical manipulator should have various types of imaging and measurement devices such as an endoscope and an ultrasound imaging probe at its end effectors. Based on this concept, a prototype of a new multi channel surgical manipulator system CM cube (CM3, Computer aided Micro Multichannel Manipulator) that has various types of imaging and measurement devices such as ultra-violet-visible camera for spectroscopic measurement, ultra-sound imaging probe, three dimensional endoscope, together with micro surgical instruments and laser surgical systems has been developed. Its performance was evaluated through in vitro/in vivo experiments and clinical application. (NEDO)

Adjacent segment disease in degenerative pathologies with posterior instrumentation

Directory of Open Access Journals (Sweden)

Ana Guadalupe Ramírez Olvera

2015-03-01

Full Text Available OBJECTIVE: To establish the real incidence of adjacent segment disease after fusion, and to identify the levels and predisposing factors for the pathology, as well as the functional results. METHODS: a retrospective case series study with level of evidence IIB, in a sample of 179 patients diagnosed with stenosis of the lumbar spine, spondylolisthesis and degenerative scoliosis, submitted to surgery in the period 2005 to December 2013, with posterior instrumentation and posterolateral fusion, with follow-up from 2007 until May 2014, in which the symptomology and radiographic findings were evaluated, to establish the diagnosis and treatment. RESULTS: the study included 179 patients diagnosed with stenosis of the lumbar spine (n=116, isthmic and degenerative spondylolisthesis (n=50 and degenerative scoliosis (n=13; during the study, 20 cases of adjacent level segment were identified, 80% of which were treated surgically with extension of the instrumentation, while 20% were treated conservatively with NSAIDs and therapeutic blocks. CONCLUSION: An incidence of 11% was found, with an average of 3.25 years in diagnosis and treatment, a prevalence of females and diagnosis of stenosis of the lumbar canal on posterior instrumentation, a predominance of levels L4-L5; 80% were treated with extension of the instrumentation. The complications were persistent radiculopathy, infection of the surgical wound, and one death due to causes not related to the lumbar pathology.

Protein Analysis Using Real-Time PCR Instrumentation: Incorporation in an Integrated, Inquiry-Based Project

Science.gov (United States)

Southard, Jonathan N.

2014-01-01

Instrumentation for real-time PCR is used primarily for amplification and quantitation of nucleic acids. The capability to measure fluorescence while controlling temperature in multiple samples can also be applied to the analysis of proteins. Conformational stability and changes in stability due to ligand binding are easily assessed. Protein…

Real-time surgery simulation of intracranial aneurysm clipping with patient-specific geometries and haptic feedback

Science.gov (United States)

Fenz, Wolfgang; Dirnberger, Johannes

2015-03-01

Providing suitable training for aspiring neurosurgeons is becoming more and more problematic. The increasing popularity of the endovascular treatment of intracranial aneurysms leads to a lack of simple surgical situations for clipping operations, leaving mainly the complex cases, which present even experienced surgeons with a challenge. To alleviate this situation, we have developed a training simulator with haptic interaction allowing trainees to practice virtual clipping surgeries on real patient-specific vessel geometries. By using specialized finite element (FEM) algorithms (fast finite element method, matrix condensation) combined with GPU acceleration, we can achieve the necessary frame rate for smooth real-time interaction with the detailed models needed for a realistic simulation of the vessel wall deformation caused by the clamping with surgical clips. Vessel wall geometries for typical training scenarios were obtained from 3D-reconstructed medical image data, while for the instruments (clipping forceps, various types of clips, suction tubes) we use models provided by manufacturer Aesculap AG. Collisions between vessel and instruments have to be continuously detected and transformed into corresponding boundary conditions and feedback forces, calculated using a contact plane method. After a training, the achieved result can be assessed based on various criteria, including a simulation of the residual blood flow into the aneurysm. Rigid models of the surgical access and surrounding brain tissue, plus coupling a real forceps to the haptic input device further increase the realism of the simulation.

Surgical smoke.

Science.gov (United States)

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

2009-10-01

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

Portable real time analysis system for regional cerebral blood flow

International Nuclear Information System (INIS)

Tiernan, T.; Entine, G.; Stump, D.A.; Prough, D.S.

1988-01-01

A very portable, regional cerebral blood flow (rCBF) analysis instrument system suitable for use in the operating theater during surgery is under development. Cadmium telluride (CdTe) solid state radiation detectors, an 8086 based data acquisition and communications module and a DEC Microvax computer are used so that the instrument is very compact, yet has the computational power to provide real time data analysis in the clinical environment. The instrument is currently being used at Bowman Gray School of Medicine to study rCBF during cardiopulmonary bypass surgery (CPB). Preliminary studies indicate that monitoring rCBF during this surgical procedure may provide insights into the mechanism that causes a significant fraction of these patients to suffer post operative neuropsychological deficit

Development of a surgical navigation system based on augmented reality using an optical see-through head-mounted display.

Science.gov (United States)

Chen, Xiaojun; Xu, Lu; Wang, Yiping; Wang, Huixiang; Wang, Fang; Zeng, Xiangsen; Wang, Qiugen; Egger, Jan

2015-06-01

The surgical navigation system has experienced tremendous development over the past decades for minimizing the risks and improving the precision of the surgery. Nowadays, Augmented Reality (AR)-based surgical navigation is a promising technology for clinical applications. In the AR system, virtual and actual reality are mixed, offering real-time, high-quality visualization of an extensive variety of information to the users (Moussa et al., 2012) [1]. For example, virtual anatomical structures such as soft tissues, blood vessels and nerves can be integrated with the real-world scenario in real time. In this study, an AR-based surgical navigation system (AR-SNS) is developed using an optical see-through HMD (head-mounted display), aiming at improving the safety and reliability of the surgery. With the use of this system, including the calibration of instruments, registration, and the calibration of HMD, the 3D virtual critical anatomical structures in the head-mounted display are aligned with the actual structures of patient in real-world scenario during the intra-operative motion tracking process. The accuracy verification experiment demonstrated that the mean distance and angular errors were respectively 0.809±0.05mm and 1.038°±0.05°, which was sufficient to meet the clinical requirements. Copyright © 2015 Elsevier Inc. All rights reserved.

A Portable Array-Type Optical Fiber Sensing Instrument for Real-Time Gas Detection

Directory of Open Access Journals (Sweden)

San-Shan Hung

2016-12-01

Full Text Available A novel optical fiber array-type of sensing instrument with temperature compensation for real-time detection was developed to measure oxygen, carbon dioxide, and ammonia simultaneously. The proposed instrument is multi-sensing array integrated with real-time measurement module for portable applications. The sensing optical fibers were etched and polished before coating to increase sensitivities. The ammonia and temperature sensors were each composed of a dye-coated single-mode fiber with constructing a fiber Bragg grating and a long-period filter grating for detecting light intensity. Both carbon dioxide and oxygen sensing structures use multimode fibers where 1-hydroxy-3,6,8-pyrene trisulfonic acid trisodium salt is coated for carbon dioxide sensing and Tris(2,2′-bipyridyl dichlororuthenium(II hexahydrate and Tris(bipyridineruthenium(II chloride are coated for oxygen sensing. Gas-induced fluorescent light intensity variation was applied to detect gas concentration. The portable gas sensing array was set up by integrating with photo-electronic measurement modules and a human-machine interface to detect gases in real time. The measured data have been processed using piecewise-linear method. The sensitivity of the oxygen sensor were 1.54%/V and 9.62%/V for concentrations less than 1.5% and for concentrations between 1.5% and 6%, respectively. The sensitivity of the carbon dioxide sensor were 8.33%/V and 9.62%/V for concentrations less than 2% and for concentrations between 2% and 5%, respectively. For the ammonia sensor, the sensitivity was 27.78%/V, while ammonia concentration was less than 2%.

A Portable Array-Type Optical Fiber Sensing Instrument for Real-Time Gas Detection.

Science.gov (United States)

Hung, San-Shan; Chang, Hsing-Cheng; Chang, I-Nan

2016-12-08

A novel optical fiber array-type of sensing instrument with temperature compensation for real-time detection was developed to measure oxygen, carbon dioxide, and ammonia simultaneously. The proposed instrument is multi-sensing array integrated with real-time measurement module for portable applications. The sensing optical fibers were etched and polished before coating to increase sensitivities. The ammonia and temperature sensors were each composed of a dye-coated single-mode fiber with constructing a fiber Bragg grating and a long-period filter grating for detecting light intensity. Both carbon dioxide and oxygen sensing structures use multimode fibers where 1-hydroxy-3,6,8-pyrene trisulfonic acid trisodium salt is coated for carbon dioxide sensing and Tris(2,2'-bipyridyl) dichlororuthenium(II) hexahydrate and Tris(bipyridine)ruthenium(II) chloride are coated for oxygen sensing. Gas-induced fluorescent light intensity variation was applied to detect gas concentration. The portable gas sensing array was set up by integrating with photo-electronic measurement modules and a human-machine interface to detect gases in real time. The measured data have been processed using piecewise-linear method. The sensitivity of the oxygen sensor were 1.54%/V and 9.62%/V for concentrations less than 1.5% and for concentrations between 1.5% and 6%, respectively. The sensitivity of the carbon dioxide sensor were 8.33%/V and 9.62%/V for concentrations less than 2% and for concentrations between 2% and 5%, respectively. For the ammonia sensor, the sensitivity was 27.78%/V, while ammonia concentration was less than 2%.

Review: The Use of Real-Time Fluorescence Instrumentation to Monitor Ambient Primary Biological Aerosol Particles (PBAP

Directory of Open Access Journals (Sweden)

Mehael J. Fennelly

2017-12-01

Full Text Available Primary biological aerosol particles (PBAP encompass many particle types that are derived from several biological kingdoms. These aerosol particles can be composed of both whole living units such as pollen, bacteria, and fungi, as well as from mechanically formed particles, such as plant debris. They constitute a significant proportion of the overall atmospheric particle load and have been linked with adverse health issues and climatic effects on the environment. Traditional methods for their analysis have focused on the direct capture of PBAP before subsequent laboratory analysis. These analysis types have generally relied on direct optical microscopy or incubation on agar plates, followed by time-consuming microbiological investigation. In an effort to address some of these deficits, real-time fluorescence monitors have come to prominence in the analysis of PBAP. These instruments offer significant advantages over traditional methods, including the measurement of concentrations, as well as the potential to simultaneously identify individual analyte particles in real-time. Due to the automated nature of these measurements, large data sets can be collected and analyzed with relative ease. This review seeks to highlight and discuss the extensive literature pertaining to the most commonly used commercially available real-time fluorescence monitors (WIBS, UV-APS and BioScout. It discusses the instruments operating principles, their limitations and advantages, and the various environments in which they have been deployed. The review provides a detailed examination of the ambient fluorescent aerosol particle concentration profiles that are obtained by these studies, along with the various strategies adopted by researchers to analyze the substantial data sets the instruments generate. Finally, a brief reflection is presented on the role that future instrumentation may provide in revolutionizing this area of atmospheric research.

Surgical navigation with QR codes

Directory of Open Access Journals (Sweden)

Katanacho Manuel

2016-09-01

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

Field instruments for real time in-situ crude oil concentration measurements

International Nuclear Information System (INIS)

Fuller, C.B.; Bonner, J.S.; Page, C.A.; Arrambide, G.; Sterling, M.C.Jr.; Ojo, T.O.

2003-01-01

Accidental oil spills, contaminant release during resuspension, storms, and harmful algal blooms are all episodic events that can effect coastal margins. It is important to quantitatively describe water and ecological quality evolution and predict the impact to these areas by such events, but traditional sampling methods miss environmental activity during cyclical events. This paper presents a new sampling approach that involves continuous, real-time in-situ monitoring to provide data for development of comprehensive modeling protocols. It gives spill response coordinators greater assurance in making decisions using the latest visualization tools which are based on a good understanding of the physical processes at work in pulsed events. Five sensors for rapid monitoring of crude oil concentrations in aquatic systems were described. The in-situ and ex-situ sensors can measure plume transport and estimate polycyclic aromatic hydrocarbon exposure concentrations to assess risk of toxicity. A brief description and evaluation of the following 5 sensors was provided: the LISST-100 by Sequoia Instrument, a submersible multi-angle laser scattering instrument; the AU-10 field fluorometer by Turner Designs, an ex-situ single wavelength fluorometer; the Flashlamp by WET Labs Inc., an in-situ single wavelength fluorometer; and, the ECO-FL3 and SAFire by WET Labs Inc., two in-situ multiple wavelength fluorometers. These instruments were used to analyze crude oil emissions of various concentrations. All of the instruments followed a linear response within the tested concentration range. At the lowest concentrations the LISST-100 was not as effective as the fluorometers because of limited particle volume for scatter. For the AU-10 field fluorometer, the highest concentrations tested were above the measurement range of the instrument. 6 refs., 5 figs

Real-time in situ three-dimensional integral videography and surgical navigation using augmented reality: a pilot study

Science.gov (United States)

Suenaga, Hideyuki; Hoang Tran, Huy; Liao, Hongen; Masamune, Ken; Dohi, Takeyoshi; Hoshi, Kazuto; Mori, Yoshiyuki; Takato, Tsuyoshi

2013-01-01

To evaluate the feasibility and accuracy of a three-dimensional augmented reality system incorporating integral videography for imaging oral and maxillofacial regions, based on preoperative computed tomography data. Three-dimensional surface models of the jawbones, based on the computed tomography data, were used to create the integral videography images of a subject's maxillofacial area. The three-dimensional augmented reality system (integral videography display, computed tomography, a position tracker and a computer) was used to generate a three-dimensional overlay that was projected on the surgical site via a half-silvered mirror. Thereafter, a feasibility study was performed on a volunteer. The accuracy of this system was verified on a solid model while simulating bone resection. Positional registration was attained by identifying and tracking the patient/surgical instrument's position. Thus, integral videography images of jawbones, teeth and the surgical tool were superimposed in the correct position. Stereoscopic images viewed from various angles were accurately displayed. Change in the viewing angle did not negatively affect the surgeon's ability to simultaneously observe the three-dimensional images and the patient, without special glasses. The difference in three-dimensional position of each measuring point on the solid model and augmented reality navigation was almost negligible (augmented reality system was highly accurate and effective for surgical navigation and for overlaying a three-dimensional computed tomography image on a patient's surgical area, enabling the surgeon to understand the positional relationship between the preoperative image and the actual surgical site, with the naked eye. PMID:23703710

Is hospital information system relevant to detect surgical site infection? Findings from a prospective surveillance study in posterior instrumented spinal surgery.

Science.gov (United States)

Boetto, J; Chan-Seng, E; Lonjon, G; Pech, J; Lotthé, A; Lonjon, N

2015-11-01

Spinal instrumentation has a high rate of surgical site infection (SSI), but results greatly vary depending on surveillance methodology, surgical procedures, or quality of follow-up. Our aim was to study true incidence of SSI in spinal surgery by significant data collection, and to compare it with the results obtained through the hospital information system. This work is a single center prospective cohort study that included all patients consecutively operated on for spinal instrumentation by posterior approach over a six-month period regardless the etiology. For all patients, a "high definition" prospective method of surveillance was performed by the infection control (IC) department during at least 12 months after surgery. Results were then compared with findings from automatic surveillance though the hospital information system (HIS). One hundred and fifty-four patients were included. We found no hardly difference between "high definition" and automatic surveillance through the HIS, even if HIS tended to under-estimate the infection rate: rate of surgical site infection was 2.60% and gross SSI incidence rate via the hospital information system was 1.95%. Smoking and alcohol consumption were significantly related to a SSI. Our SSI rates to reflect the true incidence of infectious complications in posterior instrumented adult spinal surgery in our hospital and these results were consistent with the lower levels of published infection rate. In-house surveillance by surgeons only is insufficiently sensitive. Further studies with more patients and a longer inclusion time are needed to conclude if SSI case detection through the HIS could be a relevant and effective alternative method. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Development of a generic system for real-time data access and remote control of multiple in-situ water quality monitoring instruments

Science.gov (United States)

Wright, S. A.; Bennett, G. E.; Andrews, T.; Melis, T. S.; Topping, D. J.

2005-05-01

Currently, in-situ monitoring of water quality parameters (e.g. water temperature, conductivity, turbidity) in the Colorado River ecosystem typically consists of deploying instruments in the river, retrieving them at a later date, downloading the datalogger, then examining the data; an arduous process in the remote settings of Grand Canyon. Under this protocol, data is not available real-time and there is no way to detect problems with the instrumentation until after retrieval. The next obvious stage in the development of in-situ monitoring in Grand Canyon was the advent of one-way telemetry, i.e. streaming data in real-time from the instrument to the office and/or the world-wide-web. This protocol allows for real-time access to data and the identification of instrumentation problems, but still requires a site visit to address instrument malfunctions, i.e. the user does not have the ability to remotely control the instrument. At some field sites, such as the Colorado River in Grand Canyon, site visitation is restricted by remoteness and lack of traditional access routes (i.e. roads). Even at less remote sites, it may still be desirable to have two-way communication with instruments in order to, for example, diagnose and potentially fix instrumentation problems, change sampling parameters to save battery power, etc., without having to visit the site. To this end, the U.S. Geological Survey, Grand Canyon Monitoring and Research Center, is currently developing and testing a high-speed, two-way communication system that allows for real-time data access and remote control of instrumentation. The approach tested relies on internet access and may be especially useful in areas where land-line or cellular connections are unavailable. The system is composed of off-the-shelf products, uses a commercial broadband satellite service, and is designed in a generic way such that any instrument that communicates through RS-232 communication (i.e. a serial port) is compatible with

Develop real-time dosimetry concepts and instrumentation for long-term missions

International Nuclear Information System (INIS)

Braby, L.A.; Ratcliffe, C.A.; Metting, N.F.; Lien, M.K.

1984-06-01

The objective was to develop a small, self-contained system to measure dose and evaluate dose equivalent in real time in the complex radiation environment encountered in space. The device utilizes a microdosimetric approach. The instrument consists of two propane filled proportional counters, one of which measures energy deposition by penetrating radiations with LET between 0.24 and 200 keV/μm. The second detector is intended for particles with LET greater than or equal to 200 keV/μm for a minimum of 100 μm. This detector is physically larger in order to obtain reasonable counting statistics on these infrequent micro lesion-forming events. The detectors are combined with an electronic system which consists of three multi-channel analyzers with independent analog to digital converters, computer controlled detector bias supplies, signal conditioning amplifiers, data recording and display devices and a microcomputer which controls the system and calculates dose and dose equivalent. This report includes a brief discussion of microdosimetry as it applies to health physics, an evaluation of different methods for calculating dose equivalent, descriptions of the hardware and software making up the prototype instrument and the results of evaluations of the instrument when exposed to a variety of radiations. Included are operating instructions, software listings, and circuit diagrams. 18 references, 9 figures, 8 tables

Application of a real-time three-dimensional navigation system to various oral and maxillofacial surgical procedures.

Science.gov (United States)

Ohba, Seigo; Yoshimura, Hitoshi; Ishimaru, Kyoko; Awara, Kousuke; Sano, Kazuo

2015-09-01

The aim of this study was to confirm the effectiveness of a real-time three-dimensional navigation system for use during various oral and maxillofacial surgeries. Five surgeries were performed with this real-time three-dimensional navigation system. For mandibular surgery, patients wore acrylic surgical splints when they underwent computed tomography examinations and the operation to maintain the mandibular position. The incidence of complications during and after surgery was assessed. No connection with the nasal cavity or maxillary sinus was observed at the maxilla during the operation. The inferior alveolar nerve was not injured directly, and any paresthesia around the lower lip and mental region had disappeared within several days after the surgery. In both maxillary and mandibular cases, there was no abnormal hemorrhage during or after the operation. Real-time three-dimensional computer-navigated surgery allows minimally invasive, safe procedures to be performed with precision. It results in minimal complications and early recovery.

Posterior Rigid Instrumentation of C7: Surgical Considerations and Biomechanics at the Cervicothoracic Junction. A Review of the Literature.

Science.gov (United States)

Bayoumi, Ahmed B; Efe, Ibrahim E; Berk, Selim; Kasper, Ekkehard M; Toktas, Zafer Orkun; Konya, Deniz

2018-03-01

The cervicothoracic junction is a challenging anatomic transition in spine surgery. It is commonly affected by different types of diseases that may significantly impair stability in this region. The seventh cervical vertebra (C7) is an atypical cervical vertebra with unique anatomic features compared to subaxial cervical spine (C3 to C6). C7 has relatively broader laminae, larger pedicles, smaller lateral masses, and a long nonbifid spinous process. These features allow a variety of surgical methods for performing posterior rigid instrumentation in the form of different types of screws, such as lateral mass screws, pedicle screws, transfacet screws, and intralaminar screws. Many biomechanical studies on cadavers have evaluated and compared different types of implants at C7. We reviewed PubMed/Medline by using specific combinations of keywords to summarize previously published articles that examined C7 posterior rigid instrumentation thoroughly in an experimental fashion on patients or cadavers with additional descriptive radiologic parameters for evaluation of the optimum surgical technique for each type. A total of 44 articles were reported, including 22 articles that discussed anatomic considerations (entry points, sagittal and axial trajectories, and features of screws) and another 22 articles that discussed the relevant biomechanical testing at this transitional region if C7 was directly involved in terms of receiving posterior rigid implants. C7 can accommodate different types of screws, which can provide additional benefits and risks based on availability of bony purchase, awareness of surgical technique, biomechanics, and anatomic considerations. Copyright © 2017 Elsevier Inc. All rights reserved.

Study on real-time force feedback for a master-slave interventional surgical robotic system.

Science.gov (United States)

Guo, Shuxiang; Wang, Yuan; Xiao, Nan; Li, Youxiang; Jiang, Yuhua

2018-04-13

In robot-assisted catheterization, haptic feedback is important, but is currently lacking. In addition, conventional interventional surgical robotic systems typically employ a master-slave architecture with an open-loop force feedback, which results in inaccurate control. We develop herein a novel real-time master-slave (RTMS) interventional surgical robotic system with a closed-loop force feedback that allows a surgeon to sense the true force during remote operation, provide adequate haptic feedback, and improve control accuracy in robot-assisted catheterization. As part of this system, we also design a unique master control handle that measures the true force felt by a surgeon, providing the basis for the closed-loop control of the entire system. We use theoretical and empirical methods to demonstrate that the proposed RTMS system provides a surgeon (using the master control handle) with a more accurate and realistic force sensation, which subsequently improves the precision of the master-slave manipulation. The experimental results show a substantial increase in the control accuracy of the force feedback and an increase in operational efficiency during surgery.

Mobile instrumentation platform and robotic accessory for real-time screening of hazardous waste

International Nuclear Information System (INIS)

Anderson, M.S.; Jaselskis, E.J.

1992-01-01

An innovative mobile laboratory for real-time field screening of soils for inorganic hazardous waste using laser ablation-inductively coupled plasma-atomic emission spectrometry sampling and analysis technique is being developed at Ames Laboratory. This sampling technique as well as the concept for installing, monitoring, and controlling the instrumentation and utilities in the mobile laboratory, the robotic sampling accessory, and manual sampling method are discussed. Benefits of this mobile configuration and future development plans also are described

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

Science.gov (United States)

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

2011-01-01

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

Virtual reality in surgical education.

Science.gov (United States)

Ota, D; Loftin, B; Saito, T; Lea, R; Keller, J

1995-03-01

Virtual reality (VR) is an emerging technology that can teach surgeons new procedures and can determine their level of competence before they operate on patients. Also VR allows the trainee to return to the same procedure or task several times later as a refresher course. Laparoscopic surgery is a new operative technique which requires the surgeon to observe the operation on a video-monitor and requires the acquisition of new skills. VR simulation could duplicate the operative field and thereby enhance training and reduce the need for expensive animal training models. Our preliminary experience has shown that we have the technology to model tissues and laparoscopic instruments and to develop in real time a VR learning environment for surgeons. Another basic need is to measure competence. Surgical training is an apprenticeship requiring close supervision and 5-7 years of training. Technical competence is judged by the mentor and has always been subjective. If VR surgical simulators are to play an important role in the future, quantitative measurement of competence would have to be part of the system. Because surgical competence is "vague" and is characterized by such terms as "too long, too short" or "too close, too far," it is possible that the principles of fuzzy logic could be used to measure competence in a VR surgical simulator. Because a surgical procedure consists of a series of tasks and each task is a series of steps, we will plan to create two important tasks in a VR simulator and validate their use. These tasks consist of laparoscopic knot tying and laparoscopic suturing. Our hypothesis is that VR in combination with fuzzy logic can educate surgeons and determine when they are competent to perform these procedures on patients.

A study on factors of dissatisfaction and stress of the blacksmiths resulting from the organizational culture in the surgical instrument industry of India.

Science.gov (United States)

Ghosh, Tirthankar; Das, Banibrata; Gangopadhyay, Somnath

2011-07-01

It is important to understand what motivates workers and the extent to which the organization and other contextual variables satisfy them. The aim of the study was to determine factors of dissatisfaction resulting from the organizational culture among the blacksmiths involved in the surgical instrument industry. Fifty male surgical blacksmiths each of the skilled and unskilled groups of the forging section were selected. Organizational Role Stress Scale was used to measure the individuals' role stress and several forms of conflict within an organization. Also, the organizational culture and personal involvement in an organization was measured among the surgical blacksmiths. The mean score for total role stress for Skilled was 71.7 and for unskilled was 77.2. The most frequent type of organizational culture was reported to be hierarchy, both by skilled and unskilled surgical blacksmiths, followed by market and clan culture. This study shows that the skilled surgical blacksmiths have lower level of stress and conflicts in comparison with unskilled surgical blacksmiths. Both skilled and unskilled surgical blacksmiths estimated their level of personal involvement as low and indicated insufficient involvement in work teams. The satisfaction of the employees with their status and role in the organizational culture was also poor for both skilled and unskilled surgical blacksmiths.

DEVELOPMENT OF AN ON-LINE, REAL-TIME ALPHA RADIATION MEASURING INSTRUMENT FOR LIQUID STREAMS

International Nuclear Information System (INIS)

Unknown

1999-01-01

The US Department of Energy (DOE) has expressed a need for an on-line, real-time instrument for assaying alpha-emitting radionuclides (uranium and the transuranics) in effluent waters leaving DOE sites to ensure compliance with regulatory limits. Due to the short range of alpha particles in water (approximately40 Im), it is necessary now to intermittently collect samples of water and send them to a central laboratory for analysis. A lengthy and costly procedure is used to separate and measure the radionuclides from each sample. Large variations in radionuclide concentrations in the water may go undetected due to the sporadic sampling. Even when detected, the reading may not be representative of the actual stream concentration. To address these issues, the Advanced Technologies Group of Thermo Power Corporation (a Thermo Electron company) is developing a real-time, field-deployable alpha monitor based on a solid-state silicon wafer semiconductor (US Patent 5,652,013 and pending, assigned to the US Department of Energy). The Thermo Water Alpha Monitor will serve to monitor effluent water streams (Subsurface Contaminants Focus Area) and will be suitable for process control of remediation as well as decontamination and decommissioning (D and D) operations, such as monitoring scrubber or rinse water radioactivity levels (Mixed Waste, Plutonium, and D and D Focus Area). It would be applicable for assaying other liquids, such as oil, or solids after proper preconditioning. Rapid isotopic alpha air monitoring is also possible using this technology. This report details the program's accomplishments to date. Most significantly, the Alpha Monitoring Instrument was successfully field demonstrated on water 100X below the Environmental Protection Agency's proposed safe drinking water limit--down to under 1 pCi/1. During the Field Test, the Alpha Monitoring Instrument successfully analyzed isotopic uranium levels on a total of five different surface water, process water, and

A study on factors of dissatisfaction and stress of the blacksmiths resulting from the organizational culture in the surgical instrument industry of India

Directory of Open Access Journals (Sweden)

Tirthankar Ghosh

2011-01-01

Full Text Available Background: It is important to understand what motivates workers and the extent to which the organization and other contextual variables satisfy them. The aim of the study was to determine factors of dissatisfaction resulting from the organizational culture among the blacksmiths involved in the surgical instrument industry. Materials and Methods: Fifty male surgical blacksmiths each of the skilled and unskilled groups of the forging section were selected. Organizational Role Stress Scale was used to measure the individuals′ role stress and several forms of conflict within an organization. Also, the organizational culture and personal involvement in an organization was measured among the surgical blacksmiths. Results: The mean score for total role stress for Skilled was 71.7 and for unskilled was 77.2. The most frequent type of organizational culture was reported to be hierarchy, both by skilled and unskilled surgical blacksmiths, followed by market and clan culture. Conclusion: This study shows that the skilled surgical blacksmiths have lower level of stress and conflicts in comparison with unskilled surgical blacksmiths. Both skilled and unskilled surgical blacksmiths estimated their level of personal involvement as low and indicated insufficient involvement in work teams. The satisfaction of the employees with their status and role in the organizational culture was also poor for both skilled and unskilled surgical blacksmiths.

Freeman's transorbital lobotomy as an anomaly: A material culture examination of surgical instruments and operative spaces.

Science.gov (United States)

Collins, Brianne M; Stam, Henderikus J

2015-05-01

In 1946, Walter Freeman introduced the transorbital ice pick lobotomy. Touted as a procedure that could be learned and subsequently performed by psychiatrists outside of the operating room, the technique was quickly criticized by neurosurgeons. In this article, we take a material culture approach to consider 2 grounds upon which neurosurgeons based their objections-surgical instruments and operative spaces. On both counts, Freeman was in contravention of established normative neurosurgical practices and, ultimately, his technique was exposed as an anomaly by neurosurgeons. Despite its rejection, the transorbital lobotomy became entrenched in contemporary memory and remains the emblematic procedure of the psychosurgery era. (c) 2015 APA, all rights reserved).

手术污染器械保湿过程中的污染控制%Contamination control during wetting of contaminated surgical instruments

Institute of Scientific and Technical Information of China (English)

龚珊; 许多朵; 董薪

2015-01-01

目的：分析手术污染器械保湿以提高器械的清洗效果，确保手术安全。方法选择2014年3－6月污染的医疗器械1200件，分为保湿组与未保湿组，每组各600件，通过对手术污染器械处理过程中技术规范的实践，分析器械保湿对于提高器械清洗效果的重要性。结果在器械回收、转运、预清洗、正式清洗等环节中，不同时间保湿组细菌菌落数低于未保湿组，使用专用保湿剂抑制了细菌生长；保湿组目测及5倍放大镜下监测器械清洁合格率分别为100．0％、99．5％，均高于未保湿组的98．7％、97．8％；保湿组污染器械清洗后隐血试验合格率100．0％，高于未保湿组的98．7％。结论适当的保湿处理能提高器械清洗合格率，确保清洗质量，对于手术污染器械的感染控制有重要作用，为杜绝由于器械清洗不彻底引起医源性感染提供保证。%OBJECTIVE To analyze the wetting process of contaminated surgical instruments and improve cleanlinessso as to ensure the safety of surgical operation .METHODS Totally 1 200 contaminated items of surgical instruments during Mar .2014 to Jun .2014 were divided into two groups ,the wetted group and the non‐wetted group with 600 items in each group .The technical standard was implemented during the wetting management of contaminated surgical instruments .The results were analyzed to illustrate the importance of a wet condition for the benefit of improving sterilization .RESULTS During the processes of instrument recollection ,transfer ,pre‐cleaning and formal cleaning ,the bacterial colony count was less in the wetted group than in the non‐wetted group at each time point ,indicating that the use of specific humectant inhibited bacterial growth .The cleaning qualified rate reached 100 .0% by visual inspection and 99 .5% by magnifying glass in the wetted group ,higher than 98 .7% and 97 .8% in the non‐wetted group .The

Face, content, and construct validity of four, inanimate training exercises using the da Vinci ® Si surgical system configured with Single-Site ™ instrumentation.

Science.gov (United States)

Jarc, Anthony M; Curet, Myriam

2015-08-01

Validated training exercises are essential tools for surgeons as they develop technical skills to use robot-assisted minimally invasive surgical systems. The purpose of this study was to show face, content, and construct validity of four, inanimate training exercises using the da Vinci (®) Si surgical system configured with Single-Site (™) instrumentation. New (N = 21) and experienced (N = 6) surgeons participated in the study. New surgeons (11 Gynecology [GYN] and 10 General Surgery [GEN]) had not completed any da Vinci Single-Site cases but may have completed multiport cases using the da Vinci system. They participated in this study prior to attending a certification course focused on da Vinci Single-Site instrumentation. Experienced surgeons (5 GYN and 1 GEN) had completed at least 25 da Vinci Single-Site cases. The surgeons completed four inanimate training exercises and then rated them with a questionnaire. Raw metrics and overall normalized scores were computed using both video recordings and kinematic data collected from the surgical system. The experienced surgeons significantly outperformed new surgeons for many raw metrics and the overall normalized scores derived from video review (p da Vinci Single-Site surgery and actually testing the technical skills used during da Vinci Single-Site surgery. In summary, the four training exercises showed face, content, and construct validity. Improved overall scores could be developed using additional metrics not included in this study. The results suggest that the training exercises could be used in an overall training curriculum aimed at developing proficiency in technical skills for surgeons new to da Vinci Single-Site instrumentation.

Shortened OR time and decreased patient risk through use of a modular surgical instrument with artificial intelligence.

Science.gov (United States)

Miller, David J; Nelson, Carl A; Oleynikov, Dmitry

2009-05-01

With a limited number of access ports, minimally invasive surgery (MIS) often requires the complete removal of one tool and reinsertion of another. Modular or multifunctional tools can be used to avoid this step. In this study, soft computing techniques are used to optimally arrange a modular tool's functional tips, allowing surgeons to deliver treatment of improved quality in less time, decreasing overall cost. The investigators watched University Medical Center surgeons perform MIS procedures (e.g., cholecystectomy and Nissen fundoplication) and recorded the procedures to digital video. The video was then used to analyze the types of instruments used, the duration of each use, and the function of each instrument. These data were aggregated with fuzzy logic techniques using four membership functions to quantify the overall usefulness of each tool. This allowed subsequent optimization of the arrangement of functional tips within the modular tool to decrease overall time spent changing instruments during simulated surgical procedures based on the video recordings. Based on a prototype and a virtual model of a multifunction laparoscopic tool designed by the investigators that can interchange six different instrument tips through the tool's shaft, the range of tool change times is approximately 11-13 s. Using this figure, estimated time savings for the procedures analyzed ranged from 2.5 to over 32 min, and on average, total surgery time can be reduced by almost 17% by using the multifunction tool.

Vernier Caliper and Micrometer Computer Models Using Easy Java Simulation and Its Pedagogical Design Features--Ideas for Augmenting Learning with Real Instruments

Science.gov (United States)

Wee, Loo Kang; Ning, Hwee Tiang

2014-01-01

This paper presents the customization of Easy Java Simulation models, used with actual laboratory instruments, to create active experiential learning for measurements. The laboratory instruments are the vernier caliper and the micrometer. Three computer model design ideas that complement real equipment are discussed. These ideas involve (1) a…

Surgical inpatient satisfaction: what are the real drivers?

Science.gov (United States)

Danforth, Rachel M; Pitt, Henry A; Flanagan, Mindy E; Brewster, Benjamin D; Brand, Elizabeth W; Frankel, Richard M

2014-08-01

Inpatient satisfaction is a key element of hospital pay-for-performance programs. Communication and pain management are known to influence results, but additional factors may affect satisfaction scores. We tested the hypothesis that patient factors and outcome parameters not considered previously are clinically important drivers of inpatient satisfaction. Medical records were reviewed for 1,340 surgical patients who returned nationally standardized inpatient satisfaction questionnaires. These patients were managed by 41 surgeons in seven specialties at two academic medical centers. Thirty-two parameters based on the patient, surgeon, outcomes, and survey were measured. Univariate and multivariable analyses were performed. Inpatients rated their overall experience favorably 75.7% of the time. Less-satisfied patients were more likely to be female, younger, less ill, taking outpatient narcotics, and admitted via the emergency department (all P expectations of patients with cancer, and postoperative complications are important and clinically relevant drivers of surgical inpatient satisfaction. Programs to manage expectations of cancer patient expectations and decrease postoperative morbidity should improve surgical inpatient satisfaction. Further efforts to risk-adjust patient satisfaction scores should be undertaken. Copyright © 2014 Mosby, Inc. All rights reserved.

Remote video auditing with real-time feedback in an academic surgical suite improves safety and efficiency metrics: a cluster randomised study.

Science.gov (United States)

Overdyk, Frank J; Dowling, Oonagh; Newman, Sheldon; Glatt, David; Chester, Michelle; Armellino, Donna; Cole, Brandon; Landis, Gregg S; Schoenfeld, David; DiCapua, John F

2016-12-01

Compliance with the surgical safety checklist during operative procedures has been shown to reduce inhospital mortality and complications but proper execution by the surgical team remains elusive. We evaluated the impact of remote video auditing with real-time provider feedback on checklist compliance during sign-in, time-out and sign-out and case turnover times. Prospective, cluster randomised study in a 23-operating room (OR) suite. Surgeons, anaesthesia providers, nurses and support staff. ORs were randomised to receive, or not receive, real-time feedback on safety checklist compliance and efficiency metrics via display boards and text messages, followed by a period during which all ORs received feedback. Checklist compliance (Pass/Fail) during sign-in, time-out and sign-out demonstrated by (1) use of checklist, (2) team attentiveness, (3) required duration, (4) proper sequence and duration of case turnover times. Sign-in, time-out and sign-out PASS rates increased from 25%, 16% and 32% during baseline phase (n=1886) to 64%, 84% and 68% for feedback ORs versus 40%, 77% and 51% for no-feedback ORs (pauditing with feedback improves surgical safety checklist compliance for all cases, and turnover time for scheduled cases, but not for unscheduled cases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Automatic multimodal real-time tracking for image plane alignment in interventional Magnetic Resonance Imaging

International Nuclear Information System (INIS)

Neumann, Markus

2014-01-01

Interventional magnetic resonance imaging (MRI) aims at performing minimally invasive percutaneous interventions, such as tumor ablations and biopsies, under MRI guidance. During such interventions, the acquired MR image planes are typically aligned to the surgical instrument (needle) axis and to surrounding anatomical structures of interest in order to efficiently monitor the advancement in real-time of the instrument inside the patient's body. Object tracking inside the MRI is expected to facilitate and accelerate MR-guided interventions by allowing to automatically align the image planes to the surgical instrument. In this PhD thesis, an image-based work-flow is proposed and refined for automatic image plane alignment. An automatic tracking work-flow was developed, performing detection and tracking of a passive marker directly in clinical real-time images. This tracking work-flow is designed for fully automated image plane alignment, with minimization of tracking-dedicated time. Its main drawback is its inherent dependence on the slow clinical MRI update rate. First, the addition of motion estimation and prediction with a Kalman filter was investigated and improved the work-flow tracking performance. Second, a complementary optical sensor was used for multi-sensor tracking in order to decouple the tracking update rate from the MR image acquisition rate. Performance of the work-flow was evaluated with both computer simulations and experiments using an MR compatible test bed. Results show a high robustness of the multi-sensor tracking approach for dynamic image plane alignment, due to the combination of the individual strengths of each sensor. (author)

Next-generation robotic surgery--from the aspect of surgical robots developed by industry.

Science.gov (United States)

Nakadate, Ryu; Arata, Jumpei; Hashizume, Makoto

2015-02-01

At present, much of the research conducted worldwide focuses on extending the ability of surgical robots. One approach is to extend robotic dexterity. For instance, accessibility and dexterity of the surgical instruments remains the largest issue for reduced port surgery such as single port surgery or natural orifice surgery. To solve this problem, a great deal of research is currently conducted in the field of robotics. Enhancing the surgeon's perception is an approach that uses advanced sensor technology. The real-time data acquired through the robotic system combined with the data stored in the robot (such as the robot's location) provide a major advantage. This paper aims at introducing state-of-the-art products and pre-market products in this technological advancement, namely the robotic challenge in extending dexterity and hopefully providing the path to robotic surgery in the near future.

Prototyping a Hybrid Cooperative and Tele-robotic Surgical System for Retinal Microsurgery.

Science.gov (United States)

Balicki, Marcin; Xia, Tian; Jung, Min Yang; Deguet, Anton; Vagvolgyi, Balazs; Kazanzides, Peter; Taylor, Russell

2011-06-01

This paper presents the design of a tele-robotic microsurgical platform designed for development of cooperative and tele-operative control schemes, sensor based smart instruments, user interfaces and new surgical techniques with eye surgery as the driving application. The system is built using the distributed component-based cisst libraries and the Surgical Assistant Workstation framework. It includes a cooperatively controlled EyeRobot2, a da Vinci Master manipulator, and a remote stereo visualization system. We use constrained optimization based virtual fixture control to provide Virtual Remote-Center-of-Motion (vRCM) and haptic feedback. Such system can be used in a hybrid setup, combining local cooperative control with remote tele-operation, where an experienced surgeon can provide hand-over-hand tutoring to a novice user. In another scheme, the system can provide haptic feedback based on virtual fixtures constructed from real-time force and proximity sensor information.

Multisensor Instrument for Real-Time Biological Monitoring

Science.gov (United States)

Zhang, Sean (Zhanxiang); Xu, Guoda; Qiu, Wei; Lin, Freddie

2004-01-01

The figure schematically depicts an instrumentation system, called a fiber optic-based integration system (FOBIS), that is undergoing development to enable real-time monitoring of fluid cell cultures, bioprocess flows, and the like. The FOBIS design combines a micro flow cytometer (MFC), a microphotometer (MP), and a fluorescence-spectrum- or binding-force-measuring micro-sensor (MS) in a single instrument that is capable of measuring multiple biological parameters simultaneously or sequentially. The fiber-optic-based integration system is so named because the MFC, the MP, and the MS are integrated into a single optical system that is coupled to light sources and photometric equipment via optical fibers. The optical coupling components also include a wavelength-division multiplexer and diffractive optical elements. The FOBIS includes a laserdiode- and fiber-optic-based optical trapping subsystem (optical tweezers ) with microphotometric and micro-sensing capabilities for noninvasive confinement and optical measurement of relevant parameters of a single cell or other particle. Some of the measurement techniques implemented together by the FOBIS have long been used separately to obtain basic understanding of the optical properties of individual cells and other organisms, the optical properties of populations of organisms, and the interrelationships among these properties, physiology of the organisms, and physical processes that govern the media that surround the organisms. For example, flow cytometry yields information on numerical concentrations, cross-sectional areas, and types of cells or other particles. Micro-sensing can be used to measure pH and concentrations of oxygen, carbon dioxide, glucose, metabolites, calcium, and antigens in a cell-culture fluid, thereby providing feedback that can be helpful in improving control over a bioprocess. Microphotometry (including measurements of scattering and fluorescence) can yield further information about optically

Instrumentation development for real time brainwave monitoring.

Energy Technology Data Exchange (ETDEWEB)

Anderson, Lawrence Frederick; Clough, Benjamin W.

2005-12-01

The human brain functions through a chemically-induced biological process which operates in a manner similar to electrical systems. The signal resulting from this biochemical process can actually be monitored and read using tools and having patterns similar to those found in electrical and electronics engineering. The primary signature of this electrical activity is the ''brain wave'', which looks remarkably similar to the output of many electrical systems. Likewise, the device currently used in medical arenas to read brain electrical activity is the electroencephalogram (EEG) which is synonymous with a multi-channel oscilloscope reading. Brain wave readings and recordings for medical purposes are traditionally taken in clinical settings such as hospitals, laboratories or diagnostic clinics. The signal is captured via externally applied scalp electrodes using semi-viscous gel to reduce impedance. The signal will be in the 10 to 100 microvolt range. In other instances, where surgeons are attempting to isolate particular types of minute brain signals, the electrodes may actually be temporarily implanted in the brain during a preliminary procedure. The current configurations of equipment required for EEGs involve large recording instruments, many electrodes, wires, and large amounts of hard disk space devoted to storing large files of brain wave data which are then eventually analyzed for patterns of concern. Advances in sensors, signal processing, data storage and microelectronics over the last decade would seem to have paved the way for the realization of devices capable of ''real time'' external monitoring, and possible assessment, of brain activity. A myriad of applications for such a capability are likewise presenting themselves, including the ability to assess brain functioning, level of functioning and malfunctioning. Our plan is to develop the sensors, signal processing, and portable instrumentation package which could

Real-time Near-infrared Virtual Intraoperative Surgical Photoacoustic Microscopy

Directory of Open Access Journals (Sweden)

Changho Lee

2015-09-01

Full Text Available We developed a near infrared (NIR virtual intraoperative surgical photoacoustic microscopy (NIR-VISPAM system that combines a conventional surgical microscope and an NIR light photoacoustic microscopy (PAM system. NIR-VISPAM can simultaneously visualize PA B-scan images at a maximum display rate of 45 Hz and display enlarged microscopic images on a surgeon's view plane through the ocular lenses of the surgical microscope as augmented reality. The use of the invisible NIR light eliminated the disturbance to the surgeon's vision caused by the visible PAM excitation laser in a previous report. Further, the maximum permissible laser pulse energy at this wavelength is approximately 5 times more than that at the visible spectral range. The use of a needle-type ultrasound transducer without any water bath for acoustic coupling can enhance convenience in an intraoperative environment. We successfully guided needle and injected carbon particles in biological tissues ex vivo and in melanoma-bearing mice in vivo.

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

Science.gov (United States)

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

2008-12-01

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

[Evaluation of Medical Instruments Cleaning Effect of Fluorescence Detection Technique].

Science.gov (United States)

Sheng, Nan; Shen, Yue; Li, Zhen; Li, Huijuan; Zhou, Chaoqun

2016-01-01

To compare the cleaning effect of automatic cleaning machine and manual cleaning on coupling type surgical instruments. A total of 32 cleaned medical instruments were randomly sampled from medical institutions in Putuo District medical institutions disinfection supply center. Hygiena System SUREII ATP was used to monitor the ATP value, and the cleaning effect was evaluated. The surface ATP values of the medical instrument of manual cleaning were higher than that of the automatic cleaning machine. Coupling type surgical instruments has better cleaning effect of automatic cleaning machine before disinfection, the application is recommended.

21 CFR 872.4565 - Dental hand instrument.

Science.gov (United States)

2010-04-01

... chisel, endodontic broach, dental wax carver, endodontic pulp canal file, hand instrument for calculus... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Dental hand instrument. 872.4565 Section 872.4565...) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4565 Dental hand instrument. (a) Identification. A...

Three-dimensional modeling of physiological tremor for hand-held surgical robotic instruments.

Science.gov (United States)

Tatinati, Sivanagaraja; Yan Naing Aye; Pual, Anand; Wei Tech Ang; Veluvolu, Kalyana C

2016-08-01

Hand-held robotic instruments are developed to compensate physiological tremor in real-time while augmenting the required precision and dexterity into normal microsurgical work-flow. The hardware (sensors and actuators) and software (causal linear filters) employed for tremor identification and filtering introduces time-varying unknown phase-delay that adversely affects the device performance. The current techniques that focus on three-dimensions (3D) tip position control involves modeling and canceling the tremor in 3-axes (x, y, and z axes) separately. Our analysis with the tremor data recorded from surgeons and novice subjects show that there exists significant correlation in tremor motion across the dimensions. Motivated by this, a new multi-dimensional modeling approach based on extreme learning machines (ELM) is proposed in this paper to correct the phase delay and to accurately model tremulous motion in three dimensions simultaneously. A study is conducted with tremor data recorded from the microsurgeons to analyze the suitability of proposed approach.

DEVELOPMENT OF AN ON-LINE, REAL-TIME ALPHA RADIATION MEASURING INSTRUMENT FOR LIQUID STREAMS

International Nuclear Information System (INIS)

1996-01-01

The Department of Energy (DOE) has expressed a need for an on-line, real-time instrument for assaying alpha-emitting radionuclides (uranium and the transuranics) in effluent waters leaving DOE sites to ensure compliance with regulatory limits. Due to the short range of alpha particles in water (approximately40 Tm), it is necessary now to intermittently collect samples of water and send them to a central laboratory for analysis. A lengthy and costly procedure is used to separate and measure the radionuclides from each sample. Large variations in radionuclide concentrations in the water may go undetected due to the sporadic sampling. Even when detected, the reading may not be representative of the actual stream concentration. To address these issues, Tecogen, a division of Thermo Power Corporation, a Thermo Electron company, is developing a real-time, field-deployable, alpha monitor based on a solid-state silicon wafer semiconductor (patent pending, to be assigned to the Department of Energy). The Thermo Alpha Monitor (TAM) will serve to monitor effluent water streams (Subsurface Contaminants Focus Area) and will be suitable for process control of remediation as well as decontamination and decommissioning operations, such as monitoring scrubber or rinse water radioactivity levels (Mixed Waste Focus Area and D and D Focus Area). It would be applicable for assaying other liquids, such as oil, or solids after proper preconditioning. Rapid isotopic alpha air monitoring is also possible using this technology. This instrument for direct counting of alpha-emitters in aqueous streams is presently being developed by Thermo Power under a development program funded by the DOE Environmental Management program (DOE-EM), administered by the Morgantown Energy Technology Center (METC). Under this contract, Thermo Power has demonstrated a solid-state, silicon-based semiconductor instrument, which uses a proprietary film-based collection system to quantitatively extract the

21 CFR 882.4275 - Dowel cutting instrument.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Dowel cutting instrument. 882.4275 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4275 Dowel cutting instrument. (a) Identification. A dowel cutting instrument is a device used to cut dowels of bone for bone grafting. (b...

Real-Time On-Board Airborne Demonstration of High-Speed On-Board Data Processing for Science Instruments (HOPS)

Science.gov (United States)

Beyon, Jeffrey Y.; Ng, Tak-Kwong; Davis, Mitchell J.; Adams, James K.; Bowen, Stephen C.; Fay, James J.; Hutchinson, Mark A.

2015-01-01

The project called High-Speed On-Board Data Processing for Science Instruments (HOPS) has been funded by NASA Earth Science Technology Office (ESTO) Advanced Information Systems Technology (AIST) program since April, 2012. The HOPS team recently completed two flight campaigns during the summer of 2014 on two different aircrafts with two different science instruments. The first flight campaign was in July, 2014 based at NASA Langley Research Center (LaRC) in Hampton, VA on the NASA's HU-25 aircraft. The science instrument that flew with HOPS was Active Sensing of CO2 Emissions over Nights, Days, and Seasons (ASCENDS) CarbonHawk Experiment Simulator (ACES) funded by NASA's Instrument Incubator Program (IIP). The second campaign was in August, 2014 based at NASA Armstrong Flight Research Center (AFRC) in Palmdale, CA on the NASA's DC-8 aircraft. HOPS flew with the Multifunctional Fiber Laser Lidar (MFLL) instrument developed by Excelis Inc. The goal of the campaigns was to perform an end-to-end demonstration of the capabilities of the HOPS prototype system (HOPS COTS) while running the most computationally intensive part of the ASCENDS algorithm real-time on-board. The comparison of the two flight campaigns and the results of the functionality tests of the HOPS COTS are presented in this paper.

Instruments for radiation measurement in life sciences (5). Development of imaging technology in life science. 4. Real-time bioradiography

International Nuclear Information System (INIS)

Sasaki, Toru; Iwamoto, Akinori; Tsuboi, Hisashi; Katoh, Toru; Kudo, Hiroyuki; Kazawa, Erito; Watanabe, Yasuyoshi

2006-01-01

Real-time bioradiography, new bioradiography method, can collect and produce image of metabolism and function of cell in real-time. The principles of instrumentation, development process and the application examples of neuroscience and biomedical gerontology are stated. The bioradiography method, the gas-tissue live-cell autoradiography method and the real-time bioradiography method are explained. As the application examples, the molecular mechanism of oxidative stress at brain ischemia and the analysis of SOD gene knockout animals are reported. Comparison between FDG-PET of epileptic brain and FDG- bioradiography image of live-cell of brain tissue, the real-time bioradiography system, improvement of image by surface treatment, the detection limit of β + ray from F 18 , image of living-slices of brain tissue by FDG-real-time bioradiography and radioluminography, continuous FDG image of living-slices of rat brain tissue, and analysis of carbohydrate metabolism of living-slices of brain tissue of mouse lacking SOD gene during aerophobia and reoxygenation process are reported. (S.Y.)

Instrument care: everyone's responsibility

Directory of Open Access Journals (Sweden)

Renée du Toit

2011-12-01

Full Text Available Everyone working in an ophthalmic operating theatre must be competent in the care, handling, storage, and maintenance of instruments. This will help to improve surgical outcomes, maintain an economic and affordable service for patients, and provide a safe environment for the wellbeing of patients and staff.Including instrument care in theatre courses and in-service training is one way of ensuring staff competence.

Design and development of a highly sensitive, field portable plasma source instrument for on-line liquid stream monitoring and real-time sample analysis

International Nuclear Information System (INIS)

Duan, Yixiang; Su, Yongxuan; Jin, Zhe; Abeln, Stephen P.

2000-01-01

The development of a highly sensitive, field portable, low-powered instrument for on-site, real-time liquid waste stream monitoring is described in this article. A series of factors such as system sensitivity and portability, plasma source, sample introduction, desolvation system, power supply, and the instrument configuration, were carefully considered in the design of the portable instrument. A newly designed, miniature, modified microwave plasma source was selected as the emission source for spectroscopy measurement, and an integrated small spectrometer with a charge-coupled device detector was installed for signal processing and detection. An innovative beam collection system with optical fibers was designed and used for emission signal collection. Microwave plasma can be sustained with various gases at relatively low power, and it possesses high detection capabilities for both metal and nonmetal pollutants, making it desirable to use for on-site, real-time, liquid waste stream monitoring. An effective in situ sampling system was coupled with a high efficiency desolvation device for direct-sampling liquid samples into the plasma. A portable computer control system is used for data processing. The new, integrated instrument can be easily used for on-site, real-time monitoring in the field. The system possesses a series of advantages, including high sensitivity for metal and nonmetal elements; in situ sampling; compact structure; low cost; and ease of operation and handling. These advantages will significantly overcome the limitations of previous monitoring techniques and make great contributions to environmental restoration and monitoring. (c)

Custom ultrasonic instrumentation for flow measurement and real-time binary gas analysis in the CERN ATLAS experiment

Science.gov (United States)

Alhroob, M.; Battistin, M.; Berry, S.; Bitadze, A.; Bonneau, P.; Boyd, G.; Crespo-Lopez, O.; Degeorge, C.; Deterre, C.; Di Girolamo, B.; Doubek, M.; Favre, G.; Hallewell, G.; Katunin, S.; Lombard, D.; Madsen, A.; McMahon, S.; Nagai, K.; O'Rourke, A.; Pearson, B.; Robinson, D.; Rossi, C.; Rozanov, A.; Stanecka, E.; Strauss, M.; Vacek, V.; Vaglio, R.; Young, J.; Zwalinski, L.

2017-01-01

The development of custom ultrasonic instrumentation was motivated by the need for continuous real-time monitoring of possible leaks and mass flow measurement in the evaporative cooling systems of the ATLAS silicon trackers. The instruments use pairs of ultrasonic transducers transmitting sound bursts and measuring transit times in opposite directions. The gas flow rate is calculated from the difference in transit times, while the sound velocity is deduced from their average. The gas composition is then evaluated by comparison with a molar composition vs. sound velocity database, based on the direct dependence between sound velocity and component molar concentration in a gas mixture at a known temperature and pressure. The instrumentation has been developed in several geometries, with five instruments now integrated and in continuous operation within the ATLAS Detector Control System (DCS) and its finite state machine. One instrument monitors C3F8 coolant leaks into the Pixel detector N2 envelope with a molar resolution better than 2ṡ 10-5, and has indicated a level of 0.14 % when all the cooling loops of the recently re-installed Pixel detector are operational. Another instrument monitors air ingress into the C3F8 condenser of the new C3F8 thermosiphon coolant recirculator, with sub-percent precision. The recent effect of the introduction of a small quantity of N2 volume into the 9.5 m3 total volume of the thermosiphon system was clearly seen with this instrument. Custom microcontroller-based readout has been developed for the instruments, allowing readout into the ATLAS DCS via Modbus TCP/IP on Ethernet. The instrumentation has many potential applications where continuous binary gas composition is required, including in hydrocarbon and anaesthetic gas mixtures.

A digital, constant-frequency pulsed phase-locked-loop instrument for real-time, absolute ultrasonic phase measurements

Science.gov (United States)

Haldren, H. A.; Perey, D. F.; Yost, W. T.; Cramer, K. E.; Gupta, M. C.

2018-05-01

A digitally controlled instrument for conducting single-frequency and swept-frequency ultrasonic phase measurements has been developed based on a constant-frequency pulsed phase-locked-loop (CFPPLL) design. This instrument uses a pair of direct digital synthesizers to generate an ultrasonically transceived tone-burst and an internal reference wave for phase comparison. Real-time, constant-frequency phase tracking in an interrogated specimen is possible with a resolution of 0.000 38 rad (0.022°), and swept-frequency phase measurements can be obtained. Using phase measurements, an absolute thickness in borosilicate glass is presented to show the instrument's efficacy, and these results are compared to conventional ultrasonic pulse-echo time-of-flight (ToF) measurements. The newly developed instrument predicted the thickness with a mean error of -0.04 μm and a standard deviation of error of 1.35 μm. Additionally, the CFPPLL instrument shows a lower measured phase error in the absence of changing temperature and couplant thickness than high-resolution cross-correlation ToF measurements at a similar signal-to-noise ratio. By showing higher accuracy and precision than conventional pulse-echo ToF measurements and lower phase errors than cross-correlation ToF measurements, the new digitally controlled CFPPLL instrument provides high-resolution absolute ultrasonic velocity or path-length measurements in solids or liquids, as well as tracking of material property changes with high sensitivity. The ability to obtain absolute phase measurements allows for many new applications than possible with previous ultrasonic pulsed phase-locked loop instruments. In addition to improved resolution, swept-frequency phase measurements add useful capability in measuring properties of layered structures, such as bonded joints, or materials which exhibit non-linear frequency-dependent behavior, such as dispersive media.

Retained Surgical Foreign Bodies after Surgery

Directory of Open Access Journals (Sweden)

Valon A. Zejnullahu

2017-01-01

Full Text Available The problem of retained surgical bodies (RSB after surgery is an issue for surgeons, hospitals and the entire medical team. They have potentially harmful consequences for the patient as they can be life threatening and usually, a further operation is necessary. The incidence of RSB is between 0.3 to 1.0 per 1,000 abdominal operations, and they occur due to a lack of organisation and communication between surgical staff during the process. Typically, the RSB are surgical sponges and instruments located in the abdomen, retroperitoneum and pelvis.

Virtual reality based surgical assistance and training system for long duration space missions.

Science.gov (United States)

Montgomery, K; Thonier, G; Stephanides, M; Schendel, S

2001-01-01

Access to medical care during long duration space missions is extremely important. Numerous unanticipated medical problems will need to be addressed promptly and efficiently. Although telemedicine provides a convenient tool for remote diagnosis and treatment, it is impractical due to the long delay between data transmission and reception to Earth. While a well-trained surgeon-internist-astronaut would be an essential addition to the crew, the vast number of potential medical problems necessitate instant access to computerized, skill-enhancing and diagnostic tools. A functional prototype of a virtual reality based surgical training and assistance tool was created at our center, using low-power, small, lightweight components that would be easy to transport on a space mission. The system consists of a tracked, head-mounted display, a computer system, and a number of tracked surgical instruments. The software provides a real-time surgical simulation system with integrated monitoring and information retrieval and a voice input/output subsystem. Initial medical content for the system has been created, comprising craniofacial, hand, inner ear, and general anatomy, as well as information on a number of surgical procedures and techniques. One surgical specialty in particular, microsurgery, was provided as a full simulation due to its long training requirements, significant impact on result due to experience, and likelihood for need. However, the system is easily adapted to realistically simulate a large number of other surgical procedures. By providing a general system for surgical simulation and assistance, the astronaut-surgeon can maintain their skills, acquire new specialty skills, and use tools for computer-based surgical planning and assistance to minimize overall crew and mission risk.

Troubleshooting in nuclear instruments

International Nuclear Information System (INIS)

1987-06-01

This report on troubleshooting of nuclear instruments is the product of several scientists and engineers, who are closely associated with nuclear instrumentation and with the IAEA activities in the field. The text covers the following topics: Preamplifiers, amplifiers, scalers, timers, ratemeters, multichannel analyzers, dedicated instruments, tools, instruments, accessories, components, skills, interfaces, power supplies, preventive maintenance, troubleshooting in systems, radiation detectors. The troubleshooting and repair of instruments is illustrated by some real examples

Advancements in Actuated Musical Instruments

DEFF Research Database (Denmark)

Overholt, Daniel; Berdahl, Edgar; Hamilton, Robert

2011-01-01

are physical instruments that have been endowed with virtual qualities controlled by a computer in real-time but which are nevertheless tangible. These instruments provide intuitive and engaging new forms of interaction. They are different from traditional (acoustic) and fully automated (robotic) instruments...

Using the Electronic Health Record Data in Real Time and Predictive Analytics to Prevent Hospital-Acquired Postoperative/Surgical Site Infections.

Science.gov (United States)

Falen, Thomas; Noblin, Alice M; Russell, O Lucia; Santiago, Nonica

Of critical concern to hospitals today is the prevention of postoperative (surgical site) infections that often result in increased lengths of stays for patients, increased resource demands and costs, loss of public trust and lawsuits, and needless pain and suffering for patients and their families. While all surgical patients have the potential to develop a postoperative infection, the main challenge is to identify key risk factors (both patient centered and operational) through an electronic early-warning system to reduce the likelihood of a postoperative infection from occurring. Currently, most postoperative infection risk prevention practices encompass limited use of informatics technologies or do not maximize the potential benefits. In addition, from a research perspective, there has been more focus on extrapolating electronically housed data (eg, from progress notes, operative notes, laboratory, pharmacy, radiology) retrospectively to describe poor patient outcomes for benchmarking purposes (revealing poor results and opportunities for improvement) rather than using similar sources of real-time data to prevent poor patient outcomes from occurring. This article proposes that standardized indicators, both patient centered and operational, linked to the patient's electronic health record could allow for implementation of 24/7, "real-time" monitoring/surveillance to implement well-timed preventive interventions scaled to each patient and facility to assist caregivers in reducing the numbers of postoperative infections and improve the overall quality and costs of patient care.

Use of a life-size three-dimensional-printed spine model for pedicle screw instrumentation training.

Science.gov (United States)

Park, Hyun Jin; Wang, Chenyu; Choi, Kyung Ho; Kim, Hyong Nyun

2018-04-16

Training beginners of the pedicle screw instrumentation technique in the operating room is limited because of issues related to patient safety and surgical efficiency. Three-dimensional (3D) printing enables training or simulation surgery on a real-size replica of deformed spine, which is difficult to perform in the usual cadaver or surrogate plastic models. The purpose of this study was to evaluate the educational effect of using a real-size 3D-printed spine model for training beginners of the free-hand pedicle screw instrumentation technique. We asked whether the use of a 3D spine model can improve (1) screw instrumentation accuracy and (2) length of procedure. Twenty life-size 3D-printed lumbar spine models were made from 10 volunteers (two models for each volunteer). Two novice surgeons who had no experience of free-hand pedicle screw instrumentation technique were instructed by an experienced surgeon, and each surgeon inserted 10 pedicle screws for each lumbar spine model. Computed tomography scans of the spine models were obtained to evaluate screw instrumentation accuracy. The length of time in completing the procedure was recorded. The results of the latter 10 spine models were compared with those of the former 10 models to evaluate learning effect. A total of 37/200 screws (18.5%) perforated the pedicle cortex with a mean of 1.7 mm (range, 1.2-3.3 mm). However, the latter half of the models had significantly less violation than the former half (10/100 vs. 27/100, p 3D-printed spine model can be an excellent tool for training beginners of the free-hand pedicle screw instrumentation.

Real-time synchronous measurement of curing characteristics and polymerization stress in bone cements with a cantilever-beam based instrument

Science.gov (United States)

Palagummi, Sri Vikram; Landis, Forrest A.; Chiang, Martin Y. M.

2018-03-01

An instrumentation capable of simultaneously determining degree of conversion (DC), polymerization stress (PS), and polymerization exotherm (PE) in real time was introduced to self-curing bone cements. This comprises the combination of an in situ high-speed near-infrared spectrometer, a cantilever-beam instrument with compliance-variable feature, and a microprobe thermocouple. Two polymethylmethacrylate-based commercial bone cements, containing essentially the same raw materials but differ in their viscosity for orthopedic applications, were used to demonstrate the applicability of the instrumentation. The results show that for both the cements studied the final DC was marginally different, the final PS was different at the low compliance, the peak of the PE was similar, and their polymerization rates were significantly different. Systematic variation of instrumental compliance for testing reveals differences in the characteristics of PS profiles of both the cements. This emphasizes the importance of instrumental compliance in obtaining an accurate understanding of PS evaluation. Finally, the key advantage for the simultaneous measurements is that these polymerization properties can be correlated directly, thus providing higher measurement confidence and enables a more in-depth understanding of the network formation process.

[Surgical manipulators in ear surgery: a future vision?].

Science.gov (United States)

Hofer, M; Dietz, A; Strauss, G

2011-04-01

Middle ear surgery bears a high risk for injury of difficult to differentiate risk structures. Thus, a precise preparation in this area must be the surgical task. However, there are human (tremor) and systematic limitations (OR setup, narrow access). Assistance systems in terms of manipulators are so far not part of the clinical routine. Although, they could compensate for the above mentioned limitations. MANIPULATORS: This work reviews existing surgical manipulator systems. The expected value is an elevated patient safety through improving surgical accuracy and the reduction of ergonomic deficits. CLINICAL APPLICATION AND DEVELOPMENT: In clinical application there are simply modified industrial robots, highly complex master slave systems and small miniature master slave systems which are directly located at the patient. A disadvantage of most systems is the limited number of applicable instruments. Often, only especially designed instruments can be used. The goal in development should be to create a compact, short distance operated master slave system. The usability of standard (already available) instruments with an easy integration into the surgical and sterilisation procedure would lower the threshold for acceptance of such systems.The surgeon will remain the key player. He can only work efficiently in an ergonomic environment and will always have the responsibility for the intervention. From the authors perspective, highly automated systems should not be the research goal. © Georg Thieme Verlag KG Stuttgart · New York.

Adherence to the use of the surgical checklist for patient safety

Directory of Open Access Journals (Sweden)

Eliane Cristina Sanches Maziero

Full Text Available Objective: Evaluate adherence to the checklist of the Programa Cirurgias Seguras (safe surgery programme at a teaching hospital. Methods: Evaluative study conducted at a teaching hospital in the south of Brazil in 2012. Data were collected by means of non-participant observation in 20 hip and knee replacement surgeries and an instrument that was created for research based on the checklist and used by the institution. Results: In the observed procedures (n = 20 there was significant adhesion (p<0.05 to the instrument in relation to the verification of documentation, fasting, hair removal in the surgical site, absence of nail varnish and accessories, identification of the patient and surgical site on admission to the surgical unit, availability of blood and functionality of materials. However, there was no significant adherence to the checklist in the operating room in relation to patient identification, procedure and laterality, team introduction, surgical break and materials count. Conclusion: The results showed that the items on the checklist were verified nonverbally and there was no significant adherence to the instrument.

Custom real-time ultrasonic instrumentation for simultaneous mixture and flow analysis of binary gases in the CERN ATLAS experiment

CERN Document Server

Alhroob, M.; Berry, S.; Bitadze, A.; Bonneau, P.; Boyd, G.; Crespo-Lopez, O.; Degeorge, C.; Deterre, C.; Di Girolamo, B.; Doubek, M.; Favre, G.; Hallewell, G.; Hasib, A.; Katunin, S.; Lombard, D.; Madsen, A.; McMahon, S.; Nagai, K.; O'Rourke, A.; Pearson, B.; Robinson, D.; Rossi, C.; Rozanov, A.; Stanecka, E.; Strauss, M.; Vacek, V.; Vaglio, R.; Young, J.; Zwalinski, L.

2017-01-01

Custom ultrasonic instruments have been developed for simultaneous monitoring of binary gas mixture and flow in the ATLAS Inner Detector. Sound transit times are measured in opposite directions in flowing gas. Flow rate and sound velocity are respectively calculated from their difference and average. Gas composition is evaluated in real-time by comparison with a sound velocity/composition database, based on the direct dependence of sound velocity on component concentrations in a mixture at known temperature and pressure. Five devices are integrated into the ATLAS Detector Control System. Three instruments monitor coolant leaks into N2 envelopes of the silicon microstrip and Pixel detectors. Resolutions better than ±2×10−5±2×10−5 and ±2×10−4±2×10−4 are seen for C3F8 and CO2 leak concentrations in N2 respectively. A fourth instrument detects sub-percent levels of air ingress into the C3F8 condenser of the new thermosiphon coolant recirculator. Following extensive studies a fifth instrument was b...

LR-Spring Mass Model for Cardiac Surgical Simulation

DEFF Research Database (Denmark)

Mosegaard, Jesper

2004-01-01

The purpose of the research conducted was to develop a real-time surgical simulator for preoperative planning of surgery in congenital heart disease. The main problem simulating procedures on cardiac morphology is the need for a large degree of detail and simulation speed. In combination with a d......The purpose of the research conducted was to develop a real-time surgical simulator for preoperative planning of surgery in congenital heart disease. The main problem simulating procedures on cardiac morphology is the need for a large degree of detail and simulation speed. In combination...

21 CFR 872.4120 - Bone cutting instrument and accessories.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bone cutting instrument and accessories. 872.4120... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4120 Bone cutting instrument and accessories. (a) Identification. A bone cutting instrument and accessories is a metal device intended for use...

Robotic technologies in surgical oncology training and practice.

Science.gov (United States)

Orvieto, Marcelo A; Marchetti, Pablo; Castillo, Octavio A; Coelho, Rafael F; Chauhan, Sanket; Rocco, Bernardo; Ardila, Bobby; Mathe, Mary; Patel, Vipul R

2011-09-01

The modern-day surgeon is frequently exposed to new technologies and instrumentation. Robotic surgery (RS) has evolved as a minimally invasive technique aimed to improve clinical outcomes. RS has the potential to alleviate the inherent limitations of laparoscopic surgery such as two dimensional imaging, limited instrument movement and intrinsic human tremor. Since the first reported robot-assisted surgical procedure performed in 1985, the technology has dramatically evolved and currently multiple surgical specialties have incorporated RS into their daily clinical armamentarium. With this exponential growth, it should not come as a surprise the ever growing requirement for surgeons trained in RS as well as the interest from residents to receive robotic exposure during their training. For this reason, the establishment of set criteria for adequate and standardized training and credentialing of surgical residents, fellows and those trained surgeons wishing to perform RS has become a priority. In this rapidly evolving field, we herein review the past, present and future of robotic technologies and its penetration into different surgical specialties. Copyright © 2010 Elsevier Ltd. All rights reserved.

Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation in surgical treatment for single-segment lumbar spinal tuberculosis

OpenAIRE

Zeng, Hao; Wang, Xiyang; Zhang, Penghui; Peng, Wei; Zhang, Yupeng; Liu, Zheng

2015-01-01

Objective: The aim of this study is to determine the feasibility and efficacy of surgical management of single-segment lumbar spinal tuberculosis (TB) by using single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation.Methods: Seventeen cases of single-segment lumbar TB were treated with single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reco...

Instrument calls and real-time code for laboratory automation

International Nuclear Information System (INIS)

Taber, L.; Ames, H.S.; Yamauchi, R.K.; Barton, G.W. Jr.

1978-01-01

These programs are the result of a joint Lawrence Livermore Laboratory and Environmental Protection Agency project to automate water quality laboratories. They form the interface between the analytical instruments and the BASIC language programs for data reduction and analysis. They operate on Data General NOVA 840's at Cincinnati and Chicago and on a Data General ECLIPSE C330 at Livermore. The operating system consists of unmodified RDOS, Data General's disk operating system, and Data General's multiuser BASIC modified to provide the instrument CALLs and other functions described. Instruments automated at various laboratories include Technicon AutoAnalyzers, atomic absorption spectrophotometers, total organic carbon analyzers, an emission spectrometer, an electronic balance, sample changers, and an optical spectrophotometer. Other instruments may be automated using these same CALLs, or new CALLs may be written as described

Optimized positioning of autonomous surgical lamps

Science.gov (United States)

Teuber, Jörn; Weller, Rene; Kikinis, Ron; Oldhafer, Karl-Jürgen; Lipp, Michael J.; Zachmann, Gabriel

2017-03-01

We consider the problem of finding automatically optimal positions of surgical lamps throughout the whole surgical procedure, where we assume that future lamps could be robotized. We propose a two-tiered optimization technique for the real-time autonomous positioning of those robotized surgical lamps. Typically, finding optimal positions for surgical lamps is a multi-dimensional problem with several, in part conflicting, objectives, such as optimal lighting conditions at every point in time while minimizing the movement of the lamps in order to avoid distractions of the surgeon. Consequently, we use multi-objective optimization (MOO) to find optimal positions in real-time during the entire surgery. Due to the conflicting objectives, there is usually not a single optimal solution for such kinds of problems, but a set of solutions that realizes a Pareto-front. When our algorithm selects a solution from this set it additionally has to consider the individual preferences of the surgeon. This is a highly non-trivial task because the relationship between the solution and the parameters is not obvious. We have developed a novel meta-optimization that considers exactly this challenge. It delivers an easy to understand set of presets for the parameters and allows a balance between the lamp movement and lamp obstruction. This metaoptimization can be pre-computed for different kinds of operations and it then used by our online optimization for the selection of the appropriate Pareto solution. Both optimization approaches use data obtained by a depth camera that captures the surgical site but also the environment around the operating table. We have evaluated our algorithms with data recorded during a real open abdominal surgery. It is available for use for scientific purposes. The results show that our meta-optimization produces viable parameter sets for different parts of an intervention even when trained on a small portion of it.

Surgical Emphysema: A Rare Complication of a Simple Surgical Dental Extraction Without the Use of an Air-Driven Rotor.

Science.gov (United States)

Gowans, Keegan; Patel, Muneer; Lewis, Khari

2017-03-01

Surgical emphysema is a rare complication of dental extractions, often associated with the use of high-speed air rotors. This report describes a case of extensive surgical emphysema following a simple surgical extraction of a LL6 under local anaesthetic. There was no use of air-driven handpieces during the procedure. The patient developed extensive surgical emphysema bi-laterally in both cervical neck and facial planes. After prophylactic antibiotics with careful monitoring in a secondary care setting, the patient made a full unremarkable recovery. Clinical relevance: Simple extraction of teeth is a procedure carried out daily by most general dental practitioners. However, the risk of surgical emphysema without the use of high-speed air rotors or instruments using pressurized air/water is not well known or documented.

Image-guidance for surgical procedures

International Nuclear Information System (INIS)

Peters, Terry M

2006-01-01

Contemporary imaging modalities can now provide the surgeon with high quality three- and four-dimensional images depicting not only normal anatomy and pathology, but also vascularity and function. A key component of image-guided surgery (IGS) is the ability to register multi-modal pre-operative images to each other and to the patient. The other important component of IGS is the ability to track instruments in real time during the procedure and to display them as part of a realistic model of the operative volume. Stereoscopic, virtual- and augmented-reality techniques have been implemented to enhance the visualization and guidance process. For the most part, IGS relies on the assumption that the pre-operatively acquired images used to guide the surgery accurately represent the morphology of the tissue during the procedure. This assumption may not necessarily be valid, and so intra-operative real-time imaging using interventional MRI, ultrasound, video and electrophysiological recordings are often employed to ameliorate this situation. Although IGS is now in extensive routine clinical use in neurosurgery and is gaining ground in other surgical disciplines, there remain many drawbacks that must be overcome before it can be employed in more general minimally-invasive procedures. This review overviews the roots of IGS in neurosurgery, provides examples of its use outside the brain, discusses the infrastructure required for successful implementation of IGS approaches and outlines the challenges that must be overcome for IGS to advance further. (topical review)

Ex Vivo (Fluorescence) Confocal Microscopy in Surgical Pathology: State of the Art.

Science.gov (United States)

Ragazzi, Moira; Longo, Caterina; Piana, Simonetta

2016-05-01

First developed in 1957, confocal microscopy is a powerful imaging tool that can be used to obtain near real-time reflected light images of untreated human tissue with nearly histologic resolution. Besides its research applications, in the last decades, confocal microscopy technology has been proposed as a useful device to improve clinical diagnosis, especially in ophthalmology, dermatology, and endomicroscopy settings, thanks to advances in instrument development. Compared with the wider use of the in vivo tissue assessment, ex vivo applications of confocal microscopy are not fully explored. A comprehensive review of the current literature was performed here, focusing on the reliable applications of ex vivo confocal microscopy in surgical pathology and on some potential evolutions of this new technique from pathologists' viewpoint.

Evaluation of the Factors Affecting the Loss of Lumbar Lordosis in Surgical Treatment of Patients with Adolescent Idiopathic Scoliosis Using Segmental Instrumentation

Directory of Open Access Journals (Sweden)

Farshad Nikouei

2016-12-01

Full Text Available Background The identification of independent factors affecting the loss of lumbar lordosis can facilitate programmed surgery in adolescent idiopathic scoliosis (AIS patients especially with considering the importance of sagittal characteristics. Objectives This study aimed to investigate the factors affecting the amount of the loss of lumbar lordosis in surgical treatment of the patients with AIS using segmental instrumentation. Methods In this study which was conducted in three years, 91 AIS patients who underwent segmental instrumentation were studied and 63 patients remained in the study according to the inclusion criteria. All patients’ information was recorded on admission in separate forms and radiography results were coded and archived before the surgery for more evaluation. All patients were subject to standing whole spine radiograph again 12 months after the surgery. Ultimately, the information was put into predetermined forms and was used for a statistical analysis after the completion of forms. Results The mean age of the patients was 15.62 ± 3.09 years. The mean preoperative lumbar lordosis was 45.25 ± 12.17 degrees and the mean preoperative thoracic kyphosis was 41.54 ± 16.31 degrees. The mean postoperative lumbar lordosis was 34.37 ± 10.26 degrees. The mean postoperative thoracic kyphosis was obtained 26.56 ± 9.17. The mean surgical correction of thoracic kyphotic deformity and lumbar lordosis were correlated with each other with the correlation coefficient of 0.71 (P < 0.001. Men have more (16.62 ± 8.74 loss of lumbar lordosis than women (10.05 ± 8.53 (P < 0.001. There was not any significant correlation between the type (hook/hybrid of the instrumentation with the loss of lumbar lordosis (P = 0.07, P = 0.41. Conclusions Considering the findings of this study, the most important factor affecting the amount of post-operative loss of lumbar lordosis in segmental instrumentation in AIS patients is the amount of the

[Simulation in surgical training].

Science.gov (United States)

Nabavi, A; Schipper, J

2017-01-01

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

On Gamma Ray Instrument On-Board Data Processing Real-Time Computational Algorithm for Cosmic Ray Rejection

Science.gov (United States)

Kizhner, Semion; Hunter, Stanley D.; Hanu, Andrei R.; Sheets, Teresa B.

2016-01-01

Richard O. Duda and Peter E. Hart of Stanford Research Institute in [1] described the recurring problem in computer image processing as the detection of straight lines in digitized images. The problem is to detect the presence of groups of collinear or almost collinear figure points. It is clear that the problem can be solved to any desired degree of accuracy by testing the lines formed by all pairs of points. However, the computation required for n=NxM points image is approximately proportional to n2 or O(n2), becoming prohibitive for large images or when data processing cadence time is in milliseconds. Rosenfeld in [2] described an ingenious method due to Hough [3] for replacing the original problem of finding collinear points by a mathematically equivalent problem of finding concurrent lines. This method involves transforming each of the figure points into a straight line in a parameter space. Hough chose to use the familiar slope-intercept parameters, and thus his parameter space was the two-dimensional slope-intercept plane. A parallel Hough transform running on multi-core processors was elaborated in [4]. There are many other proposed methods of solving a similar problem, such as sampling-up-the-ramp algorithm (SUTR) [5] and algorithms involving artificial swarm intelligence techniques [6]. However, all state-of-the-art algorithms lack in real time performance. Namely, they are slow for large images that require performance cadence of a few dozens of milliseconds (50ms). This problem arises in spaceflight applications such as near real-time analysis of gamma ray measurements contaminated by overwhelming amount of traces of cosmic rays (CR). Future spaceflight instruments such as the Advanced Energetic Pair Telescope instrument (AdEPT) [7-9] for cosmos gamma ray survey employ large detector readout planes registering multitudes of cosmic ray interference events and sparse science gamma ray event traces' projections. The AdEPT science of interest is in the

Real-time statistical quality control and ARM

International Nuclear Information System (INIS)

Blough, D.K.

1992-05-01

An important component of the Atmospheric Radiation Measurement (ARM) Program is real-time quality control of data obtained from meteorological instruments. It is the goal of the ARM program to enhance the predictive capabilities of global circulation models by incorporating in them more detailed information on the radiative characteristics of the earth's atmosphere. To this end, a number of Cloud and Radiation Testbeds (CART's) will be built at various locations worldwide. Each CART will consist of an array of instruments designed to collect radiative data. The large amount of data obtained from these instruments necessitates real-time processing in order to flag outliers and possible instrument malfunction. The Bayesian dynamic linear model (DLM) proves to be an effective way of monitoring the time series data which each instrument generates. It provides a flexible yet powerful approach to detecting in real-time sudden shifts in a non-stationary multivariate time series. An application of these techniques to data arising from a remote sensing instrument to be used in the CART is provided. Using real data from a wind profiler, the ability of the DLM to detect outliers is studied. 5 refs

Remote Access to Instrumental Analysis for Distance Education in Science

Directory of Open Access Journals (Sweden)

Dietmar Kennepohl

2005-11-01

Full Text Available Remote access to experiments offers distance educators another tool to integrate a strong laboratory component within a science course. Since virtually all modern chemical instrumental analysis in industry now use devices operated by a computer interface, remote control of instrumentation is not only relatively facile, it enhances students’ opportunity to learn the subject matter and be exposed to “real world” contents. Northern Alberta Institute of Technology (NAIT and Athabasca University are developing teaching laboratories based on the control of analytical instruments in real-time via an Internet connection. Students perform real-time analysis using equipment, methods, and skills that are common to modern analytical laboratories (or sophisticated teaching laboratories. Students obtain real results using real substances to arrive at real conclusions, just as they would if they were in a physical laboratory with the equipment; this approach allows students to access to conduct instrumental science experiments, thus providing them with an advantageous route to upgrade their laboratory skills while learning at a distance.

A real time study of the human equilibrium using an instrumented insole with 3 pressure sensors.

Science.gov (United States)

Abou Ghaida, Hussein; Mottet, Serge; Goujon, Jean-Marc

2014-01-01

The present work deals with the study of the human equilibrium using an ambulatory e-health system. One of the point on which we focus is the fall risk, when losing equilibrium control. A specific postural learning model is presented, and an ambulatory instrumented insole is developed using 3 pressures sensors per foot, in order to determine the real-time displacement and the velocity of the centre of pressure (CoP). The increase of these parameters signals a loss of physiological sensation, usually of vision or of the inner ear. The results are compared to those obtained from classical more complex systems.

Cost assessment of instruments for single-incision laparoscopic cholecystectomy

DEFF Research Database (Denmark)

Henriksen, Nadia A; Al-Tayar, Haytham; Rosenberg, Jacob

2012-01-01

Specially designed surgical instruments have been developed for single-incision laparoscopic surgery, but high instrument costs may impede the implementation of these procedures. The aim of this study was to compare the cost of operative implements used for elective cholecystectomy performed...

Nuclear instrumentation for research reactors

International Nuclear Information System (INIS)

Hofer, Carlos G.; Pita, Antonio; Verrastro, Claudio A.; Maino, Eduardo J.

1997-01-01

The nuclear instrumentation for research reactors in Argentina was developed in 70'. A gradual modernization of all the nuclear instrumentation is planned. It includes start-up and power range instrumentation, as well as field monitors, clamp, scram and rod movement control logic. The new instrumentation is linked to a computer network, based on real time operating system for data acquisition, display and logging. This paper describes the modules and whole system aspects. (author). 2 refs

Computer-Assisted Technique for Surgical Tooth Extraction

Directory of Open Access Journals (Sweden)

Hosamuddin Hamza

2016-01-01

Full Text Available Introduction. Surgical tooth extraction is a common procedure in dentistry. However, numerous extraction cases show a high level of difficulty in practice. This difficulty is usually related to inadequate visualization, improper instrumentation, or other factors related to the targeted tooth (e.g., ankyloses or presence of bony undercut. Methods. In this work, the author presents a new technique for surgical tooth extraction based on 3D imaging, computer planning, and a new concept of computer-assisted manufacturing. Results. The outcome of this work is a surgical guide made by 3D printing of plastics and CNC of metals (hybrid outcome. In addition, the conventional surgical cutting tools (surgical burs are modified with a number of stoppers adjusted to avoid any excessive drilling that could harm bone or other vital structures. Conclusion. The present outcome could provide a minimally invasive technique to overcome the routine complications facing dental surgeons in surgical extraction procedures.

Surgical Robotics Research in Cardiovascular Disease

Energy Technology Data Exchange (ETDEWEB)

Pohost, Gerald M; Guthrie, Barton L; Steiner, Charles

2008-02-29

This grant is to support a research in robotics at three major medical centers: the University of Southern California-USC- (Project 1); the University of Alabama at Birmingham-UAB-(Project 2); and the Cleveland Clinic Foundation-CCF-(Project 3). Project 1 is oriented toward cardiovascular applications, while projects 2 and 3 are oriented toward neurosurgical applications. The main objective of Project 1 is to develop an approach to assist patients in maintaining a constant level of stress while undergoing magnetic resonance imaging or spectroscopy. The specific project is to use handgrip to detect the changes in high energy phosphate metabolism between rest and stress. The high energy phosphates, ATP and phosphocreatine (PCr) are responsible for the energy of the heart muscle (myocardium) responsible for its contractile function. If the blood supply to the myocardium in insufficient to support metabolism and contractility during stress, the high energy phosphates, particularly PCr, will decrease in concentration. The high energy phosphates can be tracked using phosphorus-31 magnetic resonance spectroscopy ({sup 31}P MRS). In Project 2 the UAB Surgical Robotics project focuses on the use of virtual presence to assist with remote surgery and surgical training. The goal of this proposal was to assemble a pilot system for proof of concept. The pilot project was completed successfully and was judged to demonstrate that the concept of remote surgical assistance as applied to surgery and surgical training was feasible and warranted further development. The main objective of Project 3 is to develop a system to allow for the tele-robotic delivery of instrumentation during a functional neurosurgical procedure (Figure 3). Instrumentation such as micro-electrical recording probes or deep brain stimulation leads. Current methods for the delivery of these instruments involve the integration of linear actuators to stereotactic navigation systems. The control of these delivery

Surgical Robotics Research in Cardiovascular Disease

International Nuclear Information System (INIS)

Pohost, Gerald M; Guthrie, Barton L; Steiner, Charles

2008-01-01

This grant is to support a research in robotics at three major medical centers: the University of Southern California-USC- (Project 1); the University of Alabama at Birmingham-UAB-(Project 2); and the Cleveland Clinic Foundation-CCF-(Project 3). Project 1 is oriented toward cardiovascular applications, while projects 2 and 3 are oriented toward neurosurgical applications. The main objective of Project 1 is to develop an approach to assist patients in maintaining a constant level of stress while undergoing magnetic resonance imaging or spectroscopy. The specific project is to use handgrip to detect the changes in high energy phosphate metabolism between rest and stress. The high energy phosphates, ATP and phosphocreatine (PCr) are responsible for the energy of the heart muscle (myocardium) responsible for its contractile function. If the blood supply to the myocardium in insufficient to support metabolism and contractility during stress, the high energy phosphates, particularly PCr, will decrease in concentration. The high energy phosphates can be tracked using phosphorus-31 magnetic resonance spectroscopy ( 31 P MRS). In Project 2 the UAB Surgical Robotics project focuses on the use of virtual presence to assist with remote surgery and surgical training. The goal of this proposal was to assemble a pilot system for proof of concept. The pilot project was completed successfully and was judged to demonstrate that the concept of remote surgical assistance as applied to surgery and surgical training was feasible and warranted further development. The main objective of Project 3 is to develop a system to allow for the tele-robotic delivery of instrumentation during a functional neurosurgical procedure (Figure 3). Instrumentation such as micro-electrical recording probes or deep brain stimulation leads. Current methods for the delivery of these instruments involve the integration of linear actuators to stereotactic navigation systems. The control of these delivery devices

[ANALYSIS OF THE SURGICAL TREATMENT RESULTS IN THE THYROID GLAND DISEASES].

Science.gov (United States)

Tarashchenko, Yu N; Bolgov, M Yu

2015-08-01

The results of surgical treatment of the thyroid gland diseases were analyzed, including the specific morbidity rate, cosmetic effect of the operation, stationary treatment of patients duration, the operation radicalism. Improvement of the operation methods and introduction of modern electric surgical instruments have permitted to reduce the operation duration, the surgical access length, the rate of postoperative hypocalcaemia occurrence, duration of the patients stationary treatment.

Preliminary results of real-time in-vitro electronic speckle pattern interferometry (ESPI) measurements in otolaryngology

Science.gov (United States)

Conerty, Michelle D.; Castracane, James; Cacace, Anthony T.; Parnes, Steven M.; Gardner, Glendon M.; Miller, Mitchell B.

1995-05-01

Electronic Speckle Pattern Interferometry (ESPI) is a nondestructive optical evaluation technique that is capable of determining surface and subsurface integrity through the quantitative evaluation of static or vibratory motion. By utilizing state of the art developments in the areas of lasers, fiber optics and solid state detector technology, this technique has become applicable in medical research and diagnostics. Based on initial support from NIDCD and continued support from InterScience, Inc., we have been developing a range of instruments for improved diagnostic evaluation in otolaryngological applications based on the technique of ESPI. These compact fiber optic instruments are capable of making real time interferometric measurements of the target tissue. Ongoing development of image post- processing software is currently capable of extracting the desired quantitative results from the acquired interferometric images. The goal of the research is to develop a fully automated system in which the image processing and quantification will be performed in hardware in near real-time. Subsurface details of both the tympanic membrane and vocal cord dynamics could speed the diagnosis of otosclerosis, laryngeal tumors, and aid in the evaluation of surgical procedures.

RESULTS OF SURGICAL TREATMENT OF INFANTILE AND JUVENILE SCOLIOSIS USING VARIOUS INSTRUMENTATION

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M. V. Mikhailovsky

2015-01-01

Full Text Available Introduction. The analysis Results of surgical treatment of growing children with infantile and juvenile scoliosis (IS can the optimal method of treatment select. In young children with significant growth potential spinal fusion may not be the best option as it limits further longitudinal growth of the spine and may to the thoracic insufficiency syndrome result. To address this problem recently several techniques focused, their have advantages and drawbacks.Material and methods. Since 2008 year 127 patients (64 girls, 63 boys aged (4.5 ± 2.1 years were operated on. In group I 65 patients were operated on using VEPTR (Vertical Expandable Prosthetic Titanium Rib instrumentation, in group II 42 patients using various spinal instrumentation. 20 patients with congenital kyphosis were excluded. The average follow-up time was (5.6 ± 1.1 years.Results. In group I average value of the primary scoliotic curve before surgery was (74.7 ± 22.9, secondary curve (42.8 ± 16.0, thoracic kyphosis (46.3 ± 27.4, lumbar lordosis (54.6 ± 14. Average value of the primary scoliotic curve after surgery was reduced to (51 ± 20 (correction 31.7%, at followup to (56.5 ± 18.5, secondary curve (31.8 ± 12.8 (25.7%, at follow-up to (32.4 ± 18.4, thoracic kyphosis (36.8 ± 20.8 (20,5%, at follow-up to (41.8 ± 21.0, lumbar lordosis (45.4 ± 12.7 (16,9%, at follow-up to (48.2 ± 11.7 (p < 0.05. Space available for lung before surgery was (84.5 ± 8.7 %, after surgery was (94.8 ± 6.7%, at follow-up increased to (98.6 ± 5.4 % (p < 0.05. Complications included 11 implant dislocations and 1 infection. In group II average value of the primary scoliotic curve before surgery was (87.6 ± 6.6, secondary curve (47.8 ± 4.6, thoracic kyphosis (61.4 ± 10.4, lumbar lordosis (61.8 ± 4.9. Average value of the primary scoliotic curve after surgery was reduced to 50.6 ± 5.3 (correction 42.3%, at follow-up to (66.1 ± 6.3�

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

Science.gov (United States)

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

2017-12-01

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

Real Time Conference 2016 Overview

Science.gov (United States)

Luchetta, Adriano

2017-06-01

This is a special issue of the IEEE Transactions on Nuclear Science containing papers from the invited, oral, and poster presentation of the 20th Real Time Conference (RT2016). The conference was held June 6-10, 2016, at Centro Congressi Padova “A. Luciani,” Padova, Italy, and was organized by Consorzio RFX (CNR, ENEA, INFN, Università di Padova, Acciaierie Venete SpA) and the Istituto Nazionale di Fisica Nucleare. The Real Time Conference is multidisciplinary and focuses on the latest developments in real-time techniques in high-energy physics, nuclear physics, astrophysics and astroparticle physics, nuclear fusion, medical physics, space instrumentation, nuclear power instrumentation, general radiation instrumentation, and real-time security and safety. Taking place every second year, it is sponsored by the Computer Application in Nuclear and Plasma Sciences technical committee of the IEEE Nuclear and Plasma Sciences Society. RT2016 attracted more than 240 registrants, with a large proportion of young researchers and engineers. It had an attendance of 67 students from many countries.

Quality of surgical scrub in a heart hospital: Do not take it for granted

Directory of Open Access Journals (Sweden)

Leila Abdollahi

2017-09-01

Full Text Available Introduction: The role of scrub in the prevention of post-surgery infections is well-known. This study aimed to investigate the inputs and process of surgical scrub in operating rooms of the largest heart hospital of northwest Iran. Methods: This study took place with a before-after design as a clinical audit in 2014. A check list developed based on national and international standards of surgical hand scrub was used as the study instrument. Checklists were completed by observation of surgical team scrubbing in real situation. Descriptive statistics and graphs were used to describe the results. Results: A compliance degree with the standards for prerequisites, equipment, general items, process and time of scrub was observed as 58%, 55%, 33%, 68% and 22%, respectively. The compliance degree after the intervention was 72%, 66%, 66%, 85% and 61%, respectively. Improvement was observed in all studied aspects of scrub. The total score of compliance with the standards changed from 47% to 70%. The main issues were incorrect order of scrubbing the areas of the hands, incorrect way of scrubbing the arms, insufficient scrubbing the arms (not above elbow, and lack of awareness about hospital’s policy on scrub time. Conclusion: The results showed defects in the surgical scrub of the studied hospital and that the compliance with the standards can be improved by simple interventions. Periodical audit and observation of the scrub and then feedback is recommended.

Quality of surgical scrub in a heart hospital: Do not take it for granted.

Science.gov (United States)

Abdollahi, Leila; Tabrizi, Jafar Sadegh; Jodati, Ahmadreza; Safaie, Naser; Moradi-Joo, Mohammad; Daemi, Amin

2017-01-01

Introduction: The role of scrub in the prevention of post-surgery infections is well-known. This study aimed to investigate the inputs and process of surgical scrub in operating rooms of the largest heart hospital of northwest Iran. Methods: This study took place with a before-after design as a clinical audit in 2014. A check list developed based on national and international standards of surgical hand scrub was used as the study instrument. Checklists were completed by observation of surgical team scrubbing in real situation. Descriptive statistics and graphs were used to describe the results. Results: A compliance degree with the standards for prerequisites, equipment, general items, process and time of scrub was observed as 58%, 55%, 33%, 68% and 22%, respectively. The compliance degree after the intervention was 72%, 66%, 66%, 85% and 61%, respectively. Improvement was observed in all studied aspects of scrub. The total score of compliance with the standards changed from 47% to 70%. The main issues were incorrect order of scrubbing the areas of the hands, incorrect way of scrubbing the arms, insufficient scrubbing the arms (not above elbow), and lack of awareness about hospital's policy on scrub time. Conclusion: The results showed defects in the surgical scrub of the studied hospital and that the compliance with the standards can be improved by simple interventions. Periodical audit and observation of the scrub and then feedback is recommended.

Wearable Technology for Global Surgical Teleproctoring.

Science.gov (United States)

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

2015-01-01

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

Debridement of vaginal radiation ulcers using the surgical Ultrasonic Aspirator

International Nuclear Information System (INIS)

Vanderburgh, E.; Nahhas, W.A.

1990-01-01

The surgical Ultrasonic Aspirator (USA) is a fairly new surgical instrument used for an increasingly wide range of procedures. This paper introduces a new application: debridement of vulvovaginal necrotic ulcers resulting from intracavitary radiation therapy. The ultrasonic aspirator allowed removal of the soft, necrotic tissue while preserving underlying healthy, firm tissue and blood vessels

Virtual Reality Simulator Systems in Robotic Surgical Training.

Science.gov (United States)

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

2018-06-01

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

Modern spinal instrumentation. Part 1: Normal spinal implants

International Nuclear Information System (INIS)

Davis, W.; Allouni, A.K.; Mankad, K.; Prezzi, D.; Elias, T.; Rankine, J.; Davagnanam, I.

2013-01-01

The general radiologist frequently encounters studies demonstrating spinal instrumentation, either as part of the patient's postoperative evaluation or as incidental to a study performed for another purpose. There are various surgical approaches and devices used in spinal surgery with an increased understanding of spinal and spinal implant biomechanics drives development of modern fixation devices. It is, therefore, important that the radiologist can recognize commonly used devices and identify their potential complications demonstrated on imaging. The aim of part 1 of this review is to familiarize the reader with terms used to describe surgical approaches to the spine, review the function and normal appearances of commonly used instrumentations, and understand the importance of the different fixation techniques. The second part of this review will concentrate on the roles that the different imaging techniques play in assessing the instrumented spine and the recognition of complications that can potentially occur.

Design and implementation of a wireless instrument adapter

DEFF Research Database (Denmark)

Laino, Kaori V.; Saathoff, Thore; Savarimuthu, Thiusius R.

2018-01-01

The evaluation of new methods for control and manipulation in minimally invasive robotic surgery requires a realistic setup. To decouple the evaluation of methods from overall clinical systems, we propose an instrument adapter for the S line EndoWrist\\c{opyright} instruments of the da Vinci...... surgical system. The adapter is small and lightweight and can be mounted to any robot to mimic motion. We describe its design and implementation, as well as a setup to calibrate instruments to study precise motion control. Our results indicate that each instrument requires individual calibration...

Advanced real-time multi-display educational system (ARMES): An innovative real-time audiovisual mentoring tool for complex robotic surgery.

Science.gov (United States)

Lee, Joong Ho; Tanaka, Eiji; Woo, Yanghee; Ali, Güner; Son, Taeil; Kim, Hyoung-Il; Hyung, Woo Jin

2017-12-01

The recent scientific and technologic advances have profoundly affected the training of surgeons worldwide. We describe a novel intraoperative real-time training module, the Advanced Robotic Multi-display Educational System (ARMES). We created a real-time training module, which can provide a standardized step by step guidance to robotic distal subtotal gastrectomy with D2 lymphadenectomy procedures, ARMES. The short video clips of 20 key steps in the standardized procedure for robotic gastrectomy were created and integrated with TilePro™ software to delivery on da Vinci Surgical Systems (Intuitive Surgical, Sunnyvale, CA). We successfully performed the robotic distal subtotal gastrectomy with D2 lymphadenectomy for patient with gastric cancer employing this new teaching method without any transfer errors or system failures. Using this technique, the total operative time was 197 min and blood loss was 50 mL and there were no intra- or post-operative complications. Our innovative real-time mentoring module, ARMES, enables standardized, systematic guidance during surgical procedures. © 2017 Wiley Periodicals, Inc.

Automatic tracking of laparoscopic instruments for autonomous control of a cameraman robot.

Science.gov (United States)

Khoiy, Keyvan Amini; Mirbagheri, Alireza; Farahmand, Farzam

2016-01-01

An automated instrument tracking procedure was designed and developed for autonomous control of a cameraman robot during laparoscopic surgery. The procedure was based on an innovative marker-free segmentation algorithm for detecting the tip of the surgical instruments in laparoscopic images. A compound measure of Saturation and Value components of HSV color space was incorporated that was enhanced further using the Hue component and some essential characteristics of the instrument segment, e.g., crossing the image boundaries. The procedure was then integrated into the controlling system of the RoboLens cameraman robot, within a triple-thread parallel processing scheme, such that the tip is always kept at the center of the image. Assessment of the performance of the system on prerecorded real surgery movies revealed an accuracy rate of 97% for high quality images and about 80% for those suffering from poor lighting and/or blood, water and smoke noises. A reasonably satisfying performance was also observed when employing the system for autonomous control of the robot in a laparoscopic surgery phantom, with a mean time delay of 200ms. It was concluded that with further developments, the proposed procedure can provide a practical solution for autonomous control of cameraman robots during laparoscopic surgery operations.

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

Science.gov (United States)

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

2015-12-01

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

Three-Dimensional Printing Surgical Applications.

Science.gov (United States)

AlAli, Ahmad B; Griffin, Michelle F; Butler, Peter E

2015-01-01

Three-dimensional printing, a technology used for decades in the industrial field, gains a lot of attention in the medical field for its potential benefits. With advancement of desktop printers, this technology is accessible and a lot of research is going on in the medical field. To evaluate its application in surgical field, which may include but not limited to surgical planning, surgical education, implants, and prosthesis, which are the focus of this review. Research was conducted by searching PubMed, Web of science, and other reliable sources. We included original articles and excluded articles based on animals, those more than 10 years old, and those not in English. These articles were evaluated, and relevant studies were included in this review. Three-dimensional printing shows a potential benefit in surgical application. Printed implants were used in patient in a few cases and show successful results; however, longer follow-up and more trials are needed. Surgical and medical education is believed to be more efficient with this technology than the current practice. Printed surgical instrument and surgical planning are also believed to improve with three-dimensional printing. Three-dimensional printing can be a very powerful tool in the near future, which can aid the medical field that is facing a lot of challenges and obstacles. However, despite the reported results, further research on larger samples and analytical measurements should be conducted to ensure this technology's impact on the practice.

Surgical management of Gerhardt syndrome.

Science.gov (United States)

Chirilă, M; Mureşan, R; Cosgarea, M; Tomescu, E

2010-01-01

Adduction bilateral vocal fold immobility syndrome may be due by both recurrent laryngeal nerves paralysis--Gerhardt syndrome--and all intrinsic laryngeal muscles paralysis--Riegel syndrome. Etiology of Gerhardt syndrome is thyroid surgery, intubation's maneuver, trauma, neurological disorders, extrala-ryngeal malignancies. The manifestations of Gerhardt syndrome are inspiratory dyspnea and slightly influenced voicing by paramedian vocal folds paralysis with an important narrowing of the airway at the glottic level. The surgical procedures for enlargement of the glottic space can be classified in many ways and their major characteristics are: changes at the glottic level; surgical approach: open neck or endoscopic, with or without opening of the mucosal lining; the need for tracheostomy; the equipment used. The aim of this review is to expound the variety of interventions through the last century marked by the development of the diagnostic methods, the anesthesia and the surgical armament with sophisticated instruments and technologies.

The methodological quality of systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment

Directory of Open Access Journals (Sweden)

Vasconcelos Belmiro CE

2008-09-01

Full Text Available Abstract Background Temporomandibular joint disorders (TMJD are multifactor, complex clinical problems affecting approximately 60–70% of the general population, with considerable controversy about the most effective treatment. For example, reports claim success rates of 70% and 83% for non-surgical and surgical treatment, whereas other reports claim success rates of 40% to 70% for self-improvement without treatment. Therefore, the purpose of this study was to (1 identify systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment, (2 evaluate their methodological quality, and (3 evaluate the evidence grade within the systematic reviews. Methods A search strategy was developed and implemented for MEDLINE, Cochrane Library, LILACS, and Brazilian Dentistry Bibliography databases. Inclusion criteria were: systematic reviews (± meta-analysis comparing surgical and non-surgical TMJD treatment, published in English, Spanish, Portuguese, Italian, or German between the years 1966 and 2007(up to July. Exclusion criteria were: in vitro or animal studies; narrative reviews or editorials or editorial letters; and articles published in other languages. Two investigators independently selected and evaluated systematic reviews. Three different instruments (AMSTAR, OQAQ and CASP were used to evaluate methodological quality, and the results averaged. The GRADE instrument was used to evaluate the evidence grade within the reviews. Results The search strategy identified 211 reports; of which 2 were systematic reviews meeting inclusion criteria. The first review met 23.5 ± 6.0% and the second met 77.5 ± 12.8% of the methodological quality criteria (mean ± sd. In these systematic reviews between 9 and 15% of the trials were graded as high quality, and 2 and 8% of the total number of patients were involved in these studies. Conclusion The results indicate that in spite of the widespread impact of TMJD, and the multitude of

The impact of the use of different types of gloves and bare hands for preparation of clean surgical instruments.

Science.gov (United States)

Bruna, Camila Quartim de Moraes; Souza, Rafael Queiroz de; Massaia, Irineu Francisco Silva; Cruz, Áurea Silveira; Graziano, Kazuko Uchikawa

2016-10-10

to determine if there are differences on the safety of the preparation of clean surgical instruments using different types of gloves and bare hands and evaluate the microbiological load of these preparations without gloves. laboratory procedure with a pragmatic approach, in which the samples were handled with different types of gloves and bare hands. In addition, cytotoxicity assays were carried out by means of the agar diffusion method. Further samples were subjected to microbiological analysis after being handled without gloves. none of the samples showed cytotoxic effect. All microbiological cultures showed growth of microorganisms, but no microorganism has been recovered after autoclaving. there were no differences in the cytotoxic responses regarding the use of different types of gloves and bare hands in the handling of clean surgical instruments, which could entail iatrogenic risk. It is noteworthy that the use of gloves involves increase in the costs of process and waste generation, and the potential allergenic risk to latex. determinar se existe diferenças na segurança do preparo de instrumentais cirúrgicos relacionada ao uso de distintos tipos de luvas e das mãos nuas no preparo, e avaliar a carga microbiológica destes preparados sem luvas. experimento laboratorial com abordagem pragmática, onde amostras foram manipuladas com diferentes tipos de luvas e com as mãos nuas, elaborado teste de citotoxicidade por meio da difusão em ágar. Outras Amostras sofreram análise microbiológica após serem manipuladas sem luvas. nenhuma das amostras apresentou efeito citotóxico. Todas as culturas microbiológicas apresentaram crescimento de microrganismos, embora nenhum microrganismo tenha sido recuperado após a autoclavação. não houve diferenças nas respostas citotóxicas relacionadas ao uso de diferentes tipos de luvas e das mãos nuas na manipulação do instrumental cirúrgico limpo que sinalizasse risco de iatrogenia. Ressalta-se que o uso de luvas

Comparison between carbondioxide laser and cold instruments in treatment of vocal nodule

International Nuclear Information System (INIS)

Kundi, N.A.; Qayyum, A.; Ahmed, B.; Raza, M.

2013-01-01

Background: Vocal cord nodules are one of the most frequent disorders in both children and adults who use their voice excessively. Main symptom with which patient presents is hoarseness of voice. The treatment in early stages is voice therapy. Various methods are used for its treatment e.g. surgical removal with cold instruments and carbon dioxide laser ablation. Response to the treatment is measured by improvement in voice quality. Objective: To compare the results of Carbon dioxide laser and cold instruments in the treatment of vocal nodule. Study Design: Quasi-experimental study. Place and Duration of Study: This study was conducted at Otolaryngology Department Combined Military Hospital Rawalpindi. Patients and Methods: In this study 50 patients undergoing treatment of vocal cord nodule were included, 25 patients were treated by surgical removal with cold instruments and 25 patients were treated with carbon dioxide laser ablation. The main comparative outcomes were measured by patients' perception of voice quality (worse, same, improved) one week post operatively. Results: Improvement in voice quality with carbon dioxide laser was found to be clinically superior. Voice quality was significantly improved as compared to cold surgical instruments. Conclusion: Carbon dioxide laser causes early improvement in quality of voice as compared to cold instruments in the treatment of vocal nodules. (author)

Compact instrument for fluorescence image-guided surgery

Science.gov (United States)

Wang, Xinghua; Bhaumik, Srabani; Li, Qing; Staudinger, V. Paul; Yazdanfar, Siavash

2010-03-01

Fluorescence image-guided surgery (FIGS) is an emerging technique in oncology, neurology, and cardiology. To adapt intraoperative imaging for various surgical applications, increasingly flexible and compact FIGS instruments are necessary. We present a compact, portable FIGS system and demonstrate its use in cardiovascular mapping in a preclinical model of myocardial ischemia. Our system uses fiber optic delivery of laser diode excitation, custom optics with high collection efficiency, and compact consumer-grade cameras as a low-cost and compact alternative to open surgical FIGS systems. Dramatic size and weight reduction increases flexibility and access, and allows for handheld use or unobtrusive positioning over the surgical field.

3D Surgical Simulation

Science.gov (United States)

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

2009-01-01

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

Three-dimensional surgical simulation.

Science.gov (United States)

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

2010-09-01

In this article, we discuss the development of methods for computer-aided jaw surgery, which allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3-dimensional surface models from cone-beam computed tomography, dynamic cephalometry, semiautomatic mirroring, interactive cutting of bone, and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intraoperative guidance. The system provides further intraoperative assistance with a computer display showing jaw positions and 3-dimensional positioning guides updated in real time during the surgical procedure. The computer-aided surgery system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training, and assessing the difficulties of the surgical procedures before the surgery. Computer-aided surgery can make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Adjacent segment infection after surgical treatment of spondylodiscitis.

Science.gov (United States)

Siam, Ahmed Ezzat; El Saghir, Hesham; Boehm, Heinrich

2016-03-01

This is the first case series to describe adjacent segment infection (ASI) after surgical treatment of spondylodiscitis (SD). Patients with SD, spondylitis who were surgically treated between 1994 and 2012 were included. Out of 1187 cases, 23 (1.94 %) returned to our institution (Zentralklinik Bad Berka) with ASI: 10 males, 13 females, with a mean age of 65.1 years and a mean follow-up of 69 months. ASI most commonly involved L3-4 (seven patients), T12-L1 (five) and L2-3 (four). The mean interval between operations of primary infection and ASI was 36.9 months. All cases needed surgical intervention, debridement, reconstruction and fusion with longer instrumentation, with culture and sensitivity-based postoperative antimicrobial therapy. At last follow-up, six patients (26.1 %) were mobilized in a wheelchair with a varying degree of paraplegia (three had pre-existing paralysis). Three patients died within 2 months after the ASI operation (13 %). Excellent outcomes were achieved in five patients, and good in eight. Adjacent segment infection after surgical treatment of spondylodiscitis is a rare complication (1.94 %). It is associated with multimorbidity and shows a high mortality rate and a high neurological affection rate. Possible explanations are: haematomas of repeated micro-fractures around screw loosening, haematogenous spread, direct inoculation or a combination of these factors. ASI may also lead to proximal junctional kyphosis, as found in this series. We suggest early surgical intervention with anterior debridement, reconstruction and fusion with posterior instrumentation, followed by antimicrobial therapy for 12 weeks. Level IV retrospective uncontrolled case series.

Augmenting traditional instruments with a motion capture system

DEFF Research Database (Denmark)

Götzen, Amalia De; Vidolin, Alvise; Bernardini, Nicola

2013-01-01

This paper describes some composition works where the real instruments have been augmented through a motion capture system (Phasespace). While playing his instrument in the traditional way, the player is also controlling some other sound effects by moving his hands: the instrument becomes totally...

[Organising an instrumental elective abortion].

Science.gov (United States)

Brûlé, Annie

2015-12-01

Family planning centres are structures designed to receive and care for women requesting elective abortions. Here the specially trained, dedicated teams offer personalised care. The instrumental elective abortion is prepared in the same way as a surgical procedure and is subject to the same monitoring. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

functional outcome and quality of life after surgical management

African Journals Online (AJOL)

Objective: To determine the functional outcome and quality of life of acetabular ... Outcome measures: Modified Merle d'Aubigne scale and “Squat and Smile” test for functional outcome. ..... limited number of implants, few surgical instruments.

The effect of music on robot-assisted laparoscopic surgical performance.

Science.gov (United States)

Siu, Ka-Chun; Suh, Irene H; Mukherjee, Mukul; Oleynikov, Dmitry; Stergiou, Nick

2010-12-01

Music is often played in the operating room to increase the surgeon's concentration and to mask noise. It could have a beneficial effect on surgical performance. Ten participants with limited experience with the da Vinci robotic surgical system were recruited to perform two surgical tasks: suture tying and mesh alignment when classical, jazz, hip-hop, and Jamaican music were presented. Kinematics of the instrument tips of the surgical robot and surface electromyography of the subjects were recorded. Results revealed that a significant music effect was found for both tasks with decreased time to task completion (P = .005) and total travel distance (P = .021) as well as reduced muscle activations ( P = .016) and increased median muscle frequency (P = .034). Subjects improved their performance significantly when they listened to either hip-hop or Jamaican music. In conclusion, music with high rhythmicity has a beneficial effect on robotic surgical performance. Musical environment may benefit surgical training and make acquisition of surgical skills more efficient.

Choosing Environmental Policy Instruments in the Real World

International Nuclear Information System (INIS)

Greenspan Bell, R.

2003-01-01

In their enthusiasm for efficiency over other values, the advocates for market-based instruments for environmental control have reversed the order in which environmental solutions are found. They have written their prescriptions without first doing a physical examination of the patient; in other words, they have first recommended environmental instruments and secondarily tried to bend institutions to support the already identified cure. The engine for environmental regulation consists of the institutions available country by country to carry out environmental policy. Institutional inadequacies such as low functioning legal systems, historical experience (or inexperience) with markets, distorting and often institutionalised corruption, and public acceptance certainly can be fixed. But changing these fundamentals can be a long and arduous process. Those who advise governments to adopt reforms for which the institutional basis does not yet exist put the cart before the horse, a costly mistake that directs weak countries in the direction of solutions they have little hope of implementing. Instead, the donors and advisors should be seeking alternative approaches, for example to encourage incremental improvements and pragmatic goals, by considering a transitional or tiered approach that will take into account existing capabilities and institutions, at the same time acknowledging that a long learning curve lies ahead with inevitably uneven implementation and slippage from time to time. Another approach would be to find examples of small, albeit imperfect, efforts that seem to be working and building on them. The long-term goal should be efficient solutions, but only the most developed countries should be encouraged to attempt difficult environmental policy instruments like taxation and emissions trading schemes

Innovative instrumentation

International Nuclear Information System (INIS)

Anon.

1983-01-01

At this year's particle physics conference at Brighton, a parallel session was given over to instrumentation and detector development. While this work is vital to the health of research and its continued progress, its share of prime international conference time is limited. Instrumentation can be innovative three times — first when a new idea is outlined, secondly when it is shown to be feasible, and finally when it becomes productive in a real experiment, amassing useful data rather than operational experience. Hyams' examples showed that it can take a long time for a new idea to filter through these successive stages, if it ever makes it at all

Innovative instrumentation

Energy Technology Data Exchange (ETDEWEB)

Anon.

1983-11-15

At this year's particle physics conference at Brighton, a parallel session was given over to instrumentation and detector development. While this work is vital to the health of research and its continued progress, its share of prime international conference time is limited. Instrumentation can be innovative three times — first when a new idea is outlined, secondly when it is shown to be feasible, and finally when it becomes productive in a real experiment, amassing useful data rather than operational experience. Hyams' examples showed that it can take a long time for a new idea to filter through these successive stages, if it ever makes it at all.

Consistency of performance of robot-assisted surgical tasks in virtual reality.

Science.gov (United States)

Suh, I H; Siu, K-C; Mukherjee, M; Monk, E; Oleynikov, D; Stergiou, N

2009-01-01

The purpose of this study was to investigate consistency of performance of robot-assisted surgical tasks in a virtual reality environment. Eight subjects performed two surgical tasks, bimanual carrying and needle passing, with both the da Vinci surgical robot and a virtual reality equivalent environment. Nonlinear analysis was utilized to evaluate consistency of performance by calculating the regularity and the amount of divergence in the movement trajectories of the surgical instrument tips. Our results revealed that movement patterns for both training tasks were statistically similar between the two environments. Consistency of performance as measured by nonlinear analysis could be an appropriate methodology to evaluate the complexity of the training tasks between actual and virtual environments and assist in developing better surgical training programs.

Clinical Performance of Emergency Surgical Officers in Southern ...

African Journals Online (AJOL)

GB

The proportion of cesarean and instrumental deliveries over the total deliveries were 13% and 0.7%, respectively. Explorative laparotomies and appendectomies were the majority of the non-obstetric emergency operations. Interviewed staff in the respective hospitals stated that ESOs' clinical decision making, surgical skill ...

Study of Individual Characteristic Abdominal Wall Thickness Based on Magnetic Anchored Surgical Instruments

Directory of Open Access Journals (Sweden)

Ding-Hui Dong

2015-01-01

Full Text Available Background: Magnetic anchored surgical instruments (MASI, relying on magnetic force, can break through the limitations of the single port approach in dexterity. Individual characteristic abdominal wall thickness (ICAWT deeply influences magnetic force that determines the safety of MASI. The purpose of this study was to research the abdominal wall characteristics in MASI applied environment to find ICAWT, and then construct an artful method to predict ICAWT, resulting in better safety and feasibility for MASI. Methods: For MASI, ICAWT is referred to the thickness of thickest point in the applied environment. We determined ICAWT through finding the thickest point in computed tomography scans. We also investigated the traits of abdominal wall thickness to discover the factor that can be used to predict ICAWT. Results: Abdominal wall at C point in the middle third lumbar vertebra plane (L3 is the thickest during chosen points. Fat layer thickness plays a more important role in abdominal wall thickness than muscle layer thickness. "BMI-ICAWT" curve was obtained based on abdominal wall thickness of C point in L3 plane, and the expression was as follow: f(x = P1 × x 2 + P2 × x + P3, where P1 = 0.03916 (0.01776, 0.06056, P2 = 1.098 (0.03197, 2.164, P3 = −18.52 (−31.64, −5.412, R-square: 0.99. Conclusions: Abdominal wall thickness of C point at L3 could be regarded as ICAWT. BMI could be a reliable predictor of ICAWT. In the light of "BMI-ICAWT" curve, we may conveniently predict ICAWT by BMI, resulting a better safety and feasibility for MASI.

Building a framework for ergonomic research on laparoscopic instrument handles.

Science.gov (United States)

Li, Zheng; Wang, Guohui; Tan, Juan; Sun, Xulong; Lin, Hao; Zhu, Shaihong

2016-06-01

Laparoscopic surgery carries the advantage of minimal invasiveness, but ergonomic design of the instruments used has progressed slowly. Previous studies have demonstrated that the handle of laparoscopic instruments is vital for both surgical performance and surgeon's health. This review provides an overview of the sub-discipline of handle ergonomics, including an evaluation framework, objective and subjective assessment systems, data collection and statistical analyses. Furthermore, a framework for ergonomic research on laparoscopic instrument handles is proposed to standardize work on instrument design. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

The Development of a Novel Perfused Cadaver Model With Dynamic Vital Sign Regulation and Real-World Scenarios to Teach Surgical Skills and Error Management.

Science.gov (United States)

Minneti, Michael; Baker, Craig J; Sullivan, Maura E

The landscape of graduate medical education has changed dramatically over the past decade and the traditional apprenticeship model has undergone scrutiny and modifications. The mandate of the 80-hour work-week, the introduction of integrated residency programs, increased global awareness about patient safety along with financial constraints have spurred changes in graduate educational practices. In addition, new technologies, more complex procedures, and a host of external constraints have changed where and how we teach technical and procedural skills. Simulation-based training has been embraced by the surgical community and has quickly become an essential component of most residency programs as a method to add efficacy to the traditional learning model. The purpose of this paper is twofold: (1) to describe the development of a perfused cadaver model with dynamic vital sign regulation, and (2) to assess the impact of a curriculum using this model and real world scenarios to teach surgical skills and error management. By providing a realistic training environment our aim is to enhance the acquisition of surgical skills and provide a more thorough assessment of resident performance. Twenty-six learners participated in the scenarios. Qualitative data showed that participants felt that the simulation model was realistic, and that participating in the scenarios helped them gain new knowledge, learn new surgical techniques and increase their confidence performing the skill in a clinical setting. Identifying the importance of both technical and nontechnical skills in surgical education has hastened the need for more realistic simulators and environments in which they are placed. Team members should be able to interact in ways that allow for a global display of their skills thus helping to provide a more comprehensive assessment by faculty and learners. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

An instrument for real time detection of contamination in space environmental tests chambers

Science.gov (United States)

Richmond, R. G.; Harmon, H. N.

1972-01-01

An instrument for in situ vacuum detection of surface reflectance changes at 1216A was designed. Using successive reflections, this instrument is more sensitive as an indicator of reflectance changes than similar instruments having only a single reflection. The selection of each component of the instrument and its operational performance is discussed.

Evaluation of Augmented Reality Feedback in Surgical Training Environment.

Science.gov (United States)

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

2018-02-01

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

Review of emerging surgical robotic technology.

Science.gov (United States)

Peters, Brian S; Armijo, Priscila R; Krause, Crystal; Choudhury, Songita A; Oleynikov, Dmitry

2018-04-01

The use of laparoscopic and robotic procedures has increased in general surgery. Minimally invasive robotic surgery has made tremendous progress in a relatively short period of time, realizing improvements for both the patient and surgeon. This has led to an increase in the use and development of robotic devices and platforms for general surgery. The purpose of this review is to explore current and emerging surgical robotic technologies in a growing and dynamic environment of research and development. This review explores medical and surgical robotic endoscopic surgery and peripheral technologies currently available or in development. The devices discussed here are specific to general surgery, including laparoscopy, colonoscopy, esophagogastroduodenoscopy, and thoracoscopy. Benefits and limitations of each technology were identified and applicable future directions were described. A number of FDA-approved devices and platforms for robotic surgery were reviewed, including the da Vinci Surgical System, Sensei X Robotic Catheter System, FreeHand 1.2, invendoscopy E200 system, Flex® Robotic System, Senhance, ARES, the Single-Port Instrument Delivery Extended Research (SPIDER), and the NeoGuide Colonoscope. Additionally, platforms were reviewed which have not yet obtained FDA approval including MiroSurge, ViaCath System, SPORT™ Surgical System, SurgiBot, Versius Robotic System, Master and Slave Transluminal Endoscopic Robot, Verb Surgical, Miniature In Vivo Robot, and the Einstein Surgical Robot. The use and demand for robotic medical and surgical platforms is increasing and new technologies are continually being developed. New technologies are increasingly implemented to improve on the capabilities of previously established systems. Future studies are needed to further evaluate the strengths and weaknesses of each robotic surgical device and platform in the operating suite.

Evaluation of Instrumentation and Dynamic Thermal Ratings for Overhead Lines

Energy Technology Data Exchange (ETDEWEB)

Phillips, A. [New York Power Authority, White Plains, NY (United States)

2013-01-31

In 2010, a project was initiated through a partnership between the Department of Energy (DOE) and the New York Power Authority (NYPA) to evaluate EPRI's rating technology and instrumentation that can be used to monitor the thermal states of transmission lines and provide the required real-time data for real-time rating calculations. The project included the installation and maintenance of various instruments at three 230 kV line sites in northern New York. The instruments were monitored, and data collection and rating calculations were performed for about a three year period.

The application of digital surgical diagnosis and treatment technology: a promising strategy for surgical reconstruction of craniomaxillofacial defect and deformity.

Science.gov (United States)

Wang, Li-ya; Du, Hong-ming; Zhang, Gang; Tang, Wei; Liu, Lei; Jing, Wei; Long, Jie

2011-12-01

The craniomaxillofacial defect and deformity always leads to serious dysfunction in mastication and facial contour damage, significantly reducing patients' quality of life. However, surgical reconstruction of a craniomaxillofacial hard tissue defect or deformity is extremely complex and often does not result in desired facial morphology. Improving the result for patients with craniomaxillofacial defect and deformity remains a challenge for surgeons. Using digital technology for surgical diagnosis and treatment may help solve this problem. Computer-assisted surgical technology and surgical navigation technology are included in the accurate digital diagnosis and treatment system we propose. These technologies will increase the accuracy of the design of the operation plan. In addition, the intraoperative real-time navigating location system controlling the robotic arm or advanced intelligent robot will provide accurate, individualized surgical treatment for patients. Here we propose the hypothesis that a digital surgical diagnosis and treatment technology may provide a new approach for precise surgical reconstruction of complicated craniomaxillofacial defect and deformity. Our hypothesis involves modern digital surgery, a three-dimensional navigation surgery system and modern digital imaging technology, and our key aim is to establish a technological platform for customized digital surgical design and surgical navigation for craniomaxillofacial defect and deformity. If the hypothesis is proven practical, this novel therapeutic approach could improve the result of surgical reconstruction for craniomaxillofacial defect and deformity for many patients. Copyright © 2011 Elsevier Ltd. All rights reserved.

Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation in surgical treatment for single-segment lumbar spinal tuberculosis.

Science.gov (United States)

Zeng, Hao; Wang, Xiyang; Zhang, Penghui; Peng, Wei; Liu, Zheng; Zhang, Yupeng

2015-01-01

The aim of this study is to determine the feasibility and efficacy of surgical management of single-segment lumbar spinal tuberculosis (TB) by using single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation. Seventeen cases of single-segment lumbar TB were treated with single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation. The mean follow-up was 36.9 months (range: 24-62 months). The kyphotic angle ranged from 15.2-35.1° preoperatively, with an average measurement of 27.8°. The American Spinal Injury Association (ASIA) score system was used to evaluate the neurological deficits and erythrocyte sedimentation rate (ESR) used to judge the activity of TB. Spinal TB was completely cured in all 17 patients. There was no recurrent TB infection. The postoperative kyphotic angle was 6.6-10.2°, 8.1° in average, and there was no significant loss of the correction at final follow-up. Solid fusion was achieved in all cases. Neurological condition in all patients was improved after surgery. Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation can be a feasible and effective method the in treatment of single-segment lumbar spinal TB.

Excised Abdominoplasty Material as a Systematic Plastic Surgical Training Model

Directory of Open Access Journals (Sweden)

M. Erol Demirseren

2012-01-01

Full Text Available Achieving a level of technical skill and confidence in surgical operations is the main goal of plastic surgical training. Operating rooms were accepted as the practical teaching venues of the traditional apprenticeship model. However, increased patient population, time, and ethical and legal considerations made preoperation room practical work a must for plastic surgical training. There are several plastic surgical teaching models and simulators which are very useful in preoperation room practical training and the evaluation of plastic surgery residents. The full thickness skin with its vascular network excised in abdominoplasty procedures is an easily obtainable real human tissue which could be used as a training model in plastic surgery.

Measuring patient participation in surgical treatment decision-making from healthcare professionals' perspective.

Science.gov (United States)

Heggland, Liv-Helen; Mikkelsen, Aslaug; Øgaard, Torvald; Hausken, Kjell

2014-02-01

To develop, empirical test, and validate an instrument measuring patient participation in surgical treatment decision-making from healthcare professionals' perspective. Since the advent of New Public Management in many Western countries, patient participation in healthcare decision-making has been considered to be a best practice. A common notion is that well-educated and well-informed public want to choose their own treatments and providers and want to ask questions about the quality of their health services. Survey. A self-report-measuring instrument was designed and administered to 620 healthcare professionals. Items were developed, validated and tested by 451 nurses and physicians working in six surgical wards in a University Hospital in Norway. A 16-item scale with the following four dimensions was developed: information dissemination, formulation of options, integration of information and control. Factor analysis procedures and reliability testing were performed. A one-way, between-groups analysis of variance was conducted to compare doctors' and nurses' opinions on four dimensions of patient participation in surgical treatment decision-making. This article shows that patient participation in surgical treatment decision-making can be measured by a 16-item scale and four distinct dimensions. The analysis demonstrated a reasonable level of construct validity and reliability. Nurses and physicians have a positive attitude towards patient participation overall, but the two groups differ in the extent to which they accept the idea of patient participation in treatment decision-making. The instrument can be a tool for managers and healthcare professionals in the implementation of patient participation in clinical practice. Data from the instrument can be useful to identify health services being provided and what areas that could strengthen patient participation. © 2013 Blackwell Publishing Ltd.

Overview: Field instrumentation - A Mikado's dream

International Nuclear Information System (INIS)

Spittler, T.M.

1992-01-01

The Mikado of Gilbert ampersand Sullivan fame held out as an open-quotes object all sublimeclose quotes which he hoped to open-quotes achieve in timeclose quotes the fitting of the punishment to the crime. Like that potentate, I too have long held the hope of finding instrumentation which is ideally suited to measurement of environmental contaminants in the field. Today, at least one of us has had that dream fulfilled. For years, those of us interested in field analysis have had to apply time consuming and cumbersome methods to relatively simple and often short-term environmental measurement problems. Meanwhile, we watched the literature and perused the product blurbs in hopes of finding the ideal tools for on-site, real time analysis. Of course, that search will always go forward as better instruments are developed. Today we can finally point to many pieces of equipment that are on the market and which provide high quality data in real time for a number of the most important environmental contaminants. Furthermore, the sensitivity of some of these field instruments exceeds that of conventional lab instrumentation. Coupled with innovative techniques for sample preparation and proper quality control, field instrumentation can often go a long way to solving problems in rapid detection, quantitation, and positive identification

In vivo virtual intraoperative surgical photoacoustic microscopy

International Nuclear Information System (INIS)

Han, Seunghoon; Kim, Sehui; Kim, Jeehyun; Lee, Changho; Jeon, Mansik; Kim, Chulhong

2013-01-01

We developed a virtual intraoperative surgical photoacoustic microscopy system by combining with a commercial surgical microscope and photoacoustic microscope (PAM). By sharing the common optical path in the microscope and PAM system, we could acquire the PAM and microscope images simultaneously. Moreover, by employing a beam projector to back-project 2D PAM images onto the microscope view plane as augmented reality, the conventional microscopic and 2D cross-sectional PAM images are concurrently mapped on the plane via an ocular lens of the microscope in real-time. Further, we guided needle insertion into phantom ex vivo and mice skins in vivo

In vivo virtual intraoperative surgical photoacoustic microscopy

Energy Technology Data Exchange (ETDEWEB)

Han, Seunghoon, E-mail: hsh860504@gmail.com; Kim, Sehui, E-mail: sehui0916@nate.com; Kim, Jeehyun, E-mail: jeehk@knu.ac.kr, E-mail: chulhong@postech.edu [School of Electrical Engineering and Computer Science, Kyungpook National University, Daegu 702-701 (Korea, Republic of); Lee, Changho, E-mail: ch31037@postech.edu; Jeon, Mansik, E-mail: msjeon@postech.edu [Department of Creative IT Engineering, Pohang University of Science and Technology (POSTECH), Pohang 790-784 (Korea, Republic of); Kim, Chulhong, E-mail: jeehk@knu.ac.kr, E-mail: chulhong@postech.edu [Department of Creative IT Engineering, Pohang University of Science and Technology (POSTECH), Pohang 790-784 (Korea, Republic of); Department of Biomedical Engineering, The State University of New York at Buffalo, Buffalo, New York 14221 (United States)

2013-11-11

We developed a virtual intraoperative surgical photoacoustic microscopy system by combining with a commercial surgical microscope and photoacoustic microscope (PAM). By sharing the common optical path in the microscope and PAM system, we could acquire the PAM and microscope images simultaneously. Moreover, by employing a beam projector to back-project 2D PAM images onto the microscope view plane as augmented reality, the conventional microscopic and 2D cross-sectional PAM images are concurrently mapped on the plane via an ocular lens of the microscope in real-time. Further, we guided needle insertion into phantom ex vivo and mice skins in vivo.

Development of an Educational Game to Set Up Surgical Instruments on the Mayo Stand or Back Table: Applied Research in Production Technology.

Science.gov (United States)

Paim, Crislaine Pires Padilha; Goldmeier, Silvia

2017-01-10

Existing research suggests that digital games can be used effectively for educational purposes at any level of training. Perioperative nursing educators can use games to complement curricula, in guidance and staff development programs, to foster team collaboration, and to give support to critical thinking in nursing practice because it is a complex environment. To describe the process of developing an educational game to set up surgical instruments on the Mayo stand or back table as a resource to assist the instructor in surgical instrumentation training for students and nursing health professionals in continued education. The study was characterized by applied research in production technology. It included the phases of analysis and design, development, and evaluation. The objectives of the educational game were developed through Bloom's taxonomy. Parallel to the physical development of the educational game, a proposed model for the use of digital elements in educational game activities was applied to develop the game content. The development of the game called "Playing with Tweezers" was carried out in 3 phases and was evaluated by 15 participants, comprising students and professional experts in various areas of knowledge such as nursing, information technology, and education. An environment was created with an initial screen, menu buttons containing the rules of the game, and virtual tour modes for learning and assessment. The "digital" nursing student needs engagement, stimulation, reality, and entertainment, not just readings. "Playing with Tweezers" is an example of educational gaming as an innovative teaching strategy in nursing that encourages the strategy of involving the use of educational games to support theoretical or practical classroom teaching. Thus, the teacher does not work with only 1 type of teaching methodology, but with a combination of different methodologies. In addition, we cannot forget that skill training in an educational game does not

The Application of Surgical Navigation in the Treatment of Temporomandibular Joint Ankylosis.

Science.gov (United States)

Sun, Guowen; Lu, Mingxing; Hu, Qingang

2015-11-01

The purpose of this study was to assess the safety and the accuracy of surgical navigation technology in the resection of severe ankylosis of the mandibular condyle with the middle cranial fossa. The computed tomography scan data were transferred to a Windows-based computer workstation, and the patient's individual anatomy was assessed in multiplanar views at the workstation. In the operation, the patient and the virtual image were matched by individual registration with the reference points which were set on the skull bone surface and the teeth. Then, the real-time navigation can be performed. The acquisition of the data sets was uncomplicated, and image quality was sufficient to assess the operative result in 2 cases. Both of the operations were performed successfully with the guidance of real-time navigation. The application of surgical navigation has enhanced the safety and the accuracy of the surgery for bony ankylosis of temporomandibular joint. The use of surgical navigation resulted in the promotion of accurate and safe surgical excision of the ankylosed skull base tissue.

Surgical Clipping versus Endovascular Intervention for the Treatment of Subarachnoid Hemorrhage Patients in New York State.

Directory of Open Access Journals (Sweden)

Kimon Bekelis

Full Text Available Randomized trials have demonstrated a survival benefit for endovascular treatment of ruptured cerebral aneurysms. We investigated the association of surgical clipping and endovascular coiling with outcomes in subarachnoid hemorrhage (SAH patients in a real-world regional cohort.We performed a cohort study involving patients with ruptured cerebral aneurysms, who underwent surgical clipping, or endovascular coiling from 2009-2013 and were registered in the Statewide Planning and Research Cooperative System (SPARCS database. An instrumental variable analysis was used to investigate the association of treatment technique with outcomes.Of the 4,098 patients undergoing treatment, 2,585 (63.1% underwent coiling, and 1,513 (36.9% underwent clipping. Using an instrumental variable analysis, we did not identify a difference in inpatient mortality [marginal effect (ME, -0.56; 95% CI, -1.03 to 0.02], length of stay (LOS (ME, 1.72; 95% CI, -3.39 to 6.84, or the rate of 30-day readmissions (ME, -0.30; 95% CI, -0.82 to 0.22 between the two treatment techniques for patients with SAH. Clipping was associated with a higher rate of discharge to rehabilitation (ME, 0.63; 95% CI, 0.24 to 1.01. In sensitivity analysis, mixed effect regression, and propensity score adjusted regression models demonstrated identical results.Using a comprehensive all-payer cohort of patients in New York State presenting with aneurysmal SAH we did not identify an association of treatment method with mortality, LOS or 30-day readmission. Clipping was associated with a higher rate of discharge to rehabilitation.

Thermal processes identification using virtual instrumentation

Directory of Open Access Journals (Sweden)

Iosif OLAH

2007-12-01

Full Text Available In this paper the experimental identification problem of thermal processes is presented, in order to establish their mathematical models which permit the adoption of the automation solutions, respectively the specification of a suitable control law. With this aim in view, the authors resorted to use Virtual Instrumentation with the aid of the LabVIEW development medium. In order to solve the problem of acquisition and processing data from physical real processes, Virtual Instruments which provide at the end a mathematical model which is basis of choosing the automation equipment of the aim followed was designed and achieved. The achieved Virtual Instruments get the opportunity to be used either in student instruction field with the virtual processes identification techniques or to put the identification of some real processes to good use of diverse beneficiaries. The results of some experimental attempts which were achieved during different thermal processes, illustrate the utility of the demarches performed in this paper.

Creating a Super Instrument

DEFF Research Database (Denmark)

Kallionpää, Maria; Gasselseder, Hans-Peter

2015-01-01

Thanks to the development of new technology, musical instruments are no more tied to their existing acoustic or technical limitations as almost all parameters can be augmented or modified in real time. An increasing number of composers, performers, and computer programmers have thus become intere...

Current Limitations of Surgical Robotics in Reconstructive Plastic Microsurgery

Directory of Open Access Journals (Sweden)

Youri P. A. Tan

2018-03-01

Full Text Available Surgical robots have the potential to provide surgeons with increased capabilities, such as removing physiologic tremor, scaling motion and increasing manual dexterity. Several surgical specialties have subsequently integrated robotic surgery into common clinical practice. Plastic and reconstructive microsurgical procedures have not yet  benefitted significantly from technical developments observed over the last two decades. Several studies have successfully demonstrated the feasibility of utilising surgical robots in plastic surgery procedures, yet limited work has been done to identify and analyse current barriers that have prevented wide-scale adaptation of surgical robots for microsurgery. Therefore, a systematic review using PubMed, MEDLINE, Embase and Web of Science databases was performed, in order to evaluate current state of surgical robotics within the field of reconstructive microsurgery and their limitations. Despite the theoretical potential of surgical robots, current commercially available robotic systems are suboptimal for plastic or reconstructive microsurgery. Absence of bespoke microsurgical instruments, increases in operating time, and high costs associated with robotic-assisted provide a barrier to using such systems effectively for reconstructive microsurgery. Consequently, surgical robots provide currently little overall advantage over conventional microsurgery. Nevertheless, if current barriers can be addressed and systems are specifically designed for microsurgery, surgical robots may have the potential of meaningful impact on clinical outcomes within  this surgical subspeciality.

Current Limitations of Surgical Robotics in Reconstructive Plastic Microsurgery

Science.gov (United States)

Tan, Youri P. A.; Liverneaux, Philippe; Wong, Jason K. F.

2018-01-01

Surgical robots have the potential to provide surgeons with increased capabilities, such as removing physiologic tremor, scaling motion and increasing manual dexterity. Several surgical specialties have subsequently integrated robotic surgery into common clinical practice. Plastic and reconstructive microsurgical procedures have not yet  benefitted significantly from technical developments observed over the last two decades. Several studies have successfully demonstrated the feasibility of utilising surgical robots in plastic surgery procedures, yet limited work has been done to identify and analyse current barriers that have prevented wide-scale adaptation of surgical robots for microsurgery. Therefore, a systematic review using PubMed, MEDLINE, Embase and Web of Science databases was performed, in order to evaluate current state of surgical robotics within the field of reconstructive microsurgery and their limitations. Despite the theoretical potential of surgical robots, current commercially available robotic systems are suboptimal for plastic or reconstructive microsurgery. Absence of bespoke microsurgical instruments, increases in operating time, and high costs associated with robotic-assisted provide a barrier to using such systems effectively for reconstructive microsurgery. Consequently, surgical robots provide currently little overall advantage over conventional microsurgery. Nevertheless, if current barriers can be addressed and systems are specifically designed for microsurgery, surgical robots may have the potential of meaningful impact on clinical outcomes within  this surgical subspeciality. PMID:29740585

Towards real-time remote processing of laparoscopic video

Science.gov (United States)

Ronaghi, Zahra; Duffy, Edward B.; Kwartowitz, David M.

2015-03-01

Laparoscopic surgery is a minimally invasive surgical technique where surgeons insert a small video camera into the patient's body to visualize internal organs and small tools to perform surgical procedures. However, the benefit of small incisions has a drawback of limited visualization of subsurface tissues, which can lead to navigational challenges in the delivering of therapy. Image-guided surgery (IGS) uses images to map subsurface structures and can reduce the limitations of laparoscopic surgery. One particular laparoscopic camera system of interest is the vision system of the daVinci-Si robotic surgical system (Intuitive Surgical, Sunnyvale, CA, USA). The video streams generate approximately 360 megabytes of data per second, demonstrating a trend towards increased data sizes in medicine, primarily due to higher-resolution video cameras and imaging equipment. Processing this data on a bedside PC has become challenging and a high-performance computing (HPC) environment may not always be available at the point of care. To process this data on remote HPC clusters at the typical 30 frames per second (fps) rate, it is required that each 11.9 MB video frame be processed by a server and returned within 1/30th of a second. The ability to acquire, process and visualize data in real-time is essential for performance of complex tasks as well as minimizing risk to the patient. As a result, utilizing high-speed networks to access computing clusters will lead to real-time medical image processing and improve surgical experiences by providing real-time augmented laparoscopic data. We aim to develop a medical video processing system using an OpenFlow software defined network that is capable of connecting to multiple remote medical facilities and HPC servers.

Virtual reality cerebral aneurysm clipping simulation with real-time haptic feedback.

Science.gov (United States)

Alaraj, Ali; Luciano, Cristian J; Bailey, Daniel P; Elsenousi, Abdussalam; Roitberg, Ben Z; Bernardo, Antonio; Banerjee, P Pat; Charbel, Fady T

2015-03-01

With the decrease in the number of cerebral aneurysms treated surgically and the increase of complexity of those treated surgically, there is a need for simulation-based tools to teach future neurosurgeons the operative techniques of aneurysm clipping. To develop and evaluate the usefulness of a new haptic-based virtual reality simulator in the training of neurosurgical residents. A real-time sensory haptic feedback virtual reality aneurysm clipping simulator was developed using the ImmersiveTouch platform. A prototype middle cerebral artery aneurysm simulation was created from a computed tomographic angiogram. Aneurysm and vessel volume deformation and haptic feedback are provided in a 3-dimensional immersive virtual reality environment. Intraoperative aneurysm rupture was also simulated. Seventeen neurosurgery residents from 3 residency programs tested the simulator and provided feedback on its usefulness and resemblance to real aneurysm clipping surgery. Residents thought that the simulation would be useful in preparing for real-life surgery. About two-thirds of the residents thought that the 3-dimensional immersive anatomic details provided a close resemblance to real operative anatomy and accurate guidance for deciding surgical approaches. They thought the simulation was useful for preoperative surgical rehearsal and neurosurgical training. A third of the residents thought that the technology in its current form provided realistic haptic feedback for aneurysm surgery. Neurosurgical residents thought that the novel immersive VR simulator is helpful in their training, especially because they do not get a chance to perform aneurysm clippings until late in their residency programs.

[Spinal instrumentation, source of progress, but also revealing pitfalls].

Science.gov (United States)

Dubousset, Jean

2003-01-01

The second half of the XXo century and especially the last 30 years have been the source of a great improvement for surgical treatment of spinal pathology essentially in 3 directions:--First, for the patient himself and his comfort by suppression for most of the cases of any post operative external support thanks to the rigidity, security and strength of segmental fixation given by the hooks, screws and rods systems, as well for posterior as anterior instrumentation. In addition, these new techniques allow the patient to return quickly to standing and walking activity and subsequently the surgery for adult people increased dramatically especially for all kind of degenerative diseases and more and more extended spinal deformities.--The second major improvement came from the real and new understanding of the 3 dimensions for all the physiology and pathology of the spine leading to practical applications for the design and surgical strategies for correction. The exploding expansion of the era of computer technology brought a lot of help in such understanding as well as for the development of spinal instrumentation.--Finally the impressive development of medical imaging with CT scan and less and less invasive techniques like MRI allow a much better vision of spinal cord and roots (a major concern for the spinal surgeon). All this occurs also because simultaneous revolution occurred in the field of anesthesia and intensive care especially post operatively, but also because the big progress for monitoring of vital function as well as neurological monitoring during surgery. The consequence of that was an improvement for the results concerning the patient for functional quality of life as well as for cosmesis. The subsequent failures resulting of these improvements came from various fields even if we exclude infection or neurological complications more and more controlled now.--At the level of the indications because of these lack of post operative external immobilization

Validation of a virtual reality-based robotic surgical skills curriculum.

Science.gov (United States)

Connolly, Michael; Seligman, Johnathan; Kastenmeier, Andrew; Goldblatt, Matthew; Gould, Jon C

2014-05-01

The clinical application of robotic-assisted surgery (RAS) is rapidly increasing. The da Vinci Surgical System™ is currently the only commercially available RAS system. The skills necessary to perform robotic surgery are unique from those required for open and laparoscopic surgery. A validated laparoscopic surgical skills curriculum (fundamentals of laparoscopic surgery or FLS™) has transformed the way surgeons acquire laparoscopic skills. There is a need for a similar skills training and assessment tool specific for robotic surgery. Based on previously published data and expert opinion, we developed a robotic skills curriculum. We sought to evaluate this curriculum for evidence of construct validity (ability to discriminate between users of different skill levels). Four experienced surgeons (>20 RAS) and 20 novice surgeons (first-year medical students with no surgical or RAS experience) were evaluated. The curriculum comprised five tasks utilizing the da Vinci™ Skills Simulator (Pick and Place, Camera Targeting 2, Peg Board 2, Matchboard 2, and Suture Sponge 3). After an orientation to the robot and a period of acclimation in the simulator, all subjects completed three consecutive repetitions of each task. Computer-derived performance metrics included time, economy of motion, master work space, instrument collisions, excessive force, distance of instruments out of view, drops, missed targets, and overall scores (a composite of all metrics). Experienced surgeons significantly outperformed novice surgeons in most metrics. Statistically significant differences were detected for each task in regards to mean overall scores and mean time (seconds) to completion. The curriculum we propose is a valid method of assessing and distinguishing robotic surgical skill levels on the da Vinci Si™ Surgical System. Further study is needed to establish proficiency levels and to demonstrate that training on the simulator with the proposed curriculum leads to improved robotic

Analysis of the learning curve for transurethral resection of the prostate. Is there any influence of musical instrument and video game skills on surgical performance?

Science.gov (United States)

Yamaçake, Kleiton Gabriel Ribeiro; Nakano, Elcio Tadashi; Soares, Iva Barbosa; Cordeiro, Paulo; Srougi, Miguel; Antunes, Alberto Azoubel

2015-09-01

To evaluate the learning curve for transurethral resection of the prostate (TURP) among urology residents and study the impact of video game and musical instrument playing abilities on its performance. A prospective study was performed from July 2009 to January 2013 with patients submitted to TURP for benign prostatic hyperplasia. Fourteen residents operated on 324 patients. The following parameters were analyzed: age, prostate-specific antigen levels, prostate weight on ultrasound, pre- and postoperative serum sodium and hemoglobin levels, weight of resected tissue, operation time, speed of resection, and incidence of capsular lesions. Gender, handedness, and prior musical instrument and video game playing experience were recorded using survey responses. The mean resection speed in the first 10 procedures was 0.36 g/min and reached a mean of 0.51 g/min after the 20(th) procedure. The incidence of capsular lesions decreased progressively. The operation time decreased progressively for each subgroup regardless of the difference in the weight of tissue resected. Those experienced in playing video games presented superior resection speed (0.45 g/min) when compared with the novice (0.35 g/min) and intermediate (0.38 g/min) groups (p=0.112). Musical instrument playing abilities did not affect the surgical performance. Speed of resection, weight of resected tissue, and percentage of resected tissue improve significantly and the incidence of capsular lesions reduces after the performance of 10 TURP procedures. Experience in playing video games or musical instruments does not have a significant effect on outcomes.

Development and preliminary validation of a post-fistula repair reintegration instrument among Ugandan women

OpenAIRE

El Ayadi, Alison; Nalubwama, Hadija; Barageine, Justus; Neilands, Torsten B.; Obore, Susan; Byamugisha, Josaphat; Kakaire, Othman; Mwanje, Haruna; Korn, Abner; Lester, Felicia; Miller, Suellen

2017-01-01

Background Obstetric fistula is a debilitating and traumatic birth injury affecting 2?3 million women globally, mostly in sub-Saharan Africa and Asia. Affected women suffer physically, psychologically and socioeconomically. International efforts have increased access to surgical treatment, yet attention to a holistic outcome of post-surgical rehabilitation is nascent. We sought to develop and pilot test a measurement instrument to assess post-surgical family and community reintegration. Metho...

Visualization and simulation techniques for surgical simulators using actual patient's data.

Science.gov (United States)

Radetzky, Arne; Nürnberger, Andreas

2002-11-01

Because of the increasing complexity of surgical interventions research in surgical simulation became more and more important over the last years. However, the simulation of tissue deformation is still a challenging problem, mainly due to the short response times that are required for real-time interaction. The demands to hard and software are even larger if not only the modeled human anatomy is used but the anatomy of actual patients. This is required if the surgical simulator should be used as training medium for expert surgeons rather than students. In this article, suitable visualization and simulation methods for surgical simulation utilizing actual patient's datasets are described. Therefore, the advantages and disadvantages of direct and indirect volume rendering for the visualization are discussed and a neuro-fuzzy system is described, which can be used for the simulation of interactive tissue deformations. The neuro-fuzzy system makes it possible to define the deformation behavior based on a linguistic description of the tissue characteristics or to learn the dynamics by using measured data of real tissue. Furthermore, a simulator for minimally-invasive neurosurgical interventions is presented that utilizes the described visualization and simulation methods. The structure of the simulator is described in detail and the results of a system evaluation by an experienced neurosurgeon--a quantitative comparison between different methods of virtual endoscopy as well as a comparison between real brain images and virtual endoscopies--are given. The evaluation proved that the simulator provides a higher realism of the visualization and simulation then other currently available simulators. Copyright 2002 Elsevier Science B.V.

In-pile Instrumentation Development

International Nuclear Information System (INIS)

Vermeeren, L.

2005-01-01

Advanced irradiations in research reactors require the on-line monitoring of crucial parameters like neutron fluxes, gamma dose rates, central fuel rod temperatures, fission gas release pressures and small geometry changes. Our activities in this field aim at a detailed understanding of the sensor behaviour in the irradiation conditions in order to extract reliable real-time information. The objectives of work performed by SCK-CEN are to study of the on-line in-pile measurement of gamma and neutron fluxes in real time and to investigate parasitic radiation-induced signals in instrumentation cables

Minimally invasive surgical treatment of valvular heart disease.

Science.gov (United States)

Goldstone, Andrew B; Joseph Woo, Y

2014-01-01

Cardiac surgery is in the midst of a practice revolution. Traditionally, surgery for valvular heart disease consisted of valve replacement via conventional sternotomy using cardiopulmonary bypass. However, over the past 20 years, the increasing popularity of less-invasive procedures, accompanied by advancements in imaging, surgical instrumentation, and robotic technology, has motivated and enabled surgeons to develop and perform complex cardiac surgical procedures through small incisions, often eliminating the need for sternotomy or cardiopulmonary bypass. In addition to the benefits of improved cosmesis, minimally invasive mitral valve surgery was pioneered with the intent of reducing morbidity, postoperative pain, blood loss, hospital length of stay, and time to return to normal activity. This article reviews the current state-of-the-art of minimally invasive approaches to the surgical treatment of valvular heart disease. Copyright © 2014 Elsevier Inc. All rights reserved.

Voice tuning with new instruments for type II thyroplasty in the treatment of adductor spasmodic dysphonia.

Science.gov (United States)

Sanuki, Tetsuji; Yumoto, Eiji; Toya, Yutaka; Kumai, Yoshihiko

2016-10-01

Adductor spasmodic dysphonia is a rare voice disorder characterized by strained and strangled voice quality with intermittent phonatory breaks and adductory vocal fold spasms. Type II thyroplasty differs from previous treatments in that this surgery does not involve any surgical intervention into the laryngeal muscle, nerve or vocal folds. Type II thyroplasty intervenes in the thyroid cartilage, which is unrelated to the lesion. This procedure, conducted with the aim of achieving lateralization of the vocal folds, requires utmost surgical caution due to the extreme delicacy of the surgical site, critically sensitive adjustment, and difficult procedures to maintain the incised cartilages at a correct position. During surgery, the correct separation of the incised cartilage edges with voice monitoring is the most important factor determining surgical success and patient satisfaction. We designed new surgical instruments: a thyroid cartilage elevator for undermining the thyroid cartilage, and spacer devices to gauge width while performing voice monitoring. These devices were designed to prevent surgical complications, and to aid in selecting the optimal size of titanium bridges while temporally maintaining a separation during voice monitoring. We designed new surgical instruments, including a thyroid cartilage elevator and spacer devices. Precise surgical procedures and performing voice tuning during surgery with the optimal separation width of the thyroid cartilage are key points for surgical success. We introduce the technique of voice tuning using these surgical tools in order to achieve a better outcome with minimal surgical complications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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

Directory of Open Access Journals (Sweden)

Łępicka M.

2016-09-01

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

LabVIEW Real-Time

CERN Multimedia

CERN. Geneva; Flockhart, Ronald Bruce; Seppey, P

2003-01-01

With LabVIEW Real-Time, you can choose from a variety of RT Series hardware. Add a real-time data acquisition component into a larger measurement and automation system or create a single stand-alone real-time solution with data acquisition, signal conditioning, motion control, RS-232, GPIB instrumentation, and Ethernet connectivity. With the various hardware options, you can create a system to meet your precise needs today, while the modularity of the system means you can add to the solution as your system requirements grow. If you are interested in Reliable and Deterministic systems for Measurement and Automation, you will profit from this seminar. Agenda: Real-Time Overview LabVIEW RT Hardware Platforms - Linux on PXI Programming with LabVIEW RT Real-Time Operating Systems concepts Timing Applications Data Transfer

Mentoring console improves collaboration and teaching in surgical robotics.

Science.gov (United States)

Hanly, Eric J; Miller, Brian E; Kumar, Rajesh; Hasser, Christopher J; Coste-Maniere, Eve; Talamini, Mark A; Aurora, Alexander A; Schenkman, Noah S; Marohn, Michael R

2006-10-01

One of the most significant limitations of surgical robots has been their inability to allow multiple surgeons and surgeons-in-training to engage in collaborative control of robotic surgical instruments. We report the initial experience with a novel two-headed da Vinci surgical robot that has two collaborative modes: the "swap" mode allows two surgeons to simultaneously operate and actively swap control of the robot's four arms, and the "nudge" mode allows them to share control of two of the robot's arms. The utility of the mentoring console operating in its two collaborative modes was evaluated through a combination of dry laboratory exercises and animal laboratory surgery. The results from surgeon-resident collaborative performance of complex three-handed surgical tasks were compared to results from single-surgeon and single-resident performance. Statistical significance was determined using Student's t-test. Collaborative surgeon-resident swap control reduced the time to completion of complex three-handed surgical tasks by 25% compared to single-surgeon operation of a four-armed da Vinci (P nudge mode was particularly useful for guiding a resident's hands during crucially precise steps of an operation (such as proper placement of stitches). The da Vinci mentoring console greatly facilitates surgeon collaboration during robotic surgery and improves the performance of complex surgical tasks. The mentoring console has the potential to improve resident participation in surgical robotics cases, enhance resident education in surgical training programs engaged in surgical robotics, and improve patient safety during robotic surgery.

Quantitative analysis of residual protein contamination of podiatry instruments reprocessed through local and central decontamination units.

Science.gov (United States)

Smith, Gordon Wg; Goldie, Frank; Long, Steven; Lappin, David F; Ramage, Gordon; Smith, Andrew J

2011-01-10

The cleaning stage of the instrument decontamination process has come under increased scrutiny due to the increasing complexity of surgical instruments and the adverse affects of residual protein contamination on surgical instruments. Instruments used in the podiatry field have a complex surface topography and are exposed to a wide range of biological contamination. Currently, podiatry instruments are reprocessed locally within surgeries while national strategies are favouring a move toward reprocessing in central facilities. The aim of this study was to determine the efficacy of local and central reprocessing on podiatry instruments by measuring residual protein contamination of instruments reprocessed by both methods. The residual protein of 189 instruments reprocessed centrally and 189 instruments reprocessed locally was determined using a fluorescent assay based on the reaction of proteins with o-phthaldialdehyde/sodium 2-mercaptoethanesulfonate. Residual protein was detected on 72% (n = 136) of instruments reprocessed centrally and 90% (n = 170) of instruments reprocessed locally. Significantly less protein (p podiatry instruments when protein contamination is considered, though no significant difference was found in residual protein between local decontamination unit and central decontamination unit processes for Blacks files. Further research is needed to undertake qualitative identification of protein contamination to identify any cross contamination risks and a standard for acceptable residual protein contamination applicable to different instruments and specialities should be considered as a matter of urgency.

Aethalometer™ Instrument Handbook

Energy Technology Data Exchange (ETDEWEB)

Sedlacek, Arthur J. [Brookhaven National Lab. (BNL), Upton, NY (United States)

2016-04-01

The Aethalometer is an instrument that provides a real-time readout of the concentration of “Black” or “Elemental” carbon aerosol particles (BC or E) in an air stream (see Figure 1 and Figure 2). It is a self-contained instrument that measures the rate of change of optical transmission through a spot on a filter where aerosol is being continuously collected and uses the information to calculate the concentration of optically absorbing material in the sampled air stream. The instrument measures the transmitted light intensities through the “sensing” portion of the filter, on which the aerosol spot is being collected, and a “reference” portion of the filter as a check on the stability of the optical source. A mass flowmeter monitors the sample air flow rate. The data from these three measurements is used to determine the mean BC content of the air stream.

Towards real-time metabolic profiling of a biopsy specimen during a surgical operation by 1H high resolution magic angle spinning nuclear magnetic resonance: a case report

Directory of Open Access Journals (Sweden)

Piotto Martial

2012-01-01

Full Text Available Abstract Introduction Providing information on cancerous tissue samples during a surgical operation can help surgeons delineate the limits of a tumoral invasion more reliably. Here, we describe the use of metabolic profiling of a colon biopsy specimen by high resolution magic angle spinning nuclear magnetic resonance spectroscopy to evaluate tumoral invasion during a simulated surgical operation. Case presentation Biopsy specimens (n = 9 originating from the excised right colon of a 66-year-old Caucasian women with an adenocarcinoma were automatically analyzed using a previously built statistical model. Conclusions Metabolic profiling results were in full agreement with those of a histopathological analysis. The time-response of the technique is sufficiently fast for it to be used effectively during a real operation (17 min/sample. Metabolic profiling has the potential to become a method to rapidly characterize cancerous biopsies in the operation theater.

Digital Education Governance: Data Visualization, Predictive Analytics, and "Real-Time" Policy Instruments

Science.gov (United States)

Williamson, Ben

2016-01-01

Educational institutions and governing practices are increasingly augmented with digital database technologies that function as new kinds of policy instruments. This article surveys and maps the landscape of digital policy instrumentation in education and provides two detailed case studies of new digital data systems. The Learning Curve is a…

Real-time Grill Bar Occupation: Archiving Instrument

DEFF Research Database (Denmark)

2015-01-01

The project explores the unregarded function of the classic Danish grill bar, currently disappearing due to processes of gentrification. Despite its unassuming appearance, the grill bar is a vital place for social interaction and coexistence on an informal basis.Its architecture, often referred......’, conducted at the Aarhus School of Architecture. Engaging Through Architecture: “Real time Grill Bar Occupation wants to engage with the audience and questions the role of the architect (and architecture itself) in relation to the social dimension of the city – more specifically the seemingly banal function...... of the typical Danish grill bar as a vital place of social co-existence and informal interaction”....

Virtual Reality Cerebral Aneurysm Clipping Simulation With Real-time Haptic Feedback

Science.gov (United States)

Alaraj, Ali; Luciano, Cristian J.; Bailey, Daniel P.; Elsenousi, Abdussalam; Roitberg, Ben Z.; Bernardo, Antonio; Banerjee, P. Pat; Charbel, Fady T.

2014-01-01

Background With the decrease in the number of cerebral aneurysms treated surgically and the increase of complexity of those treated surgically, there is a need for simulation-based tools to teach future neurosurgeons the operative techniques of aneurysm clipping. Objective To develop and evaluate the usefulness of a new haptic-based virtual reality (VR) simulator in the training of neurosurgical residents. Methods A real-time sensory haptic feedback virtual reality aneurysm clipping simulator was developed using the Immersive Touch platform. A prototype middle cerebral artery aneurysm simulation was created from a computed tomography angiogram. Aneurysm and vessel volume deformation and haptic feedback are provided in a 3-D immersive VR environment. Intraoperative aneurysm rupture was also simulated. Seventeen neurosurgery residents from three residency programs tested the simulator and provided feedback on its usefulness and resemblance to real aneurysm clipping surgery. Results Residents felt that the simulation would be useful in preparing for real-life surgery. About two thirds of the residents felt that the 3-D immersive anatomical details provided a very close resemblance to real operative anatomy and accurate guidance for deciding surgical approaches. They believed the simulation is useful for preoperative surgical rehearsal and neurosurgical training. One third of the residents felt that the technology in its current form provided very realistic haptic feedback for aneurysm surgery. Conclusion Neurosurgical residents felt that the novel immersive VR simulator is helpful in their training especially since they do not get a chance to perform aneurysm clippings until very late in their residency programs. PMID:25599200

Virtual Sensor Test Instrumentation

Science.gov (United States)

Wang, Roy

2011-01-01

Virtual Sensor Test Instrumentation is based on the concept of smart sensor technology for testing with intelligence needed to perform sell-diagnosis of health, and to participate in a hierarchy of health determination at sensor, process, and system levels. A virtual sensor test instrumentation consists of five elements: (1) a common sensor interface, (2) microprocessor, (3) wireless interface, (4) signal conditioning and ADC/DAC (analog-to-digital conversion/ digital-to-analog conversion), and (5) onboard EEPROM (electrically erasable programmable read-only memory) for metadata storage and executable software to create powerful, scalable, reconfigurable, and reliable embedded and distributed test instruments. In order to maximize the efficient data conversion through the smart sensor node, plug-and-play functionality is required to interface with traditional sensors to enhance their identity and capabilities for data processing and communications. Virtual sensor test instrumentation can be accessible wirelessly via a Network Capable Application Processor (NCAP) or a Smart Transducer Interlace Module (STIM) that may be managed under real-time rule engines for mission-critical applications. The transducer senses the physical quantity being measured and converts it into an electrical signal. The signal is fed to an A/D converter, and is ready for use by the processor to execute functional transformation based on the sensor characteristics stored in a Transducer Electronic Data Sheet (TEDS). Virtual sensor test instrumentation is built upon an open-system architecture with standardized protocol modules/stacks to interface with industry standards and commonly used software. One major benefit for deploying the virtual sensor test instrumentation is the ability, through a plug-and-play common interface, to convert raw sensor data in either analog or digital form, to an IEEE 1451 standard-based smart sensor, which has instructions to program sensors for a wide variety of

Rehabilitation with 4 zygomatic implants with a new surgical protocol using ultrasonic technique.

Science.gov (United States)

Mozzati, Marco; Mortellaro, Carmen; Arata, Valentina; Gallesio, Giorgia; Previgliano, Valter

2015-05-01

When the residual bone crest cannot allow the placement of standard implants, the treatment for complete arch rehabilitation of severely atrophic maxillae can be performed with 4 zygomatic implants (ZIs) and immediate function with predictable results in terms of aesthetics, function, and comfort for the patient. However, even if ZIs' rehabilitations showed a good success rate, this surgery is difficult and need a skillful operator. Complications in this kind of rehabilitation are not uncommon; the main difficulties can be related to the reduced surgical visibility and instrument control in a critical anatomic area. All the surgical protocols described in the literature used drilling techniques. Furthermore, the use of ultrasonic instruments in implant surgery compared with drilling instruments have shown advantages in many aspects of surgical procedures, tissues management, enhancement of control, surgical visualization, and healing. The aim of this study was to report on the preliminary experience using ultrasound technique for ZIs surgery in terms of safety and technical improvement. Ten consecutive patients with severely atrophic maxilla have been treated with 4 ZIs and immediate complete arch acrylic resin provisional prostheses. The patients were followed up from 30 to 32 months evaluating implant success, prosthetic success, and patient satisfaction with a questionnaire. No implants were lost during the study period, with a 100% implant and prosthetic success rate. Within the limitations of this preliminary study, these data indicate that ultrasonic implant site preparation for ZIs can be a good alternative to the drilling technique and an improvement for the surgeon.

In vivo Real-Time Mass Spectrometry for Guided Surgery Application

Science.gov (United States)

Fatou, Benoit; Saudemont, Philippe; Leblanc, Eric; Vinatier, Denis; Mesdag, Violette; Wisztorski, Maxence; Focsa, Cristian; Salzet, Michel; Ziskind, Michael; Fournier, Isabelle

2016-05-01

Here we describe a new instrument (SpiderMass) designed for in vivo and real-time analysis. In this instrument ion production is performed remotely from the MS instrument and the generated ions are transported in real-time to the MS analyzer. Ion production is promoted by Resonant Infrared Laser Ablation (RIR-LA) based on the highly effective excitation of O-H bonds in water molecules naturally present in most biological samples. The retrieved molecular patterns are specific to the cell phenotypes and benign versus cancer regions of patient biopsies can be easily differentiated. We also demonstrate by analysis of human skin that SpiderMass can be used under in vivo conditions with minimal damage and pain. Furthermore SpiderMass can also be used for real-time drug metabolism and pharmacokinetic (DMPK) analysis or food safety topics. SpiderMass is thus the first MS based system designed for in vivo real-time analysis under minimally invasive conditions.

Polarization properties of real aluminum mirrors; I. Influence of the aluminum oxide layer

NARCIS (Netherlands)

van Harten, G.; Snik, F.; Keller, C.U.

2009-01-01

In polarimetry, it is important to characterize the polarization properties of the instrument itself to disentangle real astrophysical signals from instrumental effects. This article deals with the accurate measurement and modeling of the polarization properties of real aluminum mirrors, as used in

Manual Control for Medical Instruments in Minimally Invasive Surgery

NARCIS (Netherlands)

Fan, C.

2014-01-01

With the introduction of new technologies, surgical procedures have been varying from free access in open surgery towards limited access in minimal invasive surgery. During such procedures, surgeons have to manoeuver the instruments from outside the patient while looking at the monitor. Long and

Modelling and evaluation of surgical performance using hidden Markov models.

Science.gov (United States)

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

2006-10-01

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

Clinical, laboratory and instrumental methods of pre-surgical diagnosis of the parathyroid glands cancer

Directory of Open Access Journals (Sweden)

Natalia G. Mokrysheva

2017-12-01

Full Text Available Backgraund. When defining symptomatic primary hyperparathyroidism (PHPT, differential diagnosis between a benign and malignant neoplasm of parathyroid glands (PG may be challenging. The diagnosis of carcinoma or a benign tumor determines the extent of the surgical intervention and further observation tactics. Aims. The purpose of the study is to determine the clinical and laboratory and instrumental predictors of PG cancer. Materials and methods. A retrospective study included 385 patients with PHPT (273 with adenomas of the PG, 66 with hyperplasia, and 19 patients with cancer of the PG, who had been examined and operated from 2000 to 2014. The primary goal of the study was to define the level of ionized calcium (Ca++, parathyroid hormone (PTH, and the volume of the tumor PG specific for cancer of the PG. The level of parathyroid hormone (PTH was determined by electrochemoluminescent method on the Roche analyzer Cobas 6000; ionized calcium (Ca++ ion-selective method. The size of the PG was determined by the ellipse formula: V(cm3 = (A × B × C × 0.49 by ultrasound investigation using the Valuson E8 device from General Electric. Results. The group of patients with PG carcinoma showed the increased level of Ca++ of more than 1.60 mmol/l (p = 0.004 and increased level of PTH of more than 600 pg/ml (p = 0.03. The size of tumors of more than 6 cm3 is more typical to malignant neoplasm compared to the adenoma of the PG (p = 0.01. Conclusions. The group of patients with PHPT that are at risk of having PG carcinoma include individuals that have a combination of the following indicators: PTH levels of more than 600 pg/ml, an increase in ionized calcium of more than 1.60 mmol/l, the tumor size of more than 6 cm3.

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

Science.gov (United States)

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

2017-02-22

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

Virtual reality simulation in endovascular surgical training.

LENUS (Irish Health Repository)

Tsang, J S

2008-08-01

Shortened trainingtimes duetothe European Working Time Directive (EWTD) and increased public scrutiny of surgical competency have led to a move away from the traditional apprenticeship model of training. Virtual reality (VR) simulation is a fascinating innovation allowing surgeons to develop without the need to practice on real patients and it may be a solution to achieve competency within a shortened training period.

Quantitative analysis of residual protein contamination of podiatry instruments reprocessed through local and central decontamination units

Directory of Open Access Journals (Sweden)

Ramage Gordon

2011-01-01

Full Text Available Abstract Background The cleaning stage of the instrument decontamination process has come under increased scrutiny due to the increasing complexity of surgical instruments and the adverse affects of residual protein contamination on surgical instruments. Instruments used in the podiatry field have a complex surface topography and are exposed to a wide range of biological contamination. Currently, podiatry instruments are reprocessed locally within surgeries while national strategies are favouring a move toward reprocessing in central facilities. The aim of this study was to determine the efficacy of local and central reprocessing on podiatry instruments by measuring residual protein contamination of instruments reprocessed by both methods. Methods The residual protein of 189 instruments reprocessed centrally and 189 instruments reprocessed locally was determined using a fluorescent assay based on the reaction of proteins with o-phthaldialdehyde/sodium 2-mercaptoethanesulfonate. Results Residual protein was detected on 72% (n = 136 of instruments reprocessed centrally and 90% (n = 170 of instruments reprocessed locally. Significantly less protein (p Conclusions Overall, the results show the superiority of central reprocessing for complex podiatry instruments when protein contamination is considered, though no significant difference was found in residual protein between local decontamination unit and central decontamination unit processes for Blacks files. Further research is needed to undertake qualitative identification of protein contamination to identify any cross contamination risks and a standard for acceptable residual protein contamination applicable to different instruments and specialities should be considered as a matter of urgency.

Surgical Treatment of Tattoo Complications.

Science.gov (United States)

Sepehri, Mitra; Jørgensen, Bo

2017-01-01

With a continuing increase in the number of tattoos performed worldwide, the need to treat tattoo complications is growing. Earlier treatments of chronic inflammatory tattoo reactions were dominated by a medical approach, or with no active intervention. In this chapter, we will address modern surgical approaches applied to situations when medical treatment is inefficient and lasers are not applicable. Dermatome shaving is positioned as first-line treatment of allergic tattoo reactions and also indicated in a number of other tattoo reactions, supplemented with excision in selected cases. The methods allow fundamental treatment with removal of the culprit pigment from the dermis. The different instruments, surgical methods, and treatment schedules are reviewed, and a guide to surgeons is presented. Postoperative treatments and the long-term outcomes are described in detail. An algorithm on specialist treatment and follow-up of tattoo reactions, which can be practiced in other countries, is presented. © 2017 S. Karger AG, Basel.

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

Science.gov (United States)

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

2016-04-01

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

A real-time radiation mapping system

International Nuclear Information System (INIS)

Scoggins, W.A.; VanEtten, D.M.

1988-01-01

A prototype of a real-time radiation mapping system, Ranger, was developed to respond to an accident involving the release of plutonium for the Department of Energy's Accident Response Group. In 1987 Ranger demonstrated that it can provide an efficient method of monitoring large areas of land for radioactive contamination. With the experience gained from the operation of the prototype, the external computer and software are being upgraded in order to obtain a fully operational system. The new system uses the prototype's commercially available line-of-sight microwave system for determining position and the same radiation detection instruments. The data obtained from the radiation detection instrument(s) are linked back to the external computer along with the relative position of the measurement through the ranging system. The data are displayed on a gridded map as colored circles and permanently stored in real-time. The different colors represent different contamination levels. Contours can be drawn using the permanently stored data. 4 figs

Prior video game exposure does not enhance robotic surgical performance.

Science.gov (United States)

Harper, Jonathan D; Kaiser, Stefan; Ebrahimi, Kamyar; Lamberton, Gregory R; Hadley, H Roger; Ruckle, Herbert C; Baldwin, D Duane

2007-10-01

Prior research has demonstrated that counterintuitive laparoscopic surgical skills are enhanced by experience with video games. A similar relation with robotic surgical skills has not been tested. The purpose of this study was to determine whether prior video-game experience enhances the acquisition of robotic surgical skills. A series of 242 preclinical medical students completed a self-reported video-game questionnaire detailing the frequency, duration, and peak playing time. The 10 students with the highest and lowest video-game exposure completed a follow-up questionnaire further quantifying video game, sports, musical instrument, and craft and hobby exposure. Each subject viewed a training video demonstrating the use of the da Vinci surgical robot in tying knots, followed by 3 minutes of proctored practice time. Subjects then tied knots for 5 minutes while an independent blinded observer recorded the number of knots tied, missed knots, frayed sutures, broken sutures, and mechanical errors. The mean playing time for the 10 game players was 15,136 total hours (range 5,840-30,000 hours). Video-game players tied fewer knots than nonplayers (5.8 v 9.0; P = 0.04). Subjects who had played sports for at least 4 years had fewer mechanical errors (P = 0.04), broke fewer sutures (P = 0.01), and committed fewer total errors (P = 0.01). Similarly, those playing musical instruments longer than 5 years missed fewer knots (P = 0.05). In the extremes of video-game experience tested in this study, game playing was inversely correlated with the ability to learn robotic suturing. This study suggests that advanced surgical skills such as robotic suturing may be learned more quickly by athletes and musicians. Prior extensive video-game exposure had a negative impact on robotic performance.

Comparison of impact of four surgical methods on surgical outcomes in endoscopic dacryocystorhinostomy.

Science.gov (United States)

Roh, Hyun Cheol; Baek, Sehyun; Lee, Hwa; Chang, Minwook

2016-06-01

To evaluate differences in the surgical outcomes of endoscopic dacryocystorhinostomy (DCR) according to four different surgical methods. This retrospective study included 222 patients who underwent endoscopic DCR from 2011 to 2013. All patients were assigned to one of four groups according to instruments for incision of nasal mucosa and the formation of mucosal flap: group 1, a sickle knife with mucosal flap; group 2, a sickle knife without mucosal flap; group 3, electrocautery with mucosal flap; and group 4, electrocautery without mucosal flap. The follow up period was at least 6 months. There were 33 eyes in group 1, 44 eyes in group 2, 49 eyes in group 3, and 97 eyes in group 4. There were no significant differences in success rate between groups (P = 0.878). Wound healing time was significantly different between groups (P knife may be more helpful and effective for shortening wound healing time rather than making mucosal flaps in endoscopic DCR. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Multi-Institutional Development of a Mastoidectomy Performance Evaluation Instrument.

Science.gov (United States)

Kerwin, Thomas; Hittle, Brad; Stredney, Don; De Boeck, Paul; Wiet, Gregory

A method for rating surgical performance of a mastoidectomy procedure that is shown to apply universally across teaching institutions has not yet been devised. This work describes the development of a rating instrument created from a multi-institutional consortium. Using a participatory design and a modified Delphi approach, a multi-institutional group of expert otologists constructed a 15-element task-based checklist for evaluating mastoidectomy performance. This instrument was further refined into a 14-element checklist focusing on the concept of safety after using it to rate a large and varied population of performances. Twelve otolaryngological surgical training programs in the United States. A total of 14 surgeons from 12 different institutions took part in the construction of the instrument. By using 14 experts from 12 different institutions and a literature review, individual metrics were identified, rated as to the level of importance and operationally defined to create a rating scale for mastoidectomy performance. Initial use of the rating scale showed modest rater agreement. The operational definitions of individual metrics were modified to emphasize "safe" as opposed to "proper" technique. A second rating instrument was developed based on this feedback. Using a consensus-building approach with multiple rounds of communication between experts is a feasible way to construct a rating instrument for mastoidectomy. Expert opinion alone using a Delphi method provides face and content validity evidence, however, this is not sufficient to develop a universally acceptable rating instrument. A continued process of development and experimentation to demonstrate evidence for reliability and validity making use of a large population of raters and performances is necessary to achieve universal acceptance. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Frequency of nursing tasks in medical and surgical wards.

Science.gov (United States)

Farquharson, Barbara; Bell, Cheryl; Johnston, Derek; Jones, Martyn; Schofield, Pat; Allan, Julia; Ricketts, Ian; Morrison, Kenny; Johnston, Marie

2013-09-01

To explore the frequency of different nursing tasks in medical and surgical wards. The time nurses spend on direct patient care is important for both patients and nurses. However, little is known about the time nurses spend on various nursing tasks. A real-time, repeated measures design conducted amongst 67 (n = 39 medical, n = 28 surgical) UK hospital nurses. Between September 2011 and August 2012 participants completed an electronic diary version of a classification of nursing tasks (WOMBAT) during shifts. A total of 961 real-time measures of nursing task were obtained. Direct patient care [median = 37.5%, interquartile range = 27.8], indirect care (median = 11.1%, interquartile range = 19.4) and medication (median = 11.1%, interquartile range = 18.8) were most commonly reported. Participants were interrupted in 62% of entries (interquartile range = 35), reported adequate time in 78% (interquartile range = 31) and adequate resources in 89% (interquartile range = 36). Ward-related tasks were significantly more frequent on medical wards than surgical wards but otherwise there were no significant differences. Nurses spend the highest proportion of time in direct patient care and majority of this on core nursing activities. Interruptions to tasks are common. Nurses tend to report adequate time/resources. The frequency of nursing tasks is similar in medical and surgical wards. Nurse managers should review the level of interruptions to nurses' work and ensure appropriate levels of supervision. © 2013 John Wiley & Sons Ltd.

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

Science.gov (United States)

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

2017-12-01

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

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.)

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.)

A projective surgical navigation system for cancer resection

Science.gov (United States)

Gan, Qi; Shao, Pengfei; Wang, Dong; Ye, Jian; Zhang, Zeshu; Wang, Xinrui; Xu, Ronald

2016-03-01

Near infrared (NIR) fluorescence imaging technique can provide precise and real-time information about tumor location during a cancer resection surgery. However, many intraoperative fluorescence imaging systems are based on wearable devices or stand-alone displays, leading to distraction of the surgeons and suboptimal outcome. To overcome these limitations, we design a projective fluorescence imaging system for surgical navigation. The system consists of a LED excitation light source, a monochromatic CCD camera, a host computer, a mini projector and a CMOS camera. A software program is written by C++ to call OpenCV functions for calibrating and correcting fluorescence images captured by the CCD camera upon excitation illumination of the LED source. The images are projected back to the surgical field by the mini projector. Imaging performance of this projective navigation system is characterized in a tumor simulating phantom. Image-guided surgical resection is demonstrated in an ex-vivo chicken tissue model. In all the experiments, the projected images by the projector match well with the locations of fluorescence emission. Our experimental results indicate that the proposed projective navigation system can be a powerful tool for pre-operative surgical planning, intraoperative surgical guidance, and postoperative assessment of surgical outcome. We have integrated the optoelectronic elements into a compact and miniaturized system in preparation for further clinical validation.

Marketing instruments of foreign trade promotion

Directory of Open Access Journals (Sweden)

Bjelić Predrag

2011-01-01

Full Text Available Instruments of promotion as a part of marketing mix are usually associated with companies but more and more countries use this instrument in order to boost their exports. These foreign trade promotion instruments are now popular in many countries in the world since their use is not opposed to any World Trade Organization rules. Marketing instruments of trade promotions are the most important. They include National Exhibitions and National labels of origin and quality. In order to coordinate the application of these instruments countries have established national bodies for trade promotion. Many studies in the past had argued that national Agencies established to promote export did not had any real success, but recent studies indicate that they could have a significant impact on country export promotion. The result of this rise in impact of national export promotion agencies is due to international effort spearheaded by International Trade Center. The aim of this paper is to point out types and methods of marketing instruments application in trade promotion and to present the effectiveness of these instruments applications.

Trends in the Surgical Correction of Gynecomastia.

Science.gov (United States)

Brown, Rodger H; Chang, Daniel K; Siy, Richard; Friedman, Jeffrey

2015-05-01

Gynecomastia refers to the enlargement of the male breast due to a proliferation of ductal, stromal, and/or fatty tissue. Although it is a common condition affecting up to 65% of men, not all cases require surgical intervention. Contemporary surgical techniques in the treatment of gynecomastia have become increasingly less invasive with the advent of liposuction and its variants, including power-assisted and ultrasound-assisted liposuction. These techniques, however, have been largely limited in their inability to address significant skin excess and ptosis. For mild to moderate gynecomastia, newer techniques using arthroscopic morcellation and endoscopic techniques promise to address the fibrous component, while minimizing scar burden by utilizing liposuction incisions. Nevertheless, direct excision through periareolar incisions remains a mainstay in treatment algorithms for its simplicity and avoidance of additional instrumentation. This is particularly true for more severe cases of gynecomastia requiring skin resection. In the most severe cases with significant skin redundancy and ptosis, breast amputation with free nipple grafting remains an effective option. Surgical treatment should be individualized to each patient, combining techniques to provide adequate resection and optimize aesthetic results.

Real Estate Financing and Interest Rate Hedging : A quantitative real estate investment case study

OpenAIRE

van de Wiel, Wimjan; Kristopher Bock, Felix

2017-01-01

Background: The expansive monetary policy of the European Central Bank has been leading to all-time-low interest rates and to a strong move into real estate investment. Low interest rates can work in favor of the investor (due to low interest rate expenditures), but increasing interest rates can jeopardize real estate investments. Since changes in interest rates are unpredictable, an investor needs to deal with this volatility. The capital market offers several financial instruments (so-calle...

On Representative Spaceflight Instrument and Associated Instrument Sensor Web Framework

Science.gov (United States)

Kizhner, Semion; Patel, Umeshkumar; Vootukuru, Meg

2007-01-01

Sensor Web-based adaptation and sharing of space flight mission resources, including those of the Space-Ground and Control-User communication segment, could greatly benefit from utilization of heritage Internet Protocols and devices applied for Spaceflight (SpaceIP). This had been successfully demonstrated by a few recent spaceflight experiments. However, while terrestrial applications of Internet protocols are well developed and understood (mostly due to billions of dollars in investments by the military and industry), the spaceflight application of Internet protocols is still in its infancy. Progress in the developments of SpaceIP-enabled instrument components will largely determine the SpaceIP utilization of those investments and acceptance in years to come. Likewise SpaceIP, the development of commercial real-time and instrument colocated computational resources, data compression and storage, can be enabled on-board a spacecraft and, in turn, support a powerful application to Sensor Web-based design of a spaceflight instrument. Sensor Web-enabled reconfiguration and adaptation of structures for hardware resources and information systems will commence application of Field Programmable Arrays (FPGA) and other aerospace programmable logic devices for what this technology was intended. These are a few obvious potential benefits of Sensor Web technologies for spaceflight applications. However, they are still waiting to be explored. This is because there is a need for a new approach to spaceflight instrumentation in order to make these mature sensor web technologies applicable for spaceflight. In this paper we present an approach in developing related and enabling spaceflight instrument-level technologies based on the new concept of a representative spaceflight Instrument Sensor Web (ISW).

Cellular telephone-based radiation detection instrument

Science.gov (United States)

Craig, William W [Pittsburg, CA; Labov, Simon E [Berkeley, CA

2011-06-14

A network of radiation detection instruments, each having a small solid state radiation sensor module integrated into a cellular phone for providing radiation detection data and analysis directly to a user. The sensor module includes a solid-state crystal bonded to an ASIC readout providing a low cost, low power, light weight compact instrument to detect and measure radiation energies in the local ambient radiation field. In particular, the photon energy, time of event, and location of the detection instrument at the time of detection is recorded for real time transmission to a central data collection/analysis system. The collected data from the entire network of radiation detection instruments are combined by intelligent correlation/analysis algorithms which map the background radiation and detect, identify and track radiation anomalies in the region.

Teaching computer interfacing with virtual instruments in an object-oriented language.

Science.gov (United States)

Gulotta, M

1995-01-01

LabVIEW is a graphic object-oriented computer language developed to facilitate hardware/software communication. LabVIEW is a complete computer language that can be used like Basic, FORTRAN, or C. In LabVIEW one creates virtual instruments that aesthetically look like real instruments but are controlled by sophisticated computer programs. There are several levels of data acquisition VIs that make it easy to control data flow, and many signal processing and analysis algorithms come with the software as premade VIs. In the classroom, the similarity between virtual and real instruments helps students understand how information is passed between the computer and attached instruments. The software may be used in the absence of hardware so that students can work at home as well as in the classroom. This article demonstrates how LabVIEW can be used to control data flow between computers and instruments, points out important features for signal processing and analysis, and shows how virtual instruments may be used in place of physical instrumentation. Applications of LabVIEW to the teaching laboratory are also discussed, and a plausible course outline is given. PMID:8580361

Ultra-high throughput real-time instruments for capturing fast signals and rare events

Science.gov (United States)

Buckley, Brandon Walter

Wide-band signals play important roles in the most exciting areas of science, engineering, and medicine. To keep up with the demands of exploding internet traffic, modern data centers and communication networks are employing increasingly faster data rates. Wide-band techniques such as pulsed radar jamming and spread spectrum frequency hopping are used on the battlefield to wrestle control of the electromagnetic spectrum. Neurons communicate with each other using transient action potentials that last for only milliseconds at a time. And in the search for rare cells, biologists flow large populations of cells single file down microfluidic channels, interrogating them one-by-one, tens of thousands of times per second. Studying and enabling such high-speed phenomena pose enormous technical challenges. For one, parasitic capacitance inherent in analog electrical components limits their response time. Additionally, converting these fast analog signals to the digital domain requires enormous sampling speeds, which can lead to significant jitter and distortion. State-of-the-art imaging technologies, essential for studying biological dynamics and cells in flow, are limited in speed and sensitivity by finite charge transfer and read rates, and by the small numbers of photo-electrons accumulated in short integration times. And finally, ultra-high throughput real-time digital processing is required at the backend to analyze the streaming data. In this thesis, I discuss my work in developing real-time instruments, employing ultrafast optical techniques, which overcome some of these obstacles. In particular, I use broadband dispersive optics to slow down fast signals to speeds accessible to high-bit depth digitizers and signal processors. I also apply telecommunication multiplexing techniques to boost the speeds of confocal fluorescence microscopy. The photonic time stretcher (TiSER) uses dispersive Fourier transformation to slow down analog signals before digitization and

Real-Time Mapping Spectroscopy on the Ground, in the Air, and in Space

Science.gov (United States)

Thompson, D. R.; Allwood, A.; Chien, S.; Green, R. O.; Wettergreen, D. S.

2016-12-01

Real-time data interpretation can benefit both remote in situ exploration and remote sensing. Basic analyses at the sensor can monitor instrument performance and reveal invisible science phenomena in real time. This promotes situational awareness for remote robotic explorers or campaign decision makers, enabling adaptive data collection, reduced downlink requirements, and coordinated multi-instrument observations. Fast analysis is ideal for mapping spectrometers providing unambiguous, quantitative geophysical measurements. This presentation surveys recent computational advances in real-time spectroscopic analysis for Earth science and planetary exploration. Spectral analysis at the sensor enables new operations concepts that significantly improve science yield. Applications include real-time detection of fugitive greenhouse emissions by airborne monitoring, real-time cloud screening and mineralogical mapping by orbital spectrometers, and adaptive measurement by the PIXL instrument on the Mars 2020 rover. Copyright 2016 California Institute of Technology. All Rights Reserved. We acknowledge support of the US Government, NASA, the Earth Science Division and Terrestrial Ecology program.

Surgical and procedural skills training at medical school - a national review.

Science.gov (United States)

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

2014-01-01

This national study quantifies procedural and surgical skills training at medical schools in the United Kingdom (UK), a stipulated requirement of all graduates by the General Medical Council (GMC). A questionnaire recorded basic procedural and surgical skills training provided by medical schools and surgical societies in the UK. Skills were extracted from (1) GMC Tomorrows Doctors and (2) The Royal College of Surgeons Intercollegiate Basic Surgical Skills (BSS) course. Data from medical school curricula and extra-curricular student surgical societies were compared against the national GMC guidelines and BSS course content. Data were analysed using Mann-Whitney U tests. Representatives from 23 medical schools completed the survey (71.9% response). Thirty one skills extracted from the BSS course were split into 5 categories, with skills content cross referenced against GMC documentation. Training of surgical skills by medical schools was as follows: Gowning and gloving (72.8%), handling instruments (29.4%), knot tying (17.4%), suturing (24.7%), other surgical techniques (4.3%). Surgical societies provided significantly more training of knot tying (64.4%, P = 0.0013) and suturing (64.5%, P = 0.0325) than medical schools. Medical schools provide minimal basic surgical skills training, partially supplemented by extracurricular student surgical societies. Our findings suggest senior medical students do not possess simple surgical and procedural skills. Newly qualified doctors are at risk of being unable to safely perform practical procedures, contradicting GMC Guidelines. We propose a National Undergraduate Curriculum in Surgery and Surgical Skills to equip newly qualified doctors with basic procedural skills to maximise patient safety. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

The surgical stress response: should it be prevented?

DEFF Research Database (Denmark)

Kehlet, H

1991-01-01

clinical trials have demonstrated a reduction in various aspects of postoperative morbidity by such a nociceptive blockade. Although a causal relationship has still to be demonstrated, these findings strongly argue the concept of "stress-free anesthesia and surgery" as an important instrument in improving......Postoperative complications such as myocardial infarction, pulmonary infection, thromboembolism and fatigue are probably related to increased demands, hypermetabolism, catabolism and other physiologic changes included in the global "surgical stress response." Strategies have been developed...... to suppress the detrimental components of the stress response so as to improve postoperative outcome. Of the various techniques to reduce the surgical stress response, afferent neural blockade with regional anesthesia to relieve pain is the most effective, although not optimal. Data from numerous controlled...

Management of surgical waiting lists through a Possibilistic Linear Multiobjective Programming problem

OpenAIRE

Pérez Gladish, Blanca María; Arenas Parra, María del Mar; Bilbao Terol, Amelia María; Rodríguez Uria, María Victoria

2005-01-01

This study attempts to apply a management science technique to improve the efficiency of Hospital Administration. We aim to design the performance of the surgical services at a Public Hospital that allows the Decision-Maker to plan surgical scheduling over one year in order to reduce waiting lists. Real decision problems usually involve several objectives that have parameters which are often given by the decision maker in an imprecise way. It is possible to handle these kinds of problems ...

Creating an animation-enhanced video library of hepato-pancreato-biliary and transplantation surgical procedures.

Science.gov (United States)

Fung, Albert; Kelly, Paul; Tait, Gordon; Greig, Paul D; McGilvray, Ian D

2016-01-01

The potential for integrating real-time surgical video and state-of-the art animation techniques has not been widely applied to surgical education. This paper describes the use of new technology for creating videos of liver, pancreas and transplant surgery, annotating them with 3D animations, resulting in a freely-accessible online resource: The Toronto Video Atlas of Liver, Pancreas and Transplant Surgery ( http://tvasurg.ca ). The atlas complements the teaching provided to trainees in the operating room, and the techniques described in this study can be readily adapted by other surgical training programmes.

Effects on instruments of the World Health Organization--recommended protocols for decontamination after possible exposure to transmissible spongiform encephalopathy-contaminated tissue.

Science.gov (United States)

Brown, Stanley A; Merritt, Katharine; Woods, Terry O; Busick, Deanna N

2005-01-15

It has been recommended by the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) that rigorous decontamination protocols be used on surgical instruments that have been exposed to tissue possibly contaminated with Creutzfeldt-Jakob disease (CJD). This study was designed to examine the effects of these protocols on various types of surgical instruments. The most important conclusions are: (1) autoclaving in 1N NaOH will cause darkening of some instruments; (2) soaking in 1N NaOH at room temperature damages carbon steel but not stainless steel or titanium; (3) soaking in chlorine bleach will badly corrode gold-plated instruments and will damage some, but not all, stainless-steel instruments, especially welded and soldered joints. Damage became apparent after the first exposure and therefore long tests are not necessary to establish which instruments will be damaged. Copyright 2004 Wiley Periodicals, Inc.

[Nutritional support response in critically ill patients; differences between medical and surgical patients].

Science.gov (United States)

Zamora Elson, M; Serón Arbeloa, C; Labarta Monzón, L; Garrido Ramírez de Arellano, I; Lander Azcona, A; Marquina Lacueva, M I; López Claver, J C; Escós Orta, J

2012-01-01

To assess the nutritional response of a group of critically ill patients, as well as the differences in the response to nutritional support between medical and surgical patients. One-year long retrospective study including critically ill patients on artificial nutrition for 7 days. Throughout the first week, three nutritional biochemical controls were done that included albumin, prealbumin, transferrin, cholesterol, and electrolytes. Other data gathered were: nutritional risk index, age, gender, weight, height, APACHE, delay of onset of nutritional support, access route, predicted and real caloric intake, medical or surgical patient, hospital stay, duration of the central venous catheter, urinary tube, and/or mechanical ventilation, incidence and density of incidence of nosocomial infections. Sixty-three patients were studied, 30 (47%) medical and 33 (53%) surgical/trauma patients, with a usage of EN higher among medical patients (16/30, 53% vs. 5/33, 15%), PN higher among surgical patients (25/33, 76%), and mixed nutrition similar in both groups (5 medical and 3 surgical patients) (p = 0.001). There were no differences between medical and surgical patients regarding: both predicted and real caloric and nitrogenous intake, APACHE, delay of onset of nutrition, phosphorus, magnesium or glucose levels, mortality and incidence of nosocomial infections. There were no differences either in hospital stay or use of mechanical ventilation, although these tended to be lower in surgical patients. The baseline biochemical parameters did not show differences between both groups, although they were worse among surgical patients. These patients presented during the study period steady albumin levels with improvement in the remaining parameters, whereas medical patients showed a decrease in albumin and transferrin levels, steady prealbumin levels, and slightly improvement in cholesterol levels. We have observed higher usage of PN among surgical patients, which showed worse

Novel mass spectrometric instrument for gaseous and particulate characterization and monitoring

International Nuclear Information System (INIS)

Coggiola, M.J.

1994-02-01

SRI International will develop a unique new instrument that will be capable of providing real-time (<1 minute), quantitative, chemical characterization of gaseous and particulate pollutants generated from DOE waste cleanup activities. The instrument will be capable of detecting and identifying volatile organic compounds, polynuclear aromatic hydrocarbons, heavy metals, and transuranic species released during waste cleanup activities. The instrument will be unique in its ability to detect and quantify in real-time these diverse pollutants in both vapor and particulate form. The instrument to be developed under this program will consist of several major components: (1) an isokinetic sampler capable of operating over a wide range of temperatures (up to 500 K) and flow rates; (2) a high pressure to low pressure transition and sampling region that efficiently separates particles from vapor-phase components for separate, parallel analyses; (3) two small mass spectrometers, one optimized for organic analysis using a unique field ionization source and one optimized for particulate characterization using thermal pyrolysis and electron-impact ionization (EI); and (4) a powerful personal computer for control and data acquisition. Initially, the instrument will be developed for targeted use in conjunction with the K-1435 Toxic Substances Control Act (TSCA) incinerator at the Oak Ridge National Laboratory K-25 site. Ultimately, the instrument will be designed to operate in the field at any cleanup site, located close to the stack or process vent, providing the plant operations personnel with real-time information and alarm capabilities. In addition, this instrument will be very broadly applicable for cleanup or sampling, for example, any time contaminated soil is moved or disturbed

Surgical ergonomics. Analysis of technical skills, simulation models and assessment methods.

Science.gov (United States)

Papaspyros, Sotiris C; Kar, Ashok; O'Regan, David

2015-06-01

Over the past two centuries the surgical profession has undergone a profound evolution in terms of efficiency and outcomes. Societal concerns in relation to quality assurance, patient safety and cost reduction have highlighted the issue of training expert surgeons. The core elements of a training model build on the basic foundations of gross and fine motor skills. In this paper we provide an analysis of the ergonomic principles involved and propose relevant training techniques. We have endeavored to provide both the trainer and trainee perspectives. This paper is structured into four sections: 1) Pre-operative preparation issues, 2) technical skills and instrument handling, 3) low fidelity simulation models and 4) discussion of current concepts in crew resource management, deliberate practice and assessment. Rehearsal, warm-up and motivation-enhancing techniques aid concentration and focus. Appropriate posture, comprehension of ergonomic principles in relation to surgical instruments and utilisation of the non-dominant hand are essential skills to master. Low fidelity models can be used to achieve significant progress through the early stages of the learning curve. Deliberate practice and innate ability are complementary to each other and may be considered useful adjuncts to surgical skills development. Safe medical care requires that complex patient interventions be performed by highly skilled operators supported by reliable teams. Surgical ergonomics lie at the heart of any training model that aims to produce professionals able to function as leaders of a patient safety oriented culture. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Work domain constraints for modelling surgical performance.

Science.gov (United States)

Morineau, Thierry; Riffaud, Laurent; Morandi, Xavier; Villain, Jonathan; Jannin, Pierre

2015-10-01

Three main approaches can be identified for modelling surgical performance: a competency-based approach, a task-based approach, both largely explored in the literature, and a less known work domain-based approach. The work domain-based approach first describes the work domain properties that constrain the agent's actions and shape the performance. This paper presents a work domain-based approach for modelling performance during cervical spine surgery, based on the idea that anatomical structures delineate the surgical performance. This model was evaluated through an analysis of junior and senior surgeons' actions. Twenty-four cervical spine surgeries performed by two junior and two senior surgeons were recorded in real time by an expert surgeon. According to a work domain-based model describing an optimal progression through anatomical structures, the degree of adjustment of each surgical procedure to a statistical polynomial function was assessed. Each surgical procedure showed a significant suitability with the model and regression coefficient values around 0.9. However, the surgeries performed by senior surgeons fitted this model significantly better than those performed by junior surgeons. Analysis of the relative frequencies of actions on anatomical structures showed that some specific anatomical structures discriminate senior from junior performances. The work domain-based modelling approach can provide an overall statistical indicator of surgical performance, but in particular, it can highlight specific points of interest among anatomical structures that the surgeons dwelled on according to their level of expertise.

Visual tracking of da Vinci instruments for laparoscopic surgery

Science.gov (United States)

Speidel, S.; Kuhn, E.; Bodenstedt, S.; Röhl, S.; Kenngott, H.; Müller-Stich, B.; Dillmann, R.

2014-03-01

Intraoperative tracking of laparoscopic instruments is a prerequisite to realize further assistance functions. Since endoscopic images are always available, this sensor input can be used to localize the instruments without special devices or robot kinematics. In this paper, we present an image-based markerless 3D tracking of different da Vinci instruments in near real-time without an explicit model. The method is based on different visual cues to segment the instrument tip, calculates a tip point and uses a multiple object particle filter for tracking. The accuracy and robustness is evaluated with in vivo data.

Management of wound infection after lumbar arthrodesis maintaining the instrumentation

Directory of Open Access Journals (Sweden)

Asdrubal Falavigna

2015-06-01

Full Text Available OBJECTIVE: To determinate whether a surgical protocol with immediate extensive debridement, closed irrigation system and antibiotic therapy would be effective to achieve healing of deep wound infection without removing the instrumentation.METHODS: Prospective cohort study with 19 patients presenting degenerative spinal stenosis or degenerative spondylolisthesis, who developed infection after posterior lumbar arthrodesis. The diagnosis was confirmed by a microbial culture from subfascial lumbar fluid and/or blood. Patients were treated with a protocol of wound exploration, extensive flushing and debridement, placement of a closed irrigation system that was maintained for five days and intravenous antibiotics. The instrumentation system was not removed.RESULTS: Mean age was 59.31 (±13.17 years old and most patients were female (94.7%; 18/19. The mean period for the identification of the infection was 2 weeks and 57.9% underwent a single wound exploration. White blood count, erythrocyte sedimentation rate and C-reactive protein showed a significant decrease post-treatment when compared to pre-treatment values. A significant reduction of erythrocyte sedimentation rate and C-reactive protein was also observed at the final evaluation. No laboratory test was useful to predict the need for more than one debridement.CONCLUSION: Patients with wound infection after instrumentation can be treated without removal of the instrumentation through wound exploration, extensive flushing, debridement of necrotic tissue, closed irrigation system during 5 days and proper antibiotic therapy. The blood tests were not useful to predict surgical re-interventions.

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

Science.gov (United States)

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

2017-01-01

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

CODA Performance in the Real World

International Nuclear Information System (INIS)

D.J. Abbott; W.G. Heyes; E. Jastrzembski; R. W. MacLeod; C. Timmer; E. Wolin

2000-01-01

The most ambitious implementation of the Jefferson Lab data acquisition system (CODA) to date is for the CLAS spectrometer in Experimental Hall B. CLAS has over 40,000 instrumented channels and uses up to 30 front-end (FASTBUS/VME) crates in the DAQ subsystem. During the initial experiments we found that performance of the fully instrumented DAQ system did not scale as expected based on single point to point benchmarks. Over the past year we have been able to study various performance bottlenecks in the CLAS DAQ system including front-end real time performance, switched 100BaseT Ethernet data transport, and online data distribution and recording. Performance tuning was necessary for components on both real time (VxWorks) and UNIX (Solaris) operating systems. In addition, a new efficient Event Transfer System (ET) was developed to provide faster online monitoring while having minimal impact on data throughput to storage. We discuss these issues and efforts to overcome the real world problems associated with running a high performance DAQ system on a variety of commercial hardware and software

CODA performance in the real world

International Nuclear Information System (INIS)

Abbott, D.J.; Heyes, W.G.; Jastrzembski, E.; MacLeod, R.W.; Timmer, C.; Wolin, E.

1999-01-01

The most ambitious implementation of the Jefferson Lab data acquisition system (CODA) to date is for the CLAS spectrometer in Experimental Hall B. CLAS has over 40,000 instrumented channels and uses up to 30 front-end (FASTBUS/VME) crates in the DAQ subsystem. During the initial experiments the authors found that performance of the fully instrumented DAQ system did not scale as expected based on single point to point benchmarks. Over the past year the authors have been able to study various performance bottlenecks in the CLAS DAQ system including front-end real time performance, switched 100BaseT Ethernet data transport, and online data distribution and recording. Performance tuning was necessary for components on both real time (VxWorks) and UNIX (Solaris) operating systems. In addition, a new efficient Event Transfer System (ET) was developed to provide faster online monitoring while having minimal impact on data throughput to storage. They discuss these issues and efforts to overcome the real world problems associated with running a high performance DAQ system on a variety of commercial hardware and software

Surgical implantation techniques for electronic tags in fish

Energy Technology Data Exchange (ETDEWEB)

Wagner, Glenn N.; Cooke, Steven J.; Brown, Richard S.; Deters, Katherine A.

2011-01-01

Intracoelomic implantation of transmitters into fish requires making a surgical incision, incision closure, and other surgery related techniques; however, the tools and techniques used in the surgical process vary widely. We review the available literature and focus on tools and techniques used for conducting surgery on juvenile salmonids because of the large amount of research that is conducted on them. The use of sterilized surgical instruments properly selected for a given size of fish will minimize tissue damage and infection rates, and speed the wound healing of fish implanted with transmitters. For the implantation of transmitters into small fish, the optimal surgical methods include making an incision on the ventral midline along the linea alba (for studies under 1 month), protecting the viscera (by lifting the skin with forceps while creating the incision), and using absorbable monofilament suture with a small-swaged-on swaged-on tapered or reverse-cutting needle. Standardizing the implantation techniques to be used in a study involving particular species and age classes of fish will improve survival and transmitter retention while allowing for comparisons to be made among studies and across multiple years. This review should be useful for researchers working on juvenile salmonids and other sizes and species of fish.

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

Science.gov (United States)

Finke, M; Schweikard, A

2010-09-01

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

Another Perspective: The iPad Is a REAL Musical Instrument

Science.gov (United States)

Williams, David A.

2014-01-01

This article looks at the iPad's role as a musical instrument through the lens of a live performance ensemble that performs primarily on iPads. It also offers an overview of a pedagogical model used by this ensemble, which emphasizes musician autonomy in small groups, where music is learned primarily through aural means and concerts are…

Virtual interactive presence and augmented reality (VIPAR) for remote surgical assistance.

Science.gov (United States)

Shenai, Mahesh B; Dillavou, Marcus; Shum, Corey; Ross, Douglas; Tubbs, Richard S; Shih, Alan; Guthrie, Barton L

2011-03-01

Surgery is a highly technical field that combines continuous decision-making with the coordination of spatiovisual tasks. We designed a virtual interactive presence and augmented reality (VIPAR) platform that allows a remote surgeon to deliver real-time virtual assistance to a local surgeon, over a standard Internet connection. The VIPAR system consisted of a "local" and a "remote" station, each situated over a surgical field and a blue screen, respectively. Each station was equipped with a digital viewpiece, composed of 2 cameras for stereoscopic capture, and a high-definition viewer displaying a virtual field. The virtual field was created by digitally compositing selected elements within the remote field into the local field. The viewpieces were controlled by workstations mutually connected by the Internet, allowing virtual remote interaction in real time. Digital renderings derived from volumetric MRI were added to the virtual field to augment the surgeon's reality. For demonstration, a fixed-formalin cadaver head and neck were obtained, and a carotid endarterectomy (CEA) and pterional craniotomy were performed under the VIPAR system. The VIPAR system allowed for real-time, virtual interaction between a local (resident) and remote (attending) surgeon. In both carotid and pterional dissections, major anatomic structures were visualized and identified. Virtual interaction permitted remote instruction for the local surgeon, and MRI augmentation provided spatial guidance to both surgeons. Camera resolution, color contrast, time lag, and depth perception were identified as technical issues requiring further optimization. Virtual interactive presence and augmented reality provide a novel platform for remote surgical assistance, with multiple applications in surgical training and remote expert assistance.

Design of virtual three-dimensional instruments for sound control

Science.gov (United States)

Mulder, Axel Gezienus Elith

An environment for designing virtual instruments with 3D geometry has been prototyped and applied to real-time sound control and design. It enables a sound artist, musical performer or composer to design an instrument according to preferred or required gestural and musical constraints instead of constraints based only on physical laws as they apply to an instrument with a particular geometry. Sounds can be created, edited or performed in real-time by changing parameters like position, orientation and shape of a virtual 3D input device. The virtual instrument can only be perceived through a visualization and acoustic representation, or sonification, of the control surface. No haptic representation is available. This environment was implemented using CyberGloves, Polhemus sensors, an SGI Onyx and by extending a real- time, visual programming language called Max/FTS, which was originally designed for sound synthesis. The extension involves software objects that interface the sensors and software objects that compute human movement and virtual object features. Two pilot studies have been performed, involving virtual input devices with the behaviours of a rubber balloon and a rubber sheet for the control of sound spatialization and timbre parameters. Both manipulation and sonification methods affect the naturalness of the interaction. Informal evaluation showed that a sonification inspired by the physical world appears natural and effective. More research is required for a natural sonification of virtual input device features such as shape, taking into account possible co- articulation of these features. While both hands can be used for manipulation, left-hand-only interaction with a virtual instrument may be a useful replacement for and extension of the standard keyboard modulation wheel. More research is needed to identify and apply manipulation pragmatics and movement features, and to investigate how they are co-articulated, in the mapping of virtual object

Trends in the Surgical Correction of Gynecomastia

Science.gov (United States)

Brown, Rodger H.; Chang, Daniel K.; Siy, Richard; Friedman, Jeffrey

2015-01-01

Gynecomastia refers to the enlargement of the male breast due to a proliferation of ductal, stromal, and/or fatty tissue. Although it is a common condition affecting up to 65% of men, not all cases require surgical intervention. Contemporary surgical techniques in the treatment of gynecomastia have become increasingly less invasive with the advent of liposuction and its variants, including power-assisted and ultrasound-assisted liposuction. These techniques, however, have been largely limited in their inability to address significant skin excess and ptosis. For mild to moderate gynecomastia, newer techniques using arthroscopic morcellation and endoscopic techniques promise to address the fibrous component, while minimizing scar burden by utilizing liposuction incisions. Nevertheless, direct excision through periareolar incisions remains a mainstay in treatment algorithms for its simplicity and avoidance of additional instrumentation. This is particularly true for more severe cases of gynecomastia requiring skin resection. In the most severe cases with significant skin redundancy and ptosis, breast amputation with free nipple grafting remains an effective option. Surgical treatment should be individualized to each patient, combining techniques to provide adequate resection and optimize aesthetic results. PMID:26528088

Practice management education during surgical residency.

Science.gov (United States)

Jones, Kory; Lebron, Ricardo A; Mangram, Alicia; Dunn, Ernest

2008-12-01

Surgical education has undergone radical changes in the past decade. The introductions of laparoscopic surgery and endovascular techniques have required program directors to alter surgical training. The 6 competencies are now in place. One issue that still needs to be addressed is the business aspect of surgical practice. Often residents complete their training with minimal or no knowledge on coding of charges or basic aspects on how to set up a practice. We present our program, which has been in place over the past 2 years and is designed to teach the residents practice management. The program begins with a series of 10 lectures given monthly beginning in August. Topics include an introduction to types of practices available, negotiating a contract, managed care, and marketing the practice. Both medical and surgical residents attend these conferences. In addition, the surgical residents meet monthly with the business office to discuss billing and coding issues. These are didactic sessions combined with in-house chart reviews of surgical coding. The third phase of the practice management plan has the coding team along with the program director attend the outpatient clinic to review in real time the evaluation and management coding of clinic visits. Resident evaluations were completed for each of the practice management lectures. The responses were recorded on a Likert scale. The scores ranged from 4.1 to 4.8 (average, 4.3). Highest scores were given to lectures concerning negotiating employee agreements, recruiting contracts, malpractice insurance, and risk management. The medical education department has tracked resident coding compliance over the past 2 years. Surgical coding compliance increased from 36% to 88% over a 12-month period. The program director who participated in the educational process increased his accuracy from 50% to 90% over the same time period. When residents finish their surgical training they need to be ready to enter the world of business

Reducing healthcare costs facilitated by surgical auditing: a systematic review.

Science.gov (United States)

Govaert, Johannes Arthuur; van Bommel, Anne Charlotte Madeline; van Dijk, Wouter Antonie; van Leersum, Nicoline Johanneke; Tollenaar, Robertus Alexandre Eduard Mattheus; Wouters, Michael Wilhemus Jacobus Maria

2015-07-01

Surgical auditing has been developed in order to benchmark and to facilitate quality improvement. The aim of this review is to determine if auditing combined with systematic feedback of information on process and outcomes of care results in lower costs of surgical care. A systematic search of published literature before 21-08-2013 was conducted in Pubmed, Embase, Web of Science, and Cochrane Library. Articles were selected if they met the inclusion criteria of describing a surgical audit with cost-evaluation. The systematic search resulted in 3608 papers. Six studies were identified as relevant, all showing a positive effect of surgical auditing on quality of healthcare and therefore cost savings was reported. Cost reductions ranging from $16 to $356 per patient were seen in audits evaluating general or vascular procedures. The highest potential cost reduction was described in a colorectal surgical audit (up to $1,986 per patient). All six identified articles in this review describe a reduction in complications and thereby a reduction in costs due to surgical auditing. Surgical auditing may be of greater value when high-risk procedures are evaluated, since prevention of adverse events in these procedures might be of greater clinical and therefore of greater financial impact. This systematic review shows that surgical auditing can function as a quality instrument and therefore as a tool to reduce costs. Since evidence is scarce so far, further studies should be performed to investigate if surgical auditing has positive effects to turn the rising healthcare costs around. In the future, incorporating (actual) cost analyses and patient-related outcome measures would increase the audits' value and provide a complete overview of the value of healthcare.

New developments for the surgical treatment of shoulder problems

International Nuclear Information System (INIS)

Anderl, W.

2004-01-01

Tremendous advancement has been made in the surgical treatment of the shoulder within the last years. Arthroscopic techniques for treatment of rotator cuff lesions, instability problems and biceps tendon lesions are today established because of significant improvement of instruments, suture materials and anchor techniques. The 4th generation of shoulder prosthesis systems guarantee today anatomical and biomechanical advantages with significant functional improvement for the patient. (orig.) [de

Active instrumental guidance in interventional magnetic resonance imaging

International Nuclear Information System (INIS)

Wildermuth, S.; Erhart, P.; Leung, D.A.; Goehde, S.; Schoenenberger, A.; Debatin, J.F.

1998-01-01

Purpose: An active MR-based guidance system for visualisation of invasive instruments is described. Methods: The principle of MR tracking is based on the integration of a miniaturised coil into the tip of the instrument itself. A phantom experiment was designed to demonstrate the localising accuracy of this technique. In [dition, bicompatibility and warming effects were evaluated. Preliminary intravascular applications that were performed in animal experiments under MR guidance included embolisation, vascular occlusion as well as transjugular intrahepatic punctures. Percutaneous biopsies, cholecystostomies and laparoscopic applications were also evaluated with MR tracking. Results: Phantom experiments confirmed an excellent localisation accuracy of MR tracking compared to conventional r[iography. At a field strength of 0.5 T, the temperature increase remained below 2 C. Results of phantom experiments revealed a potential of significant heating dependent on the sequence parameters employed. MR tracking allowed a robust, simultaneously biplanar visualisation of the instrument tips in real time. Based on MR 'ro[ map' images, various intravascular and percutaneous interventions were successfully performed in vivo under MR guidance. Conclusions: MR tracking is a flexible concept permitting monitoring in the guidance of instruments in an MR environment. Various preliminary in vitro and in vivo experiments demonstrate safety, localisation accuracy and feasibility of this biplanar localisation technique in real time. (orig.) [de

NCU-SWIP Space Weather Instrumentation Payload - Intelligent Sensors On Efficient Real-Time Distributed LUTOS

Science.gov (United States)

Yeh, Tse-Liang; Dmitriev, Alexei; Chu, Yen-Hsyang; Jiang, Shyh-Biau; Chen, Li-Wu

The NCU-SWIP - Space Weather Instrumentation Payload is developed for simultaneous in-situ and remote measurement of space weather parameters for cross verifications. The measurements include in-situ electron density, electron temperature, magnetic field, the deceleration of satellite due to neutral wind, and remotely the linear cumulative intensities of oxygen ion air-glows at 135.6nm and 630.0nm along the flight path in forward, nader, and backward directions for tomographic reconstruction of the electron density distribution underneath. This instrument package is suitable for micro satellite constellation to establish nominal space weather profiles and, thus, to detect abnormal variations as the signs of ionospheric disturbances induced by severe atmospheric weather, or earth quake - mantle movement through their Lithosphere-Atmosphere-Ionosphere Coupling Mechanism. NCU-SWIP is constructed with intelligent sensor modules connected by common bus with their functionalities managed by an efficient distributed real-time system LUTOS. The same hierarchy can be applied to the level of satellite constellation. For example SWIP's in a constellation in coordination with the GNSS Occultation Experiment TriG planned for the Formosa-7 constellation, data can be cross correlated for verification and refinement for real-time, stable and reliable measurements. A SWIP will be contributed to the construction of a MAI Micro Satellite for verification. The SWIP consists of two separate modules: the SWIP main control module and the SWIP-PMTomo sensor module. They are respectively a 1.5kg W120xL120xH100 (in mm) box with forward facing 120mmPhi circular disk probe on a boom top edged at 470mm height and a 7.2kg W126xL590x372H (in mm) slab containing 3 legs looking downwards along the flight path, while consuming the maximum electricity of 10W and 12W. The sensors are 1) ETPEDP measuring 16bits floating potentials for electron temperature range of 1000K to 3000K and 24bits electron

Nuclear instrumentation for research reactors; Instrumentacion nuclear para reactores nucleares de investigacion

Energy Technology Data Exchange (ETDEWEB)

Hofer, Carlos G.; Pita, Antonio; Verrastro, Claudio A.; Maino, Eduardo J. [Comision Nacional de Energia Atomica, Buenos Aires (Argentina). Unidad de Actividades de Reactores y Centrales Nucleares. Sector Instrumentacion y Control

1997-10-01

The nuclear instrumentation for research reactors in Argentina was developed in 70`. A gradual modernization of all the nuclear instrumentation is planned. It includes start-up and power range instrumentation, as well as field monitors, clamp, scram and rod movement control logic. The new instrumentation is linked to a computer network, based on real time operating system for data acquisition, display and logging. This paper describes the modules and whole system aspects. (author). 2 refs.

Two, four, six, eight... stop and count before it is too late! An audit on swab, needle and instrument counts in theatre.

LENUS (Irish Health Repository)

Donnelly, T.

2014-07-01

A concurrent audit was conducted over a four week period to determine if the counting of swabs, needles and instruments for surgery adhered to local policy and recommended guidelines. Data were collected on 30 abdominal surgical procedures. This audit highlighted failings in the count process. It identified poor communication within the multidisciplinary team. There needs to be an increased awareness about local policy, national and international guidelines regarding the counting of swabs, needles and instruments for all surgical procedures.

Instrument for Airborne Measurement of Carbonyl Sulfide, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — Southwest Sciences proposes to develop small, low power instrumentation for the real-time direct measurement of carbonyl sulfide (OCS) in the atmosphere, especially...

High correlation between performance on a virtual-reality simulator and real-life cataract surgery

DEFF Research Database (Denmark)

Thomsen, Ann Sofia Skou; Smith, Phillip; Subhi, Yousif

2017-01-01

-tracking software of cataract surgical videos with a Pearson correlation coefficient of -0.70 (p = 0.017). CONCLUSION: Performance on the EyeSi simulator is significantly and highly correlated to real-life surgical performance. However, it is recommended that performance assessments are made using multiple data......PURPOSE: To investigate the correlation in performance of cataract surgery between a virtual-reality simulator and real-life surgery using two objective assessment tools with evidence of validity. METHODS: Cataract surgeons with varying levels of experience were included in the study. All...... antitremor training, forceps training, bimanual training, capsulorhexis and phaco divide and conquer. RESULTS: Eleven surgeons were enrolled. After a designated warm-up period, the proficiency-based test on the EyeSi simulator was strongly correlated to real-life performance measured by motion...

28 CFR 552.13 - X-ray, major instrument, fluoroscope, or surgical intrusion.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false X-ray, major instrument, fluoroscope, or... INSTITUTIONAL MANAGEMENT CUSTODY Searches of Housing Units, Inmates, and Inmate Work Areas § 552.13 X-ray, major... reasons only, with the inmate's consent. (b) The institution physician may authorize use of an X-ray for...

Virtual Cerebral Aneurysm Clipping with Real-Time Haptic Force Feedback in Neurosurgical Education.

Science.gov (United States)

Gmeiner, Matthias; Dirnberger, Johannes; Fenz, Wolfgang; Gollwitzer, Maria; Wurm, Gabriele; Trenkler, Johannes; Gruber, Andreas

2018-04-01

Realistic, safe, and efficient modalities for simulation-based training are highly warranted to enhance the quality of surgical education, and they should be incorporated in resident training. The aim of this study was to develop a patient-specific virtual cerebral aneurysm-clipping simulator with haptic force feedback and real-time deformation of the aneurysm and vessels. A prototype simulator was developed from 2012 to 2016. Evaluation of virtual clipping by blood flow simulation was integrated in this software, and the prototype was evaluated by 18 neurosurgeons. In 4 patients with different medial cerebral artery aneurysms, virtual clipping was performed after real-life surgery, and surgical results were compared regarding clip application, surgical trajectory, and blood flow. After head positioning and craniotomy, bimanual virtual aneurysm clipping with an original forceps was performed. Blood flow simulation demonstrated residual aneurysm filling or branch stenosis. The simulator improved anatomic understanding for 89% of neurosurgeons. Simulation of head positioning and craniotomy was considered realistic by 89% and 94% of users, respectively. Most participants agreed that this simulator should be integrated into neurosurgical education (94%). Our illustrative cases demonstrated that virtual aneurysm surgery was possible using the same trajectory as in real-life cases. Both virtual clipping and blood flow simulation were realistic in broad-based but not calcified aneurysms. Virtual clipping of a calcified aneurysm could be performed using the same surgical trajectory, but not the same clip type. We have successfully developed a virtual aneurysm-clipping simulator. Next, we will prospectively evaluate this device for surgical procedure planning and education. Copyright © 2018 Elsevier Inc. All rights reserved.

Development of haptic system for surgical robot

Science.gov (United States)

Gang, Han Gyeol; Park, Jiong Min; Choi, Seung-Bok; Sohn, Jung Woo

2017-04-01

In this paper, a new type of haptic system for surgical robot application is proposed and its performances are evaluated experimentally. The proposed haptic system consists of an effective master device and a precision slave robot. The master device has 3-DOF rotational motion as same as human wrist motion. It has lightweight structure with a gyro sensor and three small-sized MR brakes for position measurement and repulsive torque generation, respectively. The slave robot has 3-DOF rotational motion using servomotors, five bar linkage and a torque sensor is used to measure resistive torque. It has been experimentally demonstrated that the proposed haptic system has good performances on tracking control of desired position and repulsive torque. It can be concluded that the proposed haptic system can be effectively applied to the surgical robot system in real field.

7 CFR 1980.333 - Promissory notes and security instruments.

Science.gov (United States)

2010-01-01

... promissory notes, real estate mortgages, including deeds of trust and similar instruments, and security... Interest Assistance Agreement, assure that the closing agent properly records a junior mortgage or deed of...

Instrument for Airborne Measurement of Carbonyl Sulfide, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — In this Phase II SBIR program, Southwest Sciences will continue the development of small, low power instrumentation for real-time direct measurement of carbonyl...

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

Directory of Open Access Journals (Sweden)

Heiko T. Santana

2016-09-01

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

Utilization of the NASA Robonaut as a Surgical Avatar in Telemedicine

Science.gov (United States)

Dean, Marc; Diftler, Myron

2015-01-01

The concept of teleoperated robotic surgery is not new; however, most of the work to date has utilized specialized robots designed for specific set of surgeries. This activity explores the use of a humanoid robot to perform surgical procedures using the same hand held instruments that a human surgeon employs. For this effort, the tele-operated Robonaut (R2) was selected due to its dexterity, its ability to perform a wide range of tasks, and its adaptability to changing environments. To evaluate this concept, a series of challenges was designed with the goal of assessing the feasibility of utilizing Robonaut as a telemedicine based surgical avatar.

Advances in Miniaturized Instruments for Genomics

Directory of Open Access Journals (Sweden)

Cihun-Siyong Alex Gong

2014-01-01

Full Text Available In recent years, a lot of demonstrations of the miniaturized instruments were reported for genomic applications. They provided the advantages of miniaturization, automation, sensitivity, and specificity for the development of point-of-care diagnostics. The aim of this paper is to report on recent developments on miniaturized instruments for genomic applications. Based on the mature development of microfabrication, microfluidic systems have been demonstrated for various genomic detections. Since one of the objectives of miniaturized instruments is for the development of point-of-care device, impedimetric detection is found to be a promising technique for this purpose. An in-depth discussion of the impedimetric circuits and systems will be included to provide total consideration of the miniaturized instruments and their potential application towards real-time portable imaging in the “-omics” era. The current excellent demonstrations suggest a solid foundation for the development of practical and widespread point-of-care genomic diagnostic devices.

Spinal instrumentation for unstable C1-2 injury.

Science.gov (United States)

Mizuno, J; Nakagawa, H

1999-06-01

Seventeen patients with unstable C1-2 injuries were treated between 1990 and 1997. Various methods of instrumentation surgery were performed in 16 patients, excluding a case of atlantoaxial rotatory fixation. Posterior stabilization was carried out in 14 cases using Halifax interlaminar clamp, Sof'wire or Danek cable, or more recently, transarticular screws. Transodontoid anterior screw fixation was performed in four cases of odontoid process fractures, with posterior instrumentation in two cases because of malunion. Rigid internal fixation by instrumentation surgery for the unstable C1-2 injury avoids long-term application of a Halo brace and facilitates early rehabilitation. However, the procedure is technically demanding with the risk of neural and vascular injuries, particularly with posterior screw fixation. Sagittal reconstruction of thin-sliced computed tomography scans at the C1-2 region, neuronavigator, and intraoperative fluoroscopy are essential to allow preoperative surgical planning and intraoperative guidance.

Developments in architecture for real-time data systems

International Nuclear Information System (INIS)

Heath, R.L.; Myers, W.R.

1975-01-01

Real-time data systems typically operate at two levels: a fast-response instrument-oriented level for data acquisition and control, and a slow human-oriented level for interaction and computation. Traditional minicomputer data systems support real-time applications by implementation of background/foreground software. Recent developments in computer technology including microprocessors enable the functional organization of hardware in distributed or hierarchical form to provide new system structures for real-time requirements. Examples of systems with distributed architecture will be discussed in detail

Retention of fundamental surgical skills learned in robot-assisted surgery.

Science.gov (United States)

Suh, Irene H; Mukherjee, Mukul; Shah, Bhavin C; Oleynikov, Dmitry; Siu, Ka-Chun

2012-12-01

Evaluation of the learning curve for robotic surgery has shown reduced errors and decreased task completion and training times compared with regular laparoscopic surgery. However, most training evaluations of robotic surgery have only addressed short-term retention after the completion of training. Our goal was to investigate the amount of surgical skills retained after 3 months of training with the da Vinci™ Surgical System. Seven medical students without any surgical experience were recruited. Participants were trained with a 4-day training program of robotic surgical skills and underwent a series of retention tests at 1 day, 1 week, 1 month, and 3 months post-training. Data analysis included time to task completion, speed, distance traveled, and movement curvature by the instrument tip. Performance of the participants was graded using the modified Objective Structured Assessment of Technical Skills (OSATS) for robotic surgery. Participants filled out a survey after each training session by answering a set of questions. Time to task completion and the movement curvature was decreased from pre- to post-training and the performance was retained at all the corresponding retention periods: 1 day, 1 week, 1 month, and 3 months. The modified OSATS showed improvement from pre-test to post-test and this improvement was maintained during all the retention periods. Participants increased in self-confidence and mastery in performing robotic surgical tasks after training. Our novel comprehensive training program improved robot-assisted surgical performance and learning. All trainees retained their fundamental surgical skills for 3 months after receiving the training program.

Work group I: Measures of the food and physical activity environment: instruments.

Science.gov (United States)

Saelens, Brian E; Glanz, Karen

2009-04-01

A work group was convened to identify the core challenges, content gaps, and corresponding possible solutions for improving food- and physical activity-environment instrumentation. Identified challenges included instrument proliferation, the scaling or grain of instruments and appropriate aggregation to the neighborhood or community level, and unknown sensitivity to change of most instruments. Solutions for addressing these challenges included establishing an interactive and real-time instrument repository, developing and enforcing high standards for instrument reporting, increasing community-researcher collaborations, and implementing surveillance of food and physical activity environment. Solid instrumentation will accelerate a better understanding of food- and physical activity-environment effects on eating and physical activity behaviors.

Abortion - surgical

Science.gov (United States)

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

Developing Process Maps as a Tool for a Surgical Infection Prevention Quality Improvement Initiative in Resource-Constrained Settings.

Science.gov (United States)

Forrester, Jared A; Koritsanszky, Luca A; Amenu, Demisew; Haynes, Alex B; Berry, William R; Alemu, Seifu; Jiru, Fekadu; Weiser, Thomas G

2018-06-01

Surgical infections cause substantial morbidity and mortality in low-and middle-income countries (LMICs). To improve adherence to critical perioperative infection prevention standards, we developed Clean Cut, a checklist-based quality improvement program to improve compliance with best practices. We hypothesized that process mapping infection prevention activities can help clinicians identify strategies for improving surgical safety. We introduced Clean Cut at a tertiary hospital in Ethiopia. Infection prevention standards included skin antisepsis, ensuring a sterile field, instrument decontamination/sterilization, prophylactic antibiotic administration, routine swab/gauze counting, and use of a surgical safety checklist. Processes were mapped by a visiting surgical fellow and local operating theater staff to facilitate the development of contextually relevant solutions; processes were reassessed for improvements. Process mapping helped identify barriers to using alcohol-based hand solution due to skin irritation, inconsistent administration of prophylactic antibiotics due to variable delivery outside of the operating theater, inefficiencies in assuring sterility of surgical instruments through lack of confirmatory measures, and occurrences of retained surgical items through inappropriate guidelines, staffing, and training in proper routine gauze counting. Compliance with most processes improved significantly following organizational changes to align tasks with specific process goals. Enumerating the steps involved in surgical infection prevention using a process mapping technique helped identify opportunities for improving adherence and plotting contextually relevant solutions, resulting in superior compliance with antiseptic standards. Simplifying these process maps into an adaptable tool could be a powerful strategy for improving safe surgery delivery in LMICs. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

The surgical management of the rheumatoid spine: Has the evolution of surgical intervention changed outcomes?

Directory of Open Access Journals (Sweden)

Robin Bhatia

2014-01-01

Full Text Available Context: Surgery for the rheumatoid cervical spine has been shown to stabilize the unstable spine; arrest/improve the progression of neurological deficit, help neck pain, and possibly decelerate the degenerative disease process. Operative intervention for the rheumatoid spine has significantly changed over the last 30 years. Aims: The purpose of this study was to review all cases of cervical rheumatoid spine requiring surgical intervention in a single unit over the last 30 years. Materials and Methods: A prospectively-maintained spine database was retrospectively searched for all cases of rheumatoid spine, leading to a review of indications, imaging, Ranawat and Myelopathy Disability Index measures, surgical morbidity, and survival curve analysis. Results: A total of 224 cases were identified between 1981 and 2011. Dividing the data into three time-epochs, there has been a significant increase in the ratio of segment-saving Goel-Harms C1-C2: Occipitocervical fixation (OCF surgery and survival has increased between 1981 and 2011 from 30% to 51%. Patients undergoing C1-C2 fixation were comparatively less myelopathic and in a better Ranawat class preoperatively, but postoperative outcome measures were well-preserved with favorable mortality rates over mean 39.6 months of follow-up. However, 11% of cases required OCF at mean 28 months post-C1-C2 fixation, largely due to instrumentation failure (80%. Conclusion: We present the largest series of surgically managed rheumatoid spines, revealing comparative data on OCF and C1-C2 fixation. Although survival has improved over the last 30 years, there have been changes in medical, surgical and perioperative management over that period of time too confounding the interpretation; however, the analysis presented suggests that rheumatoid patients presenting early in the disease process may benefit from C1 to C2 fixation, albeit with a proportion requiring OCF at a later time.

Systems engineering real estate development projects

Science.gov (United States)

Gusakova, Elena; Titarenko, Boris; Stepanov, Vitaliy

2017-10-01

In recent years, real estate development has accumulated a wealth of experience in implementing major projects, which requires comprehension and systematization. The scientific instrument of system engineering is studied in the article and is substantively interpreted with reference to real estate development projects. The most perspective approaches and models are substantiated, allowing strategically to plan the life cycle of the project as a whole, and also to solve the engineering butt problems of the project. The relevance of further scientific studies of regularities and specifics of the life cycle of real estate development projects conducted at the Moscow State University of Economics and Management at the ISTA department is shown.

Technical and instrumental prerequisites for single-port laparoscopic solo surgery: state of art.

Science.gov (United States)

Kim, Say-June; Lee, Sang Chul

2015-04-21

With the aid of advanced surgical techniques and instruments, single-port laparoscopic surgery (SPLS) can be accomplished with just two surgical members: an operator and a camera assistant. Under these circumstances, the reasonable replacement of a human camera assistant by a mechanical camera holder has resulted in a new surgical procedure termed single-port solo surgery (SPSS). In SPSS, the fixation and coordinated movement of a camera held by mechanical devices provides fixed and stable operative images that are under the control of the operator. Therefore, SPSS primarily benefits from the provision of the operator's eye-to-hand coordination. Because SPSS is an intuitive modification of SPLS, the indications for SPSS are the same as those for SPLS. Though SPSS necessitates more actions than the surgery with a human assistant, these difficulties seem to be easily overcome by the greater provision of static operative images and the need for less lens cleaning and repositioning of the camera. When the operation is expected to be difficult and demanding, the SPSS process could be assisted by the addition of another instrument holder besides the camera holder.

Real Exchange Rate Dynamics in a Small, Primary-Exporting Country

OpenAIRE

Mohsin S. Khan; Peter J. Montiel

1987-01-01

Although the nominal exchange rate is often used as a policy instrument in small, primary-commodity-exporting countries, the real exchange rate is an endogenous variable that responds to both exogenous and policyinduced shocks. This paper examines the dynamic effects on the real exchange rate of various shocks, such as devaluation, fiscal and trade policies, and changes in the terms of trade and foreign real interest rates. Because the path of the real exchange rate differs for different type...

Development and preliminary validation of a post-fistula repair reintegration instrument among Ugandan women.

Science.gov (United States)

El Ayadi, Alison; Nalubwama, Hadija; Barageine, Justus; Neilands, Torsten B; Obore, Susan; Byamugisha, Josaphat; Kakaire, Othman; Mwanje, Haruna; Korn, Abner; Lester, Felicia; Miller, Suellen

2017-09-02

Obstetric fistula is a debilitating and traumatic birth injury affecting 2-3 million women globally, mostly in sub-Saharan Africa and Asia. Affected women suffer physically, psychologically and socioeconomically. International efforts have increased access to surgical treatment, yet attention to a holistic outcome of post-surgical rehabilitation is nascent. We sought to develop and pilot test a measurement instrument to assess post-surgical family and community reintegration. We conducted an exploratory sequential mixed-methods study, beginning with 16 in-depth interviews and four focus group discussions with 17 women who underwent fistula surgery within two previous years to inform measure development. The draft instrument was validated in a longitudinal cohort of 60 women recovering from fistula surgery. Qualitative data were analyzed through thematic analysis. Socio-demographic characteristics were described using one-way frequency tables. We used exploratory factor analysis to determine the latent structure of the scale, then tested the fit of a single higher-order latent factor. We evaluated internal consistency and temporal stability reliability through Raykov's ρ and Pearson's correlation coefficient, respectively. We estimated a series of linear regression models to explore associations between the standardized reintegration measure and validated scales representing theoretically related constructs. Themes central to women's experiences following surgery included resuming mobility, increasing social interaction, improved self-esteem, reduction of internalized stigma, resuming work, meeting their own needs and the needs of dependents, meeting other expected and desired roles, and negotiating larger life issues. We expanded the Return to Normal Living Index to reflect these themes. Exploratory factor analysis suggested a four-factor structure, titled 'Mobility and social engagement', 'Meeting family needs', 'Comfort with relationships', and 'General life

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

African Journals Online (AJOL)

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

Assessment of surgeon fatigue by surgical simulators

Directory of Open Access Journals (Sweden)

Tuwairqi K

2015-04-01

Full Text Available Khaled Tuwairqi,1 Jessica H Selter,2 Shameema Sikder3 1College of Medicine, University of Utah, Salt Lake City, UT, 2Johns Hopkins School of Medicine, 3Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA Background: The impact of fatigue on surgical performance and its implications for patient care is a growing concern. While investigators have employed a number of different tools to measure the effect of fatigue on surgical performance, the use of the surgical simulator has been increasingly implemented for this purpose. The goal of this paper is to review the published literature to achieve a better understanding of evaluation of fatigue on performance as studied with surgical simulators. Methods: A PubMed and Cochrane search was conducted using the search terms “simulator”, “surgery”, and “fatigue”. In total, 50 papers were evaluated, and 20 studies were selected after application of exclusion criteria. Articles were excluded if they did not use the simulator to assess the impact of fatigue on surgeon performance. Systematic reviews and case reports were also excluded. Results: Surgeon fatigue led to a consistent decline in cognitive function in six studies. Technical skills were evaluated in 18 studies, and a detrimental impact was reported in nine studies, while the remaining nine studies showed either no change or positive results with regard to surgical skills after experience of fatigue. Two pharmacological intervention studies reversed the detrimental impact of fatigue on cognitive function, but no change or a worsening effect was recognized for technical skills. Conclusion: Simulators are increasingly being used to evaluate the impact of fatigue on the surgeon's performance. With regard to the impact of fatigue in this regard, studies have demonstrated a consistent decline in cognitive function and mixed outcomes for technical skills. Larger studies that relate the simulator's results to real surgical

Strengthening linkages of the financial services and real sectors of ...

African Journals Online (AJOL)

Strengthening linkages of the financial services and real sectors of the ... policy, financial sector credit and capital market activities have impacted on the real sector growth. ... sector as a result such financial crimes like misappropriation of funds. ... better results; more investment instruments such as derivatives, convertibles, ...

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

Directory of Open Access Journals (Sweden)

George Garas

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

Example of an in-plant near-real-time accountancy/process control system

International Nuclear Information System (INIS)

Anon.

1981-01-01

This session describes an existing computerized in-plant near-real-time accounting and process monitoring system at the Allied-General Nuclear Services (AGNS) Barnwell Nuclear Fuel Plant (BNFP). Details of the system performance, objectives, hardware, plant instrumentation, and system functions are presented. Examples of actual programs for accounting and monitoring are described and system benefits will be discussed. The purpose of this session is to enable participants to: (1) identify the major computer hardware components of functional near-real-time accounting systems; (2) identify the types of process instrumentation necessary to perform near-real-time accounting; (3) describe the major nuclear material control and accounting functions of the AGNS computer system; and (4) assess the benefits to safeguards and plant operations of a computerized near-real-time accounting system

[Changing surgical therapy because of clinical studies?].

Science.gov (United States)

Schwenk, W; Haase, O; Müller, J M

2002-04-01

The randomised controlled clinical trial (RCT) is a powerful instrument to evaluate different therapeutic regimens. In a survey among 115 physicians visiting the 25th annual meeting of the Surgical Society of Berlin and Brandenburg, the RCT was judged to be very important when changes of therapeutic strategies are discussed. 90 % of all participants claimed to use data from RCTs in the clinical routine and 89 % would participate in such a trial. In official (e. g. discussions during coffee breaks at scientific meetings) or non-medical (e. g. non-scientific press or media) sources of information were assessed as irrelevant for decisions regarding therapeutic strategies. However, in contrast to this view laparoscopic cholecystectomy was introduced into clinical practice rapidly because patients informed by external (non-medical) sources preferred to be operated on with the "modern" technique. Clinical trials with a high level of evidence had no relevant influence on the rapid distribution of laparoscopic cholecystectomy. Controversial discussions concerning the extent of lymphadenectomy with gastric resection for carcinoma demonstrate that the value of excellent clinical RCTs is low if their results challenge a stable paradigma of the surgical scientific society. To allow a rational judgement, new surgical technologies should undergo a scientific gradual evaluation in agreement with the principles of evidence based medicine.

Foreign Body Retrieval

Medline Plus

Full Text Available ... endoscopic or surgical intervention is required only 10 to 20 percent of the time. Evaluation and treatment will depend on the type ... to view the surgical instrument as it advances to the location of the foreign object in real-time. Your physician also may locate soft-tissue objects ...

Design of real-time communication system for image recognition based colony picking instrument

Science.gov (United States)

Wang, Qun; Zhang, Rongfu; Yan, Hua; Wu, Huamin

2017-11-01

In order to aachieve autommated observatiion and pickinng of monocloonal colonies, an overall dessign and realizzation of real-time commmunication system based on High-throoughput monooclonal auto-piicking instrumment is propossed. The real-time commmunication system is commposed of PCC-PLC commuunication systtem and Centrral Control CComputer (CCC)-PLC communicatioon system. Bassed on RS232 synchronous serial communnication methood to develop a set of dedicated shoort-range commmunication prootocol betweenn the PC and PPLC. Furthermmore, the systemm uses SQL SSERVER database to rrealize the dataa interaction between PC andd CCC. Moreoover, the commmunication of CCC and PC, adopted Socket Ethernnet communicaation based on TCP/IP protoccol. TCP full-dduplex data cannnel to ensure real-time data eexchange as well as immprove system reliability andd security. We tested the commmunication syystem using sppecially develooped test software, thee test results show that the sysstem can realizze the communnication in an eefficient, safe aand stable way between PLC, PC andd CCC, keep thhe real-time conntrol to PLC annd colony inforrmation collecttion.

Instrumented fusion in a 12-month-old with atlanto-occipital dislocation: case report and literature review of infant occipitocervical fusion.

Science.gov (United States)

Hale, Andrew T; Dewan, Michael C; Patel, Bhairav; Geck, Matthew J; Tomycz, Luke D

2017-08-01

The treatment of atlantoaxial dislocation in very young children is challenging and lacks a consensus management strategy. We review the literature on infantile occipitocervical (OC) fusion is appraised and technical considerations are organized for ease of reference. Surgical decisions such as graft type and instrumentation details are summarized, along with the use of bone morphogenic protein and post-operative orthoses. We present the case of a 12-month-old who underwent instrumented occipitocervical (OC) fusion in the setting of traumatic atlanto-occipital dislocation (AOD). Occipitocervical (OC) arthrodesis is obtainable in very young infants and children. Surgical approaches are variable and use a combination of autologous grafting and creative screw and/or wire constructs. The heterogeneity of pathologic etiology leading to OC fusion makes it difficult to make definitive recommendations for surgical management.

Real-time continuous image-guided surgery: Preclinical investigation in glossectomy.

Science.gov (United States)

Tabanfar, Reza; Qiu, Jimmy; Chan, Harley; Aflatouni, Niousha; Weersink, Robert; Hasan, Wael; Irish, Jonathan C

2017-10-01

To develop, validate, and study the efficacy of an intraoperative real-time continuous image-guided surgery (RTC-IGS) system for glossectomy. Prospective study. We created a RTC-IGS system and surgical simulator for glossectomy, enabling definition of a surgical target preoperatively, real-time cautery tracking, and display of a surgical plan intraoperatively. System performance was evaluated by a group of otolaryngology residents, fellows, medical students, and staff under a reproducible setting by using realistic tongue phantoms. Evaluators were grouped into a senior and a junior group based on surgical experience, and guided and unguided tumor resections were performed. National Aeronautics and Space Administration Task Load Index (NASA-TLX) scores and a Likert scale were used to measure workloads and impressions of the system, respectively. Efficacy was studied by comparing surgical accuracy, time, collateral damage, and workload between RTC-IGS and non-navigated resections. The senior group performed more accurately (80.9% ± 3.7% vs. 75.2% ± 5.5%, P = .28), required less time (5.0 ± 1.3 minutes vs. 7.3 ± 1.2 minutes, P = .17), and experienced lower workload (43 ± 2.0 vs. 64.4 ± 1.3 NASA-TLX score, P = .08), suggesting a trend of construct validity. Impressions were favorable, with participants reporting the system is a valuable practice tool (4.0/5 ± 0.3) and increases confidence (3.9/5 ± 0.4). Use of RTC-IGS improved both groups' accuracy, with the junior group improving from 64.4% ± 5.4% to 75.2% ± 5.5% (P = .01) and the senior group improving from 76.1% ± 4.5% to 80.9% ± 3.7% (P = .16). We created an RTC-IGS system and surgical simulator and demonstrated a trend of construct validity. Our navigated simulator allows junior trainees to practice glossectomies outside the operating room. In all evaluators, navigation assistance resulted in increased surgical accuracy. NA Laryngoscope, 127:E347-E353, 2017. © 2017 The American Laryngological

Effect of Surgical Approach on Pulmonary Function in Adolescent Idiopathic Scoliosis Patients: A Systemic Review and Meta-analysis.

Science.gov (United States)

Lee, Andy C H; Feger, Mark A; Singla, Anuj; Abel, Mark F

2016-11-15

Systemic review and meta-analysis. To analyze the effect of spinal fusion and instrumentation for adolescent idiopathic scoliosis (AIS) on absolute pulmonary function test (PFTs). Pulmonary function is correlated with severity of deformity in AIS patients and studies that have analyzed the effect of spinal fusion and instrumentation on PFTs for AIS have reported inconsistent results. There is a need to analyze the effect of spinal fusion on PFTs with stratification by surgical approach. Our analysis included 22 studies. Cohen's d effect sizes were calculated for absolute PFT outcome measures with 95% confidence intervals (CI). Meta-analyses were performed at each postoperative time frame for six homogeneous surgical approaches: (i) combined anterior release and posterior fusion with instrumentation; (ii) combined video assisted anterior release and posterior fusion with instrumentation without thoracoplasty; (iii) posterior fusion with instrumentation without thoracoplasty; (iv) anterior fusion with instrumentation and without thoracoplasty; (v) video assisted anterior fusion with instrumentation without thoracoplasty; and (vi) any scoliosis surgery with additional thoracoplasty. Anterior spinal fusion with instrumentation, any scoliosis surgery with concomitant thoracoplasty, or video-assisted anterior fusion with instrumentation for AIS had similar absolute PFTs at their 2 year postoperative follow up compared with their preoperative PFTs (effect sizes ranging from -0.2-0.2 with all CI crossing "0"). Posterior spinal fusion with instrumentation (with or without an anterior release) demonstrated small to moderate increases in PFTs 2 years postoperatively (effect sizes ranging from 0.35-0.65 with all CI not crossing "0"). Anterior fusion with instrumentation, regardless of the approach, and any scoliosis surgery with concomitant thoracoplasty do not lead to significant change in pulmonary functions 2 year after surgery. Posterior spinal fusion with instrumentation

Real time 2 dimensional detector for charged particle and soft X-ray images

International Nuclear Information System (INIS)

Ishikawa, M.; Ito, M.; Endo, T.; Oba, K.

1995-01-01

The conventional instruments used in experiments for the soft X-ray region such as X-ray diffraction analysis are X-ray films or imaging plates. However, these instruments are not suitable for real time observation. In this paper, newly developed imaging devices will be presented, which have the capability to take X-ray images in real time with a high detection efficiency. Also, another capability, to take elementary particle tracking images, is described. (orig.)

Portable Chemical Sterilizer for Microbial Decontamination of Surgical Instruments, Fruits and Vegetables, and Field Feeding Equipment

National Research Council Canada - National Science Library

Doona, C. J; Feeherry, F. E; Kustin, K; Curtin, M. A; Baer, D. G

2006-01-01

The Portable Chemical Sterilizer (PCS) is a revolutionary biomedical sterilization technology that provides the capability for portable, power-free, point-of-use sterilization to meet the Army's Far-Forward Surgical Teams (FSTs...

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

Science.gov (United States)

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

1999-01-01

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

Preoperative and perioperative factors effect on adolescent idiopathic scoliosis surgical outcomes.

Science.gov (United States)

Sanders, James O; Carreon, Leah Y; Sucato, Daniel J; Sturm, Peter F; Diab, Mohammad

2010-09-15

Prospective multicenter database. To identify factors associated with outcomes from adolescent idiopathic scoliosis (AIS) surgery outcomes and especially poor results. Because AIS is rarely symptomatic during adolescence, excellent surgical results are expected. However, some patients have poor outcomes. This study seeks to identify factors correlating with results and especially those making poor outcomes more likely. Demographic, surgical, and radiographic parameters were compared to 2-year postoperative Scoliosis Research Society (SRS) scores in 477 AIS surgical patients using stepwise linear regression to identify factors predictive of 2-year domain and total scores. Poor postoperative score patients (>2 SD below mean) were compared using t tests to those with better results. The SRS instrument exhibited a strong ceiling effect. Two-year scores showed more improvement with greater curve correction (self-image, pain, and total), and were worse with larger body mass index (pain, mental, total), larger preoperative trunk shift (mental and total), larger preoperative Cobb (self-image), and preoperative symptoms (function). Poor results were more common in those with Lenke 3 curve pattern (pain), less preoperative coronal imbalance, trunk shift and rib prominence (function), preoperative bracing (self-image), and anterior procedures (mental). Poor results also had slightly less average curve correction (50% vs. 60%) and larger curve residuals (31° vs. 23°). Complications, postoperative curve magnitude, and instrumentation type did not significantly contribute to postoperative scores, and no identifiable factors contributed to satisfaction. Curve correction improves patient's self-image whereas pain and poor function before surgery carry over after surgery. Patients with less spinal appearance issues (higher body mass index, Lenke 3 curves) are less happy with their results. Except in surgical patient selection, many of these factors are beyond physician control.

The impact of missing sensor information on surgical workflow management.

Science.gov (United States)

Liebmann, Philipp; Meixensberger, Jürgen; Wiedemann, Peter; Neumuth, Thomas

2013-09-01

Sensor systems in the operating room may encounter intermittent data losses that reduce the performance of surgical workflow management systems (SWFMS). Sensor data loss could impact SWFMS-based decision support, device parameterization, and information presentation. The purpose of this study was to understand the robustness of surgical process models when sensor information is partially missing. SWFMS changes caused by wrong or no data from the sensor system which tracks the progress of a surgical intervention were tested. The individual surgical process models (iSPMs) from 100 different cataract procedures of 3 ophthalmologic surgeons were used to select a randomized subset and create a generalized surgical process model (gSPM). A disjoint subset was selected from the iSPMs and used to simulate the surgical process against the gSPM. The loss of sensor data was simulated by removing some information from one task in the iSPM. The effect of missing sensor data was measured using several metrics: (a) successful relocation of the path in the gSPM, (b) the number of steps to find the converging point, and (c) the perspective with the highest occurrence of unsuccessful path findings. A gSPM built using 30% of the iSPMs successfully found the correct path in 90% of the cases. The most critical sensor data were the information regarding the instrument used by the surgeon. We found that use of a gSPM to provide input data for a SWFMS is robust and can be accurate despite missing sensor data. A surgical workflow management system can provide the surgeon with workflow guidance in the OR for most cases. Sensor systems for surgical process tracking can be evaluated based on the stability and accuracy of functional and spatial operative results.

Surveillance instrumentation for spent-fuel safeguards

International Nuclear Information System (INIS)

McKenzie, J.M.; Holmes, J.P.; Gillman, L.K.; Schmitz, J.A.; McDaniel, P.J.

1978-01-01

The movement, in a facility, of spent reactor fuel may be tracked using simple instrumentation together with a real time unfolding algorithm. Experimental measurements, from multiple radiation monitors and crane weight and position monitors, were obtained during spent fuel movements at the G.E. Morris Spent-Fuel Storage Facility. These data and a preliminary version of an unfolding algorithm were used to estimate the position of the centroid and the magnitude of the spent fuel radiation source. Spatial location was estimated to +-1.5 m and source magnitude to +-10% of their true values. Application of this surveillance instrumentation to spent-fuel safeguards is discussed

New instrumentation for the IPR-R1 reactor of CDTN

International Nuclear Information System (INIS)

Carvalho, P.V.R. de.

1992-01-01

The Nuclear Engineering Institute reactor instrumentation area has developed systems and equipment for reactor operation and safety. In such way, the new I and C for IEN Argonauta reactor and the nuclear instrumentation for IPEN critical facility were built. This paper describes our real work, the new I and C systems for IPR-R1, a Triga type reactor, located at CDTN (Belo Horizonte - MG). (author)

Innovative real CSF leak simulation model for rhinology training: human cadaveric design.

Science.gov (United States)

AlQahtani, Abdulaziz A; Albathi, Abeer A; Alhammad, Othman M; Alrabie, Abdulkarim S

2018-04-01

To study the feasibility of designing a human cadaveric simulation model of real CSF leak for rhinology training. The laboratory investigation took place at the surgical academic center of Prince Sultan Military Medical City between 2016 and 2017. Five heads of human cadaveric specimens were cannulated into the intradural space through two frontal bone holes. Fluorescein-dyed fluid was injected intracranialy, then endoscopic endonasal iatrogenic skull base defect was created with observation of fluid leak, followed by skull base reconstruction. The outcome measures included subjective assessment of integrity of the design, the ability of creating real CSF leak in multiple site of skull base and the possibility of watertight closure by various surgical techniques. The fluid filled the intradural space in all specimens without spontaneous leak from skull base or extra sinus areas. Successfully, we demonstrated fluid leak from all areas after iatrogenic defect in the cribriform plate, fovea ethmoidalis, planum sphenoidale sellar and clival regions. Watertight closure was achieved in all defects using different reconstruction techniques (overly, underlay and gasket seal closure). The design is simulating the real patient with CSF leak. It has potential in the learning process of acquiring and maintaining the surgical skills of skull base reconstruction before direct involvement of the patient. This model needs further evaluation and competence measurement as training tools in rhinology training.

Real-time monitoring of harmful algal blooms in the southern ...

African Journals Online (AJOL)

A half-hourly acquisition regime collects data from the instruments, which are transmitted in real time using cellular phone telemetry. A website is updated with these data, when available, along with satellite data and shellfish warnings, to provide near real-time information on conditions in the area. Demonstration data from ...

Surgical lighting

NARCIS (Netherlands)

Knulst, A.J.

2017-01-01

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

Implementation of the Land, Atmosphere Near Real-Time Capability for EOS (LANCE)

Science.gov (United States)

Michael, Karen; Murphy, Kevin; Lowe, Dawn; Masuoka, Edward; Vollmer, Bruce; Tilmes, Curt; Teague, Michael; Ye, Gang; Maiden, Martha; Goodman, H. Michael;

A software-based tool for video motion tracking in the surgical skills assessment landscape

NARCIS (Netherlands)

Ganni, S.; Botden, Sanne M.B.I.; Chmarra, M.K.; Goossens, R.H.M.; Jakimowicz, J.J.

2018-01-01

Background: The use of motion tracking has been proved to provide an objective assessment in surgical skills training. Current systems, however, require the use of additional equipment or specialised laparoscopic instruments and cameras to extract the data. The aim of this study was to determine

Modern spinal instrumentation. Part 2: Multimodality imaging approach for assessment of complications

International Nuclear Information System (INIS)

Allouni, A.K.; Davis, W.; Mankad, K.; Rankine, J.; Davagnanam, I.

2013-01-01

Radiologists frequently encounter studies demonstrating spinal instrumentation, either as part of the patient's postoperative evaluation, or as incidental to a study performed for another purpose. It is important for the reporting radiologist to identify potential complications of commonly used spinal implants. Part 1 of this review examined both the surgical approaches used and the normal appearances of these spinal implants and bone grafting techniques. This second part of the review will focus on the multimodal imaging strategy adopted in the assessment of the instrumented spine and the demonstration of imaging findings of common postoperative complications.

A GPU Accelerated Spring Mass System for Surgical Simulation

DEFF Research Database (Denmark)

Mosegaard, Jesper; Sørensen, Thomas Sangild

2005-01-01

There is a growing demand for surgical simulators to dofast and precise calculations of tissue deformation to simulateincreasingly complex morphology in real-time. Unfortunately, evenfast spring-mass based systems have slow convergence rates for largemodels. This paper presents a method to accele...... to accelerate computation of aspring-mass system in order to simulate a complex organ such as theheart. This acceleration is achieved by taking advantage of moderngraphics processing units (GPU)....

Estimating Tool-Tissue Forces Using a 3-Degree-of-Freedom Robotic Surgical Tool.

Science.gov (United States)

Zhao, Baoliang; Nelson, Carl A

2016-10-01

Robot-assisted minimally invasive surgery (MIS) has gained popularity due to its high dexterity and reduced invasiveness to the patient; however, due to the loss of direct touch of the surgical site, surgeons may be prone to exert larger forces and cause tissue damage. To quantify tool-tissue interaction forces, researchers have tried to attach different kinds of sensors on the surgical tools. This sensor attachment generally makes the tools bulky and/or unduly expensive and may hinder the normal function of the tools; it is also unlikely that these sensors can survive harsh sterilization processes. This paper investigates an alternative method by estimating tool-tissue interaction forces using driving motors' current, and validates this sensorless force estimation method on a 3-degree-of-freedom (DOF) robotic surgical grasper prototype. The results show that the performance of this method is acceptable with regard to latency and accuracy. With this tool-tissue interaction force estimation method, it is possible to implement force feedback on existing robotic surgical systems without any sensors. This may allow a haptic surgical robot which is compatible with existing sterilization methods and surgical procedures, so that the surgeon can obtain tool-tissue interaction forces in real time, thereby increasing surgical efficiency and safety.

A novel technique for preventing skin pressure sores using a rubber tube during surgical treatment of mandibular condyle fractures.

Science.gov (United States)

Kawase-Koga, Yoko; Mori, Yoshiyuki; Hoshi, Kazuhito; Takato, Tsuyoshi

2013-11-01

Craniofacial surgery occasionally results in sores and necrosis of the facial skin because of pressure from surgical instruments. During surgical treatment of mandibular condylar process fractures, the main mandibular fragment is routinely retracted downward using a wire to achieve a satisfactory anatomic reduction. This procedure may injure the facial skin. This potential complication is easily overlooked by medical staff, but it is easily preventable. We herein describe a method of using a rubber tube to avoid causing pressure sores of the facial skin during surgical treatment of mandibular condylar process fractures.

The clinical outcomes of surgical treatment of noncontiguous spinal tuberculosis: a retrospective study in 23 cases.

Directory of Open Access Journals (Sweden)

Jia Huang

Full Text Available STUDY DESIGN: A retrospective clinical study. OBJECTIVE: To evaluate the clinical efficacy of the surgical treatment of noncontiguous spinal tuberculosis (NSTB, and to discuss its therapeutic strategies. METHODS: We performed a retrospective review of clinical and radiographic data that were prospectively collected on 550 consecutive spinal tubercular patients including 27 patients who were diagnosed and treated as NSTB in our institution from June 2005 to June 2011. Apart from 4 patients being treated conservatively, the remainder received surgery by posterior transforaminal debridement, interbody fusion with instrumentation, posterior instrumentation and anterior debridement with fusion in a single or two-stage operation. The clinical outcomes were evaluated before and after treatment in terms of hematologic and radiographic examinations, bone fusion and neurologic status. The Oswestry Disability Index score was determined before treatment and at the last follow-up visit. RESULTS: 23 patients (15 M/8F, averaged 44.6 ± 14.2 years old (range, 19 to 70 yd, who received surgical treatment, were followed up after surgery for a mean of 52.5 ± 19.5 months (range, 24 to 72 months. The kyphotic angle was changed significantly between pre- and postoperation (P<0.05. The mean amount of correction was 12.6 ± 7.2 degrees, with a small loss of correction at last follow-up. All patients achieved solid bone fusion. No patients with neurological deficit deteriorated postoperatively. Neither mortalities nor any major complications were found. There was a significant difference of Oswestry Disability Index scores between preoperation and the final follow-up. CONCLUSION: The outcomes of follow-up showed that posterior and posterior-anterior surgical treatment methods were both viable surgical options for NSTB. Posterior transforaminal debridement, interbody fusion and posterior instrumentation, as a less invasive technique, was feasible and effective to treat

Monetary Policy Frameworks and Real Equilibrium Determinacy

DEFF Research Database (Denmark)

Jensen, Henrik

2002-01-01

In a simple "prototype" model of monetary policymaking, I examine the issue of real equilibrium determinacy under targeting and instrument rules. The former framework involves minimization of a loss function (under discretion or commitment), whereas the latter involves commitment to an interest...... rate rule. While instrument rules only lead to determinacy under certain conditions, the targeting rules under consideration always secure determinacy. Within an extended model, I argue that econometric estimations of nominal interest rate response functions may tell little about the economy...

Surgical outcomes in two different age groups with Focal Cortical Dysplasia type II: Any real difference?

Science.gov (United States)

Ramírez-Molina, Jorge Luis; Di Giacomo, Roberta; Mariani, Valeria; Deleo, Francesco; Cardinale, Francesco; Uscátegui-Daccarett, Angélica María; Lorenzana, Pablo; Tassi, Laura

2017-05-01

Focal Cortical Dysplasias (FCDs) represent a common architectural cortical disorder underlying drug-resistant focal epilepsy. So far, studies aimed at evaluating whether age at surgery is a factor influencing surgical outcome are lacking, so that data on the comparison between patients harboring Type II FCD operated at younger age and those operated at adult age are still scarce. We compared presurgical clinical features and surgical outcomes of patients with histopathologically diagnosed Type II FCD undergoing surgery at an earlier age with those operated after 20 years of age. We retrospectively analyzed 1660 consecutive patients operated at the "Claudio Munari" Epilepsy Surgery Centre. There were 289 patients (17.4%) with a neuropathological diagnosis of Type II FCD. We included two different groups of patients, the first one including patients operated on at less than 6years, the second sharing the same seizure onset age but with delayed surgery, carried out after the age of 20. Seizure characteristics and, neuropsychological and postoperative seizure outcomes were evaluated by study group. Forty patients underwent surgery before the age of 6 and 66 patients after the age of 20. Surgical outcome was favorable in the whole population (72.6% were classified in Engel's Class Ia+Ic), independently from age at surgery. In the children group, 32 patients were classified in Class I, including 30 (75%) children in classes Ia and Ic. In the adult group, 53 belonged to Class I of whom 47 (71%) were in classes Ia and Ic. The percentage of permanent complications, the surgical outcomes, and AED withdrawal did not significantly differ by study group. Our results indicate that there is no difference between the groups, suggesting that outcome depends mainly on the histological findings and not on timing of surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Science.gov (United States)

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

2018-02-01

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

Surgical Assisting

Science.gov (United States)

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

Paediatric Abdominal Surgical Emergencies in a General Surgical ...

African Journals Online (AJOL)

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

An integrated portable hand-held analyser for real-time isothermal nucleic acid amplification

International Nuclear Information System (INIS)

Smith, Matthew C.; Steimle, George; Ivanov, Stan; Holly, Mark; Fries, David P.

2007-01-01

A compact hand-held heated fluorometric instrument for performing real-time isothermal nucleic acid amplification and detection is described. The optoelectronic instrument combines a Printed Circuit Board/Micro Electro Mechanical Systems (PCB/MEMS) reaction detection/chamber containing an integrated resistive heater with attached miniature LED light source and photo-detector and a disposable glass waveguide capillary to enable a mini-fluorometer. The fluorometer is fabricated and assembled in planar geometry, rolled into a tubular format and packaged with custom control electronics to form the hand-held reactor. Positive or negative results for each reaction are displayed to the user using an LED interface. Reaction data is stored in FLASH memory for retrieval via an in-built USB connection. Operating on one disposable 3 V lithium battery >12, 60 min reactions can be performed. Maximum dimensions of the system are 150 mm (h) x 48 mm (d) x 40 mm (w), the total instrument weight (with battery) is 140 g. The system produces comparable results to laboratory instrumentation when performing a real-time nucleic acid sequence-based amplification (NASBA) reaction, and also displayed comparable precision, accuracy and resolution to laboratory-based real-time nucleic acid amplification instrumentation. A good linear response (R 2 = 0.948) to fluorescein gradients ranging from 0.5 to 10 μM was also obtained from the instrument indicating that it may be utilized for other fluorometric assays. This instrument enables an inexpensive, compact approach to in-field genetic screening, providing results comparable to laboratory equipment with rapid user feedback as to the status of the reaction

An integrated portable hand-held analyser for real-time isothermal nucleic acid amplification

Energy Technology Data Exchange (ETDEWEB)

Smith, Matthew C. [College of Marine Science, University of South Florida, St Petersburg, FL (United States)], E-mail: msmith@marine.usf.edu; Steimle, George; Ivanov, Stan; Holly, Mark; Fries, David P. [College of Marine Science, University of South Florida, St Petersburg, FL (United States)

2007-08-29

A compact hand-held heated fluorometric instrument for performing real-time isothermal nucleic acid amplification and detection is described. The optoelectronic instrument combines a Printed Circuit Board/Micro Electro Mechanical Systems (PCB/MEMS) reaction detection/chamber containing an integrated resistive heater with attached miniature LED light source and photo-detector and a disposable glass waveguide capillary to enable a mini-fluorometer. The fluorometer is fabricated and assembled in planar geometry, rolled into a tubular format and packaged with custom control electronics to form the hand-held reactor. Positive or negative results for each reaction are displayed to the user using an LED interface. Reaction data is stored in FLASH memory for retrieval via an in-built USB connection. Operating on one disposable 3 V lithium battery >12, 60 min reactions can be performed. Maximum dimensions of the system are 150 mm (h) x 48 mm (d) x 40 mm (w), the total instrument weight (with battery) is 140 g. The system produces comparable results to laboratory instrumentation when performing a real-time nucleic acid sequence-based amplification (NASBA) reaction, and also displayed comparable precision, accuracy and resolution to laboratory-based real-time nucleic acid amplification instrumentation. A good linear response (R{sup 2} = 0.948) to fluorescein gradients ranging from 0.5 to 10 {mu}M was also obtained from the instrument indicating that it may be utilized for other fluorometric assays. This instrument enables an inexpensive, compact approach to in-field genetic screening, providing results comparable to laboratory equipment with rapid user feedback as to the status of the reaction.

Microscope-integrated optical coherence tomography for image-aided positioning of glaucoma surgery

Science.gov (United States)

Li, Xiqi; Wei, Ling; Dong, Xuechuan; Huang, Ping; Zhang, Chun; He, Yi; Shi, Guohua; Zhang, Yudong

2015-07-01

Most glaucoma surgeries involve creating new aqueous outflow pathways with the use of a small surgical instrument. This article reported a microscope-integrated, real-time, high-speed, swept-source optical coherence tomography system (SS-OCT) with a 1310-nm light source for glaucoma surgery. A special mechanism was designed to produce an adjustable system suitable for use in surgery. A two-graphic processing unit architecture was used to speed up the data processing and real-time volumetric rendering. The position of the surgical instrument can be monitored and measured using the microscope and a grid-inserted image of the SS-OCT. Finally, experiments were simulated to assess the effectiveness of this integrated system. Experimental results show that this system is a suitable positioning tool for glaucoma surgery.

Microscope-integrated optical coherence tomography for image-aided positioning of glaucoma surgery.

Science.gov (United States)

Li, Xiqi; Wei, Ling; Dong, Xuechuan; Huang, Ping; Zhang, Chun; He, Yi; Shi, Guohua; Zhang, Yudong

2015-07-01

Most glaucoma surgeries involve creating new aqueous outflow pathways with the use of a small surgical instrument. This article reported a microscope-integrated, real-time, high-speed, swept-source optical coherence tomography system (SS-OCT) with a 1310-nm light source for glaucoma surgery. A special mechanism was designed to produce an adjustable system suitable for use in surgery. A two-graphic processing unit architecture was used to speed up the data processing and real-time volumetric rendering. The position of the surgical instrument can be monitored and measured using the microscope and a grid-inserted image of the SS-OCT. Finally, experiments were simulated to assess the effectiveness of this integrated system. Experimental results show that this system is a suitable positioning tool for glaucoma surgery.

Real charge according to the current Serbian Draft Law on property rights and other real rights

Directory of Open Access Journals (Sweden)

Vujović Dragana

2014-01-01

Full Text Available Within reforms of loan security instruments law, Serbian Draft Law on Property Rights and Other Real Rights demonstrates interest for introducing new forms of non-accessory security rights. Real charge is a new institute in our legislation. It is a kind of real right on immovable thing that is regulated after the model of the German and Swiss laws, and which is in practice mostly used to secure a receivable, so that it is, to an extent, a personal hypothec. The most important reason for introduction of this institute into the Law was to allow for a security right on immovables that is more flexible than the accessorial hypothec, thus creating the environment conducive for the development of the secondary market of real loans, facilitating refinancing, and allowing for the extension of the offer of bank products with the reduction of transaction costs.

Toward the Development of Virtual Surgical Tools to Aid Orthopaedic FE Analyses

Directory of Open Access Journals (Sweden)

Srinivas C. Tadepalli

2010-01-01

Full Text Available Computational models of joint anatomy and function provide a means for biomechanists, physicians, and physical therapists to understand the effects of repetitive motion, acute injury, and degenerative diseases. Finite element models, for example, may be used to predict the outcome of a surgical intervention or to improve the design of prosthetic implants. Countless models have been developed over the years to address a myriad of orthopaedic procedures. Unfortunately, few studies have incorporated patient-specific models. Historically, baseline anatomic models have been used due to the demands associated with model development. Moreover, surgical simulations impose additional modeling challenges. Current meshing practices do not readily accommodate the inclusion of implants. Our goal is to develop a suite of tools (virtual instruments and guides which enable surgical procedures to be readily simulated and to facilitate the development of all-hexahedral finite element mesh definitions.

Real-time PCR Machine System Modeling and a Systematic Approach for the Robust Design of a Real-time PCR-on-a-Chip System

Directory of Open Access Journals (Sweden)

Da-Sheng Lee

2010-01-01

Full Text Available Chip-based DNA quantification systems are widespread, and used in many point-of-care applications. However, instruments for such applications may not be maintained or calibrated regularly. Since machine reliability is a key issue for normal operation, this study presents a system model of the real-time Polymerase Chain Reaction (PCR machine to analyze the instrument design through numerical experiments. Based on model analysis, a systematic approach was developed to lower the variation of DNA quantification and achieve a robust design for a real-time PCR-on-a-chip system. Accelerated lift testing was adopted to evaluate the reliability of the chip prototype. According to the life test plan, this proposed real-time PCR-on-a-chip system was simulated to work continuously for over three years with similar reproducibility in DNA quantification. This not only shows the robustness of the lab-on-a-chip system, but also verifies the effectiveness of our systematic method for achieving a robust design.

Cloud Instrument Powered by Solar Cell Sends Data to Pachube

Directory of Open Access Journals (Sweden)

Doru Ursutiu

2010-11-01

Full Text Available Despite the economic downturn, there have been quite a few new developments in the world of remote measurements lately. Tag4M (www.tag4m.com introduced the concept of cloud instrument where sensors connected to WiFi tags send data to off-the-shelf Access Points which are part of the WiFi infrastructure that exists in enterprises, retail outlets, factories, and warehouses. Access Points route the data to the Internet where specialized web applications receive the information for processing and display. One of these specialized web applications is Pachube, (http://www.pachube.com which bills itself as a “real-time data brokerage platform”. Pachube enables people to tag and share real time sensor data from objects, devices and spaces around the world. This article presents the pachube cloud instrument where sensors connected to Tag4M WiFi tags send digitized data to www.pachube.com for public display. The article contains very detailed analysis of the solar cell power source that is used to continuously power the Tag4M tag during this application. Cloud Instruments powered by solar cells enable people around the world to share real time sensor data using web pages on the Internet. This is a very interesting and exciting technology development that we want to bring to your attention.

The design of a simple radon-detecting instrument based on MCU

International Nuclear Information System (INIS)

Du Genyuan; Qiu Yingyu; Zhang Jiang

2007-01-01

Introduction are given on the internal composition of the radon-detecting instrument based on MCU and the working of the real electric circuit. The single-chip microcomputer P89C58 of PHILIPS is adopted as the micro-controller of the instrument, realizing such functions as counting input pulses within fixed time, data processing, liquid crystal display, keyboard interface, serial communication, etc. The instrument turns out to be low in work consumption, with relatively high degree of concentration and computerization, and is recommended for field operations. (authors)

The design of a simple radon-detecting instrument based on MCU

International Nuclear Information System (INIS)

Du Genyuan; Chen Jianjun; Zhang Jiang

2008-01-01

Introduction are given on the internal composition of the radon-detecting instrument based on MCU and the working of the real electric circuit. The single-chip microcomputer P89C58 of PHILIPS is adopted as the micro-controller of the instrument, realizing such functions as counting input pulses within fixed time, data processing, liquid crystal display, keyboard interface, serial communication, etc. The instrument turns out to be low in work consumption, with relatively high degree of concentration and computerization, and is recommended for field operations. (authors)

The role of student surgical interest groups and surgical Olympiads in anatomical and surgical undergraduate training in Russia.

Science.gov (United States)

Dydykin, Sergey; Kapitonova, Marina

2015-01-01

Traditional department-based surgical interest groups in Russian medical schools are useful tools for student-based selection of specialty training. They also form a nucleus for initiating research activities among undergraduate students. In Russia, the Departments of Topographical Anatomy and Operative Surgery play an important role in initiating student-led research and providing learners with advanced, practical surgical skills. In tandem with department-led activities, student surgical interest groups prepare learners through surgical competitions, known as "Surgical Olympiads," which have been conducted in many Russian centers on a regular basis since 1988. Surgical Olympiads stimulate student interest in the development of surgical skills before graduation and encourage students to choose surgery as their postgraduate specialty. Many of the participants in these surgical Olympiads have become highly qualified specialists in general surgery, orthopedic surgery, neurosurgery, urology, gynecology, and emergency medicine. The present article emphasizes the role of student interest groups and surgical Olympiads in clinical anatomical and surgical undergraduate training in Russia. © 2015 American Association of Anatomists.

An integrated movement capture and control platform applied towards autonomous movements of surgical robots.

Science.gov (United States)

Daluja, Sachin; Golenberg, Lavie; Cao, Alex; Pandya, Abhilash K; Auner, Gregory W; Klein, Michael D

2009-01-01

Robotic surgery has gradually gained acceptance due to its numerous advantages such as tremor filtration, increased dexterity and motion scaling. There remains, however, a significant scope for improvement, especially in the areas of surgeon-robot interface and autonomous procedures. Previous studies have attempted to identify factors affecting a surgeon's performance in a master-slave robotic system by tracking hand movements. These studies relied on conventional optical or magnetic tracking systems, making their use impracticable in the operating room. This study concentrated on building an intrinsic movement capture platform using microcontroller based hardware wired to a surgical robot. Software was developed to enable tracking and analysis of hand movements while surgical tasks were performed. Movement capture was applied towards automated movements of the robotic instruments. By emulating control signals, recorded surgical movements were replayed by the robot's end-effectors. Though this work uses a surgical robot as the platform, the ideas and concepts put forward are applicable to telerobotic systems in general.

Novel mass spectrometric instrument for gaseous and particulate characterization and monitoring

International Nuclear Information System (INIS)

Coggiola, M.J.

1993-04-01

Under contract DE-AC21-92MC29116, SRI International will develop a unique new instrument that will be capable of providing real-time (< l minute), quantitative, chemical characterization of gaseous and particulate pollutants generated from DOE waste cleanup activities. The instrument will be capable of detecting and identifying volatile organic compounds, polynuclear aromatic hydrocarbons, heavy metals, and transuranic species released during waste cleanup activities. The instrument will be unique in its ability to detect and quantify in real-time these diverse pollutants in both vapor and particulate form. The instrument to be developed under this program will consist of several major components: (1) an isokinetic sampler capable of operating over a wide range of temperatures (up to 500 K) and flow rates; (2) a high pressure to low pressure transition and sampling region that efficiently separates particles from vapor-phase components for separate, parallel analyses; (3) two small mass spectrometers, one optimized for organic analysis using a unique field ionization source and one optimized for particulate characterization using thermal pyrolysis and electron-impact ionization (EI); and (4) a powerful personal computer for control and data acquisition

Postsurgical consequences in lower third molar surgical extraction using micromotor and piezosurgery.

Science.gov (United States)

Mistry, Freddy Kersi; Hegde, Nidarsh Diwakar; Hegde, Mithra Nidarsh

2016-01-01

One of the most critical and crucial steps in surgical extraction is cutting the bone or osteotomy, for which many techniques are used, e.g., chisels and mallet, rotary instruments, and ultrasound bone-cutting instruments. If they are not used judiciously, they can be hazardous. To assess the efficiency of piezosurgery unit over micromotor while performing surgical extraction of lower third molars by assessing the time taken for the surgery and measuring postoperative parameters such as pain, trismus, and swelling. Thirty patients having bilateral impacted third molars with the same difficulty index were selected for the study. One side surgical removal was done using micromotor and other side by piezosurgery with an interval of 15 days. After each surgery, time taken to finish was measured and patients were followed up on postoperative days 1, 3, 5, 7, and 15 for assessing pain, trismus, and swelling. Data obtained were statistically analyzed. The mean time taken for the micromotor group is 37.90 min whereas by the piezosurgery group is 54.63 min, showing a statistically significant difference ( P < 0.001). Furthermore, there is statistically significant difference ( P < 0.001) in the level of pain, trismus, and swelling on postoperative days 1, 3, 5, and 7. Even the intragroup comparison of piezosurgical group for trismus and swelling showed no statistically significant difference on postoperative day 7, indicating faster recovery of trismus and swelling. On postoperative day 15, there was no difference in any parameter in both groups indicating complete symptom-free recovery in both groups. It takes more time to perform surgical extraction of third molars when piezosurgical unit is used. Despite that, it causes less pain postoperatively with faster improvement in trismus and quicker reduction in swelling.

Precision of GNSS instruments by static method comparing in real time

Directory of Open Access Journals (Sweden)

Slavomír Labant

2009-09-01

Full Text Available Tablet paper describes comparison of measuring accuracy two apparatus from the firm Leica. One of them recieve signals onlyfrom GPS satelites and another instrument is working with GPS and also with GLONASS satelites. Measuring is carry out by RTK staticmethod with 2 minutes observations. Measurement processing is separated to X, Y (position and h (heigh. Adjustment of directobservations is used as a adjusting method.

20th IEEE-NPSS Real Time Conference

CERN Document Server

2016-01-01

We invite you at the Centro Congressi “A. Luciani” in Padova for the 2016 Real Time Conference (RT2016). It will take place Monday 6 through Friday 10 June 2016, with optional pre-conference tutorials Sunday, June 5. Like the previous editions, RT2016 will be a multidisciplinary conference devoted to the latest developments on realtime techniques in the fields of Plasma and Nuclear Fusion, particle physics, nuclear physics and astrophysics, space science, accelerators, medical physics, nuclear power instrumentation and other radiation instrumentation.

Assessment of communication, professionalism, and surgical skills in an objective structured performance-related examination (OSPRE): a psychometric study.

Science.gov (United States)

Ponton-Carss, Alicia; Hutchison, Carol; Violato, Claudio

2011-10-01

The purpose of this study was to investigate the reliability and validity of a performance assessment of communication, professionalism, and surgical skills competencies for surgery residents. Fourteen residents from the general surgery program of the University of Calgary were assessed in 7 surgical simulation stations that included communication and professionalism skills. The internal consistency reliability of the checklists and global rating scales combined was adequate for communication (α = .75-.92) and surgical skills (α = .86-.96), but not for professionalism (α = 0). There was evidence of validity as surgical skills performance improved as a function of postgraduate year level but not for the professionalism checklist. Surgical skills and communication correlated in the 2 stations assessed (r = .55 and .57; P communication skills. Further instrument development is required to assess professionalism in a structured examination context. Copyright © 2011 Elsevier Inc. All rights reserved.

VERSE - Virtual Equivalent Real-time Simulation

Science.gov (United States)

Zheng, Yang; Martin, Bryan J.; Villaume, Nathaniel

2005-01-01

Distributed real-time simulations provide important timing validation and hardware in the- loop results for the spacecraft flight software development cycle. Occasionally, the need for higher fidelity modeling and more comprehensive debugging capabilities - combined with a limited amount of computational resources - calls for a non real-time simulation environment that mimics the real-time environment. By creating a non real-time environment that accommodates simulations and flight software designed for a multi-CPU real-time system, we can save development time, cut mission costs, and reduce the likelihood of errors. This paper presents such a solution: Virtual Equivalent Real-time Simulation Environment (VERSE). VERSE turns the real-time operating system RTAI (Real-time Application Interface) into an event driven simulator that runs in virtual real time. Designed to keep the original RTAI architecture as intact as possible, and therefore inheriting RTAI's many capabilities, VERSE was implemented with remarkably little change to the RTAI source code. This small footprint together with use of the same API allows users to easily run the same application in both real-time and virtual time environments. VERSE has been used to build a workstation testbed for NASA's Space Interferometry Mission (SIM PlanetQuest) instrument flight software. With its flexible simulation controls and inexpensive setup and replication costs, VERSE will become an invaluable tool in future mission development.

Practice Makes Perfect: Correlations Between Prior Experience in High-level Athletics and Robotic Surgical Performance Do Not Persist After Task Repetition.

Science.gov (United States)

Shee, Kevin; Ghali, Fady M; Hyams, Elias S

Robotic surgical skill development is central to training in urology as well as in other surgical disciplines. Here, we describe a pilot study assessing the relationships between robotic surgery simulator performance and 3 categories of activities, namely, videogames, musical instruments, and athletics. A questionnaire was administered to preclinical medical students for general demographic information and prior experiences in surgery, videogames, musical instruments, and athletics. For follow-up performance studies, we used the Matchboard Level 1 and 2 modules on the da Vinci Skills Simulator, and recorded overall score, time to complete, economy of motion, workspace range, instrument collisions, instruments out of view, and drops. Task 1 was run once, whereas task 2 was run 3 times. All performance studies on the da Vinci Surgical Skills Simulator took place in the Simulation Center at Dartmouth-Hitchcock Medical Center. All participants were medical students at the Geisel School of Medicine. After excluding students with prior hands-on experience in surgery, a total of 30 students completed the study. We found a significant correlation between athletic skill level and performance for both task 1 (p = 0.0002) and task 2 (p = 0.0009). No significant correlations were found for videogame or musical instrument skill level. Students with experience in certain athletics (e.g., volleyball, tennis, and baseball) tended to perform better than students with experience in other athletics (e.g., track and field). For task 2, which was run 3 times, this association did not persist after the third repetition due to significant improvements in students with low-level athletic skill (levels 0-2). Our study suggests that prior experience in high-level athletics, but not videogames or musical instruments, significantly influences surgical proficiency in robot-naive students. Furthermore, our study suggests that practice through task repetition can overcome initial differences

Advanced In-Pile Instrumentation for Materials Testing Reactors

Science.gov (United States)

Rempe, J. L.; Knudson, D. L.; Daw, J. E.; Unruh, T. C.; Chase, B. M.; Davis, K. L.; Palmer, A. J.; Schley, R. S.

2014-08-01

The U.S. Department of Energy sponsors the Advanced Test Reactor (ATR) National Scientific User Facility (NSUF) program to promote U.S. research in nuclear science and technology. By attracting new research users - universities, laboratories, and industry - the ATR NSUF facilitates basic and applied nuclear research and development, advancing U.S. energy security needs. A key component of the ATR NSUF effort is to design, develop, and deploy new in-pile instrumentation techniques that are capable of providing real-time measurements of key parameters during irradiation. This paper describes the strategy developed by the Idaho National Laboratory (INL) for identifying instrumentation needed for ATR irradiation tests and the program initiated to obtain these sensors. New sensors developed from this effort are identified, and the progress of other development efforts is summarized. As reported in this paper, INL researchers are currently involved in several tasks to deploy real-time length and flux detection sensors, and efforts have been initiated to develop a crack growth test rig. Tasks evaluating `advanced' technologies, such as fiber-optics based length detection and ultrasonic thermometers, are also underway. In addition, specialized sensors for real-time detection of temperature and thermal conductivity are not only being provided to NSUF reactors, but are also being provided to several international test reactors.

Use of the Real Time xCelligence System for Purposes of Medical Microbiology.

Science.gov (United States)

Junka, Adam Feliks; Janczura, Adriana; Smutnicka, Danuta; Mączyńska, Beata; Anna, Secewicz; Nowicka, Joanna; Bartoszewicz, Marzenna; Gościniak, Grażyna

2012-09-28

Roche's xCelligence impedance-measuring instrument is one of a few commercially available systems of such type. According to the best knowledge of authors, instrument was tested so far only for eukaryotic cell research. The aim of this work was to estimate xCELLigence suitability for the microbiological tests, including (i) measurement of morphological changes in eukaryotic cells as a result of bacterial toxin activity, (ii) measurement of bacterial biofilm formation and (iii) impact of antiseptics on the biofilm structure. To test the infuence of bacterial LT enterotoxin on eukaryotic cell lines, Chinese Hamster Ovary (CHO) cell line and reference strain Escherichia coli ATTC 35401 were used. To investigate Roche's instrument ability to measure biofilm formation and impact of antiseptics on its development, Staphylococcus aureus ATTC6538 reference strain was used. The data generated during the experiments indicate excellent ability of xCelligence instrument to detect cytopathic effect caused by bacterial LT endotoxin and to detect staphylococcal biofilm formation. However, interpretation of the results obtained during real-time measurement of antiseptic's bactericidal activity against staphylococcal biofilm, caused many difficulties. xCelligence instrument can be used for real-time monitoring of morphological changes in CHO cells treated with bacterial LT enterotoxin and for real-time measurement of staphylococcal biofilm formation in vitro. Further investigation is necessary to confirm suitability of system to analyze antiseptic's antimicrobial activity against biofilm in vitro.

Simulated surgical workshops enhance medical school students’ preparation for clinical rotation

Directory of Open Access Journals (Sweden)

Patricia Johnson

2013-02-01

Full Text Available BackgroundA major focus of the medical school curriculum is to ensure medical students are well prepared prior to entering clinical rotations, which includes the compulsory surgical rotation.AimsThe objective of this research was to design and formally evaluate a set of real-life surgical workshops aimed at better preparing medical students for their clinical rotation in surgery. These workshops would be incorporated into the pre-clinical medical school curriculum.MethodDedicated surgical workshops were introduced into the preclinical component of the Bachelor of Medicine/Bachelor of Surgery (MBBS program at our University in 2009. These workshops encompassed training in the clinical skills needed in the perioperative and wider hospital setting. A survey comprising of eight to nine ranked questions (utilising a five-point Likert Scale as well as three short answer questions was administered to the medical students after they completed their compulsory surgical clinical rotation.ResultsThe overall response rate to the survey evaluating the surgical workshops was 79% (123/155. The mean of the ranked questions ranged from 4.05 to 4.89 which indicated that the students found the workshops useful. When evaluating the short answer questions (via topic coding, additional information was provided that supported and explained the survey findings and also included suggestions for improvements.ConclusionThe findings of the medical student survey demonstrated the value of incorporating dedicated preparatory surgical workshops in the medical school pre-clinical curriculum. However, further research is warranted to determine if this inclusion translated into improved student performance during the clinical surgical rotation.

Ergonomic investigation of weight distribution of laparoscopic instruments.

Science.gov (United States)

Lin, Chiuhsiang Joe; Chen, Hung-Jen; Lo, Ying-Chu

2011-06-01

Laparoscopic surgery procedures require highly specialized visually controlled movements. Investigations of industrial applications indicate that the length as well as the weight of hand-held tools substantially affects movement time (MT). Different weight distributions may have similar effects on long-shafted laparoscopic instruments when performing surgical procedures. For this reason, the current experiment aimed at finding direct evidence of the weight distribution effect in an accurate task. Ten right-handed subjects made continuous Fitts' pointing tasks using a long laparoscopic instrument. The factors and levels were target width: (2.5, 3, 3.5, and 4 cm), target distance (14, 23, and 37 cm), and weight distribution (uniform, front, middle, and rear). Weight distribution was made by chips of lead attached to the laparoscopic instrument. MT, error rate, and throughput (TP) were recorded as dependent variables. There were significant differences between the weight distribution in MT and in TP. The middle position was found to require the least time to manipulate the laparoscopic instrument in pointing tasks and also obtained the highest TP. These analyses and findings pointed to a design direction for the ergonomics and usability of the long hand-held tool such as the laparoscopic instrument in this study. To optimize efficiency in using these tools, the consideration of a better weight design is important and should not be neglected.

An introduction to electronic learning and its use to address challenges in surgical training.

Science.gov (United States)

Baran, Szczepan W; Johnson, Elizabeth J; Kehler, James

2009-06-01

The animal research community faces a shortage of surgical training opportunities along with an increasing demand for expertise in surgical techniques. One possible means of overcoming this challenge is the use of computer-based or electronic learning (e-learning) to disseminate material to a broad range of animal users. E-learning platforms can take many different forms, ranging from simple text documents that are posted online to complex virtual courses that incorporate dynamic video or audio content and in which students and instructors can interact in real time. The authors present an overview of e-learning and discuss its potential benefits as a supplement to hands-on rodent surgical training. They also discuss a few basic considerations in developing and implementing electronic courses.

Localized intraoperative virtual endoscopy (LIVE) for surgical guidance in 16 skull base patients.

Science.gov (United States)

Haerle, Stephan K; Daly, Michael J; Chan, Harley; Vescan, Allan; Witterick, Ian; Gentili, Fred; Zadeh, Gelareh; Kucharczyk, Walter; Irish, Jonathan C

2015-01-01

Previous preclinical studies of localized intraoperative virtual endoscopy-image-guided surgery (LIVE-IGS) for skull base surgery suggest a potential clinical benefit. The first aim was to evaluate the registration accuracy of virtual endoscopy based on high-resolution magnetic resonance imaging under clinical conditions. The second aim was to implement and assess real-time proximity alerts for critical structures during skull base drilling. Patients consecutively referred for sinus and skull base surgery were enrolled in this prospective case series. Five patients were used to check registration accuracy and feasibility with the subsequent 11 patients being treated under LIVE-IGS conditions with presentation to the operating surgeon (phase 2). Sixteen skull base patients were endoscopically operated on by using image-based navigation while LIVE-IGS was tested in a clinical setting. Workload was quantitatively assessed using the validated National Aeronautics and Space Administration Task Load Index (NASA-TLX) questionnaire. Real-time localization of the surgical drill was accurate to ~1 to 2 mm in all cases. The use of 3-mm proximity alert zones around the carotid arteries and optic nerve found regular clinical use, as the median minimum distance between the tracked drill and these structures was 1 mm (0.2-3.1 mm) and 0.6 mm (0.2-2.5 mm), respectively. No statistical differences were found in the NASA-TLX indicators for this experienced surgical cohort. Real-time proximity alerts with virtual endoscopic guidance was sufficiently accurate under clinical conditions. Further clinical evaluation is required to evaluate the potential surgical benefits, particularly for less experienced surgeons or for teaching purposes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

Benefits of using customized instrumentation in total knee arthroplasty: results from an activity-based costing model.

Science.gov (United States)

Tibesku, Carsten O; Hofer, Pamela; Portegies, Wesley; Ruys, C J M; Fennema, Peter

2013-03-01

The growing demand for total knee arthroplasty (TKA) associated with the efforts to contain healthcare expenditure by advanced economies necessitates the use of economically effective technologies in TKA. The present analysis based on activity-based costing (ABC) model was carried out to estimate the economic value of patient-matched instrumentation (PMI) compared to standard surgical instrumentation in TKA. The costs of the two approaches, PMI and standard instrumentation in TKA, were determined by the use of ABC which measures the cost of a particular procedure by determining the activities involved and adding the cost of each activity. Improvement in productivity due to increased operating room (OR) turn-around times was determined and potential additional revenue to the hospital by the efficient utilization of gained OR time was estimated. Increased efficiency in the usage of OR and utilization of surgical trays were noted with patient-specific approach. Potential revenues to the hospital were estimated with the use of PMI by efficient utilization of time saved in OR. Additional revenues of 78,240 per year were estimated considering utilization of gained OR time to perform surgeries other than TKA. The analysis suggests that use of PMI in TKA is economically effective when compared to standard instrumentation.

A review of psychological assessment instruments for use in bariatric surgery evaluations.

Science.gov (United States)

Marek, Ryan J; Heinberg, Leslie J; Lavery, Megan; Merrell Rish, Julie; Ashton, Kathleen

2016-09-01

Bariatric surgery is a viable treatment option for patients with extreme obesity and associated medical comorbidities; however, optimal surgical outcomes are not universal. Surgical societies, such as the American Society for Metabolic and Bariatric Surgery (ASMBS), recommend that patients undergo a presurgical psychological evaluation that includes reviewing patients' medical charts, conducting a comprehensive clinical interview, and employing some form of objective psychometric testing. Despite numerous societies recommending the inclusion of self-report assessments, only about 2/3 of clinics actively use psychological testing-some of which have limited empirical support to justify their use. This review aims to critically evaluate the psychometric properties of self-report measures when used in bariatric surgery settings and provide recommendations to help guide clinicians in selecting instruments to use in bariatric surgery evaluations. Recommended assessment batteries include use of a broadband instrument along with a narrowband eating measure. Suggestions for self-report measures to include in a presurgical psychological evaluation in bariatric surgery settings are also provided. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

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

Science.gov (United States)

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

2015-08-01

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

A framework for predicting three-dimensional prostate deformation in real time

NARCIS (Netherlands)

Jahya, Alex; Herink, Mark; Misra, Sarthak

2013-01-01

Background Surgical simulation systems can be used to estimate soft tissue deformation during pre- and intra-operative planning. Such systems require a model that can accurately predict the deformation in real time. In this study, we present a back-propagation neural network for predicting

Black carbon emissions in gasoline vehicle exhaust: a measurement and instrument comparison.

Science.gov (United States)

Kamboures, Michael A; Hu, Shishan; Yu, Yong; Sandoval, Julia; Rieger, Paul; Huang, Shiou-Mei; Zhang, Sherry; Dzhema, Inna; Huo, Darey; Ayala, Alberto; Chang, M C Oliver

2013-08-01

A pilot study was conducted to evaluate the performance and agreement of several commercially available black carbon (BC) measurement instruments, when applied to the quantification of BC in light-duty vehicle (LDV) exhaust. Samples from six vehicles, three fuels, and three driving cycles were used. The pilot study included determinations of the method detection limit (MDL) and repeatability. With respect to the MDL, the real-time instruments outperformed the time-integrated instruments, with MDL = 0.12 mg/mi for the AE51 Aethalometer, and 0.15 mg/mi for the Micro Soot Sensor (MSS), versus 0.38 mg/mi for the IMPROVE_A thermal/ optical method, and 0.35 mg/mi for the OT21_T Optical Transmissometer. The real-time instruments had repeatability values ranging from 30% to 35%, which are somewhat better than those of the time-integrated instruments (40-41%). These results suggest that, despite being less resource intensive, real-time methods can be equivalent or superior to time-integrated methods in terms of sensitivity and repeatability. BC mass data, from the photoacoustic and light attenuation instruments, were compared against same-test EC data, determined using the IMPROVE_A method. The MSS BC data was well correlated with EC, with R2 = 0.85 for the composite results and R2 = 0.86 for the phase-by-phase (PBP) results. The correlation of BC, by the AE51, AE22, and OT21_T with EC was moderate to weak. The weaker correlation was driven by the inclusion of US06 test data in the linear regression analysis. We hypothesize that test-cycle-dependent BC:EC ratios are due to the different physicochemical properties of particulate matter (PM) in US06 and Federal Test Procedure (FTP) tests. Correlation amongst the real-time MSS, PASS-1, AE51, and AE22 instruments was excellent (R2 = 0.83-0.95), below 1 mg/mi levels. In the process of investigating these BC instruments, we learned that BC emissions at sub-1 mg/mi levels can be measured and are achievable by current

Real-time Continuous Esophageal High-resolution Manometry (HRM) During Laparoscopic Heller Myotomy and Dor Fundoplication for the Treatment of Achalasia. A Promising Novelty in Regards of Perfecting Surgical Technique: Could It Guide Surgical Technique Toward Excellent Results?

Science.gov (United States)

Triantafyllou, Tania; Doulami, Georgia; Papailiou, Joanna; Mantides, Apostolos; Zografos, Georgios; Theodorou, Dimitrios

2016-12-01

High-resolution manometry (HRM) is the gold-standard diagnostic tool for achalasia of the esophagus. Laparoscopic Heller-Dor technique is the preferred surgical approach with success rate estimated 90%. The use of intraoperative HRM provides real-time estimation of intraluminal esophageal pressures and identifies the exact points of esophageal luminal pressure during laparoscopy. Ten patients with achalasia underwent surgery. All patients preoperatively completed 1 manometric study and Quality of Life questionnaires (EORTC QLQ-C30 version 3.0) with Eckardt scores. We collected intraoperative manometry data and repeated manometric studies, EORTC QLQ-C30, and Eckardt scores postoperatively. Median Eckardt score was decreased from 7.5 to 0.5, mean resting pressure decreased from 51.4 to 11.9 mm Hg, whereas mean residual pressure diminished from 45.9 to 9.5 mm Hg postoperatively. The simultaneous use of HRM during the Heller-Dor technique may lead to an individualized management of the disease.

The future of innovation and training in surgical oncology.

Science.gov (United States)

Kim, Michael J; Monson, John R T

2011-09-01

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

Instrumental biosensors: new perspectives for the analysis of biomolecular interactions.

Science.gov (United States)

Nice, E C; Catimel, B

1999-04-01

The use of instrumental biosensors in basic research to measure biomolecular interactions in real time is increasing exponentially. Applications include protein-protein, protein-peptide, DNA-protein, DNA-DNA, and lipid-protein interactions. Such techniques have been applied to, for example, antibody-antigen, receptor-ligand, signal transduction, and nuclear receptor studies. This review outlines the principles of two of the most commonly used instruments and highlights specific operating parameters that will assist in optimising experimental design, data generation, and analysis.

Surgical orthodontics.

Science.gov (United States)

Strohl, Alexis M; Vitkus, Lauren

2017-08-01

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

Surgical options for lumbosacral fusion: biomechanical stability, advantage, disadvantage and affecting factors in selecting options.

Science.gov (United States)

Yoshihara, Hiroyuki

2014-07-01

Numerous surgical procedures and instrumentation techniques for lumbosacral fusion (LSF) have been developed. This is probably because of its high mechanical demand and unique anatomy. Surgical options include anterior column support (ACS) and posterior stabilization procedures. Biomechanical studies have been performed to verify the stability of those options. The options have their own advantage but also disadvantage aspects. This review article reports the surgical options for lumbosacral fusion, their biomechanical stability, advantages/disadvantages, and affecting factors in option selection. Review of literature. LSF has lots of options both for ACS and posterior stabilization procedures. Combination of posterior stabilization procedures is an option. Furthermore, combinations of ACS and posterior stabilization procedures are other options. It is difficult to make a recommendation or treatment algorithm of LSF from the current literature. However, it is important to know all aspects of the options and decision-making of surgical options for LSF needs to be tailored for each patient, considering factors such as biomechanical stress and osteoporosis.

[Sir Geoffrey Keynes 1887-1982. Surgical pioneer, medical historian, humanist].

Science.gov (United States)

Bergljung, Lars

2005-01-01

Sir Geoffrey Keynes (1887 - 1982), was a pioneer in the surgery of breast cancer and thymic deseases, n.b. in patients suffering from myastenia gravis. He strongly disapproved of the longstanding dogma of so called radical mastectomy in breast cancer, and advocated a more limited surgical approach, followed by radiation therapy. This was done more than fifty years before breastconserving surgery has become the therapy of choice and against considerable opposition from the surgical establishment of his days. He also became a pioneer in the surgical treatment of myastenia gravis by thymectomy, at a time when there was no real understanding of the pathophysiology of the disease and when considerable controversy existed as to the importance or non importance of concomitant tumour formation in the thymus. Besides being a busy surgeon Sir Geoffrey was a medical historian, writing the biography of among others William Harvey, a bibliographer with a special interest in the poet and artist William Blake and a bibliophil with a large book collection of great value to medical history.

Risk Implications of Energy Policy Instruments

DEFF Research Database (Denmark)

Kitzing, Lena

papers and a working paper), based on a combination of micro-economic and policy analysis. Financial theory is used for the quantitative analysis of investment problems under uncertainty, including mean-variance portfolio theory, real option analysis, Monte Carlo simulations and time series analysis...... show, both qualitatively and quantitatively, that policy makers cannot neglect risk implications when designing RES support instruments without compromising either on effectiveness or cost-efficiency of energy policy. The central research questions are: how can risk implications of RES policy...... instruments be integrated into policy design, so that the policies provide adequate investment incentives? And can the consideration of such risk implications in policy design make overall energy policy more successful? These questions are answered in seven research papers (four journal papers, two conference...

AUTOMATED CONTROL AND REAL-TIME DATA PROCESSING OF WIRE SCANNER/HALO SCRAPER MEASUREMENTS

International Nuclear Information System (INIS)

Day, L.A.; Gilpatrick, J.D.

2001-01-01

The Low-Energy Demonstration Accelerator (LEDA), assembled and operating at Los Alamos National Laboratory, provides the platform for obtaining measurements of high-power proton beam-halo formation. Control system software and hardware have been integrated and customized to enable the production of real-time beam-halo profiles. The Experimental Physics and Industrial Control System (EPICS) hosted on a VXI platform, Interactive Data Language (IDL) programs hosted on UNIX platforms, and LabVIEW (LV) Virtual Instruments hosted on a PC platform have been integrated and customized to provide real-time, synchronous motor control, data acquisition, and data analysis of data acquired through specialized DSP instrumentation. These modules communicate through EPICS Channel Access (CA) communication protocol extensions to control and manage execution flow ensuring synchronous data acquisition and real-time processing of measurement data. This paper describes the software integration and management scheme implemented to produce these real-time beam profiles

Computer utility for interactive instrument control

International Nuclear Information System (INIS)

Day, P.

1975-08-01

A careful study of the ANL laboratory automation needs in 1967 led to the conclusion that a central computer could support all of the real-time needs of a diverse collection of research instruments. A suitable hardware configuration would require an operating system to provide effective protection, fast real-time response and efficient data transfer. An SDS Sigma 5 satisfied all hardware criteria, however it was necessary to write an original operating system; services include program generation, experiment control real-time analysis, interactive graphics and final analysis. The system is providing real-time support for 21 concurrently running experiments, including an automated neutron diffractometer, a pulsed NMR spectrometer and multi-particle detection systems. It guarantees the protection of each user's interests and dynamically assigns core memory, disk space and 9-track magnetic tape usage. Multiplexor hardware capability allows the transfer of data between a user's device and assigned core area at rates of 100,000 bytes/sec. Real-time histogram generation for a user can proceed at rates of 50,000 points/sec. The facility has been self-running (no computer operator) for five years with a mean time between failures of 10 []ays and an uptime of 157 hours/week. (auth)

Risk-neutral valuation of real estate derivatives

NARCIS (Netherlands)

van Bragt, D.; Francke, M.K.; Singor, S.N.; Pelsser, A.

2015-01-01

Despite the importance of residential real estate as both an asset class for investors and as a source of "housing services" for individual home owners, as well as the relatively high volatility in house prices, markets for derivative instruments to hedge these risks have been slow to develop. The

Real-time PCR Machine System Modeling and a Systematic Approach for the Robust Design of a Real-time PCR-on-a-Chip System

OpenAIRE

Lee, Da-Sheng

2010-01-01

Chip-based DNA quantification systems are widespread, and used in many point-of-care applications. However, instruments for such applications may not be maintained or calibrated regularly. Since machine reliability is a key issue for normal operation, this study presents a system model of the real-time Polymerase Chain Reaction (PCR) machine to analyze the instrument design through numerical experiments. Based on model analysis, a systematic approach was developed to lower the variation of DN...

Work-family conflict and neck and back pain in surgical nurses.

Science.gov (United States)

Baur, Heiner; Grebner, Simone; Blasimann, Angela; Hirschmüller, Anja; Kubosch, Eva Johanna; Elfering, Achim

2018-03-01

Surgical nurses' work is physically and mentally demanding, possibly leading to work-family conflict (WFC). The current study tests WFC to be a risk factor for neck and lower back pain (LBP). Job influence and social support are tested as resources that could buffer the detrimental impact of WFC. Forty-eight surgical nurses from two university hospitals in Germany and Switzerland were recruited. WFC was assessed with the Work-Family Conflict Scale. Job influence and social support were assessed with the Copenhagen Psychosocial Questionnaire, and back pain was assessed with the North American Spine Society Instrument. Multiple linear regression analyses confirmed WFC as a significant predictor of cervical pain (β = 0.45, p Work-life interventions may have the potential to reduce WFC in surgery nurses.

Surgical Tip for Prevention of Lip Injury During Orthognathic and Facial Bone Contouring Surgery.

Science.gov (United States)

Lee, Tae Sung; Park, Sanghoon

2017-10-01

Iatrogenic lip injury is a rather common complication after facial bone surgery, but is usually treated lightly by the surgeon compared with other more severe functional complications. However, these injuries can have permanent sequelae and can therefore be a reason for patient dissatisfaction, especially after cosmetic surgery. Intraoperative lip injuries during facial bone surgery are usually caused by heat-generating surgical instruments or forced traction on the operative fields. The authors have applied a special technical strategy using a hydrocolloid dressing material to avoid these intraoperative lip injuries. This method does not disturb the operative procedure itself, but efficiently prevents lip injuries and decreases surgical morbidities and postoperative swelling.

“Reality Surgery” — A Research Ethics Perspective on the Live Broadcast of Surgical Procedures

Science.gov (United States)

Williams, Judson B.; Mathews, Robin; D'Amico, Thomas A.

2013-01-01

In recent years, the live broadcasting of medical and surgical procedures has gained worldwide popularity. While the practice has appropriately been met with concerns for patient safety and privacy, many physicians tout the merits of real time viewing as a form of investigation, accelerating the process leading to adoption or abolition of newer techniques or technologies. This view introduces a new series of ethical considerations that need to be addressed. As such, this article considers, from a research ethics perspective, the use of live surgical procedure broadcast for investigative purposes. PMID:21292217

Analyzer of neutron flux in real time; Analizador de flujo neutronico en tiempo real

Energy Technology Data Exchange (ETDEWEB)

Rojas S, A.S.; Carrillo M, R.A.; Balderas, E.G. [Instituto Nacional de Investigaciones Nucleares, A.P. 18-1027, 11801 Mexico D.F. (Mexico)

1999-07-01

With base in the study of the real signals of neutron flux of instability events occurred in the Laguna Verde nuclear power plant where the nucleus oscillation phenomena of the reactor are in the 0 to 2.5 Hz range, it has been seen the possibility about the development a surveillance and diagnostic equipment capable to analyze in real time the behavior of nucleus in this frequencies range. An important method for surveillance the stability of the reactor nucleus is the use of the Power spectral density which allows to determine the frequencies and amplitudes contained in the signals. It is used an instrument carried out by LabVIEW graphic programming with a data acquisition card of 16 channels which works at Windows 95/98 environment. (Author)

RICE: A Reliable and Efficient Remote Instrumentation Collaboration Environment

Directory of Open Access Journals (Sweden)

Prasad Calyam

2008-01-01

Full Text Available Remote access of scientific instruments over the Internet (i.e., remote instrumentation demand high-resolution (2D and 3D video image transfers with simultaneous real-time mouse and keyboard controls. Consequently, user quality of experience (QoE is highly sensitive to network bottlenecks. Further, improper user control while reacting to impaired video caused due to network bottlenecks could result in physical damages to the expensive instrument equipment. Hence, it is vital to understand the interplay between (a user keyboard/mouse actions toward the instrument, and (b corresponding network reactions for transfer of instrument video images toward the user. In this paper, we first present an analytical model for characterizing user and network interplay during remote instrumentation sessions in terms of demand and supply interplay principles of traditional economics. Next, we describe the trends of the model parameters using subjective and objective measurements obtained from QoE experiments. Thereafter, we describe our Remote Instrumentation Collaboration Environment (RICE software that leverages our experiences from the user and network interplay studies, and has functionalities that facilitate reliable and efficient remote instrumentation such as (a network health awareness to detect network bottleneck periods, and (b collaboration tools for multiple participants to interact during research and training sessions.

Increased Science Instrumentation Funding Strengthens Mars Program

Science.gov (United States)

Graham, Lee D.; Graff, T. G.

2012-01-01

As the strategic knowledge gaps mature for the exploration of Mars, Mars sample return (MSR), and Phobos/Deimos missions, one approach that becomes more probable involves smaller science instrumentation and integrated science suites. Recent technological advances provide the foundation for a significant evolution of instrumentation; however, the funding support is currently too small to fully utilize these advances. We propose that an increase in funding for instrumentation development occur in the near-term so that these foundational technologies can be applied. These instruments would directly address the significant knowledge gaps for humans to Mars orbit, humans to the Martian surface, and humans to Phobos/ Deimos. They would also address the topics covered by the Decadal Survey and the Mars scientific goals, objectives, investigations and priorities as stated by the MEPAG. We argue that an increase of science instrumentation funding would be of great benefit to the Mars program as well as the potential for human exploration of the Mars system. If the total non-Earth-related planetary science instrumentation budget were increased 100% it would not add an appreciable amount to the overall NASA budget and would provide the real potential for future breakthroughs. If such an approach were implemented in the near-term, NASA would benefit greatly in terms of science knowledge of the Mars, Phobos/Deimos system, exploration risk mitigation, technology development, and public interest.

The design of a simple portable γ ray detecting instrument based on MCU

International Nuclear Information System (INIS)

Liu Chunmei; Cao Wen; Zhang Jiang

2008-01-01

The internal composition of the γ ray detecting instrument based on MCU and the working of the real electric circuit are introduced. The single-chip microcomputer of PHILIPS is adopted as the micro-controller of the instrument, realizing such functions as counting input pulses within fixed time, data processing, liquid crystal display, keyboard interface, serial communication, etc. The instrument turns out to be low in work consumption, with relatively high degree of concentration and computerization, and is recommended for field operations. (authors)

Coaching Non-technical Skills Improves Surgical Residents' Performance in a Simulated Operating Room.

Science.gov (United States)

Yule, Steven; Parker, Sarah Henrickson; Wilkinson, Jill; McKinley, Aileen; MacDonald, Jamie; Neill, Adrian; McAdam, Tim

2015-01-01

To investigate the effect of coaching on non-technical skills and performance during laparoscopic cholecystectomy in a simulated operating room (OR). Non-technical skills (situation awareness, decision making, teamwork, and leadership) underpin technical ability and are critical to the success of operations and the safety of patients in the OR. The rate of developing assessment tools in this area has outpaced development of workable interventions to improve non-technical skills in surgical training and beyond. A randomized trial was conducted with senior surgical residents (n = 16). Participants were randomized to receive either non-technical skills coaching (intervention) or to self-reflect (control) after each of 5 simulated operations. Coaching was based on the Non-Technical Skills For Surgeons (NOTSS) behavior observation system. Surgeon-coaches trained in this method coached participants in the intervention group for 10 minutes after each simulation. Primary outcome measure was non-technical skills, assessed from video by a surgeon using the NOTSS system. Secondary outcomes were time to call for help during bleeding, operative time, and path length of laparoscopic instruments. Non-technical skills improved in the intervention group from scenario 1 to scenario 5 compared with those in the control group (p = 0.04). The intervention group was faster to call for help when faced with unstoppable bleeding in the final scenario (no. 5; p = 0.03). Coaching improved residents' non-technical skills in the simulated OR compared with those in the control group. Important next steps are to implement non-technical skills coaching in the real OR and assess effect on clinically important process measures and patient outcomes. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Patient specific instrumentation in total knee arthroplasty: a state of the art

Science.gov (United States)

Mattei, Lorenzo; Pellegrino, Pietro; Bistolfi, Alessandro; Castoldi, Filippo

2016-01-01

Patient specific instrumentation (PSI) is a modern technique in total knee arthroplasty (TKA) aiming to facilitate the implant of the prosthesis. The customized cutting blocks of the PSI are generated from pre-operative three-dimensional model, using computed tomography (CT) or magnetic resonance imaging (MRI). A correct surgical plan is mandatory for a good surgical implant. The PSI guide takes into account any slight deformities or osteophytes and applies preoperative planning for bone resection, using the pre-determined implant size, position, and rotation. The apparent benefits of this technology are that neutral postoperative alignment is more reproducible, surgical time is decreased, and the entire procedure results more efficient and cost-effective. The use of PSI is indicated when advanced osteoarthritis, severe pain, and limited function/walking ability are present, such as in a standard instrumentation TKA. In addition to that, PSI finds its indication when intra-medullary guides cannot be used. For example, when there is a post-traumatic femoral deformity. Large debates have taken place about this topic during the last years and, at the moment, there is no consensus in literature regarding the accuracy and reliability of PSI as many studies have shown controversial and inconsistent results. Literature does not suggest PSI techniques as a gold standard in TKA, and therefore it cannot be recommended as a standard technique in standard, not complicated primary TKA. Moreover, literature does not underline any improvement in components alignment, surgical time, blood loss or functional outcomes. Nevertheless, many patients who underwent TKA suffered a previous trauma. In case of deformities, like femoral or tibial fractures healed with a malalignment, preoperative planning may result difficult, and some intra-operative technical difficulties can occur, such as the use of intra-medullar rod. In these selected cases, PSIs may be very useful to avoid errors in

Radiation burden to personal during surgical and urological reentgenology

Energy Technology Data Exchange (ETDEWEB)

Doubravsky, J; Kukacka, R

1976-01-01

The radiation load was measured in surgical personnel during operation of femoral neck fracture and during instrumental urological roentgenology, using film dosimetry. Here are the conclusions: (1) It is obligatory for medical personnel to use protective lead-rubber aprons during surgical and urological roentgenology. At surgical examinations, where the surgeon stands at the operating table, a short apron, covering the lower half of the body, may suffice. (2) Skiascopy, being the chief source of radiation load, should be reduced to the shortest possible time. (3) When handling the patient or film holder, protective gloves should be worn and the primary radiation beam avoided. (4) Clinical workers should be repeatedly instructed, both in theory and practice, how to work with X radiation sources. (5) In larger clinics with intensive roentgenological services the workers should be rotated; nurses should not be in the reproductive age. For newly established uro-roentgenological examination rooms the regional hygiene officer may issue regulations limiting the number of examinations per day and per person. (6) Non-roentgenologists participating in roentgenological examinations should be provided with dosimeters and included in compulsory preventive periodical examinations in accordance with the regulation ''Mandatory Measures No. 49/1967, Directives Concerning Medical Fitness for Work''.

Real-time simulation of the nonlinear visco-elastic deformations of soft tissues.

Science.gov (United States)

Basafa, Ehsan; Farahmand, Farzam

2011-05-01

Mass-spring-damper (MSD) models are often used for real-time surgery simulation due to their fast response and fairly realistic deformation replication. An improved real time simulation model of soft tissue deformation due to a laparoscopic surgical indenter was developed and tested. The mechanical realization of conventional MSD models was improved using nonlinear springs and nodal dampers, while their high computational efficiency was maintained using an adapted implicit integration algorithm. New practical algorithms for model parameter tuning, collision detection, and simulation were incorporated. The model was able to replicate complex biological soft tissue mechanical properties under large deformations, i.e., the nonlinear and viscoelastic behaviors. The simulated response of the model after tuning of its parameters to the experimental data of a deer liver sample, closely tracked the reference data with high correlation and maximum relative differences of less than 5 and 10%, for the tuning and testing data sets respectively. Finally, implementation of the proposed model and algorithms in a graphical environment resulted in a real-time simulation with update rates of 150 Hz for interactive deformation and haptic manipulation, and 30 Hz for visual rendering. The proposed real time simulation model of soft tissue deformation due to a laparoscopic surgical indenter was efficient, realistic, and accurate in ex vivo testing. This model is a suitable candidate for testing in vivo during laparoscopic surgery.

Lowest instrumented vertebra selection in Lenke 3C and 6C scoliosis

DEFF Research Database (Denmark)

Wang, Yu; Bünger, Cody; Zhang, Yanqun

2012-01-01

PURPOSE: The aim of this study was to investigate whether or not post-op curve behaviour differs due to different choices of lowest instrumented vertebra (LIV) with reference to lumbar apical vertebra (LAV) in Lenke 3C and 6C scoliosis. METHODS: We reviewed all the AIS cases surgically treated...... it can yield similar correction while preserving more lumbar mobility and growth potential....

Mental practice with interactive 3D visual aids enhances surgical performance.

Science.gov (United States)

Yiasemidou, Marina; Glassman, Daniel; Mushtaq, Faisal; Athanasiou, Christos; Williams, Mark-Mon; Jayne, David; Miskovic, Danilo

2017-10-01

Evidence suggests that Mental Practice (MP) could be used to finesse surgical skills. However, MP is cognitively demanding and may be dependent on the ability of individuals to produce mental images. In this study, we hypothesised that the provision of interactive 3D visual aids during MP could facilitate surgical skill performance. 20 surgical trainees were case-matched to one of three different preparation methods prior to performing a simulated Laparoscopic Cholecystectomy (LC). Two intervention groups underwent a 25-minute MP session; one with interactive 3D visual aids depicting the relevant surgical anatomy (3D-MP group, n = 5) and one without (MP-Only, n = 5). A control group (n = 10) watched a didactic video of a real LC. Scores relating to technical performance and safety were recorded by a surgical simulator. The Control group took longer to complete the procedure relative to the 3D&MP condition (p = .002). The number of movements was also statistically different across groups (p = .001), with the 3D&MP group making fewer movements relative to controls (p = .001). Likewise, the control group moved further in comparison to the 3D&MP condition and the MP-Only condition (p = .004). No reliable differences were observed for safety metrics. These data provide evidence for the potential value of MP in improving performance. Furthermore, they suggest that 3D interactive visual aids during MP could potentially enhance performance, beyond the benefits of MP alone. These findings pave the way for future RCTs on surgical preparation and performance.

34 CFR 12.5 - Who may apply for surplus Federal real property?

Science.gov (United States)

2010-07-01

... 34 Education 1 2010-07-01 2010-07-01 false Who may apply for surplus Federal real property? 12.5 Section 12.5 Education Office of the Secretary, Department of Education DISPOSAL AND UTILIZATION OF... Federal real property: (a) A State. (b) A political subdivision or instrumentality of a State. (c) A tax...

Remote Instrument Control with CIMA Web Services and Web 2.0 Technology

Directory of Open Access Journals (Sweden)

Douglas John du Boulay

2008-02-01

Full Text Available The Common Instrument Middleware Architecture (CIMA model for Web services based monitoring of remote scientific instruments is being extended and enhanced to provide a capability for remote instrument control. X-ray diffraction has been selected as an ideal domain for prototype development, with the goal being a comprehensive and feature rich portal system for access to remote instruments and their data. The system has two principle components, one of which serves the instrument and data, and the second serves the client user. Plugin modules are used to provide flexibility and re-use, and the notion of plugin control is being developed. The architecture supports remote access to multiple instruments from a single portal. The use of Web 2.0 Pushlet and AJAX technologies has been introduced for push based portlet refresh and updating. An X3D based 3D virtual representation of the instrument provides data collection simulation and (pseudo real time instrument representation.

Advanced In-pile Instrumentation for Material and Test Reactors

International Nuclear Information System (INIS)

Rempe, J.L.; Knudson, D.L.; Daw, J.E.; Unruh, T.C.; Chase, B.M.; Davis, K.L.; Palmer, A.J.; Schley, R.S.

2013-06-01

The US Department of Energy sponsors the Advanced Test Reactor (ATR) National Scientific User Facility (NSUF) program to promote U.S. research in nuclear science and technology. By attracting new research users - universities, laboratories, and industry - the ATR NSUF facilitates basic and applied nuclear research and development, advancing U.S. energy security needs. A key component of the ATR NSUF effort is to design, develop, and deploy new in-pile instrumentation techniques that are capable of providing real-time measurements of key parameters during irradiation. This paper describes the strategy developed by the Idaho National Laboratory (INL) for identifying instrumentation needed for ATR irradiation tests and the program initiated to obtain these sensors. New sensors developed from this effort are identified; and the progress of other development efforts is summarized. As reported in this paper, INL staff is currently involved in several tasks to deploy real-time length and flux detection sensors, and efforts have been initiated to develop a crack growth test rig. Tasks evaluating 'advanced' technologies, such as fiber-optics based length detection and ultrasonic thermometers are also underway. In addition, specialized sensors for real-time detection of temperature and thermal conductivity are not only being provided to NSUF reactors, but are also being provided to several international test reactors. (authors)

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

Science.gov (United States)

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

2014-03-01

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

Micro-surgical endodontics.

Science.gov (United States)

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

2014-02-01

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

Development of ultrasonic instrument 'UT1000 Series'

International Nuclear Information System (INIS)

Ogura, Yukio; Ikeda, Toshimichi

1984-01-01

The ultrasonic flaw detectors with 'A-scope indication' have been frequently used as the means for confirming the soundness of structures and equipments, but there are problems in their operational, quantifying and recording capabilities. Recently, the digital ultrasonic measuring instrument of touch panel type ''UT 1000 Series'' has been developed, which resolves these problems by a single effort. This measuring instrument is that of portable type, which gives the digital output of measured results in real time only by lightly touching the peak point of an echo on the Brown tube. This instrument contains the rich software for measurement, and can measure the positions and dimensions of defects and the pressure on contact surfaces with high accuracy. 'A-scope indication' is the indication with an oscilloscope taking the intensity of echo and the propagation time of ultrasonic waves on the ordinate and abscissa, respectively. There are three types of the instrument, that is, for detecting defects, for measuring contact surface pressure and for both purposes. The size of the instrument is 240 mm width, 350 mm length and 175 mm height, and the weight is 8.5 kgf. The specification, function and features of the ultrasonic flaw detector, touch panel, gain setter, key board, microcomputer and others are reported. (Kako, I.)

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.

Real time production optimization

Energy Technology Data Exchange (ETDEWEB)

Saputelli, Luigi; Otavio, Joao; Araujo, Turiassu; Escorcia, Alvaro [Halliburton, Houston, TX (United States). Landmark Division

2004-07-01

Production optimization encompasses various activities of measuring, analyzing, modeling, prioritizing and implementing actions to enhance productivity of a field. We present a state-of-the-art framework for optimizing production on a continuous basis as new sensor data is acquired in real time. Permanently acquired data is modeled and analyzed in order to create predictive models. A model based control strategy is used to regulate well and field instrumentation. The optimum field operating point, which changes with time, satisfies the maximum economic return. This work is a starting point for further development in automatic, intelligent reservoir technologies which get the most out of the abilities of permanent, instrumented wells and remotely activated downhole completions. The strategy, tested with history-matched data from a compartmentalised giant field, proved to reduce operating costs while increasing oil recovery by 27% in this field. (author)

Investigation of incidence and risk factors for surgical glove perforation in small animal surgery.

Science.gov (United States)

Hayes, Galina M; Reynolds, Deborah; Moens, Noel M M; Singh, Ameet; Oblak, Michelle; Gibson, Thomas W G; Brisson, Brigitte A; Nazarali, Alim; Dewey, Cate

2014-05-01

To identify incidence and risk factors for surgical glove perforation in small animal surgery. Observational cohort study. Surgical gloves (n = 2132) worn in 363 surgical procedures. All gloves worn by operative personnel were assessed for perforation at end-procedure using a water leak test. Putative risk factors were recorded by a surgical team member. Associations between risk factors and perforation were assessed using multivariable multi-level random-effects logistic regression models to control for hierarchical data structure. At least 1 glove perforation occurred in 26.2% of procedures. Identified risk factors for glove perforation included increased surgical duration (surgery >1 hour OR = 1.79, 95% CI = 1.12-2.86), performing orthopedic procedures (OR = 1.88; 95% CI = 1.23-2.88), any procedure using powered instruments (OR = 1.93; 95% CI = 1.21-3.09) or surgical wire (OR = 3.02; 95% CI = 1.50-6.05), use of polyisoprene as a glove material (OR = 1.59, 95% CI = 1.05-2.39), and operative role as primary surgeon (OR = 2.01; 95% CI = 1.35-2.98). The ability of the wearer to detect perforations intraoperatively was poor, with a sensitivity of 30.8%. There is a high incidence of unrecognized glove perforations in small animal surgery. © Copyright 2014 by The American College of Veterinary Surgeons.

Real-time Optical Coherence Tomography Incorporated in the Operating Microscope during Cataract Surgery.

Science.gov (United States)

Almutlak, Mohammed A; Aloniazan, Turki; May, William

2017-01-01

A 55-year-old male presented with reduced vision due to senile cataract. The patient consented to undergo real-time intraoperative anterior segment-optical coherence tomography (AS-OCT) during phacoemulsification with intraocular lens (IOL) implantation. Images were captured at various points during the surgery. The use of AS-OCT incorporated into the surgical microscope was evaluated as an adjunct to cataract surgery. We were able to successfully evaluate, in real-time, wound architecture, the attachment of Descemet's membrane, the posterior capsule, and IOL position. Real-time AS-OCT can be used to proactively address potential complications and verify IOL placement intraoperatively.

Calibration procedure for Slocum glider deployed optical instruments.

Science.gov (United States)

Cetinić, Ivona; Toro-Farmer, Gerardo; Ragan, Matthew; Oberg, Carl; Jones, Burton H

2009-08-31

Recent developments in the field of the autonomous underwater vehicles allow the wide usage of these platforms as part of scientific experiments, monitoring campaigns and more. The vehicles are often equipped with sensors measuring temperature, conductivity, chlorophyll a fluorescence (Chl a), colored dissolved organic matter (CDOM) fluorescence, phycoerithrin (PE) fluorescence and spectral volume scattering function at 117 degrees, providing users with high resolution, real time data. However, calibration of these instruments can be problematic. Most in situ calibrations are performed by deploying complementary instrument packages or water samplers in the proximity of the glider. Laboratory calibrations of the mounted sensors are difficult due to the placement of the instruments within the body of the vehicle. For the laboratory calibrations of the Slocum glider instruments we developed a small calibration chamber where we can perform precise calibrations of the optical instruments aboard our glider, as well as sensors from other deployment platforms. These procedures enable us to obtain pre- and post-deployment calibrations for optical fluorescence instruments, which may differ due to the biofouling and other physical damage that can occur during long-term glider deployments. We found that biofouling caused significant changes in the calibration scaling factors of fluorescent sensors, suggesting the need for consistent and repetitive calibrations for gliders as proposed in this paper.

Cost-effectiveness of decompression according to Gill versus instrumented spondylodesis in the treatment of sciatica due to low grade spondylolytic spondylolisthesis: A prospective randomised controlled trial [NTR1300

NARCIS (Netherlands)

M.P. Arts (Mark); M.J.T. Verstegen (Marco); R. Brand (René); B.W. Koes (Bart); M.E. van den Akker-van Marle (Elske); W.C. Peul (Wilco)

2008-01-01

textabstractBackground. Nerve root decompression with instrumented spondylodesis is the most frequently performed surgical procedure in the treatment of patients with symptomatic low-grade spondylolytic spondylolisthesis. Nerve root decompression without instrumented fusion, i.e. Gill's procedure,

A Radar/Radiometer Instrument for Mapping Soil Moisture and Ocean Salinity

Science.gov (United States)

Hildebrand, Peter H.; Hilliard, Laurence; Rincon, Rafael; LeVine, David; Mead, James

2003-01-01

The RadSTAR instrument combines an L-band, digital beam-forming radar with an L-band synthetic aperture, thinned array (STAR) radiometer. The RadSTAR development will support NASA Earth science goals by developing a novel, L-band scatterometer/ radiometer that measures Earth surface bulk material properties (surface emissions and backscatter) as well as surface characteristics (backscatter). Present, real aperture airborne L-Band active/passive measurement systems such as the JPUPALS (Wilson, et al, 2000) provide excellent sampling characteristics, but have no scanning capabilities, and are extremely large; the huge JPUPALS horn requires a the C-130 airborne platform, operated with the aft loading door open during flight operation. The approach used for the upcoming Aquarius ocean salinity mission or the proposed Hydros soil mission use real apertures with multiple fixed beams or scanning beams. For real aperture instruments, there is no upgrade path to scanning over a broad swath, except rotation of the whole aperture, which is an approach with obvious difficulties as aperture size increases. RadSTAR will provide polarimetric scatterometer and radiometer measurements over a wide swath, in a highly space-efficient configuration. The electronic scanning approaches provided through STAR technology and digital beam forming will enable the large L-band aperture to scan efficiently over a very wide swath. RadSTAR technology development, which merges an interferometric radiometer with a digital beam forming scatterometer, is an important step in the path to space for an L-band scatterometer/radiometer. RadSTAR couples a patch array antenna with a 1.26 GHz digital beam forming radar scatterometer and a 1.4 GHz STAR radiometer to provide Earth surface backscatter and emission measurements in a compact, cross-track scanning instrument with no moving parts. This technology will provide the first L-band, emission and backscatter measurements in a compact aircraft instrument

Foreign Body Retrieval

Medline Plus

Full Text Available ... saved. Using an ultrasound transducer to visualize the location of the object, the physician may make an ... the surgical instrument as it advances to the location of the foreign object in real-time. Your ...

Surgical management of traumatic brain injury

DEFF Research Database (Denmark)

Hartings, Jed A; Vidgeon, Steven; Strong, Anthony J

2014-01-01

in the treatment of TBI at 2 academic medical centers to document variations in real-world practice and evaluate the efficacies of different approaches on postsurgical course and long-term outcome. METHODS: Patients 18 years of age or older who required neurosurgical lesion evacuation or decompression for TBI were...... monitoring of spreading depolarizations; injury characteristics, physiological monitoring data, and 6-month outcomes were collected prospectively. CT scans and medical records were reviewed retrospectively to determine lesion characteristics, surgical indications, and procedures performed. RESULTS: Patients......%-52%), signs of mass effect (midline shift ≥ 5 mm: 43%-52%), and preoperative intracranial pressure (ICP). At VCU, however, surgeries were performed earlier (median 0.51 vs 0.83 days posttrauma, p performed...

Instrumentation to Enhance Advanced Test Reactor Irradiations

Energy Technology Data Exchange (ETDEWEB)

J. L. Rempe; D. L. Knudson; K. G. Condie; J. E. Daw; S. C. Taylor

2009-09-01

The Department of Energy (DOE) designated the Advanced Test Reactor (ATR) as a National Scientific User Facility (NSUF) in April 2007 to support U.S. leadership in nuclear science and technology. By attracting new research users - universities, laboratories, and industry - the ATR will support basic and applied nuclear research and development, further advancing the nation's energy security needs. A key component of the ATR NSUF effort is to prove new in-pile instrumentation techniques that are capable of providing real-time measurements of key parameters during irradiation. To address this need, an assessment of instrumentation available and under-development at other test reactors has been completed. Based on this review, recommendations are made with respect to what instrumentation is needed at the ATR and a strategy has been developed for obtaining these sensors. Progress toward implementing this strategy is reported in this document. It is anticipated that this report will be updated on an annual basis.

Instrumentation to Enhance Advanced Test Reactor Irradiations

International Nuclear Information System (INIS)

Rempe, J.L.; Knudson, D.L.; Condie, K.G.; Daw, J.E.; Taylor, S.C.

2009-01-01

The Department of Energy (DOE) designated the Advanced Test Reactor (ATR) as a National Scientific User Facility (NSUF) in April 2007 to support U.S. leadership in nuclear science and technology. By attracting new research users - universities, laboratories, and industry - the ATR will support basic and applied nuclear research and development, further advancing the nation's energy security needs. A key component of the ATR NSUF effort is to prove new in-pile instrumentation techniques that are capable of providing real-time measurements of key parameters during irradiation. To address this need, an assessment of instrumentation available and under-development at other test reactors has been completed. Based on this review, recommendations are made with respect to what instrumentation is needed at the ATR and a strategy has been developed for obtaining these sensors. Progress toward implementing this strategy is reported in this document. It is anticipated that this report will be updated on an annual basis.

Value Added: the Case for Point-of-View Camera use in Orthopedic Surgical Education.

Science.gov (United States)

Karam, Matthew D; Thomas, Geb W; Taylor, Leah; Liu, Xiaoxing; Anthony, Chris A; Anderson, Donald D

2016-01-01

Orthopedic surgical education is evolving as educators search for new ways to enhance surgical skills training. Orthopedic educators should seek new methods and technologies to augment and add value to real-time orthopedic surgical experience. This paper describes a protocol whereby we have started to capture and evaluate specific orthopedic milestone procedures with a GoPro® point-of-view video camera and a dedicated video reviewing website as a way of supplementing the current paradigm in surgical skills training. We report our experience regarding the details and feasibility of this protocol. Upon identification of a patient undergoing surgical fixation of a hip or ankle fracture, an orthopedic resident places a GoPro® point-of-view camera on his or her forehead. All fluoroscopic images acquired during the case are saved and later incorporated into a video on the reviewing website. Surgical videos are uploaded to a secure server and are accessible for later review and assessment via a custom-built website. An electronic survey of resident participants was performed utilizing Qualtrics software. Results are reported using descriptive statistics. A total of 51 surgical videos involving 23 different residents have been captured to date. This includes 20 intertrochanteric hip fracture cases and 31 ankle fracture cases. The average duration of each surgical video was 1 hour and 16 minutes (range 40 minutes to 2 hours and 19 minutes). Of 24 orthopedic resident surgeons surveyed, 88% thought capturing a video portfolio of orthopedic milestones would benefit their education. There is a growing demand in orthopedic surgical education to extract more value from each surgical experience. While further work in development and refinement of such assessments is necessary, we feel that intraoperative video, particularly when captured and presented in a non-threatening, user friendly manner, can add significant value to the present and future paradigm of orthopedic surgical

[Effect of a multifunctional instrument (HF scissors) in parotis surgery].

Science.gov (United States)

Strauss, G; Schaller, S; Gollnick, I

2014-03-01

Lateral parotidectomy is a demanding surgical procedure and requires a large number of instruments with a high frequency (HF) of alternating. Many functions, such as preparing, spreading, coagulating and cutting could be combined by using scissors with an integrated function of bipolar coagulation. This study has targeted an investigation of technical application, influence on surgery time, frequency of HF application and change of instruments. In the period between 01 April 2011 and 30 September 2012 (18 months) 35 procedures of lateral parotidectomy in 35 patients were investigated. In all cases lateral parotidectomy was carried out with a similar technique (modified extracapsular preparation). Workflow data were used from a control group in the period between 01 January 2009 and 31 December 2010 (24 months). The following parameters from both groups were documented and evaluated: incision-suture times (subdivided into nine sections of the procedure), change of instruments, period of application for HF function and early facial nerve function (6 h and 6 days after surgery according to House-Brackmann). Additionally, in the HF+ group a questionnaire that facilitated subjective evaluation of instruments was analyzed. It was possible to perform the surgery in both groups with neither technical nor surgical intraoperative complications. Incision-suture times showed an average reduction of 31.6 min (34.8 %) in the HF+ group. There was a reduction in the change of instruments compared to a conventional group (CONV) by up to 62.7 %. With the deployment of HF scissors there was a clear increase in the use of HF surgery by more than 100 % when comparing incision-suture times. Evaluation of both groups according to House-Brackmann showed a similar postoperative facial nerve function. The surgeons involved were of the opinion that in all 35 surgeries with HF scissors the intervention was easier and more comfortable. The use of HF scissors is appropriate for parotid gland

Real-time diesel particulate monitor for underground mines.

Science.gov (United States)

Noll, James; Janisko, Samuel; Mischler, Steven E

The standard method for determining diesel particulate matter (DPM) exposures in underground metal/ nonmetal mines provides the average exposure concentration for an entire working shift, and several weeks might pass before results are obtained. The main problem with this approach is that it only indicates that an overexposure has occurred rather than providing the ability to prevent an overexposure or detect its cause. Conversely, real-time measurement would provide miners with timely information to allow engineering controls to be deployed immediately and to identify the major factors contributing to any overexposures. Toward this purpose, the National Institute for Occupational Safety and Health (NIOSH) developed a laser extinction method to measure real-time elemental carbon (EC) concentrations (EC is a DPM surrogate). To employ this method, NIOSH developed a person-wearable instrument that was commercialized in 2011. This paper evaluates this commercial instrument, including the calibration curve, limit of detection, accuracy, and potential interferences. The instrument was found to meet the NIOSH accuracy criteria and to be capable of measuring DPM concentrations at levels observed in underground mines. In addition, it was found that a submicron size selector was necessary to avoid interference from mine dust and that cigarette smoke can be an interference when sampling in enclosed cabs.

Mobile surgical skills education unit: a new concept in surgical training.

Science.gov (United States)

Shaikh, Faisal M; Hseino, Hazem; Hill, Arnold D K; Kavanagh, Eamon; Traynor, Oscar

2011-08-01

Basic surgical skills are an integral part of surgical training. Simulation-based surgical training offers an opportunity both to trainees and trainers to learn and teach surgical skills outside the operating room in a nonpatient, nonstressed environment. However, widespread adoption of simulation technology especially in medical education is prohibited by its inherent higher cost, limited space, and interruptions to clinical duties. Mobile skills laboratory has been proposed as a means to address some of these limitations. A new program is designed by the Royal College of Surgeons in Ireland (RCSI), in an approach to teach its postgraduate basic surgical trainees the necessary surgical skills, by making the use of mobile innovative simulation technology in their own hospital settings. In this article, authors describe the program and students response to the mobile surgical skills being delivered in the region of their training hospitals and by their own regional consultant trainers.

Frequency-Zooming ARMA Modeling for Analysis of Noisy String Instrument Tones

Directory of Open Access Journals (Sweden)

Paulo A. A. Esquef

2003-09-01

Full Text Available This paper addresses model-based analysis of string instrument sounds. In particular, it reviews the application of autoregressive (AR modeling to sound analysis/synthesis purposes. Moreover, a frequency-zooming autoregressive moving average (FZ-ARMA modeling scheme is described. The performance of the FZ-ARMA method on modeling the modal behavior of isolated groups of resonance frequencies is evaluated for both synthetic and real string instrument tones immersed in background noise. We demonstrate that the FZ-ARMA modeling is a robust tool to estimate the decay time and frequency of partials of noisy tones. Finally, we discuss the use of the method in synthesis of string instrument sounds.

Nuclear instrumentation for the industrial measuring systems

International Nuclear Information System (INIS)

Normand, S.

2010-01-01

This work deals with nuclear instrumentation and its application to industry, power plant fuel reprocessing plant and finally with homeland security. The first part concerns the reactor instrumentation, in-core and ex-core measurement system. Ionization Uranium fission chamber will be introduced with their acquisition system especially Campbell mode system. Some progress have been done on regarding sensors failure foresee. The second part of this work deals with reprocessing plant and associated instrumentation for nuclear waste management. Proportional counters techniques will be discussed, especially Helium-3 counter, and new development on electronic concept for reprocessing nuclear waste plant (one electronic for multipurpose acquisition system). For nuclear safety and security for human and homeland will be introduce. First we will explain a new particular approach on operational dosimetric measurement and secondly, we will show new kind of organic scintillator material and associated electronics. Signal treatment with real time treatment is embedded, in order to make neutron gamma discrimination possible even in solid organic scintillator. Finally, the conclusion will point out future, with most trends in research and development on nuclear instrumentation for next years. (author) [fr

Investing in European market real property through reits

Science.gov (United States)

Adamuscin, A.

2010-03-01

For institutional and private investors, investing in real estate represents an attractive form of the consignment of their money. Real estate provides a regular source of income in the form of the rent from or interest on the credit provided. At the same time, real estate is a good investment instrument, because it provides diversified contributions and security against inflation for investors. In their efforts to diversify risk, investors are expressing growing interest in investing in the whole European Union. The success of Real Estate Investment Trusts (REITs) in the U.S. also opened the door for investing in this market for small investors, which is the reason for the development of this type of investment company in the European arena. One problem concerning the development of European real estate investment funds is the unsolved issue of the harmonization of the legislation and regulatory safety measures, which would enable the creation of a common market for new investment products in Europe.

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

Science.gov (United States)

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

2003-12-01

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

Real-time solar magnetograph operation system software design and user's guide

Science.gov (United States)

Wang, C.

1984-01-01

The Real Time Solar Magnetograph (RTSM) Operation system software design on PDP11/23+ is presented along with the User's Guide. The RTSM operation software is for real time instrumentation control, data collection and data management. The data is used for vector analysis, plotting or graphics display. The processed data is then easily compared with solar data from other sources, such as the Solar Maximum Mission (SMM).

Real-time Astrometry Using Phase Congruency

Science.gov (United States)

Lambert, A.; Polo, M.; Tang, Y.

Phase congruency is a computer vision technique that proves to perform well for determining the tracks of optical objects (Flewelling, AMOS 2014). We report on a real-time implementation of this using an FPGA and CMOS Image Sensor, with on-sky data. The lightweight instrument can provide tracking update signals to the mount of the telescope, as well as determine abnormal objects in the scene.

Image-guided neurosurgery. Global concept of a surgical tele-assistance using obstacle detection robotics

International Nuclear Information System (INIS)

Desgeorges, M.; Bellegou, N.; Faillot, Th.; Cordoliani, Y.S.; Dutertre, G.; Blondet, E.; Soultrait, F. de; Boissy, J.M.

2000-01-01

Surgical tele-assistance significantly increases accuracy of surgical gestures, especially in the case of brain tumor neurosurgery. The robotic device is tele-operated through a microscope and the surgeon's gestures are guided by real-time overlaying of the X-ray imagery in the microscope. During the device's progression inside the brain, the focus is ensured by the microscope auto-focus feature. The surgeon can thus constantly check his position on the field workstation. Obstacles to avoid or dangerous areas can be previewed in the operation field. This system is routinely used for 5 years in the neurosurgery division of the Val de Grace hospital. More than 400 brain surgery operations have been done using it. An adaptation is used for rachis surgery. Other military hospitals begin to be equipped with similar systems. It will be possible to link them for data transfer. When it will be operational, such a network it will show what could be, in the future, a medical/surgical remote-assistance system designed to take care of wounded/critical conditions people, including assistance to surgical gestures. (authors)

Flute-like musical instruments: A toy model investigated through numerical continuation

Science.gov (United States)

Terrien, Soizic; Vergez, Christophe; Fabre, Benoît

2013-07-01

Self-sustained musical instruments (bowed string, woodwind and brass instruments) can be modelled by nonlinear lumped dynamical systems. Among these instruments, flutes and flue organ pipes present the particularity to be modelled as a delay dynamical system. In this paper, such a system, a toy model of flute-like instruments, is studied using numerical continuation. Equilibrium and periodic solutions are explored with respect to the blowing pressure, with focus on amplitude and frequency evolutions along the different solution branches, as well as "jumps" between periodic solution branches. The influence of a second model parameter (namely the inharmonicity) on the behaviour of the system is addressed. It is shown that harmonicity plays a key role in the presence of hysteresis or quasiperiodic regime. Throughout the paper, experimental results on a real instrument are presented to illustrate various phenomena, and allow some qualitative comparisons with numerical results.

Wind, METOP ASCAT, 0.25 degrees, Global, Near Real Time, Modulus

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NOAA CoastWatch distributes near real time wind divergence data originating with wind velocity measurements from the ASCAT instrument onboard EUMETSAT's ASCAT...

Wind, METOP ASCAT, 0.25 degrees, Global, Near Real Time, Zonal

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NOAA CoastWatch distributes near real time wind divergence data originating with wind velocity measurements from the ASCAT instrument onboard EUMETSAT's ASCAT...

Instrument for real-time pulse-shape analysis of slit-scan flow cytometry signals

NARCIS (Netherlands)

van Oven, C.; Aten, J. A.

1990-01-01

An instrument is described which analyses shapes of fluorescence profiles generated by particles passing through the focussed laser beam of a flow cytometer. The output signal of this pulse-shape analyzer is used as input for the signal processing electronics of a commercial flow cytometer system.

Port positioning and docking for single-stage totally robotic dissection for rectal cancer surgery with the Si and Xi Da Vinci Surgical System.

Science.gov (United States)

Toh, James Wei Tatt; Kim, Seon-Hahn

2017-11-04

We have previously reported our technique of single-docking totally robotic dissection for rectal cancer surgery using the Da Vinci ® Si Surgical System in 2009. However, we have since optimised our port placement for the Si system and have developed a novel configuration of port placement and docking for the Da Vinci ® Xi Surgical System. We have performed over 700 cases using this technique with the Si system and have used our Xi technique since 2016 for totally robotic dissection for rectal cancer. We have kept the configuration of port placements for both the Xi and Si system as similar as possible, with the priorities to avoid arm collisions as well as to provide a workable port configuration of two left-handed instruments and one right-handed instrument. To date, there have had no major complications or arm collisions related to this technique of docking, port positioning and instrument placement.

Health hazards of child labor in the leather products and surgical instrument manufacturing industries of Sialkot, Pakistan

International Nuclear Information System (INIS)

Junaid, Muhammad; Malik, Riffat Naseem; Pei, De-Sheng

2017-01-01

Child labor is a major challenge in the developing countries and comprehensive health hazard identification studies on this issue are still lacking. Therefore, the current study is an effort to highlight the health concerns of child labor exposed in the key small scale industries of Sialkot, Pakistan. Our findings revealed jolting levels of heavy metals in the urine, blood, serum, saliva, and hair samples collected from the exposed children. For example, in the urine samples, Cd, Cr, Ni, and Pb were measured at the respective concentrations of 39.17, 62.02, 11.94 and 10.53 μg/L in the surgical industries, and 2.10, 4.41, 1.04 and 5.35 μg/L in the leather industries. In addition, source apportionment revealed polishing, cutting, and welding sections in the surgical industries and surface coating, crusting, and stitching sections in the leather industries were the highest contributors of heavy metals in the bio-matrices of the exposed children, implying the dusty, unhygienic, and unhealthy indoor working conditions. Further, among all the bio-matrices, the hair samples expressed the highest bioaccumulation factor for heavy metals. In accordance with the heavy metal levels reported in the exposed children, higher oxidative stress was found in the children working in the surgical industries than those from the leather industries. Moreover, among heavy metals’ exposure pathways, inhalation of industrial dust was identified as the primary route of exposure followed by the ingestion and dermal contact. Consequently, chemical daily intake (CDI), carcinogenic and non-carcinogenic hazard quotients (HQs) of heavy metals were also reported higher in the exposed children and were also alarmingly higher than the corresponding US EPA threshold limits. Taken all together, children were facing serious health implications in these industries and need immediate protective measures to remediate the current situation. - Highlights: • Children occupational exposure assessment

Mobile Instruments Measure Atmospheric Pollutants

Science.gov (United States)

2009-01-01

As a part of NASA's active research of the Earth s atmosphere, which has included missions such as the Atmospheric Laboratory of Applications and Science (ATLAS, launched in 1992) and the Total Ozone Mapping Spectrometer (TOMS, launched on the Earth Probe satellite in 1996), the Agency also performs ground-based air pollution research. The ability to measure trace amounts of airborne pollutants precisely and quickly is important for determining natural patterns and human effects on global warming and air pollution, but until recent advances in field-grade spectroscopic instrumentation, this rapid, accurate data collection was limited and extremely difficult. In order to understand causes of climate change and airborne pollution, NASA has supported the development of compact, low power, rapid response instruments operating in the mid-infrared "molecular fingerprint" portion of the electromagnetic spectrum. These instruments, which measure atmospheric trace gases and airborne particles, can be deployed in mobile laboratories - customized ground vehicles, typically - to map distributions of pollutants in real time. The instruments must be rugged enough to operate rapidly and accurately, despite frequent jostling that can misalign, damage, or disconnect sensitive components. By measuring quickly while moving through an environment, a mobile laboratory can correlate data and geographic points, revealing patterns in the environment s pollutants. Rapid pollutant measurements also enable direct determination of pollutant sources and sinks (mechanisms that remove greenhouse gases and pollutants), providing information critical to understanding and managing atmospheric greenhouse gas and air pollutant concentrations.

[Surgical treatment of diffuse adult orbital lymphangioma: two case studies].

Science.gov (United States)

Berthout, A; Jacomet, P V; Putterman, M; Galatoire, O; Morax, S

2008-12-01

Orbital lymphangioma is a rare vascular malformation; it is a benign but severe anomaly because of its infiltrative, diffuse, and hemorrhagic nature, and its high morbidity rate. Surgical resection is a real challenge on account of the intricate architecture of the lesion. The authors report their surgical experience concerning two cases of diffuse orbital lymphangioma whose diagnosis was established in adulthood and whose surgical treatment was successful. Two patients presented with adult orbital lymphangioma. Progression was slow during the first decade and then was quickly followed by complications: major exorbitism, compressive optic neuropathy, and corneal exposure. Neuroimaging showed a diffuse and cystic orbital malformation. Surgical resection was performed as completely as possible, in one case with a Krönlein orbitotomy and in the other case only via a conjunctive route. An aspirate drain was put in the orbit for 48 h so as to prevent dead spaces forming after resection, an essential risk factor of hemorrhagic or cystic recurrence. Systemic corticotherapy was administered for the 5 days following surgery. The resection was total in one case and subtotal in the other. The surgical follow-up was uneventful with an excellent aesthetic result and an improvement in visual acuity. After 12 months, no tumoral or hemorrhagic recurrence was noted. The surgical treatment of orbital lymphangiomas is challenging because of their infiltrative nature. In diffuse forms, a complete resection is rarely possible because of the risk of sacrificing visual function. In the two cases reported herein, the resection of the extraconal portion was complete, but the intraconal portion was completely removed only in one case. Using the aspirate drain, negative pressure was maintained in the orbital cavity, preventing the formation of chocolate cysts induced by surgery. Although the clinical result was very satisfying, long-term follow-up is necessary to evaluate recurrence

Ontology-based prediction of surgical events in laparoscopic surgery

Science.gov (United States)

Katić, Darko; Wekerle, Anna-Laura; Gärtner, Fabian; Kenngott, Hannes; Müller-Stich, Beat Peter; Dillmann, Rüdiger; Speidel, Stefanie

2013-03-01

Context-aware technologies have great potential to help surgeons during laparoscopic interventions. Their underlying idea is to create systems which can adapt their assistance functions automatically to the situation in the OR, thus relieving surgeons from the burden of managing computer assisted surgery devices manually. To this purpose, a certain kind of understanding of the current situation in the OR is essential. Beyond that, anticipatory knowledge of incoming events is beneficial, e.g. for early warnings of imminent risk situations. To achieve the goal of predicting surgical events based on previously observed ones, we developed a language to describe surgeries and surgical events using Description Logics and integrated it with methods from computational linguistics. Using n-Grams to compute probabilities of followup events, we are able to make sensible predictions of upcoming events in real-time. The system was evaluated on professionally recorded and labeled surgeries and showed an average prediction rate of 80%.

Real world instrumentation with Python automated data acquisition and control systems

CERN Document Server

Hughes, John

2010-01-01

Learn how to develop your own applications to monitor or control instrumentation hardware. Whether you need to acquire data from a device or automate its functions, this practical book shows you how to use Python's rapid development capabilities to build interfaces that include everything from software to wiring. You get step-by-step instructions, clear examples, and hands-on tips for interfacing a PC to a variety of devices. Use the book's hardware survey to identify the interface type for your particular device, and then follow detailed examples to develop an interface with Python and C. O

Solo surgeon single-port laparoscopic surgery with a homemade laparoscope-anchored instrument system in benign gynecologic diseases.

Science.gov (United States)

Yang, Yun Seok; Kim, Seung Hyun; Jin, Chan Hee; Oh, Kwoan Young; Hur, Myung Haeng; Kim, Soo Young; Yim, Hyun Soon

2014-01-01

The objective of this study was to present the initial operative experience of solo surgeon single-port laparoscopic surgery (SPLS) in the laparoscopic treatment of benign gynecologic diseases and to investigate its feasibility and surgical outcomes. Using a novel homemade laparoscope-anchored instrument system that consisted of a laparoscopic instrument attached to a laparoscope and a glove-wound retractor umbilical port, we performed solo surgeon SPLS in 13 patients between March 2011 and June 2012. Intraoperative complications and postoperative surgical outcomes were determined. The primary operative procedures performed were unilateral salpingo-oophorectomy (n = 5), unilateral salpingectomy (n = 2), adhesiolysis (n = 1), and laparoscopically assisted vaginal hysterectomy (n = 5). Additional surgical procedures included additional adhesiolysis (n = 4) and ovarian drilling (n = 1).The primary indications for surgery were benign ovarian tumors (n = 5), ectopic pregnancy (n = 2), pelvic adhesion (infertility) (n = 1), and benign uterine tumors (n = 5). Solo surgeon SPLS was successfully accomplished in all procedures without a laparoscopic assistant. There were no intraoperative or postoperative complications. Our laparoscope-anchored instrument system obviates the need for an additional laparoscopic assistant and enables SPLS to be performed by a solo surgeon. The findings show that with our system, solo surgeon SPLS is a feasible and safe alternative technique for the treatment of benign gynecologic diseases in properly selected patients. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

Intraoperative Ultrasound for Peripheral Nerve Applications.

Science.gov (United States)

Willsey, Matthew; Wilson, Thomas J; Henning, Phillip Troy; Yang, Lynda J-S

2017-10-01

Offering real-time, high-resolution images via intraoperative ultrasound is advantageous for a variety of peripheral nerve applications. To highlight the advantages of ultrasound, its extraoperative uses are reviewed. The current intraoperative uses, including nerve localization, real-time evaluation of peripheral nerve tumors, and implantation of leads for peripheral nerve stimulation, are reviewed. Although intraoperative peripheral nerve localization has been performed previously using guide wires and surgical dyes, the authors' approach using ultrasound-guided instrument clamps helps guide surgical dissection to the target nerve, which could lead to more timely operations and shorter incisions. Copyright © 2017 Elsevier Inc. All rights reserved.

PACMAN: PRIMA astrometric instrument software

Science.gov (United States)

Abuter, Roberto; Sahlmann, Johannes; Pozna, Eszter

2010-07-01

The dual feed astrometric instrument software of PRIMA (PACMAN) that is currently being integrated at the VLTI will use two spatially modulated fringe sensor units and a laser metrology system to carry out differential astrometry. Its software and hardware compromises a distributed system involving many real time computers and workstations operating in a synchronized manner. Its architecture has been designed to allow the construction of efficient and flexible calibration and observation procedures. In parallel, a novel scheme of integrating M-code (MATLAB/OCTAVE) with standard VLT (Very Large Telescope) control software applications had to be devised in order to support numerically intensive operations and to have the capacity of adapting to fast varying strategies and algorithms. This paper presents the instrument software, including the current operational sequences for the laboratory calibration and sky calibration. Finally, a detailed description of the algorithms with their implementation, both under M and C code, are shown together with a comparative analysis of their performance and maintainability.

Progress in Near Real-Time Volcanic Cloud Observations Using Satellite UV Instruments

Science.gov (United States)

Krotkov, N. A.; Yang, K.; Vicente, G.; Hughes, E. J.; Carn, S. A.; Krueger, A. J.

2011-12-01

Volcanic clouds from explosive eruptions can wreak havoc in many parts of the world, as exemplified by the 2010 eruption at the Eyjafjöll volcano in Iceland, which caused widespread disruption to air traffic and resulted in economic impacts across the globe. A suite of satellite-based systems offer the most effective means to monitor active volcanoes and to track the movement of volcanic clouds globally, providing critical information for aviation hazard mitigation. Satellite UV sensors, as part of this suite, have a long history of making unique near-real time (NRT) measurements of sulfur dioxide (SO2) and ash (aerosol Index) in volcanic clouds to supplement operational volcanic ash monitoring. Recently a NASA application project has shown that the use of near real-time (NRT,i.e., not older than 3 h) Aura/OMI satellite data produces a marked improvement in volcanic cloud detection using SO2 combined with Aerosol Index (AI) as a marker for ash. An operational online NRT OMI AI and SO2 image and data product distribution system was developed in collaboration with the NOAA Office of Satellite Data Processing and Distribution. Automated volcanic eruption alarms, and the production of volcanic cloud subsets for multiple regions are provided through the NOAA website. The data provide valuable information in support of the U.S. Federal Aviation Administration goal of a safe and efficient National Air Space. In this presentation, we will highlight the advantages of UV techniques and describe the advances in volcanic SO2 plume height estimation and enhanced volcanic ash detection using hyper-spectral UV measurements, illustrated with Aura/OMI observations of recent eruptions. We will share our plan to provide near-real-time volcanic cloud monitoring service using the Ozone Mapping and Profiler Suite (OMPS) on the Joint Polar Satellite System (JPSS).

Micro-dosemeter instrument (MIDN) for assessing risk in space

International Nuclear Information System (INIS)

Pisacane, V. L.; Dolecek, Q. E.; Malak, H.; Cucinotta, F. A.; Zaider, M.; Rosenfeld, A. B.; Rusek, A.; Sivertz, M.; Dicello, J. F.

2011-01-01

Radiation in space generally produces higher dose rates than that on the Earth's surface, and contributions from primary galactic and solar events increase with altitude within the magnetosphere. Presently, no personnel monitor is available to astronauts for real-time monitoring of dose, radiation quality and regulatory risk. This group is developing a prototypic instrument for use in an unknown, time-varying radiation field. This micro-dosemeter-dosemeter nucleon instrument is for use in a space-suit, spacecraft, remote rover and other applications. It provides absorbed dose, dose rate and dose equivalent in real time so that action can be taken to reduce exposure. Such a system has applications in health physics, anti-terrorism and radiation-hardening of electronics as well. The space system is described and results of ground-based studies are presented and compared with predictions of transport codes. An early prototype in 2007 was successfully launched, the only solid-state micro-dosemeter to have flown in space. Published by Oxford Univ. Press on behalf of the US Government 2011. (authors)

Beam Instrumentation and Diagnostics

CERN Document Server

Strehl, Peter

2006-01-01

This treatise covers all aspects of the design and the daily operations of a beam diagnostic system for a large particle accelerator. A very interdisciplinary field, it involves contributions from physicists, electrical and mechanical engineers and computer experts alike so as to satisfy the ever-increasing demands for beam parameter variability for a vast range of operation modi and particles. The author draws upon 40 years of research and work, most of them spent as the head of the beam diagnostics group at GSI. He has illustrated the more theoretical aspects with many real-life examples that will provide beam instrumentation designers with ideas and tools for their work.

Health hazards of child labor in the leather products and surgical instrument manufacturing industries of Sialkot, Pakistan.

Science.gov (United States)

Junaid, Muhammad; Malik, Riffat Naseem; Pei, De-Sheng

2017-07-01

Child labor is a major challenge in the developing countries and comprehensive health hazard identification studies on this issue are still lacking. Therefore, the current study is an effort to highlight the health concerns of child labor exposed in the key small scale industries of Sialkot, Pakistan. Our findings revealed jolting levels of heavy metals in the urine, blood, serum, saliva, and hair samples collected from the exposed children. For example, in the urine samples, Cd, Cr, Ni, and Pb were measured at the respective concentrations of 39.17, 62.02, 11.94 and 10.53 μg/L in the surgical industries, and 2.10, 4.41, 1.04 and 5.35 μg/L in the leather industries. In addition, source apportionment revealed polishing, cutting, and welding sections in the surgical industries and surface coating, crusting, and stitching sections in the leather industries were the highest contributors of heavy metals in the bio-matrices of the exposed children, implying the dusty, unhygienic, and unhealthy indoor working conditions. Further, among all the bio-matrices, the hair samples expressed the highest bioaccumulation factor for heavy metals. In accordance with the heavy metal levels reported in the exposed children, higher oxidative stress was found in the children working in the surgical industries than those from the leather industries. Moreover, among heavy metals' exposure pathways, inhalation of industrial dust was identified as the primary route of exposure followed by the ingestion and dermal contact. Consequently, chemical daily intake (CDI), carcinogenic and non-carcinogenic hazard quotients (HQs) of heavy metals were also reported higher in the exposed children and were also alarmingly higher than the corresponding US EPA threshold limits. Taken all together, children were facing serious health implications in these industries and need immediate protective measures to remediate the current situation. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

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

2012-01-01

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

Musical Instrument Identification using Multiscale Mel-frequency Cepstral Coefficients

DEFF Research Database (Denmark)

Sturm, Bob L.; Morvidone, Marcela; Daudet, Laurent

2010-01-01

We investigate the benefits of evaluating Mel-frequency cepstral coefficients (MFCCs) over several time scales in the context of automatic musical instrument identification for signals that are monophonic but derived from real musical settings. We define several sets of features derived from MFCC...... multiscale decompositions perform significantly better than features computed using a single time-resolution....

Applicability and limitations of instruments for particle sizing and real time evaluation of airbone particulate matter; Applicabilita` e limiti di strumenti per la separazione granulometrica e per la valutazione in tempo reale del particolato in sospensione

Energy Technology Data Exchange (ETDEWEB)

De Zaiacomo, T. [ENEA, Centro Ricerche `Ezio Clementel`, Bologna (Italy). Dip. Ambiente

1998-12-31

After a brief of difficulties in characterizing airbone particulates by means of particle sizing instruments, the accumulation mode of the atmospheric aerosol is highlighted as carrier of many noxious substances. Two different types of impactors are described in detail, and examples of particle size distributions obtainable by means of these instruments are shown; a miniaturized real-time aerosol monitor is briefly described too. Results of some tests are shown, carried on by sampling both a laboratory produced aerosol and ambient airbone particulate, by means of two identical impactors, with the aim of verifying their responses in term of collected ponderal mass; examples of the aerosol size distributions obtained are reported, together with some comments about problems arising when sampling morphologically complex (agglomerates) and hygroscopic urban particulate matter in different meteorological conditions. Then aerosol size distribution data are presented, obtained by simultaneously sampling airbone particulate matter both in an urban and extra-urban area, by means of the two cited impactors. Some proposals are finally made, in order to use a portable system, equipped with two optical monitors and a miniaturized personal-type impactor, to evaluate both fine and coarse mode of urban particulate matter, with the aim of better estimate the contribution of these two aerosol fractions both in personal exposures and in environmental monitoring data.

Preventive maintenance instrumentation results in Spanish nuclear power plants

International Nuclear Information System (INIS)

Curiel, M.; Palomo, M. J.; Verdu, G.; Arnaldos, A.

2010-10-01

This paper is a recompilation of the most significance results in relation to the researching in preventive and predictive maintenance in critical nuclear instrumentation for power plant operation, which it is being developed by Logistica y Acondicionamientos Industriales and the Isirym Institute of the Polytechnic University of Valencia. Instrumentation verification and test, it is a priority of the power plants control and instrumentation department's technicians. These procedures are necessary information for the daily power plant work. It is performed according to different procedures and in different moments of the fuel cycle depending on the instrumentation critical state and the monitoring process. Normally, this study is developed taking into account the instantaneous values of the instrumentation measures and, after their conversion to physical magnitude, they are analyzed according to the power plant operation point. Moreover, redundant sensors measurements are taken into consideration to the equipment and/or power plant monitoring. This work goes forward and it is in advanced to the instrument analysis as it is, independently of the operation point, using specific signal analysis techniques for preventive and predictive maintenance, with the object to obtain not only information about possible malfunctions, but the degradation scale presented in the instrument or in the system measured. We present seven real case studies of Spanish nuclear power plants each of them shall give a significant contribution to problem resolution and power plant performance. (Author)

Retail payments and the real economy

OpenAIRE

Hasan, Iftekhar; De Renzis, Tania; Schmiedel, Heiko

2013-01-01

This paper examines the fundamental relationship between retail payments and the real economy. Using data from across 27 European markets over the period 1995-2009, the results confirm that migration to efficient electronic retail payments stimulates the overall economy, consumption and trade. Among different payment instruments, this relationship is strongest for card payments, followed by credit transfers. Cheque payments are found to have a relatively low macroeconomic impact. Retail payme...

Open surgical simulation--a review.

Science.gov (United States)