[Benchmarking and other functions of ROM: back to basics].

Science.gov (United States)

Barendregt, M

2015-01-01

Since 2011 outcome data in the Dutch mental health care have been collected on a national scale. This has led to confusion about the position of benchmarking in the system known as routine outcome monitoring (rom). To provide insight into the various objectives and uses of aggregated outcome data. A qualitative review was performed and the findings were analysed. Benchmarking is a strategy for finding best practices and for improving efficacy and it belongs to the domain of quality management. Benchmarking involves comparing outcome data by means of instrumentation and is relatively tolerant with regard to the validity of the data. Although benchmarking is a function of rom, it must be differentiated form other functions from rom. Clinical management, public accountability, research, payment for performance and information for patients are all functions of rom which require different ways of data feedback and which make different demands on the validity of the underlying data. Benchmarking is often wrongly regarded as being simply a synonym for 'comparing institutions'. It is, however, a method which includes many more factors; it can be used to improve quality and has a more flexible approach to the validity of outcome data and is less concerned than other rom functions about funding and the amount of information given to patients. Benchmarking can make good use of currently available outcome data.

The Novice User and CD-ROM Database Services. ERIC Digest.

Science.gov (United States)

Schamber, Linda

This digest answers the following questions that beginning or novice users may have about CD-ROM (a compact disk with read-only memory) database services: (1) What is CD-ROM? (2) What databases are available? (3) Is CD-ROM difficult to use? (4) How much does CD-ROM cost? and (5) What is the future of CD-ROM? (15 references) (MES)

Comparison of continuous interscalene block and subacromial infusion of local anesthetic for postoperative analgesia after open shoulder surgery.

Science.gov (United States)

Baskan, Semih; Cankaya, Deniz; Unal, Hidayet; Yoldas, Burak; Taspinar, Vildan; Deveci, Alper; Tabak, Yalcin; Baydar, Mustafa

2017-01-01

This study compared the efficacy of continuous interscalene block (CISB) and subacromial infusion of local anesthetic (CSIA) for postoperative analgesia after open shoulder surgery. This randomized, prospective, double-blinded, single-center study included 40 adult patients undergoing open shoulder surgery. All patients received a standardized general anesthetic. The patients were separated into group CISB and group CSIA. A loading dose of 40 mL 0.25% bupivacaine was administered and patient-controlled analgesia was applied by catheter with 0.1% bupivacaine 5 mL/h throughout 24 h basal infusion, 2 mL bolus dose, and 20 min knocked time in both groups postoperatively. Visual analog scale (VAS) scores, additional analgesia need, local anesthetic consumption, complications, and side effects were recorded during the first 24 h postoperatively. The range of motion (ROM) score was recorded preoperatively and in the first and third weeks postoperatively. A statistically significant difference was determined between the groups in respect of consumption of local anesthetic, VAS scores, additional analgesia consumption, complications, and side effects, with lower values recorded in the CISB group. There were no significant differences in ROM scoring in the preoperative and postoperative third week between the two groups but there were significant differences in ROM scoring in the postoperative first week, with higher ROM scoring values in the group CISB patients. The results of this study have shown that continuous interscalene infusion of bupivacaine is an effective and safe method of postoperative analgesia after open shoulder surgery.

Modular femoral component for conversion of previous hip surgery in total hip arthroplasty.

Science.gov (United States)

Goldstein, Wayne M; Branson, Jill J

2005-09-01

The conversion of previous hip surgery to total hip arthroplasty creates a durable construct that is anatomically accurate. Most femoral components with either cemented or cementless design have a fixed tapered proximal shape. The proximal femoral anatomy is changed due to previous hip surgery for fixation of an intertrochanteric hip fracture, proximal femoral osteotomy, or a fibular allograft for avascular necrosis. The modular S-ROM (DePuy Orthopaedics Inc., Warsaw, Ind) hip stem accommodates these issues and independently prepares the proximal and distal portion of the femur. In preparation and implantation, the S-ROM hip stem creates less hoop stresses on potentially fragile stress risers from screws and thin bone. The S-ROM hip stem also prepares a previously distorted anatomy by milling through cortical bone that can occlude the femoral medullar canals and recreate proper femoral anteversion and reduces the risk of intraoperative or postoperative periprosthetic fracture due to the flexible titanium-slotted stem. The S-ROM femoral stem is recommended for challenging total hip reconstructions.

The Nuclear CD-Rom

International Nuclear Information System (INIS)

James, J.Z.

1993-01-01

September 1992 will see the publication of the first open-quotes Nuclear CD-ROMclose quotes-a Compact Disk Read-Only Memory (CD-ROM) containing both the entire Evaluated Nuclear Data Files (ENDF) library and the Evaluated Nuclear Structure Data Files (ENSDF) library. The CD-ROM will also contain codes for processing and visualizing the data, and some nuclear physics codes to use the ENDF data. Finally, the data and program files will be accompanied by fully-formatted documentation that can be read on many different workstations and microcomputers

An x ray archive on your desk: The Einstein CD-ROM's

Science.gov (United States)

Prestwich, A.; Mcdowell, J.; Plummer, D.; Manning, K.; Garcia, M.

1992-01-01

Data from the Einstein Observatory imaging proportional counter (IPC) and high resolution imager (HRI) were released on several CD-ROM sets. The sets released so far include pointed IPC and HRI observations in both simple image and detailed photon event list format, as well as the IPC slew survey. With the data on these CD-ROMS's the user can perform spatial analysis (e.g., surface brightness distributions), spectral analysis (with the IPC event lists), and timing analysis (with the IPC and HRI event lists). The next CD-ROM set will contain IPC unscreened data, allowing the user to perform custom screening to recover, for instance, data during times of lost aspect data or high particle background rates.

A condensed review of the manageral aspects of CD-ROM network system

Energy Technology Data Exchange (ETDEWEB)

Choi, Kwang

2001-10-01

This report discussed manageral aspects of CD-ROM Network system to reduce executing errors and to provide effective information services to users. The results of this study are follows. 1) Library has to decide the type fo cd-rom network system compatible to the library. 2) A way of acquiring of system purchasing budget is commom utility budgets and has to include system maintenance budget. 3) When decides a provider, it is needed to review price, maintenance ability, statistics s/w, anti-virus functions.4) System manager would be a one wide-range of knowledge about network, equipment, s/w and needs continuous education about system. 5) The system users are required to have more basic knowledge than general users other users, library has to provide various user educations and minute user manuals. 6) Purchasing of CD-ROM for network use is essential and cost-benefit analysis between on-line DB and cd-rom for one user are needed. 7) when constructing Local DB using CD-RM NETWORK SYSTEM, library give attention to copyrigths of the cd-rom. 8) To provide good services through the system, cross cooperation between library and related departments is required.

Mawul Rom Project: Openness, obligation and reconciliation

NARCIS (Netherlands)

Brigg, M.; Tonnaer, A.A.C.

2008-01-01

Aboriginal Australian initiatives to restore balanced relationships with White Australians have recently become part of reconciliation efforts. This paper provides a contextualised report on one such initiative, the Mawul Rom cross-cultural mediation project. Viewing Mawul Rom as a diplomatic

Food Chains & Webs. A Multimedia CD-ROM. [CD-ROM].

Science.gov (United States)

2001

This CD-ROM is designed for classroom and individual use to teach and learn about food chains and food webs. Integrated animations, custom graphics, three-dimensional representations, photographs, and sound are featured for use in user-controlled activities. Interactive lessons are available to reinforce the subject material. Pre- and post-testing…

Comment scolariser les enfants Roms? Les enfants Roms dans les dispositifs mis en place à Bordeaux Métropole.

OpenAIRE

Øhlund, Ida

2016-01-01

Dans ce mémoire, je m intéresse à la scolarisation des enfants Roms en France. Je présente la place des enfants Roms dans la scolarisation en Europe et en France. Je discute les efforts qu on fait en France pour scolariser ces enfants, et je prends comme exemple les mesures d intégration prises par les autorités de Bordeaux Métropole en expliquant les rôles des différents acteurs locaux. Dans la première partie, j essaye de présenter le groupe minoritaire européen appelé « Rom ». J aborde l h...

The planetary data system educational CD-ROM

Science.gov (United States)

Guinness, E. A.; Arvidson, R. E.; Martin, M.; Dueck, S.

1993-01-01

The Planetary Data System (PDS) is producing a special educational CD-ROM that contains samples of PDS datasets and is expected to be released in 1993. The CD-ROM will provide university-level instructors with PDS-compatible materials and information that can be used to construct student problem sets using real datasets. The main purposes of the CD-ROM are to facilitate wide use of planetary data and to introduce a large community to the PDS. To meet these objectives the Educational CD-ROM will also contain software to manipulate the data, background discussions about scientific questions that can be addressed with the data, and a suite of exercises that illustrate analysis techniques. Students will also be introduced to the SPICE concept, which is a new way of maintaining geometry and instrument information. The exercises will be presented at the freshman through graduate student levels. With simplification, some of the material should also be of use at the high school level.

Noziegums un sods Grama Svifta romānā "Dienas gaisma" un Fjodora Dostojevska romānā "Noziegums un sods"

OpenAIRE

Hohlova, Marija

2008-01-01

Šis bakalaura darbs pēta nozieguma un soda tēmu Fjodora Dostojevska romānā "Noziegums un sods" un Grema Svifta romānā "Dienas gaisma". Darbs sastāv no četrām nodaļām. Pirmajā nodaļā, kura pamatīgi aplūko nozieguma folozofiju, autore piemin integrēto pieeju nozieguma parādībai folozofijas skatījumā, kā arī analīzē nozieguma metafiziskās un socioloģiskās īpatnības uz Fjodora Dostojevska romāna "Noziegums un sods" pamata. Otrā nodaļa apraksta Fjodora Dostojevska romāna "Noziegums un sods" un Gre...

Outcome of Expedited Rotator Cuff Surgery in Injured Workers: Determinants of Successful Recovery.

Science.gov (United States)

Razmjou, Helen; Boljanovic, Dragana; Lincoln, Sandra; Holtby, Richard; Gallay, Stephen; Henry, Patrick; Macritchie, Iona; Borthwick, Cheryl; Mayer, Lauren; Roknic, Carolyn; Shore, Deborah; Kamino, Allison; Grossman, Julie; Hill, Joanne; Singh, Gargi; Travers, Niki; Yanofsky, Loraine; Wilson, Marni; Sumar, Shellina; Savona, Alicia; De Medeiros, Filomena; Mann, Helen; Champsi, Aisha; Chau, Stefanie; Medeiros, Danielle; Richards, Robin R

2017-05-01

Work-related rotator cuff injuries are a common cause of disability and employee time loss. To examine the effectiveness of expedited rotator cuff surgery in injured workers who underwent rotator cuff decompression or repair and to explore the impact of demographic, clinical, and psychosocial factors in predicting the outcome of surgery. Case series; Level of evidence, 4. Injured workers who were seen at a shoulder specialty program and who underwent expedited arthroscopic rotator cuff decompression or repair were observed for a period of 6 to 12 months based on their type of surgery and recovery trajectory. The primary outcome measure was the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form. The impact of surgery was assessed by whether the change in the ASES score exceeded the minimal clinically important difference (MCID) of 17 points. Secondary outcomes were range of motion (ROM), medication consumption, and work status. One hundred forty-six patients (43 women [29%], 103 men [71%]; mean age, 52 years; SD, 8 years) completed the study. Sixty-seven (46%) patients underwent rotator cuff repair. The mean time between the date the patient consented to have surgery and the date of surgery was 82 (SD, 44) days. There was a statistically significant improvement in ASES score and ROM and work status (52 returned to regular duties and 59 to modified duties) ( P satisfaction with the job. Expedited rotator cuff surgery improved disability, ROM, and work status in injured workers. Successful recovery after work-related shoulder injuries may further be facilitated by improving the psychosocial work environment and increasing access to care.

Conserving Earth's Biodiversity. [CD-ROM and] Instructor's Manual.

Science.gov (United States)

2000

This CD-ROM is designed as an interactive learning tool to support teaching in highly interdisciplinary fields such as conservation of biodiversity. Topics introduced in the software include the impact of humans on natural landscapes, threats to biodiversity, methods and theories of conservation biology, environmental laws, and relevant economic…

The surgery of peripheral nerves (including tumors)

DEFF Research Database (Denmark)

Fugleholm, Kåre

2013-01-01

Surgical pathology of the peripheral nervous system includes traumatic injury, entrapment syndromes, and tumors. The recent significant advances in the understanding of the pathophysiology and cellular biology of peripheral nerve degeneration and regeneration has yet to be translated into improved...... surgical techniques and better outcome after peripheral nerve injury. Decision making in peripheral nerve surgery continues to be a complex challenge, where the mechanism of injury, repeated clinical evaluation, neuroradiological and neurophysiological examination, and detailed knowledge of the peripheral...... nervous system response to injury are prerequisite to obtain the best possible outcome. Surgery continues to be the primary treatment modality for peripheral nerve tumors and advances in adjuvant oncological treatment has improved outcome after malignant peripheral nerve tumors. The present chapter...

The Market Place: An Internal View of the Future of CD-ROM--The Perspective of the H. W. Wilson Company.

Science.gov (United States)

Miller, Frank W.; Loeding, Deborah Voigt

1989-01-01

Discussion of technological developments in library reference services focuses on contributions of the H. W. Wilson Company and highlights CD-ROM technology. Topics discussed include online access; menu-driven systems; CD-ROM hardware and software concerns; user response to CD-ROM; quality control of databases; pricing considerations; and future…

CD-ROM: towards a strategy for teaching and learning.

Science.gov (United States)

Aarvold, J; Walton, G

1992-12-01

Compact Disc Read Only Memory (CD-ROM) represents an exciting innovation in nurse education yet paradoxically has a potential to induce disillusionment and frustration. Purchasers of systems may well find that their investment does not bring the benefits they had been lead to expect. CD-ROM systems have the capacity to generate huge quantities of data on an equally large number of nursing topics. Arguably this very capability ensures certain 'built-in' problems. The purpose of this articles is to provide nurse teachers with information about CD-ROM, to highlight the resource implications of CD-ROM use and to consider the relative merits of various teaching and learning methods. To be worthwhile, strategies developed must be part of an information retrieval skills programme.

Energy & Environmental Issues Interactive CD-ROM. Version 2.0. [CD-ROM].

Science.gov (United States)

Florida State Univ., Tallahassee.

This CD-ROM presents various energy and environmental topics. "Great Energy Debate" uses video clips to explore the pros and cons of solar, coal, nuclear, and oil energy sources. "Energy Plant Tour" presents a virtual tour through a plant that converts solid waste into energy. "How Stuff Works" explains energy…

DNA: The Molecule of Life. A Multimedia CD-ROM. [CD-ROM].

Science.gov (United States)

2001

This CD-ROM is designed for classroom and individual use to teach and learn about DNA. Integrated animations, custom graphics, three-dimensional representations, photographs, and sound are featured for use in user-controlled activities. Interactive lessons are available to reinforce the subject material. Pre- and post-testing sections are also…

Reactive oxygen metabolites (ROMs) are associated with cardiovascular disease in chronic hemodialysis patients.

Science.gov (United States)

Bossola, Maurizio; Vulpio, Carlo; Colacicco, Luigi; Scribano, Donata; Zuppi, Cecilia; Tazza, Luigi

2012-02-11

The aim of our study was to measure reactive oxygen metabolites (ROMs) in chronic hemodialysis (HD) patients and evaluate the possible association with cardiovascular disease (CVD) and mortality. We measured ROMs in 76 HD patients and correlated with CVD, cardiovascular (CV) events in the follow-up and all-cause and CVD-related mortality. The levels of ROMs presented a median value of 270 (238.2-303.2) CARR U (interquartile range). We created a ROC curve (ROMs levels vs. CVD) and we identified a cut-off point of 273 CARR U. Patients with ROMs levels ≥273 CARR U were significantly older, had higher C-reactive protein levels and lower creatinine concentrations. The prevalence of CVD was higher in patients with ROMs levels ≥273 (87.1%) than in those with ROMs levels <273 CARR U (17.7%; p<0.0001). ROMs levels were significantly higher in patients with CVD (317±63.8) than in those without (242.7±49.1; p<0.0001). At multiple regression analysis, age, creatinine and C-reactive protein were independent factors associated with ROMs. At multiple logistic regression analysis the association between ROMs and CVD was independent (OR: 1.02, 95% CI: 1.00-1.05; p=0.03). Twenty six patients developed cardiovascular (CV) events during the follow-up. Of these, seven were in the group with ROMs levels <273 CARR U and 19 in the group with ROMs levels ≥273 CARR U. The logistic regression analysis showed that both age (OR: 1.06, 95% CI: 1.01-1.12; p=0.013) and ROMs levels (OR: 1.10, 95% CI: 1.00-1.02; p=0.045) were independently associated with CV events in the follow-up. ROMs are independently associated with CVD and predict CV events in chronic HD patients.

Stretching & Flexibility: An Interactive Encyclopedia of Stretching. [CD-ROM].

Science.gov (United States)

2002

This CD-ROM offers 140 different stretches in full-motion video sequences. It focuses on the proper techniques for overall physical fitness, injury prevention and rehabilitation, and 23 different sports (e.g., golf, running, soccer, skiing, climbing, football, and baseball). Topics include stretching for sports; stretching awareness and education…

Syd for Rom

DEFF Research Database (Denmark)

Frandsen, Steen Bo

Bogen fortæller historien om et af Europas mest berømte vildnisser, De Pontinske Sumpe, der strakte sig i kystlandet umiddelbart syd for Rom fra romertiden til tørlægningen og forvandlingen til landbrugsland i 1930'erne. Allerede under romerne vandt sumpen uophørligt terræn og forvandlede det fla...

FPGA Based Low Power ROM Design Using Capacitance Scaling

DEFF Research Database (Denmark)

Bansal, Meenakshi; Bansal, Neha; Saini, Rishita

2015-01-01

An ideal capacitor will not dissipate any power, but a real capacitor wil l have some power dissipation. In this work, we are going to design capacitance scaling based low power ROM design. In order to test the compatibility of this ROM design with latest i7 Processor, we are operating this ROM w...... in I/O Power, saving of 0.2% occur in Leakage Power, there will be a saving of 11.54% occur in Total Power. This design is implemented on Virtex-5 FPGA using Xilinx ISE and Verilog....

Calculation method of passive tracer using regional ocean modeling system (ROMS)

International Nuclear Information System (INIS)

Tubono, Takaki; Tsumune, Daisuke; Misumi, Kazuhiro; Yoshida, Yoshikatsu

2010-01-01

A dose assessments method for packages shipping radioactive materials was developed to calculate concentrations of radioactive materials discharged from the hypothetically sinking point using Regional Ocean Modeling System (ROMS). The programs of ROMS were improved for simultaneously calculating the flow fields around Japan and the concentrations discharged from several bottom points in the continental shelf. The model domain covered the northeast pacific region around Japan, 20degN-65degN, 120degE-165degE, with 1/10 degree horizontal resolution and 30 sigma-levels. The ROMS model captured main features such as Kuroshio currents, including the separation location and the Kuroshio extension, and Oyashio currents. The calculated volume transports through the main straits such as Tokara strait, Tsushima strait and Tsugaru strait were compared well to the measured or estimated that. The calculated concentrations discharged from 12 bottom points showed mixing associated with the eddies of ocean currents. This method is available to evaluate effectively the concentrations of radioactive materials only by setting the subsidence location and the concentrations and volume discharged. (author)

Our God is Gold: Vlashika Rom at a Crossroads?

Directory of Open Access Journals (Sweden)

Andrš Zbyněk

2016-12-01

Full Text Available This article explicates the sociocultural dynamics in the changing lives of the Vlashika Rom group in the Czech and Slovak Republics and contemplates the prospective development of this Roma subculture. To provide a better insight into the endeavour of the Vlashika Rom to maintain their integrity and into their adaptation strategies, the author outlines the genesis of this subethnic group, pointing out the historical circumstances that have formed them in the past. Contrary to former descriptions, the author provides an entirely new concept for dividing the Vlashika Rom into subgroups, identifying three distinct levels that create social boundaries within this community. He describes the way of living of this subgroup in the past as well as the relationships between the Vlashika Rom and the dominant society. Frequently antagonistic, these relationships depend on their way of life, substantially determined by the way they earn their living. The author analyses the inner resources that keep sustaining the contemporary Vlashika Rom culture and, drawing on his own experience and impulses from literature, inquires how long this anachronistic yet at the same time very adaptable culture will be able to resist the assimilation pressures deriving from the very nature of the modern national state.

CD-ROM storing JENDL-3.2 plots and data

Energy Technology Data Exchange (ETDEWEB)

Fukahori, Tokio; Iwamoto, Osamu; Nakagawa, Tsuneo; Shibata, Keiichi; Narita, Tsutomu; Katakura, Jun-ichi; Hasegawa, Akira [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

1998-01-01

Numerical data and graphs of Japanese Evaluated Nuclear Data Library, Version 3, Revision 2 (JENDL-3.2) have been stored into CD-ROM. JENDL-3.2 is an evaluated nuclear data library which is highly rated in the world, and consists of neutron nuclear data and secondary gamma-ray data for 340 nuclides. JENDL-3.2 has been already released through World Wide Web (WWW, http://cracker.tokai.jaeri.go.jp). For users` convenience and to promote further utilization, this CD-ROM has been produced. The data stored in CD-ROM are the original data and point-wise data (0 K and 300 K) of JENDL-3.2 and graphs of cross sections in gif, PostScript and PDF formats. These data can be retrieved by users` personal computers and engineering workstations, and also can be seen by using WWW browsers. This CD-ROM makes user completely free from downloading, which takes a lot of time, and tedious management such a treating big amount of data. (author)

Scaffolding or Distracting: CD-ROM Storybooks and Young Readers

Science.gov (United States)

Pearman, Cathy J.; Chang, Ching-Wen

2010-01-01

CD-ROM storybooks, often referred to as electronic texts, e-books, and interactive stories, are learning tools with supplemental features such as automatic reading of text, sound effects, word pronunciations, and graphic animations which support the development of reading skills and comprehension in beginning readers. Some CD-ROM storybooks also…

The New York Trade Publishers and CD-ROM: Where Are They Heading?

Science.gov (United States)

Newmark, Eileen

1994-01-01

Discusses the strategies top trade publishers, including Putnam New Media, Paramount Communications, Random House, Penguin USA, and Reader's Digest, are taking toward CD-ROM publishing. Strategies include purchasing electronic media companies; setting up an independent business; and building a new media business by integrating new efforts into the…

Review of CD Rom

African Journals Online (AJOL)

"The Virtual Surgeon consists of a ground breaking series of CD-ROMs, which aims to provide surgeons with a new and powerful training tool. It provides surgeons with the most accurate and realistic model of the knee available, and our developments in animation allow them to see all aspects of the surgical procedure.

Marketing and Selling CD-ROM Products on the World-Wide Web.

Science.gov (United States)

Walker, Becki

1995-01-01

Describes three companies' approaches to marketing and selling CD-ROM products on the World Wide Web. Benefits include low overhead for Internet-based sales, allowance for creativity, and ability to let customers preview products online. Discusses advertising, information delivery, content, information services, and security. (AEF)

Thoracic ROM measurement system with visual bio-feedback: system design and biofeedback evaluation.

Science.gov (United States)

Ando, Takeshi; Kawamura, Kazuya; Fujitani, Junko; Koike, Tomokazu; Fujimoto, Masashi; Fujie, Masakatsu G

2011-01-01

Patients with diseases such as chronic obstructive pulmonary disease (COPD) need to improve their thorax mobility. Thoracic ROM is one of the simplest and most useful indexes to evaluate the respiratory function. In this paper, we have proposed the prototype of a simple thoracic ROM measurement system with real-time visual bio-feedback in the chest expansion test. In this system, the thoracic ROM is measured using a wire-type linear encoder whose wire is wrapped around the thorax. In this paper, firstly, the repeatability and reliability of measured thoracic ROM was confirmed as a first report of the developed prototype. Secondly, we analyzed the effect of the bio-feedback system on the respiratory function. The result of the experiment showed that it was easier to maintain a large and stable thoracic ROM during deep breathing by using the real-time visual biofeedback system of the thoracic ROM.

Environmental awareness -- An interactive multimedia CD-ROM

Energy Technology Data Exchange (ETDEWEB)

Huntelmann, A.; Petruk, M.W.

1998-07-01

As corporations move to new and innovative ways of structuring high-performance work teams, effective training is being recognized as a key to insuring success. Time and scheduling constraints tend to limit the effectiveness of traditional approaches to training. This has led Edmonton Power Inc. to explore the use of CD-ROM based multimedia as a means of delivering individualized instruction in an effective and timely manner. This session will demonstrate a multimedia CD-ROM based course on Environmental Awareness designed for workers in the electrical utilities industry. The objective of the course is to make workers aware of their roles and responsibilities with respect to their impact on the environment. This session will also describe the instructional design strategy underlying this approach to training and will present some preliminary findings with respect to the effectiveness of this approach. Individuals who are interested in improving the effectiveness of their environmental training program as well as individuals who are interested in understanding the strengths of multimedia CD-ROM based training will find this session useful and informative.

Is there a role for rifampicin, ofloxacin and minocycline (ROM) therapy in the treatment of leprosy? Systematic review and meta-analysis.

Science.gov (United States)

Setia, Maninder S; Shinde, Santosh S; Jerajani, Hemangi R; Boivin, Jean-François

2011-12-01

A combination of rifampicin, ofloxacin and minocycline (ROM) is one of the newer recommendations for treatment of leprosy. We performed a systematic review and a meta-analysis of studies that had evaluated the efficacy of ROM therapy in treatment of paucibacillary and multibacillary leprosy patients. Studies were identified by searching the PubMed, Embase, LILACS and Cochrane databases. Data were abstracted from all relevant studies, and fixed effects models were used to calculate the summary estimate of effect in paucibacillary and multibacillary leprosy patients. Six studies comparing ROM therapy to multidrug therapy and eight studies that evaluated the effect of ROM therapy alone (no comparison group) were included in the review and meta-analysis. The combined estimate for single dose ROM vs. multidrug therapy in paucibacillary leprosy patients suggested that ROM was less effective than multidrug therapy in these patients [relative risk: 0.91, 95% confidence intervals (CI): 0.86-0.97]. However, the combined estimate for multiple doses of ROM vs. multidrug therapy in multibacillary leprosy patients suggested that ROM was as effective as multidrug therapy in reducing bacillary indices in these patients (proportion change: -4%, 95% CI -31% to 23%). No major side effects were reported in either the ROM or the multidrug treatment groups. Single-dose ROM therapy was less effective than multidrug therapy in paucibacillary patients. However, there are insufficient data to come to a valid conclusion on the efficacy of multidose ROM therapy in multibacillary leprosy, and additional studies with ROM therapy in multibacillary leprosy are needed. Furthermore, multiple doses may be considered as another alternative even for paucibacillary patients, and randomised controlled trials of this therapy may be useful to understand its contribution in the treatment and control of leprosy. © 2011 Blackwell Publishing Ltd.

Qualitative evaluation of a colorectal cancer education CD-ROM for Community Health Aides/practitioners in Alaska.

Science.gov (United States)

Cueva, Melany; Dignan, Mark; Lanier, Anne; Kuhnley, Regina

2014-12-01

Colorectal cancer (CRC) is an important contributor to the cancer burden among Alaska Native people. CRC is the leading incident cancer and the second leading cause of cancer mortality among Alaska Native people. Completing recommended CRC screening procedures has the potential to reduce both CRC incidence and mortality. "Taking Action Colorectal Health," a multidimensional audiovisual, interactive CD-ROM, incorporates adult education learning principles to provide Alaska's Community Health Aides/Practitioners with timely, medically accurate, and culturally relevant CRC place-based education. Providing this resource on CD-ROM empowers learning within communities and places where people live or choose to learn. The dynamic process of developing, implementing, and evaluating this CRC CD-ROM was informed by a sociocultural approach to share health messages. Within this approach, cultural values, beliefs, and behaviors are affirmed as a place of wisdom and resilience and built upon to provide context and meaning for health messaging. Alaska Native values that honor family, relationships, the land, storytelling, and humor were included in CD-ROM content. Between January and May 2012, 20 interviews were conducted with individuals who had used the CD-ROM. Four categorical themes emerged from analysis of interview transcripts: likeability, utilization, helpfulness, and behavior change. As a result of self-paced learning through stories, movies, and interactive games, respondents reported healthy behavior changes they were making for themselves, with their families and in their patient care practices. This CD-ROM is a culturally based practical course that increased knowledge and activities around colorectal cancer screening by Community Health Aides/Practitioners in Alaska.

Setting Up CD-ROM Work Areas. Part I: Ergonomic Considerations, User Furniture, Location.

Science.gov (United States)

Vasi, John; LaGuardia, Cheryl

1992-01-01

The first of a two-part series on design of CD-ROM work areas in libraries discusses (1) space and location considerations; (2) ergonomics, including work surface, chairs, lighting, printers, other accessories, and security; and (3) other considerations, including staff assistance, reference tools, literature racks, and promotional materials. (MES)

New Access Points to ERIC--CD-ROM Versions. ERIC Digest.

Science.gov (United States)

McLaughlin, Pamela W.

This digest reviews three CD-ROM (compact disc-read only memory) versions of the ERIC (Educational Resources Information Center) database currently being delivered or tested and provides information for comparison. However, no attempt is made to recommend any one product. The advantages and disadvantages of the acquisition of CD-ROM databases are…

Regional Ocean Modeling System (ROMS): CNMI

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Regional Ocean Modeling System (ROMS) 7-day, 3-hourly forecast for the region surrounding the Commonwealth of the Northern Mariana Islands (CNMI) at approximately...

CD-ROM technology at the EROS data center

Science.gov (United States)

Madigan, Michael E.; Weinheimer, Mary C.

1993-01-01

The vast amount of digital spatial data often required by a single user has created a demand for media alternatives to 1/2" magnetic tape. One such medium that has been recently adopted at the U.S. Geological Survey's EROS Data Center is the compact disc (CD). CD's are a versatile, dynamic, and low-cost method for providing a variety of data on a single media device and are compatible with various computer platforms. CD drives are available for personal computers, UNIX workstations, and mainframe systems, either directly connected, or through a network. This medium furnishes a quick method of reproducing and distributing large amounts of data on a single CD. Several data sets are already available on CD's, including collections of historical Landsat multispectral scanner data and biweekly composites of Advanced Very High Resolution Radiometer data for the conterminous United States. The EROS Data Center intends to provide even more data sets on CD's. Plans include specific data sets on a customized disc to fulfill individual requests, and mass production of unique data sets for large-scale distribution. Requests for a single compact disc-read only memory (CD-ROM) containing a large volume of data either for archiving or for one-time distribution can be addressed with a CD-write once (CD-WO) unit. Mass production and large-scale distribution will require CD-ROM replication and mastering.

Regional Ocean Modeling System (ROMS): Samoa

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Regional Ocean Modeling System (ROMS) 7-day, 3-hourly forecast for the region surrounding the islands of Samoa at approximately 3-km resolution. While considerable...

Regional Ocean Modeling System (ROMS): Guam

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Regional Ocean Modeling System (ROMS) 6-day, 3-hourly forecast for the region surrounding Guam at approximately 2-km resolution. While considerable effort has been...

Regional Ocean Modeling System (ROMS): Oahu

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Regional Ocean Modeling System (ROMS) 7-day, 3-hourly forecast for the region surrounding the island of Oahu at approximately 1-km resolution. While considerable...

Data on the environment. Accompanying brochure of the CD ROM; Daten zur Umwelt. Begleitbroschuere zur CD-ROM

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-07-15

During the past 25 years, the Federal Environmental Office (UBA) has been publishing annual data on the environmental situation in Germany. This is the most recent publication; it contains data on climate protection, resources management, environment, health and quality of life, natural cycles and environmental media, and the economic importance of environmental protection. The CD-ROM contains data and facts on all of these subjects. It provides detailed and comprehensive information on the current condition of the environment in Germany, strategies and goals of environmental policy, books and other publications for further reading, and links. The CD-ROM also contains a system of key environmental indicators which illustrates successful activities and needs for action of environmental policy. Integrated internet access ensures access to current information on the internet. (orig.)

SM-ROM-GL (Strong Motion Romania Ground Level Database

Directory of Open Access Journals (Sweden)

Ioan Sorin BORCIA

2015-07-01

Full Text Available The SM-ROM-GL database includes data obtained by the processing of records performed at ground level by the Romanian seismic networks, namely INCERC, NIEP, NCSRR and ISPH-GEOTEC, during recent seismic events with moment magnitude Mw ≥ 5 and epicenters located in Romania. All the available seismic records were re-processed using the same basic software and the same procedures and options (filtering and baseline correction, in order to obtain a consistent dataset. The database stores computed parameters of seismic motions, i.e. peak values: PGA, PGV, PGD, effective peak values: EPA, EPV, EPD, control periods, spectral values of absolute acceleration, relative velocity and relative displacement, as well as of instrumental intensity (as defined bz Sandi and Borcia in 2011. The fields in the database include: coding of seismic events, stations and records, a number of associated fields (seismic event source parameters, geographical coordinates of seismic stations, links to the corresponding ground motion records, charts of the response spectra of absolute acceleration, relative velocity, relative displacement and instrumental intensity, as well as some other representative parameters of seismic motions. The conception of the SM-ROM-GL database allows for an easy maintenance; such that elementary knowledge of Microsoft Access 2000 is sufficient for its operation.

Type 1 Diabetes in Children: A Passport to Knowledge. [CD-ROM].

Science.gov (United States)

2001

This educational CD-ROM is designed to provide a working knowledge of diabetes and its effect on children. It is intended for parents, health care professionals, pharmacists, teachers, coaches, and child care providers. The CD-ROM examines issues related to diabetes management (food, insulin, monitoring, hypoglycemia, and illness); lifestyle; and…

CD-ROM for the PGAA-IAEA database

International Nuclear Information System (INIS)

Firestone, R.B.; Zerking, V.

2007-01-01

Both the database of prompt gamma rays from slow neutron capture for elemental analysis and the results of this CRP are available on the accompanying CD-ROM. The file index.html is the home page for the CD-ROM, and provides links to the following information: (a) The CRP - General information, papers and reports relevant to this CRP. (b) The PGAA-IAEA database viewer - An interactive program to display and search the PGAA database by isotope, energy or capture cross-section. (c) The Database of Prompt Gamma Rays from Slow Neutron Capture for Elemental Analysis - This report. (d) The PGAA database files - Adopted PGAA database and associated files in EXCEL, PDF and Text formats. The archival databases by Lone et al. and by Reedy and Frankle are also available. (e) The Evaluated Gamma-Ray Activation File (EGAF) - The adopted PGAA database in ENSDF format. Data can be viewed with the Isotope Explorer 2.2 ENSDF Viewer. (f) The PGAA database evaluation - ENSDF format versions of the adopted PGAA database, and the Budapest and ENSDF isotopic input files. Decay scheme balance and statistical analysis summaries are provided. (g) The Isotope Explorer 2.2 ENSDF viewer - Windows software for viewing the level scheme drawings and tables provided in ENSDF format. The complete ENSDF database is included, as of December 2002. The databases and viewers are discussed in greater detail in the following sections

NODC Standard Product: NODC Taxonomic Code on CD-ROM (NODC Accession 0050418)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The content of the NODC Taxonomic Code, Version 8 CD-ROM (CD-ROM NODC-68) distributed by NODC is archived in this accession. Version 7 of the NODC Taxonomic Code...

Development and Evaluation of a Multimedia CD-ROM for Exercise During Pregnancy and Postpartum

Science.gov (United States)

Hausenblas, Heather A.; Brewer, Britton W.; Van Raalte, Judy L.; Cook, Brian; Downs, Danielle Symons; Weis, Carol Ann; Nigg, Claudio; Cruz, Amelia

2008-01-01

Objective To meet the need for an interactive product on exercise during pregnancy and postpartum, we developed and evaluated a personally-tailored multimedia CD-ROM. Methods Pregnant and postpartum women, who were randomly assigned to either the experimental group (PregXercise™ CD-ROM) or the control group (CD-ROM with neutral content), navigated through the CD-ROM for 1 hour. Main outcomes were exercise self-efficacy and knowledge. Results In analyses of covariance, compared with the control group, the experimental group had significant increases in self-efficacy and knowledge. Conclusion The multimedia CD-ROM delivering information about exercise motivation, guidelines, and prescription was effective in improving exercise self-efficacy and knowledge. Practice Implications Our preliminary results illustrate that healthcare professionals and researchers may use interactive multimedia for improving exercise behavior and related outcomes with pregnant and postpartum women. PMID:18068940

Validation of accuracy and reliability of a simple measurement device for the lumber range of motion (SMD-L-ROM)

International Nuclear Information System (INIS)

Kato, Nakayuki; Fujiwara, Atsushi; Honda, Toshio; Taneichi, Hiroshi

2007-01-01

It is important to evaluate mobility of the lumbar spine for assessment of lumbar spinal disorders and their therapeutic effects. We developed a simple measurement device for the lumbar range of motion (SMD-L-ROM) which can be installed on the trunk. SMD-L-ROM allows to evaluate mobility of the lumbar spine without x-ray exposure. Accuracy and reliability of the measurement device was assessed in this article. SMD-L-ROM comprises two metallic immobilization plates (IPs) with a vertically installed bar and a rubber band for fixation of IP to the trunk. Two IPs were installed at the level of Th12 and the sacrum. Range of motion (ROM) of the lumbar spine was measured by using SMD-L-ROM and radiographic modalities (X-ray and CT). Consistency of the measured values by both of SMD-L-ROM and radiographic modalities was evaluated. Furthermore, inter- and intra-observer agreement of measured values by SMD-L-ROM was assessed. Regarding measurement of ROM, there was a high correlation between SMD-L-ROM and X-ray/CT especially in the sagittal and axial plane. There was no significant difference in the average values of ROM between the two methods. On the other hand, SMD-L-ROM did not detect accurate position of the lumbar spine in all dimensions. There were no inter- and intra-observer errors of measured values by SMD-L-ROM. ROM of the lumbar spine was simply and economically measured with SMD-L-ROM. Accuracy and reliability of SMD-L-ROM was good enough for ROM measurement in the lumbar spine. (author)

Caspian Sea Energy: Oil, Politics and Development in the Caspian Sea Region (CD-ROM)

National Research Council Canada - National Science Library

Light, Chris

2004-01-01

...: 1 CD-ROM; 4 3/4 in.; 5.0 MB. ABSTRACT: The purpose of this paper is to present the major issues impacting Caspian hydrocarbon development Specifically, a number of topics including the regions geography, history, governments, politics...

Design issues and caching strategies for CD-ROM-based multimedia storage

Science.gov (United States)

Shastri, Vijnan; Rajaraman, V.; Jamadagni, H. S.; Venkat-Rangan, P.; Sampath-Kumar, Srihari

1996-03-01

CD-ROMs have proliferated as a distribution media for desktop machines for a large variety of multimedia applications (targeted for a single-user environment) like encyclopedias, magazines and games. With CD-ROM capacities up to 3 GB being available in the near future, they will form an integral part of Video on Demand (VoD) servers to store full-length movies and multimedia. In the first section of this paper we look at issues related to the single- user desktop environment. Since these multimedia applications are highly interactive in nature, we take a pragmatic approach, and have made a detailed study of the multimedia application behavior in terms of the I/O request patterns generated to the CD-ROM subsystem by tracing these patterns. We discuss prefetch buffer design and seek time characteristics in the context of the analysis of these traces. We also propose an adaptive main-memory hosted cache that receives caching hints from the application to reduce the latency when the user moves from one node of the hyper graph to another. In the second section we look at the use of CD-ROM in a VoD server and discuss the problem of scheduling multiple request streams and buffer management in this scenario. We adapt the C-SCAN (Circular SCAN) algorithm to suit the CD-ROM drive characteristics and prove that it is optimal in terms of buffer size management. We provide computationally inexpensive relations by which this algorithm can be implemented. We then propose an admission control algorithm which admits new request streams without disrupting the continuity of playback of the previous request streams. The algorithm also supports operations such as fast forward and replay. Finally, we discuss the problem of optimal placement of MPEG streams on CD-ROMs in the third section.

Evaluation of the acceptability of a CD-Rom as a health promotion tool for Inuit in Ottawa.

Science.gov (United States)

McShane, Kelly E; Smylie, Janet K; Hastings, Paul D; Prince, Conrad; Siedule, Connie

2013-01-01

There are few health promotion tools for urban Inuit, and there is a specific dearth of evaluations on such tools. The current study used a community-specific approach in the evaluation of a health promotion tool, based on an urban Inuit community's preferences of health knowledge sources and distribution strategies. In partnership with the Tungasuvvingat Inuit Family Health Team in Ottawa, a CD-Rom was developed featuring an Inuk Elder presenting prenatal health messages in both Inuktitut and English. Also, relevant evaluation materials were developed. Using a mixed methods approach, 40 participants completed interviews prior to viewing the CD-Rom and participated in a focus group at follow-up. Questionnaires were also completed pre- and post-viewing to assess changes between expectations and reactions in order to document acceptability. Significant increases were found on satisfaction, acceptability of medium and relevance of content ratings. Qualitative findings also included (a) interest, uncertainty and conditional interest prior to viewing; and (b) positive evaluations of the CD-Rom. This suggests that CD-Rom technology has the potential for health promotion for urban Inuit, and the community-specific evaluation approach yielded useful information.

Pricing Strategies for CD-ROM Products.

Science.gov (United States)

Rowley, J. E.

1994-01-01

Pricing strategies for subscriptions and licenses for CD-ROMs are different for single users and networks. The basic components of pricing strategies are charges for subscription, connect line, display/print, telecommunication, session rate, special commands, and special services. Highlights selected supplier pricing strategies for single users…

Operating Experience with Nuclear Power Stations in Member States in 2013. 2014 Edition (CD-ROM)

International Nuclear Information System (INIS)

2014-07-01

This CD-ROM contains the 45th edition of the IAEA's series of annual reports on operating experience with nuclear power plants in Member States. It is a direct output from the IAEA's Power Reactor Information System (PRIS) and contains information on electricity production and overall performance of individual plants during 2013. In addition to annual information, the report contains a historical summary of performance during the lifetime of individual plants and figures illustrating worldwide performance of the nuclear industry. The CD-ROM contains also an overview of design characteristics and dashboards (not included into the web version) of all operating nuclear power plants worldwide

IDC Reengineering Phase 2 & 3 Rough Order of Magnitude (ROM) Cost Estimate Summary (Leveraged NDC Case).

Energy Technology Data Exchange (ETDEWEB)

Harris, James M.; Prescott, Ryan; Dawson, Jericah M.; Huelskamp, Robert M.

2014-11-01

Sandia National Laboratories has prepared a ROM cost estimate for budgetary planning for the IDC Reengineering Phase 2 & 3 effort, based on leveraging a fully funded, Sandia executed NDC Modernization project. This report provides the ROM cost estimate and describes the methodology, assumptions, and cost model details used to create the ROM cost estimate. ROM Cost Estimate Disclaimer Contained herein is a Rough Order of Magnitude (ROM) cost estimate that has been provided to enable initial planning for this proposed project. This ROM cost estimate is submitted to facilitate informal discussions in relation to this project and is NOT intended to commit Sandia National Laboratories (Sandia) or its resources. Furthermore, as a Federally Funded Research and Development Center (FFRDC), Sandia must be compliant with the Anti-Deficiency Act and operate on a full-cost recovery basis. Therefore, while Sandia, in conjunction with the Sponsor, will use best judgment to execute work and to address the highest risks and most important issues in order to effectively manage within cost constraints, this ROM estimate and any subsequent approved cost estimates are on a 'full-cost recovery' basis. Thus, work can neither commence nor continue unless adequate funding has been accepted and certified by DOE.

Networking CD-ROMs: The Decision Maker's Guide to Local Area Network Solutions.

Science.gov (United States)

Elshami, Ahmed M.

In an era when patrons want access to CD-ROM resources but few libraries can afford to buy multiple copies, CD-ROM local area networks (LANs) are emerging as a cost-effective way to provide shared access. To help librarians make informed decisions, this manual offers information on: (1) the basics of LANs, a "local area network primer";…

Advanced grammar in use a self-study reference and practice book for advanced students of English : with answers and CD-ROM

CERN Document Server

Hewings, Martin

2013-01-01

An updated version of the highly successful Advanced Grammar in Use. This third edition, with answers and CD-ROM, is ideal for self-study. The book contains 100 units of grammar reference and practice materials, with illustrations in full colour and a user-friendly layout. It is ideal for learners preparing for the Cambridge Advanced, Proficiency or IELTS examinations, and is informed by the Cambridge International Corpus, which ensures the language is authentic and up-to-date. The CD-ROM includes 200 interactive exercises to reinforce the language learned in the book, plus customised tests and audio recordings to accompany the main exercises. Versions without answers and without the CD-ROM are available to purchase separately.

CD-ROM-aided Databases

Science.gov (United States)

Kusama, Hideo; Matsumoto, Toshiaki

The CD-ROM system can be used independently or as a compliment to an on-line data system. It has many of the same features as an on-line system. Nippan developed the CD-NOCS system as a reinforcement or substitute for the on-line systems of the customers (bookstores). CD-NOCS is not necessarily designed just for bookstores, it is also applicable to libraries and companies. Authors would also like to emphasize that it is important to understand the development and background of the CD-NOCS system, as well as its operations.

Intertekstualitāte Dž.K. Roulingas "Harija Potera" romānu serijā

OpenAIRE

Strunga-Raude, Aija

2009-01-01

Šī bakalaura darba tēma ir „Intertekstualitāte Dž. K. Roulingas "Harija Potera" romānu sērijā”. Es izvēlējos šo tēmu, jo 2008. gadā tika izdota pēdējā septītā grāmata šajā romānu sērijā un šīs grāmatas jau ir izraisījušas plašas diskusijas dažādās sabiedrības grupās. Šī ir lieliska iespēja izpētīt ko tieši Džoanna Ketlīna Roulinga ir izmantojusi savā romānā “Harijs Poters”. Šī darba mērķis ir ilustrēt kā Dž. K. Roulinga, rakstot „Harija Potera” romānu sēriju, ir izmantojusi intertekstualit...

[Five years of ROM in substance abuse treatment centres in the Netherlands].

Science.gov (United States)

Oudejans, S C C; Schippers, G M; Spits, M E; Stollenga, M; van den Brink, W

2012-01-01

Three substance abuse treatment centres set up a benchmarking project for routine outcome management (ROM) of structured cognitive behavioral treatments for outpatients with a substance use disorder. To present the results of five years benchmarking. All patients were included at intake and the follow-up assessment was performed by a call-center nine months later. Twice a year aggregated data were fed back to management and treatment teams. Since 2005, clinical outcome data, including substance abuse data, have been collected for more than half of all 15.786 treated patients. At follow-up, nine months after intake, 23% was abstinent, 28% reported moderate substance use and 49% reported excessive substance use. The Dutch centres for the treatment of substance abuse were successful in setting up ROM projects to monitor and compare the development and the effects of outpatient addiction treatments. The clinical results are acceptable and correspond to the results of the American project called match. It is not yet clear whether the biannual feedback of aggregated outcomes to management and treatment teams has contributed to the creation of learning organisations, but it has provided transparency and has made it possible for teams to learn from the outcomes.

Regional Ocean Modeling System (ROMS): Main Hawaiian Islands

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Regional Ocean Modeling System (ROMS) 7-day, 3-hourly forecast for the region surrounding the main Hawaiian islands at approximately 4-km resolution. While...

Regional Ocean Modeling System (ROMS): CNMI: Data Assimilating

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Regional Ocean Modeling System (ROMS) 3-day, 3-hourly data assimilating hindcast for the region surrounding the Commonwealth of the Northern Mariana Islands (CNMI)...

Regional Ocean Modeling System (ROMS): Samoa: Data Assimilating

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Regional Ocean Modeling System (ROMS) 3-day, 3-hourly data assimilating hindcast for the region surrounding the islands of Samoa at approximately 3-km resolution....

Regional Ocean Modeling System (ROMS): Oahu: Data Assimilating

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Regional Ocean Modeling System (ROMS) 2-day, 3-hourly data assimilating hindcast for the region surrounding the island of Oahu at approximately 1-km resolution....

The Basic Economics of CD-ROM Pricing.

Science.gov (United States)

Erkkila, John E.

1991-01-01

This explanation of how the basic economic model of pricing applies to the CD-ROM industry considers the supply and demand sides of the market and compares three distinct pricing strategies: (1) pricing to maximize profits; (2) average cost pricing; and (3) marginal cost pricing. (EAM)

Regional Ocean Modeling System (ROMS): Oahu South Shore

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Regional Ocean Modeling System (ROMS) 2-day, 3-hourly forecast for the region surrounding the south shore of the island of Oahu at approximately 200-m resolution....

Between Freedom and Constraint: ROM Hacking of Pokémon Games

OpenAIRE

Barnabé, Fanny

2018-01-01

This paper aims to study a creative practice widespread in video game cultures: “ROM hacking”. By examining with the tools of rhetoric a defined corpus of ROM hacks derived from 『Pokémon』 games, the presentation will show that the formal construction of these derivative works demonstrates less a free or subversive transformation than a fairly strict respect for the original games’ conventions. By reproducing the structure of official 『Pokémon 』games, these fan productions become mirrors revea...

Studi Korelasi Motivasi Pengguna Dengan Pemanfaatan Koleksi CD-ROM Di UPT Pusat Perpustakaan UII Yogyakarta (Study on Correlation Between The Motivation of Users and The Use of CD-ROM Collection At The Main Library of Indonesia Islamic University of Yogyakarta

Directory of Open Access Journals (Sweden)

Keni Hesti Handayani

2015-12-01

Full Text Available The research addresses three main issues: student motivation of Indonesia Islamic University of Yogyakarta, the use of CD-ROM collection at the main library of Indonesia Islamic University of Yogyakarta, and the correlation between student motivation and the use of CD-ROM collection at the library. The study uses a field research. The sample is accidental sampling which involves students using the collection of CD-ROM at the library. In the term of data collection, the writer uses some techniques those of which are documentation, observation, interview and questionnaire. The result of the research shows that, there are correlation between the motivation and the use of CD-ROM collection at the main library of Indonesia Islamic University of Yogyakarta. The research is hoped to contribute to the improvement of services of CD-ROM collection at library in particular and to the development of through collection at the library. Keyword: user motivation, the use of CD-ROM collection

Review of Cornaline de l'Inde/Carnelian in India CD-Rom.

Directory of Open Access Journals (Sweden)

Peter Grave

2002-10-01

Full Text Available The CD-Rom format has been around for some time now with CD-Rom readers a standard fitting on even the most basic PC. The strength of this technology is that it enables large amounts of data to be stored (650-700 MB on a reliable, portable and economical medium. The character of data stored is virtually only dependant on developments in the hardware and software used to generate and manage datasets, whether numeric arrays, databases, digital imagery or multimedia. These features have made it a popular mode for a diverse range of interactive educational, reference and entertainment software. As a medium that can hold thousand of 'pages' of text, spreadsheets, colour images, animations and digital movies, CD-Rom technology also offers obvious benefits for the delivery of the diversity of data produced by archaeological research. It is surprising then that projects such as the bilingual Cornaline de l'Inde/Carnelian in India are few and far between.

Arquitectura románica en la provincia de Soria, 1856-2014. Marco historiográfico y metodológico

Directory of Open Access Journals (Sweden)

Lorenzo Arribas, Josemi

2014-12-01

Full Text Available The historiography of Romanesque in the province of Soria has three different stages. The former one begins with Eduardo Saavedra’s researches (1856 and it extends until 1934, when Gaya Nuño defends his PhD Thesis (La arquitectura románica en la provincia de Soria, which will not be published until 1946. The Spanish Civil War and the post-war period mark the beginning of the second stage, which is merely transitional, lacking any important contribution. The last stage begins with the publication of the three volumes of the Enciclopedia del Románico en Castilla y León (2002. These works have largely improved the knowledge of Romanesque architectural heritage, enhanced besides by the task undertaken by the technical office of the Cultural Project Soria Románica (2007- 2012, responsible for studying and restoring more than thirty Romanesque buildings in the Southern part of province. It is within this working frame that the building recording of the churches here presented must be understood. This historiographical assessment about provincial Romanesque does not include those buildings sited in the capital city, the Cathedral of El Burgo de Osma, the Monastery of Santa Maria de Huerta and the hermitage of San Baudelio (Casillas de Berlanga.La historiografía del Románico en la provincia de Soria tiene tres etapas diferenciadas. Una inicial, que parte de los estudios de Eduardo Saavedra (1856 y se extiende hasta 1934, fecha de la lectura de la tesis doctoral de Gaya Nuño (La arquitectura románica en la provincia de Soria, cuya publicación, no obstante, se demora hasta 1946. La Guerra Civil y posguerra marcan el comienzo de la segunda etapa, transicional y sin grandes aportaciones. La última etapa se inaugura con la publicación de los tres volúmenes sorianos de la Enciclopedia del Románico en Castilla y León (2002. Esta obra ha multiplicado el conocimiento del patrimonio edilicio románico, acrecentado, después, por la labor de la

Development and Utilization of Regional Oceanic Modeling System (ROMS) & Delicacy, Imprecision, and Uncertainty of Oceanic Simulations: An Investigation with ROMS

Science.gov (United States)

2010-09-30

and Ecosystems: An important community use for ROMS is biogeochemisty: chemical cycles, water quality, blooms , micro-nutrients, larval dispersal... Chile current system. J. Climate, submitted. Colas, F., X. Capet, and J. McWilliams, 2010b: Mesoscale eddy buoyancy flux and eddy-induced

Ģimene Mārgaretas Atvudas romānos

OpenAIRE

Voitiņa, Laura

2009-01-01

Mūsdienās diskusijas par ģimeni, tās vērtībām, mainīgo uzbūvi un problēmām, kas ietekmē šo institūtu, ir sastopamas ne tikai mutvārdu runā, bet arī rakstos. Dotā pētījuma mērķis bija veikt saturisku analīzi par ģimenes aprakstiem Margaretas Atvudas romānos “Istabenes Stāsts” un “Oriksa un Kreiks”, lai identificētu romānos aprakstītos ģimenes modeļus, vērtības, paražas un notikumus, kas ietekmē šo institūtu. Tika izmantotas gan teorētiskas, gan empīriskas pētījuma metodes. Lai sniegtu teorētis...

Effects of an immuno-enhanced diet containing antioxidants in esophageal cancer surgery following neoadjuvant therapy.

Science.gov (United States)

Aiko, S; Kumano, I; Yamanaka, N; Tsujimoto, H; Takahata, R; Maehara, T

2012-02-01

Neoadjuvant therapy-induced immunological deterioration may be a key factor in postoperative morbidity in patients with esophageal cancer. This study aimed to determine the effects of perioperative feeding with an immuno-enhanced diet on immune competence in patients treated with neoadjuvant therapy followed by surgery. Because an immuno-enhanced diet that contained several antioxidants was used, perioperative oxidative stress and the effects of the immuno-enhanced diet on this stress were also investigated. Of 39 patients with esophageal cancer who underwent similar surgical procedures, 26 patients who received chemotherapy or chemoradiation therapy before surgery were randomly divided into two groups: group 1 (n= 14) was given an immuno-enhanced diet for 5 days before surgery, and group 2 (n= 12) received no enteral feeding products before surgery. Group 3 (n= 13) consisted of patients that did not receive neoadjuvant therapy and received no enteral feeding products before surgery. Several markers for coagulation and fibrinolysis were determined and immunological assessments were performed for each patient. To measure reactive oxygen metabolites and the total antioxidant capacity, diacron-reactive oxygen metabolites (d-ROMs) and OXY-adsorbent tests were performed using a free radical elective evaluator. Significant depression in lymphocyte numbers was observed in groups 1 and 2 before and early after surgery as compared to group 3. Numbers of B cells, CD4/CD8 ratio, and phytohemagglutinin-induced lymphocyte transformation tests were also significantly decreased in groups 1 and 2 on postoperative day 1. Fibrin and fibrinogen degradation products were significantly elevated in group 2 compared to group 1. d-ROMs and OXY-adsorbent test values were elevated before surgery and were decreased transiently early after surgery. Compared to groups 2 and 3, d-ROMs values were significantly lower in group 1 patients throughout the postoperative period, while OXY

The systems prioritization method (SPM) CD-ROM demonstration for Waste Management '96

International Nuclear Information System (INIS)

Harris, C.L.; Boak, D.M.; Prindle, N.H.; Beyeler, W.

1996-01-01

In March 1994, the Department of Energy Carlsbad Area Office (DOE/CAO) implemented a performance-based planning method to assist in prioritization within the Waste Isolation Pilot Plant (WIPP). Probabilistic performance calculations were required for the Systems Prioritization Method (SPM) and roughly 46,700 combinations of activities were analyzed, generating a large volume of information to be documented, analyzed, and communicated. A self-contained information management system consisting of a relational database on a 600-megabyte CD-ROM was built to meet this need. The CD-ROM was used to store performance assessment results, data analysis and visualization tools, information about the activities, electronic copies of 40 ILFR 191 and 40 CFR 268, technical reference papers, and the final SPM report. Copies of the CD-ROM were distributed to interested members of the public, WIPP participants, and the Environmental Protection Agency (EPA)

On-line vs DC-ROM delivery of information

NARCIS (Netherlands)

Waaijers, L.

1992-01-01

Considers the use of new technologies in library information delivery systems. Discusses the virtues of paper, CD-ROM, and online media in terms of accessibility, timeliness, compactness, searchability, preservability, authenticity, and appearance, as well as end user benefit. Surmises that

Use of CD-Rom databases by staff and students in the University of ...

African Journals Online (AJOL)

The focus of this study is the use of CD-ROM databases by staff and students in the university of Jos library. This is of interest as CD-ROM database services is in consonant with the vision of providing excellent and effective information services to all staff and students of university of Jos. The study was guided by six ...

Dea Computrix - another deity for the Roman Pantheon? Journeys in the Roman Empire CD-Rom

Directory of Open Access Journals (Sweden)

T. Sam N. Moorhead

2002-08-01

Full Text Available This article outlines a personal view on the content and production of a CD-Rom on the Roman world produced by The British Museum, Channel 4, Verulamium Museum and Braunarts: Journeys in the Roman Empire. I discuss some of the benefits of and problems with multimedia production and outline feedback from various evaluation projects of the CD-Rom. I also briefly discuss the future of CD-Roms in the face of a rapidly expanding internet with reference to other multimedia projects at The British Museum.

Public census data on CD-ROM at Lawrence Berkeley Laboratory

Energy Technology Data Exchange (ETDEWEB)

Merrill, D.W.

1992-07-02

In connection with the Comprehensive Epidemiologic Data Resource (CEDR) and Populations at Risk to Environmental Pollution (PAREP) projects, of the Information and Computing Sciences Division (ICSD) at Lawrence Berkeley Laboratory (LBL), are using public socioeconomic and geographic data files which are available to CEDR and PAREP collaborators via LBL's computing network. At this time 67 CD-ROM diskettes (approximately 35 gigabytes) are on line via the Unix file server cedrcd.lbl.gov. Most of the files are from the US Bureau of the Census, and most pertain to the 1990 Census of Population and Housing. This paper contains a list of the CD-ROMs available.

En teoretisk utdyping av rom og materialitet som pedagogisk ressurs i barnehagen

Directory of Open Access Journals (Sweden)

Solveig Nordtømme

2015-07-01

Full Text Available Abstract: This article is a theoretical exploration with the aim of discussing an ontological basis for space and materiality as educational resources in kindergarten. Attention is directed on children’s play experiences interacting with space and materiality, and how children use and create space. The metaphors front stage, space in between, and backstage (inspired from Erving Goffman, 1969, which form the study's main findings, are used as the backdrop for the issue and analyzes. The empirical material used in this exploration has been collected with an ethnographic methodological approach in two kindergartens. Maurice Merleau-Ponty’s (1962 focus on bodily experience and presence in space, along with concepts from Latour’s (2005 actor-network theory, is used to explore the data. The article contributes with theoretical tools for professionals in kindergarten teaching, to shed light on the importance of space, materiality and play in children's everyday life in kindergarten.Sammendrag: Denne artikkelen diskuterer et ontologisk grunnlag og er en teoretisk utforskning av rom og materialitet som en pedagogisk ressurs i barnehagen. Oppmerksomheten er rettet mot barns lekeerfaringer i samspill med rom og materialitet, og hvordan barn bruker og skaper rom. Metaforene hovedrom, mellomrom, og bakrom (inspirert fra Erving Goffman, 1969, som danner studiens hovedfunn, blir brukt som et bakteppe for problemstilling og analyser av det empiriske materialet fra to barnehager. Maurice Merleau-Ponty publikasjoner The Phenomenology of Perception (Merleau-Ponty, 1962 med sitt fokus på kroppslig erfaring i levd rom, blir brukt sammen med begreper fra Latours aktør-nettverksteori (Latour 2005 til å utforske hvordan rom og materialitet kan være pedagogiske ressurser. Artikkelens kunnskapsbidrag er å presentere et teoretisk verktøy for barnehageprofesjonen og kunnskaper om lekens betydning i barns hverdag i barnehagen.

Relationships among range of motion, functional mobility, and quality of life in children and adolescents after limb-sparing surgery for lower-extremity sarcoma.

Science.gov (United States)

Marchese, Victoria G; Spearing, Elena; Callaway, Lulie; Rai, Shesh N; Zhang, Lijun; Hinds, Pamela S; Carlson, Claire A; Neel, Michael D; Rao, Bhaskar N; Ginsberg, Jill

2006-01-01

The study was designed to examine relationships between range of motion (ROM), functional mobility, and quality of life (QL) in patients with lower-extremity sarcoma (LES) after limb-sparing surgery Sixty-eight patients with LES (age, 10-26 years) participated. The patients performed hip flexion, hip extension, knee flexion, and knee extension, Timed Up and Down Stairs (TUDS), Timed Up and Go (TUG), nine-minute run-walk (9-min), and completed the QL measure, Short-Form-36 version two (SF-36v2). Significant correlations (p < 0.01) were found between hip extension and SF-36v2 physical component scale (PCS; r = 0.33), TUDS (r = -0.32), TUG (r = -0.33); hip flexion and TUDS (r = -0.31), TUG (r = -0.39), 9-min (r = 0.44); knee flexion and TUDS (r = -0.52), TUG (r = -0.40), 9-min (r = 0.37); SF-36v2 PCS and TUDS (r = -0.56), TUG (r = -0.51), 9-min (r = 0.60). ROM correlates with functional mobility and QL in patients with LES after limb-sparing surgery. ROM exercises are important component of a physical therapy program for children and adolescents with LES.

The Virtual Man Project's CD-ROM "Voice Assessment: Speech-Language Pathology and Audiology & Medicine", Vol.1

Directory of Open Access Journals (Sweden)

Millena Maria Ramalho Matta Vieira

2009-01-01

Full Text Available The CD-ROM "Voice Assessment: Speech-Language Pathology and Audiology & Medicine" was developed as a teaching tool for people interested in the production of the spoken or sung human voice. Its content comprises several subjects concerning the anatomy and physiology of spoken and sung voice. A careful assessment becomes necessary in order to ensure the effectiveness of teaching and learning educational materials, whether related to education or health, within the proposal of education mediated by technology. OBJECTIVE: This study aimed to evaluate the efficacy of the Virtual Man Project's CD-ROM "Voice Assessment: Speech-Language Pathology and Audiology & Medicine", as a self-learning material, in two different populations: Speech-Language Pathology and Audiology students and Lyrical Singing students. The participants were instructed to study the CD-ROM during 1 month and answer two questionnaires: one before and another one after studying the CD-ROM. The quantitative results were compared statistically by the Student's t-test at a significance level of 5%. RESULTS: Seventeen out of the 28 students who completed the study, were Speech-Language Pathology and Audiology students, while 11 were Lyrical Singing students (dropout rate of 44%. Comparison of the answers to the questionnaires before and after studying the CD-ROM showed a statistically significant increase of the scores for the questionnaire applied after studying the CD-ROM for both Speech-Language Pathology and Audiology and Lyrical Singing students, with p<0.001 and p<0.004, respectively. There was also a statistically significant difference in all topics of this questionnaire for both groups of students. CONCLUSION: The results concerning the evaluation of the Speech-Language Pathology and Audiology and Lyrical Singing students' knowledge before and after learning from the CD-ROM allowed concluding that the participants made significant improvement in their knowledge of the proposed

Utilizing the Evaluation Process in CD-ROM Development.

Science.gov (United States)

Crews, Tena B.; Chalupa, Marilyn R.

1999-01-01

While a CD-ROM on network topologies was being developed, it was evaluated formatively by 14 office systems teachers and summatively by 23 students using it in class. Improvements in ease of use, performance, and the accuracy and clarity of content were made. (SK)

Public census data on CD-ROM at Lawrence Berkeley Laboratory

Energy Technology Data Exchange (ETDEWEB)

Merrill, D.W.

1993-01-16

The Comprehensive Epidemiologic Data Resource (CEDR) and Populations at Risk to Environmental Pollution (PAREP) projects, of the Information and Computing Sciences Division (ICSD) at Lawrence Berkeley Laboratory (LBL), are using public socioeconomic and geographic data files which are available to CEDR and PAREP collaborators via LBL's computing network. At this time 72 CD-ROM diskettes (approximately 37 gigabytes) are on line via the Unix file server cedrcd.lbl.gov''. Most of the files are from the US Bureau of the Census, and many of these pertain to the 1990 Census of Population and Housing. All the CD-ROM diskettes contain documentation in the form of ASCII text files. In addition, printed documentation for most files is available for inspection at University of California Data and Technical Assistance (UC DATA), tel. (510) 642-6571, or the UC Documents Library, tel. (510) 642-2569, both located on the UC Berkeley Campus. Many of the CD-ROM diskettes distributed by the Census Bureau contain software for PC compatible computers, for easily accessing the data. Shared access to the data is maintained through a collaboration among the CEDR and PAREP projects at LBL, and UC DATA, and the UC Documents Library. LBL is grateful to UC DATA and the UC Documents Library for the use of their CD-ROM diskettes. Shared access to LBL facilities may be restricted in the future if costs become prohibitive. Via the Sun Network File System (NFS), these data can be exported to Internet computers for direct access by the user's application program(s). Due to the size of the files, this access method is preferred over File Transfer Protocol (FTP) access. Please contact Deane Merrill (dwmerrill lbl.gov) if you wish to make use of the data.

CD roms and multimedia projector as complimentary educational ...

African Journals Online (AJOL)

This paper examines the potentials of utilizing Compact Disk Read Only Memory (CD-ROM) and the multimedia projector as complimentary educational technology for teaching music in colleges of education in Nigeria. While recognizing the problem of ineffective methods of teaching in Nigeria's educational system, the ...

Strict follow-up programme including CT and (18) F-FDG-PET after curative surgery for colorectal cancer

DEFF Research Database (Denmark)

Sørensen, N F; Jensen, A B; Wille-Jørgensen, P

2010-01-01

carcinogenic embryonic antigen (CEA), chest X-ray, abdominal ultrasound (US), computed tomography (CT) and (18) F-FDG positron emission tomography (FDG-PET). Method  A cohort of 132 patients, treated by surgery with curative intent for CRC, was included. Patients were followed prospectively with scheduled...... controls at 3, 6, 12 and 24 months after curative surgery. CEA, chest X-ray, US, CT and FDG-PET supplemented by clinical examination. The end-point was recurrence. Sensitivity and specificity was estimated 2 years after surgery. Results  Of the 132 patients included in the study, 25 experienced recurrence...

Public census data on CD-ROM at Lawrence Berkeley Laboratory

Energy Technology Data Exchange (ETDEWEB)

Merrill, D.W.

1992-10-01

The Comprehensive Epidemiologic Data Resource (CEDR) and Populations at Risk to Environmental Pollution (PAREP) projects, of the Information and Computing Sciences Division (ICSD) at Lawrence Berkeley Laboratory (LBL), are using public socio-economic and geographic data files which are available to CEDR and PAREP collaborators via LBL's computing network. At this time 70 CD-ROM diskettes (approximately 36 gigabytes) are on line via the Unix file server cedrcd. lbl. gov. Most of the files are from the US Bureau of the Census, and most pertain to the 1990 Census of Population and Housing. All the CD-ROM diskettes contain documentation in the form of ASCII text files. Printed documentation for most files is available for inspection at University of California Data and Technical Assistance (UC DATA), or the UC Documents Library. Many of the CD-ROM diskettes distributed by the Census Bureau contain software for PC compatible computers, for easily accessing the data. Shared access to the data is maintained through a collaboration among the CEDR and PAREP projects at LBL, and UC DATA, and the UC Documents Library. Via the Sun Network File System (NFS), these data can be exported to Internet computers for direct access by the user's application program(s).

Public census data on CD-ROM at Lawrence Berkeley Laboratory

Energy Technology Data Exchange (ETDEWEB)

Merrill, D.W.

1992-10-01

The Comprehensive Epidemiologic Data Resource (CEDR) and Populations at Risk to Environmental Pollution (PAREP) projects, of the Information and Computing Sciences Division (ICSD) at Lawrence Berkeley Laboratory (LBL), are using public socio-economic and geographic data files which are available to CEDR and PAREP collaborators via LBL`s computing network. At this time 70 CD-ROM diskettes (approximately 36 gigabytes) are on line via the Unix file server cedrcd. lbl. gov. Most of the files are from the US Bureau of the Census, and most pertain to the 1990 Census of Population and Housing. All the CD-ROM diskettes contain documentation in the form of ASCII text files. Printed documentation for most files is available for inspection at University of California Data and Technical Assistance (UC DATA), or the UC Documents Library. Many of the CD-ROM diskettes distributed by the Census Bureau contain software for PC compatible computers, for easily accessing the data. Shared access to the data is maintained through a collaboration among the CEDR and PAREP projects at LBL, and UC DATA, and the UC Documents Library. Via the Sun Network File System (NFS), these data can be exported to Internet computers for direct access by the user`s application program(s).

Effects of Using Human Patient Simulator (HPS versus a CD-ROM on Cognition and Critical Thinking

Directory of Open Access Journals (Sweden)

Don Johnson, PhD

2008-01-01

Full Text Available Background: Very little prospective randomized experimental research exists on the use of simulation as a teaching method, and no studies have compared the two strategies of using the HPS and a CD-ROM. In addition, no researchers have investigated the effects of simulation on various levels of cognition, specifically lower-level and higher-level cognition or critical thinking.Objectives: A prospective pretest-posttest experimental mixed design (within and between was used to determine if there were statistically significant differences in HPS and CD-ROM educational strategies in lower-level, higher-level cognition and critical thinking.Results: A repeated measures multivariate analysis of variance (RMANOVA with LSD post-hoc tests were used to analyze the data. There were no significant differences between the HPS and CD-ROM groups on lower-level cognition scores. The HPS group did significantly better than the CD-ROM group on higher-level cognition and critical thinking scores.Conclusion: This study demonstrated that the choice of teaching strategies for lower-level cognition does not make a statistically significant difference in outcome. However, the HPS is superior to using CD-ROM and should be considered as the choice in teaching.

The Application of a Modified d-ROMs Test for Measurement of Oxidative Stress and Oxidized High-Density Lipoprotein

Directory of Open Access Journals (Sweden)

Fumiaki Ito

2017-02-01

Full Text Available Reactive oxygen species (ROS are involved in the initiation and progression of atherosclerosis. ROS-derived hydroperoxides, as an indicator of ROS production, have been measured by using the diacron reactive oxygen metabolites (d-ROMs test, which requires iron-containing transferrin in the reaction mixture. In this study we developed a modified d-ROMs test, termed the Fe-ROMs test, where iron ions were exogenously added to the reaction mixture. This modification is expected to exclude the assay variation that comes from different blood iron levels in individuals. In addition, this Fe-ROMs test was helpful for determining the class of plasma lipoproteins that are hydroperoxidized. Low-density lipoprotein/very low-density lipoprotein (LDL/VLDL and high-density lipoprotein (HDL were purified by use of an LDL/VLDL purification kit and the dextran sulfate-Mg2+ precipitation method, respectively; their hydroperoxide contents were assessed by performing the Fe-ROMs test. The majority of the hydroperoxides were detected only in the HDL fraction, not in the LDL/VLDL. Further detailed analysis of HDLs by size-exclusion high-performance liquid chromatography revealed that the hydroperoxide-containing molecules were small-sized HDLs. Because HDL was shown to be the principal vehicle for the plasma hydroperoxides, this Fe-ROMs test is a beneficial method for the assessment of oxidized-HDL levels. Indeed, Fe-ROMs levels were strongly associated with the levels of oxidized HDL, which were determined by performing the malondialdehyde-modified HDL enzyme immunoassay. In conclusion, the Fe-ROMs test using plasma itself or the HDL fraction after dextran sulfate-Mg2+ precipitation is useful to assess the functionality of HDL, because the oxidation of HDL impairs its antiatherogenic capacity.

Analysis of Users' Searches of CD-ROM Databases in the National and University Library in Zagreb.

Science.gov (United States)

Jokic, Maja

1997-01-01

Investigates the search behavior of CD-ROM database users in Zagreb (Croatia) libraries: one group needed a minimum of technical assistance, and the other was completely independent. Highlights include the use of questionnaires and transaction log analysis and the need for end-user education. The questionnaire and definitions of search process…

Cd-Rom and Access to Information

OpenAIRE

Chacón Alvarado, Lucía

2011-01-01

The scientific and technological advances in the world and its application in different areas of knowledge have developed a new electronic age.Computers and telecommunications have created a new scenario for libraries and information centers leading to further changes in the use of its collections and its services increased. Libraries and information centers must address these changes because users demand access to information quickly and efficiently.The CD-ROM is a new technology that has be...

Adolescencia, relaciones románticas y actividad sexual: una revisión

OpenAIRE

Vargas Trujillo, Elvia; Barrera, Fernando

2008-01-01

Se presenta una revisión de algunas de las investigaciones más recientes sobre la adolescencia y los factores asociados a las relaciones románticas y la actividad sexual durante la adolescencia. Se parte de la premisa de que el análisis de la iniciación romántica y sexual durante la adolescencia requiere de modelos de causalidad múltiple que permitan dar cuenta, conjuntamente, de los factores que se encuentran en los contextos individual, familiar y social asociados con estos dos procesos. Se...

Experimental study on x-rays dose enhancement effects for floating gate ROMs

CERN Document Server

Guo Hong Xia; Chen Yu Sheng; Han Fu Bin; He Chao Hui; Zhao Hui

2002-01-01

Experimental results of x-ray dose enhancement effects are given for floating gate read-only memory (ROMs) irradiated in the Beijing Synchrotron Radiation Facility. The wrong byte numbers vs. total irradiation dose have been tested and the equivalent relation of total dose damage is provided compared the response of devices irradiated with sup 6 sup 0 Co gamma-ray source. The x-ray dose enhancement factors for floating gate ROMs are obtained firstly in China. These results can be an effective evaluation data for x-rays radiation hardening technology

OCONUS Compliance Assessment Protocols - Qatar (Army Version) (CD-ROM)

National Research Council Canada - National Science Library

Krooks, David A

2004-01-01

...: 1 CD-ROM; 4 3/4 in.; 578 KB. ABSTRACT: This environmental compliance assessment manual is based on the Final Governing Standards for Environmental Security of United States Forces in the State of Qatar, 21 May 1999, and the Overseas...

A Look at Dialog's First CD-ROM Product.

Science.gov (United States)

Duggan, Mary Kay

1987-01-01

Discusses reasons for selecting ERIC with the Dialog OnDisc software for training information professionals in online searching at the University of California, Berkeley, and analyzes some of the features of the CD-ROM software. Pros and cons of online and OnDisc access are summarized, and three references are listed. (Author/MES)

Strict follow-up programme including CT and (18) F-FDG-PET after curative surgery for colorectal cancer

DEFF Research Database (Denmark)

Sørensen, N F; Jensen, A B; Wille-Jørgensen, P

2010-01-01

Aim The risk of local recurrence following curative surgery for colorectal cancer (CRC) is up to 50%. A rigorous follow-up program may increase survival. Guidelines on suitable methods for scheduled follow up examinations are needed. This study evaluates a strict follow-up program including...... supported a strict follow-up program following curative surgery for colorectal cancer. FDG-PET combined with CT should be included in control programs....

CD ROM 'Natural heritage of Slovakia'

International Nuclear Information System (INIS)

Uradnikova, B.

2005-01-01

Centre of Environmental Education Geopark ('Centre') applied environmental education into school and out-of-school institutions. The 'Centre' is working in the fields: environmental education, eco-tourism development, presentation of the cultural landscape and world heritage. The CD ROM 'Natural heritage of Slovakia' was created with aim enhancement of environmental awareness, pedagogy, education and development of eco-tourism on the Slovakia. It abets general review about environment, its components, legislative, history and the present day of nature and landscape protection

Lab Manual & Resources for Materials Science, Engineering and Technology on CD-Rom

Science.gov (United States)

Jacobs, James A.; McKenney, Alfred E.

2001-01-01

The National Educators' Workshop (NEW:Update) series of workshops has been in existence since 1986. These annual workshops focus on technical updates and laboratory experiments for materials science, engineering and technology, involving new and traditional content in the field. Scores of educators and industrial and national laboratory personnel have contributed many useful experiments and demonstrations which were then published as NASA Conference Proceedings. This "out poring of riches" creates an ever-expanding shelf of valuable teaching tools for college, university, community college and advanced high school instruction. Now, more than 400 experiments and demonstrations, representing the first thirteen years of NEW:Updates have been selected and published on a CD-ROM, through the collaboration of this national network of materials educators, engineers, and scientists. The CD-ROM examined in this document utilizes the popular Adobe Acrobat Reader format and operates on most popular computer platforms. This presentation provides an overview of the second edition of Experiments in Materials Science, Engineering and Technology (EMSET2) CD-ROM, ISBN 0-13-030534-0.

Regional Ocean Modeling System (ROMS): Main Hawaiian Islands: Data Assimilating

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Regional Ocean Modeling System (ROMS) 3-day, 3-hourly data assimilating hindcast for the region surrounding the main Hawaiian islands at approximately 4-km...

Tidal simulation using regional ocean modeling systems (ROMS)

Science.gov (United States)

Wang, Xiaochun; Chao, Yi; Li, Zhijin; Dong, Changming; Farrara, John; McWilliams, James C.; Shum, C. K.; Wang, Yu; Matsumoto, Koji; Rosenfeld, Leslie K.;

The Writing Process for "Edutaining" CD-ROM Adventures.

Science.gov (United States)

Mountain, Lee

2000-01-01

Describes a CD-ROM adventure story written by the author to educate her students about the word relationships of synonyms and antonyms. Discusses how this interactive medium put a different twist on each of the stages of the writing process itself. Relates how two students enthusiastically used the program, and were inspired to write one of their…

Land and Marine Gravity Data on CD-ROM - 1999 Edition

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Land and Marine Gravity 1999 Edition 2-volume CD-ROM set contains observed and derived land and marine gravity data contributed by many national and...

Significance of measuring oxidative stress in lifestyle-related diseases from the viewpoint of correlation between d-ROMs and BAP in Japanese subjects

International Nuclear Information System (INIS)

Fukui, Toshiki; Yamauchi, Kazuhiro; Maruyama, Mie; Yasuda, Tadashi; Abe, Youichi; Kohno, Masakazu

2011-01-01

In recent years, oxidative stress has been postulated to be an important factor in the pathogenesis and development of lifestyle-related diseases. In this study, we investigated the association between the derivatives of reactive oxygen metabolites (d-ROMs), as an index of products of reactive oxygen species (ROS), and biological antioxidant potential (BAP), as an index of antioxidant potential. We also investigated the associations between d-ROMs or BAP and the risk factors for lifestyle-related diseases or metabolic syndrome-associated factors to evaluate their usefulness in preventive medicine. There were 442 subjects who underwent health checkup examination in our facilities. In addition to standard medical checkup items, we analyzed d-ROMs, BAP, brachial-ankle pulse wave velocity, high-sensitivity C-reactive protein level and visceral fat area (VFA) visualized on a computed tomography scan. The mean d-ROM value in females was significantly higher than that in males. There was a positive correlation between the d-ROM and VFA levels. On correlation analysis, there was a negative correlation between the d-ROM and creatinine levels. As factors that influence d-ROMs, the level of VFA was selected, suggesting the significance of oxidative stress measurement with d-ROMs. In addition, there was a positive correlation between d-ROMs and BAP values. Further research is required to resolve whether increased production of ROS or the antioxidant potential that can compensate for such an increase of ROS is more important in vivo. (author)

Nanotechnology Aerospace Applications (Applications aerospatiales de la nanotechnologie) (CD-ROM)

National Research Council Canada - National Science Library

2007-01-01

...: 1 CD-ROM; 4 3/4 in.; 116 MB. ABSTRACT: The Educational Notes contain the abstracts and the lecture material of ten presentations, which provide a general introduction into nanotechnologies with selected topics, such as nanotechnology...

Alois Riegl, Die Entstehung der Barockkunst in Rom, 1908

NARCIS (Netherlands)

Witte, A.; Bacchi, A.; Barroero, L.

2017-01-01

In 1908, Alois Riegl's unfinished text on the Italian Baroque was published by Max Dvorak and Arthur Burda; they edited part of his notes for three consecutive series of lectures at Vienna University. Riegl's book title aply reads Entstehung der Barockkunst in Rom: Akademische Vorlesungen and deals

Nanotechnology Aerospace Applications (Applications aerospatiales de la nanotechnologie) (CD-ROM)

National Research Council Canada - National Science Library

2005-01-01

...: 1 CD-ROM; 4 3/4 in.; 59.1 MB. ABSTRACT: The Educational Notes contain the abstracts and the lecture material of ten presentations, which provide a general introduction into nanotechnologies with selected topics, such as nanotechnology...

Management of CD-ROM Resources in Nigeria Academic Libraries ...

African Journals Online (AJOL)

The study is on management of CD-ROM resources in Nigerian academic libraries with reference to Federal Polytechnic Nekede Library, Owerri. A descriptive survey method was adopted random sampling technique was used in selecting twenty five (25) staff from the library under study. The questionnaire was the major ...

Guide Structures in CD-ROM Dic- tionaries, with Specific Reference ...

African Journals Online (AJOL)

Not all the search options in CD-ROM dictionaries necessarily maintain the boundaries ... In this article all derivatives of lase are highlighted in the microstructure, ... searches frustrates the user and should be addressed in future editions of the.

Public census data on CD-ROM at Lawrence Berkeley Laboratory. Revision 4

Energy Technology Data Exchange (ETDEWEB)

Merrill, D.W.

1993-03-12

The Comprehensive Epidemiologic Data Resource (CEDR) and Populations at Risk to Environmental Pollution (PAREP) projects, of the Information and Computing sciences Division (ICSD) at Lawrence Berkeley Laboratory (LBL), are using public socioeconomic and geographic data files which are available to CEDR and PAREP collaborators via LBL`s computing network. At this time 89 CD-ROM diskettes (approximately 45 gigabytes) are on line via the Unix file server cedrcd.lbl.gov. Most of the files are from the US Bureau of the Census, and many of these pertain to the 1990 Census of Population and Housing. All the CD-ROM diskettes contain documentation in the form of ASCII text files. In addition, printed documentation for most files is available for inspection at University of California Data and Technical Assistance (UC DATA), tel. (510) 642-6571, or the UC Documents Library, tel. (510) 642-2569, both located on the UC Berkeley Campus. Many of the CD-ROM diskettes distributed by the Census Bureau contain software for PC compatible computers, for easily accessing the data. Shared access to the data is maintained through a collaboration among the CEDR and PAREP projects at LBL, and UC DATA, and the UC Documents Library. LBL is grateful to UC DATA and the UC Documents Library for the use of their CD-ROM diskettes. Shared access to LBL facilities may be restricted in the future if costs become prohibitive. Via the Sun Network File System (NFS), these data can be exported to Internet computers for direct access by the user`s application program(s). Due to the size of the files, this access method is preferred over File Transfer Protocol (FTP) access.

Effects of using simulation versus CD-ROM in the performance of ultrasound-guided regional anesthesia.

Science.gov (United States)

Gasko, John; Johnson, Arthur; Sherner, John; Craig, John; Gegel, Brian; Burgert, James; Sama, Samuel; Franzen, Thomas

2012-08-01

The purpose of this study was to determine which method of teaching, CD-ROM, simulation, or a combination of both, was more effective in increasing the performance of ultrasound-guided regional anesthesia. No studies have investigated these methods. The framework for this study was critical thinking. The study was a prospective, mixed (between and within) subjects, experimental design. The sample consisted of 29 student registered nurse anesthetists randomly assigned to 1 of 3 groups: CD-ROM (n = 11), simulation (n = 11), and combination (n = 7). All groups were evaluated by the use of cadavers before and 2 months after the intervention using a valid and reliable instrument of performance. A repeated-measures analysis of variance indicated that the combination was significantly better than the CD-ROM and simulation (P teaching ultrasound-guided regional anesthesia techniques.

ROMS/TOMS Tangent Linear and Adjoint Models: Testing and Applications

National Research Council Canada - National Science Library

Miller, Arthur J; Cornuelle, Bruce D

2004-01-01

... (Regional Ocean Modeling System/Terrain-Following Ocean Modeling System) that is suitable for general use by the ROMS/TOMS community and to develop computational platforms based on the TLM and ADM for 4D variational data assimilation (4DVar...

Public census data on CD-ROM at Lawrence Berkeley Laboratory. Revision 1

Energy Technology Data Exchange (ETDEWEB)

Merrill, D.W.

1992-07-02

In connection with the Comprehensive Epidemiologic Data Resource (CEDR) and Populations at Risk to Environmental Pollution (PAREP) projects, of the Information and Computing Sciences Division (ICSD) at Lawrence Berkeley Laboratory (LBL), are using public socioeconomic and geographic data files which are available to CEDR and PAREP collaborators via LBL`s computing network. At this time 67 CD-ROM diskettes (approximately 35 gigabytes) are on line via the Unix file server cedrcd.lbl.gov. Most of the files are from the US Bureau of the Census, and most pertain to the 1990 Census of Population and Housing. This paper contains a list of the CD-ROMs available.

Mars Navigator: An Interactive Multimedia Program about Mars, Aerospace Engineering, Astronomy, and the JPL Mars Missions. [CD-ROM

Science.gov (United States)

Gramoll, Kurt

This CD-ROM introduces basic astronomy and aerospace engineering by examining the Jet Propulsion Laboratory's (JPL) Mars Pathfinder and Mars Global Surveyor missions to Mars. It contains numerous animations and narrations in addition to detailed graphics and text. Six interactive laboratories are included to help understand topics such as the…

The Correlation of Exercise and Range of Motion (ROM on Elderly Knee Observasional Study on Elderly People in Pedurungan Semarang

Directory of Open Access Journals (Sweden)

Adhitya Putra Widyantoro

2012-06-01

Design and Method: Observastional study with a cross sectional design 80 elderly men and women were divided into 2 groups: gymnastics group in the Social Rehabilitation Unit Of Pucang Gading (n=40 and unexcercises group in the Penggaron village (n=40. In both groups, the degree of ROM of knee was assessed using the Goniometer. To evaluate the value of its significance, the data were analyzed using the Mann Withney test followed by Spearmann’s rho test. Result: ROM for gymnastic(exercised group and unexercised group were 115.50°±11.591°, 95.38°±12.780° respectively with p<0. 001. Resuts showed that doing exercise was useful for maintaining ROM of knee in elderly people. Spearmann’s rho test resulted in a strong correlation between ROM and exercise with r value of 0.652. Conclusion: exercise correlates with ROM of knee in elderly (Sains Medika, 4(1:39-45.

Operating Experience with Nuclear Power Stations in Member States. 2016 Edition (CD-ROM)

International Nuclear Information System (INIS)

2016-06-01

This CD-ROM contains the 47th edition of the IAEA’s series of annual reports on operating experience with nuclear power plants in Member States. It is a direct output from the IAEA’s Power Reactor Information System (PRIS) and contains information on electricity production and overall performance of individual plants during 2015. In addition to annual information, the report contains a historical summary of performance during the lifetime of individual plants and figures illustrating worldwide performance of the nuclear industry. The CD-ROM contains also an overview of design characteristics and dashboards of all operating nuclear power plants worldwide

Public census data on CD-ROM at Lawrence Berkeley Laboratory. Revision 3

Energy Technology Data Exchange (ETDEWEB)

Merrill, D.W.

1993-01-16

The Comprehensive Epidemiologic Data Resource (CEDR) and Populations at Risk to Environmental Pollution (PAREP) projects, of the Information and Computing Sciences Division (ICSD) at Lawrence Berkeley Laboratory (LBL), are using public socioeconomic and geographic data files which are available to CEDR and PAREP collaborators via LBL`s computing network. At this time 72 CD-ROM diskettes (approximately 37 gigabytes) are on line via the Unix file server ``cedrcd.lbl.gov``. Most of the files are from the US Bureau of the Census, and many of these pertain to the 1990 Census of Population and Housing. All the CD-ROM diskettes contain documentation in the form of ASCII text files. In addition, printed documentation for most files is available for inspection at University of California Data and Technical Assistance (UC DATA), tel. (510) 642-6571, or the UC Documents Library, tel. (510) 642-2569, both located on the UC Berkeley Campus. Many of the CD-ROM diskettes distributed by the Census Bureau contain software for PC compatible computers, for easily accessing the data. Shared access to the data is maintained through a collaboration among the CEDR and PAREP projects at LBL, and UC DATA, and the UC Documents Library. LBL is grateful to UC DATA and the UC Documents Library for the use of their CD-ROM diskettes. Shared access to LBL facilities may be restricted in the future if costs become prohibitive. Via the Sun Network File System (NFS), these data can be exported to Internet computers for direct access by the user`s application program(s). Due to the size of the files, this access method is preferred over File Transfer Protocol (FTP) access. Please contact Deane Merrill (dwmerrill@lbl.gov) if you wish to make use of the data.

Development and Utilization of Regional Oceanic Modeling System (ROMS). Delicacy, Imprecision, and Uncertainty of Oceanic Simulations: An Investigation with the Regional Oceanic Modeling System (ROMS). Mixing in the Ocean Surface Layer Using the Regional Oceanic Modeling System (ROMS).

Science.gov (United States)

2011-09-30

community use for ROMS is biogeochemisty: chemical cycles, water quality, blooms , micro-nutrients, larval dispersal, biome transitions, and coupling to...J.C. McWilliams, X. Capet, and J. Kurian, 2010: Heat balance and eddies in the Peru- Chile Current System. Climate Dynamics, 37, in press. doi10.1007

Biblioteca Naţională a României: obiective şi perspective în valorificarea patrimoniului cultural

Directory of Open Access Journals (Sweden)

Elena Tîrziman

2008-01-01

Biblioteca Naţională a României este implicată în proiecte internaţionale care au ca scop crearea de conţinut digital relevant pentru memoria culturală europeană: The European Library – TEL (Biblioteca europeană, Manuscriptorium şi ENRICH – European Networking Resources and Information concerning Cultural Heritage, proiecte coordonate de Biblioteca Naţională a Cehiei. Biblioteca Naţională a României a contribuit la proiectele Manuscriptorium / ENRICH prin carte românească veche din perioada corespunzătoare secolelor XVI-XVII.

Reservoir and civil engineering geophysics (CD-Rom); Geophysique de gisement et de genie civil (CD-Rom)

Energy Technology Data Exchange (ETDEWEB)

Mari, J.L.; Chapellier, D.

1999-07-01

This CD-Rom is a pedagogical tool developed from the book 'field and civil engineering geophysics' (Technip ed., 1998). It presents the geophysical methods (surface and well geophysical surveys, radar surveys and well logging) and their application in the study of oil fields and also in civil engineering. Several cartoons illustrate the principle of methods, their domain of use and their limitations. It covers the following topics: surface seismic surveys (waves propagation, equipments, reflexion and refraction seismic surveys, surface waves); well seismic surveys (operation, data processing, imaging); well logging (acoustic, nuclear,electrical and others, methods of interpretation); radar surveys (principle, surface, wells, possibilities and limitations). (J.S.)

OCONUS Compliance Assessment Protocols (OCAP) - Saudi Arabia (Army Version) (CD-ROM)

National Research Council Canada - National Science Library

Krooks, David A; Schell, Donna J

2004-01-01

...: 1 CD-ROM; 4 3/4 in.; 670 KB. ABSTRACT: This environmental compliance assessment manual is based on the Final Governing Standards for Environmental Security by United States Forces in the Kingdom of Saudi Arabia (FGS-SA...

A Community Terrain-Following Ocean Modeling System (ROMS)

Science.gov (United States)

2015-09-30

funded NOPP project titled: Toward the Development of a Coupled COAMPS-ROMS Ensemble Kalman filter and adjoint with a focus on the Indian Ocean and the...surface temperature and surface salinity daily averages for 31-Jan-2014. Similarly, Figure 3 shows the sea surface height averaged solution for 31-Jan... temperature (upper panel; Celsius) and surface salinity (lower panel) for 31-Jan-2014. The refined solution for the Hudson Canyon grid is overlaid on

Molecular Cloning, Expression and Characterization of Plasmid Encoding Rhomboid 4 (ROM4 of Tachyzoite of Toxoplasma gondii RH Strain

Directory of Open Access Journals (Sweden)

Mohammad Taghi RAHIMI

2017-12-01

Full Text Available AbstractBackground: The objective of this study was to clone, express and characterize the gene encoding rhomboid 4 (ROM4 proteins, a vital gene in surface adhesion and host cell invasion process of tachyzoite of T. gondii in an appropriate expression vector and eukaryotic cell for production of recombinant protein.Methods: Toxoplasma RNA was isolated from tachyzoites (RH strain and complementary DNA was synthesized. Oligonucleotide primer pair was designed based on Toxoplasma ROM4 gene sequence with XhoI and EcoRI restriction sites at 5´ end of forward and reverse primers, respectively. ROM4 gene was amplified by PCR, cloned into pTG19-T vector and the recombinant plasmid was sequenced. The gene was subcloned into pcDNA3 plasmid and expressed in CHO cells as eukaryotic cell. SDS-PAGE and western blotting were performed for protein determination and verification.Results: Cloning of ROM4 gene in pTG19-T vector was confirmed by colony-PCR and enzymatic digestion. The results of enzymatic digestion and gene sequencing confirmed successful cloning and subcloning procedures. The nucleotide sequence of the cloned ROM4 gene showed 99% homology compared to the corresponding sequences of original gene. SDS-PAGE and western blotting analyses of the purified protein revealed a single band having expected size of 65 kDa.Conclusion: This eukaryotic expression system is an appropriate system for high-level recombinant protein production of ROM4 gene from T. gondii tachyzoites used as antigenic component for serological assay and vaccine development.

NODC Standard Product: World Ocean Circulation Experiment (WOCE) Global Data Resource (GDR), versions 1-3, on CD-ROM and DVD

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NODC produced twelve (12) CD-ROMs containing WOCE Version 1 project data in the summer of 1998. NODC produced fifteen (15) CD-ROMs containing WOCE Version 2 project...

Educational program in crisis management for cardiac surgery teams including high realism simulation.

Science.gov (United States)

Stevens, Louis-Mathieu; Cooper, Jeffrey B; Raemer, Daniel B; Schneider, Robert C; Frankel, Allan S; Berry, William R; Agnihotri, Arvind K

2012-07-01

Cardiac surgery demands effective teamwork for safe, high-quality care. The objective of this pilot study was to develop a comprehensive program to sharpen performance of experienced cardiac surgical teams in acute crisis management. We developed and implemented an educational program for cardiac surgery based on high realism acute crisis simulation scenarios and interactive whole-unit workshop. The impact of these interventions was assessed with postintervention questionnaires, preintervention and 6-month postintervention surveys, and structured interviews. The realism of the acute crisis simulation scenarios gradually improved; most participants rated both the simulation and whole-unit workshop as very good or excellent. Repeat simulation training was recommended every 6 to 12 months by 82% of the participants. Participants of the interactive workshop identified 2 areas of highest priority: encouraging speaking up about critical information and interprofessional information sharing. They also stressed the importance of briefings, early communication of surgical plan, knowing members of the team, and continued simulation for practice. The pre/post survey response rates were 70% (55/79) and 66% (52/79), respectively. The concept of working as a team improved between surveys (P = .028), with a trend for improvement in gaining common understanding of the plan before a procedure (P = .075) and appropriate resolution of disagreements (P = .092). Interviewees reported that the training had a positive effect on their personal behaviors and patient care, including speaking up more readily and communicating more clearly. Comprehensive team training using simulation and a whole-unit interactive workshop can be successfully deployed for experienced cardiac surgery teams with demonstrable benefits in participant's perception of team performance. Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Experimental study on gamma irradiation effects of floating gate ROMs The ROM is stated for Read-only Memory

CERN Document Server

He Chao Hui; Chen Xiao Hua; Wang Yan Ping; Peng Hong Lun

2002-01-01

Experimental results of gamma irradiation effects are given for Floating gate ROMs. There is an accumulated dose threshold. Errors occur when accumulated dose is above the threshold, no error occurs when below the threshold. The errors go up with the increase of the accumulated dose. Errors occur in devices that are measured during irradiation and irradiated in power on, moreover, new data cannot be written in these devices with programmer. However, under more accumulated dose, there is no error in devices in power off mode and new data can be written in these devices with programmer

Natural Tasking of Robots Based on Human Interaction Cues (CD-ROM)

National Research Council Canada - National Science Library

Brooks, Rodney A

2005-01-01

...: 1 CD-ROM; 4 3/4 in.; 207 MB. ABSTRACT: We proposed developing the perceptual and intellectual abilities of robots so that in the field, war-fighters can interact with them in the same natural ways as they do with their human cohorts...

Ionospheric data available on CD-ROM and on NDADS

International Nuclear Information System (INIS)

Bilitza, D.

1996-01-01

Information is provided on two CD-ROMs (for PCs) with ionospheric data: the ionosonde CD issued by NGDC/WDC-A-STP/NOAA/Boulder and the Atmosphere Explorer CD produced by NSSDC/WDC-A-R and S/NASA/Greenbelt. We also briefly describe the ionospheric/thermospheric data available through NSSDC's automated mail retrieval system (NDADS) and explain the procedure for obtaining NDADS data. (author). 3 figs

Frontal sinus revision rate after nasal polyposis surgery including frontal recess clearance and middle turbinectomy: A long-term analysis.

Science.gov (United States)

Benkhatar, Hakim; Khettab, Idir; Sultanik, Philippe; Laccourreye, Ollivier; Bonfils, Pierre

2018-08-01

To determine the frontal sinus revision rate after nasal polyposis (NP) surgery including frontal recess clearance (FRC) and middle turbinectomy (MT), to search for predictive factors and to analyse surgical management. Longitudinal analysis of 153 patients who consecutively underwent bilateral sphenoethmoidectomy with FRC and MT for NP with a minimum follow-up of 7 years. Decision of revision surgery was made in case of medically refractory chronic frontal sinusitis or frontal mucocele. Univariate and multivariate analysis incorporating clinical and radiological variables were performed. The frontal sinus revision rate was 6.5% (10/153). The mean time between the initial procedure and revision surgery was 3 years, 10 months. Osteitis around the frontal sinus outflow tract (FSOT) was associated with a higher risk of frontal sinus revision surgery (p=0.01). Asthma and aspirin intolerance did not increase the risk, as well as frontal sinus ostium diameter or residual frontoethmoid cells. Among revised patients, 60% required multiple procedures and 70% required frontal sinus ostium enlargement. Our long-term study reports that NP surgery including FRC and MT is associated with a low frontal sinus revision rate (6.5%). Patients developing osteitis around the FSOT have a higher risk of frontal sinus revision surgery. As mucosal damage can lead to osteitis, FSOT mucosa should be preserved during initial NP surgery. However, as multiple procedures are common among NP patients requiring frontal sinus revision, frontal sinus ostium enlargement should be considered during first revision in the hope of reducing the need of further revisions. Copyright © 2018 Elsevier B.V. All rights reserved.

Canister Design for Deep Borehole Disposal of Nuclear Waste (CD-ROM)

National Research Council Canada - National Science Library

Hoag, Christopher I

2006-01-01

...: 1 CD-ROM; 4 3/4 in.; 28.7 MB. ABSTRACT: The objective of this thesis was to design a canister for the disposal of spent nuclear fuel and other high-level waste in deep borehole repositories using currently available and proven oil, gas...

[Cost-effectiveness in Dutch mental health care: future because of ROM?

NARCIS (Netherlands)

Agthoven, M. van; Kolk, A. van der; Knegtering, H.; Delespaul, P.A.; Arends, J.; Jeurissen, P.P.T.; Krabbe, P.F.M.; Huijsman, R.; Luijk, R.; Beurs, E. de; Hakkaart-van Roijen, L.; Bruggeman, R.

2015-01-01

BACKGROUND: The document reporting Dutch mental health care negotiations for 2014 - 2017 calls for a cost decrease based on cost-effectiveness. Thanks to rom, the Dutch mental health care seems well prepared for cost-effectiveness research.
AIM: Evaluate how valid cost-effectiveness research

Planning and Preparation for CD-ROM Implementation: The Citadel Library.

Science.gov (United States)

Maynard, J. Edmund

Management guidelines for library planning and a strategic planning program profile based on the literature were used in the planning process for implementing access to databases on CD-ROM at the Daniel Library of the Citadel, Military College of South Carolina. According to this model, the planning process would consist of five stages: (1)…

Air Force Research Laboratorv Success Stories: A Review of 2004 (CD-ROM)

National Research Council Canada - National Science Library

2004-01-01

...). PHYSICAL DESCRIPTION: 1 CD-ROM; 4 3/4 in.; 43.5 MB. ABSTRACT: The Air Force Science and Technology Success Stories herein often represent the combined effort of several scientists and engineers working as a team...

Experience teaching CD-ROM-based course on CANDU nuclear-power-plant systems and operation

International Nuclear Information System (INIS)

Rouben, Benjamin

2008-01-01

This paper presents personal experience garnered from teaching a CD-ROM-based course on CANDU Power-Plant Systems and Operation. This course was originally developed by Prof. G.T. Bereznai as research in distance-learning techniques when he was directing the Thai-Canadian Human Resources Development Project at Chulalongkorn University in Bangkok. The course has been offered in a number of universities, including McMaster University and the University of Ontario Institute of Technology. All the course material, including lectures, assignments, and a simulator, is provided on a CD-ROM. Lectures include a spoken soundtrack covering the material. The class often includes both undergraduate and graduate students. I found that most students appreciate having the material on electronic format, which they can view and review at will and on their own time. Students find this course quite intensive - it covers all major systems in the CANDU reactor and power plant in detail. A very important component of the course is the simulator, which teaches students how systems operate in normal operation, in power manoeuvres, and during process-system malfunctions. Effort in absorbing the material and performing assignments can often exceed 10 hours per week. Some of the simulator assignments involve tricky manoeuvres, requiring several tries to achieve the expected result. Some assignments may take several hours, especially if the manoeuvres requiring repetition take 30 minutes or more in real time. I found that some instruction in the basic theory of reactor physics and systems is appreciated by students. A few possible enhancements to the simulator model were identified. Graduate students taking the course are required to do an additional project; I assigned an investigation of the effects of xenon-concentration changes during 1 week of load cycling. In summary, this course provides to students the opportunity to learn a great deal about the workings of CANDU-plant systems. (author)

Ambient Temperature Based Thermal Aware Energy Efficient ROM Design on FPGA

DEFF Research Database (Denmark)

Saini, Rishita; Bansal, Neha; Bansal, Meenakshi

2015-01-01

Thermal aware design is currently gaining importance in VLSI research domain. In this work, we are going to design thermal aware energy efficient ROM on Virtex-5 FPGA. Ambient Temperature, airflow, and heat sink profile play a significant role in thermal aware hardware design life cycle. Ambient...

In Praise of Mr. S. Platter and His Marvelous, Magnificent CD ROM Laser Disc Index for ERIC and PSYCHLIT.

Science.gov (United States)

Huffman, Robert F.

These instructions are designed to help patrons of the University of Missouri-Columbia library perform searches on PSYCHLIT, a CD-ROM (compact disc, read only memory) version of the Psych Abstracts database, and a CD-ROM version of the ERIC database, both produced by SilverPlatter Information Services. Basic information is provided about the disk…

An electrically reprogrammable 1024 bits MNOS ROM using MNOS-SOS e/d technology

International Nuclear Information System (INIS)

Mackowiak, E.; Le Goascoz, V.

1976-01-01

A 1024 bits fully decoded electrically writable and erasable non volatile ROM is described. Memory cells and peripheral circuits are made using P channel silicon on sapphire enhancement depletion technology [fr

Students' Attitudes toward ABI/INFORM on CD-ROM: A Factor Analysis.

Science.gov (United States)

Wang, Vicky; Lau, Shuk-fong

Two years after the introduction of CD-ROM bibliographic database searching in the Memphis State University libraries (Tennessee), a survey was conducted to examine students' attitudes toward the business database, ABI/INFORM. ABI/INFORM contains indexes and abstracts of articles from over 800 journals on management, accounting, banking, human…

Energy-Smart Choices for Schools. An HVAC Comparison Tool. [CD-ROM].

Science.gov (United States)

Geothermal Heat Pump Consortium, Inc., Washington, DC.

A CD ROM program provides comparison construction cost capabilities for heating, ventilation, and air conditioning (HVAC) systems in educational facilities. The program combines multiple types of systems with square footage data on low and high construction cost and school size to automatically calculate HVAC comparative construction costs. (GR)

Operating Experience with Nuclear Power Stations in Member States in 2014. 2015 Edition (CD-ROM)

International Nuclear Information System (INIS)

2015-01-01

This CD-ROM contains the 46th edition of the IAEA’s series of annual reports on operating experience with nuclear power plants in Member States. It is a direct output from the IAEA’s Power Reactor Information System (PRIS) and contains information on electricity production and overall performance of individual plants during 2014. In addition to annual information, the report contains a historical summary of performance during the lifetime of individual plants and figures illustrating worldwide performance of the nuclear industry. The CD-ROM contains also an overview of design characteristics and dashboards of all operating nuclear power plants worldwide

Development and testing of a CD-ROM program for improving adolescent knowledge of inflammatory bowel disease.

Science.gov (United States)

Boamah, Lynelle M; Bohren, Janet R; Pentiuk, Scott; Baker, Raymond; Yi, Michael; Moyer, M Susan

2010-05-01

The aim of this study was to design a theory-based educational program for adolescents with inflammatory bowel disease (IBD) using an interactive multimedia CD-ROM and to test its effectiveness in improving knowledge in IBD. Curriculum-based instruction using educational theory and principles was designed for adolescents on an interactive multimedia CD-ROM. Twenty subjects completed summative evaluation of the CD-ROM measuring gain in knowledge about IBD immediately and 9 months after instruction. Subjects found the CD-ROM to be informative, appealing, and easy to use. The mean baseline score of the adolescents on the Crohn's and Colitis Knowledge questionnaire was 12.2 (standard deviation 5.14, range 3-24). After an average of 30 minutes of self-directed learning, adolescent subjects increased their posttest score to a mean of 19.8, a gain of 7.6 points over baseline (95% confidence interval 5.2-10.1, P < 0.0001). Knowledge of medications, disease complications, and gastrointestinal structure and function was gained and retained upon retesting at 9 months with a mean Crohn's and Colitis Knowledge questionnaire score of 17.5 (standard deviation 3.9, range 12-26), which was still an improvement over the mean pretest knowledge score of 12.2 (P < 0.001). Adolescents with IBD have low baseline knowledge about their disease. A rigorously developed interactive educational tool is now available for instructing adolescent patients about their IBD.

The effects of neural mobilization on cervical radiculopathy patients' pain, disability, ROM, and deep flexor endurance.

Science.gov (United States)

Kim, Dong-Gyu; Chung, Sin Ho; Jung, Ho Bal

2017-09-22

Cervical radiculopathy (CR) is a disease of the cervical spine and a space-occupying lesion that occurs because of pathological problems with cervical nerve roots. Nerve root injury to produce functional disability. The purpose of this study was to examine the effects of neural mobilization with manual cervical traction (NMCT) compared with manual cervical traction (MCT) on pain, functional disability, muscle endurance, and range of motion (ROM) in individuals with CR patients. A blinded randomized clinical trial was conducted. Thirty CR patients were divided into two groups - those who received NMCT and those who received MCT. The intervention was applied three times per week for eight weeks. It was measured in order to determine the pain and functional disability in patients with CR. The numeric pain rating scale (NPRS), neck disability index (NDI), ROM, and deep flexor endurance of patients were measured prior to the experiment, four weeks, and eight weeks after the experiment to compare the time points. A repeated-measures analysis of variance was used to compare differences within each group prior to the experiment. And Bonferroni test was performed to examine the significance of each time point. There were significant differences within each group prior to the intervention, four weeks after the intervention, and eight weeks after the intervention in NPRS, NDI, ROM, and deep flexor endurance (Ppain relief, recovery from neck disability, ROM, and deep flexor endurance for patients with CR.

經由校園網路存取圖書館光碟資料庫之研究 Studies on Multiuser Access Library CD-ROM Database via Campus Network

Directory of Open Access Journals (Sweden)

Ruey-shun Chen

1992-06-01

Full Text Available 無Library CD-ROM with its enormous storage, retrieval capabilities and reasonable price. It has been gradually replacing some of its printed counterpart. But one of the greatest limitation on the use of stand-alone CD-ROM workstation is that only one user can access the CD-ROM database at a time. This paper is proposed a new method to solve this problem. The method use personal computer via standard network system Ethernet high speed fiber network FADDY and standard protocol TCP/IP can access library CD-ROM database and perform a practical CD-ROM campus network system. Its advantage reduce redundant CD-ROM purchase fee and reduce damage by handed in and out and allows multiuser to access the same CD-ROM disc simultaneously.

In company pre-intermediate student's book with CD-ROM

CERN Document Server

Clarke, Simon; Sharma, Pete

2009-01-01

In Company has established itself as the Business English course for professionals because of its immediate results through topic-based content, active skills, and real-world tasks that are instantly relevant to everyday business English development. In Company Second Edition builds on the success of the original but is now updated and improved with a host of new features. For extra online practice for your students, take a look at the new Second Edition In Company Practice Online solution. Accompanying the popular In Company series in British English, these online courses provide carefully designed resources to supplement the Student's Books at all levels. Units are clearly defined as Topic or Skills based NEW phrase banks with useful phrases for reference and revision 5 NEW case studies, within the Student's Book reflect real-life business scenarios Second Edition CD-ROM now includes a new interactive glossary and the class audio as a donwloadable MP3.

Adolescencia, relaciones románticas y actividad sexual: una revisión

Directory of Open Access Journals (Sweden)

Elvia Vargas

2002-01-01

Full Text Available Se presenta una revisión de algunas de las investigaciones más recientes sobre la adolescencia y los factores asociados a las relaciones románticas y la actividad sexual durante la adolescencia. Se parte de la premisa de que el análisis de la iniciación romántica y sexual durante la adolescencia requiere de modelos de causalidad múltiple que permitan dar cuenta, conjuntamente, de los factores que se encuentran en los contextos individual, familiar y social asociados con estos dos procesos. Se destaca el papel de los padres en el desarrollo de hijos adolescentes autónomos, capaces de manejar la influencia negativa del grupo de pares. Se hacen algunas recomendaciones a los responsables de diseñar programas de prevención y a los interesados en el estudio de la adolescencia y en el desarrollo de la disciplina

Verification of Data Accuracy in Japan Congenital Cardiovascular Surgery Database Including Its Postprocedural Complication Reports.

Science.gov (United States)

Takahashi, Arata; Kumamaru, Hiraku; Tomotaki, Ai; Matsumura, Goki; Fukuchi, Eriko; Hirata, Yasutaka; Murakami, Arata; Hashimoto, Hideki; Ono, Minoru; Miyata, Hiroaki

2018-03-01

Japan Congenital Cardiovascluar Surgical Database (JCCVSD) is a nationwide registry whose data are used for health quality assessment and clinical research in Japan. We evaluated the completeness of case registration and the accuracy of recorded data components including postprocedural mortality and complications in the database via on-site data adjudication. We validated the records from JCCVSD 2010 to 2012 containing congenital cardiovascular surgery data performed in 111 facilities throughout Japan. We randomly chose nine facilities for site visit by the auditor team and conducted on-site data adjudication. We assessed whether the records in JCCVSD matched the data in the source materials. We identified 1,928 cases of eligible surgeries performed at the facilities, of which 1,910 were registered (99.1% completeness), with 6 cases of duplication and 1 inappropriate case registration. Data components including gender, age, and surgery time (hours) were highly accurate with 98% to 100% concordance. Mortality at discharge and at 30 and 90 postoperative days was 100% accurate. Among the five complications studied, reoperation was the most frequently observed, with 16 and 21 cases recorded in the database and source materials, respectively, having a sensitivity of 0.67 and a specificity of 0.99. Validation of JCCVSD database showed high registration completeness and high accuracy especially in the categorical data components. Adjudicated mortality was 100% accurate. While limited in numbers, the recorded cases of postoperative complications all had high specificities but had lower sensitivity (0.67-1.00). Continued activities for data quality improvement and assessment are necessary for optimizing the utility of these registries.

CD-ROM training course in quality assurance in diagnostic imaging

International Nuclear Information System (INIS)

Khoury, H.J.; Machado, P.; Drexler, G.

2001-01-01

This paper discusses the CD-ROM elaborated to provide a continuous professional formation and a practical guidance on the implementation and operation of routine quality assurance (QA) programme for medical physicists, regulator authorities and for those personnel concerned with the daily provision of diagnostic radiology services. The CD-ROM contains topics on the basic concepts of QA in radiodiagnostic, and it also allows the user to visualise effects on the variation of technical parameters (tube potential (kV) and current (mA), filtration) in the quality of the image. This possibility will contribute to the better understanding of the phenomena associated with the quality of the image. Besides, the program contains the procedures for the execution of the tests of the equipment and the route of implantation of program of quality assurance. It is interactive with the user, it fills a gap in the medical physics area and it allows the student's continuous formation because it assists the beginner, with the basic concepts, and the professional, with the aid in the implantation of the program of QA. The presentation is in the Portuguese language. (author)

Poemele homerice în veșminte românești. O analiză diacronică (I

Directory of Open Access Journals (Sweden)

Petre Gheorghe Bârlea

2015-07-01

Full Text Available Lucrarea pe care o propunem vizează istoria traducerilor românești ale poemelor homerice, din perspectiva evoluției limbii române literare. Pornim de la premisa că orice asemenea traducere reprezintă o probă de virtuozitate nu numai pentru traducătorul în cauză, ci și pentru limba și cultura modernă respectivă, așa încît este interesant de studiat modul în care dezvoltarea exegezei homerice și a teoriilor traductologice se manifestă în paralel cu etapele evoluției limbilor moderne. Grila de analiză va include, așadar, principii, metode și instrumente de lucru ale domeniilor amintite aici (istoria limbii, traductologie, dar și elemente împrumutate din gramatica constrastiv-tipologică, din filologie, în sensul restrîns al conceptului, din teoria mentalităților, istoria culturală ș.a. Demersul nostru evidențiază faptul că evoluția istorică a actului traducerii este marcată, în mod firesc, de personalitatea traducătorului (opțiuni teoretice, ideologice, pe lîngă competențe lingvistice, har poetic etc., dar și de contextul cultural al epocii și al spațiului respectiv. Pentru cultura română, cel puțin, putem constata că, în ansamblu, versiunea cea mai recentă este și cea mai reușită.

Nanomechanical recognition of prognostic biomarker suPAR with DVD-ROM optical technology

DEFF Research Database (Denmark)

Bache, Michael; Bosco, Filippo; Brøgger, Anna Line

2013-01-01

In this work the use of a high-throughput nanomechanical detection system based on a DVD-ROM optical drive and cantilever sensors is presented for the detection of urokinase plasminogen activator receptor inflammatory biomarker (uPAR). Several large scale studies have linked elevated levels...

Multimedia CD-Rom on hydrogen and fuel cells. 2. rev. ed.; Die Multimedia CD-Rom zum Thema Wasserstoff und Brennstoffzellen

Energy Technology Data Exchange (ETDEWEB)

Anon.

2007-07-01

This CD-Rom contains well-presented information with informative illustrations, as well as a large download section with publications, reports, and presentations in.pdf form for in-depth studies. There is also a list of links to selected websites, with short explanations. [German] Die CD zum Thema ''Wasserstoff und Brennstoffzellen'' bietet sowohl gut gegliederte Informationen mit anschaulichen Bildern fuer die Lektuere am Monitor als auch eine grosse Download-Rubrik, in der zahlreiche Publikationen, Fachberichte, Praesentationen als PDF-Dateien abgelegt sind und fuers Studium bereitstehen. Ausserdem gibt es ein Link-Verzeichnis mit Verweisen und Erlaeuterungen zu ausgewaehlten Internet-Seiten.

Pitfalls in the Assessment, Analysis, and Interpretation of Routine Outcome Monitoring (ROM) Data : Results from an Outpatient Clinic for Integrative Mental Health

NARCIS (Netherlands)

Hoenders, Rogier H. J.; Bos, Elisabeth H.; Bartels-Velthuis, Agna A.; Vollbehr, Nina K.; van der Ploeg, Karen; de Jonge, Peter; de Jong, Joop T. V. M.

There is considerable debate about routine outcome monitoring (ROM) for scientific or benchmarking purposes. We discuss pitfalls associated with the assessment, analysis, and interpretation of ROM data, using data of 376 patients. 206 patients (55 %) completed one or more follow-up measurements.

Provocarea Facebook pentru bibliotecile publice din România

Directory of Open Access Journals (Sweden)

Octavia-Luciana Madge

2014-01-01

Full Text Available Reţelele sociale şi-au câştigat rapid un loc în viaţa noastră şi în activitatea multor organizaţii şi instituţii publice şi private. La nivelul bibliotecilor, reţelele sociale şi-au demonstrat utilitatea şi rolul în calitate de instrumente de marketing pentru o mai bună comunicare cu utilizatorii. Bibliotecile publice din România au cunoscut în ultimul timp transformări mari în ceea ce priveşte modul de abordare a relaţiei cu utilizatorii şi îmbunătăţirea activităţii lor. Au lansat, de asemenea, o serie de noi servicii pentru a răspunde nevoilor comunităţii pe care o servesc şi pentru a atrage noi utilizatori. Implementarea şi utilizarea de noi aplicaţii precum reţelele de socializare online, mai exact Facebook, a fost una dintre aceste dezvoltări recente. Această lucrare analizează modul în care reţelele sociale sunt utilizate la nivelul bibliotecilor publice din România prin exemplul a trei biblioteci publice mari şi a modului în care aceste biblioteci îşi promovează serviciile prin intermediul reţelei Facebook.

Radiotherapy during surgery. Summarizing progress achieved after 5 years of experience

International Nuclear Information System (INIS)

Wannenmacher, M.; Herfarth, C.

1998-01-01

Complemental radiotherapy during surgery for ensuring radical removal of multi-invasive and multicentric tumors is an acknowledged principle. Irradiation under the operation permits pin-pointed application of a high, single radiation dose to a sharply defined target area, while movable radiosensitive organs can be optimally protected. The requirements of this treatment call for close interdisciplinary collaboration of surgeons and radiooncologists. Due to the demand for highly experienced personnel and sophisticated technology, application of this type of radiotherapy is restricted so far to a few medical centers. The value of the treatment was analysed and proven by an international multi-center study performed by experienced hospitals. The CD-ROM in hand presents a topical survey of ongoing activities, techniques and developments relating to radiotherapy during surgery at the national and international level and is intended to serve as a source of information and further learning for colleagues wishing to specialize in this field. (orig./CB) [de

Comparative gait analysis of ankle arthrodesis and arthroplasty: initial findings of a prospective study.

Science.gov (United States)

Hahn, Michael E; Wright, Elise S; Segal, Ava D; Orendurff, Michael S; Ledoux, William R; Sangeorzan, Bruce J

2012-04-01

Little is known about functional outcomes of ankle arthroplasty compared with arthrodesis. This study compared pre-surgical and post-surgical gait measures in both patient groups. Eighteen patients with end-stage ankle arthritis participated in an ongoing longitudinal study (pre-surgery, 12 months post-surgery) involving gait analysis, assessment of pain and physical function. Outcome measures included temporal-distance, kinematic and kinetic data, the Short Form 36 (SF-36) body pain score, and average daily step count. A mixed effects linear model was used to detect effects of surgical group (arthrodesis and arthroplasty, n = 9 each) with walking speed as a covariate (α = 0.05). Both groups were similar in demographics and anthropometrics. Followup time was the same for each group. There were no complications in either group. Pain decreased (p < 0.001) and gait function improved (gait velocity, p = 0.02; stride length, p = 0.035) in both groups. Neither group increased average daily step count. Joint range of motion (ROM) differences were observed between groups after surgery (increased hip ROM in arthrodesis, p = 0.001; increased ankle ROM in arthroplasty, p = 0.036). Peak plantar flexor moment increased in arthrodesis patients and decreased in arthroplasty patients (p = 0.042). Initial findings of this ongoing clinical study indicate pain reduction and improved gait function 12 months after surgery for both treatments. Arthroplasty appears to regain more natural ankle joint function, with increased ROM. Long-term follow up should may reveal more clinically meaningful differences.

Şcoli şi biserici româneşti din Peninsula Balcanică 1864-1948. Documente de arhivă

Directory of Open Access Journals (Sweden)

Adina Berciu-Drăghicescu

2006-01-01

Full Text Available Articolul de faţă privind şcolile şi bisericile româneşti din Peninsula Balcanică în perioada 1918-1948 este realizat pe baza unor documente identificate în fonduri păstrate la Arhivele Diplomatice ale Ministerului Afacerilor Externe şi la Direcţia Arhivelor Naţioanle Istorice Centrale din Bucureşti. Au fost studiate şi selectate documente de cea mai mare semnificaţie în scopul prezentării evoluţiei situaţiei şcolilor şi bisericilor comunităţilor româneşti situate la sud de Dunăre începând cu anul 1864, când a fost înfiinţată prima şcoală în Târnova (Macedonia şi până în 1948 când statul român a abandonat acţiunea iniţiată de conducătorul Al. Ioan Cuza. Articolul prezintă această situaţie, foarte dramatică, a comunităţilor româneşti din Balcani pe baza documentelor de arhivă.

Factors Affecting Pre-Service TESOL Teachers' Attitudes towards Using CD-ROM Dictionary

Science.gov (United States)

Issa, Jinan Hatem; Jamil, Hazri

2011-01-01

Rapid technological advances in communication technologies and computational power are altering the nature of knowledge, skills, talents and the know-how of individuals. A CD-ROM dictionary is an interesting and effective teaching tool, which captures pre-service teachers' interest and does much more than just translates especially with the…

Guide Structures in CD-ROM Dictionaries, with Specific Reference to the EWED and the ELHAT

Directory of Open Access Journals (Sweden)

Philip Louw

2011-10-01

Full Text Available

macro- and microstructural information. In order to evaluate the methods which lexicographers employ to improve dictionary accessibility, the concept of guide structures was introduced by Hausmann and Wiegand (1989. Since the appearance of that article, various academics have written articles and read papers on guide structures in print dictionaries, but few studies have focussed on the tremendous potential of guide structures in electronic dictionaries. In this article it will be shown that electronic dictionaries add dimensions to the implementation of guide structures not possible in print versions. The role of two of the guide structures in the transfer of infonnation in CD-ROM dictionaries will be discussed. The access and mediostructures of the Microsoft Encarta World English Dictionary and the Elektroniese Handwoordeboek van die Afrikaanse Taal will be analysed and critically evaluated to illustrate the advantages of electronic dictionaries over print dictionaries and the urgent need for metalexicographical discussion of this publication medium.

Keywords: ACCESS STRUCTURE; ACTIVE CROSS-REFERENCES; CD-ROM DICTIONARY; DICTIONARY ACCESSIBILITY; ENCYCLOPAEDIC DICTIONARY; GUIDE STRUCTURES; INNER ACCESS STRUCTURE; INNER SEARCH PATH; INTERNET; MEDIOSTRUCTURE; MULTIMEDIA; OUTER ACCESS STRUCTURE; OUTER SEARCH PATH; PASSIVE CROSSREFERENCING; USER-FRIENDLINESS

Opsomming: Gidsstrukture in CD-ROM-woordeboeke, met spesifieke verwysingna EWED en ELHA T. Die sukses van modeme woordeboeke hang grootliles af vandie toeganklikheid van hulle makro- en mikrostrukturele inligting. Hausmann en Wiegand (1989het die konsep van gidsstrukture ingevoer om die metodes te evalueer wat leksikograwe gebruikom woordeboektoeganklikheid Ie verbeter. Sedert hierdie artikel verskyn het, het verskeie akademic:i artikels gepubliseer en referate gelewer oor gidsstrukture in gedrukte woordeboeke, maarmin studies het gefokus op die geweldige potensiaal van

Occupational Analysis Products: Space Systems Operations - AFSC 1C6X1 (CD-ROM)

National Research Council Canada - National Science Library

Boerstler, Robert E

2004-01-01

...: 1 CD-ROM; 4 3/4 in.; 30.4 MB. SYSTEMS DETAIL NOTE: ABSTRACT: The Space Systems Operations career ladder was surveyed to obtain current task and equipment data for use in evaluating current training programs...

Galvenais varonis Dž.K.Roulingas romānu sērijā "Harijs Poters"

OpenAIRE

Kalsone, Ineta

2012-01-01

Dotā bakalaura darba temats ir "Galvenais varonis Dž.K. Roulingas romānu sērijā "Harijs Poters". Pirmajā nodaļā es analizēju sērijas popularitāti, publicēšanas datus un apbalvojumus, ko saņēmusi Dž.K. Roulinga. Otrajā nodaļā tiek analizēti dažādi raksturojuma veidi. Sīkāk tiek pētīta galvenā varoņa un citu nozīmīgāko tēlu loma. Meklējuma literatūras elementi,kas dod pamatu galvenā varoņa izaugsmei, tika analizēti detalizēti. Trešajā nodaļā tiek analizēta galvenā varoņa izaugsme šajā romānu sē...

Fine mapping of Best`s macular dystrophy localises the gene in close proximity to, but distinct from, the D115480/ROM1

Energy Technology Data Exchange (ETDEWEB)

Graff, C.; Ahlbom, B.E.; Anneren, G. [University Hospital, Uppsala (Sweden)] [and others

1994-09-01

Best`s macular dystrophy (BMD) is an autosomal dominant disease characterized by accumulation of lipofuscin beneath the pigment epithelium of the macula, leading to early-onset impairment of central vision. The gene has previously been mapped to 11q13. Based on DNA from 191 people from a large 12-generation family, the gene now has been mapped to a 1.5 cM interval between the markers Fc{epsilon}RI and D11S480/ROM1. By disequilibrium analysis the gene was estimated to be 0.321 cM centromeric to the marker D11S480. Since this on average corresponds to 300 kb, the gene may be at a distance contained in YAC molecules. To physically characterize this region, YAC clones positive for markers flanking BMD have been identified. Sequence analysis of the candidate gene ROM1 did not reveal any mutation. However, one recombination between intragenic ROM1 polymorphisms and BMD was detected, which make it highly unlikely that mutations in ROM1 are causing BMD.

COPPER RESISTANT STRAIN CANDIDA TROPICALIS RomCu5 INTERACTION WITH SOLUBLE AND INSOLUBLE COPPER COMPOUNDS

Directory of Open Access Journals (Sweden)

Ie. P. Prekrasna

2015-10-01

Full Text Available The focus of the study was interaction of Candida tropicalis RomCu5 isolated from highland Ecuador ecosystem with soluble and insoluble copper compounds. Strain C. tropicalis RomCu5 was cultured in a liquid medium of Hiss in the presence of soluble (copper citrate and CuCl2 and insoluble (CuO and CuCO3 copper compounds. The biomass growth was determined by change in optical density of culture liquid, composition of the gas phase was measured on gas chromatograph, redox potential and pH of the culture fluid was defined potentiometrically. The concentration of soluble copper compounds was determined colorimetrically. Maximal permissible concentration of Cu2+ for C. tropicalis RomCu5 was 30 000 ppm of Cu2+ in form of copper citrate and 500 ppm of Cu2+ in form of CuCl2. C. tropicalis was metabolically active at super high concentrations of Cu2+, despite the inhibitory effect of Cu2+. C. tropicalis immobilized Cu2+ in the form of copper citrate and CuCl2 by it accumulation in the biomass. Due to medium acidification C. tropicalis dissolved CuO and CuCO3. High resistance of C. tropicalis to Cu2+ and ability to interact with soluble and insoluble copper compounds makes it biotechnologically perspective.

Year 5 Pupils Reading an "Interactive Storybook" on CD-ROM: Losing the Plot?

Science.gov (United States)

Trushell, John; Burrell, Clare; Maitland, Amanda

2001-01-01

This study examined whether small groups of grade 5 students in a London primary school, without teacher supervision, progressed linearly through an interactive storybook on CD-ROM, and whether such diversions as cued animations affected pupil comprehension. Results showed students' recall of the storyline was poor. (Author/LRW)

Processing of Irradiated Graphite to Meet Acceptance Criteria for Waste Disposal. Results of a Coordinated Research Project. Companion CD-ROM

International Nuclear Information System (INIS)

2016-05-01

Graphite is widely used in the nuclear industry and in research facilities and this has led to increasing amounts of irradiated graphite residing in temporary storage facilities pending disposal. This publication arises from a coordinated research project (CRP) on the processing of irradiated graphite to meet acceptance criteria for waste disposal. It presents the findings of the CRP, the general conclusions and recommendations. The topics covered include, graphite management issues, characterization of irradiated graphite, processing and treatment, immobilization and disposal. Included on the attached CD-ROM are formal reports from the participants

Helping Family Physicians Improve Their Cardiac Auscultation Skills with an Interactive CD-ROM.

Science.gov (United States)

Roy, Douglas; Sargeant, Joan; Gray, Jean; Hoyt, Brian; Allen, Michael; Fleming, Michael

2002-01-01

Physicians (n=42) studied cardiac auscultation using a 15-hour CD-ROM program. Nine months later, 21 who completed a posttest showed significant improvement in identifying heart sounds. CDs were valued for opportunities to review material at an individual pace. Lack of computer skills hindered use. (Contains 26 references.) (SK)

Whole Language, Computers and CD-ROM Technology: A Kindergarten Unit on "Benjamin Bunny."

Science.gov (United States)

Balajthy, Ernest

A kindergarten teacher, two preservice teachers, and a college consultant on educational computer technology designed and developed a 10-day whole-language integrated unit on the theme of Beatrix Potter's "Benjamin Bunny." The project was designed as a demonstration of the potential of integrating the CD-ROM-based version of…

How To Use the SilverPlatter Software To Search the ERIC CD ROM.

Science.gov (United States)

Merrill, Paul F.

This manual provides detailed instructions for using SilverPlatter software to search the ERIC CD ROM (Compact Disk Read Only Memory), a large bibliographic database relating to education which contains reference information on numerous journal articles from over 750 journals cited in the "Current Index to Journals in Education" (CIJE),…

Dāvida Lodža „Mazā pasaule” un „Paradīzes jaunumi” kā piedzīvojumu romāni

OpenAIRE

Kaušakīte, Inessa

2007-01-01

Maģistra darbā „Deivida Lodža „Mazā pasaule” un „Paradīzes Jaunumi” kā piedzīvojumu romāni” mērķis ir pievērst uzmanību piedzīvojuma žanra dažādām īpatnībām mūsdienu angļu romānista darbos. Darbs arī atklāj postmodernā piedzīvojumu romāna varoņa rakstura īpatnības. Pirmā nodaļa izceļ klasiskā 16. gadsimta spāņu literatūras piedzīvojumu romāna svarīgākās īpatnības. Šī nodaļa pēta apstākļus, kas palīdzējuši žanra attīstībai Anglijā. Otrā nodaļa pievērš uzmanību Deivida Lodža liktenim, kas kā...

LOYALTY – THE NUCLEUS OF BRAND CAPITAL. CASE STUDY: ROM CHOCOLATE BAR

Directory of Open Access Journals (Sweden)

Brindusa Mariana Amalancei

2013-12-01

Full Text Available It is considered that loyalty to the brand of some primary customers is the core of the brand capital. A brand, however, may have substantial value, which is given to it by its symbol and slogans, if it is continued with the purchase of a brand after the buyers have made a comparison with the competing products that have superior characteristics. Structured on several levels, which are each a different marketing challenge, the loyalty to the brand consists of many factors, among which the most important is the user experience. The paper aims to highlight, starting from a series of articles in online media, the manner in which a traditional Romanian brand, ROM chocolate bar, continuously repositions itself, attempting to maintain and even increase the loyalty of its consumers, as well as to answer the consumer’s authenticity, accessibility, credibility and modernity needs. Even though in specialized literature there are opinions according to which traditional brands are commonly old-fashioned or dull, ROM chocolate bar shows the opposite view, being considered a successful brand which is appreciated both at national and international levels.

Static aeroelastic analysis including geometric nonlinearities based on reduced order model

Directory of Open Access Journals (Sweden)

Changchuan Xie

2017-04-01

Full Text Available This paper describes a method proposed for modeling large deflection of aircraft in nonlinear aeroelastic analysis by developing reduced order model (ROM. The method is applied for solving the static aeroelastic and static aeroelastic trim problems of flexible aircraft containing geometric nonlinearities; meanwhile, the non-planar effects of aerodynamics and follower force effect have been considered. ROMs are computational inexpensive mathematical representations compared to traditional nonlinear finite element method (FEM especially in aeroelastic solutions. The approach for structure modeling presented here is on the basis of combined modal/finite element (MFE method that characterizes the stiffness nonlinearities and we apply that structure modeling method as ROM to aeroelastic analysis. Moreover, the non-planar aerodynamic force is computed by the non-planar vortex lattice method (VLM. Structure and aerodynamics can be coupled with the surface spline method. The results show that both of the static aeroelastic analysis and trim analysis of aircraft based on structure ROM can achieve a good agreement compared to analysis based on the FEM and experimental result.

Modified rerouting procedure for failed peroneal tendon dislocation surgery.

Science.gov (United States)

Gaulke, R; Hildebrand, F; Panzica, M; Hüfner, T; Krettek, C

2010-04-01

Recurrent dislocation of the peroneal tendons following operative treatment is relatively uncommon, but can be difficult to treat. We asked whether subligamental transposition of the peroneus brevis tendon, fibular grooving, and reattachment of the superior peroneal retinaculum for failed peroneal tendon dislocation surgery would achieve a stable fixation of the peroneal tendons and whether there would be restrictions of ROM or instability of the hindfoot. We reviewed six female patients (mean age, 24.5 years) with general laxity of joints preoperatively and at 6 weeks and 3, 6, and 12 months postoperatively. Within 1 year postoperatively no recurrence was found. In two ankles the extension was restricted 5 degrees to 10 degrees . In another pronation and supination was restricted 5 degrees each. Stability of the ankle increased in four patients and stayed unchanged in two. AOFAS score increased from a mean value of 36 +/- 20.6 preoperatively to 90 +/- 7 postoperatively at 1 year. We conclude transposition of the peroneus brevis tendon is a reasonable treatment for failed peroneal tendon dislocation surgery. Level IV, therapeutic study (prospective case series). See Guidelines for Authors for a complete description of levels of evidence.

Occupational Analysis Products: Operations Management- AFSC 3E6X1 (CD-ROM)

Science.gov (United States)

computer laser optical disc (CD-ROM); 4 3/4 in.; 23.4 MB. SYSTEMS DETAIL NOTE: ABSTRACT: This is a report of an occupational survey of the Operations ... Management (AFSC 3E6X1, OSSN 2560, Feb 04) career ladder, conducted by the Occupational Analysis Flight, AFOMS. The OSR reports the findings of current

Intercomparison of Antarctic ice-shelf, ocean, and sea-ice interactions simulated by MetROMS-iceshelf and FESOM 1.4

Science.gov (United States)

Naughten, Kaitlin A.; Meissner, Katrin J.; Galton-Fenzi, Benjamin K.; England, Matthew H.; Timmermann, Ralph; Hellmer, Hartmut H.; Hattermann, Tore; Debernard, Jens B.

2018-04-01

An increasing number of Southern Ocean models now include Antarctic ice-shelf cavities, and simulate thermodynamics at the ice-shelf/ocean interface. This adds another level of complexity to Southern Ocean simulations, as ice shelves interact directly with the ocean and indirectly with sea ice. Here, we present the first model intercomparison and evaluation of present-day ocean/sea-ice/ice-shelf interactions, as simulated by two models: a circumpolar Antarctic configuration of MetROMS (ROMS: Regional Ocean Modelling System coupled to CICE: Community Ice CodE) and the global model FESOM (Finite Element Sea-ice Ocean Model), where the latter is run at two different levels of horizontal resolution. From a circumpolar Antarctic perspective, we compare and evaluate simulated ice-shelf basal melting and sub-ice-shelf circulation, as well as sea-ice properties and Southern Ocean water mass characteristics as they influence the sub-ice-shelf processes. Despite their differing numerical methods, the two models produce broadly similar results and share similar biases in many cases. Both models reproduce many key features of observations but struggle to reproduce others, such as the high melt rates observed in the small warm-cavity ice shelves of the Amundsen and Bellingshausen seas. Several differences in model design show a particular influence on the simulations. For example, FESOM's greater topographic smoothing can alter the geometry of some ice-shelf cavities enough to affect their melt rates; this improves at higher resolution, since less smoothing is required. In the interior Southern Ocean, the vertical coordinate system affects the degree of water mass erosion due to spurious diapycnal mixing, with MetROMS' terrain-following coordinate leading to more erosion than FESOM's z coordinate. Finally, increased horizontal resolution in FESOM leads to higher basal melt rates for small ice shelves, through a combination of stronger circulation and small-scale intrusions of

SEM REGRA NEM FREIOS - Loucura e criação na discussão romântica em torno do gênio

Directory of Open Access Journals (Sweden)

Yuri Cerqueira dos Anjos

2014-12-01

Full Text Available A relação entre genialidade e loucura, tópos bastante antigo, parece ganhar contornos peculiares no pensamento romântico. Inspirado, ultrassensível, isolado e visionário, o gênio romântico transita com certa frequência no campo semântico da loucura. Entre oráculo, profeta e louco, ele se caracteriza pela sua capacidade de transgredir o estado atual das coisas e criar um novo mundo de possibilidades e experiências. Nesse sentido, exploraremos no presente artigo alguns aspectos dessa relação entre o gênio e o louco no contexto do debate romântico francês do início do século XIX e no livro William Shakespeare, de Victor Hugo.

Evaluation of the use of CD-ROM upload into the PACS or institutional web server

NARCIS (Netherlands)

van Ooijen, P. M. A.; Roosjen, R.; de Blecourt, M. J.; van Dam, R.; Broekema, A.; Oudkerk, M.

2006-01-01

Purpose: Patient data are increasingly distributed between hospitals using CD-ROMs instead of actual films. This introduces problems because different viewers from different vendors are provided, and sometimes viewers are unusable because local software installation is not allowed. In 2004, we

DICOM storage into PACS of out-hospital CD-ROMs - a half year experience report

NARCIS (Netherlands)

van Ooijen, PMA; ten Bhomer, PJM; Blecourt, MJ; Roosjen, R; van Dam, R; Oudkerk, A; Lemke, HU; Inamura, K; Doi, K; Vannier, MW; Farman, AG

2005-01-01

With the advance of digitalization of radiology departments, the interchange of data between institutions is shifting towards shipment of CD-ROMs instead of physical film. Although this is a positive change in terms of costs, it also has its downsides. One of the main problems is how to integrate

Abordagens do amor romântico: aspectos históricos, sociais e literários

Directory of Open Access Journals (Sweden)

Luana Grasiela Schonarth

2015-06-01

Full Text Available O presente estudo vincula-se ao projeto de pesquisa Narrativas e conhecimentos: especificidades teóricas e constituição de sentido, coordenado pela Prof.ª Dra. Eunice Terezinha Piazza Gai. Considerando os caminhos cursados no desenvolvimento da pesquisa, utilizamos o tema do amor para refletir sobre os possíveis conhecimentos que o processo narrativo propicia, os aspectos históricos e sociais nos quais a temática foi abordada na literatura, assim como um resgate de informações acerca das origens do tema e personagens consolidados nos romances românticos. Nessa perspectiva, delimitamos o estudo entre os amores irrealizados, os impasses responsáveis pelos impedimentos amorosos, bem como os conflitos entre a paixão e o casamento nas narrativas românticas. Para bem fundamentar esta pesquisa, tomamos o mito considerado matriz das histórias de amor, o próprio nascimento da paixão na literatura ocidental: Tristão e Isolda. O mito apresenta a visão do amor cortês e as contradições que se manifestaram desde a segunda metade do século XII entre a regra cavalheiresca e os costumes feudais. Diante da teoria do amor, abstraída do mito do amor romântico, partimos para a literatura do século XIX, considerando a presença dos amores não correspondidos. Nesta etapa, analisamos o romance de Balzac, Eugênia Grandet, que se torna exemplo da irrealização amorosa na literatura, vivida de modo mais contundente pela personagem que intitula a obra. A escolha dessa narrativa, para a análise do amor-paixão, deve-se ao fato de que o casamento é tratado como mero interesse financeiro, desconsiderando todo e qualquer envolvimento amoroso entre o casal em questão: Eugênia e Charles. Tratamos, pois, desta pluralidade significativa, deste amplo caminho trilhado não só pela literatura, mas por todos aqueles que se deixam despertar pela eternidade e fascínio dos romances românticos.

A Fuel-Sensitive Reduced-Order Model (ROM) for Piston Engine Scaling Analysis

Science.gov (United States)

2017-09-29

of high Reynolds number nonreacting and reacting JP-8 sprays in a constant pressure flow vessel with a detailed chemistry approach . J Energy Resour...for rapid grid generation applied to in-cylinder diesel engine simulations. Society of Automotive Engineers ; 2007 Apr. SAE Technical Paper No.: 2007...ARL-TR-8172 ● Sep 2017 US Army Research Laboratory A Fuel-Sensitive Reduced-Order Model (ROM) for Piston Engine Scaling Analysis

Introducing students to ocean modeling via a web-based implementation for the Regional Ocean Modeling System (ROMS) river plume case study

Science.gov (United States)

Harris, C. K.; Overeem, I.; Hutton, E.; Moriarty, J.; Wiberg, P.

2016-12-01

Numerical models are increasingly used for both research and applied sciences, and it is important that we train students to run models and analyze model data. This is especially true within oceanographic sciences, many of which use hydrodynamic models to address oceanographic transport problems. These models, however, often require a fair amount of training and computer skills before a student can run the models and analyze the large data sets produced by the models. One example is the Regional Ocean Modeling System (ROMS), an open source, three-dimensional primitive equation hydrodynamic ocean model that uses a structured curvilinear horizontal grid. It currently has thousands of users worldwide, and the full model includes modules for sediment transport and biogeochemistry, and several options for turbulence closures and numerical schemes. Implementing ROMS can be challenging to students, however, in part because the code was designed to provide flexibility for the choice of model parameterizations and processes, and to run on a variety of High Performance Computing (HPC) platforms. To provide a more accessible tool for classroom use, we have modified an existing idealized ROMS implementation to be run on a High Performance Computer (HPC) via the WMT (Web Modeling Toolkit), and developed a series of lesson plans that explore sediment transport within the idealized model domain. This has addressed our goal to provide a relatively easy introduction to the numerical modeling process that can be used within upper level undergraduate and graduate classes to explore sediment transport on continental shelves. The model implementation includes wave forcing, along-shelf currents, a riverine source, and suspended sediment transport. The model calculates suspended transport and deposition of sediment delivered to the continental shelf by a riverine flood. Lesson plans lead the students through running the model on a remote HPC, modifying the standard model. The lesson

Plastic Surgery

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español Plastic Surgery KidsHealth / For Teens / Plastic Surgery What's in ... her forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word " ...

Technical and Scientific Support Organizations Providing Support to Regulatory Functions. Companion CD-ROM

International Nuclear Information System (INIS)

2018-01-01

This publication introduces the general principles underlying the provision of technical and scientific support to a regulatory body and the characteristics of organizations providing such support. It describes the services provided to support regulatory functions as well as the associated activities and processes to maintain the needed level of expertise, state of the art tools and equipment. The publication is intended for use primarily by organizations that provide technical and scientific support in the field of nuclear and radiation safety. This also includes organizations that acquire such support, and regulatory bodies and governments, as they make decisions on the model of technical and scientific support to be developed at the national level, for example in the case of a country embarking on the development of a nuclear power programme. It is the first IAEA publication dedicated to the specific practices and challenges to be met by the technical and scientific support organizations. This CD-ROM includes the annexes to the printed publication of examples of TSOs and their interactions with key stakeholders.

The Clinical Features, Risk Factors, and Surgical Treatment of Cervicogenic Headache in Patients With Cervical Spine Disorders Requiring Surgery.

Science.gov (United States)

Shimohata, Keiko; Hasegawa, Kazuhiro; Onodera, Osamu; Nishizawa, Masatoyo; Shimohata, Takayoshi

2017-07-01

features, and scores were compared between baseline (ie, preoperatively) and 3, 6, and 12 months post-surgery. The prevalence of CEH in our population was 15/70 (21.4%, 95%CI: 11.8% to 31.0%). The main clinical features were dull and tightening/pressing headache sensations in the occipital region. Headache severity was mild (VAS, 32 ± 11 mm) and only one patient reported use of an oral analgesic. Compared to patients without CEH, patients with CEH had higher frequencies of neck pain (86.7% vs. 50.9%; P = .017), cervical range of motion limitation (ROM) (66.7% vs. 38.2%; P = .049), and higher Neck Disability Index scores (14 vs. 3; P headache VAS that slightly diminished by 12 months post-surgery (P headache sensations in the occipital region. Potential risk factors for CEH included neck pain, limited cervical ROM, high Neck Disability Index score, and a diagnosis of cervical spondylotic myeloradiculopathy. The further accumulation of patients in a multi-institutional study may be required in order to discuss the diagnostic criteria and pathophysiology of this condition. © 2017 American Headache Society.

Comparison of 2 Analgesia Modalities in Total Knee Replacement Surgery: Is There an Effect on Knee Function Rehabilitation?

Science.gov (United States)

Zinkus, Janis; Mockutė, Lina; Gelmanas, Arūnas; Tamošiūnas, Ramūnas; Vertelis, Arūnas; Macas, Andrius

2017-06-20

BACKGROUND We compared the effects of continuous femoral nerve block (CFNB) and continuous intraarticular block (CIAB) on pain, functional recovery and adverse effects after total knee arthroplasty (TKA). MATERIAL AND METHODS We prospectively randomized 54 patients undergoing TKA into 2 groups: CFNB (Group F) and CIAB (Group I). Surgery was performed under spinal anesthesia. All patients received patient-controlled analgesia (PCA) with morphine, diclofenac, and acetaminophen for the first 72 h postoperatively. Pain was assessed with a visual analog scale (VAS), 48-h morphine consumption and 72-h local anesthetic dosage were recorded, motor blockade was assessed, maximum range of motion (ROM) was measured, and adverse effect profiles were recorded. RESULTS There was no significant difference in postoperative pain at rest, in passive motion, active motion, or active movement (2-min walk test (2MWT)) between study groups. Group I had less opioid usage in the first 24 h postoperatively (p0.05). Significantly lower scores of Bromage scale in Group I in 72 h after surgery (pknee function on day 7 and at 1 month after surgery.

Effectiveness of Music Listening in Patients With Total Knee Replacement During CPM Rehabilitation.

Science.gov (United States)

Hsu, Chih-Chung; Chen, Wei-Ming; Chen, Su-Ru; Tseng, Yen-Ting; Lin, Pi-Chu

2016-01-01

This study investigated the effects of music listening on the anxiety, heart rate variability (HRV), and joint range of motion (ROM) of patients undergoing continuous passive motion (CPM) after total knee replacement surgery. An experimental design was used. Participants in the experimental group (n = 49) listened to music from 10 min before receiving CPM until the end of the session (25 min in total) on the first and second day following surgery, whereas participants in the control group (n = 42) did not listen to music but rested quietly in bed starting 10 min before and throughout CPM. Compared with the control group, the experimental group exhibited significantly lower anxiety levels (p CPM angles (p < .05) during treatment and increased active flexion ROM (p < .05) upon discharge. The low-frequency (LF)/high-frequency (HF) power ratio, normalized LF HRV, and normalized HF HRV of the two groups differed significantly, indicating that the patients in the experimental group had greater parasympathetic activity compared with those in the control group. Music listening can effectively reduce patient anxiety and enhance the ROM of their joints during postoperative rehabilitation. Health-care practitioners should consider including music listening as a routine practice for postoperative rehabilitation following orthopedic surgery. © The Author(s) 2015.

Bariatric surgery insurance requirements independently predict surgery dropout.

Science.gov (United States)

Love, Kaitlin M; Mehaffey, J Hunter; Safavian, Dana; Schirmer, Bruce; Malin, Steven K; Hallowell, Peter T; Kirby, Jennifer L

2017-05-01

Many insurance companies have considerable prebariatric surgery requirements despite a lack of evidence for improved clinical outcomes. The hypothesis of this study is that insurance-specific requirements will be associated with a decreased progression to surgery and increased delay in time to surgery. Retrospective data collection was performed for patients undergoing bariatric surgery evaluation from 2010-2015. Patients who underwent surgery (SGY; n = 827; mean body mass index [BMI] 49.1) were compared with those who did not (no-SGY; n = 648; mean BMI: 49.4). Univariate and multivariate analysis were performed to identify specific co-morbidity and insurance specific predictors of surgical dropout and time to surgery. A total of 1475 patients using 12 major insurance payors were included. Univariate analysis found insurance requirements associated with surgical drop out included longer median diet duration (no-SGY = 6 mo; SGY = 3 mo; Psurgery dropout. Additionally, surgical patients had an average interval between initial visit and surgery of 5.8±4.6 months with significant weight gain (2.1 kg, Psurgery insurance requirements were associated with lack of patient progression to surgery in this study. In addition, delays in surgery were associated with preoperative weight gain. Although prospective and multicenter studies are needed, these findings have major policy implications suggesting insurance requirements may need to be reconsidered to improve medical care. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Recovery of Data from the Narragansett Bay Project, 1985-1992: User's Manual and CD-ROM

Science.gov (United States)

Data from the 1985-1992 era of the Narragansett Bay Project, an estuary of the National Estuary Program, were recovered from numerous storage media, updated to modern software, and burned to CD-ROM. The data will be used by, among others, EPA researchers working on long-term tren...

Exploiting the Potential of CD-ROM Databases: Staff Induction at the University of East Anglia.

Science.gov (United States)

Guillot, Marie-Noelle; Kenning, Marie-Madeleine

1995-01-01

Overviews a project exploring the possibility of using CD-ROM applications and the design of exploratory didactic materials to introduce academic staff to the field of computer-assisted instruction. The project heightened the staff's awareness of electronic resources and their potential as research, teaching, and learning aids, with particular…

Asociación entre relaciones románticas y la calidad de sueño percibida por jóvenes universitarios

OpenAIRE

EcheverrÍa-Palacio, Carlos-Mario

2013-01-01

Introducción: Uno de los aspectos con mayor variación durante la adolescencia es el sueño, el cual se ve afectado por factores biológicos así como por los estados afectivos y emocionales. En esta etapa, los individuos establecen sus primeras relaciones sentimentales románticas, vínculos esenciales para la maduración de las relaciones sociales y psicosexuales. Este trabajo busca determinar la asociación existente entre las relaciones sentimentales románticas y sus características, con la calid...

Submesoscale Flows and Mixing in the Oceanic Surface Layer Using the Regional Oceanic Modeling System (ROMS)

Science.gov (United States)

2014-09-30

IMPACT/APPLICATIONS Geochemistry and Ecosystems: An important community use for ROMS is biogeochemisty: chemical cycles, water quality, blooms ...published, refereed] Colas, F., J.C. McWilliams, X. Capet, and J. Kurian, 2012: Heat balance and eddies in the Peru- Chile Current System. Climate

Preoperative oral nutritional interventions in surgery, including arginine- and glutamine-enhanced supplements

NARCIS (Netherlands)

Brinkmann, S.J.H.; Buijs, N.; Luttikhold, J.; Mahdavian Delavary, B.; Niessen, F.B.; van Leeuwen, P.A.M.

2013-01-01

The patients' condition prior to surgery is of major importance for clinical outcome. It is believed nowadays that artificial nutrition in the form of a preoperative drink may improve postoperative outcome. Until now, a clear overview concerning the effects of preoperative supplementation on

Flight Experiments for Hypersonic Vehicle Development (Experimentations envol pour le developpement d'un vehicule hypersonique) (CD-ROM)

National Research Council Canada - National Science Library

2007-01-01

...: 1 CD-ROM; 4 3/4 in.; 124 MB. ABSTRACT: This RTO-AVT/VKI Lecture Series brought together specialists from Europe, USA, and Russia to discuss flight experiments that pertain to the development of hypersonic vehicles...

Comparing a quasi-3D to a full 3D nearshore circulation model: SHORECIRC and ROMS

Science.gov (United States)

Haas, Kevin A.; Warner, John C.

2009-01-01

Predictions of nearshore and surf zone processes are important for determining coastal circulation, impacts of storms, navigation, and recreational safety. Numerical modeling of these systems facilitates advancements in our understanding of coastal changes and can provide predictive capabilities for resource managers. There exists many nearshore coastal circulation models, however they are mostly limited or typically only applied as depth integrated models. SHORECIRC is an established surf zone circulation model that is quasi-3D to allow the effect of the variability in the vertical structure of the currents while maintaining the computational advantage of a 2DH model. Here we compare SHORECIRC to ROMS, a fully 3D ocean circulation model which now includes a three dimensional formulation for the wave-driven flows. We compare the models with three different test applications for: (i) spectral waves approaching a plane beach with an oblique angle of incidence; (ii) monochromatic waves driving longshore currents in a laboratory basin; and (iii) monochromatic waves on a barred beach with rip channels in a laboratory basin. Results identify that the models are very similar for the depth integrated flows and qualitatively consistent for the vertically varying components. The differences are primarily the result of the vertically varying radiation stress utilized by ROMS and the utilization of long wave theory for the radiation stress formulation in vertical varying momentum balance by SHORECIRC. The quasi-3D model is faster, however the applicability of the fully 3D model allows it to extend over a broader range of processes, temporal, and spatial scales.

Delicacy, Imprecision, and Uncertainty of Oceanic Simulations: An Investigation with the Regional Oceanic Modeling System (ROMS)

Science.gov (United States)

2013-09-30

Geochemistry and Ecosystems: An important community use for ROMS is biogeochemisty: chemical cycles, water quality, blooms , micro-nutrients, larval...Sci., submitted. Colas, F., J.C. McWilliams, X. Capet, and J. Kurian, 2012: Heat balance and eddies in the Peru- Chile Current System. Climate

[Medical knowledge in immunological security of red blood cells transfusion in Tunisia: evaluation of a CD-ROM of auto-learning].

Science.gov (United States)

Ben Salah, N; El Borgi, W; Aounallah Skhiri, H; Ben Lakhal, F; Mouelhi, H; Zoueri, B; Gouider, E; Hafsia, R

2013-09-01

In Tunisia, red blood cells (RBC) transfusion joins in a statutory frame but remains subject to failures because of the misunderstanding of legislation and regulations. Our purpose is to estimate the knowledge of the medical staff in the immunological safety of RBC transfusion before and after reading an auto-education CD-ROM. It is a study of evaluation of an intervention. Eighty physicians participated to the study. The evaluation was done using an anonymous questionnaire, containing seven questions with multiple choices (QMC) relating to several items. The rate of good answers (RGA) calculated by questions and by items took into account the impact of the CD-ROM on the improvement of the answers after reading. The global average mark is 2.9/7. The RGA to questions varies from 22.5 % to 76.3%. All participants answered correctly to more than 50% of all items. Two answered correctly to all items. Among the participants, 31.3% answered to all "important" items, concerning ABO blood groups compatibility and ultimate bedside test. The rate of participation to the final evaluation was 83%. The impact of the CD-ROM was important and statistically significant. In the final evaluation, the global mark raised from 2.9 to 5.8/7, 31.5% (vs 2%) answered correctly all the questions and 95.5% (vs 31.3%) answered correctly all "important" items. This study revealed a misunderstanding of the doctors in immunological safety of RBC transfusions. Auto-teaching by CD-ROM was efficient. An improvement of the knowledge by continuous training is necessary in our country. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

The Impact of Animation in CD-ROM Books on Students' Reading Behaviors and Comprehension.

Science.gov (United States)

Okolo, Cindy; Hayes, Renee

This study evaluated the use of children's literature presented via one of three conditions: an adult reading a book to the child; the child reading a CD-ROM version of a book on the computer but without animation; and the child reading the book on the computer with high levels of animation. The study, in one primary grade classroom, involved 10…

Surgical specialty procedures in rural surgery practices: implications for rural surgery training.

Science.gov (United States)

Sticca, Robert P; Mullin, Brady C; Harris, Joel D; Hosford, Clint C

2012-12-01

Specialty procedures constitute one eighth of rural surgery practice. Currently, general surgeons intending to practice in rural hospitals may not get adequate training for specialty procedures, which they will be expected to perform. Better definition of these procedures will help guide rural surgery training. Current Procedural Terminology codes for all surgical procedures for 81% of North Dakota and South Dakota rural surgeons were entered into the Dakota Database for Rural Surgery. Specialty procedures were analyzed and compared with the Surgical Council on Resident Education curriculum to determine whether general surgery training is adequate preparation for rural surgery practice. The Dakota Database for Rural Surgery included 46,052 procedures, of which 5,666 (12.3%) were specialty procedures. Highest volume specialty categories included vascular, obstetrics and gynecology, orthopedics, cardiothoracic, urology, and otolaryngology. Common procedures in cardiothoracic and vascular surgery are taught in general surgical residency, while common procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology are usually not taught in general surgery training. Optimal training for rural surgery practice should include experience in specialty procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology. Copyright © 2012 Elsevier Inc. All rights reserved.

Effect of Ankle Range of Motion (ROM) and Lower-Extremity Muscle Strength on Static Balance Control Ability in Young Adults: A Regression Analysis

Science.gov (United States)

Kim, Seong-Gil

2018-01-01

Background The purpose of this study was to investigate the effect of ankle ROM and lower-extremity muscle strength on static balance control ability in young adults. Material/Methods This study was conducted with 65 young adults, but 10 young adults dropped out during the measurement, so 55 young adults (male: 19, female: 36) completed the study. Postural sway (length and velocity) was measured with eyes open and closed, and ankle ROM (AROM and PROM of dorsiflexion and plantarflexion) and lower-extremity muscle strength (flexor and extensor of hip, knee, and ankle joint) were measured. Pearson correlation coefficient was used to examine the correlation between variables and static balance ability. Simple linear regression analysis and multiple linear regression analysis were used to examine the effect of variables on static balance ability. Results In correlation analysis, plantarflexion ROM (AROM and PROM) and lower-extremity muscle strength (except hip extensor) were significantly correlated with postural sway (pregression analysis, plantar flexion PROM with eyes open significantly influenced sway length (B=0.681) and sway velocity (B=0.011). Conclusions Lower-extremity muscle strength and ankle plantarflexion ROM influenced static balance control ability, with ankle plantarflexion PROM showing the greatest influence. Therefore, both contractile structures and non-contractile structures should be of interest when considering static balance control ability improvement. PMID:29760375

Investigating the use of CD-Rom CBT for bulimia nervosa and binge eating disorder in an NHS adult outpatient eating disorders service.

Science.gov (United States)

Graham, Lisa; Walton, Mark

2011-07-01

Many patients who experience bulimia nervosa (BN) and binge eating disorder (BED) find it hard to access evidence-based treatments. Rates of failure to enter outpatient services following initial assessment are high, as are dropout rates from specialist outpatient eating disorders services. To offer CD-Rom CBT, a cognitive-behavioural multi-media supported self-help treatment, in a locality-based outpatient NHS Eating Disorders Service to patients who have binge eating disorder and bulimia nervosa. Patients referred to a catchment-based NHS outpatient eating disorders service who were assessed and had an eating disorder with a binge-eating component were offered CD-Rom based CBT (Overcoming Bulimia) whilst on the waiting list for individual CBT. Forty patients completed the 8 sessions and attended the evaluation appointment (13 had BN, 27 had BED). For both groups, there were significant improvements in well-being and functioning, as well as significant reductions in problems and risk. There was also a significant reduction on the "Bulimic Subscale" of the EDI. These results were comparable with the original study findings (Schmidt, Treasure and Williams, 2001). Dropouts from the CD-Rom reflected rates common to other EDS treatments suggesting that CD-Rom did not directly impact upon service dropout rates. Computer assisted CBT for Eating Disorders offers a promising, feasible and acceptable first step for patients who have bulimia nervosa or binge eating disorder and access treatment from specialist eating disorders services.

An overview of surgery-first approach: Recent advances in orthognathic surgery.

Science.gov (United States)

Sharma, Vipul Kumar; Yadav, Kirti; Tandon, Pradeep

2015-01-01

The disadvantages of having orthodontic interventions both before and after orthognathic surgery include a long treatment time of 7-47 months and temporary worsening of facial appearance. Nowadays, the concept of surgery-first, followed by orthodontic treatment is applied to orthognathic surgery cases in different orthodontic centers in the world. This concept and technique is called "surgery-first-orthognathic-approach" or "surgery-first approach" (SFA) rigid fixation (skeletal anchorage system) of the bony segments and regional acceleratory phenomenon were keys to broad implementation of the SFA. This article is intended to provide an overview of SFA including indications, general and specific guidelines, different protocol variations, success rate and potential problems.

[Does routine outcome monitoring have a promising future? An investigation into the use of shared decision-making combined with ROM for patients with a combination of physical and psychiatric symptoms].

Science.gov (United States)

van der Feltz-Cornelis, C M; Andrea, H; Kessels, E; Duivenvoorden, H J; Biemans, H; Metz, M

2014-01-01

Although routine outcome monitoring (ROM) has been developed and widely used in the course of patient centered outcome research in the Netherlands, so far the technique has hardly ever been used to improve the treatment of individual patients. To describe how a rom technique based on the principles of shared decision-making (SDM) was developed and evaluated at the Center for Body, Mind and Health at GGz Breburg, a specialised mental health institution in the Netherlands. We have developed a conceptual model for SDM that involves patient participation and the use of evidence-based decision-aids with cut-off scores. According to the conceptual model for SDM that we developed, the patient and the health professional involved took 'shared' decisions in three phases; the decisions related to triage, the drawing-up of a treatment plan and a follow-up treatment course. At the end of the 6 month intake-phase 7 of the 67 patients who were deemed eligible for ROM/SDM were dropped from the study because they were incapable of performing ROM assessments. Due to diagnostic advice and referral at the end of the intake-phase, 25 patients did not require further treatment. Of the remaining 35 patients, 33 delivered at least one follow-up ROM assessment during the subsequent treatment phases. In these patients somatic and psychiatric symptoms were found to be significantly reduced. ROM combined with sdm can be used successfully with patients who have a combination of physical and psychiatric symptoms and the technique can be applied by the professional in charge. Very few patients dropped out of the follow-up measurements and somatic as well as depressive or psychiatric symptoms diminished significantly. These findings indicate that a Randomised Clinical Trial is warranted in order to test the effectiveness of sdm combined with ROM as a decision-making instrument.

Comparison of the cable pin system with conventional open surgery for transverse patella fractures.

Science.gov (United States)

Mao, Ningfang; Liu, Deding; Ni, Haijian; Tang, Hao; Zhang, Qiulin

2013-07-01

The cable pin system is an effective device for fixation of transverse patella fractures. However, whether this device provides superior results using a minimally invasive technique instead of conventional open surgery using the K wire tension band method is unclear. We asked whether a minimally invasive technique would be associated with (1) increased operative time; (2) reduced postoperative pain; (3) faster recovery of ROM; (4) higher knee scores; and (5) reduced complications. Forty patients with displaced transverse fractures of the patella participated in this prospective, randomized, controlled trial. Twenty of these patients underwent a minimally invasive technique and the others had conventional open surgery using K wires. Some data for six of the 20 patients who underwent the minimally invasive technique were published in an earlier prospective, observational trial. At postoperative intervals of 1, 3, 6, 12, and 24 months, pain was measured by VAS scores, active flexion and extension of the knee were measured in degrees by goniometry, and knee function was evaluated using the Böstman clinical grading scale. Operative time was longer in the minimally invasive surgery group (54.3 ± 9.8 minutes versus 48.5 ± 6.1 minutes). Pain scores were better (lower) in the minimally invasive surgery group at 1 and 3 months but not at 6 months. Early flexion, ultimate flexion, and knee scores from 3 to 24 months, likewise, were better in the minimally invasive surgery group. Complications mostly related to symptomatic hardware were less common in the minimally invasive surgery group. The minimally invasive technique is superior to conventional open surgery using K wires in terms of less early postoperative pain, better mobility angles of the injured knee, higher functional score of the injured knee, and decreased incidence of complications. Level I, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Total hip arthroplasty (S-ROM stem and subtrochanteric osteotomy for Crowe type IV developmental dysplasia of the hip

Directory of Open Access Journals (Sweden)

Liangtao Li

2016-01-01

Conclusions: In the primary THA for the treatment of irreducible DDH, subtrochanteric oblique osteotomy combined with the freely-rotatable S-ROM stem provided favorable short term outcomes by affording both morphological and functional advantages.

Ionospheric Electron/Ion Densities Temperatures on CD-ROM and WWW

Science.gov (United States)

Bilitza, Dieter; Papitashvili, Natasha; Schar, Bill; Grebowsky, Joseph

2002-01-01

As part of this project a large volume of ionospheric satellite insitu data from the sixties, seventies and early eighties were made accessible online in ASCII format for public use. This includes 14 data sets from the BE-B, Alouette 2, DME-A, AE-B, ISIS-1, ISIS-2, OGO-6, DE-2, AEROS-A, AE-C, AE-D, AE-E, and Hinotori satellites. The original data existed in various machine-specific, highly compressed, binary encoding on 7-, or 9-track magnetic tapes. The data were decoded and converted to a common ASCII data format, solar and magnetic indices were added, and some quality control measures were taken. The original intent of producing CD-ROMs with these data was overtaken by the rapid development of the Internet. Most users now prefer to obtain the data directly online and greatly value WWW-interfaces to browse, plot and subset the data. Accordingly the data were made available online on the anonymous ftp site of NASA's National Space Science Data Center (NSSDC) at ftp://nssdcftp.gsfc.nasa.gov/spacecraft data/ and on NSSDC's ATMOWeb (http://nssdc.gsfc.nasa.gov/atmoweb/), a WWW-interface for plotting, subsetting, and downloading the data. Several new features were implemented into ATMOWeb as part of this project including a filtering and scatter plot capability. The availability of this new database and WWW system was announced through several electronic mailer (AGU, CEDAR, IRI, etc) and through talks and posters during scientific meetings.

RCRA and operational monitoring (ROM): Multi-year program plan and fiscal year 96 work plan. WBS 1.5.3, Revision 1

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-09-01

The RCRA & Operational Monitoring (ROM) Program Office manages the Hanford Site direct funded Resource Conservation and Recovery Act (RCRA) and Operational Monitoring under Work Breakdown Structure (WBS) 1.01.05.03. The ROM Program Office is included in Hanford Technical Services, a part of Projects & Site Services of Westinghouse Hanford Company (WHC). The 1996 Multi-Year Program Plan (MYPP) includes the Fiscal Year Work Plan (FYWP). The Multi-Year Program Plan takes its direction from the Westinghouse Planning Baseline Integration Organization. The MYPP provides both the near term, enhanced details and the long term, projected details for the Program Office to use as baseline Cost, Scope and Schedule. Change Control administered during the fiscal year is against the baseline provided by near term details of this document. The MYPP process has been developed by WHC to meet its internal planning and integration needs and complies with the requirements of the US Department of Energy, Richland Operations Office (RL) Long Range Planning Process Directive (RLID 5000.2). Westinghouse Hanford Company (WHC) has developed the multi-year planning process for programs to establish the technical, schedule and cost baselines for program and support activities under WHC`s scope of responsibility. The baseline information is developed by both WHC indirect funded support services organization, and direct funded programs in WHC. WHC Planning and Integration utilizes the information presented in the program specific MYPP and the Program Master Baseline Schedule (PMBS) to develop the Site-Wide Integrated Schedule.

RCRA and operational monitoring (ROM): Multi-year program plan and fiscal year 96 work plan. WBS 1.5.3, Revision 1

International Nuclear Information System (INIS)

1995-09-01

The RCRA ampersand Operational Monitoring (ROM) Program Office manages the Hanford Site direct funded Resource Conservation and Recovery Act (RCRA) and Operational Monitoring under Work Breakdown Structure (WBS) 1.01.05.03. The ROM Program Office is included in Hanford Technical Services, a part of Projects ampersand Site Services of Westinghouse Hanford Company (WHC). The 1996 Multi-Year Program Plan (MYPP) includes the Fiscal Year Work Plan (FYWP). The Multi-Year Program Plan takes its direction from the Westinghouse Planning Baseline Integration Organization. The MYPP provides both the near term, enhanced details and the long term, projected details for the Program Office to use as baseline Cost, Scope and Schedule. Change Control administered during the fiscal year is against the baseline provided by near term details of this document. The MYPP process has been developed by WHC to meet its internal planning and integration needs and complies with the requirements of the US Department of Energy, Richland Operations Office (RL) Long Range Planning Process Directive (RLID 5000.2). Westinghouse Hanford Company (WHC) has developed the multi-year planning process for programs to establish the technical, schedule and cost baselines for program and support activities under WHC's scope of responsibility. The baseline information is developed by both WHC indirect funded support services organization, and direct funded programs in WHC. WHC Planning and Integration utilizes the information presented in the program specific MYPP and the Program Master Baseline Schedule (PMBS) to develop the Site-Wide Integrated Schedule

CD-ROM nutrient analysis database assists self-monitoring behavior of active duty Air Force personnel receiving nutrition counseling for weight loss.

Science.gov (United States)

Heetderks-Cox, M J; Alford, B B; Bednar, C M; Heiss, C J; Tauai, L A; Edgren, K K

2001-09-01

This study observed the effect of using a computerized vs manual method of self-monitoring among Air Force personnel receiving nutrition counseling for weight loss. Subjects who enrolled during the first 2 weeks of the 4-week recruitment period completed food records for 6 weeks using a CD-ROM nutrient database (intervention group) whereas those who enrolled during the last 2 weeks used a food record booklet (comparison group). Of the 42 subjects (n = 23 intervention group and n = 19 comparison group), only 113 intervention and 11 comparison group subjects (57% of study enrollees) submitted at least 1 food record during the study and were included in the analysis, which included review of pre- and poststudy questionnaires, food records, and focus group data. There were no significant differences between the number of days per week documented or average number of items recorded daily. All 9 intervention as compared to 2 comparison group subjects who completed a poststudy questionnaire searched for lower-energy and lower-fat items and reported changing their dietary intake as a result. All intervention group subjects who participated in a focus group (n=6) had favorable comments about using the CD-ROM for monitoring and changing eating habits, indicating that it is a beneficial self-monitoring tool. Participants enjoyed the immediate dietary feedback, and computerized food records may be easier to interpret by nutrition counselors. A number of computerized nutrient databases are available to assist patients and consumers in managing nutritional concerns.

Defense Information for All: DTIC 2007 Conference Held in Alexandria, Virginia on March 26-28, 2007 (CD-ROM)

National Research Council Canada - National Science Library

2007-01-01

...: 1 CD-ROM; 4 3/4 in.; 88.6 MB. ABSTRACT: The conference will bring together information professionals from the science, technology, research and development, and acquisition communities who create, disseminate and use DoD scientific...

Effectiveness of prolonged use of continuous passive motion (CPM, as an adjunct to physiotherapy, after total knee arthroplasty

Directory of Open Access Journals (Sweden)

Geesink Ruud JT

2008-04-01

Full Text Available Abstract Background Adequate and intensive rehabilitation is an important requirement for successful total knee arthroplasty. Although research suggests that Continuous Passive Motion (CPM should be implemented in the first rehabilitation phase after surgery, there is substantial debate about the duration of each session and the total period of CPM application. A Cochrane review on this topic concluded that short-term use of CPM leads to greater short-term range of motion. It also suggested, however, that future research should concentrate on the treatment period during which CPM should be administered. Methods In a randomised controlled trial we investigated the effectiveness of prolonged CPM use in the home situation as an adjunct to standardised PT. Efficacy was assessed in terms of faster improvements in range of motion (RoM and functional recovery, measured at the end of the active treatment period, 17 days after surgery. Sixty patients with knee osteoarthritis undergoing TKA and experiencing early postoperative flexion impairment were randomised over two treatment groups. The experimental group received CPM + PT for 17 consecutive days after surgery, whereas the usual care group received the same treatment during the in-hospital phase (i.e. about four days, followed by PT alone (usual care in the first two weeks after hospital discharge. From 18 days to three months after surgery, both groups received standardised PT. The primary focus of rehabilitation was functional recovery (e.g. ambulation and regaining RoM in the knee. Results Prolonged use of CPM slightly improved short-term RoM in patients with limited RoM at the time of discharge after total knee arthroplasty when added to a semi-standard PT programme. Assessment at 6 weeks and three months after surgery found no long-term effects of this intervention Neither did we detect functional benefits of the improved RoM at any of the outcome assessments. Conclusion Although results

Effectiveness of prolonged use of continuous passive motion (CPM), as an adjunct to physiotherapy, after total knee arthroplasty

Science.gov (United States)

Lenssen, Ton AF; van Steyn, Mike JA; Crijns, Yvonne HF; Waltjé, Eddie MH; Roox, George M; Geesink, Ruud JT; Brandt, Piet A van den; De Bie, Rob A

2008-01-01

Background Adequate and intensive rehabilitation is an important requirement for successful total knee arthroplasty. Although research suggests that Continuous Passive Motion (CPM) should be implemented in the first rehabilitation phase after surgery, there is substantial debate about the duration of each session and the total period of CPM application. A Cochrane review on this topic concluded that short-term use of CPM leads to greater short-term range of motion. It also suggested, however, that future research should concentrate on the treatment period during which CPM should be administered. Methods In a randomised controlled trial we investigated the effectiveness of prolonged CPM use in the home situation as an adjunct to standardised PT. Efficacy was assessed in terms of faster improvements in range of motion (RoM) and functional recovery, measured at the end of the active treatment period, 17 days after surgery. Sixty patients with knee osteoarthritis undergoing TKA and experiencing early postoperative flexion impairment were randomised over two treatment groups. The experimental group received CPM + PT for 17 consecutive days after surgery, whereas the usual care group received the same treatment during the in-hospital phase (i.e. about four days), followed by PT alone (usual care) in the first two weeks after hospital discharge. From 18 days to three months after surgery, both groups received standardised PT. The primary focus of rehabilitation was functional recovery (e.g. ambulation) and regaining RoM in the knee. Results Prolonged use of CPM slightly improved short-term RoM in patients with limited RoM at the time of discharge after total knee arthroplasty when added to a semi-standard PT programme. Assessment at 6 weeks and three months after surgery found no long-term effects of this intervention Neither did we detect functional benefits of the improved RoM at any of the outcome assessments. Conclusion Although results indicate that prolonged CPM use

Effectiveness of prolonged use of continuous passive motion (CPM), as an adjunct to physiotherapy, after total knee arthroplasty.

Science.gov (United States)

Lenssen, Ton A F; van Steyn, Mike J A; Crijns, Yvonne H F; Waltjé, Eddie M H; Roox, George M; Geesink, Ruud J T; van den Brandt, Piet A; De Bie, Rob A

2008-04-29

Adequate and intensive rehabilitation is an important requirement for successful total knee arthroplasty. Although research suggests that Continuous Passive Motion (CPM) should be implemented in the first rehabilitation phase after surgery, there is substantial debate about the duration of each session and the total period of CPM application. A Cochrane review on this topic concluded that short-term use of CPM leads to greater short-term range of motion. It also suggested, however, that future research should concentrate on the treatment period during which CPM should be administered. In a randomised controlled trial we investigated the effectiveness of prolonged CPM use in the home situation as an adjunct to standardised PT. Efficacy was assessed in terms of faster improvements in range of motion (RoM) and functional recovery, measured at the end of the active treatment period, 17 days after surgery. Sixty patients with knee osteoarthritis undergoing TKA and experiencing early postoperative flexion impairment were randomised over two treatment groups. The experimental group received CPM + PT for 17 consecutive days after surgery, whereas the usual care group received the same treatment during the in-hospital phase (i.e. about four days), followed by PT alone (usual care) in the first two weeks after hospital discharge. From 18 days to three months after surgery, both groups received standardised PT. The primary focus of rehabilitation was functional recovery (e.g. ambulation) and regaining RoM in the knee. Prolonged use of CPM slightly improved short-term RoM in patients with limited RoM at the time of discharge after total knee arthroplasty when added to a semi-standard PT programme. Assessment at 6 weeks and three months after surgery found no long-term effects of this intervention Neither did we detect functional benefits of the improved RoM at any of the outcome assessments. Although results indicate that prolonged CPM use might have a small short-term effect

Diastereoselective Synthesis of Novel Heterocyclic Scaffolds through Tandem Petasis 3-Component/Intramolecular Diels-Alder and ROM-RCM Reactions

DEFF Research Database (Denmark)

Ishøy, Mette; Petersen, Rico; Petersen, Michael Åxman

2017-01-01

A high-yielding, stereoselective and extraordinarily complexity generatingPetasis 3-component/intramolecular Diels-Alderreaction has been developed. In combination with ROM-RCM, rapid access to complex sp3-rich heterocyclic scaffolds amenableto subsequent functionalization and library synthesis...

Effect of Ankle Range of Motion (ROM) and Lower-Extremity Muscle Strength on Static Balance Control Ability in Young Adults: A Regression Analysis.

Science.gov (United States)

Kim, Seong-Gil; Kim, Wan-Soo

2018-05-15

BACKGROUND The purpose of this study was to investigate the effect of ankle ROM and lower-extremity muscle strength on static balance control ability in young adults. MATERIAL AND METHODS This study was conducted with 65 young adults, but 10 young adults dropped out during the measurement, so 55 young adults (male: 19, female: 36) completed the study. Postural sway (length and velocity) was measured with eyes open and closed, and ankle ROM (AROM and PROM of dorsiflexion and plantarflexion) and lower-extremity muscle strength (flexor and extensor of hip, knee, and ankle joint) were measured. Pearson correlation coefficient was used to examine the correlation between variables and static balance ability. Simple linear regression analysis and multiple linear regression analysis were used to examine the effect of variables on static balance ability. RESULTS In correlation analysis, plantarflexion ROM (AROM and PROM) and lower-extremity muscle strength (except hip extensor) were significantly correlated with postural sway (psimple correlation analysis, all variables that passed the correlation analysis procedure had significant influence (plinear regression analysis, plantar flexion PROM with eyes open significantly influenced sway length (B=0.681) and sway velocity (B=0.011). CONCLUSIONS Lower-extremity muscle strength and ankle plantarflexion ROM influenced static balance control ability, with ankle plantarflexion PROM showing the greatest influence. Therefore, both contractile structures and non-contractile structures should be of interest when considering static balance control ability improvement.

Dificultăți de traducere în limba română a Aforismelor lui Arthur Schopenhauer. O analiză contrastiv-diacronică (I

Directory of Open Access Journals (Sweden)

Cecilia-Iuliana Vârlan

2016-02-01

Full Text Available Lucrarea de față se concentrează asupra unei opere de maturitate a filozofului german Arthur Schopenhauer, Aforisme asupra înțelepciunii în viață, și asupra singurei versiuni românești a acesteia, realizate de Titu Maiorescu la sfîrșitul secolului al XIX-lea. Existența a cinci variante ale versiunii românești, publicate de traducătorul însuși de-a lungul a patru decenii, reprezintă o dovadă clară a faptului că transpunerea în românește a acestui text de filozofie practică a incumbat o serie întreagă de dificultăți de traducere. Urmărind modul în care Titu Maiorescu a încercat să rezolve aceste dificultăți, prin adoptarea anumitor soluții traductologice, am realizat o analiză a acestora, din perspectivă lingvistică, cercetarea urmînd concomitent două direcții: contrastivă (rezultată din supra- punerea textului-sursă și a textului-țintă și diacronică (urmărind intervențiile realizate de același traducător asupra propriului text, la intervale de timp diferite. Demersul de analiză lingvistică a traducerii unui text filozofic ni s-a părut util nu doar studiului nostru, ci și viitorilor eventuali traducători ai Aforismelor, a căror intenție ar putea fi aceea de a adapta discursul versiunii românești a lui Titu Maiorescu la limba română contemporană, ținînd seama de evoluția evidentă a acesteia și, mai ales, a componentei sale de limbaj filozofic.

Prospective evaluation of dermatologic surgery complications including patients on multiple antiplatelet and anticoagulant medications.

Science.gov (United States)

Bordeaux, Jeremy S; Martires, Kathryn J; Goldberg, Dori; Pattee, Sean F; Fu, Pingfu; Maloney, Mary E

2011-09-01

Few prospective studies have evaluated the safety of dermatologic surgery. We sought to determine rates of bleeding, infection, flap and graft necrosis, and dehiscence in outpatient dermatologic surgery, and to examine their relationship to type of repair, anatomic location of repair, antibiotic use, antiplatelet use, or anticoagulant use. Patients presenting to University of Massachusetts Medical School Dermatology Clinic for surgery during a 15-month period were prospectively entered. Medications, procedures, and complications were recorded. Of the 1911 patients, 38% were on one anticoagulant or antiplatelet medication, and 8.0% were on two or more. Risk of hemorrhage was 0.89%. Complex repair (odds ratio [OR] = 5.80), graft repair (OR = 7.58), flap repair (OR = 11.93), and partial repair (OR = 43.13) were more likely to result in bleeding than intermediate repair. Patients on both clopidogrel and warfarin were 40 times more likely to have bleeding complications than all others (P = .03). Risk of infection was 1.3%, but was greater than 3% on the genitalia, scalp, back, and leg. Partial flap necrosis occurred in 1.7% of flaps, and partial graft necrosis occurred in 8.6% of grafts. Partial graft necrosis occurred in 20% of grafts on the scalp and 10% of grafts on the nose. All complications resolved without sequelae. The study was limited to one academic dermatology practice. The rate of complications in dermatologic surgery is low, even when multiple oral anticoagulant and antiplatelet medications are continued, and prophylactic antibiotics are not used. Closure type and use of warfarin or clopidogrel increase bleeding risk. However, these medications should be continued to avoid adverse thrombotic events. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Spinal fusion limits upper body range of motion during gait without inducing compensatory mechanisms in adolescent idiopathic scoliosis patients.

Science.gov (United States)

Holewijn, R M; Kingma, I; de Kleuver, M; Schimmel, J J P; Keijsers, N L W

2017-09-01

Previous studies show a limited alteration of gait at normal walking speed after spinal fusion surgery for adolescent idiopathic scoliosis (AIS), despite the presumed essential role of spinal mobility during gait. This study analyses how spinal fusion affects gait at more challenging walking speeds. More specifically, we investigated whether thoracic-pelvic rotations are reduced to a larger extent at higher gait speeds and whether compensatory mechanisms above and below the stiffened spine are present. 18 AIS patients underwent gait analysis at increasing walking speeds (0.45 to 2.22m/s) before and after spinal fusion. The range of motion (ROM) of the upper (thorax, thoracic-pelvic and pelvis) and lower body (hip, knee and ankle) was determined in all three planes. Spatiotemporal parameters of interest were stride length and cadence. Spinal fusion diminished transverse plane thoracic-pelvic ROM and this difference was more explicit at higher walking speeds. Transversal pelvis ROM was also decreased but this effect was not affected by speed. Lower body ROM, step length and cadence remained unaffected. Despite the reduction of upper body ROM after spine surgery during high speed gait, no altered spatiotemporal parameters or increased compensatory ROM above or below the fusion (i.e. in the shoulder girdle or lower extremities) was identified. Thus, it remains unclear how patients can cope so well with such major surgery. Future studies should focus on analyzing the kinematics of individual spinal levels above and below the fusion during gait to investigate possible compensatory mechanisms within the spine. Copyright © 2017 Elsevier B.V. All rights reserved.

Evaluation of neck pain by using a visual analog scale before and after laminoplasty in patients with cervical myelopathy: relationship with clinical results.

Science.gov (United States)

Ara, Tsuyoshi; Iizuka, Haku; Sorimachi, Yasunori; Iizuka, Yoichi; Nakajima, Takashi; Nishinome, Masahiro; Tsutsumi, Satoshi; Takagishi, Kenji

2010-06-01

In this study the authors investigated the neck pain of patients with cervical myelopathy by using a visual analog scale (VAS) before and after laminoplasty, and they analyzed the association of amount of neck pain with the clinical results. A retrospective review was conducted in 41 patients with cervical myelopathy who underwent cervical laminoplasty. The patients were assessed using questionnaires to evaluate the neck pain intensity before surgery, and 2 years after surgery, the outcome was assessed using a VAS. The degree of cervical lordosis and range of motion (ROM) of the cervical spine were evaluated before and after laminoplasty. The neurological status was also evaluated before and after surgery. The patients were classified into 2 groups according to their preoperative neck pain: 1) the pain (PA) group, which included patients whose preoperative VAS score was more than 1 mm; and 2) the no pain (NP) group, which included patients whose preoperative VAS score was 0 mm. Inclusion in the PA group indicated a restriction of the cervical ROM before laminoplasty; however, the improvement of neck pain in this group and the deterioration of pain status in the NP group eliminated this difference after laminoplasty. Thereafter, the PA group was classified into 2 subgroups according to the improvement of the preoperative neck pain: 1) the improved group, which included patients whose postoperative VAS score decreased; and 2) the no improvement group, which included patients who were not in the improved group. No significant differences were observed in the average recovery and radiographic results between these 2 subgroups. Neck pain before surgery in the PA group indicated a restriction of the cervical ROM; however, the improvement of neck pain in this group and the deterioration of pain status in the NP group indicated the disappearance of this difference postoperatively. Moreover, improvement of preoperative neck pain was not associated with the radiographic

One-stage surgical treatment for concomitant rotator cuff tears with shoulder stiffness has comparable results with isolated rotator cuff tears: a systematic review.

Science.gov (United States)

Sabzevari, Soheil; Kachooei, Amir Reza; Giugale, Juan; Lin, Albert

2017-08-01

Addressing preoperative shoulder stiffness before rotator cuff repair (RCR) is advocated, but the effectiveness of this approach is debatable. We hypothesized that 1-stage treatment of concomitant rotator cuff tear (RCT) with shoulder stiffness has comparable results with isolated RCT. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the databases including MEDLINE, Embase, Cochrane Library, and Scopus were searched using the keywords of "shoulder stiffness" OR "adhesive capsulitis" OR "frozen shoulder" AND "rotator cuff." Studies that met all the criteria compared the 2 arms of isolated RCT vs. RCT with concomitant shoulder stiffness, received no physical therapy before surgery, and reported data of preoperative and postoperative range of motion (ROM) and functional outcomes after surgery. Four level III studies met the inclusion criteria. The non-stiff group (isolated RCT) included 460 patients who underwent RCR; the stiff group (RCT with concomitant shoulder stiffness) included 111 patients who underwent RCR and manipulation under anesthesia with or without capsular release. There were significant differences in preoperative ROM between stiff and non-stiff groups. At final follow-up, there were no statistical differences in all ROM between the 2 groups. There was no significant difference in comparing preoperative and postoperative outcome scores including visual analog scale for pain, Constant, modified American Shoulder and Elbow Surgeons, and University of California-Los Angeles scores. Concomitant surgical treatment of nonmassive RCT and moderate shoulder stiffness in 1 stage may have comparable results to the surgical treatment of RCT in patients without preoperative stiffness. Therefore, a physical therapy regimen before surgical intervention may not be necessary. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

An end-to-end coupled model ROMS-N 2 P 2 Z 2 D 2 -OSMOSE of ...

African Journals Online (AJOL)

An end-to-end coupled model ROMS-N 2 P 2 Z 2 D 2 -OSMOSE of the southern Benguela foodweb: parameterisation, calibration and pattern-oriented validation. ... We also highlight the capacity of this model for tracking indicators at various hierarchical levels. Keywords: individual-based model, model validation, ...

Car Builder: Design, Construct and Test Your Own Cars. School Version with Lesson Plans. [CD-ROM].

Science.gov (United States)

Highsmith, Joni Bitman

Car Builder is a scientific CD-ROM-based simulation program that lets students design, construct, modify, test, and compare their own cars. Students can design sedans, four-wheel-drive vehicles, vans, sport cars, and hot rods. They may select for aerodynamics, power, and racing ability, or economic and fuel efficiency. It is a program that teaches…

Grafiskā stāstījuma uzbūve un trauma Hāleda Hoseinī grafiskajā romānā “Pūķa ķērājs”

OpenAIRE

Vanaga, Alīna

2016-01-01

Hāleda Hoseinī grafiskais romāns “Pūķa ķērājs”demonstrē grafisko romānu spēju vienlaicīgi uzrunāt lielu cilvēku daudzumu un tajā pašā laikā izteikt neaprakstāmo, kas apliecina to, ka grafiskie romāni ļoti labi prot darīt saprotamas tādas neaprakstāmas tēmas, kā trauma. Tādēļ, šī maģistra darba mērķis ir noteikt, kā grafiskā stāstījuma uzbūve attēlo traumu Hāleda Hoseinī grafiskajā romāna “Pūķa ķērājs” un kādu rezultātu tas rada. Iepriekš minētā mērķa sasniegšanai tika izvēlētas divas pētīšana...

Breast Reduction Surgery

Science.gov (United States)

... considering breast reduction surgery, consult a board-certified plastic surgeon. It's important to understand what breast reduction surgery entails — including possible risks and complications — as ...

Patient Safety in Spine Surgery: Regarding the Wrong-Site Surgery

OpenAIRE

Lee, Seung-Hwan; Kim, Ji-Sup; Jeong, Yoo-Chul; Kwak, Dae-Kyung; Chun, Ja-Hae; Lee, Hwan-Mo

2013-01-01

Patient safety regarding wrong site surgery has been one of the priority issues in surgical fields including that of spine care. Since the wrong-side surgery in the DM foot patient was reported on a public mass media in 1996, the wrong-site surgery issue has attracted wide public interest as regarding patient safety. Despite the many wrong-site surgery prevention campaigns in spine care such as the operate through your initial program by the Canadian Orthopaedic Association, the sign your sit...

Adventures in Evaluation: Reviewing a CD-ROM Based Adventure Game Designed for Young People Recovering from Psychosis

Science.gov (United States)

Shrimpton, Bradley; Hurworth, Rosalind

2005-01-01

Recently the Centre for Program Evaluation (CPE) at the University of Melbourne was approached by a mental health agency to undertake the unique and challenging task of evaluating a prototype CD-ROM based adventure game designed for young people recovering from psychosis. This unusual and inventive game, titled Pogo's Pledge, used…

Is it time to include point-of-care ultrasound in general surgery training? A review to stimulate discussion.

Science.gov (United States)

Mollenkopf, Maximilian; Tait, Noel

2013-12-01

Point-of-care ultrasound scanning or POCUS is a focused ultrasound (US) scan, performed by non-imaging clinicians during physical examination, an invasive procedure or surgery. As this technology becomes cheaper, smaller and easier to use, its scope for use by surgeons grows, a trend that may generate a gap between use and training. Opportunities for enhanced general surgery skill sets may be reduced unless consideration is given to inclusion of POCUS in general surgery training. To stimulate discussion regarding inclusion of POCUS in the general surgery curriculum; to resource this discussion with an overview of current trends and issues around POCUS; and to discuss concerns and controversies that may arise if POCUS was adopted into general surgery training. A literature search was performed using PUBMED, MEDLINE, Google and Google Scholar, using the terms 'ultrasound', 'point-of-care-ultrasound', 'bedside ultrasound', 'portable ultrasound' and 'hand-held ultrasound'. Literature, references and non-literature resources found were reviewed for relevance to US education in general surgery. Increasingly, medical students are graduating with basic POCUS skills. Specialty-specific uses of POCUS are proliferating. Training and assessment resources are not keeping up, in accessibility or standardization. A learned surgical college led training and accreditation process would require aligned education in anatomy and US technology and collaboration with the specialist imaging community to ensure appropriate standards are clarified and met. Research is also required into how general surgery trainees can best achieve and maintain POCUS competence. © 2013 Royal Australasian College of Surgeons.

Enhanced Recovery After Surgery: The Plastic Surgery Paradigm Shift.

Science.gov (United States)

Bartlett, Erica L; Zavlin, Dmitry; Friedman, Jeffrey D; Abdollahi, Aariane; Rappaport, Norman H

2017-12-14

With a focus on providing high quality care and reducing facility based expenses there has been an evolution in perioperative care by way of enhanced recovery after surgery (ERAS). ERAS allows for a multidisciplinary and multimodal approach to perioperative care which not only expedites recovery but maximizes patient outcomes. This paradigm shift has been generally accepted by most surgical specialties, including plastic surgery. The goal of this study was to evaluate the impact of ERAS on outcomes in cosmetic plastic surgery. A prospective study consisting of phone call questionnaires was designed where patients from two senior plastic surgeons (N.H.R. and J.D.F.) were followed. The treatment group (n = 10) followed an ERAS protocol while the control group (n = 12) followed the traditional recovery after surgery which included narcotic usage. Patients were contacted on postoperative days (POD) 0 through 7+ and surveyed about a number of outcomes measures. The ERAS group demonstrated a significant reduction in postoperative pain on POD 0, 1, 2, and 3 (all P plastic surgery. The utility lies in the ability to expedite patient's recovery while still providing quality care. This study showed a reduction in postoperative complaints by avoiding narcotics without an increase in complications. Our findings signify the importance of ERAS protocols within cosmetic plastic surgery. 4. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

Quality Management Audits in Nuclear Medicine Practices. 2. Ed. Companion CD-ROM

International Nuclear Information System (INIS)

2015-01-01

Quality management systems are essential and should be maintained with the intent to continuously improve effectiveness and efficiency, enabling nuclear medicine to achieve the expectations of its quality policy, satisfy its customers and improve professionalism. The quality management (QM) audit methodology in nuclear medicine practice, introduced in this publication, is designed to be applied to a variety of economic circumstances. A key outcome is a culture of reviewing all processes of the clinical service for continuous improvement in nuclear medicine practice. Regular quality audits and assessments are vital for modern nuclear medicine services. More importantly, the entire QM and audit process has to be systematic, patient oriented and outcome based. The management of services should also take into account the diversity of nuclear medicine services around the world and multidisciplinary contributions. The latter include clinical, technical, radiopharmaceutical, medical physics and radiation safety procedures. This companion CD-ROM is attached to the printed STI/PUB/1683 and contains the full-text of STI/PUB/1683 as well as checklists in PDF and Excel format and a table with the contents of a standardized audit report

DEVELOPMENT OF PLASTIC SURGERY.

Science.gov (United States)

Pećanac, Marija Đ

2015-01-01

Plastic surgery is a medical specialty dealing with corrections of defects, improvements in appearance and restoration of lost function. Ancient times. The first recorded account of reconstructive plastic surgery was found in ancient Indian Sanskrit texts, which described reconstructive surgeries of the nose and ears. In ancient Greece and Rome, many medicine men performed simple plastic cosmetic surgeries to repair damaged parts of the body caused by war mutilation, punishment or humiliation. In the Middle Ages, the development of all medical braches, including plastic surgery was hindered. New age. The interest in surgical reconstruction of mutilated body parts was renewed in the XVIII century by a great number of enthusiastic and charismatic surgeons, who mastered surgical disciplines and became true artists that created new forms. Modern era. In the XX century, plastic surgery developed as a modern branch in medicine including many types of reconstructive surgery, hand, head and neck surgery, microsurgery and replantation, treatment of burns and their sequelae, and esthetic surgery. Contemporary and future plastic surgery will continue to evolve and improve with regenerative medicine and tissue engineering resulting in a lot of benefits to be gained by patients in reconstruction after body trauma, oncology amputation, and for congenital disfigurement and dysfunction.

Advanced laparoscopic bariatric surgery Is safe in general surgery training.

Science.gov (United States)

Kuckelman, John; Bingham, Jason; Barron, Morgan; Lallemand, Michael; Martin, Matthew; Sohn, Vance

2017-05-01

Bariatric surgery makes up an increasing percentage of general surgery training. The safety of resident involvement in these complex cases has been questioned. We evaluated patient outcomes in resident performed laparoscopic bariatric procedures. Retrospective review of patients undergoing a laparoscopic bariatric procedure over seven years at a tertiary care single center. Procedures were primarily performed by a general surgery resident and proctored by an attending surgeon. Primary outcomes included operative volume, operative time and leak rate with perioperative outcomes evaluated as secondary outcomes. A total of 1649 bariatric procedures were evaluated. Operations included laparoscopic bypass (690) and laparoscopic sleeve gastrectomy (959). Average operating time was 136 min. Eighteen leaks (0.67%) were identified. Graduating residents performed an average of 89 laparoscopic bariatric cases during their training. There were no significant differences between resident levels with concern to operative time or leak rate (p 0.97 and p = 0.54). General surgery residents can safely perform laparoscopic bariatric surgery. When proctored by a staff surgeon, a resident's level of training does not significantly impact leak rate. Published by Elsevier Inc.

Rojas Zorrilla ante la crítica romántica

Directory of Open Access Journals (Sweden)

Pedraza Jiménez, Felipe B

2007-06-01

Full Text Available To Romantic Criticism, Rojas Zorrilla’s fame becomed obscure by the figure of his contemporary, friend and collaborator, Pedro Calderón de la Barca. This logical situation is clearly evident in the great german critics: Rojas Zorrilla is scarcely mentioned by the Schlegel brothers. To other historians he occupied a secondary place and the only exception was Johann Ludwig Tieck, who exalted his works even above Calderón masterpieces. It can be affirmed that Rojas Zorrilla reception was irregular. If we examine Musso Valiente’s library, Agustín Durán’s Discurso, and the romantic period editions, we will find some interest in his figure and that it was situated in a secondary place in relation to our great theater. It seems clear that Martínez de la Rosa and Alberto Lista were the critics who pay more attention to him. Martínez de la Rosa established an approach based in the neoclassic topics about our writer, meanwhile Alberto Lista developed a closer and original reading, specially centered in the poet’s tragic dimension and elements that, from his point of view, anticipated romantic Aesthetics. Rojas Zorrilla inclusion in romantic Literary Histories, and his edition in the «Biblioteca de Autores Españoles», prepared by Mesonero Romanos, make him enter the canon among the «six great stars» in Spanish Golden Age Theater.Para la crítica romántica, la fama de Rojas Zorrilla quedó oscurecida, de forma perfectamente lógica, por la de su coetáneo, amigo y colaborador don Pedro Calderón de la Barca. Esta situación es muy patente en los grandes críticos alemanes. Los hermanos Schlegel apenas citan a nuestro dramaturgo. Otros historiadores le conceden un lugar secundario, con la excepción de Johann Ludwig Tieck, que lo exaltó incluso por encima del autor de La vida es sueño. La recepción de su obra en España fue irregular. Del análisis de la biblioteca y escritos de Musso Valiente, del discurso de Agustín Durán, de las

Specificity of facelift surgery, including mid facelift, in case of facial palsy.

Science.gov (United States)

Le Louarn, C

2015-10-01

The asymmetry created by the facial palsy is of course a cause of demand for facelift surgery. As this lifting action is specific and different from the standard procedures, 3 zones of analysis are proposed: first the frontal and temporal areas with the direct eyebrow lift, second the neck and jawline with action on the depressor anguli oris for the non-paralyzed side and the anterior sub SMAS dissection and third the midface. A new and more simple technique of concentric malar lift is proposed. The first publication on concentric malar lift was made 11years ago. Midface rejuvenation stays very challenging. As a proof of that, many authors prefer a partial rejuvenation of mid face with fat reinjection, with no effect on skin excess, even if all the MRI studies demonstrated no fat loss with time but only fat transfer. This proves that midface lift did not acquire enough simplicity, reliability to become a standard procedure. Six hundred concentric malar lift later, a technical simplification validated with 110 patients and 2years of follow-up is proposed. The improvement is due to a new way to pass the threads deeply on the bone, using permanent barbed sutures. This surgery becomes easier and more efficient. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Combined surgery versus cataract surgery alone for eyes with cataract and glaucoma.

Science.gov (United States)

Zhang, Mingjuan Lisa; Hirunyachote, Phenpan; Jampel, Henry

2015-07-14

Cataract and glaucoma are leading causes of blindness worldwide, and their co-existence is common in elderly people. Glaucoma surgery can accelerate cataract progression, and performing both surgeries may increase the rate of postoperative complications and compromise the success of either surgery. However, cataract surgery may independently lower intraocular pressure (IOP), which may allow for greater IOP control among patients with co-existing cataract and glaucoma. The decision between undergoing combined glaucoma and cataract surgery versus cataract surgery alone is complex. Therefore, it is important to compare the effectiveness of these two interventions to aid clinicians and patients in choosing the better treatment approach. To assess the relative effectiveness and safety of combined surgery versus cataract surgery (phacoemulsification) alone for co-existing cataract and glaucoma. The secondary objectives include cost analyses for different surgical techniques for co-existing cataract and glaucoma. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 10), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to October 2014), EMBASE (January 1980 to October 2014), PubMed (January 1948 to October 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to October 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 3 October 2014.We checked the reference lists of the included trials to identify further relevant trials. We used the Science Citation Index to search for references to

Innovations in robotic surgery.

Science.gov (United States)

Gettman, Matthew; Rivera, Marcelino

2016-05-01

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

Smoking and surgery

Science.gov (United States)

Surgery - quitting smoking; Surgery - quitting tobacco; Wound healing - smoking ... Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: Blood clots and aneurysms in ...

Systematic review of the surgery-first approach in orthognathic surgery

Directory of Open Access Journals (Sweden)

Chiung Shing Huang

2014-08-01

Full Text Available The surgery-first approach in orthognathic surgery has recently created a broader interest in completely eliminating time-consuming preoperative orthodontic treatment. Available evidence on the surgery-first approach should be appraised to support its use in orthognathic surgery. A MEDLINE search using the keywords "surgery first" and "orthognathic surgery" was conducted to select studies using the surgery-first approach. We also manually searched the reference list of the selected keywords to include articles not selected by the MEDLINE search. The search identified 18 articles related to the surgery-first approach. There was no randomized controlled clinical trial. Four papers were excluded as the content was only personal opinion or basic scientific research. Three studies were retrospective cohort studies in nature. The other 11 studies were case reports. For skeletal Class III surgical correction, the final long-term outcomes for maxillofacial and dental relationship were not significantly different between the surgery-first approach and the orthodontics-first approach in transverse (e.g., intercanine or intermolar width dimension, vertical (e.g., anterior open bite, lower anterior facial height dimension, and sagittal (e.g., anterior-posterior position of pogonion and lower incisors dimension. Total treatment duration was substantially shorter in cases of surgery-first approach use. In conclusion, most published studies related to the surgery-first approach were mainly on orthognathic correction of skeletal Class III malocclusion. Both the surgery-first approach and orthodontics-first approach had similar long-term outcomes in dentofacial relationship. However, the surgery-first approach had shorter treatment time.

Glenohumeral range of motion (ROM) and isometric strength of professional team handball athletes, part III: changes over the playing season.

Science.gov (United States)

Fieseler, Georg; Jungermann, Philipp; Koke, Alexander; Irlenbusch, Lars; Delank, Karl-Stefan; Schwesig, René

2015-12-01

The aim of our study was to investigate the relation of workload on range of motion and isometric strength of team handball athletes' shoulders over a competitive season. 31 Professional male handball athletes underwent clinical shoulder examinations. Athletes were examined subsequently during the complete playing season (week 0, 6, 22 and 40) to determine bilateral isometric shoulder rotational strength and active range of motion (ROM). In addition, relative (intraclass correlation coefficients (ICC) and absolute (standard error of measurement) reliability were calculated. Intraobserver reliability was excellent (ICC 0.76-0.98) for isometric strength and flexibility measurements. Internal rotation (IR) and total arc ROM in the throwing shoulder (TS) decreased significantly (p handball players' shoulders changed significantly from the beginning to the end of a season. More specifically, the repetitive forces accumulated during the competitive season resulted in altered GIRD, ERG and isometric strength of the dominant glenohumeral joint.

Machado: do discurso romântico da nacionalidade à crítica radical da nação

Directory of Open Access Journals (Sweden)

João Hernesto Weber

Full Text Available O artigo se detém, inicialmente, numa leitura da camada aparente de "Instinto de nacionalidade", destacando sua vinculação com as teses românticas sobre o sentido de "nação" e "literatura nacional", insistindo Machado na literatura indigenista, na cor local, na feição americana como paradigma para detectar a nacionalidade do texto literário. Em outra camada de leitura, apontam-se as reticências, as negações, o estilo carregado de adversativas que permeiam o texto, a ponto de Machado vir a negar as teses românticas em sua exclusividade, para, finalmente, abrir o leque do que poderia significar "literatura nacional": tudo é matéria de poesia. Na sequência, analisa-se a formação do Machado ficcionista, quando viria a exercitar o que já se encontrava, em tese, no "Instinto". Por fim, lançam-se algumas questões sobre a importância do ensaio para a crítica e a historiografia literária locais.

Concomitant atrial fibrillation surgery for people undergoing cardiac surgery

Science.gov (United States)

Huffman, Mark D; Karmali, Kunal N; Berendsen, Mark A; Andrei, Adin-Cristian; Kruse, Jane; McCarthy, Patrick M; Malaisrie, S C

2016-01-01

Background People with atrial fibrillation (AF) often undergo cardiac surgery for other underlying reasons and are frequently offered concomitant AF surgery to reduce the frequency of short- and long-term AF and improve short- and long-term outcomes. Objectives To assess the effects of concomitant AF surgery among people with AF who are undergoing cardiac surgery on short-term and long-term (12 months or greater) health-related outcomes, health-related quality of life, and costs. Search methods Starting from the year when the first “maze” AF surgery was reported (1987), we searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library (March 2016), MEDLINE Ovid (March 2016), Embase Ovid (March 2016), Web of Science (March 2016), the Database of Abstracts of Reviews of Effects (DARE, April 2015), and Health Technology Assessment Database (HTA, March 2016). We searched trial registers in April 2016. We used no language restrictions. Selection criteria We included randomised controlled trials evaluating the effect of any concomitant AF surgery compared with no AF surgery among adults with preoperative AF, regardless of symptoms, who were undergoing cardiac surgery for another indication. Data collection and analysis Two review authors independently selected studies and extracted data. We evaluated the risk of bias using the Cochrane ‘Risk of bias’ tool. We included outcome data on all-cause and cardiovascular-specific mortality, freedom from atrial fibrillation, flutter, or tachycardia off antiarrhythmic medications, as measured by patient electrocardiographic monitoring greater than three months after the procedure, procedural safety, 30-day rehospitalisation, need for post-discharge direct current cardioversion, health-related quality of life, and direct costs. We calculated risk ratios (RR) for dichotomous data with 95% confidence intervals (CI) using a fixed-effect model when heterogeneity was low (I2 ≤ 50%) and random

Computer Based Radiation Protection- A New Cd-Rom

International Nuclear Information System (INIS)

Geringer, T.; Bammer, M.; Ablber, M.

2004-01-01

Within the next few years, there'll be a lot of new challenges required from radiation protection. According to EU regulation[1] and the new austrian radiation protection law [2] regular additional training are requested. Patients protection in diagnostic and therapeutic usage of ionising radiation gains also more and more importance.[3] Not really surprisingly, the general population is definitely highly aware of the risks coming with the usage of radionuclides and x-rays in medicine. Furthermore, the nuclear power plant in Temelin, near the austrian border initiated a lively discussion about risks, necessity and use of ionising radiation in medicine and industry. It turned out to be a really hard job handling these topics in public. A brilliant didactics based on independent information and viewpoints was required. ARC Seibersdorf Research GmbH, represented by the department of medical technical applications and the radiation protection academy, developed an interactive CD-ROM covering several applications: Basics on radiation protection for medical and technical personnel ; preparation for a radiation protection training. Repetition of the main topics for graduates of a radiation protection training. Basics on radiation protection and emergency management for medical staff as well as for the general public. (Author)

Nuclides 2000: an electronic chart of the nuclides on CD-ROM

International Nuclear Information System (INIS)

Magill, J.

2000-01-01

The 'Nuclides 2000' software package is an electronic chart of the nuclides, available on CD-ROM for Microsoft Windows operating systems, which offers extensive basic information on physics and radiology of the familiar nuclides. Moreover, 'Nuclides 2000' contains codes for a number of applications which allow the required data to be computed quickly and reliably by means of interactive user guidance. The data and codes are supplemented by information in the format of contributions on the history of radioactivity and radiochemistry, and on subjects of interest in physics, such as C-14 dating and the generation of Ti-44 in a supernova, and by a link collection of Internet addresses. As a detailed database, 'Nuclides 2000' can be used for teaching, research, and for practical applications. (orig.) [de

History, Development and Future of TRIGA Research Reactors. Companion CD-ROM

International Nuclear Information System (INIS)

2016-01-01

Due to its particular fuel design and resulting enhanced inherent safety features, TRIGA reactors (Training, Research, Isotopes, General Atomics) constitute a ‘class of their own’ among the large variety of research reactors built world-wide. This publication summarizes in a single document the information on the past and present of TRIGA research reactors and presents an outlook in view of potential issues to be solved by TRIGA operating organizations in the near future. It covers the historical development and basic TRIGA characteristics, followed by utilization, fuel conversion and ageing management of TRIGA research reactors. It continues with issues and challenges, introduction to the global TRIGA research reactor network and concludes with future perspectives. This CD-ROM illustrates the historical developments of TRIGA research reactors through individual facility examples and experiences

The Virtual 3D Reconstruction of the East Pediment of the Temple of Zeus at Olympia – Presentation of an Interactive CD-ROM

Directory of Open Access Journals (Sweden)

András PATAY-HORVÁTH Patay-Horváth

2011-12-01

Full Text Available The paper gives an overview of a two-years project concerning a major monument of ancient Greek art and presents the interactive, bilingual (English/Hungarian CD-ROM, which is intended to summarize and visualize its final results. The presented project approaches a century-old controversy in a new way by producing a virtual 3D reconstruction of a monumental marble group. Digital models of the statues were produced by scanning the original fragments and by reconstructing them virtually. The virtual model of the pediment surrounding the sculptures was prepared on the basis of the latest architectural studies and afterwards the reconstructed models were inserted in this frame, in order to test the technical feasibility and aesthetic effects the four possible arrangements. The resulting models enable easy and very instructive experimentation, which would be otherwise impossible with the originals and/or very expensive and not very practicable with traditional tools (e.g. real-size plaster models. The complete model can effectively be used to verify the results of earlier or more recent reconstructions presented only in simple drawings. In addition, the 3D models of the individual fragments can be used for further research and for visualization.  The documentary CD-ROM presenting the full background, the methods and the conclusions of the project contains beside a comprehensive text various kinds of supporting documents (images, 3D models, papers, broadcasts, audiovisual material. It is addressed to a mixed audience: a picture gallery, a short documentary movie some other attachments including a selected bibliography is intended for the general public, but scholarly publications, presentations on related problems are also included for specialists interested in certain details.

SSTL I/O Standard Based Environment Friendly Energy Efficient ROM Design on FPGA

DEFF Research Database (Denmark)

Bansal, Neha; Bansal, Meenakshi; Saini, Rishita

2014-01-01

are operating ROM with the highest operating frequency of 4th generation i7 processor to test the compatibility of this design with the latest hardware in use. When there is no demand of peak performance, then we can save 74.5% clock power, 75% signal power, and 30.83% I/O power by operating our device with 1......Stub Series Terminated Logic (SSTL) is an Input/output standard. It is used to match the impedance of line, port and device of our design under consideration. Therefore, selection of energy efficient SSTL I/O standard among available different class of SSTL logic family in FPGA, plays a vital role...

Simultaneous bilateral cataract surgery: economic analysis; Helsinki Simultaneous Bilateral Cataract Surgery Study Report 2.

Science.gov (United States)

Leivo, Tiina; Sarikkola, Anna-Ulrika; Uusitalo, Risto J; Hellstedt, Timo; Ess, Sirje-Linda; Kivelä, Tero

2011-06-01

To present an economic-analysis comparison of simultaneous and sequential bilateral cataract surgery. Helsinki University Eye Hospital, Helsinki, Finland. Economic analysis. Effects were estimated from data in a study in which patients were randomized to have bilateral cataract surgery on the same day (study group) or sequentially (control group). The main clinical outcomes were corrected distance visual acuity, refraction, complications, Visual Function Index-7 (VF-7) scores, and patient-rated satisfaction with vision. Health-care costs of surgeries and preoperative and postoperative visits were estimated, including the cost of staff, equipment, material, floor space, overhead, and complications. The data were obtained from staff measurements, questionnaires, internal hospital records, and accountancy. Non-health-care costs of travel, home care, and time were estimated based on questionnaires from a random subset of patients. The main economic outcome measures were cost per VF-7 score unit change and cost per patient in simultaneous versus sequential surgery. The study comprised 520 patients (241 patients included non-health-care and time cost analyses). Surgical outcomes and patient satisfaction were similar in both groups. Simultaneous cataract surgery saved 449 Euros (€) per patient in health-care costs and €739 when travel and paid home-care costs were included. The savings added up to €849 per patient when the cost of lost working time was included. Compared with sequential bilateral cataract surgery, simultaneous bilateral cataract surgery provided comparable clinical outcomes with substantial savings in health-care and non-health-care-related costs. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Shoulder and Elbow Recovery at 2 and 11 Years Following Brachial Plexus Reconstruction.

Science.gov (United States)

Wang, Jung-Pan; Rancy, Schneider K; Lee, Steve K; Feinberg, Joseph H; Wolfe, Scott W

2016-02-01

To report short-term and long-term outcomes on a single patient cohort observed longitudinally after nerve reconstruction for adult brachial plexus injury. Eleven male patients who underwent plexus reconstruction by the same surgeon at 2 institutions presented for clinical examination 7.5 or more years after surgery (average, 11.4 years; range, 7.5-22 years). Average age at the time of operation was 35 years (range, 17-73 years). Mean delay until surgery was 5 months (range, 2-11 months). Two patients had C5 paralysis, 2 had C5-C6 paralysis, 2 had C5-C7 paralysis, and 5 had complete 5-level injuries. Outcome parameters included active range of motion (ROM) in degrees, a modified British Medical Research Council (mBMRC) scale for muscle strength, and electromyographic motor unit configuration and recruitment pattern. Differences in ROM and mBMRC between 2-year and long-term follow-up were assessed with paired-sample t tests using an alpha value of .05. Average shoulder abduction and mBMRC at final follow-up were both significantly improved compared with the 2-year follow-up results (P motor unit configuration in 10 of 15 muscles and improved recruitment in 3 of 15 muscles compared with 2-year electromyographic results. Patients continued to gain ROM and strength in the shoulder and elbow well after 2 to 3 years after surgery, contrary to previous reports. Although the precise mechanism is unknown, we speculate that a number of factors may be involved, including terminal collateral sprouting, maturation of motor units, improvements in motor unit recruitment, additional muscle fiber hypertrophy, or an as-yet undescribed mechanism. We recommend that patients be encouraged to continue strengthening exercises well after the initial recovery period and that more comparative long-term data be collected to expand on these observations. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Does previous abdominal surgery affect the course and outcomes of laparoscopic bariatric surgery?

Science.gov (United States)

Major, Piotr; Droś, Jakub; Kacprzyk, Artur; Pędziwiatr, Michał; Małczak, Piotr; Wysocki, Michał; Janik, Michał; Walędziak, Maciej; Paśnik, Krzysztof; Hady, Hady Razak; Dadan, Jacek; Proczko-Stepaniak, Monika; Kaska, Łukasz; Lech, Paweł; Michalik, Maciej; Duchnik, Michał; Kaseja, Krzysztof; Pastuszka, Maciej; Stepuch, Paweł; Budzyński, Andrzej

2018-03-26

Global experiences in general surgery suggest that previous abdominal surgery may negatively influence different aspects of perioperative care. As the incidence of bariatric procedures has recently increased, it is essential to assess such correlations in bariatric surgery. To assess whether previous abdominal surgery influences the course and outcomes of laparoscopic bariatric surgery. Seven referral bariatric centers in Poland. We conducted a retrospective analysis of 2413 patients; 1706 patients who underwent laparoscopic sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) matched the inclusion criteria. Patients with no history of abdominal surgery were included as group 1, while those who had undergone at least 1 abdominal surgery were included as group 2. Group 2 had a significantly prolonged median operation time for RYGB (P = .012), and the longest operation time was observed in patients who had previously undergone surgeries in both the upper and lower abdomen (P = .002). Such a correlation was not found in SG cases (P = .396). Groups 1 and 2 had similar rates of intraoperative adverse events and postoperative complications (P = .562 and P = .466, respectively). Group 2 had a longer median duration of hospitalization than group 1 (P = .034), while the readmission rate was similar between groups (P = .079). There was no significant difference between groups regarding the influence of the long-term effects of bariatric treatment on weight loss (percentage of follow-up was 55%). Previous abdominal surgery prolongs the operative time of RYGB and the duration of postoperative hospitalization, but does not affect the long-term outcomes of bariatric treatment. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Data base management system and display software for the National Geophysical Data Center geomagnetic CD-ROM's

Science.gov (United States)

Papitashvili, N. E.; Papitashvili, V. O.; Allen, J. H.; Morris, L. D.

1995-01-01

The National Geophysical Data Center has the largest collection of geomagnetic data from the worldwide network of magnetic observatories. The data base management system and retrieval/display software have been developed for the archived geomagnetic data (annual means, monthly, daily, hourly, and 1-minute values) and placed on the center's CD-ROM's to provide users with 'user-oriented' and 'user-friendly' support. This system is described in this paper with a brief outline of provided options.

Analysis of User Need with CD-ROM Databases: A Case Study Based on Work Sampling at One University Library.

Science.gov (United States)

Wells, Amy Tracy

Analysis of the needs of users of Compact Disk-Read Only Memory (CD-ROM) was performed at the Tampa campus of the University of South Florida. A review of the literature indicated that problems associated with selecting the appropriate database, searching, and requiring technical assistance were the probable areas of user need. The library has 17…

El realismo científico en Rom Harré (análisis crítico)

OpenAIRE

Carman, Christián Carlos

2004-01-01

Universidad Nacional de Quilmes Carman, C. (2016). El Realismo Científico en Rom Harré (análisis crítico) (Tesis de posgrado). Universidad Nacional de Quilmes, Bernal, Argentina El trabajo se propone recorrer tres objetivos principales, a saber, el relativo a elucidar el problema del realismo científico; el de abordar una sistematización del pensamiento de Harré respecto del problema del realismo científico y por último, un análisis crítico de la posición de su posición.

Proceedings of the High Performance Embedded Computing Workshop (HPEC 2006) (10th). Held in Lexington, Massachusetts on September 19-21, 2006 (CD-ROM)

National Research Council Canada - National Science Library

Kepner, Jeremy

2007-01-01

...: 1 CD-ROM; 4 3/4 in.; 78.3 MB. ABSTRACT: The High-Performance Embedded Computing (HPEC) technical committee announced the tenth annual HPEC Workshop held in September 2006 at MIT Lincoln Laboratory in Lexington, MA...

Making the semiconductor-metal transition in a growth-dominant phase-change alloy InSb for double density blu-ray super-RENS-ROM disc

Energy Technology Data Exchange (ETDEWEB)

Hyot, Berangere [CEA, LETI, MINATEC, F- 38054 Grenoble (France)

2012-10-15

Phenomenologically, a semiconductor-metal transition is characterized by a sudden change in electrical properties but also in optical behaviours, as a consequence of a change in electron behaviour. The ability to induce a reversible semiconductor-metal transition in a material by varying conditions such as applied temperature or electrical field, results in attractive changes in properties that have fuelled the curiosity of scientists. In this paper, we discuss the interest of such materials exhibiting the reversible semiconductor-metal transition in the development of the next generation of optical Bly-ray discs (BD), the so-called super-resolution near field structure (super-RENS) discs and we show that InSb semiconductor material exhibits huge variations of its optical properties during the optically (thermally)-induced solid-to-liquid change corresponding to a semiconductor-metal transition. First success in the video playback on HDTV (High Definition TeleVision) display from 50 GB (BD capacity x 2) InSb-based super-RENS-ROM discs including a high definition video content with 1920 x 1080 pixels was realized in September 2009 by the super-RENS consortium joining three partners: AIST (National Institute of Advanced Industrial Science and Technology), Mitsubishi Electric Co. and LETI. Snapshot of high definition video content from InSb-based super-RENS-ROM disc corresponding to 50 GB per layer (BD capacity x 2) displayed on HDTV. (Copyright copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

School Survey on Crime and Safety (SSOCS) 2000 Public-Use Data Files, User's Manual, and Detailed Data Documentation. [CD-ROM].

Science.gov (United States)

National Center for Education Statistics (ED), Washington, DC.

This CD-ROM contains the raw, public-use data from the 2000 School Survey on Crime and Safety (SSOCS) along with a User's Manual and Detailed Data Documentation. The data are provided in SAS, SPSS, STATA, and ASCII formats. The User's Manual and the Detailed Data Documentation are provided as .pdf files. (Author)

Gastric and intestinal surgery.

Science.gov (United States)

Fossum, Theresa W; Hedlund, Cheryl S

2003-09-01

Gastric surgery is commonly performed to remove foreign bodies and correct gastric dilatation-volvulus and is less commonly performed to treat gastric ulceration or erosion, neoplasia, and benign gastric outflow obstruction. Intestinal surgery, although commonly performed by veterinarians, should never be considered routine. The most common procedures of the small intestinal tract performed in dogs and cats include enterotomy and resection/anastomosis. Surgery of the large intestine is indicated for lesions causing obstruction, perforations, colonic inertia, or chronic inflammation.

Effects of Contract Delivery Method on the LEED(trademark) Score of U.S. Navy Military Construction Projects (Fiscal Years 2004-2006) (CD-ROM)

National Research Council Canada - National Science Library

Carpenter, Deanna S

2005-01-01

...: 1 CD-ROM; 4 3/4 in.; 484 KB. ABSTRACT: This research study focused on determining the effects that the two major contract delivery methods had on the LEED score of projects over the design and construction time horizon...

Bariatric Surgery and Precision Nutrition.

Science.gov (United States)

Nicoletti, Carolina F; Cortes-Oliveira, Cristiana; Pinhel, Marcela A S; Nonino, Carla B

2017-09-06

This review provides a literature overview of new findings relating nutritional genomics and bariatric surgery. It also describes the importance of nutritional genomics concepts in personalized bariatric management. It includes a discussion of the potential role bariatric surgery plays in altering the three pillars of nutritional genomics: nutrigenetics, nutrigenomics, and epigenetics. We present studies that show the effect of each patient's genetic and epigenetic variables on the response to surgical weight loss treatment. We include investigations that demonstrate the association of single nucleotide polymorphisms with obesity phenotypes and their influence on weight loss after bariatric surgery. We also present reports on how significant weight loss induced by bariatric surgery impacts telomere length, and we discuss studies on the existence of an epigenetic signature associated with surgery outcomes and specific gene methylation profile, which may help to predict weight loss after a surgical procedure. Finally, we show articles which evidence that bariatric surgery may affect expression of numerous genes involved in different metabolic pathways and consequently induce functional and taxonomic changes in gut microbial communities. The role nutritional genomics plays in responses to weight loss after bariatric surgery is evident. Better understanding of the molecular pathways involved in this process is necessary for successful weight management and maintenance.

Bariatric Surgery and Precision Nutrition

Directory of Open Access Journals (Sweden)

Carolina F. Nicoletti

2017-09-01

Full Text Available This review provides a literature overview of new findings relating nutritional genomics and bariatric surgery. It also describes the importance of nutritional genomics concepts in personalized bariatric management. It includes a discussion of the potential role bariatric surgery plays in altering the three pillars of nutritional genomics: nutrigenetics, nutrigenomics, and epigenetics. We present studies that show the effect of each patient’s genetic and epigenetic variables on the response to surgical weight loss treatment. We include investigations that demonstrate the association of single nucleotide polymorphisms with obesity phenotypes and their influence on weight loss after bariatric surgery. We also present reports on how significant weight loss induced by bariatric surgery impacts telomere length, and we discuss studies on the existence of an epigenetic signature associated with surgery outcomes and specific gene methylation profile, which may help to predict weight loss after a surgical procedure. Finally, we show articles which evidence that bariatric surgery may affect expression of numerous genes involved in different metabolic pathways and consequently induce functional and taxonomic changes in gut microbial communities. The role nutritional genomics plays in responses to weight loss after bariatric surgery is evident. Better understanding of the molecular pathways involved in this process is necessary for successful weight management and maintenance.

Bariatric Surgery and Precision Nutrition

Science.gov (United States)

Nicoletti, Carolina F.; Cortes-Oliveira, Cristiana; Pinhel, Marcela A. S.; Nonino, Carla B.

2017-01-01

This review provides a literature overview of new findings relating nutritional genomics and bariatric surgery. It also describes the importance of nutritional genomics concepts in personalized bariatric management. It includes a discussion of the potential role bariatric surgery plays in altering the three pillars of nutritional genomics: nutrigenetics, nutrigenomics, and epigenetics. We present studies that show the effect of each patient’s genetic and epigenetic variables on the response to surgical weight loss treatment. We include investigations that demonstrate the association of single nucleotide polymorphisms with obesity phenotypes and their influence on weight loss after bariatric surgery. We also present reports on how significant weight loss induced by bariatric surgery impacts telomere length, and we discuss studies on the existence of an epigenetic signature associated with surgery outcomes and specific gene methylation profile, which may help to predict weight loss after a surgical procedure. Finally, we show articles which evidence that bariatric surgery may affect expression of numerous genes involved in different metabolic pathways and consequently induce functional and taxonomic changes in gut microbial communities. The role nutritional genomics plays in responses to weight loss after bariatric surgery is evident. Better understanding of the molecular pathways involved in this process is necessary for successful weight management and maintenance. PMID:28878180

Education on the Business of Plastic Surgery During Training: A Survey of Plastic Surgery Residents.

Science.gov (United States)

Ovadia, Steven A; Gishen, Kriya; Desai, Urmen; Garcia, Alejandro M; Thaller, Seth R

2018-06-01

Entrepreneurial skills are important for physicians, especially plastic surgeons. Nevertheless, these skills are not typically emphasized during residency training. Evaluate the extent of business training at plastic surgery residency programs as well as means of enhancing business training. A 6-question online survey was sent to plastic surgery program directors for distribution to plastic surgery residents. Responses from residents at the PGY2 level and above were included for analysis. Tables were prepared to present survey results. Hundred and sixty-six residents including 147 PGY2 and above residents responded to our survey. Only 43.5% reported inclusion of business training in their plastic surgery residency. A majority of residents reported they do not expect on graduation to be prepared for the business aspects of plastic surgery. Additionally, a majority of residents feel establishment of a formal lecture series on the business of plastic surgery would be beneficial. Results from our survey indicate limited training at plastic surgery programs in necessary business skills. Plastic surgery residency programs should consider incorporating or enhancing elements of business training in their curriculum. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Applications of piezoelectric surgery in endodontic surgery: a literature review.

Science.gov (United States)

Abella, Francesc; de Ribot, Joan; Doria, Guillermo; Duran-Sindreu, Fernando; Roig, Miguel

2014-03-01

Piezosurgery (piezoelectric bone surgery) devices were developed to cut bone atraumatically using ultrasonic vibrations and to provide an alternative to the mechanical and electrical instruments used in conventional oral surgery. Indications for piezosurgery are increasing in oral and maxillofacial surgery, as in other disciplines, such as endodontic surgery. Key features of piezosurgery instruments include their ability to selectively cut bone without damaging adjacent soft tissue, to provide a clear operative field, and to cut without generating heat. Although piezosurgery instruments can be used at most stages of endodontic surgery (osteotomy, root-end resection, and root-end preparation), no published data are available on the effect of piezosurgery on the outcomes of endodontic surgery. To our knowledge, no study has evaluated the effect of piezosurgery on root-end resection, and only 1 has investigated root-end morphology after retrograde cavity preparation using piezosurgery. We conducted a search of the PubMed and Cochrane databases using appropriate terms and keywords related to the use and applications of piezoelectric surgery in endodontic surgery. A hand search also was conducted of issues published in the preceding 2 years of several journals. Two independent reviewers obtained and analyzed the full texts of the selected articles. A total of 121 articles published between January 2000 and December 2013 were identified. This review summarizes the operating principles of piezoelectric devices and outlines the applications of piezosurgery in endodontic surgery using clinical examples. Piezosurgery is a promising technical modality with applications in several aspects of endodontic surgery, but further studies are necessary to determine the influence of piezosurgery on root-end resection and root-end preparation. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

NODC Standard Product: Coastal Change Analysis Program (C-CAP) Chesapeake Bay Region Data from 1984 to 1989 on CD-ROM (NODC Accession 9200303)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The data set on this CD-ROM shows changes in land cover for the Chesapeake Bay region over the 5-year interval from 1984 to 1988-89. The data set was produced...

Decreased risk of surgery for small bowel obstruction after laparoscopic colon cancer surgery compared with open surgery

DEFF Research Database (Denmark)

Jensen, Kristian Kiim; Andersen, Peter; Erichsen, Rune

2016-01-01

cancer resection. METHODS: This was a nationwide cohort study of patients undergoing elective colonic cancer resection with primary anastomosis in Denmark between 2001 and 2008. All included patients were operated with curative intent. Patients were identified in the Danish Colorectal Cancer Group....... The HR for mortality after colonic resection was 2.54 (CI 1.91 to 3.38, P ... surgery. Further, subsequent SBO surgery was associated with increased mortality after colonic cancer resection....

Meteonorm. Global meteorological database for solar energy and applied climatology. Version 4.0: edition 2000. Software and data on CD-ROM

International Nuclear Information System (INIS)

1999-01-01

This is a comprehensive meteorological planning tool for system design, targeted at engineers, architects, teachers, planners and anyone interested in solar energy and climatology. METEONORM includes data from 2400 meteorological stations worldwide. Version V4.0 is based on over 15 years in the development of meteorological databases for energy. It may be used for solar applications at any desired location in the world, as an interpolation model of solar radiation and additional parameters for any site in the world is included. Also, with up-to-date algorithms, solar radiation incident on surfaces of arbitrary orientation may be calculated at the touch of a button. The local skyline profile may be specified. Five languages are supported: English, French, German, Italian, Spanish. Sites may be selected on map by means of a graphical interface. User data may be imported. 16 different output formats are available. Data, programme, manual, maps and illustrations are incorporated on the CD-ROM which is available for sale

Advances in percutaneous stone surgery

OpenAIRE

Hartman, Christopher; Gupta, Nikhil; Leavitt, David; Hoenig, David; Okeke, Zeph; Smith, Arthur

2015-01-01

Treatment of large renal stones has changed considerably in recent years. The increasing prevalence of nephrolithiasis has mandated that urologists perform more surgeries for large renal calculi than before, and this has been met with improvements in percutaneous stone surgery. In this review paper, we examine recent developments in percutaneous stone surgery, including advances in diagnosis and preoperative planning, renal access, patient position, tract dilation, nephroscopes, lithotripsy, ...

Nontrauma emergency surgery: optimal case mix for general surgery and acute care surgery training.

Science.gov (United States)

Cherry-Bukowiec, Jill R; Miller, Barbra S; Doherty, Gerard M; Brunsvold, Melissa E; Hemmila, Mark R; Park, Pauline K; Raghavendran, Krishnan; Sihler, Kristen C; Wahl, Wendy L; Wang, Stewart C; Napolitano, Lena M

2011-11-01

surgical residency education, including advanced surgical critical care management. In addition, creation of an NTE service provides an optimal general surgery case mix, including major abdominal operations, that can augment declining trauma surgery caseloads, maintain acute care faculty surgical skills, and support general and acute care surgery residency training.

Robotic colorectal surgery: hype or new hope? A systematic review of robotics in colorectal surgery.

Science.gov (United States)

Mirnezami, A H; Mirnezami, R; Venkatasubramaniam, A K; Chandrakumaran, K; Cecil, T D; Moran, B J

2010-11-01

Robotic colorectal surgery is an emerging field and may offer a solution to some of the difficulties inherent to conventional laparoscopic surgery. The aim of this review is to provide a comprehensive and critical analysis of the available literature on the use of robotic technology in colorectal surgery. Studies reporting outcomes of robotic colorectal surgery were identified by systematic searches of electronic databases. Outcomes examined included operating time, length of stay, blood loss, complications, cost, oncological outcome, and conversion rates. Seventeen Studies (nine case series, seven comparative studies, one randomized controlled trial) describing 288 procedures were identified and reviewed. Study heterogeneity precluded a meta-analysis of the data. Robotic procedures tend to take longer and cost more, but may reduce the length of stay, blood loss, and conversion rates. Complication profiles and short-term oncological outcomes are similar to laparoscopic surgery. Robotic colorectal surgery is a promising field and may provide a powerful additional tool for optimal management of more challenging pathology, including rectal cancer. Further studies are required to better define its role. © 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland.

Transsphenoidal surgery for pituitary tumors from microsurgery to the endoscopic surgery. Single surgeon's experience

International Nuclear Information System (INIS)

Iwai, Yoshiyasu; Yoshimura, Masaki; Terada, Aiko; Yamanaka, Kazuhiro; Koshimo, Naomi

2011-01-01

We reviewed results of the surgical outcome of pituitary tumors treated via the transsphenoidal approach between January, 1994 and January, 2010 at our institution. This data included 100 patients (124 procedures) treated through the sublabial transsphenoidal approach and 45 patients (54 procedures) treated through the endoscopic endonasal (bilateral nostrils) transsphenoidal approach performed by a single surgeon. The extent of tumor removal was significantly improved with endoscopic surgery; adjuvant gamma knife radiosurgery was needed for 65% of patients undergoing microsurgery vs. 30% for patients who had endoscopic surgery (p<0.0001). Patients who underwent endoscopic surgery had less intraoperative blood loss (mean volume: 100 mL for microsurgery patients vs. 30 mL for endoscopic surgery patients, p<0.0001), less pain, and less need for postoperative hormone replacement therapy (19% for microsurgery patients vs. 6% for endoscopic surgery patients; p<0.05). Cerebrospinal fluid (CSF) leakage and meningitis were experienced in one microsurgery patient (1%) and one endoscopic surgery patient (2.2%). Endoscopic surgery is a reasonable alternative to microsurgery and our experience supports the concept that an otolaryngologist/neurosurgeon team skilled in endoscopic techniques and pituitary surgery can safely make the transition from microsurgery to endoscopic surgery. (author)

Metabolic Surgery in Korea: What to Consider before Surgery

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Mi-Kyung Kim

2017-09-01

Full Text Available Obesity is increasing globally and represents a significant global health problem because it predisposes towards various diseases, such as type 2 diabetes mellitus, cardiovascular disease, degenerative joint disease, and certain types of cancer. Numerous studies have shown that bariatric surgery reduces body mass and ameliorates obesity-related complications, such as hypertension and hyperglycemia, suggesting that surgery is the most effective therapeutic option for severely obese and obese diabetic patients. Recent international guidelines recommend surgical treatment for diabetic patients with class III obesity (body mass index [BMI] >40 kg/m2, regardless of their level of glycemic control or the complexity of their glucose-lowering regimens, and for patients with class II obesity (BMI 35.0 to 39.9 kg/m2 and hyperglycemia that is poorly controlled despite appropriate lifestyle and pharmacological therapy. The most popular procedures are Roux-en-Y gastric bypass and sleeve gastrectomy, but new procedures with better outcomes have been reported. For optimal surgical outcome, comprehensive management including assessments of a medical condition, nutrition, mental health, and social support is needed before and after surgery. However, there is still a lack of understanding regarding metabolic surgery in Korea. Therefore, this article reviews indications for metabolic surgery in patients with a specific focus on the situation in Korea.

Die polnischen Bücher (Bücherbestände in den Bibliotheken Roms. Eine Auswahl

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Ligia ALeksandra Henczel-Wróblewska

2017-11-01

Full Text Available Die italienisch-polnischen Beziehungen haben eine lange Geschichte hinter sich. Seit dem Mittelalter, in dem die polnischen Scholaren ihre Ausbildung an den italienischen Universitäten genießen konnten, dominierte darin der wissenschaftliche und bildende Charakter. In den folgenden Jahrhunderten wurde der gegenseitige Kontakt um die künstlerische Ebene erweitert, zumal die polnischen Künstler nach Italien reisten, um bei den besten Meistern ihre Fertigkeiten zu vervollkommnen. Seit dem Ende des 18. bis zur Mitte des 19. Jahrhunderts kam zu den bereits bestehenden, tradierten italienischpolnischen Beziehungen im Bereich der Wissenschaft und Kultur der militärische und der sozialpolitische Aspekt hinzu, und mit der Zeit auch der wirtschaftliche. Auf dem italienischen Boden beteiligten sich die Polen zunächst an den Unabhängigkeitskämpfen, die mit der Vereinigung Italiens (die Risorgimento-Zeit endeten, und nachher an den Waffeninterventionen während der zwei Weltkriege. Seit der Mitte des 20. Jahrhunderts kehrte man zum früheren beiderseitigen Kontakt auf verschiedenen Ebenen zurück.In jeder dieser Zeitspannen wurde die polnische Anwesenheit in Italien in den schriftlichen, ikonografischen, künstlerischen Quellen belegt. Die meisten davon bewährten sich in den Archiven und Bibliotheken Roms, dem Zentrum der europäischen Wissenschaft, Kultur und Christenheit. Erst im 20. Jahrhundert, seit der Entstehung der ersten wissenschaftlichen polnischen Institutionen in Rom und dank der breiten Zusammenarbeit war es möglich, die Polonica, die sich in den römischen Bibliotheken, Archiven, Kulturinstitutionen und Privatbeständen befinden, offiziell zu registrieren, bearbeiten und ordnen. Die schriftlichen Denkmäler aus den vergangenen Jahrhunderten weisen auf eine breite gegenseitige Beziehung sowohl im Bereich des sacrum als auch des profanum hin. Dieses gemeinsame historische Gedächtniserbe zeugt von einer langen Zugehörigkeit Polens zur

Mātes-meitas -attiecības Elfrīdes Jelinekas romānā "Klavierspēlētāja"

OpenAIRE

Martiņuka, Jekaterina

2014-01-01

Elfrīdes Jelinekas romānā visvairāk uzminība tiek koncentrēta uz attiecībām starp māti un meitu, kā arī šo attiecību tālāko ietekmi uz galvenās varones dzīvi. Šis darbs sniedz ieskatu pašas rakstnieces dzīvē, kā arī viņas bērnībā, no kurienes arī nākušas romānas vēsmas. Galvenās varones Ērikas uzvedībai ir cēloņi, kas nāk no viņas bērnibas, bet galvenokārt no viņas attiecībām ar pašas māti. Jelineka izveidoja autoritāru tēlu, māti, kura audzina savu bērnu savtīgiem nolūkiem, tajā pašā laik...

Cataract Surgery in Uveitis

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Rupesh Agrawal

2012-01-01

Full Text Available Cataract surgery in uveitic eyes is often challenging and can result in intraoperative and postoperative complications. Most uveitic patients enjoy good vision despite potentially sight-threatening complications, including cataract development. In those patients who develop cataracts, successful surgery stems from educated patient selection, careful surgical technique, and aggressive preoperative and postoperative control of inflammation. With improved understanding of the disease processes, pre- and perioperative control of inflammation, modern surgical techniques, availability of biocompatible intraocular lens material and design, surgical experience in performing complicated cataract surgeries, and efficient management of postoperative complications have led to much better outcome. Preoperative factors include proper patient selection and counseling and preoperative control of inflammation. Meticulous and careful cataract surgery in uveitic cataract is essential in optimizing the postoperative outcome. Management of postoperative complications, especially inflammation and glaucoma, earlier rather than later, has also contributed to improved outcomes. This manuscript is review of the existing literature and highlights the management pearls in tackling complicated cataract based on medline search of literature and experience of the authors.

Efeito antifúngico de tinturas de própolis e romã sobre espécies de Candida

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Leopoldina de Fátima Dantas de Almeida

2012-06-01

Full Text Available A utilização de produtos naturais na odontologia tem se mostrado como uma fonte alternativa no combate às patologias orais, incluindo as infecções fúngicas, causadas, geralmente, por Candida spp. Avaliar a ação antifúngica de tinturas de própolis Apis milifera e romã Punica granatum sobre Candida albicans (ATCC 76618, Candida krusei (ATCC 6538 e Candida tropicalis (ATCC 13803. A ação antifúngica das tinturas foi avaliada pelo método da Concentração Inibitória Mínima em meio de cultura sólido Ágar Saburaud Dextrose (Difco®. Foram confeccionados poços, com 6 mm de diâmetro, destinados a inserção de 50 µL das tinturas. Foram avaliadas seis concentrações seriadas das tinturas, sendo a concentração inicial para a tintura de própolis 200 mg/mL e 300 mg/mL a concentração inicial para a tintura de romã. Posteriormente, as placas de Petri foram incubadas em estufa bacteriológica por 48 h a 37 ºC. A análise dos dados para a Concentração Inibitória Mínima foi feita através da mensuração dos halos de inibição, sendo considerados quando iguais ou superiores a 10 mm de diâmetro. Para a tintura de romã observou-se que as Concentração Inibitória Mínima sobre Candida albicans, Candida krusei e Candida tropicalis foram 9,37 mg/mL, 9,37 mg/mL e 18,75 mg/mL, respectivamente. Em relação à tintura da própolis, constatou-se que apenas em sua forma pura apresentou ação antifúngica sobre Candida krusei e Candida tropicalis, entretanto a mesma ação não foi observada sobre Candida albicans. As tinturas avaliadas apresentam ação antifúngica sobre as cepas avaliadas, exceto a tintura da própolis sobre Candida albicans.

Fast-track video-assisted thoracoscopic surgery

DEFF Research Database (Denmark)

Holbek, Bo Laksafoss; Petersen, René Horsleben; Kehlet, Henrik

2016-01-01

Objectives To provide a short overview of fast-track video-assisted thoracoscopic surgery (VATS) and to identify areas requiring further research. Design A literature search was made using key words including: fast-track, enhanced recovery, video-assisted thoracoscopic surgery, robot......-assisted thoracoscopic surgery (RATS), robotic, thoracotomy, single-incision, uniportal, natural orifice transluminal endoscopic surgery (NOTES), chest tube, air-leak, digital drainage, pain management, analgesia, perioperative management, anaesthesia and non-intubated. References from articles were screened for further...

Oxidative stress ecology and the d-ROMs test: facts, misfacts and an appraisal of a decade’s work

OpenAIRE

Costantini, David

2016-01-01

In recent years, behavioural ecologists have taken to studying oxidative stress in free-ranging organisms because it has been proposed as an important mediator of life-history trade-offs. A plethora of methodological approaches to quantify biomarkers associated with oxidative stress exist, each one with its own strengths and weaknesses. The d-ROMs test has emerged as one of the favoured assays in ecological studies because of its reliability, sensitivity to specific perturbations of the organ...

Desponta novo ator no campo religioso brasileiro? O Padre Cícero Romão Batista

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Pierre Sanchis

2007-12-01

Full Text Available É em torno dos vários sentidos possíveis do qualificativo de "popular" que gira a problemática deste artigo. A figura carismática do Pe. Cícero Romão Batista, patriarca de Juazeiro, integra de há muito o panteão da devoção popular de milhões de romeiros, mas era objeto até hoje de amplas reservas no seio da Igreja oficial. O momento parece ser de revisão destas perspectivas. A reabilitação institucional do "padrinho" pode estar em curso. Pergunta-se aqui em que medida e com que condições esta transformação da sua imagem pode confluir com certa metamorfose do que se convencionou chamar de "Igreja Popular", de modo a dotar inesperadamente de novo ícone o catolicismo brasileiro em seu conjunto.The discussion presented in this paper turns around the several possible meanings of the qualifying adjective "popular". The charismatic figure of Father Cícero Romão Batista, Juazeiro's patriarch, has belonged, for many decades, to the pantheon of popular devotion of millions of pilgrims, but it is nevertheless still regarded with strong reserve inside the official Church. At the moment, it seems that this official position is being reviewed. An institutional rehabilitation of the "godfather" may well being under way. This being the case, the paper asks if, to what extent and under what conditions, can this transformation of Father Cícero's image flow together with certain metamorphosis of what has been named "Popular Church", so as to endow, even though unexpectedly, the Brazilian Catholicism with a new icon.

Advances in percutaneous stone surgery.

Science.gov (United States)

Hartman, Christopher; Gupta, Nikhil; Leavitt, David; Hoenig, David; Okeke, Zeph; Smith, Arthur

2015-01-01

Treatment of large renal stones has changed considerably in recent years. The increasing prevalence of nephrolithiasis has mandated that urologists perform more surgeries for large renal calculi than before, and this has been met with improvements in percutaneous stone surgery. In this review paper, we examine recent developments in percutaneous stone surgery, including advances in diagnosis and preoperative planning, renal access, patient position, tract dilation, nephroscopes, lithotripsy, exit strategies, and post-operative antibiotic prophylaxis.

[Demographic features and difficulties in rehabilitation in patients referred to hand rehabilitation unit for phalangeal fractures].

Science.gov (United States)

Sahin, Füsun; Yücel, Serap Dalgiç; Yilmaz, Figen; Ergöz, Ernur; Kuran, Banu

2006-01-01

We evaluated demographic and occupational features of patients with phalangeal fractures of the hand, etiologies and types of injuries, and the results of rehabilitation. The study included 91 fingers of 62 patients (54 males, 8 females; mean age 28+/-13 years; range 4 to 59 years) who were referred to our hand rehabilitation unit for phalangeal fractures. Demographic features, the cause and localization of injury, the type of surgery, time from surgery to rehabilitation, and the follow-up period were determined. At the end of rehabilitation, range of motion (ROM) of the phalangeal joint and total ROM of the injured fingers were assessed using the Strickland-Glogovac rating system. A great majority of injuries were caused by work accidents, followed by sport injuries and falls occurring in students. Sixty patients (96.8%) were right-handed. The fractures occurred in the dominant hand in 29 patients (46.8%). The majority of patients (n=45) were primary school graduates. The most common mechanism of injury was accidents related to heavy work machinery (n=18). The most commonly injured finger and the phalanx were the third finger (n=25, 27.5%) and the proximal phalanx (n=59, 56.7%), respectively. Only 27 patients (43.6%) had a sufficient follow-up with a mean of 79.7+/-46.6 days (range 30 to 254 days). Following rehabilitation, the mean ROM and the total ROM were 45.0+/-22.9 degrees and 63.3+/-16.1 degrees for the injured joint and the thumb, and 31.3+/-22.5 degrees and 122+/-60.3 degrees for the injured joint and the other fingers, respectively. Our data provide important insight into appropriate treatment and rehabilitation of phalangeal fractures, in particular, shortcomings in the treatment and follow-up.

The use of CD-ROMs for storage and document delivery at the British Library Document Supply Centre

International Nuclear Information System (INIS)

Bradbury, D.

1990-05-01

The British Library Document Supply Centre (BLDSC) has been in the forefront of international document delivery for 20 years. During the last 5 years it has been very actively involved in the ADONIS Project, through which the full text of some 200 journals in the life sciences have been stored, accessed, and delivered through the medium of CD-ROM. The BLDSC's involvement in this project is described and indications of the lessons learned and of the implications for international document delivery systems in the future are given. (author)

The use of CD-ROMs for storage and document delivery at the British Library Document Supply Centre

Energy Technology Data Exchange (ETDEWEB)

Bradbury, D [British Library Document Supply Centre, Boston SPA (United Kingdom)

1990-05-01

The British Library Document Supply Centre (BLDSC) has been in the forefront of international document delivery for 20 years. During the last 5 years it has been very actively involved in the ADONIS Project, through which the full text of some 200 journals in the life sciences have been stored, accessed, and delivered through the medium of CD-ROM. The BLDSC`s involvement in this project is described and indications of the lessons learned and of the implications for international document delivery systems in the future are given. (author).

Failed epilepsy surgery deserves a second chance.

Science.gov (United States)

Reed, Chrystal M; Dewar, Sandra; Fried, Itzhak; Engel, Jerome; Eliashiv, Dawn

2017-12-01

Resective epilepsy surgery has been shown to have up to 70-80% success rates in patients with intractable seizure disorder. Around 20-30% of patients with Engel Classification III and IV will require reevaluation for further surgery. Common reasons for first surgery failures include incomplete resection of seizure focus, incorrect identification of seizure focus and recurrence of tumor. Clinical chart review of seventeen patients from a single adult comprehensive epilepsy program who underwent reoperation from 2007 to 2014 was performed. High resolution Brain MRI, FDG-PET, Neuropsychometric testing were completed in all cases in both the original surgery and the second procedure. Postoperative outcomes were confirmed by prospective telephone follow up and verified by review of the patient's electronic medical records. Outcomes were classified according to the modified Engel classification system: Engel classes I and II are considered good outcomes. A total of seventeen patients (involving 10 females) were included in the study. The average age of patients at second surgery was 42 (range 23-64 years). Reasons for reoperation included: incomplete first resection (n=13) and recurrence of tumor (n=4). Median time between the first and second surgery was 60 months. After the second surgery, ten of the seventeen patients (58.8%) achieved seizure freedom (Engel Class I), in agreement with other published reports. Of the ten patients who were Engel Class I, seven required extension of the previous resection margins, while three had surgery for recurrence of previously partially resected tumor. We conclude that since the risk of complications from reoperation is low and the outcome, for some, is excellent, consideration of repeat surgery is justified. Copyright © 2017 Elsevier B.V. All rights reserved.

Principiile organizării administrației publice locale consacrate de Constituția României și de legea nr. 69/1991

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Rodica PETRESCU

1999-01-01

Full Text Available Constituţia României în art. 119 prevede că administraţia publică din unităţile administrativ-teritoriale se întemeiază pe principiul autonomiei locale şi pe cel al descentralizării serviciilor publice.

Cardiac surgery in the parturient.

Science.gov (United States)

Chandrasekhar, Shobana; Cook, Christopher R; Collard, Charles D

2009-03-01

Heart disease is the primary cause of nonobstetric mortality in pregnancy, occurring in 1%-3% of pregnancies and accounting for 10%-15% of maternal deaths. Congenital heart disease has become more prevalent in women of childbearing age, representing an increasing percentage (up to 75%) of heart disease in pregnancy. Untreated maternal heart disease also places the fetus at risk. Independent predictors of neonatal complications include a maternal New York Heart Association heart failure classification >2, anticoagulation use during pregnancy, smoking, multiple gestation, and left heart obstruction. Because cardiac surgical morbidity and mortality in the parturient is higher than nonpregnant patients, most parturients with cardiac disease are first managed medically, with cardiac surgery being reserved when medical management fails. Risk factors for maternal mortality during cardiac surgery include the use of vasoactive drugs, age, type of surgery, reoperation, and maternal functional class. Risk factors for fetal mortality include maternal age >35 yr, functional class, reoperation, emergency surgery, type of myocardial protection, and anoxic time. Nonetheless, acceptable maternal and fetal perioperative mortality rates may be achieved through such measures as early preoperative detection of maternal cardiovascular decompensation, use of fetal monitoring, delivery of a viable fetus before the operation and scheduling surgery on an elective basis during the second trimester. Additionally, fetal morbidity may be reduced during cardiopulmonary bypass by optimizing maternal oxygen-carrying capacity and uterine blood flow. Current maternal bypass recommendations include: 1) maintaining the pump flow rate >2.5 L x min(-1) x m(-2) and perfusion pressure >70 mm Hg; 2) maintaining the hematocrit > 28%; 3) using normothermic perfusion when feasible; 4) using pulsatile flow; and 5) using alpha-stat pH management.

Información relevante que pasa a ser anecdótica: aerinita en las pinturas murales románicas de San Martín de Elines (Cantabria

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M. Rosa Tera Saavedra

2015-12-01

Full Text Available Ante la dificultad de consultar datos materiales y analíticas provenientes de intervenciones existentes relacionadas con el Patrimonio Cultural, el presente artículo plantea la necesidad de establecer parámetros normalizados y accesibles que aglutinen información de memorias técnicas. Como ejemplo de la funcionalidad que podría derivarse de esta propuesta se analiza cómo podría beneficiar su uso en el caso de las pinturas románicas de San Martín de Elines (Cantabria cuya analítica de materiales presenta dos parámetros fuera del contexto geográfico donde están ubicadas y que las relaciona matéricamente con las pinturas románicas del Valle del Boí.

Students' and teachers' perceptions of motivation and learning through the use in schools of multimedia encyclopaedias on CD-ROM

OpenAIRE

Wishart , Jocelyn

2000-01-01

This article is the result of interviews with teachers, students, and school librarians in eight UK secondary schools regarding their use of multimedia encyclopaedias on CD-ROM. It focuses on a content analysis of their comments on how having access to multimedia encyclopaedias changes the way students work and learn in school, how they perceive it enhances their learning, and how it hinders it. Teachers reported that they used multimedia encyclopaedias as an additional information resource, ...

Rodding Surgery

Science.gov (United States)

... Physical activity prior to surgery,  Length of the operation; anesthesia issues,  Reason for the choice of rod,  Time in the hospital,  Length of recovery time at home,  Pain management including control of muscle spasms,  The rehabilitation plan. ...

Removing intranasal splints after septal surgery.

Science.gov (United States)

Aksoy, Elif; Serin, Gediz Murat; Polat, Senol; Kaytaz, Asm

2011-05-01

The aim of this retrospective chart review of the patients who had septal surgery with or without turbinate surgery was to compare the postoperative complication rates according to the time of intranasal-splint (INS) removal. The data of 137 patients who underwent septal surgery with or without turbinate surgery at 2 different hospitals of Acıbadem Health Care Group between January 2007 and March 2009 were retrospectively evaluated. The patients who had these risk factors were eliminated, and 96 patients were included in this study. The patients were divided into 2 groups according to splint-removal time. The first group comprises patients whose nasal splints were removed in 24 hours after surgery, and the second group comprises patients whose splints were removed 5 days after the surgery. Any bleeding, septal hematoma, and synechia after pack removal were recorded. Analysis of the rate of complications was done with the χ test. Sixty-five male and 31 female patients with a mean age of 32.4 years (range, 18-57 years) were included in the study groups. Septal surgeries were performed in association with turbinate surgery in all 96 patients. These patients were divided into 2 groups. In the first group (n = 50), INSs were removed in 24 hours after surgery. In the second group (n = 46), INSs were removed 5 days after surgery. Bleeding within the first postoperative week was not recorded in both groups. Late bleeding was recorded in 2% (n = 1) of group 1 and in 2.17% (n = 1) in group 2. Septal hematoma and synechia were not recorded in none of the groups. The results were not statistically significant (P = 1). The routine use of INSs after septoplasty and removing them 24 hours after septoplasty are sufficient to avoid postoperative complications, and it minimizes postoperative discomfort.

[Advantages and disadvantages of minimally invasive surgery in colorectal cancer surgery].

Science.gov (United States)

Zheng, Minhua; Ma, Junjun

2017-06-25

Since the emergence of minimally invasive technology twenty years ago, as a surgical concept and surgical technique for colorectal cancer surgery, its obvious advantages have been recognized. Laparoscopic technology, as one of the most important technology platform, has got a lot of evidence-based support for the oncological safety and effectiveness in colorectal cancer surgery Laparoscopic technique has advantages in terms of identification of anatomic plane and autonomic nerve, protection of pelvic structure, and fine dissection of vessels. But because of the limitation of laparoscopic technology there are still some deficiencies and shortcomings, including lack of touch and lack of stereo vision problems, in addition to the low rectal cancer, especially male, obese, narrow pelvis, larger tumors, it is difficult to get better view and manipulating triangle in laparoscopy. However, the emergence of a series of new minimally invasive technology platform is to make up for the defects and deficiencies. The robotic surgical system possesses advantages, such as stereo vision, higher magnification, manipulator wrist with high freedom degree, filtering of tremor and higher stability, but still has disadvantages, such as lack of haptic feedback, longer operation time, high operation cost and expensive price. 3D system of laparoscopic surgery has similar visual experience and feelings as robotic surgery in the 3D view, the same operating skills as 2D laparoscopy and a short learning curve. The price of 3D laparoscopy is also moderate, which makes the 3D laparoscopy more popular in China. Transanal total mesorectal excision (taTME) by changing the traditional laparoscopic pelvic surgery approach, may have certain advantages for male cases with narrow pelvic and patients with large tumor, and it is in accordance with the technical concept of natural orifice, with less minimally invasive and better cosmetics, which can be regarded as a supplemental technique of the

El violón de Domingo Román (Valladolid, 1724

Directory of Open Access Journals (Sweden)

Reula Baquero, Pedro

2009-12-01

Full Text Available Domingo Roman’s cello is one of the very few surviving Spanish bowed instruments from the eighteenth century. This article basically pretends to present and describe this recently rediscovered instrument by analising it’s very peculiar way of construction, comparing it with the informations we have about the Spanish school of making from sixteen till eighteenth century and other contemporary schools like the fl amish and the german one.

El violón de Domingo Román (Valladolid, 1724 viene a enriquecer la escasa nómina de instrumentos de arco españoles conservados del siglo XVIII. Este artículo pretende ser, básicamente, una presentación y descripción del violón. El análisis del contexto estilístico trata de poner en relación sus peculiares características constructivas con las de la escuela española de los violeros de los siglos XVI a XVIII y con otras europeas como la fl amenca y alemana.

Bariatric Surgery for Obesity.

Science.gov (United States)

le Roux, Carel W; Heneghan, Helen M

2018-01-01

In this review, the authors discuss the indications for and the published outcomes of commonly performed bariatric procedures, including weight loss, perioperative morbidity and mortality, late complications, as well as the impact of bariatric surgery on comorbidities, cardiovascular risk, and mortality. They also briefly discuss the mechanisms by which bariatric/metabolic surgery causes such significant weight loss and health gain. Copyright © 2017 Elsevier Inc. All rights reserved.

Bariatric surgery and the changing current scope of general surgery practice: implications for general surgery residency training.

Science.gov (United States)

Mostaedi, Rouzbeh; Ali, Mohamed R; Pierce, Jonathan L; Scherer, Lynette A; Galante, Joseph M

2015-02-01

The scope of general surgery practice has evolved tremendously in the last 20 years. However, clinical experience in general surgery residency training has undergone relatively little change. To evaluate the current scope of academic general surgery and its implications on surgical residency. The University HealthSystem Consortium and Association of American Medical Colleges established the Faculty Practice Solution Center (FPSC) to characterize physician productivity. The FPSC is a benchmarking tool for academic medical centers created from revenue data collected from more than 90,000 physicians who practice at 95 institutions across the United States. The FPSC database was queried to evaluate the annual mean procedure frequency per surgeon (PFS) in each calendar year from 2006 through 2011. The associated work relative value units (wRVUs) were also examined to measure physician effort and skill. During the 6-year period, 146 distinct Current Procedural Terminology codes were among the top 100 procedures, and 16 of these procedures ranked in the top 10 procedures in at least 1 year. The top 10 procedures accounted for more than half (range, 52.5%-57.2%) of the total 100 PFS evaluated for each year. Laparoscopic Roux-en-Y gastric bypass was consistently among the top 10 procedures in each year (PFS, 18.2-24.6). The other most frequently performed procedures included laparoscopic cholecystectomy (PFS, 30.3-43.5), upper gastrointestinal tract endoscopy (PFS, 26.5-34.3), mastectomy (PFS, 16.5-35.0), inguinal hernia repair (PFS, 15.5-22.1), and abdominal wall hernia repair (PFS, 21.6-26.1). In all years, laparoscopic Roux-en-Y gastric bypass generated the highest number of wRVUs (wRVUs, 491.0-618.2), and laparoscopic cholecystectomy was regularly the next highest (wRVUs, 335.8-498.7). A significant proportion of academic general surgery is composed of bariatric surgery, yet surgical training does not sufficiently emphasize the necessary exposure to technical expertise

Overview of Facial Plastic Surgery and Current Developments

Science.gov (United States)

Chuang, Jessica; Barnes, Christian; Wong, Brian J. F.

2016-01-01

Facial plastic surgery is a multidisciplinary specialty largely driven by otolaryngology but includes oral maxillary surgery, dermatology, ophthalmology, and plastic surgery. It encompasses both reconstructive and cosmetic components. The scope of practice for facial plastic surgeons in the United States may include rhinoplasty, browlifts, blepharoplasty, facelifts, microvascular reconstruction of the head and neck, craniomaxillofacial trauma reconstruction, and correction of defects in the face after skin cancer resection. Facial plastic surgery also encompasses the use of injectable fillers, neural modulators (e.g., BOTOX Cosmetic, Allergan Pharmaceuticals, Westport, Ireland), lasers, and other devices aimed at rejuvenating skin. Facial plastic surgery is a constantly evolving field with continuing innovative advances in surgical techniques and cosmetic adjunctive technologies. This article aims to give an overview of the various procedures that encompass the field of facial plastic surgery and to highlight the recent advances and trends in procedures and surgical techniques. PMID:28824978

Surgery preceding orthodontics in bimaxillary cases

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B Saravana Kumar

2015-01-01

Full Text Available Orthognathic surgery is performed to alter the shape of the jaws to increase the facial esthetic and improve the occlusions. Surgery prior orthodontics reduces the total length of the treatment of the patients, followed by orthodontics treatment. Advantages is positive outcome in short period of time. Surgical procedure includes Anterior Maxillary osteotomy and Anterior subapical mandibular osteotomy. Complication includes haemorrhage, paraesthesia, malunion of bone, etc.

Propagação vegetativa de romã com material vegetal de diferentes origens sob tipos de substratos

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Romulo Magno Oliveira de Freitas

2017-02-01

Full Text Available Objetivou-se com o presente trabalho verificar a influência de diferentes procedências do material vegetal e substratos na propagação vegetativa de romã (Punica granatum L.. Foi usado o delineamento estatístico inteiramente casualizado em esquema fatorial 2x3, sendo duas origens do material vegetal (Barreiras, CE e Mossoró, RN e três substratos (Tropstrato®, Fibra de coco e Solo, constituindo 6 tratamentos em quatro repetições de cinco estacas. As estacas foram preparadas com o auxilio de uma tesoura de poda, coletadas na posição mediana do ramo, padronizadas para o diâmetro de 2 a 4 mm. Aos 45 dias foram avaliados o número de brotos por estaca, comprimento do maior broto, número de folhas por estacas, comprimento da maior raiz, percentagem de estacas enraizadas, número de raízes por estaca, massa seca da brotação e massa seca do sistema radicular. A propagação por estaquia de romã é influenciada pela origem do material vegetal e o melhor material é de Barreiras, CE. Recomenda-se o substrato Tropstrato® para a produção de mudas de romã por estaquia.Vegetative propagation of pomegranate with vegetal material of different origins under types of substratesAbstract: The objective of this study to investigate the influence of different sources of plant material and substrates in the vegetative propagation of pomegranate (Punica granatum L.. The statistical design was completely randomized in a 2x3 factorial, with two origins of the plant material collected (Barreiras, CE and Mossoró, RN and three substrates (Tropstrato®, Coconut fiber and soil, constituting six treatments and four replications. Each replication consisted of five cuttings. Cuttings were prepared with the aid of a pruning shears collected in the median position of the branch for the standardized diameter of 2 to 4 mm. At 45 days, we assessed the number of shoots per cutting, length of the longest shoot, number of leaves per cutting, length of roots

Surgery for trigger finger.

Science.gov (United States)

Fiorini, Haroldo Junior; Tamaoki, Marcel Jun; Lenza, Mário; Gomes Dos Santos, Joao Baptista; Faloppa, Flávio; Belloti, Joao Carlos

2018-02-20

Trigger finger is a common clinical disorder, characterised by pain and catching as the patient flexes and extends digits because of disproportion between the diameter of flexor tendons and the A1 pulley. The treatment approach may include non-surgical or surgical treatments. Currently there is no consensus about the best surgical treatment approach (open, percutaneous or endoscopic approaches). To evaluate the effectiveness and safety of different methods of surgical treatment for trigger finger (open, percutaneous or endoscopic approaches) in adults at any stage of the disease. We searched CENTRAL, MEDLINE, Embase and LILACS up to August 2017. We included randomised or quasi-randomised controlled trials that assessed adults with trigger finger and compared any type of surgical treatment with each other or with any other non-surgical intervention. The major outcomes were the resolution of trigger finger, pain, hand function, participant-reported treatment success or satisfaction, recurrence of triggering, adverse events and neurovascular injury. Two review authors independently selected the trial reports, extracted the data and assessed the risk of bias. Measures of treatment effect for dichotomous outcomes calculated risk ratios (RRs), and mean differences (MDs) or standardised mean differences (SMD) for continuous outcomes, with 95% confidence intervals (CIs). When possible, the data were pooled into meta-analysis using the random-effects model. GRADE was used to assess the quality of evidence for each outcome. Fourteen trials were included, totalling 1260 participants, with 1361 trigger fingers. The age of participants included in the studies ranged from 16 to 88 years; and the majority of participants were women (approximately 70%). The average duration of symptoms ranged from three to 15 months, and the follow-up after the procedure ranged from eight weeks to 23 months.The studies reported nine types of comparisons: open surgery versus steroid injections (two

España y sus castillos : la Guerra de Independencia y la iconografía romántica

Directory of Open Access Journals (Sweden)

Lily Litvak

2012-01-01

Full Text Available En los primeros años del siglo XIX, España era considerada como un país atrasado, peligroso y fanático. Esta opinión cambió con la Guerra de Independencia (1808-1814. El levantamiento del pueblo contra el poderoso invasor francés ratificaba la idea romántica de la nación como ser vivo. La alianza con Inglaterra hizo que esa revalorización se llevara a cabo en ese país a nivel político, literario y artístico. La consideración de España como país romántico atrajo a muchos viajeros que descubrieron su herencia medieval y su pasado islámico, entre ellos a diversos pintores y dibujantes ingleses que en sus escritos, láminas y pinturas revelaron las bellezas monumentales de España.Before the Peninsular War, Spain was considered a backward, dangerous and fanatical country. The war, waged by the Spanish people against the powerful French invader, revealed a different image, and confirmed the Romantic idea of a nation. In England this reconsideration was political, literary and artistic. The reputation of Spain as the archetypal Romantic country attracted many travelers that discovered Spain’s magnificent Medieval and Islamic heritage.Amongst them were several British artists who in their work revealed Spain’s monumental treasures.

Impact of enhanced recovery after surgery programs on pancreatic surgery: A meta-analysis.

Science.gov (United States)

Ji, Hai-Bin; Zhu, Wen-Tao; Wei, Qiang; Wang, Xiao-Xiao; Wang, Hai-Bin; Chen, Qiang-Pu

2018-04-21

To evaluate the impact of enhanced recovery after surgery (ERAS) programs on postoperative complications of pancreatic surgery. Computer searches were performed in databases (including PubMed, Cochrane Library and Embase) for randomized controlled trials or case-control studies describing ERAS programs in patients undergoing pancreatic surgery published between January 1995 and August 2017. Two researchers independently evaluated the quality of the studies' extracted data that met the inclusion criteria and performed a meta-analysis using RevMan5.3.5 software. Forest plots, demonstrating the outcomes of the ERAS group vs the control group after pancreatic surgery, and funnel plots were used to evaluate potential publication bias. Twenty case-control studies including 3694 patients, published between January 1995 and August 2017, were selected for the meta-analysis. This study included the ERAS group ( n = 1886) and the control group ( n = 1808), which adopted the traditional perioperative management. Compared to the control group, the ERAS group had lower delayed gastric emptying rates [odds ratio (OR) = 0.58, 95% confidence interval (CI): 0.48-0.72, P < 0.00001], lower postoperative complication rates (OR = 0.57, 95%CI: 0.45-0.72, P < 0.00001), particularly for the mild postoperative complications (Clavien-Dindo I-II) (OR = 0.71, 95%CI: 0.58-0.88, P = 0.002), lower abdominal infection rates (OR = 0.70, 95%CI: 0.54-0.90, P = 0.006), and shorter postoperative length of hospital stay (PLOS) (WMD = -4.45, 95%CI: -5.99 to -2.91, P < 0.00001). However, there were no significant differences in complications, such as, postoperative pancreatic fistulas, moderate to severe complications (Clavien-Dindo III- V), mortality, readmission and unintended reoperation, in both groups. The perioperative implementation of ERAS programs in pancreatic surgery is safe and effective, can decrease postoperative complication rates, and can promote recovery for patients.

[Laparoscopic surgery for perforated peptic ulcer].

Science.gov (United States)

Yasuda, Kazuhiro; Kitano, Seigo

2004-03-01

Laparoscopic surgery has become the treatment of choice for the management of perforated peptic ulcer. The advantages of laparoscopic repair for perforated peptic ulcer include less pain, a short hospital stay, and an early return to normal activity. Although the operation time of laparoscopic surgery is significantly longer than that of open surgery, laparoscopic technique is safe, feasible, and with morbidity and mortality comparable to that of the conventional open technique. To benefit from the advantages offered by minimally invasive laparoscopic technique, further study will need to determine whether laparoscopic surgery is safe in patients with generalized peritonitis or sepsis.

Does bariatric surgery improve adipose tissue function?

Science.gov (United States)

Frikke-Schmidt, H.; O’Rourke, R. W.; Lumeng, C. N.; Sandoval, D. A.; Seeley, R. J.

2017-01-01

Summary Bariatric surgery is currently the most effective treatment for obesity. Not only do these types of surgeries produce significant weight loss but also they improve insulin sensitivity and whole body metabolic function. The aim of this review is to explore how altered physiology of adipose tissue may contribute to the potent metabolic effects of some of these procedures. This includes specific effects on various fat depots, the function of individual adipocytes and the interaction between adipose tissue and other key metabolic tissues. Besides a dramatic loss of fat mass, bariatric surgery shifts the distribution of fat from visceral to the subcutaneous compartment favoring metabolic improvement. The sensitivity towards lipolysis controlled by insulin and catecholamines is improved, adipokine secretion is altered and local adipose inflammation as well as systemic inflammatory markers decreases. Some of these changes have been shown to be weight loss independent, and novel hypothesis for these effects includes include changes in bile acid metabolism, gut microbiota and central regulation of metabolism. In conclusion bariatric surgery is capable of improving aspects of adipose tissue function and do so in some cases in ways that are not entirely explained by the potent effect of surgery. PMID:27272117

Natural orifice translumenal endoscopic surgery (NOTES) for innovation in hepatobiliary and pancreatic surgery: preface.

Science.gov (United States)

Sugimoto, Maki

2009-01-01

Natural orifice translumenal endoscopic surgery (NOTES) has captured the interest of interventional endoscopists and may represent the next stage of evolution of minimally invasive surgery. It provides the potential for performance of incisionless operations. It is gaining momentum both in the animal laboratory and in human case reports. Developments in the field of NOTES have led to the formation of the Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR) in 2006. In this special issue, the current trends in NOTES in the field of hepatobiliary and pancreatic surgery are featured, including NOTES cholecystectomy, hepatectomy splenectomy, pancreatic necrosectomy, and the future of NOTES. In this issue, we discuss the potential benefits of these procedures in hepatobiliary and pancreatic surgery. We have just started the evaluation process for this new technology. The concept of NOTES is becoming established and is enormously advantageous for the patient. Both the surgeon and gastroenterologist should contribute to developing NOTES in making use of their specialties.

El suicidio en la novela romántica cubana

Directory of Open Access Journals (Sweden)

Abdeslam Azougarh

2012-08-01

Full Text Available Souligner les traits spécifiques de pays récemment indépendants, avec l'intention de créer chez les différents secteurs de la population hispano-américaine une mentalité appropriée pour la consolidation de nations nouvelles et souveraines est une des caractéristiques les plus importantes du romantisme hispano-américain. Il s’agit d’examiner la dimension idéologique de l’exposition nationaliste et américaniste des écrivains en nous basant sur la représentation du suicide principalement dans le roman romantique cubain Cecilia Valdés o la Loma del ángel de Cirilo Villaverde.Destacar los rasgos diferenciales de los países recién independizados con el objetivo de crear entre los distintos sectores de la población hispanoamericana de una mentalidad apropiada para la consolidación de naciones nuevas y soberanas es una de las características más importantes del romanticismo hispanoamericano.Se trata de examinar la dimensión ideológica del planteamiento nacionalista y americanista de los escritores basándonos en la representación del suicidio principalmente en la novela romántica cubana Cecilia Valdés o la Loma del ángel de Cirilo Villaverde.

Early versus delayed rehabilitation following arthroscopic rotator cuff repair: A systematic review.

Science.gov (United States)

Gallagher, Brian P; Bishop, Meghan E; Tjoumakaris, Fotios P; Freedman, Kevin B

2015-05-01

Early passive range of motion (ROM) following arthroscopic cuff repair is thought to decrease postoperative stiffness and improve functionality. However, early aggressive rehabilitation may compromise repair integrity. Our purpose was to perform a systematic review to determine if there are differences between early and delayed rehabilitation after arthroscopic rotator cuff repair in terms of clinical outcomes and healing. We performed a literature search with the terms 'arthroscopic rotator cuff', 'immobilization', 'early', 'delayed', 'late', and 'rehabilitation' using PubMed, Cochrane Central Register of Controlled Trials, and EMBASE. Selection criteria included: level I/II evidence ≤ 6 months in duration, comparing early versus delayed rehabilitation following arthroscopic repair. Data regarding demographics, sample sizes, duration, cuff pathology, surgery, rehabilitation, functional outcomes, pain, ROM and anatomic assessment of healing were analyzed. PRIMSA criteria were followed. We identified six articles matching our criteria. Three reported significantly increased functional scores within the first 3-6 months with early rehabilitation compared to the delayed group, only one of which continued to observe a difference at a final follow-up of 15 months. Four articles showed improved ROM in the first 3-6 months post-operatively with early rehabilitation. One noted transient differences in pain scores. Only one study noted significant differences in ROM at final follow-up. No study reported any significant difference in rates of rotator cuff re-tear. However, two studies noted a trend towards increased re-tear with early rehabilitation that did not reach significance. This was more pronounced in studies including medium-large tears. Early rehabilitation after arthroscopic cuff repair is associated with some initial improvements in ROM and function. Ultimately, similar clinical and anatomical outcomes between groups existed at 1 year. While there was no

GENERAL SURGERY

African Journals Online (AJOL)

Department of Surgery, University of Cape Town Health Sciences Faculty, Groote Schuur Hospital, Observatory, Cape Town,. South Africa ... included all district, regional and tertiary hospitals in the nine provinces. Clinics and so-called ..... large contingency of senior general surgeons from countries such as Cuba, who have ...

Perioperative brain damage after cardiovascular surgery; Clinical evaluation including CT scans

Energy Technology Data Exchange (ETDEWEB)

Maruyama, Michiyuki; Kuriyama, Yoshihiro; Sawada, Toru; Fujita, Tsuyoshi; Omae, T. (National Cardiovascular Center, Suita, Osaka (Japan))

1989-08-01

We examined 39 cases (1.6%) of post-operative brain damages out of 2,445 sequential cases of cardiovascular surgery in NCVC during past three years. In this study, we investigated clinical course and CT findings of each patient in details and analyzed the causes of the post operative brain damages. Of 39 cases, 23 (59%) were complicated with cerebral ischemia, 8 (21%) with subdural hematoma (SDH), 2 (5%) with intracranial hemorrhage (ICH) and 1 (2%) with subarachnoid hemorrhage (SAH), respectively. 5 cases (13%) had unclassified brain damages. In 23 cases of cerebral ischemia there were 5 cases of hypotension-induced ischemia, 4 cases of hypoxic encephalopathy, 3 cases of ischemia induced by intra-operative maneuvers, 3 cases of embolism after operation and a single case of 'microembolism'. Seven cases could not be classified into any of these categories. Duration of ECC was 169.9 {plus minus} 48.5 min on the average in patients with such brain damages as SDH, ICH, SAH and cardiogenic embolism, which were thought not to be related with ECC. On the other hand, that of the patients hypotensive ischemia or 'microembolism' gave an average value of 254.5 {plus minus} 96.8 min. And these patients were thought to have occurred during ECC. There was a statistically significant difference between these two mean values. (J.P.N.).

Gender reassignment surgery: an overview.

Science.gov (United States)

Selvaggi, Gennaro; Bellringer, James

2011-05-01

Gender reassignment (which includes psychotherapy, hormonal therapy and surgery) has been demonstrated as the most effective treatment for patients affected by gender dysphoria (or gender identity disorder), in which patients do not recognize their gender (sexual identity) as matching their genetic and sexual characteristics. Gender reassignment surgery is a series of complex surgical procedures (genital and nongenital) performed for the treatment of gender dysphoria. Genital procedures performed for gender dysphoria, such as vaginoplasty, clitorolabioplasty, penectomy and orchidectomy in male-to-female transsexuals, and penile and scrotal reconstruction in female-to-male transsexuals, are the core procedures in gender reassignment surgery. Nongenital procedures, such as breast enlargement, mastectomy, facial feminization surgery, voice surgery, and other masculinization and feminization procedures complete the surgical treatment available. The World Professional Association for Transgender Health currently publishes and reviews guidelines and standards of care for patients affected by gender dysphoria, such as eligibility criteria for surgery. This article presents an overview of the genital and nongenital procedures available for both male-to-female and female-to-male gender reassignment.

Breast conserving surgery versus mastectomy

DEFF Research Database (Denmark)

Christiansen, Peer; Carstensen, Stina Lyck; Ejlertsen, Bent

2018-01-01

Background: Observational studies have pointed at a better survival after breast conserving surgery (BCS) compared with mastectomy. The aim of the present study was to evaluate whether this remains true when more extensive tumor characteristics and treatment data were included. Methods: The cohort...... included patients registered after primary surgery for early invasive breast cancer in the database of the Danish Breast Cancer Cooperative Group, in the period 1995–2012. The cohort was divided into three groups: (i) patients who primarily had a mastectomy, (ii) patients treated by BCS, and (iii) patients...

The Lunar Source Disk: Old Lunar Datasets on a New CD-ROM

Science.gov (United States)

Hiesinger, H.

1998-01-01

A compilation of previously published datasets on CD-ROM is presented. This Lunar Source Disk is intended to be a first step in the improvement/expansion of the Lunar Consortium Disk, in order to create an "image-cube"-like data pool that can be easily accessed and might be useful for a variety of future lunar investigations. All datasets were transformed to a standard map projection that allows direct comparison of different types of information on a pixel-by pixel basis. Lunar observations have a long history and have been important to mankind for centuries, notably since the work of Plutarch and Galileo. As a consequence of centuries of lunar investigations, knowledge of the characteristics and properties of the Moon has accumulated over time. However, a side effect of this accumulation is that it has become more and more complicated for scientists to review all the datasets obtained through different techniques, to interpret them properly, to recognize their weaknesses and strengths in detail, and to combine them synoptically in geologic interpretations. Such synoptic geologic interpretations are crucial for the study of planetary bodies through remote-sensing data in order to avoid misinterpretation. In addition, many of the modem datasets, derived from Earth-based telescopes as well as from spacecraft missions, are acquired at different geometric and radiometric conditions. These differences make it challenging to compare or combine datasets directly or to extract information from different datasets on a pixel-by-pixel basis. Also, as there is no convention for the presentation of lunar datasets, different authors choose different map projections, depending on the location of the investigated areas and their personal interests. Insufficient or incomplete information on the map parameters used by different authors further complicates the reprojection of these datasets to a standard geometry. The goal of our efforts was to transfer previously published lunar

Laparoscopic Spine Surgery

Science.gov (United States)

... the frontal approach takes advantage of normal tissue planes and does not require removal of any bone. ... to the “open” procedure may include: Obesity A history of prior abdominal surgery causing dense scar tissue ...

Long-Term Stability of Pre-Orthodontic Orthognathic Bimaxillary Surgery Using Intraoral Vertical Ramus Osteotomy Versus Conventional Surgery.

Science.gov (United States)

Jeong, Jeong-Hwa; Choi, Sung-Hwan; Kim, Kee-Deog; Hwang, Chung-Ju; Lee, Sang-Hwy; Yu, Hyung-Seog

2018-02-20

The aim of the present study was to compare the long-term stability of bimaxillary surgery using an intraoral vertical ramus osteotomy (IVRO) with and without presurgical orthodontic treatment. The present retrospective study included 31 consecutive patients with skeletal Class III malocclusions who had undergone bimaxillary surgery (Le Fort I osteotomy and bilateral IVRO). Patients were divided into 2 groups based on treatment type: pre-orthodontic orthognathic surgery (POGS; n = 17) and conventional surgery with presurgical orthodontic treatment (CS; n = 14). Lateral cephalograms were obtained before surgery, 1 day after surgery, 1 month after surgery, 1 year after surgery, and 2 years after surgery to evaluate skeletal and soft tissue changes between the 2 groups. Data were analyzed using χ 2 tests, Mann-Whitney U tests, repeated-measures analyses of variance, and independent t tests. There was no significant difference in skeletal or soft tissue measurements-with the exception of the angle between the sella-and-nasion plane and the occlusal plane (SN-OP; P surgery. These findings suggest that POGS and CS have similar long-term stability in patients with skeletal Class III malocclusion. Copyright © 2018. Published by Elsevier Inc.

Brachial Plexopathy After Cervical Spine Surgery.

Science.gov (United States)

Than, Khoi D; Mummaneni, Praveen V; Smith, Zachary A; Hsu, Wellington K; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

2017-04-01

Retrospective, multicenter case-series study and literature review. To determine the prevalence of brachial plexopathy after cervical spine surgery and to review the literature to better understand the etiology and risk factors of brachial plexopathy after cervical spine surgery. A retrospective case-series study of 12 903 patients at 21 different sites was performed to analyze the prevalence of several different complications, including brachial plexopathy. A literature review of the US National Library of Medicine and the National Institutes of Health (PubMed) database was conducted to identify articles pertaining to brachial plexopathy following cervical spine surgery. In our total population of 12 903 patients, only 1 suffered from postoperative brachial plexopathy. The overall prevalence rate was thus 0.01%, but the prevalence rate at the site where this complication occurred was 0.07%. Previously reported risk factors for postoperative brachial plexopathy include age, anterior surgical procedures, and a diagnosis of ossification of the posterior longitudinal ligament. The condition can also be due to patient positioning during surgery, which can generally be detected via the use of intraoperative neuromonitoring. Brachial plexopathy following cervical spine surgery is rare and merits further study.

FUNCTIONAL IMPROVEMENT UP TO SIX MONTHS AFTER TOTAL KNEE ARTHROPLASTY: MEASURED BY KNEE RANGE OF MOTION AND SELF-REPORTED QUESTIONNAIRE

Directory of Open Access Journals (Sweden)

Mirjana Kocić

2015-12-01

Full Text Available The primary aim of this study was to assess knee range of motion (ROM as well as patients’ reported pain, stiffness and function up to six months after total knee arthroplasty (TKA. The secondary aim was to analyze the extent to which knee ROM correlates with patient-rated outcome. A prospective study included 60 patients with primary TKA for osteorthritis, admitted at Physical Medicine and Rehabilitation Clinic from April 2009 to October 2014. The patients were evaluated at 4 time points: at admission and at discharge, as well as at follow-up at 3 and at 6 months after surgery. The outcome parameters included: active knee ROM, as well as pain, stiffness and function according to self reported Western Ontario and McMaster Universities Osteoarthritis (WOMAC questionnaire. Statistically highly significant improvement in flexion and extension was observed from admission to all other assessment time points (p<0.001. Also, statistically significant improvement of all three WOMAC subscales (pain, stiffness and function was found between all assessments points (p<0.001. According to values of Spearman correlation coefficient, there was significant negative correlation of flexion with all WOMAC subscales at all assessment points, whereas correlation of extension with any assessed outcome parameter was without significance. It can be concluded that in TKA patients all outcome measures improved significantly from admission to 6 months follow-up. Knee flexion ROM negatively and moderately to strongly correlated with pain, stiffness and function, whereas correlation of extension with any assessed outcome measure was without significance.

Perioperative Rosuvastatin in Cardiac Surgery.

Science.gov (United States)

Zheng, Zhe; Jayaram, Raja; Jiang, Lixin; Emberson, Jonathan; Zhao, Yan; Li, Qi; Du, Juan; Guarguagli, Silvia; Hill, Michael; Chen, Zhengming; Collins, Rory; Casadei, Barbara

2016-05-05

Complications after cardiac surgery are common and lead to substantial increases in morbidity and mortality. Meta-analyses of small randomized trials have suggested that perioperative statin therapy can prevent some of these complications. We randomly assigned 1922 patients in sinus rhythm who were scheduled for elective cardiac surgery to receive perioperative rosuvastatin (at a dose of 20 mg daily) or placebo. The primary outcomes were postoperative atrial fibrillation within 5 days after surgery, as assessed by Holter electrocardiographic monitoring, and myocardial injury within 120 hours after surgery, as assessed by serial measurements of the cardiac troponin I concentration. Secondary outcomes included major in-hospital adverse events, duration of stay in the hospital and intensive care unit, left ventricular and renal function, and blood biomarkers. The concentrations of low-density lipoprotein cholesterol and C-reactive protein after surgery were lower in patients assigned to rosuvastatin than in those assigned to placebo (PSTICS ClinicalTrials.gov number, NCT01573143.).

Safe transition to surgery: working differently to make blood transfusion process safer for elective surgery.

Science.gov (United States)

Badjie, Karafa S W; Rogers, James C; Jenkins, Sarah M; Bundy, Kevin L; Stubbs, James R; Cima, Robert R

2015-09-01

Our institutional policy allows patients who are scheduled for elective surgery with no history of a pregnancy or blood transfusion in the preceding 3 months to have a presurgical sample (PSS) collected and tested up to 56 days before their scheduled surgery; however, our PSS TS completion rate in eligible patients before the morning of surgery was 83%. In 2011, a team was charged to develop a standardized process along with other process improvements while ensuring no increase in transfusion-related events. The team followed the DMAIC framework in appraising the effectiveness and efficiency of the current state process including baseline data collection such as PSS TS completion rate, number of eligible patients needing a PSS TS on the day of surgery, benchmarking, SSBO utilization, and future state mapping. First quarter (Q1) 2011 versus Q1 2012 postimplementation results showed significant improvements of the process including a 53% decrease in PSS TS on the day of surgery; a 13% increase in PSS TS completion before the morning of surgery; a 26% reduction in total XM RBCs; and a 58.8% reduction in XM RBCs not issued, plus a 47% decrease in RBC wastage. Q1 2011 versus Q1 2013 showed a 41% reduction in total XM RBCs and an 88.4% reduction in XM RBCs not issued but overall RBCs issued versus returned increased slightly and represents a future opportunity for improvement. The redesigned, transformational process eliminated SSBO and improved ordering process and PSS TS completion rate as well as blood product ordering and utilization. © 2015 AABB.

International surgery: definition, principles and Canadian practice

Science.gov (United States)

Lett, Ronald

2003-01-01

This article is dedicated to the Canadian international surgeon, Norman Bethune (1890–1939). International surgery is defined as a humanitarian branch of medicine concerned with the treatment of bodily injuries or disorders by incision or manipulations, emphasizing cooperation and understanding among nations and involving education, research, development and advocacy. In this article I review the colonial past, the dark ages following the Declaration of Alma-Ata, the progress made and the present challenges in international surgery. I present a definition of international surgery that recognizes the current era of surgical humanitarianism, validates a global understanding of surgical issues and promotes cooperation among nations. Included are the principles of international surgery: education, research, infrastructure development and advocacy. International surgical projects are classified according to type (clinical, relief, developmental) and integration strategy (vertical or horizontal). Also reviewed are the Canadian practice of international surgery by nongovernmental, professional and academic organizations and the requirements of international and Canadian funding agencies, the development concepts basic to all projects, including results-based management and the cross-cutting themes of gender equity, environmental protection and human safety. I recommend formalizing international surgery into a discipline as a means of promoting surgical care in low-income countries. If international surgery is to be sustained in Canada, infrastructure and support from Canadian surgeons is particularly important. An understanding of the history, definition and classification of international surgery should promote surgical care in low-income countries. PMID:14577711

Corrective Jaw Surgery

Medline Plus

Full Text Available ... performs the actual surgery. It is important to understand that your treatment, which will probably include orthodontics ... several years to complete. Your OMS and orthodontist understand that this is a long-term commitment for ...

Efficacy of the Danish epilepsy surgery programme

DEFF Research Database (Denmark)

Holm, E; Foged, M T; Beniczky, S

2018-01-01

lobe after ICR were free of disabling seizures. 12% of MTLE patients developed de novo depression after epilepsy surgery despite good surgical outcome. Three patients required rehabilitation due to post-operative hemiplegia. CONCLUSION: The outcomes of the Danish epilepsy surgery programme align...... epilepsy surgery programme from 2009 to 2014. MATERIAL AND METHODS: A total of 169 consecutive patients, operated at Rigshospitalet, were included. Information was gathered from digital patient records. Before 1-year follow-up, two patients were lost to follow-up and three were referred to new surgery...

Effects of the CD-Rom Version of the "Self-Advocacy Strategy" on Quality of Contributions in IEP Meetings of High School Students with Intellectual Disability

Science.gov (United States)

Cease-Cook, Jennifer; Test, David W.; Scroggins, La' Shawndra

2013-01-01

This study used a multiple-probe across participants design to examine the effects of the CD-Rom version of the "Self-Advocacy Strategy" on quality of contributions in Individual Education Plan (IEP) meetings of five high school students with intellectual disability. Results indicated a functional relationship between using the CD-Rom…

Essential hand surgery procedures for mastery by graduating plastic surgery residents: a survey of program directors.

Science.gov (United States)

Noland, Shelley S; Fischer, Lauren H; Lee, Gordon K; Friedrich, Jeffrey B; Hentz, Vincent R

2013-12-01

This study was designed to establish the essential hand surgery procedures that should be mastered by graduating plastic surgery residents. This framework can then be used as a guideline for developing Objective Structured Assessment of Technical Skill to teach technical skills in hand surgery. Ten expert hand surgeons were surveyed regarding the essential hand surgery procedures that should be mastered by graduating plastic surgery residents. The top 10 procedures from this survey were then used to survey all 89 Accreditation Council for Graduate Medical Education-approved plastic surgery program directors. There was a 69 percent response rate to the program director survey (n = 61). The top nine hand surgery procedures included open carpal tunnel release, open A1 pulley release, digital nerve repair with microscope, closed reduction and percutaneous pinning of metacarpal fracture, excision of dorsal or volar ganglion, zone II flexor tendon repair with multistrand technique, incision and drainage of the flexor tendon sheath for flexor tenosynovitis, flexor tendon sheath steroid injection, and open cubital tunnel release. Surgical educators need to develop objective methods to teach and document technical skill. The Objective Structured Assessment of Technical Skill is a valid method for accomplishing this task. There has been no consensus regarding which hand surgery procedures should be mastered by graduating plastic surgery residents. The authors have identified nine procedures that are overwhelmingly supported by plastic surgery program directors. These nine procedures can be used as a guideline for developing Objective Structured Assessment of Technical Skill to teach and document technical skills in hand surgery.

Iso-surface volume rendering for implant surgery

NARCIS (Netherlands)

van Foreest-Timp, Sheila; Lemke, H.U.; Inamura, K.; Doi, K.; Vannier, M.W.; Farman, A.G.

2001-01-01

Many clinical situations ask for the simultaneous visualization of anatomical surfaces and synthetic meshes. Common examples include hip replacement surgery, intra-operative visualization of surgical instruments or probes, visualization of planning information, or implant surgery. To be useful for

Effect of the Individual Strengthening Exercises for Posterior Pelvic Tilt Muscles on Back Pain, Pelvic Angle, and Lumbar ROM of a LBP Patient with Excessive Lordosis: A Case Study.

Science.gov (United States)

Yoo, Won-Gyu

2014-02-01

[Purpose] The purpose of this study was to document the effect of individual strengthening exercises for posterior pelvic tilt muscles on back pain, pelvic tilt angle, and lumbar ROM of a low back pain (LBP) patient with excessive lordosis. [Subjects] The subject was a 28 year-old male with excessive lordosis who complained of severe LBP at the L3 level. [Methods] He performed individual strengthening exercises for the posterior pelvic tilt muscles (rectus abdominis, gluteus maximus, hamstring). [Results] Pelvic tilt angles on the right and left sides recovered to his normal ranges. Limited lumbar ROM increased, and low back pain decreased. [Conclusion] We suggest that an approach of individual resistance exercises is necessary for the effective and fast strengthening of the pelvic posterior tilt muscles in case of LBP with excessive lordosis.

The development and pilot testing of a multimedia CD-ROM for diabetes education.

Science.gov (United States)

Castaldini, M; Saltmarch, M; Luck, S; Sucher, K

1998-01-01

The multimedia CD-ROM program, Take Charge of Diabetes, was found to be accurate, easy to use, and enjoyable by the clients and health professionals who completed the pilot study. Participants perceived an increase in knowledge after completing the five modules. Two of the participants verbally stated that the program clarified information for them and they wished they had had such a program when they were first diagnosed with diabetes. Further evaluation is needed to generalize the effect of the program on knowledge of diabetes because the pilot study was not designed to fully evaluate the effectiveness of the program on knowledge level or behavior change. Behavior change resulting in better control of blood sugar levels and hemoglobin A1c within normal range is the goal for diabetes education. The person who lives with diabetes must learn self-care methods. To accomplish that, the person must be able to comprehend the material presented. CAI programs provide an individualized, interactive, and interesting way to learn about diabetes and self-care, using visual effects and audio to support the written text. CAI can provide an element of excitement that is not available with other conventional methods. Providing prompt reinforcement of correct answers in quiz sections and including positive written messages can increase patients' self-confidence and self-esteem. Computer-assisted instruction is not intended to replace personal contact with physicians and diabetes educators, but rather complement this contact, reinforce learning, and possibly increase self-motivation to take charge of one's diabetes.

Laser-assisted cataract surgery: benefits and barriers.

Science.gov (United States)

Hatch, Kathryn M; Talamo, Jonathan H

2014-01-01

The use of the femtosecond laser (FSL) in cataract surgery may represent the largest advancement in the field since the inception of phacoemulsification. The goal of this review is to outline the benefits of and barriers to this technology. There are several significant potential benefits of the FSL in cataract surgery over conventional manual cataract surgery: precise capsulotomy formation, clear corneal and limbal relaxing incision construction, lens fragmentation, and lens softening. Evidence suggests that refractive benefits include more precise effective lens position as well as reduced effective phacoemulsification time with the use of FSL compared with manual surgery. Patients with conditions such as Fuchs' endothelial dystrophy, pseudoexfoliation, history of trauma, or brunescent cataracts may particularly benefit from this technology. There are significant financial and logistical issues to consider prior to the purchase of a FSL, including the cost of the laser, and charges to patients, and how the laser affects the patient flow in the operating room. The FSL may significantly change the current approach to cataract surgery.

Robotics in reproductive surgery: strengths and limitations.

Science.gov (United States)

Catenacci, M; Flyckt, R L; Falcone, T

2011-09-01

Minimally invasive surgical techniques are becoming increasingly common in gynecologic surgery. However, traditional laparoscopy can be challenging. A robotic surgical system gives several advantages over traditional laparoscopy and has been incorporated into reproductive gynecological surgeries. The objective of this article is to review recent publications on robotically-assisted laparoscopy for reproductive surgery. Recent clinical research supports robotic surgery as resulting in less post-operative pain, shorter hospital stays, faster return to normal activities, and decreased blood loss. Reproductive outcomes appear similar to alternative approaches. Drawbacks of robotic surgery include longer operating room times, the need for specialized training, and increased cost. Larger prospective studies comparing robotic approaches with laparoscopy and conventional open surgery have been initiated and information regarding long-term outcomes after robotic surgery will be important in determining the ultimate utility of these procedures. Copyright © 2011 Elsevier Ltd. All rights reserved.

Virtual reality as a method for evaluation and therapy after traumatic hand surgery.

Science.gov (United States)

Nica, Adriana Sarah; Brailescu, Consuela Monica; Scarlet, Rodica Gabriela

2013-01-01

In the last decade, Virtual Reality has encountered a continuous development concerning medical purposes and there are a lot of devices based on the classic "cyberglove" concept that are used as new therapeutic method for upper limb pathology, especially neurologic problems [1;2;3]. One of the VR devices is Pablo (Tyromotion), with very sensitive sensors that can measure the hand grip strenght and the pinch force, also the ROM (range of motion) for all the joints of the upper limb (shoulder, elbow, wrist) and offering the possibility of interactive games based on Virtual Reality concept with application in occupational therapy programs. We used Pablo in our study on patients with hand surgery as an objective tool for assessment and as additional therapeutic method to the classic Rehabilitation program [4;5]. The results of the study proved that Pablo represents a modern option for evaluation of hand deficits and dysfunctions, with objective measurement replacement of classic goniometry and dynamometry, with computerized data base of patients with monitoring of parameters during the recovery program and with better muscular and neuro-cognitive feedback during the interactive therapeutic modules.

Corrective Jaw Surgery

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Full Text Available ... surgery. It is important to understand that your treatment, which will probably include orthodontics before and after ... to realistically estimate the time required for your treatment. Correction of Common Dentofacial Deformities ​ ​ The information provided ...

Trends in pediatric epilepsy surgery.

Science.gov (United States)

Shah, Ritesh; Botre, Abhijit; Udani, Vrajesh

2015-03-01

Epilepsy surgery has become an accepted treatment for drug resistant epilepsy in infants and children. It has gained ground in India over the last decade. Certain epilepsy surgically remediable syndromes have been delineated and should be offered surgery earlier rather than later, especially if cognitive/behavioral development is being compromised. Advances in imaging, particularly in MRI has helped identify surgical candidates. Pre-surgical evaluation includes clinical assessment, structural and functional imaging, inter-ictal EEG, simultaneous video -EEG, with analysis of seizure semiology and ictal EEG and other optional investigations like neuropsychology and other newer imaging techniques. If data are concordant resective surgery is offered, keeping in mind preservation of eloquent cortical areas subserving motor, language and visual functions. In case of discordant data or non-lesional MRI, invasive EEG maybe useful using a two-stage approach. With multi-focal / generalized disease, palliative surgery like corpus callosotomy and vagal nerve stimulation maybe useful. A good outcome is seen in about 2/3rd of patients undergoing resective surgery with a low morbidity and mortality. This review outlines important learning aspects of pediatric epilepsy surgery for the general pediatrician.

Diffusivity database (DDB) system for major rocks (Version of 2006/specification and CD-ROM)

International Nuclear Information System (INIS)

Tochigi, Yoshikatsu; Sasamoto, Hirosi; Shibata, Masahiro; Sato, Haruo; Yui, Mikazu

2006-03-01

The development of the database system has been started to manage with the generally used. The database system has been constructed based on datasheets of the effective diffusion coefficient of the nuclides in the rock matrix in order to be applied on the 'H12: Project to Establish the Scientific and Technical Basis for HLW Disposal in Japan'. In this document, the examination and expansion of the datasheet structure and the process of construction of the database system and conversion of all data existing on datasheets are described. As the first step of the development of the database, this database system and its data will continue to be updated and the interface will be revised to improve the availability. The developed database system is attached on the CD-ROM as the file format of Microsoft Access. (author)

Robot-assisted surgery in gynecological oncology

DEFF Research Database (Denmark)

Kristensen, Steffen E; Mosgaard, Berit J; Rosendahl, Mikkel

2017-01-01

INTRODUCTION: Robot-assisted surgery has become more widespread in gynecological oncology. The purpose of this systematic review is to present current knowledge on robot-assisted surgery, and to clarify and discuss controversies that have arisen alongside the development and deployment. MATERIAL...... was performed by screening of titles and abstracts, and by full text scrutiny. From 2001 to 2016, a total of 76 references were included. RESULTS: Robot-assisted surgery in gynecological oncology has increased, and current knowledge supports that the oncological safety is similar, compared with previous...

Effectiveness of prolonged use of continuous passive motion (CPM) as an adjunct to physiotherapy following total knee arthroplasty: Design of a randomised controlled trial [ISRCTN85759656

Science.gov (United States)

Lenssen, Anton F; Crijns, Yvonne HF; Waltjé, Eddie MH; Roox, George M; van Steyn, Mike JA; Geesink, Ruud JT; van den Brandt, Piet A; de Bie, Rob A

2006-01-01

restricted knee ROM affects functional activities, knee ROM and knee function are regarded as the primary indicators of successful TKA. Potential effects of the intervention under study include rapid return of knee flexion accompanied by earlier return to functional activities of daily life. If patients benefit significantly from prolonged CPM use, this treatment should be added to the standard PT treatment at home. We expect the additional home CPM programme to be more effective than the usual physiotherapy programme, resulting in a difference in ROM of at least 5°, 17 days after surgery. This clinically important difference, with a possible flexion ROM of about 100°, is expected to lead to better functioning in activities of daily life, like walking, and earlier ability to cycle. These advantages should result in earlier and increasing independence. PMID:16504087

Effectiveness of prolonged use of continuous passive motion (CPM) as an adjunct to physiotherapy following total knee arthroplasty: design of a randomised controlled trial [ISRCTN85759656].

Science.gov (United States)

Lenssen, Anton F; Crijns, Yvonne H F; Waltjé, Eddie M H; Roox, George M; van Steyn, Mike J A; Geesink, Ruud J T; van den Brandt, Piet A; de Bie, Rob A

2006-02-23

functional activities, knee ROM and knee function are regarded as the primary indicators of successful TKA. Potential effects of the intervention under study include rapid return of knee flexion accompanied by earlier return to functional activities of daily life. If patients benefit significantly from prolonged CPM use, this treatment should be added to the standard PT treatment at home. We expect the additional home CPM programme to be more effective than the usual physiotherapy programme, resulting in a difference in ROM of at least 5 degrees , 17 days after surgery. This clinically important difference, with a possible flexion ROM of about 100 degrees , is expected to lead to better functioning in activities of daily life, like walking, and earlier ability to cycle. These advantages should result in earlier and increasing independence.

Current status of natural orifice trans-endoscopic surgery (NOTES and laparoendoscopic single site surgery (LESS in urologic surgery

Directory of Open Access Journals (Sweden)

Rafael E. Sanchez-Salas

2010-08-01

Full Text Available Laparoendoscopic single site surgery (LESS and natural orifice transluminal endoscopic surgery (NOTES represent novel approaches in urological surgery. To perform a review of the literature in order describe the current status of LESS and NOTES in Urology. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-02 to 15-05-09. Search terms included single port, single site, NOTES, LESS and single incision. A total of 412 manuscripts were initially identified. Out of these, 64 manuscripts were selected based in their urological content. The manuscript features subheadings for experimental and clinical studies, as NOTES-LESS is a new surgical technique and its future evolution will probably rely in initial verified feasibility. A subheading for reviews presents information regarding common language and consensus for the techniques. The issue of complications published in clinical series and the future needs of NOTES-LESS, are also presented.

Postradiation sarcomas: importance of surgery

International Nuclear Information System (INIS)

Lagrange, J.L.; Ramaioli, A.; Chateau, M.C.; Pignol, J.P.; Marchal, C.; Resbeut, M.; Richaud, P.; Rambert, P.; Tortechaux, J.; Seng, S.H.; La Fontan, B. de; Reme-Saumon, M.; Roullet, B.; Bof, J.; Coindre, J.M.

1997-01-01

Purpose: To evaluate the role of surgery in the treatment of Post-radiation sarcomas Materials. Post-radiation sarcomas is a rare entity and large series have rarely been reported. In order to improve knowledge about this entity the Radiotherapist group of the French Cancer Centres (FNCLCC) decided to collect retrospectively the cases treated in their institutions. In order to be sure of the histology, all the cases were reviewed by a panel of pathologists of the FNCLCC Pathologist group. A total of 129 cases of sarcomas, and 108 were reviewed; analysis of 8 is in progress, and no material was obtained in the other 11 cases. The diagnosis of sarcomas was confirmed in 80 cases. All patients (60 F, 20 M) have received radiation therapy (median dose 50 Gy; 9-110 Gy) for the treatment of the primary tumor. At this time the age was 44 years (6-83 y). Diagnoses included: breast C. 42%, Lymphomas 11.5%, gynaecological C. 10% benign lesions 5% miscellaneous. Sarcomas developed after a mean interval of 12 years (3-64 y), in bone in 30% of the cases and in soft tissue in 70%. The majority of lesions (90%) developed in the irradiated field (dose received was between 50 Gy and 60 Gy). Histologically there were 29% Malignant HistiocytofibroSarcomas, 19% OsteoSarcomas, 15% FibroSarcomas, 9% LipoSarcomas, 6% LeiomyoSarcomas, miscellaneous sarcomas 22%. Treatment included: Surgery 28 cases, Surgery+Chemotherapy 17 cases, Chemotherapy only 16 cases, Radiation therapy only 1 case, surgery + Radiation therapy 5 cases, Radiation therapy +chemotherapy 6 cases, Surgery + Radiation therapy + Chemotherapy 7 cases, no treatment 5 cases. Results. The outcome is known for all but 3 patients. 51 patients have died (44 of their sarcoma, 4 of the primary tumour, 2 of other cause and 1 iatrogenic). Median survival is 23 months (95% confidence interval 16-29 mo) but 9 patients survived 5 yr or more. Median survival was 43 mo for patients treated by surgery (28p), 6 mo for chemotherapy group (16 p

Corrective Jaw Surgery

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Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

Eumenes II. als persona non grata: Pergamon, Rom und der 3. Makedonische Krieg

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Christoph Kenkel

2012-11-01

Full Text Available Christoph Kenkel treads on difficult terrain with his Bachelor Thesis Eumenes II als persona non grata: Pergamon, Rom und der 3. Makedonische Krieg ( Eumenes II as persona non grata: Pergamon, Rome and the Third Macedonian War, but manages to develop his own convincing interpretation of a research topic subjected to strong discourse.Starting with the deprecatory demeanor of the Roman Senate towards Eumenes II Sotor (197-159 in 167 B.C., the author begins a search for this unusual rejection, facing the challenge of a confusing array of sources and the many diverging opinions of researchers. Further complications arise from the complex political situation at the eve of the Third Macedonian War that raises a variety of new issues.Nevertheless Kenkel manages to see through the machinations and rumors of Roman politics by applying logical thought, and explains plausibly why Eumenes, who unjustly got caught in the crossfire, has always been an ally of Rome, despite of many contemporary rumors and keen allegations.

Plastic surgery in Nigeria-Scope and challenges

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TOG Chukwuanukwu

2011-01-01

Full Text Available Background Plastic surgery as a major subspecialty of surgery has existed in Nigeria for several decades but the populace including medical practitioners are yet to fully appreciate its scope. This leads to very late presentation/referral of cases and management of cases that should have been referred by less qualified practitioners with attendant poor outcomes and complications. Most people still regard plastic surgery as being synonymous with cosmetic/aesthetic surgery but the scope goes far beyond this entity. It is therefore important that the public including medical practitioners who are the main sources of referral to the subspecialty are aware of the range of cases handled by plastic surgery units. The plastic surgeon in Nigeria is also faced with a lot of challenges ranging from the arduous task of one having to manage very many different and complicated cases to being very poorly equipped and appreciated. Objectives To educate the populace especially the medical practitioners on the scope of plastic surgery and the extent of development of the subspecialty in Nigeria and solicit for colleague′s cooperation in order to move plastic surgery forward. To also highlight the difficulties faced by the plastic surgeon in Nigeria and seeking help from appropriate quarters which will help to reduce unnecessary referrals abroad while improving the services rendered to patients locally. Conclusion Plastic surgery in Nigeria has developed significantly both in scope and manpower but it is still faced with a lot of challenges. Knowledge of its scope will help to reduce unnecessary referrals abroad while improving services/skill here in Nigeria.

Quality of life long-term after body contouring surgery following bariatric surgery: sustained improvement after 7 years.

Science.gov (United States)

van der Beek, Eva S J; Geenen, Rinie; de Heer, Francine A G; van der Molen, Aebele B Mink; van Ramshorst, Bert

2012-11-01

Bariatric surgery for morbid obesity results in massive weight loss and improvement of health and quality of life. A downside of the major weight loss is the excess of overstretched skin, which may influence the patient's quality of life by causing functional and aesthetic problems. The purpose of the current study was to evaluate the patient's quality of life long-term after body contouring following bariatric surgery. Quality of life was measured with the Obesity Psychosocial State Questionnaire in 33 post-bariatric surgery patients 7.2 years (range, 3.2 to 13.3 years) after body contouring surgery. Data were compared with previous assessments 4.1 years (range, 0.7 to 9.2 years) after body contouring surgery of the quality of life at that time and before body contouring surgery. Compared with appraisals of quality of life before body contouring surgery, a significant, mostly moderate to large, sustained improvement of quality of life was observed in post-bariatric surgery patients 7.2 years after body contouring surgery in six of the seven psychosocial domains. A small deterioration occurred between 4.1- and 7.2-year follow-up on two of the seven domains except for the domain efficacy toward eating, which showed a significant improvement. At 7-year follow-up, 18 patients (55 percent) were satisfied with the result of body contouring surgery. This study indicates a sustained quality-of-life improvement in post-bariatric surgery patients after body contouring surgery. This suggests the importance of including reconstructive surgery as a component in the multidisciplinary approach in the surgical treatment of morbid obesity. Therapeutic, IV.

Factors contributing to migraine headache surgery failure and success.

Science.gov (United States)

Larson, Kelsey; Lee, Michelle; Davis, Janine; Guyuron, Bahman

2011-11-01

The purpose of this study was to identify factors that contribute to migraine headache surgery failure and success. A retrospective chart review was conducted of patients who underwent surgery for migraine headaches performed by the senior author (B.G.) and had at least 11 months of follow-up. The study population included three groups: migraine surgery success, improvement, and failure. Thirty-six unique data points were collected for each patient. A total of 169 patients met inclusion criteria. Of these, 66 patients comprised the migraine surgery success group (S, complete elimination of migraine headaches); 67 comprised the migraine surgery improvement group (I, >50 percent reduction in migraine frequency, intensity, or duration); and 36 comprised the migraine surgery failure group (F, I, p=0.02), migraine frequency (SI, p=0.003; S>F, p=0.04), history of head or neck injury (SI, p=0.02), increased intraoperative bleeding (SF, p=0.0006; I>F, p=0.0004), site II (S>F, p=0.015), single operative site (SI, p=0.05; S>F, p=0.04). Factors associated with migraine surgery failure include increased intraoperative bleeding and surgery on fewer trigger sites. Factors associated with migraine surgery success are older age of migraine onset, higher rate of visual symptoms versus improvement group, surgery at site I or II, and deactivating all four operative sites. Risk, III.

Cryosphere-hydrosphere interactions: numerical modeling using the Regional Ocean Modeling System (ROMS) at different scales

Science.gov (United States)

Bergamasco, A.; Budgell, W. P.; Carniel, S.; Sclavo, M.

2005-03-01

Conveyor belt circulation controls global climate through heat and water fluxes with atmosphere and from tropical to polar regions and vice versa. This circulation, commonly referred to as thermohaline circulation (THC), seems to have millennium time scale and nowadays--a non-glacial period--appears to be as rather stable. However, concern is raised by the buildup of CO2 and other greenhouse gases in the atmosphere (IPCC, Third assessment report: Climate Change 2001. A contribution of working group I, II and III to the Third Assessment Report of the Intergovernmental Panel on Climate Change (Cambridge Univ. Press, UK) 2001, http://www.ipcc.ch) as these may affect the THC conveyor paths. Since it is widely recognized that dense-water formation sites act as primary sources in strengthening quasi-stable THC paths (Stommel H., Tellus131961224), in order to simulate properly the consequences of such scenarios a better understanding of these oceanic processes is needed. To successfully model these processes, air-sea-ice-integrated modelling approaches are often required. Here we focus on two polar regions using the Regional Ocean Modeling System (ROMS). In the first region investigated, the North Atlantic-Arctic, where open-ocean deep convection and open-sea ice formation and dispersion under the intense air-sea interactions are the major engines, we use a new version of the coupled hydrodynamic-ice ROMS model. The second area belongs to the Antarctica region inside the Southern Ocean, where brine rejections during ice formation inside shelf seas origin dense water that, flowing along the continental slope, overflow becoming eventually abyssal waters. Results show how nowadays integrated-modelling tasks have become more and more feasible and effective; numerical simulations dealing with large computational domains or challenging different climate scenarios can be run on multi-processors platforms and on systems like LINUX clusters, made of the same hardware as PCs, and

Cryosphere-hydrosphere interactions: Numerical modeling using the Regional Ocean Modeling System (ROMS) at different scales

International Nuclear Information System (INIS)

Bergamasco, A.; Carniel, S.; Sclavo, M.; Budgell, W.P.

2005-01-01

Conveyor belt circulation controls global climate through heat and water fluxes with atmosphere and from tropical to polar regions and vice versa. This circulation, commonly referred to as thermohaline circulation (THC), seems to have millennium time scale and nowadays-a non-glacial period-appears to be as rather stable. However, concern is raised by the buildup of CO 2 and other greenhouse gases in the atmosphere (IPCC, Third assessment report: Climate Change 2001. A contribution 01 working group I, n and In to the Third Assessment Report of the intergovernmental Panel on Climate Change (Cambridge Univ. Press, UK) 2001, http://www.ipcc.ch) as these may affect the THC conveyor paths. Since it is widely recognized that dense water formation sites ad as primary sources in strengthening quasi-stable THC paths (Stommel H., Tellus, 13 (1961) 224), in order to simulate properly the consequences of such scenarios a better understanding of these oceanic processes is needed. To successfully model these processes, air sea-ice-integrated modelling approaches are often required. Here we focus on two polar regions using the Regional Ocean Modeling System (ROMS). In the first region investigated, the North Atlantic-Arctic, where open-ocean Jeep convection and open-sea ire formation and dispersion under the intense air-sea interactions are the major engines, we use a new version of the coupled hydrodynamic-ice ROMS model. The second area belongs to the Antarctica region inside the Southern Ocean, where brine rejections during ice formation inside shelf seas origin dense water that, flowing along the continental slope, overflow becoming eventually abyssal waters. Results show how nowadays integrated-modelling tasks have become more and more feasible and effective; numerical simulations dealing with large computational domains or challenging different climate scenarios can be run on multi-processors platforms and on systems like LINUX clusters, made of the same hardware as PCs, and

Remote telepresence surgery: the Canadian experience.

Science.gov (United States)

Anvari, M

2007-04-01

On 28 February 2003, the world's first telerobotic surgical service was established between St. Joseph's Healthcare Hamilton, a teaching hospital affiliated with McMaster University, and North Bay General Hospital, a community hospital 400 km away. The service was designed to provide telerobotic surgery and assistance by expert surgeons to local surgeons in North Bay, and to improve the range and quality of advanced laparoscopic surgeries offered locally. The two surgeons have collaboratively performed 22 remote telepresence surgeries including laparoscopic fundoplications, laparoscopic colon resections, and laparoscopic inguinal hernia repairs. This article describes the important lessons learned, including the telecommunication requirements, the impact from lack of haptic feedback, surgeons' adaptation to latency, and ethical and medicolegal issues. This is currently the largest clinical experience with assisted robotic telepresence surgery (ARTS) in the world, and the lessons learned will help guide the future design and development of telesurgical robotic platforms. It also will guide the establishment of telesurgical networks connecting various centers in the world, allowing for rapid and safe dissemination of new surgical techniques.

Robotic cardiac surgery: an anaesthetic challenge.

Science.gov (United States)

Wang, Gang; Gao, Changqing

2014-08-01

Robotic cardiac surgery with the da Vinci robotic surgical system offers the benefits of a minimally invasive procedure, including a smaller incision and scar, reduced risk of infection, less pain and trauma, less bleeding and blood transfusion requirements, shorter hospital stay and decreased recovery time. Robotic cardiac surgery includes extracardiac and intracardiac procedures. Extracardiac procedures are often performed on a beating heart. Intracardiac procedures require the aid of peripheral cardiopulmonary bypass via a minithoracotomy. Robotic cardiac surgery, however, poses challenges to the anaesthetist, as the obligatory one-lung ventilation (OLV) and CO2 insufflation may reduce cardiac output and increase pulmonary vascular resistance, potentially resulting in hypoxaemia and haemodynamic compromise. In addition, surgery requires appropriate positioning of specialised cannulae such as an endopulmonary vent, endocoronary sinus catheter, and endoaortic clamp catheter under the guidance of transoesophageal echocardiography. Therefore, cardiac anaesthetists should have a working knowledge of these systems, OLV and haemodynamic support. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Acute care surgery: defining mortality in emergency general surgery in the state of Maryland.

Science.gov (United States)

Narayan, Mayur; Tesoriero, Ronald; Bruns, Brandon R; Klyushnenkova, Elena N; Chen, Hegang; Diaz, Jose J

2015-04-01

Emergency general surgery (EGS) is a major component of acute care surgery, however, limited data exist on mortality with respect to trauma center (TC) designation. We hypothesized that mortality would be lower for EGS patients treated at a TC vs non-TC (NTC). A retrospective review of the Maryland Health Services Cost Review Commission database from 2009 to 2013 was performed. The American Association for the Surgery of Trauma EGS ICD-9 codes were used to identify EGS patients. Data collected included demographics, TC designation, emergency department admissions, and All Patients Refined Severity of Illness (APR_SOI). Trauma center designation was used as a marker of a formal acute care surgery program. Primary outcomes included in-hospital mortality. Multivariable logistic regression analysis was performed controlling for age. There were 817,942 EGS encounters. Mean ± SD age of patients was 60.1 ± 18.7 years, 46.5% were males; 71.1% of encounters were at NTCs; and 75.8% were emergency department admissions. Overall mortality was 4.05%. Mortality was calculated based on TC designation controlling for age across APR_SOI strata. Multivariable logistic regression analysis did not show statistically significant differences in mortality between hospital levels for minor APR_SOI. For moderate APR_SOI, mortality was significantly lower for TCs compared with NTCs (p surgery patients treated at TCs had lower mortality for moderate APR_SOI, but increased mortality for extreme APR_SOI when compared with NTCs. Additional investigation is required to better evaluate this unexpected finding. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Preoperative radiochemotherapy and radical surgery in comparison with radical surgery alone

International Nuclear Information System (INIS)

Mohr, C.; Schettler, D.; Bohndorf, W.

1994-01-01

A multicentric, randomized study of squamous cell carcinoma (SCC) of the oral cavity and the oropharynx has been undertaken by DOeSAK. The results after radical surgery alone have been compared with the results of combined preoperative radiochemotherapy followed by radical surgery. Patients with primary (biopsy proven) SCC of the oral cavity or the oropharynx with tumor nodes metastasis (TNM) stages T2-4, N0-3, M0 were included in the study. A total of 141 patients were treated by radical surgery alone, whereas 127 patients were treated by radical surgery preceded by preoperative radiochemotherapy. The pre-operative treatment consisted of conventionally fractioned irradiation on the primary and the regional lymph nodes with a total dose of 36 Gy (5 x 2 Gy per week) and low-dose cisplatin chemotherapy with 5 x 12.5 mg cisplatin per m 2 of body surface during the first week of treatment. Radical surgery according to be DOeSAK definitions (DOeSAK, 1982) was performed after a delay of 10-14 days. During the follow-up period, 28.2% of all patients suffered from locoregional recurrence, and 27.2% of the patients died. The percentages were higher after radical surgery alone for locoregional recurrence (31% and 15.6%) and for death (28% and 18.6%). The life-table analysis showed improved survival rates of 4.5% after 1 year and 8.3% after 2 years in the group of patients treated with combined therapy. The demonstrated improvement appeared to be significant with the Gehan-Wilcoxon test as well as with the log rank test below a P value of 5%. (au) (29 refs.)

Bariatric Surgery and Kidney-Related Outcomes.

Science.gov (United States)

Chang, Alex R; Grams, Morgan E; Navaneethan, Sankar D

2017-03-01

The prevalence of severe obesity in both the general and the chronic kidney disease (CKD) populations continues to rise, with more than one-fifth of CKD patients in the United States having a body mass index of ≥35 kg/m 2 . Severe obesity has significant renal consequences, including increased risk of end-stage renal disease (ESRD) and nephrolithiasis. Bariatric surgery represents an effective method for achieving sustained weight loss, and evidence from randomized controlled trials suggests that bariatric surgery is also effective in improving blood pressure, reducing hyperglycemia, and even inducing diabetes remission. There is also observational evidence suggesting that bariatric surgery may diminish the long-term risk of kidney function decline and ESRD. Bariatric surgery appears to be relatively safe in patients with CKD, with postoperative complications only slightly higher than in the general bariatric surgery population. The use of bariatric surgery in patients with CKD might help prevent progression to ESRD or enable selected ESRD patients with severe obesity to become candidates for kidney transplantation. However, there are also renal risks in bariatric surgery, namely, acute kidney injury, nephrolithiasis, and, in rare cases, oxalate nephropathy, particularly in types of surgery involving higher degrees of malabsorption. Although bariatric surgery may improve long-term kidney outcomes, this potential benefit remains unproved and must be balanced with potential adverse events.

New trends in minimally invasive urological surgery

Directory of Open Access Journals (Sweden)

Prabhakar Rajan

2009-10-01

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

Surgery applications of virtual reality

Science.gov (United States)

Rosen, Joseph

1994-01-01

Virtual reality is a computer-generated technology which allows information to be displayed in a simulated, bus lifelike, environment. In this simulated 'world', users can move and interact as if they were actually a part of that world. This new technology will be useful in many different fields, including the field of surgery. Virtual reality systems can be used to teach surgical anatomy, diagnose surgical problems, plan operations, simulate and perform surgical procedures (telesurgery), and predict the outcomes of surgery. The authors of this paper describe the basic components of a virtual reality surgical system. These components include: the virtual world, the virtual tools, the anatomical model, the software platform, the host computer, the interface, and the head-coupled display. In the chapter they also review the progress towards using virtual reality for surgical training, planning, telesurgery, and predicting outcomes. Finally, the authors present a training system being developed for the practice of new procedures in abdominal surgery.

Current status of cardiovascular surgery in Japan 2013 and 2014: A report based on the Japan Cardiovascular Surgery Database. 2: Congenital heart surgery.

Science.gov (United States)

Hirata, Yasutaka; Hirahara, Norimichi; Murakami, Arata; Motomura, Noboru; Miyata, Hiroaki; Takamoto, Shinichi

2018-01-01

We analyzed the mortality and morbidity of congenital heart surgery in Japan using the Japan Cardiovascular Surgery Database (JCVSD). Data regarding congenital heart surgery performed between January 2013 and December 2014 were obtained from JCVSD. The 20 most frequent procedures were selected and the mortality rates and major morbidities were analyzed. The mortality rates of atrial septal defect repair and ventricular septal defect repair were less than 1%, and the mortality rates of tetralogy of Fallot repair, complete atrioventricular septal defect repair, bidirectional Glenn, and total cavopulmonary connection were less than 2%. The mortality rates of the Norwood procedure and total anomalous pulmonary venous connection repair were more than 10%. The rates of unplanned reoperation, pacemaker implantation, chylothorax, deep sternal infection, phrenic nerve injury, and neurological deficit were shown for each procedure. Using JCVSD, the national data for congenital heart surgery, including postoperative complications, were analyzed. Further improvements of the database and feedback for clinical practice are required.

Referral to Cardiac Rehabilitation After Percutaneous Coronary Intervention, Coronary Artery Bypass Surgery, and Valve Surgery: Data From the Clinical Outcomes Assessment Program.

Science.gov (United States)

Beatty, Alexis L; Bradley, Steven M; Maynard, Charles; McCabe, James M

2017-06-01

Despite guideline recommendations that patients undergoing percutaneous coronary intervention (PCI), coronary artery bypass surgery, or valve surgery be referred to cardiac rehabilitation, cardiac rehabilitation is underused. The objective of this study was to examine hospital-level variation in cardiac rehabilitation referral after PCI, coronary artery bypass surgery, and valve surgery. We analyzed data from the Clinical Outcomes Assessment Program, a registry of all nonfederal hospitals performing PCI and cardiac surgery in Washington State. We included eligible PCI, coronary artery bypass surgery, and valve surgery patients from 2010 to 2015. We analyzed PCI and cardiac surgery separately by performing multivariable hierarchical logistic regression for the outcome of cardiac rehabilitation referral at discharge, clustered by hospital. Patient-level covariates included age, sex, race/ethnicity, comorbidities, and procedure indication/status. Cardiac rehabilitation referral was reported in 48% (34 047/71 556) of PCI patients and 91% (21 831/23 972) of cardiac surgery patients. The hospital performing the procedure was a stronger predictor of referral than any individual patient characteristic for PCI (hospital referral range 3%-97%; median odds ratio, 5.94; 95% confidence interval, 4.10-9.49) and cardiac surgery (range 54%-100%; median odds ratio, 7.09; 95% confidence interval, 3.79-17.80). Hospitals having an outpatient cardiac rehabilitation program explained only 10% of PCI variation and 0% of cardiac surgery variation. Cardiac rehabilitation referral at discharge was less prevalent after PCI than cardiac surgery. The strongest predictor of cardiac rehabilitation referral was the hospital performing the procedure. Efforts to improve cardiac rehabilitation referral should focus on increasing referral after PCI, especially in low referral hospitals. © 2017 American Heart Association, Inc.

Validation of a photography-based goniometry method for measuring joint range of motion.

Science.gov (United States)

Blonna, Davide; Zarkadas, Peter C; Fitzsimmons, James S; O'Driscoll, Shawn W

2012-01-01

A critical component of evaluating the outcomes after surgery to restore lost elbow motion is the range of motion (ROM) of the elbow. This study examined if digital photography-based goniometry is as accurate and reliable as clinical goniometry for measuring elbow ROM. Instrument validity and reliability for photography-based goniometry were evaluated for a consecutive series of 50 elbow contractures by 4 observers with different levels of elbow experience. Goniometric ROM measurements were taken with the elbows in full extension and full flexion directly in the clinic (once) and from digital photographs (twice in a blinded random manner). Instrument validity for photography-based goniometry was extremely high (intraclass correlation coefficient: extension = 0.98, flexion = 0.96). For extension and flexion measurements by the expert surgeon, systematic error was negligible (0° and 1°, respectively). Limits of agreement were 7° (95% confidence interval [CI], 5° to 9°) and -7° (95% CI, -5° to -9°) for extension and 8° (95% CI, 6° to 10°) and -7° (95% CI, -5° to -9°) for flexion. Interobserver reliability for photography-based goniometry was better than that for clinical goniometry. The least experienced observer's photographic goniometry measurements were closer to the reference measurements than the clinical goniometry measurements. Photography-based goniometry is accurate and reliable for measuring elbow ROM. The photography-based method relied less on observer expertise than clinical goniometry. This validates an objective measure of patient outcome without requiring doctor-patient contact at a tertiary care center, where most contracture surgeries are done. Copyright © 2012 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

[History of cranial surgery, cerebral tumor surgery and epilepsy surgery in Mexico].

Science.gov (United States)

Chico-Ponce de León, F

2009-08-01

The first report of intra-cerebral tumor surgery was provided by Bennett & Goodle, in London, 1884. Worldwide this kind of surgery was performed in France by Chipault, in Italy by Durante, in the United States by Keen and in Deutchland by Krause & Oppenheim. Lavista in Mexico City operated on intra-cerebral tumor in 1891, and the report was printed in 1892. In the same publication, Lavista exhibited the first cases of epilepsy surgery. Since now, it is the first report of this kind of surgery in the Spanish-speaking world.

Training in breast surgery in Spain.

Science.gov (United States)

Miguelena, José M; Domínguez Cunchillos, Fernando

2016-01-01

Breast surgery is a key part of training and competency in general surgery in Spain and is a "frontier area" that can be efficiently managed by general surgeons and gynecologists. The main objective of the training process consists of the surgical treatment of breast cancer, including conservative surgery, oncoplastic and reconstructive techniques. This article analyses the current status of breast surgery training in Spain and schematically proposes potential targets of the different training programs, to improve access and training for surgeons and residents in this area, taking into account the RD 639/2014 and European regulation. The priority is to specify the level of training that should be achieved, in relation to the group of professionals involved, considering their area of competency: surgery resident, educational programs, and surgeons with special dedication to this area. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Metabolic Surgery

DEFF Research Database (Denmark)

Pareek, Manan; Schauer, Philip R; Kaplan, Lee M

2018-01-01

The alarming rise in the worldwide prevalence of obesity is paralleled by an increasing burden of type 2 diabetes mellitus. Metabolic surgery is the most effective means of obtaining substantial and durable weight loss in individuals with obesity. Randomized trials have recently shown...... the superiority of surgery over medical treatment alone in achieving improved glycemic control, as well as a reduction in cardiovascular risk factors. The mechanisms seem to extend beyond the magnitude of weight loss alone and include improvements in incretin profiles, insulin secretion, and insulin sensitivity....... Moreover, observational data suggest that the reduction in cardiovascular risk factors translates to better patient outcomes. This review describes commonly used metabolic surgical procedures and their current indications and summarizes the evidence related to weight loss and glycemic outcomes. It further...

Short convalescence after vaginal prolapse surgery

DEFF Research Database (Denmark)

Ottesen, Marianne; Sørensen, Mette; Kehlet, Henrik

2003-01-01

OBJECTIVE: Retrospectively to describe the recommended convalescence according to patients who had undergone vaginal prolapse surgery in 1996-98, and prospectively to describe the need for and limiting factors for convalescence after vaginal prolapse surgery in 1999-2000 at a Danish University...... Hospital. METHODS: The retrospective study included a validated, postal, questionnaire and review of patient files. In the prospective study, we followed consecutive women after vaginal surgery in a fast-track setting using a multimodal rehabilitation model with well-defined recommendations...... exceeding 10 kg. Limiting factors were fatigue and pain. The 1-year subjective recurrence rate was 17%. CONCLUSION: Traditionally, recommended convalescence has been median 6 weeks after vaginal prolapse surgery. Convalescence has been shortened to 1-3 weeks with a multimodal rehabilitation model...

Nutrition in Pregnancy Following Bariatric Surgery

Directory of Open Access Journals (Sweden)

Christopher Slater

2017-12-01

Full Text Available The widespread use of bariatric surgery for the treatment of morbid obesity has led to a dramatic increase in the numbers of women who become pregnant post-surgery. This can present new challenges, including a higher risk of protein and calorie malnutrition and micronutrient deficiencies in pregnancy due to increased maternal and fetal demand. We undertook a focused, narrative review of the literature and present pragmatic recommendations. It is advisable to delay pregnancy for at least 12 months following bariatric surgery. Comprehensive pre-conception and antenatal care is essential to achieving the best outcomes. Nutrition in pregnancy following bariatric surgery requires specialist monitoring and management. A multidisciplinary approach to care is desirable with close monitoring for deficiencies at each trimester.

Complications After Cosmetic Surgery Tourism.

Science.gov (United States)

Klein, Holger J; Simic, Dario; Fuchs, Nina; Schweizer, Riccardo; Mehra, Tarun; Giovanoli, Pietro; Plock, Jan A

2017-04-01

Cosmetic surgery tourism characterizes a phenomenon of people traveling abroad for aesthetic surgery treatment. Problems arise when patients return with complications or need of follow-up care. To investigate the complications of cosmetic surgery tourism treated at our hospital as well as to analyze arising costs for the health system. Between 2010 and 2014, we retrospectively included all patients presenting with complications arising from cosmetic surgery abroad. We reviewed medical records for patients' characteristics including performed operations, complications, and treatment. Associated cost expenditure and Diagnose Related Groups (DRG)-related reimbursement were analyzed. In total 109 patients were identified. All patients were female with a mean age of 38.5 ± 11.3 years. Most procedures were performed in South America (43%) and Southeast (29.4%) or central Europe (24.8%), respectively. Favored procedures were breast augmentation (39.4%), abdominoplasty (11%), and breast reduction (7.3%). Median time between the initial procedure abroad and presentation was 15 days (interquartile range [IQR], 9) for early, 81.5 days (IQR, 69.5) for midterm, and 4.9 years (IQR, 9.4) for late complications. Main complications were infections (25.7%), wound breakdown (19.3%), and pain/discomfort (14.7%). The majority of patients (63.3%) were treated conservatively; 34.8% became inpatients with a mean hospital stay of 5.2 ± 3.8 days. Overall DRG-related reimbursement premiums approximately covered the total costs. Despite warnings regarding associated risks, cosmetic surgery tourism has become increasingly popular. Efficient patients' referral to secondary/tertiary care centers with standardized evaluation and treatment can limit arising costs without imposing a too large burden on the social healthcare system. 4. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

Ambulatory surgery center market share and rates of outpatient surgery in the elderly.

Science.gov (United States)

Hollenbeck, Brent K; Hollingsworth, John M; Dunn, Rodney L; Zaojun Ye; Birkmeyer, John D

2010-12-01

Relative to outpatient surgery in hospital settings, ambulatory surgery centers (ASCs) are more efficient and associated with a lower cost per case. However, these facilities may also spur higher overall procedure utilization and thus lead to greater overall health care costs. The authors used the State Ambulatory Surgery Database from the State of Florida to identify Medicare-aged patients undergoing 4 common ambulatory procedures in 2006, including knee arthroscopy, cystoscopy, cataract removal, and colonoscopy. Hospital service areas (HSAs) were characterized according to ASC market share, that is, the proportion of residents undergoing outpatient surgery in these facilities. The authors then examined relationships between ASC market share and rates of each procedure. Age-adjusted rates of ambulatory surgery ranged from 190.5 cases per 1000 to 320.8 cases per 1000 in HSAs with low and high ASC market shares, respectively (P market share. The greatest difference, both in relative and absolute terms, was observed for patients undergoing cystoscopy. In areas of high ASC market share, the age-adjusted rate of cystoscopy was nearly 3-fold higher than in areas with low ASC market share (34.5 vs 11.9 per 1000 population; P elderly. Whether ASCs are meeting unmet clinical demand or spurring overutilization is not clear.

Improving the visual realism of virtual surgery.

Science.gov (United States)

Jin, Wei; Lim, Yi-Je; Xu, Xie George; Singh, Tejinder P; De, Suvranu

2005-01-01

In this work we focus our attention on improving the visual realism of virtual surgery. A synthetic solution by innovative use of various image-based rendering methods is presented for realistic rendering of virtual surgery scenes. We have, for the first time, developed a methodology for generating virtual surgery scenes with realistic glistening effects by a combination of various image-based rendering techniques, including image mosaicing and view-dependent texture mapping. Realistic examples are presented to showcase the results.

Knowledge and Pperception of laparoscopic surgery among ...

African Journals Online (AJOL)

Background: Laparoscopic surgery is the gold standard in developed countries. Challenges indeveloping countries apart from the cost of instrumentation include a low acceptance level among patients. The consequent low volume of surgical cases debars cost reduction for surgery. Objective: The aim of this study is to ...

Pain management after lung surgery

OpenAIRE

Maria Frödin; Margareta Warrén Stomberg

2014-01-01

Pain management is an integral challenge in nursing and includes the responsibility of managing patients’ pain, evaluating pain therapy and ensuring the quality of care. The aims of this study were to explore patients’ experiences of pain after lung surgery and evaluate their satisfaction with the postoperative pain management. A descriptive design was used which studied 51 participants undergoing lung surgery. The incidence of moderate postoperative pain varied from 36- 58% among the partici...

DOES BARIATRIC SURGERY AFFECT SEXUALITY: A SYSTEMATIC REVIEW

Directory of Open Access Journals (Sweden)

Dilek Aygin

2017-09-01

Full Text Available Obesity affects sexual health negatively due to several reasons such as impaired body image, psychological disorders and hormonal changes. Bariatric surgery is frequently used in the treatment of obesity. Besides positive effects such as an increase in physical activity due to weight loss and hormonal changes after surgery, there are some adverse effects of bariatric surgery such as sagging and wrinkling of skin due to rapid weight loss. The purpose of this study is to determine the effects of bariatric surgery on sexual function. The literature between 2004 and 2015 was reviewed by searching Scopus, Science Direct, PubMed, Ebsco, Coochrane, Medline Complete, Ovid, Springer Link, Google Scholar, Taylor & Francis, PsychInfo databases, national thesis center and Ulakbim databases; ten studies appropriate to the criteria were included in the study. A total of 524 patients (152 males underwent bariatric surgery were included in study. Sexual function has been found to improve in all the studies. Also weight loss has been shown to have positive effects on reproductive hormones in both sexes. Bariatric surgery has positive effects on weight-loss and consequently on sexual function and reproductive hormones. [J Contemp Med 2017; 7(3.000: 284-296

Breast cancer surgery effect over professional activities

Directory of Open Access Journals (Sweden)

Mirella Dias

2017-06-01

Full Text Available Introduction: Breast cancer is responsible for 25% of all cancers and is the most prevalent in the female population. Due to treatment advances and early diagnoses, survival rates have improved, however this condition impacts work absenteeism due to the productive age of these women. The main factors responsible for work absenteeism are physical complications due to surgical treatment. Objective: The aim of this study is to investigate the effects of surgical breast cancer treatments on occupation, to characterize the degree of work absenteeism and to investigate the type of relation between surgical technique and absenteeism’s main causes. Method: Cross-sectional study with 74 women diagnosed with breast cancer. A semi-structured interview was used to collect information regarding surgical and clinical aspects, sociodemographic data, work behavior and physical therapy treatments. The data was organized on Microsoft Excel and analyzed by frequency and chi-squared test. The significance level considered was p ≤ 0.05. Results: Breast cancer was most common on the left side (51%, Madden modified radical mastectomy was the most common (50% and lymph node resection was present in 93.2% of cases. The most frequent post-surgery complications were pain, problems with scarring, sensitivity alterations, ROM limitation, lymphedema and seroma. Only 58% of women were treated with physical therapy and 60% withdrew from professional activities, 23% abandoned work, 26% changed their work role and 14% retired due to the disease. Conclusion: The present study suggests the existence of a direct relation between treatment and work absenteeism.

Anesthesia for day-care surgeries: Current perspectives

Directory of Open Access Journals (Sweden)

Sukhminder Jit Singh Bajwa

2017-01-01

Full Text Available Day-care surgery has become a popular modality of surgical intervention throughout the globe. Numerous factors including the economic and financial issues are driving this therapeutic modality to a widespread acceptance among surgeons and anesthesiologists. Advancements in anesthesia and surgical techniques as well as availability of newer drugs are largely responsible for the progress of day-care surgeries. Numerous challenges are still faced by anesthesiologists and surgeons in carrying out day-care surgeries, especially in spite of these advancements, at resource-limited setups. The first right step in successfully delivering the day-care surgical services includes proper selection of the patients. The preanesthetic evaluation is highly essential in determining the suitability of the patient for day-care anesthesia and surgery as well as the formulation of various anesthetic plans and strategies. The current review is intended to highlight inherent challenges and probable solutions to them for this rapidly progressing anesthesia.

Robotic assisted minimally invasive surgery

Directory of Open Access Journals (Sweden)

Palep Jaydeep

2009-01-01

Full Text Available The term "robot" was coined by the Czech playright Karel Capek in 1921 in his play Rossom′s Universal Robots. The word "robot" is from the check word robota which means forced labor.The era of robots in surgery commenced in 1994 when the first AESOP (voice controlled camera holder prototype robot was used clinically in 1993 and then marketed as the first surgical robot ever in 1994 by the US FDA. Since then many robot prototypes like the Endoassist (Armstrong Healthcare Ltd., High Wycombe, Buck, UK, FIPS endoarm (Karlsruhe Research Center, Karlsruhe, Germany have been developed to add to the functions of the robot and try and increase its utility. Integrated Surgical Systems (now Intuitive Surgery, Inc. redesigned the SRI Green Telepresence Surgery system and created the daVinci Surgical System ® classified as a master-slave surgical system. It uses true 3-D visualization and EndoWrist ® . It was approved by FDA in July 2000 for general laparoscopic surgery, in November 2002 for mitral valve repair surgery. The da Vinci robot is currently being used in various fields such as urology, general surgery, gynecology, cardio-thoracic, pediatric and ENT surgery. It provides several advantages to conventional laparoscopy such as 3D vision, motion scaling, intuitive movements, visual immersion and tremor filtration. The advent of robotics has increased the use of minimally invasive surgery among laparoscopically naοve surgeons and expanded the repertoire of experienced surgeons to include more advanced and complex reconstructions.

Robotics in general surgery: an evidence-based review.

Science.gov (United States)

Baek, Se-Jin; Kim, Seon-Hahn

2014-05-01

Since its introduction, robotic surgery has been rapidly adopted to the extent that it has already assumed an important position in the field of general surgery. This rapid progress is quantitative as well as qualitative. In this review, we focus on the relatively common procedures to which robotic surgery has been applied in several fields of general surgery, including gastric, colorectal, hepato-biliary-pancreatic, and endocrine surgery, and we discuss the results to date and future possibilities. In addition, the advantages and limitations of the current robotic system are reviewed, and the advanced technologies and instruments to be applied in the near future are introduced. Such progress is expected to facilitate the widespread introduction of robotic surgery in additional fields and to solve existing problems.

Plasma glutamine levels before cardiac surgery are related to post-surgery infections; an observational study

Directory of Open Access Journals (Sweden)

Hanneke Buter

2016-11-01

Full Text Available Abstract Background A low plasma glutamine level was found in 34% of patients after elective cardiothoracic surgery. This could be a result of the inflammation caused by surgical stress or the use of extracorporeal circulation (ECC. But it is also possible that plasma glutamine levels were already lowered before surgery and reflect an impaired metabolic state and a higher likelihood to develop complications. In the present study plasma glutamine levels were measured before and after cardiac surgery and we questioned whether there is a relation between plasma glutamine levels and duration of ECC and the occurrence of postoperative infections. Methods We performed a single-centre prospective, observational study in a closed-format, 20-bed, mixed ICU in a tertiary teaching hospital. We included consecutive patients after elective cardiac surgery with use of extracorporeal circulation. Blood samples were collected on the day prior to surgery and at admission on the ICU. The study was approved by the local Medical Ethics Committee (Regional Review Committee Patient-related Research, Medical Centre Leeuwarden, nWMO 115, April 28th 2015. Results Ninety patients were included. Pre-operative plasma glutamine level was 0.42 ± 0.10 mmol/l and post-operative 0.38 ± 0.09 mmol/l (p < 0.001. There was no relation between duration of extracorporeal circulation or aortic occlusion time and changes in plasma glutamine levels. A logistic regression analysis showed a significant correlation between the presence of a positive culture during the post-operative course and pre-operative plasma glutamine levels (p = 0.04. Conclusion Plasma glutamine levels are significantly lower just after cardiac surgery compared to pre-operative levels. We did not find a relation between the decrease in plasma glutamine levels and the duration of extracorporeal circulation or aortic clamp time. There was a correlation between pre-operative plasma glutamine levels

Sustainability of melon cultivation in São Romão settlement in Mossoró/RN: determination of indicators by the MESMIS methodology

Directory of Open Access Journals (Sweden)

Ivanildo Martins Formiga Júnior

2015-04-01

Full Text Available Currently, agriculture is one of the most discussed topics in the theoretical field of sustainability. Debates regarding this issue are increasingly recurrent and put in question the model adopted from the post-war, the so-called green revolution. In the state of Rio Grande do Norte, the agricultural potential lies mainly in irrigated horticulture, where stands the agropolo Acu-Mossoró as one of the greatest watermelon producing regions of Brazil. The cultivation of watermelon, once dominated by large agricultural companies, is currently developed by agroecosystems whose management is characterized by family participation, including small farmers of rural settlements created by Incra. Aiming to assess the sustainability of this type of cultivation, was used the MESMIS methodology in the in São Romão settlement in Mossoró-RN, which is primarily engaged in the cultivation of irrigated melon. Seven critical points were determined and selected twenty-three indicators that directly affect the sustainability of the researched area.

Laparoendoscopic single site in pelvic surgery

Science.gov (United States)

Sanchez-Salas, Rafael; Clavijo, Rafael; Barret, Eric; Sotelo, Rene

2012-01-01

Laparoendoscopic single site (LESS) has recently gained momentum as feasible techniques for minimal access surgery. Our aim is to describe the current status of laparoendoscopic single site (LESS) in pelvic surgery. A comprehensive revision of the literature in LESS pelvic surgery was performed. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-01 to 30-11-11. References outside the search period were obtained selected manuscript΄s bibliography. Search terms included: pelvic anatomy, less in gynecology, single port colectomy, urological less, single port, single site, NOTES, LESS and single incision. 314 manuscripts were initially identified. Out of these, 46 manuscripts were selected based in their pelvic anatomy or surgical content; including experimental experience, clinical series and literature reviews. LESS drastically limit the surgeon's ability to perform in the operative field and the latter becomes hardened by the lack of space in anatomical location like the pelvis. Potential advantages of LESS are gained with the understanding that the surgical procedure is more technically challenging. Pelvic surgical procedures related to colorectal surgery, gynecology and urology have been performed with LESS technique and information available is mostly represented by case reports and short case series. Comparative series remain few. LESS pelvic surgery remain in its very beginning and due to the very specific anatomical conditions further development of LESS surgery in the mentioned area can be clearly be facilitated by using robotic technology. Standardization ad reproducibility of techniques are mandatory to further develop LESS in the surgical arena.. PMID:22557719

Laparoendoscopic single site in pelvic surgery

Directory of Open Access Journals (Sweden)

Rafael Sanchez-Salas

2012-01-01

Full Text Available Laparoendoscopic single site (LESS has recently gained momentum as feasible techniques for minimal access surgery. Our aim is to describe the current status of laparoendoscopic single site (LESS in pelvic surgery. A comprehensive revision of the literature in LESS pelvic surgery was performed. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-01 to 30-11-11. References outside the search period were obtained selected manuscript΄s bibliography. Search terms included: pelvic anatomy, less in gynecology, single port colectomy, urological less, single port, single site, NOTES, LESS and single incision. 314 manuscripts were initially identified. Out of these, 46 manuscripts were selected based in their pelvic anatomy or surgical content; including experimental experience, clinical series and literature reviews. LESS drastically limit the surgeon′s ability to perform in the operative field and the latter becomes hardened by the lack of space in anatomical location like the pelvis. Potential advantages of LESS are gained with the understanding that the surgical procedure is more technically challenging. Pelvic surgical procedures related to colorectal surgery, gynecology and urology have been performed with LESS technique and information available is mostly represented by case reports and short case series. Comparative series remain few. LESS pelvic surgery remain in its very beginning and due to the very specific anatomical conditions further development of LESS surgery in the mentioned area can be clearly be facilitated by using robotic technology. Standardization ad reproducibility of techniques are mandatory to further develop LESS in the surgical arena..

Can cardiac surgery cause hypopituitarism?

Science.gov (United States)

Francis, Flverly; Burger, Ines; Poll, Eva Maria; Reineke, Andrea; Strasburger, Christian J; Dohmen, Guido; Gilsbach, Joachim M; Kreitschmann-Andermahr, Ilonka

2012-03-01

Apoplexy of pituitary adenomas with subsequent hypopituitarism is a rare but well recognized complication following cardiac surgery. The nature of cardiac on-pump surgery provides a risk of damage to the pituitary because the vascular supply of the pituitary is not included in the cerebral autoregulation. Thus, pituitary tissue may exhibit an increased susceptibility to hypoperfusion, ischemia or intraoperative embolism. After on-pump procedures, patients often present with physical and psychosocial impairments which resemble symptoms of hypopituitarism. Therefore, we analyzed whether on-pump cardiac surgery may cause pituitary dysfunction also in the absence of pre-existing pituitary disease. Twenty-five patients were examined 3-12 months after on-pump cardiac surgery. Basal hormone levels for all four anterior pituitary hormone axes were measured and a short synacthen test and a growth hormone releasing hormone plus arginine (GHRH-ARG)-test were performed. Quality of life (QoL), depression, subjective distress for a specific life event, sleep quality and fatigue were assessed by means of self-rating questionnaires. Hormonal alterations were only slight and no signs of anterior hypopituitarism were found except for an insufficient growth hormone rise in two overweight patients in the GHRH-ARG-test. Psychosocial impairment was pronounced, including symptoms of moderate to severe depression in 9, reduced mental QoL in 8, dysfunctional coping in 6 and pronounced sleep disturbances in 16 patients. Hormone levels did not correlate with psychosocial impairment. On-pump cardiac surgery did not cause relevant hypopituitarism in our sample of patients and does not serve to explain the psychosocial symptoms of these patients.

Hand-assisted laparoscopic surgery and its applications in gynecology

Directory of Open Access Journals (Sweden)

Yueqian Wu

2016-02-01

Full Text Available Laparoscopic surgery has been used extensively since it was first applied in the 1980s. The advantages are generally accepted and include less pain, smaller incisions, faster recovery, and shorter hospital stays. However, several limitations associated with standard laparoscopic surgery (SLS have become apparent and include the loss of tactile sensation, problems with the removal of bulky and intact specimens, and the restriction of visualization of the entire operating field. These problems with SLS helped to inspire the development of laparoscopically assisted surgery followed by hand-assisted laparoscopic surgery (HALS. In a hand-assisted laparoscopic procedure, an incision is made in the patient’s abdomen. Then, a uniquely designed appliance is introduced into the abdominal cavity through the incision to maintain pneumoperitoneum. With the inserting hand, surgeons can provide manual exposure, traction, palpation, and dissection because of the feedback of tactile sensation. HALS has gained acceptance for a wide range of abdominal procedures in general surgery and urology and is now feasible for complicated surgeries such as splenectomy, nephroureterectomy, and colectomy. It has been demonstrated in numerous specialties that HALS is a safe and efficacious technique that combines the benefits of laparoscopy with the advantages of a conventional laparotomy. Standard laparoscopic surgery also has limitations in gynecological surgery. A patient may have high risks with conventional laparoscopic surgery when she has deep invasive endometriosis, multiple or massive myoma, or dense pelvic adhesions from prior surgery. HALS overcomes many of the aforementioned limitations, has less conversion to open surgery, and broadens the indications for minimally invasive surgery, not only for benign tumors but also for pelvic malignancies.

Metabolic syndrome after laparoscopic bariatric surgery.

Science.gov (United States)

Nugent, Clare; Bai, Chunhong; Elariny, Hazem; Gopalakrishnan, Priya; Quigley, Caitlin; Garone, Michael; Afendy, Mariam; Chan, Oscar; Wheeler, Angela; Afendy, Arian; Younossi, Zobair M

2008-10-01

Metabolic syndrome (MS) is common among morbidly obese patients undergoing bariatric surgery. The aim of this study was to assess the impact and predictors of bariatric surgery on the resolution of MS. Subjects included 286 patients [age 44.0 +/- 11.5, female 78.2%, BMI 48.7 +/- 9.4, waist circumference 139 +/- 20 cm, AST 23.5 +/- 14.9, ALT 30.0 +/- 20.1, type 2 diabetes mellitus (DM) 30.1% and MS 39.2%] who underwent bariatric surgery. Of the entire cohort, 27.3% underwent malabsorptive surgery, 55.9% underwent restrictive surgery, and 16.8% had combination restrictive-malabsorptive surgery. Mean weight loss was 33.7 +/- 20.1 kg after restrictive surgery (follow up period 298 +/- 271 days), 39.4 +/- 22.9 kg after malabsorptive surgery (follow-up period 306 +/- 290 days), and 28.3 +/- 14.1 kg after combination surgery (follow-up period 281 +/- 239 days). Regardless of the type of bariatric surgery, significant improvements were noted in MS (p values from <0.0001-0.01) as well as its components such as DM (p values from <0.0001-0.0005), waist circumference (p values <0.0001), BMI (p values <0.0001), fasting serum triglycerides (p values <0.0001 to 0.001), and fasting serum glucose (p values <0.0001). Additionally, a significant improvement in AST/ALT ratio (p value = 0.0002) was noted in those undergoing restrictive surgery. Multivariate analysis showed that patients who underwent malabsorptive bariatric procedures experienced a significantly greater percent excess weight loss than patients who underwent restrictive procedures (p value = 0.0451). Percent excess weight loss increased with longer postoperative follow-up (p value <0.0001). Weight loss after bariatric surgery is associated with a significant improvement in MS and other metabolic factors.

Fast track surgery at the University Teaching Hospital of Kigali: a ...

African Journals Online (AJOL)

Background: Fast Track Surgery is synonymous with Enhanced Recovery after Surgery. It was started in the 1990's initially for colorectal surgery, but later became applicable to other aspects of surgery. Its core elements include epidural or regional anaesthesia, perioperative fluid management, minimally invasive surgical ...

[Thromboelastography and its use in cardiac surgery].

Science.gov (United States)

Ak, Koray; Atalan, Nazan; Tekeli, Atike; Işbir, Selim; Civelek, Ali; Emekli, Nesrin; Arsan, Sinan

2008-04-01

Thromboelastography is an alternative method to conventional coagulation tests for the general evaluation of hemostatic system. Cardiac surgery with cardiopulmonary bypass is accomplished by complex alterations of hemostasis, including acquired dysfunction of platelets, consumption coagulopathy and increased fibrinolysis. Despite major advances in blood conservation methods and perioperative care of the patients, transfusion rates in cardiac surgery remain high. Thromboelastography has an ability to assess almost all components of haemostatic system globally. Currently, thromboelastography is used with standard coagulation tests to decrease the microvascular bleeding and homologous blood transfusion in cardiac surgery with cardiopulmonary bypass. In this review, we aimed to discuss thromboelastography technology and its usage in cardiac surgery.

Aesthetic journeys: a review of cosmetic surgery tourism.

Science.gov (United States)

Terence Pereira, Ryan; Malone, Carmel M; Flaherty, Gerard T

2018-06-01

Medical tourism has witnessed significant growth in recent years. The emerging trend towards international travel for cosmetic surgical interventions has not previously been reviewed. The current review aims to critically address the scale and impact of cosmetic surgical tourism and to delineate the complication profile of this form of medical tourism. Articles published in the English language on the PubMed database that were relevant to surgical tourism and the complications of elective surgical procedures abroad were examined. Reference lists of articles identified were further scrutinized. The search terms used included combinations of 'surgery abroad', 'cosmetic surgery abroad', 'cosmetic surgery tourism', 'cosmetic surgery complications' and 'aesthetic tourism'. This article critically reviews the epidemiology of cosmetic surgical tourism and its associated economic factors. Surgical complications of selected procedures, including perioperative complications, are described. The implications for travel medicine practice are considered and recommendations for further research are proposed. This narrative literature review focuses on the issues affecting travellers who obtain cosmetic surgical treatment overseas. There is a lack of focus in the travel medicine literature on the non-surgery-related morbidity of this special group of travellers. Original research exploring the motivation and pre-travel preparation, including the psychological counselling, of cosmetic surgical tourists is indicated.

Delirium in fast-track colonic surgery

DEFF Research Database (Denmark)

Kurbegovic, Sorel; Andersen, Jens; Krenk, Lene

2015-01-01

BACKGROUND: Postoperative delirium (PD) is a common but serious problem after major surgery with a multifactorial pathogenesis including age, pain, opioid use, sleep disturbances and the surgical stress response. These factors have been minimised by the "fast-track methodology" previously...... demonstrated to enhance recovery and reduce morbidity. METHODS: Clinical symptoms of PD were routinely collected three times daily from preoperatively until discharge in a well-defined enhanced recovery program after colonic surgery in 247 consecutive patients. RESULTS: Total median length of hospital stay...... postoperative recovery program may decrease the risk and duration of PD after colonic surgery....

Complications of laryngeal framework surgery (phonosurgery).

Science.gov (United States)

Tucker, H M; Wanamaker, J; Trott, M; Hicks, D

1993-05-01

The rising popularity of surgery involving the laryngeal framework (surgical medialization of immobile vocal folds, vocal fold tightening, pitch variation, etc.) has resulted in increasing case experience. Little has appeared in the literature regarding complications or long-term results of this type of surgery. Several years' experience in a major referral center with various types of laryngeal framework surgery has led to a small number of complications. These have included late extrusion of the prosthesis and delayed hemorrhage. A review of these complications and recommendations for modification of technique to minimize them in the future are discussed.

deal Rehabilitation Programme after Anterior Cruciate Ligament Injury: Review of Evidence

Directory of Open Access Journals (Sweden)

Adeel Nazir AHMAD

2016-03-01

Full Text Available Knee injuries are the second most common musculoskeletal injuries in primary care, with anterior cruciate the most commonly injured ligament. It is caused by contact / non - contact and accelerating/decelerating twisting injury of the knee. Typical presentation includes trauma with pain and swellin g, with laxity of the knee joint. Management includes rehabilitation alone or surgery combined with rehabilitation. Pre - surgery rehabilitation with graded physiotherapy programme results in improved postoperative recovery, reduced pain, swelling, better s tability and improved range of movement. No consensus exists on an ideal rehabilitation programme, as various factors, including injury to other knee structures, choice of graft, type of surgery performed and patient preference exist. Rehabilitation includ es accelerated vs. conservative, closed vs. open kinetic chain and techniques involving bracing, neuromuscular training and cryotherapy. Ideal personalised rehabilitation plan should include educating athletes to improve adherence, providing realistic stra tegies and approximate time frame for a return to sport. Studies support accelerated rehabilitation before and after surgery, in a clinic and home setting, with combined kinetic exercises. Accelerated rehabilitation protocol involving exercises to increas e muscle strength, knee ROM and proprioception along with reducing pain, inflammation and swelling can lead to better knee stability and a less complicated rehabilitation course.

Corrective Jaw Surgery

Medline Plus

Full Text Available ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws ...

Joint awareness after total knee arthroplasty is affected by pain and quadriceps strength.

Science.gov (United States)

Hiyama, Y; Wada, O; Nakakita, S; Mizuno, K

2016-06-01

There is a growing interest in the use of patient-reported outcomes to provide a more patient-centered view on treatment. Forgetting the artificial joint can be regarded as the goal in joint arthroplasty. The goals of the study were to describe changes in joint awareness in the artificial joint after total knee arthroplasty (TKA), and to determine which factors among pain, knee range of motion (ROM), quadriceps strength, and functional ability affect joint awareness after TKA. Patients undergoing TKA demonstrate changes in joint awareness and joint awareness is associated with pain, knee ROM, quadriceps strength, and functional ability. This prospective cohort study comprised 63 individuals undergoing TKA, evaluated at 1, 6, and 12 months postoperatively. Outcomes included joint awareness assessed using the Forgotten Joint Score (FJS), pain score, knee ROM, quadriceps strength, and functional ability. Fifty-eight individuals completed all postoperative assessments. All measures except for knee extension ROM improved from 1 to 6 months. However, there were no differences in any measures from 6 to 12 months. FJS was affected most greatly by pain at 1 month and by quadriceps strength at 6 and 12 months. Patients following TKA demonstrate improvements in joint awareness and function within 6 months after surgery, but reach a plateau from 6 to 12 months. Quadriceps strength could contribute to this plateau of joint awareness. Prospective cohort study, IV. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

HCUP State Ambulatory Surgery Databases (SASD) - Restricted Access Files

Data.gov (United States)

U.S. Department of Health & Human Services — The State Ambulatory Surgery Databases (SASD) contain the universe of hospital-based ambulatory surgery encounters in participating States. Some States include...

The ongoing emergence of robotics in plastic and reconstructive surgery.

Science.gov (United States)

Struk, S; Qassemyar, Q; Leymarie, N; Honart, J-F; Alkhashnam, H; De Fremicourt, K; Conversano, A; Schaff, J-B; Rimareix, F; Kolb, F; Sarfati, B

2018-04-01

Robot-assisted surgery is more and more widely used in urology, general surgery and gynecological surgery. The interest of robotics in plastic and reconstructive surgery, a discipline that operates primarily on surfaces, has yet to be conclusively proved. However, the initial applications of robotic surgery in plastic and reconstructive surgery have been emerging in a number of fields including transoral reconstruction of posterior oropharyngeal defects, nipple-sparing mastectomy with immediate breast reconstruction, microsurgery, muscle harvesting for pelvic reconstruction and coverage of the scalp or the extremities. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Introduction-Pediatric epilepsy surgery techniques.

Science.gov (United States)

Rydenhag, Bertil; Cukiert, Arthur

2017-04-01

This supplement includes the proceedings from the Pediatric Epilepsy Surgery Techniques Meeting held in Gothenburg (July 4-5, 2014), which focused on presentations and discussions regarding specific surgical technical issues in pediatric epilepsy surgery. Pediatric epilepsy neurosurgeons from all over the world were present and active in very fruitful and live presentations and discussions. These articles represent a synopsis of the areas and subjects dealt with there. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

Spectral entropy and haemodynamic response to surgery during ...

African Journals Online (AJOL)

Adele

Spectral entropy and haemodynamic response to surgery during sevoflurane anaesthesia. Introduction. Apart from somatic responses, surgery also evokes autonomic responses, including haemodynamic responses. Spectral entropy has been validated as a means to monitor the hypnotic state during sevoflurane ...

Venous thromboembolism prophylaxis in plastic surgery

DEFF Research Database (Denmark)

Nielsen, Lea Juul; Matzen, Steen H

2017-01-01

BACKGROUND: Venous thromboembolism is a well-documented complication of surgery, including plastic surgery. However, few consensus guidelines on thromboembolism prophylaxis exist in plastic surgery and, thus, the different approaches in the public as well as the private clinics in Denmark were...... investigated using a web-based survey. METHODS: Forty-two clinics were contacted and 45% responded. RESULTS: The collected data reveals a lack of consensus in plastic surgery in Denmark, not only regarding the use of mechanical and chemical prophylaxis, but also which type of prophylaxis to apply, the duration...... of prophylaxis, and how to risk stratify the patients. CONCLUSION: The development of a guideline, based on plastic surgical data, using a validated risk assessment model, which combines the surgical risk with the patient related risk and recommends guidelines for mechanical as well as chemoprophylaxis...

The mortality after surgery in primary lung cancer

DEFF Research Database (Denmark)

Green, Anders; Hauge, Jacob; Iachina, Maria

2015-01-01

OBJECTIVES: The study has been performed to investigate the mortality within the first year after resection in patients with primary lung cancer, together with associated prognostic factors including gender, age, tumour stage, comorbidity, alcohol abuse, type of surgery and post-surgical complica......OBJECTIVES: The study has been performed to investigate the mortality within the first year after resection in patients with primary lung cancer, together with associated prognostic factors including gender, age, tumour stage, comorbidity, alcohol abuse, type of surgery and post...... included gender, age, comorbidity (Charlson comorbidity index), perioperative stage, type of resection, registered complications to surgery and alcohol abuse. RESULTS: The cumulative deaths after 30 days, 90 days, 180 days and 360 days were 72 (2.1%), 154 (4.6%), 239 (7.1%) and 478 (14.2%), respectively...... resection, which is conventionally considered a time window of relevance for the adverse outcome of surgery. Increased efforts should be made for optimizing the selection of patients suited for resection and for identifying patients at increased risk of death after resection. Furthermore, patients should...

Taking NOTES: translumenal flexible endoscopy and endoscopic surgery.

Science.gov (United States)

Willingham, Field F; Brugge, William R

2007-09-01

To review the current state of natural orifice surgery and examine the concerns, challenges, and opportunities presented by translumenal research. Translumenal endoscopic procedures have been the focus of extensive research. Researchers have reported natural orifice translumenal endoscopic surgery in a swine model in several areas involving the abdominal cavity. Diagnostic procedures have included endoscopic peritoneoscopy, liver biopsy, lymphadenectomy, and abdominal exploration. Several gynecologic procedures including tubal ligation, oophorectomy, and partial hysterectomy have been demonstrated using current commercial endoscopes. Gastrointestinal surgical procedures, including gastrojejunostomy, cholecystectomy, splenectomy, and distal pancreatectomy have been performed successfully via transgastric and/or transcolonic approaches. There have been no studies of natural orifice translumenal endoscopic surgery procedures published in humans. While fundamental questions about the emerging technology have not been scrutinized, limitations of the large animal model will pose a challenge to the development of large randomized trials. While natural orifice translumenal endoscopic surgery may represent a paradigm shift and may offer significant benefits to patients, rigorous testing of the techniques is lacking and current data have been drawn from case series.

Recurrence factors for chronic subdural hematoma after burr-hole surgery

International Nuclear Information System (INIS)

Nagashima, Hiroaki; Sakata, Junichi; Ishii, Taiji; Chiba, Yoshiyuki; Miyake, Shigeru

2010-01-01

Although chronic subdural hematoma (CSDH) is well known as a curable condition, it also has a significant recurrence rate. To identify risk factors for recurrence, we compared the clinical features in two groups of patients with or without recurrence. The present study included 172 adult patients who had underwent one burr-hole and closed-system drainage between April 2007 and January 2010. Of these 23 cases (13.4%) experienced recurrence after surgery. The factors analyzed were patient background including, gender, age, history of drinking, diabetes, and the use of antiplatelet or anticoagulant medications, and a history of head injury, clinical symptoms, including initial neurologic symptoms, and computed tomography findings such as hematoma thickness, midline-shift, and density of the hematoma factors related to surgery such as duration from trauma to surgery and operation method and the recurrence rate. The results of this study showed that a short duration from trauma to surgery and the absence of traumatic history were recurrence factors for CSDH after burr-hole surgery. These results suggest that any cases with these risk factors should be closely observed after burr hole surgery. (author)

Improved knee flexion following high-flexion total knee arthroplasty

Directory of Open Access Journals (Sweden)

Lionberger David R

2012-06-01

Full Text Available Abstract Background The application of new techniques and materials in total knee arthroplasty (TKA continue to be a primary focus in orthopedic surgery. The primary aim of the present study is to evaluate post TKA total range of motion (ROM among a group of patients who received a gender specific high-flexion design modification implant compared to a control group of patients who received non-gender specific implants. Methods and results The control group was comprised of 39 TKAs that were recruited pre-operatively and received the non-gender specific implant while the study group consisted of 39 TKAs who received gender specific implants. The study group yielded an improvement in mean post-operative ROM of 21° at 12 months, whereas the mean improvement in ROM among the control group was 11°. Thus, the study group had a 10° increased ROM improvement (91% over the control group (p = 0.00060. In addition, 100% of the subjects with gender specific high-flexion implants achieved greater or equal ROM post-operatively compared to 82% for the control cohort. Lastly, women who exhibited greater pre-operative ROM and lower body mass index (BMI were found to benefit the most with the gender specific prosthesis. Conclusion Our study demonstrates that among subjects with a normal BMI, the gender specific high-flexion knee implant is associated with increased ROM as compared to the non-gender specific non-high-flexion implant designs.

RADIATION AND SURGERY

African Journals Online (AJOL)

Dr. S.A. Adewuyi

Radiation therapy and surgery in cancer management. 1S.A.Adewuyi,. 2 ... cancer, since axillary node status may determine whether or not a ... The principles are 'En-bloc' dissection which ... prevention of symptoms of cancer, including pain alleviation, and .... Pre-Operative And Post-Operative Radiotherapy: These terms ...

Refractive Surgery: Malpractice Litigation Outcomes.

Science.gov (United States)

Custer, Benjamin L; Ballard, Steven R; Carroll, Robert B; Barnes, Scott D; Justin, Grant A

2017-10-01

To review data on malpractice claims related to refractive surgery to identify common allegations and injuries and financial outcomes. The WestlawNext database was reviewed for all malpractice lawsuits/settlements related to refractive eye surgery. Data evaluated included patient demographics, type of operation performed, plaintiff allegation, nature of injury, and litigation outcomes. A total of 167 cases met the inclusion criteria, of which 108 cases (64.7%) were found to be favorable and 59 cases (35.3%) unfavorable to the defendant. A total of 141 cases were tried by a jury with 108 cases (76.4%) favorable and 33 cases (23.6%) unfavorable to the defendant. Laser in situ keratomileusis was performed in 127 cases (76%). The most common allegations were negligence in treatment or surgery in 127 cases (76%) and lack of informed consent in 83 cases (49.7%). For all cases, the need for future surgery (P = 0.0001) and surgery resulting in keratoconus (P = 0.05) were more likely to favor the plaintiff. In jury verdict decisions, cases in which failure to diagnose a preoperative condition was alleged favored the defendant (P = 0.03), whereas machine malfunction (P = 0.05) favored the plaintiff. After adjustment for inflation, the overall mean award was $1,287,872. Jury verdicts and settlements led to mean awards of $1,604,801 and $826,883, respectively. Malpractice litigation in refractive surgery tends to favor the defendant. However, large awards and settlements were given in cases that were favorable to the plaintiff. The need for future surgery and surgery leading to keratoconus increased the chance of an unfavorable outcome.

OSAS Surgery and Postoperative Discomfort: Phase I Surgery versus Phase II Surgery

Directory of Open Access Journals (Sweden)

Giulio Gasparini

2015-01-01

Full Text Available Introduction. This study aims to investigate the reasons that discourage the patients affected by OSAS to undergo orthognathic surgery and compares the postoperative discomfort of phase I (soft tissue surgery and phase II (orthognathic surgery procedures for treatment of OSAS. Material and Methods. A pool of 46 patients affected by OSAS was divided into two groups: “surgery patients” who accepted surgical treatments of their condition and “no surgery patients” who refused surgical procedures. The “surgery patients” group was further subdivided into two arms: patients who accepted phase I procedures (IP and those who accepted phase II (IIP. To better understand the motivations behind the refusal of II phase procedures, we asked the patients belonging to both the IP group and “no surgery” group to indicate the main reason that influenced their decision to avoid II phase procedures. We also monitored and compared five parameters of postoperative discomfort: pain, painkiller assumption, length of hospitalization, foreign body sensation, and diet assumption following IP and IIP procedures. Results. The main reason to avoid IIP procedures was the concern of a more severe postoperative discomfort. Comparison of the postoperative discomfort following IP versus IIP procedures showed that the former scored worse in 4 out of 5 parameters analyzed. Conclusion. IIP procedures produce less postoperative discomfort. IIP procedures, namely, orthognathic surgery, should be the first choice intervention in patients affected by OSAS and dentoskeletal malformation.

A New Era of Minimally Invasive Surgery: Progress and Development of Major Technical Innovations in General Surgery Over the Last Decade.

Science.gov (United States)

Siddaiah-Subramanya, Manjunath; Tiang, Kor Woi; Nyandowe, Masimba

2017-10-01

Minimally invasive surgery (MIS) continues to play an important role in general surgery as an alternative to traditional open surgery as well as traditional laparoscopic techniques. Since the 1980s, technological advancement and innovation have seen surgical techniques in MIS rapidly grow as it is viewed as more desirable. MIS, which includes natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopic surgery (SILS), is less invasive and has better cosmetic results. The technological growth and adoption of NOTES and SILS by clinicians in the last decade has however not been uniform. We look at the differences in new developments and advancement in the different techniques in the last 10 years. We also aim to explain these differences as well as the implications in general surgery for the future.

Accuracy of Three-Dimensional Planning in Surgery-First Orthognathic Surgery: Planning Versus Outcome

Science.gov (United States)

Tran, Ngoc Hieu; Tantidhnazet, Syrina; Raocharernporn, Somchart; Kiattavornchareon, Sirichai; Pairuchvej, Verasak; Wongsirichat, Natthamet

2018-01-01

Background The benefit of computer-assisted planning in orthognathic surgery (OGS) has been extensively documented over the last decade. This study aimed to evaluate the accuracy of three-dimensional (3D) virtual planning in surgery-first OGS. Methods Fifteen patients with skeletal class III malocclusion who underwent bimaxillary OGS with surgery-first approach were included. A composite skull model was reconstructed using data from cone-beam computed tomography and stereolithography from a scanned dental cast. Surgical procedures were simulated using Simplant O&O software, and the virtual plan was transferred to the operation room using 3D-printed splints. Differences of the 3D measurements between the virtual plan and postoperative results were evaluated, and the accuracy was reported using root mean square deviation (RMSD) and the Bland-Altman method. Results The virtual planning was successfully transferred to surgery. The overall mean linear difference was 0.88 mm (0.79 mm for the maxilla and 1 mm for the mandible), and the overall mean angular difference was 1.16°. The RMSD ranged from 0.86 to 1.46 mm and 1.27° to 1.45°, within the acceptable clinical criteria. Conclusion In this study, virtual surgical planning and 3D-printed surgical splints facilitated the diagnosis and treatment planning, and offered an accurate outcome in surgery-first OGS. PMID:29581806

Accuracy of Three-Dimensional Planning in Surgery-First Orthognathic Surgery: Planning Versus Outcome.

Science.gov (United States)

Tran, Ngoc Hieu; Tantidhnazet, Syrina; Raocharernporn, Somchart; Kiattavornchareon, Sirichai; Pairuchvej, Verasak; Wongsirichat, Natthamet

2018-05-01

The benefit of computer-assisted planning in orthognathic surgery (OGS) has been extensively documented over the last decade. This study aimed to evaluate the accuracy of three-dimensional (3D) virtual planning in surgery-first OGS. Fifteen patients with skeletal class III malocclusion who underwent bimaxillary OGS with surgery-first approach were included. A composite skull model was reconstructed using data from cone-beam computed tomography and stereolithography from a scanned dental cast. Surgical procedures were simulated using Simplant O&O software, and the virtual plan was transferred to the operation room using 3D-printed splints. Differences of the 3D measurements between the virtual plan and postoperative results were evaluated, and the accuracy was reported using root mean square deviation (RMSD) and the Bland-Altman method. The virtual planning was successfully transferred to surgery. The overall mean linear difference was 0.88 mm (0.79 mm for the maxilla and 1 mm for the mandible), and the overall mean angular difference was 1.16°. The RMSD ranged from 0.86 to 1.46 mm and 1.27° to 1.45°, within the acceptable clinical criteria. In this study, virtual surgical planning and 3D-printed surgical splints facilitated the diagnosis and treatment planning, and offered an accurate outcome in surgery-first OGS.

Surgery for adrenal tumors

International Nuclear Information System (INIS)

Salamah, S.M.

2002-01-01

Objective: To analyze the presentation, localization, pathology, surgical management and outcome of surgery for adrenal gland tumors. Design: Prospective clinico epidemiological study. Place and Duration of Study: The study was conducted at the Department of General Surgery, University Unit, Riyadh medical Complex Kingdom of Saudi Rabia from June, 1991 to may, 2001. Subjects and Methods: A total of 21 cases with adrenal tumors were studied for demographic data, clinical presentation, diagnostic workup, localization, surgical management, pathology and outcome. The outcome of these patients was followed prospectively. Results: The study included 12 female and 9 male patients. The mean age at surgery was 36.7 years. Hypertension (69.%) was the commonest presentation in hypersecretory functional tumors. The localization accuracy for ultrasonography, computerized tomography, MRI and MIBG scan was 95.2%, 98.3% 87.8% and 83.6% respectively. Pheochromocytoma was the most common adrenal pathology observed in 14 (66.6%) cases. The overall morbidity was 19% with no hospital mortality. Complete follow-up of available 19 patients (90.5 %) revealed no tumor recurrence and persistent hypertension in 14.3% cases. Conclusion: surgery on adrenal glands is safe in experienced hands and is recommended in institutes with all backup facilities. (author)

Anesthesia for off-pump coronary artery bypass surgery

Directory of Open Access Journals (Sweden)

Thomas M Hemmerling

2013-01-01

Full Text Available The evolution of techniques and knowledge of beating heart surgery has led anesthesia toward the development of new procedures and innovations to promote patient safety and ensure high standards of care. Off-pump coronary artery bypass (OPCAB surgery has shown to have some advantages compared to on-pump cardiac surgery, particularly the reduction of postoperative complications including systemic inflammation, myocardial injury, and cerebral injury. Minimally invasive surgery for single vessel OPCAB through a limited thoracotomy incision can offer the advantage of further reduction of complications. The anesthesiologist has to deal with different issues, including hemodynamic instability and myocardial ischemia during aorto-coronary bypass grafting. The anesthesiologist and surgeon should collaborate and plan the best perioperative strategy to provide optimal care and ensure a rapid and complete recovery. The use of high thoracic epidural analgesia and fast-track anesthesia offers particular benefits in beating heart surgery. The excellent analgesia, the ability to reduce myocardial oxygen consumption, and the good hemodynamic stability make high thoracic epidural analgesia an interesting technique. New scenarios are entering in cardiac anesthesia: ultra-fast-track anesthesia with extubation in the operating room and awake surgery tend to be less invasive, but can only be performed on selected patients.

Tennis elbow surgery

Science.gov (United States)

Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery ... Surgery to repair tennis elbow is often an outpatient surgery. This means you will not stay in the hospital overnight. You will be given ...

Dutch Lung Surgery Audit: A National Audit Comprising Lung and Thoracic Surgery Patients.

Science.gov (United States)

Berge, Martijn Ten; Beck, Naomi; Heineman, David Jonathan; Damhuis, Ronald; Steup, Willem Hans; van Huijstee, Pieter Jan; Eerenberg, Jan Peter; Veen, Eelco; Maat, Alexander; Versteegh, Michel; van Brakel, Thomas; Schreurs, Wilhemina Hendrika; Wouters, Michel Wilhelmus

2018-04-21

The nationwide Dutch Lung Surgery Audit (DLSA) started in 2012 to monitor and evaluate the quality of lung surgery in the Netherlands as an improvement tool. This outline describes the establishment, structure and organization of the audit by the Dutch Society of Lung Surgeons (NVvL) and the Dutch Society of Cardiothoracic Surgeons (NVT), in collaboration with the Dutch Institute for Clinical Auditing (DICA). In addition, first four-year results are presented. The NVvL and NVT initiated a web-based registration including weekly updated online feedback for participating hospitals. Data verification by external data managers is performed on regular basis. The audit is incorporated in national quality improvement programs and participation in the DLSA is mandatory by health insurance organizations and the National Healthcare Inspectorate. Between 1 January 2012 and 31 December 2015, all hospitals performing lung surgery participated and a total of 19,557 patients were registered from which almost half comprised lung cancer patients. Nationwide the guideline adherence increased over the years and 96.5% of lung cancer patients were discussed in preoperative multidisciplinary teams. Overall postoperative complications and mortality after non-small cell lung cancer surgery were 15.5% and 2.0%, respectively. The audit provides reliable benchmarked information for caregivers and hospital management with potential to start local, regional or national improvement initiatives. Currently, the audit is further completed with data from non-surgical lung cancer patients including treatment data from pulmonary oncologists and radiation oncologists. This will ultimately provide a comprehensive overview of lung cancer treatment in The Netherlands. Copyright © 2018. Published by Elsevier Inc.

Mohs micrographic surgery

Science.gov (United States)

Skin cancer - Mohs surgery; Basal cell skin cancer - Mohs surgery; Squamous cell skin cancer - Mohs surgery ... Mohs surgery usually takes place in the doctor's office. The surgery is started early in the morning and is ...

[Thymus surgery in a general surgery department].

Science.gov (United States)

Mega, Raquel; Coelho, Fátima; Pimentel, Teresa; Ribero, Rui; Matos, Novo de; Araújo, António

2005-01-01

Evaluation of thymectomy cases between 1990-2003, in a General Surgery Department. Evaluation of the therapeutic efficacy in Miastenia Gravis patients. Retrospective study based on evaluation of data from Serviço de Cirurgia, Neurologia and Consult de Neurology processes, between 1990-2003, of 15 patients submitted to total thymectomy. 15 patients, aged 17 to 72, 11 female and 4 male. Miastenia Gravis was the main indication for surgery, for uncontrollable symptoms or suspicion of thymoma. In patients with myasthenia, surgery was accomplish after compensation of symptoms. There weren't post-surgery complications. Pathology were divided in thymic hyperplasia and thymoma. Miastenia patients have there symptoms diminished or stable with reduction or cessation of medical therapy. Miastenia was the most frequent indication for thymectomy. Surgery was good results, with low morbimortality, as long as the protocols are respected.

Nanomechanical recognition of prognostic biomarker suPAR with DVD-ROM optical technology

International Nuclear Information System (INIS)

Bache, Michael; Bosco, Filippo G; Brøgger, Anna L; Frøhling, Kasper B; Boisen, Anja; Alstrøm, Tommy Sonne; Hwu, En-Te; Chen, Ching-Hsiu; Hwang, Ing-Shouh; Eugen-Olsen, Jesper

2013-01-01

In this work the use of a high-throughput nanomechanical detection system based on a DVD-ROM optical drive and cantilever sensors is presented for the detection of urokinase plasminogen activator receptor inflammatory biomarker (uPAR). Several large scale studies have linked elevated levels of soluble uPAR (suPAR) to infectious diseases, such as HIV, and certain types of cancer. Using hundreds of cantilevers and a DVD-based platform, cantilever deflection response from antibody–antigen recognition is investigated as a function of suPAR concentration. The goal is to provide a cheap and portable detection platform which can carry valuable prognostic information. In order to optimize the cantilever response the antibody immobilization and unspecific binding are initially characterized using quartz crystal microbalance technology. Also, the choice of antibody is explored in order to generate the largest surface stress on the cantilevers, thus increasing the signal. Using optimized experimental conditions the lowest detectable suPAR concentration is currently around 5 nM. The results reveal promising research strategies for the implementation of specific biochemical assays in a portable and high-throughput microsensor-based detection platform. (paper)

A review of medical robotics for minimally invasive soft tissue surgery.

Science.gov (United States)

Dogangil, G; Davies, B L; Rodriguez y Baena, F

2010-01-01

This paper provides an overview of recent trends and developments in medical robotics for minimally invasive soft tissue surgery, with a view to highlight some of the issues posed and solutions proposed in the literature. The paper includes a thorough review of the literature, which focuses on soft tissue surgical robots developed and published in the last five years (between 2004 and 2008) in indexed journals and conference proceedings. Only surgical systems were considered; imaging and diagnostic devices were excluded from the review. The systems included in this paper are classified according to the following surgical specialties: neurosurgery; eye surgery and ear, nose, and throat (ENT); general, thoracic, and cardiac surgery; gastrointestinal and colorectal surgery; and urologic surgery. The systems are also cross-classified according to their engineering design and robotics technology, which is included in tabular form at the end of the paper. The review concludes with an overview of the field, along with some statistical considerations about the size, geographical spread, and impact of medical robotics for soft tissue surgery today.

Animal Surgery and Resources Core

Data.gov (United States)

Federal Laboratory Consortium — The ASR services for NHLBI research animals include: animal model development, surgery, surgical support, post-operative care as well as technical services such as...

The risk of ischemic optic neuropathy post phacoemulsification cataract surgery.

Science.gov (United States)

Al-Madani, Mousa Victor; Al-Raqqad, Nancy Khalaf; Al-Fgarra, Naser Abdallah; Al-Thawaby, Amal Mousa; Jaafar, Ahmed Abdelra'of

2017-01-01

The aim was to study the risk of non arteritic ischemic optic neuropathy after phacoemulsification cataract surgery. This study was conducted at King Hussein Medical Center during the period between January 2015 and July 2016. Patients attending ophthalmology clinic complaining of decreased vision due to lens opacity were evaluated. Patients were divided into two groups. First group included patients with no medical illness and second group included patients with diabetes mellitus, hypertension or hyperlipidemia. The two groups were further divided into two subgroups. First subgroup included patients who had phacoemulsification surgery and second subgroup did not have surgery. All patients were followed up for 6 months. They were assessed by neuro-ophthalmologist looking for ischemic optic neuropathy. A total number of 568 patients were enrolled. Group 1A included patients with no medical illness who underwent surgery and group 1B did not undergo surgery. The number of patients in these two subgroups was 119 and 103 respectively. Number of patients in group 2A (medical illness and surgery) was 188 and number of patients in group 2B (medical illness and no surgery) was 130. The incidence of ischemic optic neuropathy was 4.3 % in group 2A, 4.2 % in group 1A, 0.8% in group 2B, and 0% in group 1B. Phacoemulsification is a risk factor for non arteritic ischemic optic neuropathy independent of the presence of medical risk factors. Suggested mechanisms would be local anaesthesia, intraocular pressure fluctuation and local intraocular inflammation.

Impact of robotic general surgery course on participants' surgical practice.

Science.gov (United States)

Buchs, Nicolas C; Pugin, François; Volonté, Francesco; Hagen, Monika E; Morel, Philippe

2013-06-01

Courses, including lectures, live surgery, and hands-on session, are part of the recommended curriculum for robotic surgery. However, for general surgery, this approach is poorly reported. The study purpose was to evaluate the impact of robotic general surgery course on the practice of participants. Between 2007 and 2011, 101 participants attended the Geneva International Robotic Surgery Course, held at the University Hospital of Geneva, Switzerland. This 2-day course included theory lectures, dry lab, live surgery, and hands-on session on cadavers. After a mean of 30.1 months (range, 2-48), a retrospective review of the participants' surgical practice was performed using online research and surveys. Among the 101 participants, there was a majority of general (58.4 %) and colorectal surgeons (10.9 %). Other specialties included urologists (7.9 %), gynecologists (6.9 %), pediatric surgeons (2 %), surgical oncologists (1 %), engineers (6.9 %), and others (5.9 %). Data were fully recorded in 99 % of cases; 46 % of participants started to perform robotic procedures after the course, whereas only 6.9 % were already familiar with the system before the course. In addition, 53 % of the attendees worked at an institution where a robotic system was already available. All (100 %) of participants who started a robotic program after the course had an available robotic system at their institution. A course that includes lectures, live surgery, and hands-on session with cadavers is an effective educational method for spreading robotic skills. However, this is especially true for participants whose institution already has a robotic system available.

Megarectumsigma underwent surgery for chronic faecal impact action

International Nuclear Information System (INIS)

Canessa, C.; Gomez del Valle, M.; Caraballo, M.

2002-01-01

Seven patients with megarectumsigma underwent surgery for chronic faecal impaction,reviewing clinical diagnosis, aetiology and medical and surgical management.It is suggested medical management of chronic faecal impaction trying to achieve elective surgery.The curative surgery should include the resection of all pathologic bowel, but in Duhamel procedure and its modifications distal rectal tran section should be at the peritoneal reflection.Habr-Gama modification has shown to be technically easier and it has been communicated good functional results.Local unfavourable conditions may be resolve by staged surgery,which allows outline definitive bowel reconstruction after functional assessment

The use of three-dimensional printing technology in orthopaedic surgery.

Science.gov (United States)

Wong, Tak Man; Jin, Jimmy; Lau, Tak Wing; Fang, Christian; Yan, Chun Hoi; Yeung, Kelvin; To, Michael; Leung, Frankie

2017-01-01

Three-dimensional (3-D) printing or additive manufacturing, an advanced technology that 3-D physical models are created, has been wildly applied in medical industries, including cardiothoracic surgery, cranio-maxillo-facial surgery and orthopaedic surgery. The physical models made by 3-D printing technology give surgeons a realistic impression of complex structures, allowing surgical planning and simulation before operations. In orthopaedic surgery, this technique is mainly applied in surgical planning especially revision and reconstructive surgeries, making patient-specific instruments or implants, and bone tissue engineering. This article reviews this technology and its application in orthopaedic surgery.

Corrective Jaw Surgery

Medline Plus

Full Text Available ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

Risk of Retinal Detachment After Pediatric Cataract Surgery

DEFF Research Database (Denmark)

Haargaard, Birgitte; Andersen, Elisabeth W; Oudin, Anna

2014-01-01

PURPOSE: To determine the long-term risk of retinal detachment following pediatric cataract surgery and to identify risk factors for retinal detachment. METHODS: We included all children (aged 0 to 17 years) who during the time period of 1977 to 2005 underwent pediatric cataract surgery in Denmark...... was based on medical chart review. RESULTS: Among 1043 eyes of 656 children undergoing surgery for pediatric cataract, 25 eyes (23 children) developed retinal detachment at a median time of 9.1 years after surgery. The overall 20-year risk of retinal detachment was 7% (95% confidence interval [CI]: 3...... (16% [95% CI: 6%-24%]). CONCLUSIONS: The estimated overall risk of retinal detachment 20 years after pediatric cataract surgery was 7%, but only 3% for isolated cataract. Particularly high risks of retinal detachment after cataract surgery were associated with mental retardation and having other...

Dentofacial morphology in adolescent or early adult patients with cleft lip and palate after a treatment regimen that included vomer flap surgery and pushback palatal repair.

Science.gov (United States)

Friede, H; Lilja, J

1994-06-01

Dentofacial morphology was evaluated in 94 adolescent or early adult patients born with unilateral or bilateral cleft lip and palate. As well as lip closure, the primary treatment included vomer flap surgery and pushback palatal repair. Roentgencephalometric measurements as well as classification of the patients into different classes of dentofacial deformity indicated development of bimaxillary retrognathia with severe midfacial deficiency in about a quarter of the cases. Our results were similar to those reported by other teams who used similar surgical regimen.

0 + 5 Vascular Surgery Residents' Operative Experience in General Surgery: An Analysis of Operative Logs from 12 Integrated Programs.

Science.gov (United States)

Smith, Brigitte K; Kang, P Chulhi; McAninch, Chris; Leverson, Glen; Sullivan, Sarah; Mitchell, Erica L

2016-01-01

Integrated (0 + 5) vascular surgery (VS) residency programs must include 24 months of training in core general surgery. The Accreditation Council for Graduate Medical Education currently does not require specific case numbers in general surgery for 0 + 5 trainees; however, program directors have structured this time to optimize operative experience. The aim of this study is to determine the case volume and type of cases that VS residents are exposed to during their core surgery training. Accreditation council for graduate medical education operative logs for current 0 + 5 VS residents were obtained and retrospectively reviewed to determine general surgery case volume and distribution between open and laparoscopic cases performed. Standard statistical methods were applied. A total of 12 integrated VS residency programs provided operative case logs for current residents. A total of 41 integrated VS residents in clinical years 2 through 5. During the postgraduate year-1 training year, residents participated in significantly more open than laparoscopic general surgery cases (p surgery cases are hernia repair (20%), skin and soft tissue (7.4%), and breast (6.3%). Residents in programs with core surgery over 3 years participated in significantly more general surgery operations compared with residents in programs with core surgery spread out over 4 years (p = 0.035). 0 + 5 VS residents perform significantly more open operations than laparoscopic operations during their core surgery training. The majority of these operations are minor, nonabdominal procedures. The 0 + 5 VS residency program general surgery operative training requirements should be reevaluated and case minimums defined. The general surgery training component of 0 + 5 VS residencies may need to be restructured to meet the needs of current and future trainees. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

RAPP, a systematic e-assessment of postoperative recovery in patients undergoing day surgery: study protocol for a mixed-methods study design including a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies.

Science.gov (United States)

Nilsson, U; Jaensson, M; Dahlberg, K; Odencrants, S; Grönlund, Å; Hagberg, L; Eriksson, M

2016-01-13

Day surgery is a well-established practice in many European countries, but only limited information is available regarding postoperative recovery at home though there is a current lack of a standard procedure regarding postoperative follow-up. Furthermore, there is also a need for improvement of modern technology in assessing patient-related outcomes such as mobile applications. This article describes the Recovery Assessment by Phone Points (RAPP) study protocol, a mixed-methods study to evaluate if a systematic e-assessment follow-up in patients undergoing day surgery is cost-effective and improves postoperative recovery, health and quality of life. This study has a mixed-methods study design that includes a multicentre, two-group, parallel, single-blind randomised controlled trial and qualitative interview studies. 1000 patients >17 years of age who are undergoing day surgery will be randomly assigned to either e-assessed postoperative recovery follow-up daily in 14 days measured via smartphone app including the Swedish web-version of Quality of Recovery (SwQoR) or to standard care (ie, no follow-up). The primary aim is cost-effectiveness. Secondary aims are (A) to explore whether a systematic e-assessment follow-up after day surgery has a positive effect on postoperative recovery, health-related quality of life (QoL) and overall health; (B) to determine whether differences in postoperative recovery have an association with patient characteristic, type of surgery and anaesthesia; (C) to determine whether differences in health literacy have a substantial and distinct effect on postoperative recovery, health and QoL; and (D) to describe day surgery patient and staff experiences with a systematic e-assessment follow-up after day surgery.The primary aim will be measured at 2 weeks postoperatively and secondary outcomes (A-C) at 1 and 2 weeks and (D) at 1 and 4 months. NCT02492191; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use

Morbidity and mortality of complex spine surgery

DEFF Research Database (Denmark)

Karstensen, Sven; Bari, Tanvir; Gehrchen, Martin

2016-01-01

requiring revision. METHODS: All patients undergoing spinal surgery at an academic tertiary referral center in the study period were prospectively included. The newest version of SAVES system was used, and a research coordinator collected all intraoperative and perioperative data prospectively. Once a week...... adverse events (AEs). PURPOSE: This study aimed to determine the mortality and examine the incidence of morbidity in patients undergoing complex spinal surgery, including pediatric patients, and to validate the SAVES system in a European population. STUDY DESIGN: A prospective, consecutive cohort study...

Are preoperative experimental pain assessments correlated with clinical pain outcomes after surgery?

DEFF Research Database (Denmark)

Sangesland, Anders; Støren, Carl; Vaegter, Henrik B.

2017-01-01

of surgery, QST variables, clinical pain outcome measure and main result. Results Most studies showed moderate to high risk of bias. Type of surgery investigated include 7 studies on total knee replacement, 5 studies on caesarean section, 4 studies on thoracic surgery, 2 studies on herniotomy, 2 studies......Background Pain after surgery is not uncommon with 30% of patients reporting moderate to severe postoperative pain. Early identification of patients prone to postoperative pain may be a step forward towards individualized pain medicine providing a basis for improved clinical management through......, and (3) the association between QST and pain after surgery was investigated. Forty-four unique studies were identified, with 30 studies on 2738 subjects meeting inclusion criteria. The methodological quality of the include studies was assessed and data extraction included study population, type...

Brachial Plexopathy After Cervical Spine Surgery

OpenAIRE

Than, Khoi D.; Mummaneni, Praveen V.; Smith, Zachary A.; Hsu, Wellington K.; Arnold, Paul M.; Fehlings, Michael G.; Mroz, Thomas E.; Riew, K. Daniel

2017-01-01

Study Design: Retrospective, multicenter case-series study and literature review. Objectives: To determine the prevalence of brachial plexopathy after cervical spine surgery and to review the literature to better understand the etiology and risk factors of brachial plexopathy after cervical spine surgery. Methods: A retrospective case-series study of 12?903 patients at 21 different sites was performed to analyze the prevalence of several different complications, including brachial plexopathy....

Urologic robotic surgery in Korea: past and present.

Science.gov (United States)

Seo, Ill Young

2015-08-01

Since 2005 when the da Vinci surgical system was approved as a medical device by the Korean Ministry of Health and Welfare, 51 systems have been installed in 40 institutions as of May 2015. Although robotic surgery is not covered by the national health insurance service in Korea, it has been used in several urologic fields as a less invasive surgery. Since the first robotic-assisted laparoscopic radical prostatectomy in 2005, partial nephrectomy, radical cystectomy, pyeloplasty, and other urologic surgeries have been performed. The following should be considered to extend the indications for robotic surgery: training systems including accreditation, operative outcomes from follow-up results, and cost-effectiveness. In this review, the history and current status of robotic surgeries in Korea are presented.

Reversal Surgery in Regretful Male-to-Female Transsexuals After Sex Reassignment Surgery.

Science.gov (United States)

Djordjevic, Miroslav L; Bizic, Marta R; Duisin, Dragana; Bouman, Mark-Bram; Buncamper, Marlon

2016-06-01

Sex reassignment surgery (SRS) has proved an effective intervention for patients with gender identity disorder. However, misdiagnosed patients sometimes regret their decision and request reversal surgery. This review is based on our experience with seven patients who regretted their decision to undergo male-to-female SRS. To analyze retrospectively seven patients who underwent reversal surgery after regretting their decision to undergo male-to-female SRS elsewhere. From November 2010 through November 2014, seven men 33 to 53 years old with previous male-to-female SRS underwent reversal phalloplasty. Preoperatively, they were examined by three independent psychiatrists. Surgery included three steps: removal of female genitalia with scrotoplasty and urethral lengthening, total phalloplasty with microvascular transfer of a musculocutaneous latissimus dorsi flap, and neophallus urethroplasty with penile prosthesis implantation. Self-reported esthetic and psychosexual status after reversion surgery and International Index of Erectile Function scores for sexual health after phalloplasty and penile prosthesis implantation. Follow-up was 13 to 61 months (mean = 31 months). Good postoperative results were achieved in all patients. In four patients, all surgical steps were completed; two patients are currently waiting for penile implants; and one patient decided against the penile prosthesis. Complications were related to urethral lengthening: two fistulas and one stricture were observed. All complications were repaired by minor revision. According to patients' self-reports, all patients were pleased with the esthetic appearance of their genitalia and with their significantly improved psychological status. Reversal surgery in regretful male-to-female transsexuals after SRS represents a complex, multistage procedure with satisfactory outcomes. Further insight into the characteristics of persons who regret their decision postoperatively would facilitate better future

Turbinate surgery

Science.gov (United States)

Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery; Nasal obstruction - turbinate surgery ... There are several types of turbinate surgery: Turbinectomy: All or ... This can be done in several different ways, but sometimes a ...

Laser assisted robotic surgery in cornea transplantation

Science.gov (United States)

Rossi, Francesca; Micheletti, Filippo; Magni, Giada; Pini, Roberto; Menabuoni, Luca; Leoni, Fabio; Magnani, Bernardo

2017-03-01

Robotic surgery is a reality in several surgical fields, such as in gastrointestinal surgery. In ophthalmic surgery the required high spatial precision is limiting the application of robotic system, and even if several attempts have been designed in the last 10 years, only some application in retinal surgery were tested in animal models. The combination of photonics and robotics can really open new frontiers in minimally invasive surgery, improving the precision, reducing tremor, amplifying scale of motion, and automating the procedure. In this manuscript we present the preliminary results in developing a vision guided robotic platform for laser-assisted anterior eye surgery. The robotic console is composed by a robotic arm equipped with an "end effector" designed to deliver laser light to the anterior corneal surface. The main intended application is for laser welding of corneal tissue in laser assisted penetrating keratoplasty and endothelial keratoplasty. The console is equipped with an integrated vision system. The experiment originates from a clear medical demand in order to improve the efficacy of different surgical procedures: when the prototype will be optimized, other surgical areas will be included in its application, such as neurosurgery, urology and spinal surgery.

Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery

DEFF Research Database (Denmark)

Nielsen, Henning B

2014-01-01

and number of patients included were recorded. There was included 113 articles and evidence suggests that rScO2 is reduced during thoracic surgery involving single lung ventilation, major abdominal surgery, hip surgery, and laparoscopic surgery with the patient placed in anti-Tredelenburg's position....... Shoulder arthroscopy in the beach chair and carotid endarterectomy with clamped internal carotid artery (ICA) also cause pronounced cerebral desaturation. A >20% reduction in rScO2 coincides with indices of regional and global cerebral ischemia during carotid endarterectomy. Following thoracic surgery...

Toward the Development of a Coupled COAMPS-ROMS Ensemble Kalman Filter and Adjoint with a focus on the Indian Ocean and the Intraseasonal Oscillation

Science.gov (United States)

2015-09-30

1 Approved for public release; distribution is unlimited. Toward the Development of a Coupled COAMPS-ROMS Ensemble Kalman Filter and Adjoint...system at NCAR. (2) Compare the performance of the Ensemble Kalman Filter (EnKF) using the Data Assimilation Research Testbed (DART) and 4...undercurrent is clearly visible. Figure 2 shows the horizontal temperature structure and circulation at a depth of 50 m within the surface mixed layer

Variable Operative Experience in Hand Surgery for Plastic Surgery Residents.

Science.gov (United States)

Silvestre, Jason; Lin, Ines C; Levin, Lawrence Scott; Chang, Benjamin

Efforts to standardize hand surgery training during plastic surgery residency remain challenging. We analyze the variability of operative hand experience at U.S. plastic surgery residency programs. Operative case logs of chief residents in accredited U.S. plastic surgery residency programs were analyzed (2011-2015). Trends in fold differences of hand surgery case volume between the 10th and 90th percentiles of residents were assessed graphically. Percentile data were used to calculate the number of residents achieving case minimums in hand surgery for 2015. Case logs from 818 plastic surgery residents were analyzed of which a minority were from integrated (35.7%) versus independent/combined (64.3%) residents. Trend analysis of fold differences in case volume demonstrated decreasing variability among procedure categories over time. By 2015, fold differences for hand reconstruction, tendon cases, nerve cases, arthroplasty/arthrodesis, amputation, arterial repair, Dupuytren release, and neoplasm cases were below 10-fold. Congenital deformity cases among independent/combined residents was the sole category that exceeded 10-fold by 2015. Percentile data suggested that approximately 10% of independent/combined residents did not meet case minimums for arterial repair and congenital deformity in 2015. Variable operative experience during plastic surgery residency may limit adequate exposure to hand surgery for certain residents. Future studies should establish empiric case minimums for plastic surgery residents to ensure hand surgery competency upon graduation. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

The Burden of Clostridium difficile after Cervical Spine Surgery.

Science.gov (United States)

Guzman, Javier Z; Skovrlj, Branko; Rothenberg, Edward S; Lu, Young; McAnany, Steven; Cho, Samuel K; Hecht, Andrew C; Qureshi, Sheeraz A

2016-06-01

Study Design Retrospective database analysis. Objective The purpose of this study is to investigate incidence, comorbidities, and impact on health care resources of Clostridium difficile infection after cervical spine surgery. Methods A total of 1,602,130 cervical spine surgeries from the Nationwide Inpatient Sample database from 2002 to 2011 were included. Patients were included for study based on International Classification of Diseases Ninth Revision, Clinical Modification procedural codes for cervical spine surgery for degenerative spine diagnoses. Baseline patient characteristics were determined. Multivariable analyses assessed factors associated with increased incidence of C. difficile and risk of mortality. Results Incidence of C. difficile infection in postoperative cervical spine surgery hospitalizations is 0.08%, significantly increased since 2002 (p difficile infection were significantly increased in patients with comorbidities such as congestive heart failure, renal failure, and perivascular disease. Circumferential cervical fusion (odds ratio [OR] = 2.93, p difficile infection after degenerative cervical spine surgery. C. difficile infection after cervical spine surgery results in extended length of stay (p costs (p difficile after cervical spine surgery is nearly 8% versus 0.19% otherwise (p difficile to be a significant predictor of inpatient mortality (OR = 3.99, p difficile increases the risk of in-hospital mortality and costs approximately $6,830,695 per year to manage in patients undergoing elective cervical spine surgery. Patients with comorbidities such as renal failure or congestive heart failure have increased probability of developing infection after surgery. Accepted antibiotic guidelines in this population must be followed to decrease the risk of developing postoperative C. difficile colitis.

Bariatric Surgery

Science.gov (United States)

... often. Each type of surgery has advantages and disadvantages. Bariatric Surgery Benefits Bariatric surgery can improve many ... Grants & Grant History Research Resources Research at NIDDK Technology Advancement & Transfer Meetings & Workshops Health Information Diabetes Digestive ...

Changes in heart rate during third molar surgery

NARCIS (Netherlands)

Hollander, M. H. J.; Schortinghuis, J.; Vissink, A.

2016-01-01

Anxiety is an undesirable psychological phenomenon. Patients are usually anxious when subjected to third molar surgery, but the pattern of anxiety is unknown. The aim of this study was to assess the intensity and course of anxiety during third molar surgery. This study included 48 consecutive

Single-Incision Transumbilical Surgery (SITUS) versus Single-Port Laparoscopic Surgery and conventional laparoscopic surgery: a prospective randomized comparative study of performance with novices in a dry laboratory.

Science.gov (United States)

Schoenthaler, Martin; Avcil, Tuba; Sevcenco, Sabina; Nagele, Udo; Hermann, Thomas E W; Kuehhas, Franklin E; Shariat, Shahrokh F; Frankenschmidt, Alexander; Wetterauer, Ulrich; Miernik, Arkadiusz

2015-01-01

To evaluate the Single-Incision Transumbilical Surgery (SITUS) technique as compared to an established laparoendoscopic single-site surgery (LESS) technique (Single-Port Laparoscopic Surgery, SPLS) and conventional laparoscopy (CLS) in a surgical simulator model. Sixty-three medical students without previous laparoscopic experience were randomly assigned to one of the three groups (SITUS, SPLS and CLS). Subjects were asked to perform five standardized tasks of increasing difficulty adopted from the Fundamentals of Laparoscopic Surgery curriculum. Statistical evaluation included task completion times and accuracy. Overall performances of all tasks (except precision cutting) were significantly faster and of higher accuracy in the CLS and SITUS groups than in the SPLS group (p = 0.004 to p port-assisted LESS technique such as SPLS. The demonstrated advantages of SITUS may be attributed to a preservation of the basic principles of conventional laparoscopy, such as the use of straight instruments and an adequate degree of triangulation.

Shoulder Pain After Thoracic Surgery

DEFF Research Database (Denmark)

Blichfeldt-Eckhardt, Morten R; Andersen, Claus; Ørding, Helle

2017-01-01

OBJECTIVES: To study the time course of ipsilateral shoulder pain after thoracic surgery with respect to incidence, pain intensity, type of pain (referred versus musculoskeletal), and surgical approach. DESIGN: Prospective, observational cohort study. SETTING: Odense University Hospital, Denmark...... for musculoskeletal involvement (muscle tenderness on palpation and movement) with follow-up 12 months after surgery. Clinically relevant pain was defined as a numeric rating scale score>3. Of the 60 patients included, 47 (78%) experienced ipsilateral shoulder pain, but only 25 (42%) reported clinically relevant...... shoulder pain. On postoperative day 4, 19 patients (32%) still suffered shoulder pain, but only 4 patients (7%) had clinically relevant pain. Four patients (8%) still suffered shoulder pain 12 months after surgery. In 26 patients (55%), the shoulder pain was classified as referred versus 21 patients (45...

Lung surgery

Science.gov (United States)

... are thoracotomy and video-assisted thoracoscopic surgery (VATS). Robotic surgery may also be used. Lung surgery using ... Center-Shreveport, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Genetics, mental illness, and complex disease: development and distribution of an interactive CD-ROM for genetic counselors. Final report for period 15 August 2000 - 31 December 2002

Energy Technology Data Exchange (ETDEWEB)

McInerney, Joseph D.

2003-03-31

"Genetics and Major Psychiatric Disorders: A Program for Genetic Counselors" provides an introduction to psychiatric genetics, with a focus on the genetics of common complex disease, for genetics professionals. The program is available as a CD-ROM and an online educational resource. The on-line version requires a direct internet connection. Each educational module begins with an interactive case study that raises significant issues addressed in each module. In addition, case studies provided throughout the educational materials support teaching of major concepts. Incorporated throughout the content are expert video clips, video clips from individuals affected by psychiatric illness, and optional "learn more" materials that offer greater depth about a particular topic. The structure of the CD-ROM permits self-navigation, but we have suggested a sequence that allows materials to build upon each other. At any point in the materials, users may pause and look up terms in the glossary or review the DSM-IV criteria for selected psychiatric disorders. A detailed site map is available for those who choose to self navigate through the content.

Pain prevalence and trajectories following pediatric spinal fusion surgery

OpenAIRE

Sieberg, Christine B.; Simons, Laura E.; Edelstein, Mark R.; DeAngelis, Maria R.; Pielech, Melissa; Sethna, Navil; Hresko, M. Timothy

2013-01-01

Factors contributing to pain following surgery are poorly understood with previous research largely focused on adults. With approximately 6 million children undergoing surgery each year8, there is a need to study pediatric persistent postsurgical pain. The present study includes patients with adolescent idiopathic scoliosis undergoing spinal fusion surgery enrolled in a prospective, multi-centered registry examining post-surgical outcomes. The Scoliosis Research Society Questionnaire- Version...

Repetitive endoscopic sinus surgery failure: a role for radical surgery?

NARCIS (Netherlands)

Videler, Ward J. M.; Wreesmann, Volkert B.; van der Meulen, Freerk W.; Knegt, Paul P.; Fokkens, Wytske J.

2006-01-01

OBJECTIVES: Endoscopic sinus surgery (ESS) is considered to be the golden standard for surgery in patients with chronic rhinosinusitis and nasal polyposis. However, there is still a small group of patients unresponsive despite repetitive surgery. Radical surgery aimed at reduction of the

Comparing definitions of outpatient surgery: Implications for quality measurement.

Science.gov (United States)

Mull, Hillary J; Rivard, Peter E; Legler, Aaron; Pizer, Steven D; Hawn, Mary T; Itani, Kamal M F; Rosen, Amy K

2017-08-01

Adverse event (AE) rates in outpatient surgery are inconsistently reported, partly because of the lack of a standard definition of outpatient surgery. We compared the types and rates of surgical procedures defined by two national healthcare agencies: Health Care Cost Institute (HCCI) and the Healthcare Cost and Utilization Project (HCUP) and considered implications for quality measurement. We used HCCI and HCUP definitions to identify FY2012-14 VA outpatient surgeries. There were six times as many HCCI surgeries as HCUP (6,575,830 versus 1,086,640). Ninety-nine percent of HCUP-defined surgeries were also identified by HCCI. More HCUP surgeries had higher average Medicare Relative Value Units then HCCI surgeries [5.3 (SD = 4.4) versus 1.6 (SD = 2.3) RVUs]. Rates and types of procedures vary widely between definitions. Quality measurement using HCCI versus HCUP may produce significantly lower AE rates because many of the surgeries included reflect low complexity and potentially low risk of AEs. Published by Elsevier Inc.

Reduction Mammoplasty: A Comparison Between Operations Performed by Plastic Surgery and General Surgery.

Science.gov (United States)

Kordahi, Anthony M; Hoppe, Ian C; Lee, Edward S

2015-01-01

Reduction mammoplasty is an often-performed procedure by plastic surgeons and increasingly by general surgeons. The question has been posed in both general surgical literature and plastic surgical literature as to whether this procedure should remain the domain of surgical specialists. Some general surgeons are trained in breast reductions, whereas all plastic surgeons receive training in this procedure. The National Surgical Quality Improvement Project provides a unique opportunity to compare the 2 surgical specialties in an unbiased manner in terms of preoperative comorbidities and 30-day postoperative complications. The National Surgical Quality Improvement Project database was queried for the years 2005-2012. Patients were identified as having undergone a reduction mammoplasty by Current Procedural Terminology codes. RESULTS were refined to include only females with an International Classification of Diseases, Ninth Revision, code of 611.1 (hypertrophy of breasts). Information was collected regarding age, surgical specialty performing procedure, body mass index, and other preoperative variables. The outcomes utilized were presence of superficial surgical site infection, presence of deep surgical site infection, presence of wound dehiscence, postoperative respiratory compromise, pulmonary embolism, deep vein thrombosis, perioperative transfusion, operative time, reintubation, reoperation, and length of hospital stay. During this time period, there were 6239 reduction mammaplasties performed within the National Surgical Quality Improvement Project database: 339 by general surgery and 5900 by plastic surgery. No statistical differences were detected between the 2 groups with regard to superficial wound infections, deep wound infections, organ space infections, or wound dehiscence. There were no significant differences noted between within groups with regard to systemic postoperative complications. Patients undergoing a procedure by general surgery were more likely

Common experiences of patients following suboptimal treatment outcomes: implications for epilepsy surgery.

Science.gov (United States)

Fernando, Dinusha K; McIntosh, Anne M; Bladin, Peter F; Wilson, Sarah J

2014-04-01

Few studies have investigated the patient experience of unsuccessful medical interventions, particularly in the epilepsy surgery field. The present review aimed to gain insight into the patient experience of seizure recurrence after epilepsy surgery by examining the broader literature dealing with suboptimal results after medical interventions (including epilepsy surgery). To capture the patient experience, the literature search focused on qualitative research of patients who had undergone medically unsuccessful interventions, published in English in scholarly journals. Twenty-two studies were found of patients experiencing a range of suboptimal outcomes, including seizure recurrence, cancer recurrence and progression, unsuccessful joint replacement, unsuccessful infertility treatment, organ transplant rejection, coronary bypass graft surgery, and unsuccessful weight-loss surgery. In order of frequency, the most common patient experiences included the following: altered social dynamics and stigma, unmet expectations, negative emotions, use of coping strategies, hope and optimism, perceived failure of the treating team, psychiatric symptoms, and control issues. There is support in the epilepsy surgery literature that unmet expectations and psychiatric symptoms are key issues for patients with seizure recurrence, while other common patient experiences have been implied but not systematically examined. Several epilepsy surgery specific factors influence patient perceptions of seizure recurrence, including the nature of postoperative seizures, the presence of postoperative complications, and the need for increased postoperative medications. Knowledge of common patient experiences can assist in the delivery of patient follow-up and rehabilitation services tailored to differing outcomes after epilepsy surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

TMJ surgery following orthognathic surgery: A case series

Directory of Open Access Journals (Sweden)

C. Politis

2018-06-01

Full Text Available Orthognathic surgery may affect or cause temporomandibular joint (TMJ complaints. This study evaluated the need for TMJ surgery after orthognathic surgery.A retrospective cohort study was carried out on 630 consecutive patients undergoing at least a Le Fort I or bilateral sagittal split osteotomy (BSSO. The mean follow-up time was 2,3 years. Clinical, surgical and radiographic findings were collected.Ten of the 630 patients (1.6% had additional arthroscopic TMJ-surgery in one (9 or in both (1 joints because of internal derangement, resistant to conventional therapy. Only 4/10 patients had successful outcomes following arthroscopic surgery. One patient with unsuccessful outcome required multiple additional open TMJ-surgeries, all remaining ineffective to relieve pain and restricted mouth opening. If arthroscopy failed to relieve symptoms (5/10 patients, further conservative management was opted. Arthroscopy seemed effective mainly in patients without pre-existing TMJ complaints.A further five of the 630 patients (0.8% required more treatment because of bilateral postoperative condylar resorption, but none of them required TMJ-surgery.In contrast to patients with bilateral condylar resorption where the skeletal relapse remained the issue of concern, patients with internal derangement/osteoarthrosis exhibited major occlusal changes in one patient only (1/10, leaving the TMJ complaints as the main concern. Keywords: Sagittal split osteotomy, Le Fort I osteotomy, Orthognathic surgery, Condylar remodelling, Condylar resorption, Osteoarthrosis, Internal derangement, Relapse, Arthroscopy

Comparative study of postoperative stability between conventional orthognathic surgery and a surgery-first orthognathic approach after bilateral sagittal split ramus osteotomy for skeletal class III correction.

Science.gov (United States)

Mah, Deuk-Hyun; Kim, Su-Gwan; Oh, Ji-Su; You, Jae-Seek; Jung, Seo-Yun; Kim, Won-Gi; Yu, Kyung-Hwan

2017-02-01

The purpose of this study is to compare the postoperative stability of conventional orthognathic surgery to a surgery-first orthognathic approach after bilateral sagittal split ramus osteotomy (BSSRO). The study included 20 patients who underwent BSSRO for skeletal class III conventional orthognathic surgery and 20 patients who underwent a surgery-first orthognathic approach. Serial lateral cephalograms were analyzed to identify skeletal changes before surgery (T0), immediately after surgery (T1), and after surgery (T2, after 1 year or at debonding). The amount of relapse of the mandible in the conventional orthognathic surgery group from T1 to T2 was 2.23±0.92 mm ( P surgery-first orthognathic approach group from T1 to T2 was 3.49±1.71 mm ( P surgery-first orthognathic approach. Therefore, careful planning and skeletal stability should be considered in orthognathic surgery.

English grammar in use a self-study reference and practice book for intermediate learners of English : with answers and CD-ROM

CERN Document Server

Murphy, Raymond

2012-01-01

English Grammar in Use Fourth edition is an updated version of the world's best-selling grammar title. It has a fresh, appealing new design and clear layout, with revised and updated examples, but retains all the key features of clarity and accessibility that have made the book popular with millions of learners and teachers around the world. The CD-ROM contains lots of additional practice exercises to consolidate learning, ideal for self-study but also suitable for reinforcement work in the classroom. An online version and book without answers are available separately.

Jerónimo Román de la higuera y la epigrafía de Ibahernando (Cáceres

Directory of Open Access Journals (Sweden)

María del Rosario HERNANDO SOBRINO

2010-08-01

Full Text Available : En este artículo se presentan y analizan cinco inscripciones romanas procedentes de Ibahernando (Cáceres, algunas de ellas inéditas, que se registran en un manuscrito autógrafo de Jerónimo Román de la Higuera que se conserva en la Biblioteca Nacional (Ms. 1.642 con el título Historia Eclesiástica de España (tomo V. Una vez más, se pone de relieve que, si se estudia con la debida precaución, la información epigráfica transmitida por el jesuita puede y debe ser aprovechada por los historiadores e investigadores de la Antigüedad hispana.

Wound complications following laparoscopic surgery in a Nigerian Hospital

Directory of Open Access Journals (Sweden)

Adewale O Adisa

2014-01-01

Full Text Available Background: Different complications may occur at laparoscopic port sites. The incidence of these varies with the size of the ports and the types of procedure performed through them. Objectives: The aim was to observe the rate and types of complications attending laparoscopic port wounds and to identify risk factors for their occurrence. Patients and Methods: This is a prospective descriptive study of all patients who had laparoscopic operations in one general surgery unit of a University Teaching Hospital in Nigeria between January 2009 and December 2012. Results: A total of 236 (155 female and 81 male patients were included. The laparoscopic procedures include 63 cholecystectomies, 49 appendectomies, 62 diagnostic, biopsy and staging procedures, 22 adhesiolyses, six colonic surgeries, eight hernia repairs and 22 others. Port site complications occurred in 18 (2.8% ports on 16 (6.8% patients including port site infections in 12 (5.1% and hypertrophic scars in 4 (1.7% patients, while one patient each had port site bleeding and port site metastasis. Nine of 11 infections were superficial, while eight involved the umbilical port wound. Conclusion: Port site complications are few following laparoscopic surgeries in our setting. We advocate increased adoption of laparoscopic surgeries in Nigeria to reduce wound complications that commonly follow conventional open surgeries.

Primary Surgery or Interval Debulking for Advanced Epithelial Ovarian Cancer

DEFF Research Database (Denmark)

Markauskas, Algirdas; Mogensen, Ole; dePont Christensen, René

2014-01-01

OBJECTIVE: The aim of the present study was to investigate the surgical complexity, the postoperative morbidity, and the survival of the women after primary debulking surgery (PDS) and neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS) for advanced epithelial ovarian cancer....... MATERIALS AND METHODS: We consecutively included all patients who underwent debulking surgery at our institution between January 2007 and December 2012 for stages IIIc and IV of epithelial ovarian cancer. RESULTS: Of the 332 patients included, 165 (49.7%) underwent PDS, and 167 (50.3%) had NACT...

Effectiveness of prolonged use of continuous passive motion (CPM as an adjunct to physiotherapy following total knee arthroplasty: Design of a randomised controlled trial [ISRCTN85759656

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Geesink Ruud JT

2006-02-01

. Discussion Because restricted knee ROM affects functional activities, knee ROM and knee function are regarded as the primary indicators of successful TKA. Potential effects of the intervention under study include rapid return of knee flexion accompanied by earlier return to functional activities of daily life. If patients benefit significantly from prolonged CPM use, this treatment should be added to the standard PT treatment at home. We expect the additional home CPM programme to be more effective than the usual physiotherapy programme, resulting in a difference in ROM of at least 5°, 17 days after surgery. This clinically important difference, with a possible flexion ROM of about 100°, is expected to lead to better functioning in activities of daily life, like walking, and earlier ability to cycle. These advantages should result in earlier and increasing independence.

Heart bypass surgery

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Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery; Coronary artery disease - CABG; CAD - CABG; Angina - ...

Simulation of Lake Victoria Circulation Patterns Using the Regional Ocean Modeling System (ROMS.

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Chrispine Nyamweya

Full Text Available Lake Victoria provides important ecosystem services including transport, water for domestic and industrial uses and fisheries to about 33 million inhabitants in three East African countries. The lake plays an important role in modulating regional climate. Its thermodynamics and hydrodynamics are also influenced by prevailing climatic and weather conditions on diel, seasonal and annual scales. However, information on water temperature and circulation in the lake is limited in space and time. We use a Regional Oceanographic Model System (ROMS to simulate these processes from 1st January 2000 to 31st December 2014. The model is based on real bathymetry, river runoff and atmospheric forcing data using the bulk flux algorithm. Simulations show that the water column exhibits annual cycles of thermo-stratification (September-May and mixing (June-August. Surface water currents take different patterns ranging from a lake-wide northward flow to gyres that vary in size and number. An under flow exists that leads to the formation of upwelling and downwelling regions. Current velocities are highest at the center of the lake and on the western inshore waters indicating enhanced water circulation in those areas. However, there is little exchange of water between the major gulfs (especially Nyanza and the open lake, a factor that could be responsible for the different water quality reported in those regions. Findings of the present study enhance understanding of the physical processes (temperature and currents that have an effect on diel, seasonal, and annual variations in stratification, vertical mixing, inshore-offshore exchanges and fluxes of nutrients that ultimately influence the biotic distribution and trophic structure. For instance information on areas/timing of upwelling and vertical mixing obtained from this study will help predict locations/seasons of high primary production and ultimately fisheries productivity in Lake Victoria.

Simulation of Lake Victoria Circulation Patterns Using the Regional Ocean Modeling System (ROMS).

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Nyamweya, Chrispine; Desjardins, Christopher; Sigurdsson, Sven; Tomasson, Tumi; Taabu-Munyaho, Anthony; Sitoki, Lewis; Stefansson, Gunnar

2016-01-01

Lake Victoria provides important ecosystem services including transport, water for domestic and industrial uses and fisheries to about 33 million inhabitants in three East African countries. The lake plays an important role in modulating regional climate. Its thermodynamics and hydrodynamics are also influenced by prevailing climatic and weather conditions on diel, seasonal and annual scales. However, information on water temperature and circulation in the lake is limited in space and time. We use a Regional Oceanographic Model System (ROMS) to simulate these processes from 1st January 2000 to 31st December 2014. The model is based on real bathymetry, river runoff and atmospheric forcing data using the bulk flux algorithm. Simulations show that the water column exhibits annual cycles of thermo-stratification (September-May) and mixing (June-August). Surface water currents take different patterns ranging from a lake-wide northward flow to gyres that vary in size and number. An under flow exists that leads to the formation of upwelling and downwelling regions. Current velocities are highest at the center of the lake and on the western inshore waters indicating enhanced water circulation in those areas. However, there is little exchange of water between the major gulfs (especially Nyanza) and the open lake, a factor that could be responsible for the different water quality reported in those regions. Findings of the present study enhance understanding of the physical processes (temperature and currents) that have an effect on diel, seasonal, and annual variations in stratification, vertical mixing, inshore-offshore exchanges and fluxes of nutrients that ultimately influence the biotic distribution and trophic structure. For instance information on areas/timing of upwelling and vertical mixing obtained from this study will help predict locations/seasons of high primary production and ultimately fisheries productivity in Lake Victoria.

[Clinical Practice after Bariatric Surgery: Problems and Complications].

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Gebhart, Martina

2015-12-09

The number of patients undergoing bariatric surgery because of morbid obesity is increasing rapidly. Therefore, it is an important issue to be aware of outcome and complications after bariatric surgery. This mini-review presents a compilation of important gastrointestinal symptoms, as pain, diarrhea and dumping, and includes treatment options. It characterizes possible micronutrient deficiencies, gives instructions concerning the adaptation of drugs and illustrates possible adverse outcomes, such as excessive weight loss, insufficient weight loss and weight gain after bariatric surgery.

Robotics in general surgery: A systematic cost assessment

OpenAIRE

Gkegkes, Ioannis D.; Mamais, Ioannis A.; Iavazzo, Christos

2017-01-01

The utilisation of robotic-assisted techniques is a novelty in the field of general surgery. Our intention was to examine the up to date available literature on the cost assessment of robotic surgery of diverse operations in general surgery. PubMed and Scopus databases were searched in a systematic way to retrieve the included studies in our review. Thirty-one studies were retrieved, referring on a vast range of surgical operations. The mean cost for robotic, open and laparoscopic ranged from...

Cognitive outcome of surgery.

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Gallagher, Anne; Jambaqué, Isabelle; Lassonde, Maryse

2013-01-01

Epilepsy surgery is now widely accepted as an effective therapeutic option for carefully selected children with medically refractory epilepsy. The surgical procedure may cause cognitive deficits or exacerbate existing impairments, but it may also improve cognitive abilities by the restoration of functions located in adjacent or contralateral areas that had been secondarily affected by the epilepsy or the underlying pathology. Compared to adults, better cognitive outcome has been reported in children, a finding probably due to the developing state of the brain, which possesses considerable structural and functional plasticity. More extensive and effective surgery such as hemispherectomy is more commonly used in the pediatric population, and this must also influence surgical outcome. However, studies related to cognitive outcome of epilepsy surgery in children are limited, and controversial results are often reported. In this chapter, we provide a current overview of the literature on cognitive outcomes in children who undergo different types of epilepsy surgery, including focal resections as well as corpus callosotomy and hemispherectomy. Early surgical intervention appears to be a rational option for the treatment of childhood epilepsy since many cognitive deficits are linked to the epileptic process and may disappear when seizures are controlled. Copyright © 2013 Elsevier B.V. All rights reserved.

History of shoulder instability surgery.

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Randelli, Pietro; Cucchi, Davide; Butt, Usman

2016-02-01

The surgical management of shoulder instability is an expanding and increasingly complex area of study within orthopaedics. This article describes the history and evolution of shoulder instability surgery, examining the development of its key principles, the currently accepted concepts and available surgical interventions. A comprehensive review of the available literature was performed using PubMed. The reference lists of reviewed articles were also scrutinised to ensure relevant information was included. The various types of shoulder instability including anterior, posterior and multidirectional instability are discussed, focussing on the history of surgical management of these topics, the current concepts and the results of available surgical interventions. The last century has seen important advancements in the understanding and treatment of shoulder instability. The transition from open to arthroscopic surgery has allowed the discovery of previously unrecognised pathologic entities and facilitated techniques to treat these. Nevertheless, open surgery still produces comparable results in the treatment of many instability-related conditions and is often required in complex or revision cases, particularly in the presence of bone loss. More high-quality research is required to better understand and characterise this spectrum of conditions so that successful evidence-based management algorithms can be developed. IV.

Questionnaires for Measuring Refractive Surgery Outcomes.

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Kandel, Himal; Khadka, Jyoti; Lundström, Mats; Goggin, Michael; Pesudovs, Konrad

2017-06-01

To identify the questionnaires used to assess refractive surgery outcomes, assess the available questionnaires in regard to their psychometric properties, validity, and reliability, and evaluate the performance of the available questionnaires in measuring refractive surgery outcomes. An extensive literature search was done on PubMed, MEDLINE, Scopus, CINAHL, Cochrane, and Web of Science databases to identify articles that described or used at least one questionnaire to assess refractive surgery outcomes. The information on content quality, validity, reliability, responsiveness, and psychometric properties was extracted and analyzed based on an extensive set of quality criteria. Eighty-one articles describing 27 questionnaires (12 refractive error-specific, including 4 refractive surgery-specific, 7 vision-but-non-refractive, and 8 generic) were included in the review. Most articles (56, 69.1%) described refractive error-specific questionnaires. The Quality of Life Impact of Refractive Correction (QIRC), the Quality of Vision (QoV), and the Near Activity Visual Questionnaire (NAVQ) were originally constructed using Rasch analysis; others were developed using the Classical Test Theory. The National Eye Institute Refractive Quality of Life questionnaire was the most frequently used questionnaire, but it does not provide a valid measurement. The QoV, QIRC, and NAVQ are the three best existing questionnaires to assess visual symptoms, quality of life, and activity limitations, respectively. This review identified three superior quality questionnaires for measuring different aspects of quality of life in refractive surgery. Clinicians and researchers should choose a questionnaire based on the concept being measured with superior psychometric properties. [J Refract Surg. 2017;33(6):416-424.]. Copyright 2017, SLACK Incorporated.

Home parenteral nutrition (HPN) in patients with post-bariatric surgery complications

DEFF Research Database (Denmark)

Van Gossum, A; Pironi, L; Chambrier, C

2017-01-01

BACKGROUND & AIMS: Obesity is a worldwide health problem. Bariatric surgery (BS) is becoming one of the most commonly used methods for fighting obesity and its associated comorbidities. However, current BS techniques can be associated with early or late complications that may require nutritional...... support. The aim of this retrospective observational study was to determine the indications and outcomes for patients on Home parenteral nutrition (HPN) due to post-bariatric surgery complications. METHODS: A specific questionnaire was designed by the ESPEN HAN/CIF working group and submitted to HPN...... centers. This questionnaire included: patient demographics, type of surgery, BMI before surgery and at start of HPN, indications for HPN including technical and nutritional complications (early within 2 months after surgery or late), outcome, PN regimen, and HPN complications. Patients were...

Constipation Risk in Patients Undergoing Abdominal Surgery

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Celik, Sevim; Atar, Nurdan Yalcin; Ozturk, Nilgun; Mendes, Guler; Kuytak, Figen; Bakar, Esra; Dalgiran, Duygu; Ergin, Sumeyra

2015-01-01

Background: Problems regarding bowel elimination are quite common in patients undergoing abdominal surgery. Objectives: To determine constipation risk before the surgery, bowel elimination during postoperative period, and the factors affecting bowel elimination. Patients and Methods: This is a cross-sectional study. It was conducted in a general surgery ward of a university hospital in Zonguldak, Turkey between January 2013 and May 2013. A total of 107 patients were included in the study, who were selected by convenience sampling. Constipation Risk Assessment Scale (CRAS), patient information form, medical and nursing records were used in the study. Results: The mean age of the patients was found to be 55.97 ± 15.74 (year). Most of the patients have undergone colon (37.4%) and stomach surgeries (21.5%). Open surgical intervention (83.2%) was performed on almost all patients (96.3%) under general anesthesia. Patients were at moderate risk for constipation with average scores of 11.71 before the surgery. A total of 77 patients (72%) did not have bowel elimination problem during postoperative period. The type of the surgery (P < 0.05), starting time for oral feeding after the surgery (P < 0.05), and mobilization (P < 0.05) were effective on postoperative bowel elimination. Conclusions: There is a risk for constipation after abdominal surgery. Postoperative practices are effective on the risk of constipation. PMID:26380107

Consensus statement on anaesthesia for day care surgeries

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Satish Kulkarni

2017-01-01

Full Text Available The primary aim of day-care surgery units is to allow for early recovery of the patients so that they can return to their familiar 'home' environment; the management hence should be focused towards achieving these ends. The benefits could include a possible reduction in the risk of thromboembolism and hospital-acquired infections. Furthermore, day-care surgery is believed to reduce the average unit cost of treatment by up to 70% as compared to inpatient surgery. With more than 20% of the world's disease burden, India only has 6% of the world's hospital beds. Hence, there is an immense opportunity for expansion in day-care surgery in India to ensure faster and safer, cost-effective patient turnover. For this to happen, there is a need of change in the mindset of all concerned clinicians, surgeons, anaesthesiologists and even the patients. A group of nine senior consultants from various parts of India, a mix of private and government anaesthesiologists, assembled in Mumbai and deliberated and discussed on the various aspects of day-care surgery. They formulated a consensus statement, the first of its kind in the Indian scenario, which can act as a guidance and tool for day-care anaesthesia in India. The statements are derived from the available published evidence in peer-reviewed literature including guidelines of several bodies such as the American Society of Anesthesiologists, British Association of Day Surgery and International Association of Ambulatory Surgery. The authors also offer interpretive comments wherever such evidence is inadequate or contradictory.

Current status of cerebral glioma surgery in China.

Science.gov (United States)

Wu, Jin-song; Zhang, Jie; Zhuang, Dong-xiao; Yao, Cheng-jun; Qiu, Tian-ming; Lu, Jun-feng; Zhu, Feng-ping; Mao, Ying; Zhou, Liang-fu

2011-09-01

The treatment of gliomas is highly individualized. Surgery for gliomas is essentially for histological diagnosis, to alleviate mass effect, and most importantly, to favor longer survival expectancy. During the past two decades, many surgical techniques and adjuvants have been applied to glioma surgery in China, which lead to a rapid development in the field of cerebral glioma surgery. This article broadly and critically reviewed the existing studies on cerebral glioma surgery and to portrait the current status of glioma surgery in China. A literature search was conducted covering major innovative surgical techniques and adjuvants for glioma surgery in China. The following databases were searched: the Pubmed (January 1995 to date); China Knowledge Resource Integrated Database (January 1995 to date) and VIP Database for Chinese Technical Periodicals (January 1995 to date). A selection criterion was established to exclude duplicates and irrelevant studies. The outcome measures were extracted from included studies. A total of 3307 articles were initially searched. After excluded by abstracts and full texts, 69 studies conducted in the mainland of China were included and went through further analysis. The philosophy of surgical strategies for cerebral gliomas in China is undergoing tremendous change. Nowadays Chinese neurosurgeons pay more attention to the postoperative neurofunctional status of the patients. The aim of the glioma surgery is not only the more extensive tumor resection but also the maximal safety of intervention. The well balance of longer overall survival and higher quality of life should be judged with respect to each individual patient.

Treatment of humeral shaft fractures using antegrade nailing: functional outcome in the shoulder.

Science.gov (United States)

Patino, Juan Martin

2015-08-01

The purpose of this study was to evaluate shoulder outcomes and function after humeral shaft fractures treated with antegrade nailing. Thirty patients with acute humeral shaft fractures who underwent antegrade locked intramedullary nailing were retrospectively studied. Range of motion (ROM) of the affected shoulder was evaluated, comparing it with the nonaffected shoulder, radiologic position of the nails, complications, and need for a second surgery. The study enrolled 20 men and 10 women (average age, 41.9 years). The average follow-up was 35.8 months. The average shoulder elevation averaged 157°, internal rotation was variable (reaching the sacroiliac joint to T7), and external rotation averaged 75°. Elbow flexion-extension ROM averaged 133° (115°-145°). According to the Rodriguez-Merchan criteria, 12 patients achieved excellent results (40%), 7 good (20%), and 6 fair (23.3%); poor results were found in 5 cases (16.6%). Twelve patients achieved full mobility of the shoulder, whereas 18 had some loss of motion, with significant differences between the affected and nonaffected shoulders (P = .001). Decreased shoulder ROM is common after antegrade nailing of humeral shaft fractures. Avoidance of nail impingement can improve final outcomes. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

3D printed optical phantoms and deep tissue imaging for in vivo applications including oral surgery

Science.gov (United States)

Bentz, Brian Z.; Costas, Alfonso; Gaind, Vaibhav; Garcia, Jose M.; Webb, Kevin J.

2017-03-01

Progress in developing optical imaging for biomedical applications requires customizable and often complex objects known as "phantoms" for testing, evaluation, and calibration. This work demonstrates that 3D printing is an ideal method for fabricating such objects, allowing intricate inhomogeneities to be placed at exact locations in complex or anatomically realistic geometries, a process that is difficult or impossible using molds. We show printed mouse phantoms we have fabricated for developing deep tissue fluorescence imaging methods, and measurements of both their optical and mechanical properties. Additionally, we present a printed phantom of the human mouth that we use to develop an artery localization method to assist in oral surgery.

Facial Cosmetic Surgery

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... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

Thyroid Surgery

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... Hypothyroidism in Children and Adolescents Pediatric Differentiated Thyroid Cancer Thyroid Nodules in Children and Adolescents Thyroid Surgery Resources Thyroid Surgery Brochure PDF Thyroid Surgery FAQs PDF En Español Cirugia De La Tiroides El folleto de Cirugia De La Tiroides Search Thyroid ...

Patterns of recurrence after surgery alone versus preoperative chemoradiotherapy and surgery in the CROSS trials.

Science.gov (United States)

Oppedijk, Vera; van der Gaast, Ate; van Lanschot, Jan J B; van Hagen, Pieter; van Os, Rob; van Rij, Caroline M; van der Sangen, Maurice J; Beukema, Jannet C; Rütten, Heidi; Spruit, Patty H; Reinders, Janny G; Richel, Dick J; van Berge Henegouwen, Mark I; Hulshof, Maarten C C M

2014-02-10

To analyze recurrence patterns in patients with cancer of the esophagus or gastroesophageal junction treated with either preoperative chemoradiotherapy (CRT) plus surgery or surgery alone. Recurrence pattern was analyzed in patients from the previously published CROSS I and II trials in relation to radiation target volumes. CRT consisted of five weekly courses of paclitaxel and carboplatin combined with a concurrent radiation dose of 41.4 Gy in 1.8-Gy fractions to the tumor and pathologic lymph nodes with margin. Of the 422 patients included from 2001 to 2008, 418 were available for analysis. Histology was mostly adenocarcinoma (75%). Of the 374 patients who underwent resection, 86% were allocated to surgery and 92% to CRT plus surgery. On January 1, 2011, after a minimum follow-up of 24 months (median, 45 months), the overall recurrence rate in the surgery arm was 58% versus 35% in the CRT plus surgery arm. Preoperative CRT reduced locoregional recurrence (LRR) from 34% to 14% (P < .001) and peritoneal carcinomatosis from 14% to 4% (P < .001). There was a small but significant effect on hematogenous dissemination in favor of the CRT group (35% v 29%; P = .025). LRR occurred in 5% within the target volume, in 2% in the margins, and in 6% outside the radiation target volume. In 1%, the exact site in relation to the target volume was unclear. Only 1% had an isolated infield recurrence after CRT plus surgery. Preoperative CRT in patients with esophageal cancer reduced LRR and peritoneal carcinomatosis. Recurrence within the radiation target volume occurred in only 5%, mostly combined with outfield failures.

Preparing for Surgery

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... Events Advocacy For Patients About ACOG Preparing for Surgery Home For Patients Search FAQs Preparing for Surgery ... Surgery FAQ080, August 2011 PDF Format Preparing for Surgery Gynecologic Problems What is the difference between outpatient ...

Dexmedetomidine as a Cardioprotector in Cardiac Surgery (Review

Directory of Open Access Journals (Sweden)

I. A. Kozlov

2017-01-01

Full Text Available The literature review presents an analysis of publications on the use of a selective α2-adrenergic receptor agonist (α2-AR dexmedetomidine as a cardioprotector in cardiosurgical interventions. It summarizes historical aspects of the introduction of α2-AR agonists in the intensive care practice. It analyzes possible mechanisms of the cardioprotective effect of dexmedetomidine (central sympatholysis, favorable effects on the coronary circulation and relief of the coronary steal syndrome in originally ischemized areas of the myocardium, antiinflammatory and antioxidant effects, and prevention of apoptosis activation. Data from experimental studies of dexmedetomidine cardioprotection were analyzed. Results of clinical studies, including data of metanalyses, were discussed. It dwells on data on the favorable effect of dexmedetomidine on various parameters of the postoperative period, including a decreased risk of delirium, general complications of cardiosurgical interventions, and the mortality rate in patients. It presents data on cardioprotective properties of dexmedetomidine in surgical patients who undergo noncardiac interventions, particularly vascular ones, including high risk surgeries in the aorta. A comparative analysis of results of clinical trials studying the dexmedetomidine cardioprotection during surgeries with extracorporeal circulation was performed. A range of pharmacological effects of dexmedetomidine during anesthesiological support of cardiac surgeries, including those in elderly and senile patients, was described. It has been concluded that the dexmedetomidine cardioprotection in the various fields of surgery is obviously very promising.

Enhanced recovery after bariatric surgery – a modern approach

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Bekkhan Bayalovich Khatsiev

2014-06-01

Full Text Available Guidelines for enhanced recovery after surgery (ERAS are widely used and their efficiency was clearly demonstrated by numerous studies. Number of publications on this topic in bariatric surgery is significantly lower compared with other fields of surgery. However, the data accumulated allow to compose recommendations based on studies with high level of evidence. Authors review existing methods of enhanced recovery in their implementation into bariatric surgery. Enhanced recovery methods can be used to optimize all stages of perioperative care and include data on preoperative preparation, maintenance of electrolyte balance, prevention of postoperative nausea and vomiting, sufficient analgesia and safe discharge form hospital. Suggested guidelines for bariatric surgery are implied to be used by a multidisciplinary team.

Corrective Jaw Surgery

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... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ...

High readmission rate after heart valve surgery

DEFF Research Database (Denmark)

Sibilitz, K L; Berg, S K; Thygesen, L C

2015-01-01

investigated. RESULTS: After valve surgery, the self-reported health was lower (Short Form-36 (SF-36) Physical Component Scale (PCS): 44.5 vs. 50.6 and Mental Component Scale (MCS): 51.9 vs. 55.0, pClinical signs......BACKGROUND: After heart valve surgery, knowledge on long-term self-reported health status and readmission is lacking. Thus, the optimal strategy for out-patient management after surgery remains unclear. METHODS: Using a nationwide survey with linkage to Danish registers with one year follow-up, we...... included all adults 6-12months after heart valve surgery irrespective of valve procedure, during Jan-June 2011 (n=867). Participants completed a questionnaire regarding health-status (n=742), and answers were compared with age- and sex-matched healthy controls. Readmission rates and mortality were...

Corrective Jaw Surgery

Medline Plus

Full Text Available ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

Development of a CD-ROM on written language for the continuing education of elementary school teachers

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Thaís dos Santos Gonçalves

2011-12-01

Full Text Available Distance education has emerged to minimize the anxiety of many professionals who need to update their knowledge, but do not have the time and opportunity to travel to educational centers. Objectives: To describe the development of a CD-ROM to provide distance continuing education to basic school teachers that addresses issues related to written language. Material and Methods: Previously, a script was developed with themes related to the acquisition and development of written language. Subsequently, a technical team transformed the texts in multimedia language. Results: The titles of each content area addressed are available on buttons and links. The files can be viewed in a linear sequence, allowing the teacher to start learning at the desired moment and go straight to the file that he or she wants to access. Videos that show practical applications of the concepts available in text are included. Conclusions: Brazil is a developing country. The use of technologies for education reduces cultural isolation among education professionals. It is necessary to focus on making teaching materials for distance education. In order to provide an effective learning environment, the learners reality should be considered. A multidisciplinary team should prepare the materials. The development of educational material for distance education on the acquisition and development of written language seems not only appropriate, but also warranted to provide professional growth opportunity for teachers who need time flexibility and/or live far away from academic centers.

Macroeconomic landscape of refractive surgery in the United States.

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Corcoran, Kevin J

2015-07-01

This review examines the economic history of refractive surgery and the decline of laser-assisted in-situ keratomileusis (LASIK) in the USA, and the emergence of refractive cataract surgery as an area of growth. Since it peaked in 2007 at 1.4 million procedures per year, LASIK has declined 50% in the USA, whereas refractive cataract surgery, including presbyopia-correcting intraocular lenses (IOLs), astigmatism-correcting IOLs, and femtosecond laser-assisted cataract surgery, has grown to 350 000 procedures per year, beginning in 2003. Patients are price-sensitive and responsive to publicity (good or bad) about refractive surgery and refractive cataract surgery. LASIK's decline has been partially offset by the emergence of refractive cataract surgery. About 11% of all cataract surgery in the USA involves presbyopia-correcting IOLs, astigmatism-correcting IOLs, or a femtosecond laser. From the surgeon's perspective, there are high barriers to entry into the marketplace for refractive surgery and refractive cataract surgery due to the high capital cost of excimer and femtosecond lasers, the high skill level required to deliver spectacular results to demanding patients who pay out of pocket, and the necessity to perform a high volume of surgeries to satisfy both of these requirements. Probably, less than 7% of US cataract surgeons can readily meet all of these requirements.

Arthroscopic surgery for degenerative knee