WorldWideScience

Sample records for surgery support system

  1. Support for total hip replacement surgery: Structures modeling, Gait Data Analysis and Report system

    Directory of Open Access Journals (Sweden)

    Gianluca Mario Izzo

    2012-03-01

    Full Text Available For the treatment of advanced damages of hip joints, Total Hip Arthroplasty is well proven. Due to the different mechanical properties of the prosthesis material and the bone tissue, a partial unloading of the periprosthetic bone occurs. The bone cement causes reduction in bone density as a result of removal of normal stress from the bone, leading to weakening of the bone in that area and the fracture risk increases. Bone loss is identified as one of the main reasons for loosening of the stem. Otherwise, thanks to the press-fit of the non-cemented stem achieved by surgery, the bone layers immediately adjacent to the stem are preloaded, thus encouraged growing, and the bone getting stronger. The non-cemented stem would be the better choice for every patient, but the question remains if the femur can handle the press- fitting surgery. This studies aim to develop a monitoring techniques based on Gait analysis and bone density changes to assess patient recovery after Total Hip Arthroplasty. Furthermore, to validate computational processes based on 3D modeling and Finite Element Methods for optimizing decision making in the operation process and selecting the suited surgical procedure. A vision could be minimizing risk of periprosthetic fracture during and after surgery. Patients: The sample presents 11 patients receiving cemented implant and 13 for the uncemented. Patients are grouped by type of implant. Three checkpoints were considered: before, after operation and one year later. CT scans, gaitrite and kinepro measurements have been realized. Main outcome measures: Fracture risk probability is higher in bone with low bone mineral density; therefore bones are more fragile in elderly people. BMD is indeed one parameter considered among all the observations. Periprosthetic fracture of the femur is a rare but complex complication of THA, and requires demanding surgery. As such, they result in considerable morbidity and dysfunction. Thus, tests of

  2. Grid-enabled SEE++, A Grid-Based Medical Decision Support System for Eye Muscle Surgery Conference

    CERN Document Server

    Schreiner, W.; Buchberger, M.; Kaltofen, T.

    2006-01-01

    JKU/RISC currently develops in cooperation with Upper Austrian Research (UAR) the SEE-GRID software system. SEE-GRID is based on the SEE++ software for the biomechanical 3D simulation of the human eye and its muscles. SEE++ simulates the common eye muscle surgery techniques in a graphic interactive way that is familiar to an experienced surgeon. SEE++ is world-wide the most advanced software for this purpose; it is used by various hospitals and medical doctors for surgery training and planning, SEE++ deals with the support of diagnosis and treatment of strabismus, which is the common name given to usually persistent or regularly occuring misalignment of the eyes. Strabismus is a visual defect in which eyes point in different directions. A person suffering from it may see double images due to misaligned eyes. SEE++ is able to simulate the result of the Hess-Lancaster test, from which the pathological reason of strabismus can be estimated. The outcome of such an examination is two gaze patterns of blue points a...

  3. Robotic systems in spine surgery.

    Science.gov (United States)

    Onen, Mehmet Resid; Naderi, Sait

    2014-01-01

    Surgical robotic systems have been available for almost twenty years. The first surgical robotic systems were designed as supportive systems for laparoscopic approaches in general surgery (the first procedure was a cholecystectomy in 1987). The da Vinci Robotic System is the most common system used for robotic surgery today. This system is widely used in urology, gynecology and other surgical disciplines, and recently there have been initial reports of its use in spine surgery, for transoral access and anterior approaches for lumbar inter-body fusion interventions. SpineAssist, which is widely used in spine surgery, and Renaissance Robotic Systems, which are considered the next generation of robotic systems, are now FDA approved. These robotic systems are designed for use as guidance systems in spine instrumentation, cement augmentations and biopsies. The aim is to increase surgical accuracy while reducing the intra-operative exposure to harmful radiation to the patient and operating team personnel during the intervention. We offer a review of the published literature related to the use of robotic systems in spine surgery and provide information on using robotic systems.

  4. A computer-supported management of photographic documentation in plastic surgery - System development and its clinical application.

    Science.gov (United States)

    Korczak, Karol; Kasielska-Trojan, Anna; Niedźwiedziński, Marian; Antoszewski, Bogusław

    2017-07-01

    Photographic documentation is very important for plastic, reconstructive, and especially aesthetic surgery procedures. It can be used to improve patient care as well as to carry out scientific research. The results of our previous studies confirmed a strong demand for Information Technology (IT) systems dedicated to plastic surgery. Unfortunately, most of the solutions of this type are not suited to the actual needs. For this reason we decided to develop a reliable system for photographic documentation storage. The Plastic Reconstructive Esthetic Surgery Photo System (PRESsPhoto) was developed and finally deployed in the Plastic, Reconstructive and Aesthetic Surgery Clinic of the Medical University in Łódź (Poland). Preliminary single-center performance tests proved that the PRESsPhoto system is easy to use and provides, inter alia, rapid data search and data entry as well as data security. In the future the PRESsPhoto system should be able to cooperate with Hospital Information Systems (HIS). The process of development and deployment of the PRESsPhoto system is an example of good cooperation between health care providers and the informatics, which resulted in a system that meets the expectations of plastic surgeons. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Levosimendan for Hemodynamic Support after Cardiac Surgery.

    Science.gov (United States)

    Landoni, Giovanni; Lomivorotov, Vladimir V; Alvaro, Gabriele; Lobreglio, Rosetta; Pisano, Antonio; Guarracino, Fabio; Calabrò, Maria G; Grigoryev, Evgeny V; Likhvantsev, Valery V; Salgado-Filho, Marcello F; Bianchi, Alessandro; Pasyuga, Vadim V; Baiocchi, Massimo; Pappalardo, Federico; Monaco, Fabrizio; Boboshko, Vladimir A; Abubakirov, Marat N; Amantea, Bruno; Lembo, Rosalba; Brazzi, Luca; Verniero, Luigi; Bertini, Pietro; Scandroglio, Anna M; Bove, Tiziana; Belletti, Alessandro; Michienzi, Maria G; Shukevich, Dmitriy L; Zabelina, Tatiana S; Bellomo, Rinaldo; Zangrillo, Alberto

    2017-05-25

    Acute left ventricular dysfunction is a major complication of cardiac surgery and is associated with increased mortality. Meta-analyses of small trials suggest that levosimendan may result in a higher rate of survival among patients undergoing cardiac surgery. We conducted a multicenter, randomized, double-blind, placebo-controlled trial involving patients in whom perioperative hemodynamic support was indicated after cardiac surgery, according to prespecified criteria. Patients were randomly assigned to receive levosimendan (in a continuous infusion at a dose of 0.025 to 0.2 μg per kilogram of body weight per minute) or placebo, for up to 48 hours or until discharge from the intensive care unit (ICU), in addition to standard care. The primary outcome was 30-day mortality. The trial was stopped for futility after 506 patients were enrolled. A total of 248 patients were assigned to receive levosimendan and 258 to receive placebo. There was no significant difference in 30-day mortality between the levosimendan group and the placebo group (32 patients [12.9%] and 33 patients [12.8%], respectively; absolute risk difference, 0.1 percentage points; 95% confidence interval [CI], -5.7 to 5.9; P=0.97). There were no significant differences between the levosimendan group and the placebo group in the durations of mechanical ventilation (median, 19 hours and 21 hours, respectively; median difference, -2 hours; 95% CI, -5 to 1; P=0.48), ICU stay (median, 72 hours and 84 hours, respectively; median difference, -12 hours; 95% CI, -21 to 2; P=0.09), and hospital stay (median, 14 days and 14 days, respectively; median difference, 0 days; 95% CI, -1 to 2; P=0.39). There was no significant difference between the levosimendan group and the placebo group in rates of hypotension or cardiac arrhythmias. In patients who required perioperative hemodynamic support after cardiac surgery, low-dose levosimendan in addition to standard care did not result in lower 30-day mortality than placebo

  6. [Social support in gender reassignment surgery].

    Science.gov (United States)

    Hess, J; Kurth, I; Henkel, A; Panic, L; Rübben, H; Rossi Neto, R; Hess-Busch, Y

    2017-02-01

    Gender reassignment surgery (GRS) can lead to discrimination. This transition makes great demands on the individual and also affects the social environment. To evaluate the social support of male-to-female (MtF) transgender people. Group A comprised 254 consecutive MtF transsexuals, who received a penile inversion vaginoplasty between 2004 and 2010. These women were surveyed retrospectively. Group B comprised 144 consecutive MtF transsexuals who presented for preoperative counselling. These patients were asked to answer the survey in advance of the planned GRS. The return rate was 46.9 % (A) and 95.1 % (B). In both groups, approximately two-thirds lived with their parents or children at ease. About 13.4 % (A) and 16.9 % (B) estimated the relationship towards their parents and one- seventh (A) or one-sixth (B) woman rated their relationship towards their children as poor. The acceptance of the parents regarding GRS was 65.6 % (A) and 77.1 % (B). In total 20 % (A) and 9.2 % (B) did not, however, accept GRS in their children. The acceptance of children regarding GRS was 64.9 % (A) and 71.1 % (B) with 10.8 % (A) and 6.7 % (B) who did not approve the decision. Social support is an important resource in the context of gender reassignment surgery. Understanding can help to improve the situation for transsexuals and to reduce consecutive healthcare utilisation.

  7. Web-video-mining-supported workflow modeling for laparoscopic surgeries.

    Science.gov (United States)

    Liu, Rui; Zhang, Xiaoli; Zhang, Hao

    2016-11-01

    As quality assurance is of strong concern in advanced surgeries, intelligent surgical systems are expected to have knowledge such as the knowledge of the surgical workflow model (SWM) to support their intuitive cooperation with surgeons. For generating a robust and reliable SWM, a large amount of training data is required. However, training data collected by physically recording surgery operations is often limited and data collection is time-consuming and labor-intensive, severely influencing knowledge scalability of the surgical systems. The objective of this research is to solve the knowledge scalability problem in surgical workflow modeling with a low cost and labor efficient way. A novel web-video-mining-supported surgical workflow modeling (webSWM) method is developed. A novel video quality analysis method based on topic analysis and sentiment analysis techniques is developed to select high-quality videos from abundant and noisy web videos. A statistical learning method is then used to build the workflow model based on the selected videos. To test the effectiveness of the webSWM method, 250 web videos were mined to generate a surgical workflow for the robotic cholecystectomy surgery. The generated workflow was evaluated by 4 web-retrieved videos and 4 operation-room-recorded videos, respectively. The evaluation results (video selection consistency n-index ≥0.60; surgical workflow matching degree ≥0.84) proved the effectiveness of the webSWM method in generating robust and reliable SWM knowledge by mining web videos. With the webSWM method, abundant web videos were selected and a reliable SWM was modeled in a short time with low labor cost. Satisfied performances in mining web videos and learning surgery-related knowledge show that the webSWM method is promising in scaling knowledge for intelligent surgical systems. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Systems workplace for endoscopic surgery.

    Science.gov (United States)

    Irion, K M; Novak, P

    2000-01-01

    With the advent of minimally invasive surgery (MIS) a decade ago, the requirements for operating rooms (OR) and their equipment have been increased. Compared with conventional open surgery, the new endoscopic techniques require additional tools. Television systems, for video-assisted image acquisition and visualisation, including cameras, monitors and light systems, as well as insufflators, pumps, high-frequency units, lasers and motorised therapy units, are nowadays usually made available on carts during endoscopic surgery. In conjunction with a set of endoscopic instruments, these high-tech units allow new operating techniques to be performed. The benefit for patients has become clear in recent years; however, the technical complexity of OR has also increased considerably. To minimise this problem for the OR personnel, the MIS concept 'OR1' (Operating Room 1) was developed and implemented. OR1 is a fully functional and integrated multi-speciality surgical suite for MIS. The centrepieces of the OR1 are the Storz Communication Bus (SCB) and the advanced image and data archiving system (Aida) from Karl Storz, Tuttlingen, Germany. Both components allow monitoring, access and networking of the MIS equipment and other OR facilities, as well as the acquisition, storage and display of image, patient and equipment data during the endoscopic procedure. A central user interface allows efficient, simplified operation and online clinical images. Due to the system integration, the handling of complex equipment is considerably simplified, logistical procedures in the OR are improved, procedure times are shorter and, particularly noteworthy, operative risk can be reduced through simplified device operation.

  9. Examination of bariatric surgery Facebook support groups: a content analysis.

    Science.gov (United States)

    Koball, Afton M; Jester, Dylan J; Domoff, Sarah E; Kallies, Kara J; Grothe, Karen B; Kothari, Shanu N

    2017-08-01

    Support following bariatric surgery is vital to ensure long-term postoperative success. Many individuals undergoing bariatric surgery are turning to online modalities, especially the popular social media platform Facebook, to access support groups and pages. Despite evidence suggesting that the majority of patients considering bariatric surgery are utilizing online groups, little is known about the actual content of these groups. The purpose of the present study was to conduct a content analysis of bariatric surgery support groups and pages on Facebook. Online via Facebook, independent academic medical center, United States. Data from bariatric surgery-related Facebook support groups and pages were extracted over a 1-month period in 2016. Salient content themes (e.g., progress posts, depression content, eating behaviors) were coded reliably (all κ> .70). More than 6,800 posts and replies were coded. Results indicated that seeking recommendations (11%), providing information or recommendations (53%), commenting on changes since surgery (19%), and lending support to other members (32%) were the most common types of posts. Content surrounding anxiety, eating behaviors, depression, body image, weight bias, and alcohol was found less frequently. Online bariatric surgery groups can be used to receive support, celebrate physical and emotional accomplishments, provide anecdotal accounts of the "bariatric lifestyle" for preoperative patients, and comment on challenges with mental health and experiences of weight bias. Providers should become acquainted with the content commonly found in online groups and exercise caution in recommending these platforms to information-seeking patients. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  10. Social Support for Women Who Have Undergone Bariatric Surgery.

    Science.gov (United States)

    Ogle, Jennifer Paff; Park, Juyeon; Damhorst, Mary Lynn; Bradley, Linda Arthur

    2016-01-01

    We explored the role that social support plays in the lives of women who have undergone bariatric surgery. We conducted in-depth interviews with 13 women who had had bariatric surgery (M age = 53.0 years) and analyzed the data using constant comparison processes. We found that individuals in participants' lives offered support by acting as role models and providing information, offering empathy and expressions of concern and caring, assisting with everyday responsibilities, and serving as companions. In turn, these forms of support guided participants' behavior, calmed their concerns, enhanced their self-esteem, relieved them of daily responsibilities, and offered them companionship in their bariatric journeys. Consistent with the existing theory, differently situated individuals specialized in offering particular types of support. Although participants appreciated the support received, many indicated a desire for more or "better" support, pointing to a need for resources guiding supporters in how to best offer support to bariatric patients. © The Author(s) 2015.

  11. The influence of perceived family support on post surgery recovery.

    Science.gov (United States)

    Cardoso-Moreno, M J; Tomás-Aragones, L

    2017-01-01

    The objective of this work was to investigate the possible relationship between perceived family support, levels of cortisol and post surgery recovery. The study sample comprised 42 patients that were due to undergo open cholecystectomy surgery in a Regional Health Authority Reference Centre of the Autonomous Community of Extremadura in Spain. The FACES-II questionnaire was used for the evaluation of perceived family support and to measure the three fundamental dimensions of perceived family behaviour: cohesion, adaptability and family type. The day before surgery, a sample of saliva was taken from each subject in order to determine the level of cortisol. Results showed a clear relationship between family support and recovery. Patients with higher scores on the Cohesion Scale demonstrated better post surgery recovery (F = 8.8; gl = 40; p = .005). A relationship between levels of cortisol, perceived family support and recovery was also revealed. Patients with lower scores on the Cohesion scale and higher cortisol levels demonstrated poorer post surgery recovery (F = 10.96; gl = 40; p = .006). These results are coherent with other studies that have highlighted the beneficial effects of perceived family support on mental and physical health.

  12. Patient support systems

    International Nuclear Information System (INIS)

    Braden, A.B.; McBride, T.R.; Styblo, D.J.; Taylor, S.K.; Richey, J.B.

    1979-01-01

    A patient support system for use in computerized tomography (CT) is described. The system is particularly useful for CT scanning of the brain and also of the abdominal area. The support system consists of two moveable tables which may be translated into position for X-ray scanning of the patient's body and which may be translated incrementally and automatically to obtain scans at adjacent locations. For use with brain scans, the second table is replaced by a detachable restraint assembly which is described in detail. The support system is so designed that only a small volume of low density material will intercept the X-ray beam. (UK)

  13. Can the surgical checklist reduce the risk of wrong site surgery in orthopaedics? - can the checklist help? Supporting evidence from analysis of a national patient incident reporting system

    Directory of Open Access Journals (Sweden)

    Cleary Kevin

    2011-04-01

    Full Text Available Abstract Background Surgical procedures are now very common, with estimates ranging from 4% of the general population having an operation per annum in economically-developing countries; this rising to 8% in economically-developed countries. Whilst these surgical procedures typically result in considerable improvements to health outcomes, it is increasingly appreciated that surgery is a high risk industry. Tools developed in the aviation industry are beginning to be used to minimise the risk of errors in surgery. One such tool is the World Health Organization's (WHO surgery checklist. The National Patient Safety Agency (NPSA manages the largest database of patient safety incidents (PSIs in the world, already having received over three million reports of episodes of care that could or did result in iatrogenic harm. The aim of this study was to estimate how many incidents of wrong site surgery in orthopaedics that have been reported to the NPSA could have been prevented by the WHO surgical checklist. Methods The National Reporting and Learning Service (NRLS database was searched between 1st January 2008- 31st December 2008 to identify all incidents classified as wrong site surgery in orthopaedics. These incidents were broken down into the different types of wrong site surgery. A Likert-scale from 1-5 was used to assess the preventability of these cases if the checklist was used. Results 133/316 (42% incidents satisfied the inclusion criteria. A large proportion of cases, 183/316 were misclassified. Furthermore, there were fewer cases of actual harm [9% (12/133] versus 'near-misses' [121/133 (91%]. Subsequent analysis revealed a smaller proportion of 'near-misses' being prevented by the checklist than the proportion of incidents that resulted in actual harm; 18/121 [14.9% (95% CI 8.5 - 21.2%] versus 10/12 [83.3% (95%CI 62.2 - 104.4%] respectively. Summatively, the checklist could have been prevented 28/133 [21.1% (95%CI 14.1 - 28.0%] patient safety

  14. Decision support systems

    DEFF Research Database (Denmark)

    Jørgensen, L.N.; Noe, E.; Langvad, A.M.

    2007-01-01

    system Crop Protection Online is widely used by advisors and as a learning tool for students. Although the system has been validated in many field trials over the years and has shown reliable results, the number of end-users among farmers has been relatively low during the last 10 years (approximately...... 1000 farmers). A sociological investigation of farmers' decision-making styles in the area of crop protection has shown that arable farmers can be divided into three major groups: (a) system-orientated farmers, (b) experience-based farmers and (c) advisory-orientated farmers. The information required...... by these three groups to make their decisions varies and therefore different ways of using decision support systems need to be provided. Decision support systems need to be developed in close dialogue and collaboration with user groups....

  15. Visual management support system

    Science.gov (United States)

    Lee Anderson; Jerry Mosier; Geoffrey Chandler

    1979-01-01

    The Visual Management Support System (VMSS) is an extension of an existing computer program called VIEWIT, which has been extensively used by the U. S. Forest Service. The capabilities of this program lie in the rapid manipulation of large amounts of data, specifically opera-ting as a tool to overlay or merge one set of data with another. VMSS was conceived to...

  16. Radwaste Decision Support System

    International Nuclear Information System (INIS)

    Westrom, G.; Vance, J.N.; Gelhaus, F.E.

    1989-01-01

    The purpose of the Radwaste Decision Support System (RDSS) is to provide expert advice, analysis results and instructional material relative to the treatment, handling, transport and disposal of low-level radioactive waste produced in nuclear power plants. This functional specification addresses the following topics: Functions of the RDSS, Relationships and interfaces between the function, Development of the decisions and logic tree structures embodied in waste management, Elements of the database and the characteristics required to support the decision-making process, Specific User requirements for the RDSS, Development of the user interface, Basic software architecture, and Concepts for the RDSS usage including updating and maintenance

  17. Implementation of an interactive liver surgery planning system

    Science.gov (United States)

    Wang, Luyao; Liu, Jingjing; Yuan, Rong; Gu, Shuguo; Yu, Long; Li, Zhitao; Li, Yanzhao; Li, Zhen; Xie, Qingguo; Hu, Daoyu

    2011-03-01

    Liver tumor, one of the most wide-spread diseases, has a very high mortality in China. To improve success rates of liver surgeries and life qualities of such patients, we implement an interactive liver surgery planning system based on contrastenhanced liver CT images. The system consists of five modules: pre-processing, segmentation, modeling, quantitative analysis and surgery simulation. The Graph Cuts method is utilized to automatically segment the liver based on an anatomical prior knowledge that liver is the biggest organ and has almost homogeneous gray value. The system supports users to build patient-specific liver segment and sub-segment models using interactive portal vein branch labeling, and to perform anatomical resection simulation. It also provides several tools to simulate atypical resection, including resection plane, sphere and curved surface. To match actual surgery resections well and simulate the process flexibly, we extend our work to develop a virtual scalpel model and simulate the scalpel movement in the hepatic tissue using multi-plane continuous resection. In addition, the quantitative analysis module makes it possible to assess the risk of a liver surgery. The preliminary results show that the system has the potential to offer an accurate 3D delineation of the liver anatomy, as well as the tumors' location in relation to vessels, and to facilitate liver resection surgeries. Furthermore, we are testing the system in a full-scale clinical trial.

  18. Seeking and receiving social support on Facebook for surgery.

    Science.gov (United States)

    Davis, Matthew A; Anthony, Denise L; Pauls, Scott D

    2015-04-01

    Social networking sites such as Facebook provide a new way to seek and receive social support, a factor widely recognized as important for one's health. However, few studies have used actual conversations from social networking sites to study social support for health related matters. We studied 3,899 Facebook users, among a sample of 33,326 monitored adults, who initiated a conversation that referred to surgery on their Facebook Wall during a six-month period. We explored predictors of social support as measured by number of response posts from "friends." Among our sample, we identified 8,343 Facebook conversation threads with the term "surgery" in the initial post with, on average, 5.7 response posts (SD 6.2). We used a variant of latent semantic analysis to explore the relationship between specific words in the posts that allowed us to develop three thematic categories of words related to family, immediacy of the surgery, and prayer. We used generalized linear mixed models to examine the association between characteristics of the Facebook user as well as the thematic categories on the likelihood of receiving response posts following the announcement of a surgery. Words from the three thematic categories were used in 32.5% (family), 39.5 (immediacy), and 50.7% (prayer) of root posts. Few user characteristics were associated with response in multivariate models [rate ratios, RR, 1.08 (95% CI 1.01, 1.15) for married/living with partner; 1.10 (95% CI 1.03, 1.19) for annual income > $75,000]. In multivariate models adjusted for Facebook user characteristics and network size, use of family and prayer words in the root post were associated with significantly higher number of response posts, RR 1.40 (95% CI 1.37, 1.43) and 2.07 (95% CI 2.02, 2.12) respectively. We found some evidence of social support on Facebook for surgery and that the language used in the root post of a conversation thread is predictive of overall response. Copyright © 2015 Elsevier Ltd. All

  19. Transmission market support system

    International Nuclear Information System (INIS)

    Reinschmidt, K.F.; Coles, B.C.

    1995-01-01

    An interactive, computer-based market support system has been developed for transmission access that is efficient, equitable, and fair to all parties concerned with electrical transmission: utilities, electric generators, owners of transmission networks, and wholesale purchasers of electrical power. Each participant transmits electronically to the computer system his proposed price schedule for buying, selling, or transmitting power for each future time period. The price for transmission on a single line in one direction can differ from the price in the other direction. The total quantity offered in the transmission bid represents the capacity of the line, and the flow on the line cannot exceed this value. The system automatically computes the prices that clear the market; that is, the price that each generator receives at each bus, the price that each transmission operator receives on each line, and the price that each customer pays at each bus. The computer system maximizes the benefits to all three classes while satisfying the electrical characteristics of the transmission system by means of load flow calculations. Customers never pay more than their bid prices (but may pay less), and generators and transmission operators never receive less than their bid prices (but may receive more). The price at each bus applies to all buyers and sellers at that bus: all buyers at the same bus pay the same price and all generators at a bus receive the same price

  20. Systemic hypertension and non-cardiac surgery.

    Science.gov (United States)

    Misra, Satyajeet

    2017-09-01

    Primary systemic hypertension affects 10%-25% of individuals presenting for surgery and anaesthesia and constitutes an important cause of cancellation of elective surgeries. Much of the fear stems from the fact that hypertension may lead to adverse perioperative outcomes. Although long-standing hypertension increases the risk of stroke, renal dysfunction or major adverse cardiovascular events, the same is usually not seen in the perioperative period if blood pressure is <180/110 mmHg and this has been the overriding theme in the recent guidelines on perioperative blood pressure management. Newer concepts include isolated systolic hypertension and pulse pressure hypertension that are increasingly used to stratify risk. The aim of this review is to focus on the adult patient with chronic primary systemic hypertension posted for elective non-cardiac surgery and outline the perioperative concerns.

  1. Life Support Systems: Environmental Monitoring

    Data.gov (United States)

    National Aeronautics and Space Administration — The Advanced Exploration Systems (AES) Life Support Systems project Environmental Monitoring (EM) systems task objectives are to develop and demonstrate onboard...

  2. Development of a Pilot Telehealth Bariatric Surgery Support Group

    Science.gov (United States)

    Schofield, Carin K.

    2013-01-01

    The prevalence of obesity in the United States continues to grow. Bariatric surgery is becoming more common and accepted in the treatment of obesity. Clinical candidates for bariatric surgery should have a BMI > 40 kg/m[superscript 2] alone, or a BMI > 35 kg/m[superscript 2] plus one comorbidity. A trend is emerging in the literature showing…

  3. [Habitability and life support systems].

    Science.gov (United States)

    Nefedov, Iu G; Adamovich, B A

    1988-01-01

    This paper discusses various aspects of space vehicle habitability and life support systems. It describes variations in the chemical and microbial composition of an enclosed atmosphere during prolonged real and simulated flights. The paper gives a detailed description of life support systems and environmental investigations onboard the Mir station. It also outlines the development of space vehicle habitability and life support systems as related to future flights.

  4. Computer-Supported Information Systems.

    Science.gov (United States)

    Mayhew, William H.

    1983-01-01

    The planning and implementation of a computerized management information system at a fictional small college is described. Nine key points are made regarding department involvement, centralization, gradual program implementation, lowering costs, system documentation, and upper-level administrative support. (MSE)

  5. System for technical innovation support

    International Nuclear Information System (INIS)

    2011-08-01

    This book lists field of support system, which includes tax, development work, basic research project, industrial technology, information and communications field, energy field, part and materials field, local industry, the small and medium business such as technical development field, and industry-university collaboration like summary of investment and financing support and guarantee, support of manpower such as brain pool and contact Korea, support of technique like development technology and strategy for patent, support on certification such as company and technical goods, purchase support.

  6. [Innovating to support the development of outpatient surgery].

    Science.gov (United States)

    Dubois, Ronan

    Le Confluent private hospital in Nantes has opened a unit devoted to outpatient surgery. Its architecture, organisation, facilities and services have all been designed to treat patients in as short a timeframe as possible. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  7. Conference Support - Surgery in Extreme Environments - Center for Surgical Innovation

    Science.gov (United States)

    2007-01-01

    technology accelerator. Lunar capability concerns include (1) optimization of safety, habitability, and biomechanics ; (2) clinical infrastructure, limited... remove the tissue from the animals, we would then immerse them, fixating the tissues as well. A couple of interesting things though were strange. We had...cellular surgery, new surgical tools, intelligent prosthesis , tissue engineering, and suspended animation. Each of these concepts has a potential for

  8. Clinical Information Support System (CISS)

    Data.gov (United States)

    Department of Veterans Affairs — Clinical Information Support System (CISS) is a web-based portal application that provides a framework of services for the VA enterprise and supplies an integration...

  9. Integrated Control System Engineering Support.

    Science.gov (United States)

    1984-12-01

    Advanced Medium Range Air to Air Missile ASTEC Advanced Speech Technology Experimental Configuration BA Body Axis BCIU Bus Control Interface Unit BMU Bus...support nreeded to tie an ASTEC speech recognition system into the DIGISYN fJcility and support an FIGR experiment designed to investigate the voice...information passed to the PDP computer consisted of integers which represented words or phrases recognized by the ASTEC recognition system. An interface

  10. Introduction to Life Support Systems

    Science.gov (United States)

    Perry, Jay

    2017-01-01

    This course provides an introduction to the design and development of life support systems to sustain humankind in the harsh environment of space. The life support technologies necessary to provide a respirable atmosphere and clean drinking water are emphasized in the course. A historical perspective, beginning with open loop systems employed aboard the earliest crewed spacecraft through the state-of-the-art life support technology utilized aboard the International Space Station today, will provide a framework for students to consider applications to possible future exploration missions and destinations which may vary greatly in duration and scope. Development of future technologies as well as guiding requirements for designing life support systems for crewed exploration missions beyond low-Earth orbit are also considered in the course.

  11. Comparison of Different Computer–Aided Surgery Systems in Skull Base Surgery

    OpenAIRE

    Ecke, U.; Luebben, B.; Maurer, J.; Boor, S.; Mann, W. J.

    2003-01-01

    Computer–aided surgery (CAS) based on high–resolution imaging techniques represents an important adjunct to precise intraoperative orientation when anatomical landmarks are distorted or missing. Several commercial systems, mostly based on optical or electromagnetic navigation principles, are on the market. This study investigated the application of EasyGuide®, VectorVision®, and InstaTrak® CAS systems in ENT surgery under practical and laboratory conditions. System accuracy, time required, ha...

  12. Education and training support system

    International Nuclear Information System (INIS)

    Kubota, Rhuji; Iyadomi, Motomi.

    1996-01-01

    In order to train the specialist such as operator or maintenance stuff of large scale plant such as nuclear power plant or thermal power plant, a high grade teaching and training support system is required as well as in training pilot of aeroplane. The specialist in such large scale plant is also a researcher in the field of machinery, electricity and physics at first, and is grown up a expert operator or maintenance stuff through learning of CAI system or OTJ used training material for teaching tool in addition of training used operating or maintenance training device imitating actual plant after acquiring determined knowledges by receiving fundamental education on nuclear and thermal power plants. In this paper, the teaching and training support systems of the nuclear and thermal power plants for a system supporting such teaching and training, respectively, were introduced. (G.K.)

  13. Application of da Vinci surgical robotic system in hepatobiliary surgery

    Directory of Open Access Journals (Sweden)

    Chen Jiahai

    2018-01-01

    Full Text Available The development of minimally invasive surgery has brought a revolutionary change to surgery techniques, and endoscopic surgical robots, especially Da Vinci robotic surgical system, has further broaden the scope of minimally invasive surgery, which has been applied in a variety of surgical fields including hepatobiliary surgery. Today, the application of Da Vinci surgical robot can cover most of the operations in hepatobiliary surgery which has proved to be safe and practical. What’s more, many clinical studies in recent years have showed that Da Vinci surgical system is superior to traditional laparoscopy. This paper summarize the advantage and disadvantage of Da Vinci surgical system, and outlines the current status of and future perspectives on the robot-assisted hepatobiliary surgery based on the cases reports in recent years of the application of Da Vinci surgical robot.

  14. Development of refueling support system

    International Nuclear Information System (INIS)

    Nishimura, Hiroshi; Hayashi, Shoichi; Sano, Kazuya; Hochin, Koji; Iguchi, Yukihiro

    1992-01-01

    The refueling of Fugen Nuclear Power Station requires correct management of fuels, etc. And empirical knowledge is necessary for efficient planning and refueling. Fugen developed refueling support system and put it into practical operation. The system features a network of refueling equipment and AI rules aquired from operators knowledge. The system helps make an optimized plan, displays step-by-step guidance and prints out lists of fuel locations and movements. The system reduced the labor of the operators, optimized the management and improved the reliability of the refueling. (author)

  15. Support system, excavation arrangement, and process of supporting an object

    Science.gov (United States)

    Arnold, Bill W.

    2017-08-01

    A support system, an excavation arrangement, and a process of supporting an object are disclosed. The support system includes a weight-bearing device and a camming mechanism positioned below the weight-bearing device. A downward force on the weight-bearing device at least partially secures the camming mechanism to opposing surfaces. The excavation arrangement includes a borehole, a support system positioned within and secured to the borehole, and an object positioned on and supported by the support system. The process includes positioning and securing the support system and positioning the object on the weight-bearing device.

  16. KESS: Knowledge Engineering Support System

    OpenAIRE

    Said, Mohamed Ben; Dougherty, Nini; Anderson, Curtis; Altman, Stanley J.; Bouhaddou, Omar; Warner, Homer R.

    1987-01-01

    KESS (Knowledge Engineering Support System) is a relational information management system created at the University of Utah to document each step in the building of four expert knowledge bases. In weekly knowledge engineering sessions, groups of experts propose decision making criteria and examine information sources in the process of creating HELP knowledge frames. KESS utilizes many-to-many links with multiple files and central link files to track the different kinds of information generate...

  17. ELECTRICAL SUPPORT SYSTEM DESCRIPTION DOCUMENT

    Energy Technology Data Exchange (ETDEWEB)

    S. Roy

    2004-06-24

    The purpose of this revision of the System Design Description (SDD) is to establish requirements that drive the design of the electrical support system and their bases to allow the design effort to proceed to License Application. This SDD is a living document that will be revised at strategic points as the design matures over time. This SDD identifies the requirements and describes the system design as they exist at this time, with emphasis on those attributes of the design provided to meet the requirements. This SDD has been developed to be an engineering tool for design control. Accordingly, the primary audience/users are design engineers. This type of SDD both ''leads'' and ''trails'' the design process. It leads the design process with regard to the flow down of upper tier requirements onto the system. Knowledge of these requirements is essential in performing the design process. The SDD trails the design with regard to the description of the system. The description provided in the SDD is a reflection of the results of the design process to date. Functional and operational requirements applicable to electrical support systems are obtained from the ''Project Functional and Operational Requirements'' (F&OR) (Siddoway 2003). Other requirements to support the design process have been taken from higher-level requirements documents such as the ''Project Design Criteria Document'' (PDC) (Doraswamy 2004), and fire hazards analyses. The above-mentioned low-level documents address ''Project Requirements Document'' (PRD) (Canon and Leitner 2003) requirements. This SDD contains several appendices that include supporting information. Appendix B lists key system charts, diagrams, drawings, and lists, and Appendix C includes a list of system procedures.

  18. ELECTRICAL SUPPORT SYSTEM DESCRIPTION DOCUMENT

    International Nuclear Information System (INIS)

    Roy, S.

    2004-01-01

    The purpose of this revision of the System Design Description (SDD) is to establish requirements that drive the design of the electrical support system and their bases to allow the design effort to proceed to License Application. This SDD is a living document that will be revised at strategic points as the design matures over time. This SDD identifies the requirements and describes the system design as they exist at this time, with emphasis on those attributes of the design provided to meet the requirements. This SDD has been developed to be an engineering tool for design control. Accordingly, the primary audience/users are design engineers. This type of SDD both ''leads'' and ''trails'' the design process. It leads the design process with regard to the flow down of upper tier requirements onto the system. Knowledge of these requirements is essential in performing the design process. The SDD trails the design with regard to the description of the system. The description provided in the SDD is a reflection of the results of the design process to date. Functional and operational requirements applicable to electrical support systems are obtained from the ''Project Functional and Operational Requirements'' (F andOR) (Siddoway 2003). Other requirements to support the design process have been taken from higher-level requirements documents such as the ''Project Design Criteria Document'' (PDC) (Doraswamy 2004), and fire hazards analyses. The above-mentioned low-level documents address ''Project Requirements Document'' (PRD) (Canon and Leitner 2003) requirements. This SDD contains several appendices that include supporting information. Appendix B lists key system charts, diagrams, drawings, and lists, and Appendix C includes a list of system procedures

  19. System support software for TSTA

    International Nuclear Information System (INIS)

    Claborn, G.W.; Mann, L.W.; Nielson, C.W.

    1987-01-01

    The software at the Tritium Systems Test Assembly (TSTA) is logically broken into two parts, the system support software and the subsystem software. The purpose of the system support software is to isolate the subsystem software from the physical hardware. In this sense the system support software forms the kernel of the software at TSTA. The kernel software performs several functions. It gathers data from CAMAC modules and makes that data available for subsystem processes. It services requests to send commands to CAMAC modules. It provides a system of logging functions and provides for a system-wide global program state that allows highly structured interaction between subsystem processes. The kernel's most visible function is to provide the Man-Machine Interface (MMI). The MMI allows the operators a window into the physical hardware and subsystem process state. Finally the kernel provides a data archiving and compression function that allows archival data to be accessed and plotted. Such kernel software as developed and implemented at TSTA is described

  20. Integrated logistic support analysis system

    International Nuclear Information System (INIS)

    Carnicero Iniguez, E.J.; Garcia de la Sen, R.

    1993-01-01

    Integrating logic support into a system results in a large volume of information having to be managed which can only be achieved with the help of computer applications. Both past experience and growing needs in such tasks have led Emperesarios Agrupados to undertake an ambitious development project which is described in this paper. (author)

  1. Decision support system for the operating room rescheduling problem.

    Science.gov (United States)

    van Essen, J Theresia; Hurink, Johann L; Hartholt, Woutske; van den Akker, Bernd J

    2012-12-01

    Due to surgery duration variability and arrivals of emergency surgeries, the planned Operating Room (OR) schedule is disrupted throughout the day which may lead to a change in the start time of the elective surgeries. These changes may result in undesirable situations for patients, wards or other involved departments, and therefore, the OR schedule has to be adjusted. In this paper, we develop a decision support system (DSS) which assists the OR manager in this decision by providing the three best adjusted OR schedules. The system considers the preferences of all involved stakeholders and only evaluates the OR schedules that satisfy the imposed resource constraints. The decision rules used for this system are based on a thorough analysis of the OR rescheduling problem. We model this problem as an Integer Linear Program (ILP) which objective is to minimize the deviation from the preferences of the considered stakeholders. By applying this ILP to instances from practice, we determined that the given preferences mainly lead to (i) shifting a surgery and (ii) scheduling a break between two surgeries. By using these changes in the DSS, the performed simulation study shows that less surgeries are canceled and patients and wards are more satisfied, but also that the perceived workload of several departments increases to compensate this. The system can also be used to judge the acceptability of a proposed initial OR schedule.

  2. Association of Social Support Network Size With Receipt of Cataract Surgery in Older Adults.

    Science.gov (United States)

    Stagg, Brian C; Choi, HwaJung; Woodward, Maria A; Ehrlich, Joshua R

    2018-04-01

    Cataract-related vision impairment is an important public health issue that tends to affect older adults. Little is known about the association between older adults' social support networks and their likelihood of receiving cataract surgery. To determine if older adults with smaller social support networks are less likely to receive cataract surgery. Retrospective cohort study. The National Health and Aging Trends Study, a nationally representative US survey, administered annually from 2011 to 2015 to a cohort of Medicare beneficiaries 65 years and older with no cataract surgery prior to the start of the study. Multivariable logistic regression was performed to evaluate if the number of persons in an individual's social support network influenced whether that individual received cataract surgery during a given year of the study. Overall, 3448 participants were interviewed from 2011 to 2015 for a total of 9760 observations. Of these observations, 3084 (weighted, 38.81%; 95% CI, 37.28-40.35) were aged 70 to 74 years, 5211 (weighted, 52.32%; 95% CI, 50.19-54.44) were women; 5899 (weighted, 78.53%; 95% CI, 76.29-80.61) were white, 2249 (weighted, 9.55%; 95% CI, 8.45-10.78) were black, 537 (weighted, 7.18%; 95% CI, 5.88-8.73) were Hispanic, and 303 (weighted, 4.74%; 95% CI, 3.56-62.9) reported other races. Medicare beneficiaries with smaller social support networks (0-2 individuals) were less likely to receive cataract surgery in a given year (adjusted odds ratio, 0.60; 95% CI, 0.37-0.96) than those with larger support networks (≥3 individuals). The adjusted predicted proportion of Medicare beneficiaries undergoing cataract surgery was 4.7% (95% CI, 2.7%-6.7%) and 7.5% (95% CI, 6.9%-8.1%) for those with small and large social support networks, respectively. Having fewer non-spouse/partner family members in the support network was associated with decreased odds of receiving cataract surgery (adjusted odds ratio, 0.60; 95% CI, 0.43-0.85), but having spouses

  3. Spill operation system decision support system

    International Nuclear Information System (INIS)

    Clark, R.

    1992-01-01

    The MSRC Spill Operation System (SOS) is a tool for the support of decision-making at the time of a catastrophic oil spill. SOS provides MSRC decision-makers with access to information about the source of the spill, the spill environment, and the availability of spill response resources. This system is designed to meet the information needs of a Response Supervisor, an Environmental Advisor, Logistics/Maintenance Supervisor, Operations Supervisor, and the MSRC Regional General Manager. The SOS project Objectives are: (1) integrate currently available data, systems, and technologies; (2) develop an application that effectively supports mobilized operations and can be adapted to support normal operations; (3) ensure that the development of computer applications is driven by user needs and not by technology; and (4) coordinate with government and other industry organizations to avoid duplication of effort. Design Objectives for SOS are: (1) centralize management information storage while decentralizing decision making capabilities; (2) boost User confidence by providing a system that is easy to learn, easy to use, and is open-quotes Sailor Proofclose quotes; and (3) use visualization technology in providing spill related information. This approach includes the use of Geographic Information System (GIS) technology for maps and geographically associated resource; and support MSRC's concept of operation which includes - a swift notification of response personnel; fast mobilization of response resources; and accurate tracking of resources during a spill. MSRC is organized into five responsibility regions

  4. The lacrimal system: diagnosis, management, and surgery

    National Research Council Canada - National Science Library

    Cohen, Adam J; Mercandetti, Michael; Brazzo, Brian G

    2006-01-01

    ... and techniques presented represent the state of the art of lacrimal diagnosis and surgery. There is mention of lacrimal infection dating back to the Code of Hammurabi in 2250 BC, but it was not until the late 1800s that real progress began to be made. Toti, an ENT surgeon in Florence, Italy, described external dacryocystorhinostomy (DCR) with turb...

  5. System Support for Forensic Inference

    Science.gov (United States)

    Gehani, Ashish; Kirchner, Florent; Shankar, Natarajan

    Digital evidence is playing an increasingly important role in prosecuting crimes. The reasons are manifold: financially lucrative targets are now connected online, systems are so complex that vulnerabilities abound and strong digital identities are being adopted, making audit trails more useful. If the discoveries of forensic analysts are to hold up to scrutiny in court, they must meet the standard for scientific evidence. Software systems are currently developed without consideration of this fact. This paper argues for the development of a formal framework for constructing “digital artifacts” that can serve as proxies for physical evidence; a system so imbued would facilitate sound digital forensic inference. A case study involving a filesystem augmentation that provides transparent support for forensic inference is described.

  6. In Vivo Tooth-Supported Implant Surgical Guides Fabricated With Desktop Stereolithographic Printers: Fully Guided Surgery Is More Accurate Than Partially Guided Surgery.

    Science.gov (United States)

    Bencharit, Sompop; Staffen, Adam; Yeung, Matthew; Whitley, Daniel; Laskin, Daniel M; Deeb, George R

    2018-02-21

    Desktop stereolithographic printers combined with intraoral scanning and implant planning software promise precise and cost-effective guided implant surgery. The purpose of the present study was to determine the overall range of accuracy of tooth-supported guided implant surgery using desktop printed stereolithographic guides. A cross-sectional study comparing fully and partially guided implant surgery was conducted. Preoperative cone beam computed tomography (CBCT) and intraoral scans were used to plan the implant sites. Surgical guides were then fabricated using a desktop stereolithographic 3-dimensional printer. Postoperative CBCT was used to evaluate the accuracy of placement. Deviations from the planned positions were used as the primary outcome variables. The planning software used, implant systems, and anterior/posterior positions were the secondary outcome variables. The differences between the planned and actual implant positions in the mesial, distal, buccal, and lingual dimensions and buccolingual angulations were determined, and the accuracy was compared statistically using the 1-tail F-test (P = .01), box plots, and 95% confidence intervals for the mean. Sixteen partially edentulous patients requiring placement of 31 implants were included in the present study. The implant deviations from the planned positions for mesial, distal, buccal, and lingual dimensions and buccolingual angulations with the fully guided protocol (n = 20) were 0.17 ± 0.78 mm, 0.44 ± 0.78 mm, 0.23 ± 1.08 mm, -0.22 ± 1.44 mm, and -0.32° ± 2.36°, respectively. The corresponding implant deviations for the partially guided protocol (n = 11) were 0.33 ± 1.38 mm, -0.03 ± 1.59 mm, 0.62 ± 1.15 mm, -0.27 ± 1.61 mm, and 0.59° ± 6.83°. The difference between the variances for fully and partially guided surgery for the distal and angulation dimensions was statistically significant (P = .006 and P guided implant surgery is more accurate than

  7. Picture book support for preparing children ahead of and during day surgery.

    Science.gov (United States)

    Nilsson, Elisabeth; Svensson, Gunnar; Frisman, Gunilla Hollman

    2016-10-07

    Aim To develop and evaluate the use of a specific picture book aiming to prepare children for anaesthesia and surgery. Methods An intervention comparing two different information methods before ear, nose and throat day surgery was performed. The intervention involved using a specific information sheet and a specific picture book. Parents (n=104) of children aged 2-12 years completed open-ended questions that were analysed with qualitative content analysis. They were divided into two groups: one group received routine information and one received routine information and the intervention. Findings The picture sheet and picture book were valuable aids to prepare small children for anaesthesia and surgery by explaining the procedures that would take place. The parents expressed that knowledge of the procedures made them and the child feel secure. Conclusion Peri-operative information through pictures supports children and their parents during day surgery and may be helpful in future healthcare visits.

  8. Quality of online information to support patient decision-making in breast cancer surgery.

    Science.gov (United States)

    Bruce, Jordan G; Tucholka, Jennifer L; Steffens, Nicole M; Neuman, Heather B

    2015-11-01

    Breast cancer patients commonly use the internet as an information resource. Our objective was to evaluate the quality of online information available to support patients facing a decision for breast surgery. Breast cancer surgery-related queries were performed (Google and Bing), and reviewed for content pertinent to breast cancer surgery. The DISCERN instrument was used to evaluate websites' structural components that influence publication reliability and ability of information to support treatment decision-making. Scores of 4/5 were considered "good." 45 unique websites were identified. Websites satisfied a median 5/9 content questions. Commonly omitted topics included: having a choice between breast conservation and mastectomy (67%) and potential for 2nd surgery to obtain negative margins after breast conservation (60%). Websites had a median DISCERN score of 2.9 (range 2.0-4.5). Websites achieved higher scores on structural criteria (median 3.6 [2.1-4.7]), with 24% rated as "good." Scores on supporting decision-making questions were lower (2.6 [1.3-4.4]), with only 7% scoring "good." Although numerous breast cancer-related websites exist, most do a poor job providing women with essential information necessary to actively participate in decision-making for breast cancer surgery. Providing easily- accessible, high-quality online information has the potential to significantly improve patients' experiences with decision-making. © 2015 Wiley Periodicals, Inc.

  9. Custom-Machined Miniplates and Bone-Supported Guides for Orthognathic Surgery: A New Surgical Procedure.

    Science.gov (United States)

    Brunso, Joan; Franco, Maria; Constantinescu, Thomas; Barbier, Luis; Santamaría, Joseba Andoni; Alvarez, Julio

    2016-05-01

    Several surgical strategies exist to improve accuracy in orthognathic surgery, but ideal planning and treatment have yet to be described. The purpose of this study was to present and assess the accuracy of a virtual orthognathic positioning system (OPS), based on the use of bone-supported guides for placement of custom, highly rigid, machined titanium miniplates produced using computer-aided design and computer-aided manufacturing technology. An institutional review board-approved prospective observational study was designed to evaluate our early experience with the OPS. The inclusion criteria were as follows: adult patients who were classified as skeletal Class II or III patients and as candidates for orthognathic surgery or who were candidates for maxillomandibular advancement as a treatment for obstructive sleep apnea. Reverse planning with computed tomography and modeling software was performed. Our OPS was designed to avoid the use of intermaxillary fixation and occlusal splints. The minimum follow-up period was 1 year. Six patients were enrolled in the study. The custom OPS miniplates fit perfectly with the anterior buttress of the maxilla and the mandible body surface intraoperatively. To evaluate accuracy, the postoperative 3-dimensional reconstructed computed tomography image and the presurgical plan were compared. In the maxillary fragments that underwent less than 6 mm of advancement, the OPS enabled an SD of 0.14 mm (92% within 1 mm) at the upper maxilla and 0.34 mm (86% within 1 mm) at the mandible. In the case of great advancements of more than 10 mm, the SD was 1.33 mm (66% within 1 mm) at the upper maxilla and 0.67 mm (73% within 1 mm) at the mandibular level. Our novel OPS was safe and well tolerated, providing positional control with considerable surgical accuracy. The OPS simplified surgery by being independent of support from the opposite maxilla and obviating the need for classic intermaxillary occlusal splints. Copyright © 2016

  10. Decision support system to select cover systems

    International Nuclear Information System (INIS)

    Bostick, K.V.

    1995-01-01

    The objective of this technology is to provide risk managers with a defensible, objective way to select capping alternatives for remediating radioactive and mixed waste landfills. The process of selecting containment cover technologies for mixed waste landfills requires consideration of many complex and interrelated technical, regulatory, and economic issues. A Decision Support System (DSS) is needed to integrate the knowledge of experts from scientific, engineering, and management disciplines to help in selecting the best capping practice for the site

  11. Iranian Parents' Supportive Umbrella during their Children Surgery: a Qualitative Study

    Directory of Open Access Journals (Sweden)

    Fatemeh Valizadeh

    2016-03-01

    Full Text Available Background Being in a position of vulnerability, distress and uncertainty reduces the ability of the parents to protect their children and makes them need support from others. The first step to aid clients more is to identify their supportive sources. This study aimed to determine parents' experiences of supportive sources during their children surgery. Materials and Methods This is a descriptive qualitative research. Purposive and maximum variation sampling applied to select 21 parents of operated children in Ahvaz hospitals, Iran. Semi structured interviews, with open question were used to data collection. Audio recording interviews put into written form word by word and finally analyzed with qualitative content analysis approach.  Results Parents considered the personnel's beyond-task-orientation performance, family comprehensive support, mutual facilitating of peers and the elixir of connection to God as the sources that supported them as an umbrella during their children surgery.     Conclusion It is essential for the health service providers to check each family thoroughly in terms of other supportive sources while providing professional support, and to use the sources in an organized way for the successful transition of parents from the stress of their children surgery.

  12. Supporting the Support System: How Assessment and Communication Can Help Patients and Their Support Systems.

    Science.gov (United States)

    Harkey, Jane; Young, Jared; Carter, Jolynne Jo; Demoratz, Michael

    The benefits of having a support system, such as social relationships with close friends and family, have been well documented for patients with serious health issues. As scientific evidence has shown, individuals who have the lowest level of involvement in social relationships face a greater mortality risk. Support systems, however, are not infallible. Relationship stress can have a negative impact on people-patient and caregiver alike-behaviorally, psychosocially, and physiologically. The purpose of this article is to encourage case managers who take a patient-centered approach to also consider the existence and extent of the support system, as well as any stresses or tensions that are observable within the support system. Although the case manager is ethically obliged to advocate for the individual receiving case management services, that advocacy can be extended to the support system for the good of all. This discussion applies to numerous case management practices and work settings including (but not limited to) hospital-based case management, home health, geriatrics, catastrophic case management, mental health, palliative care, and end of life/hospice. As part of the assessment phase of the case management process, case managers determine the extent of the patient's support system or social support network such as family and close friends. Although their advocacy is primarily for the patient receiving case management services, case managers also become aware of the needs of the support system members as they face their loved one's serious illness, severe injury, geriatric care demands, or end of life. Case managers can use their communication skills, especially motivational interviewing, with patients and their support systems to identify stresses and issues that can impact the pursuit of health goals. In addition, case managers ensure that individuals and their support systems are kept informed such as about the health condition, stage of disease, plan of

  13. 'RECASS'. Radioecological analysis support system

    International Nuclear Information System (INIS)

    Shershakov, V.

    1998-01-01

    The RECASS is developed as a computer system designed for radiation monitoring and decision-making support in a nuclear emergency. The RECASS system has excellent capabilities for collecting, storing, and presenting data from the radiological situation of contaminated areas. It is well designed for modeling radionuclide migration in the environmental media and for assessing countermeasures in terms of doses received by population groups as a result of radioactive contamination. For RECASS to be used as a basis for solving the problems of radioecological analysis, it is essential that mapping facilities are provided and that scaling capabilities allow data to be presented with the necessary degree of detail and accuracy. Because of the on-line links with the operating network of radiological monitoring, RECASS is capable of collecting meteorological and radiological data from across the country and storing this information in its databases. The availability of data from the network of radiological monitoring makes it possible to develop RECASS as a real-time emergency response system. (R.P.)

  14. 14 CFR 417.307 - Support systems.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Support systems. 417.307 Section 417.307... TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety System § 417.307 Support systems. (a) General. (1) A flight safety system must include the systems required by this section to support the functions of the flight...

  15. [Orthopedic and trauma surgery in the German DRG System 2007].

    Science.gov (United States)

    Franz, D; Kaufmann, M; Siebert, C H; Windolf, J; Roeder, N

    2007-03-01

    The German Diagnosis-Related Groups (DRG) System was further developed into its 2007 version. For orthopedic and trauma surgery, significant changes were made in terms of the coding of diagnoses and medical procedures, as well as in the DRG structure itself. The German Societies for Trauma Surgery and for Orthopedics and Orthopedic Surgery (Deutsch Gesellschaft für Unfallchirurgie, DGU; and Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie, DGOOC) once again cooperated constructively with the German DRG Institute InEK. Among other innovations, new International Classification of Diseases (ICD) codes for second-degree burns were implemented. Procedure codes for joint operations, endoprosthetic-surgery and spine surgery were restructured. Furthermore, a specific code for septic surgery was introduced in 2007. In addition, the DRG structure was improved. Case allocation of patients with more than one significant operation was established. Further DRG subdivisions were established according to the patients age and the Patient Clinical Complexity Level (PCCL). DRG developments for 2007 have improved appropriate case allocation, but once again increased the system's complexity. Clinicians need an ever growing amount of specific coding know-how. Still, further adjustments to the German DRG system are required to allow for a correct allocation of cases and funds.

  16. Towards ubiquitous access of computer-assisted surgery systems.

    Science.gov (United States)

    Liu, Hui; Lufei, Hanping; Shi, Weishong; Chaudhary, Vipin

    2006-01-01

    Traditional stand-alone computer-assisted surgery (CAS) systems impede the ubiquitous and simultaneous access by multiple users. With advances in computing and networking technologies, ubiquitous access to CAS systems becomes possible and promising. Based on our preliminary work, CASMIL, a stand-alone CAS server developed at Wayne State University, we propose a novel mobile CAS system, UbiCAS, which allows surgeons to retrieve, review and interpret multimodal medical images, and to perform some critical neurosurgical procedures on heterogeneous devices from anywhere at anytime. Furthermore, various optimization techniques, including caching, prefetching, pseudo-streaming-model, and compression, are used to guarantee the QoS of the UbiCAS system. UbiCAS enables doctors at remote locations to actively participate remote surgeries, share patient information in real time before, during, and after the surgery.

  17. [Hand surgery in the German DRG System 2007].

    Science.gov (United States)

    Franz, D; Windolf, J; Kaufmann, M; Siebert, C H; Roeder, N

    2007-05-01

    Hand surgery often needs only a short length of stay in hospital. Patients' comorbidity is low. Many hand surgery procedures do not need inpatient structures. Up until 2006 special procedures of hand surgery could not be coded. The DRG structure did not separate very complex and less complex operations. Specialized hospitals needed a proper case allocation of their patients within the G-DRG system. The DRG structure concerning hand surgery increased in version 2007 of the G-DRG system. The main parameter of DRG splitting is the complexity of the operation. Furthermore additional criteria such as more than one significant OR procedure, the patients' age, or special diagnoses influence case allocation. A special OPS code for complex cases treated with hand surgery was implemented. The changes in the DRG structure and the implementation of the new OPS code for complex cases establish a strong basis for the identification of different patient costs. Different case allocation leads to different economic impacts on departments of hand surgery. Whether the new OPS code becomes a DRG splitting parameter has to be calculated by the German DRG Institute for further DRG versions.

  18. Historical contributions from the Harvard system to adult spine surgery.

    Science.gov (United States)

    Schoenfeld, Andrew J

    2011-10-15

    Literature review. To document the historical contributions from the Harvard Medical School system to the field of adult spine surgery. Despite the fact that significant contributions to the discipline of spinal surgery have derived from the Harvard system, no prior study documents the history of the Harvard spine services in a cohesive narrative. This historical perspective reviews the history of adult spine surgery within the Harvard system and outlines the significant contributions made by orthopedic and neurosurgical practitioners to the field. Literature reviews were performed from historical works, as well as scientific publications to fashion a cohesive review covering the history of spine surgery at Harvard from the early 19th century to the present. The development of the spine surgical services at the three main Harvard hospitals, and significant spine surgical personalities within the system, are discussed, including W. Jason Mixter, MD, Joseph S. Barr Sr., MD, and Marius N. Smith-Petersen, MD. Substantial developments that have arisen from the Harvard teaching hospitals include the recognition of disc herniation as the cause of radicular symptoms in the lower extremities, the description of lumbar discectomy as a surgical treatment for radicular pain, osteotomy for the correction of spinal deformity, and the first attempt to create a systematic algorithm capable of informing treatment for cervical spine trauma. Despite humble beginnings, the surgeons and scientists at Harvard have influenced nearly every facet of spine surgery over the course of the last two centuries.

  19. Haptic feedback designs in teleoperation systems for minimal invasive surgery

    NARCIS (Netherlands)

    Font, I.; Weiland, S.; Franken, M.; Steinbuch, M.; Rovers, A.F.

    2004-01-01

    One of the major shortcomings of state-of-the-art robotic systems for minimal invasive surgery is the lack of haptic feedback for the surgeon. In order to provide haptic information, sensors and actuators have to be added to the master and slave device. A control system should process the data and

  20. Bioregenerative life-support systems

    Science.gov (United States)

    Mitchell, C. A.

    1994-01-01

    Long-duration future habitation of space involving great distances from Earth and/or large crew sizes (eg, lunar outpost, Mars base) will require a controlled ecological life-support system (CELSS) to simultaneously revitalize atmosphere (liberate oxygen and fix carbon dioxide), purify water (via transpiration), and generate human food (for a vegetarian diet). Photosynthetic higher plants and algae will provide the essential functions of biomass productivity in a CELSS, and a combination of physicochemical and bioregenerative processes will be used to regenerate renewable resources from waste materials. Crop selection criteria for a CELSS include nutritional use characteristics as well as horticultural characteristics. Cereals, legumes, and oilseed crops are used to provide the major macronutrients for the CELSS diet. A National Aeronautics and Space Administration (NASA) Specialized Center of Research and Training (NSCORT) was established at Purdue University to establish proof of the concept of the sustainability of a CELSS. The Biosphere 2 project in Arizona is providing a model for predicted and unpredicted situations that arise as a result of closure in a complex natural ecosystem.

  1. The Exchange of Social Support on Online Bariatric Surgery Discussion Forums: A Mixed-Methods Content Analysis.

    Science.gov (United States)

    Atwood, Molly E; Friedman, Aliza; Meisner, Brad A; Cassin, Stephanie E

    2018-05-01

    Bariatric surgery patients often experience physical and psychosocial stressors, and difficulty adjusting to significant lifestyle changes. As a result, social support groups that provide patients with support, coping skills, and nutritional information are valuable components of bariatric care. Support group attendance at bariatric centers is associated with greater post-surgery weight loss; however, several barriers hinder attendance at in-person support groups (e.g., travel distance to bariatric centers). Consequently, online support forums are an increasingly utilized resource for patients both before and after surgery. This study examined and described the type and frequency of social support provided on a large online bariatric surgery forum. A total of 1,412 messages in the pre- (n = 822) and post-surgery (n = 590) sections of the forum were coded using qualitative content analysis according to Cutrona and Suhr's (1992) Social Support Behavior Code model (i.e., including informational, tangible, esteem, network, and emotional support types). The majority of messages provided informational and emotional support regarding: a) factual information about the bariatric procedure and nutrition; b) advice for coping with the surgery preparation process, and physical symptoms; and c) encouragement regarding adherence to surgical guidelines, and weight loss progress. Network, esteem, and tangible support types were less frequent than informational and emotional support types. The results inform healthcare providers about the types of social support available to bariatric patients on online support forums and, thus, encourage appropriate referrals to this resource.

  2. Extending topological surgery to natural processes and dynamical systems.

    Directory of Open Access Journals (Sweden)

    Stathis Antoniou

    Full Text Available Topological surgery is a mathematical technique used for creating new manifolds out of known ones. We observe that it occurs in natural phenomena where a sphere of dimension 0 or 1 is selected, forces are applied and the manifold in which they occur changes type. For example, 1-dimensional surgery happens during chromosomal crossover, DNA recombination and when cosmic magnetic lines reconnect, while 2-dimensional surgery happens in the formation of tornadoes, in the phenomenon of Falaco solitons, in drop coalescence and in the cell mitosis. Inspired by such phenomena, we introduce new theoretical concepts which enhance topological surgery with the observed forces and dynamics. To do this, we first extend the formal definition to a continuous process caused by local forces. Next, for modeling phenomena which do not happen on arcs or surfaces but are 2-dimensional or 3-dimensional, we fill in the interior space by defining the notion of solid topological surgery. We further introduce the notion of embedded surgery in S3 for modeling phenomena which involve more intrinsically the ambient space, such as the appearance of knotting in DNA and phenomena where the causes and effect of the process lies beyond the initial manifold, such as the formation of black holes. Finally, we connect these new theoretical concepts with a dynamical system and we present it as a model for both 2-dimensional 0-surgery and natural phenomena exhibiting a 'hole drilling' behavior. We hope that through this study, topology and dynamics of many natural phenomena, as well as topological surgery itself, will be better understood.

  3. The University Münster Model Surgery System for Orthognathic Surgery. Part II -- KD-MMS.

    Science.gov (United States)

    Ehmer, Ulrike; Joos, Ulrich; Ziebura, Thomas; Flieger, Stefanie; Wiechmann, Dirk

    2013-01-04

    Model surgery is an integral part of the planning procedure in orthognathic surgery. Most concepts comprise cutting the dental cast off its socket. The standardized spacer plates of the KD-MMS provide for a non-destructive, reversible and reproducible means of maxillary and/or mandibular plaster cast separation. In the course of development of the system various articulator types were evaluated with regard to their capability to provide a means of realizing the concepts comprised of the KD-MMS. Special attention was dedicated to the ability to perform three-dimensional displacements without cutting of plaster casts. Various utilities were developed to facilitate maxillary displacement in accordance to the planning. Objectives of this development comprised the ability to implement the values established in the course of two-dimensional ceph planning. The system - KD-MMS comprises a set of hardware components as well as a defined procedure. Essential hardware components are red spacer and blue mounting plates. The blue mounting plates replace the standard yellow SAM mounting elements. The red spacers provide for a defined leeway of 8 mm for three-dimensional movements. The non-destructive approach of the KD-MMS makes it possible to conduct different model surgeries with the same plaster casts as well as to restore the initial, pre-surgical situation at any time. Thereby, surgical protocol generation and gnathologic splint construction are facilitated. The KD-MMS hardware components in conjunction with the defined procedures are capable of increasing efficiency and accuracy of model surgery and splint construction. In cases where different surgical approaches need to be evaluated in the course of model surgery, a significant reduction of chair time may be achieved.

  4. 49 CFR 193.2609 - Support systems.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false Support systems. 193.2609 Section 193.2609 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY...: FEDERAL SAFETY STANDARDS Maintenance § 193.2609 Support systems. Each support system or foundation of each...

  5. Preliminary development of augmented reality systems for spinal surgery

    Science.gov (United States)

    Nguyen, Nhu Q.; Ramjist, Joel M.; Jivraj, Jamil; Jakubovic, Raphael; Deorajh, Ryan; Yang, Victor X. D.

    2017-02-01

    Surgical navigation has been more actively deployed in open spinal surgeries due to the need for improved precision during procedures. This is increasingly difficult in minimally invasive surgeries due to the lack of visual cues caused by smaller exposure sites, and increases a surgeon's dependence on their knowledge of anatomical landmarks as well as the CT or MRI images. The use of augmented reality (AR) systems and registration technologies in spinal surgeries could allow for improvements to techniques by overlaying a 3D reconstruction of patient anatomy in the surgeon's field of view, creating a mixed reality visualization. The AR system will be capable of projecting the 3D reconstruction onto a field and preliminary object tracking on a phantom. Dimensional accuracy of the mixed media will also be quantified to account for distortions in tracking.

  6. Tailored patient information using a database system: Increasing patient compliance in a day surgery setting

    DEFF Research Database (Denmark)

    Grode, Jesper Nicolai Riis; Grode, Louise; Steinsøe, Ulla

    rehabilitation. The hospital is responsible of providing the patients with accurate information enabling the patient to prepare for surgery. Often patients are overloaded with uncoordinated information, letters and leaflets. The contribution of this project is a database system enabling health professionals...... to empower patients through tailored individualized information. Performing 6500 operations per year at our Day Surgery Centre, health professionals need a computer based system to create individualized information material. Health professionals must be able to adapt the information material quickly...... was established to support these requirements. A relational database system holds all information pieces in a granular, structured form. Each individual piece of information can be joined with other pieces thus supporting the tailoring of information. A web service layer caters for integration with output systems...

  7. Coping and caring: support resources integral to perioperative nurses during the process of organ procurement surgery.

    Science.gov (United States)

    Smith, Zaneta; Leslie, Gavin; Wynaden, Dianne

    2017-11-01

    To discuss and explore the levels of support provided to perioperative nurses when participating in multi-organ procurement surgery and the impact to their overall well-being. Assisting within multi-organ procurement surgical procedures has been recognised to impact on the well-being of perioperative nurses leaving little opportunity for them to recover from their participation or to seek available support resources. To date, this area has remained largely unexplored with limited evidence of how nurses manage and cope with these procedures, in addition to the support received in the workplace. A qualitative grounded theory method. The study was informed by perioperative nurses (n = 35) who had previous participatory experience in these surgical procedures from two Australian states. Theoretical sampling directed the collection of data via semistructured in-depth interviews. Data were analysed using the constant comparative method. Three components of levels of support were identified from the data: lacking support within the operating room organisation; surgical team support and access to external professional support. These findings offer new insights into how nurses manage and cope with their participation in organ procurement surgical procedures and what types of support resources can be seen as barriers or enablers to their overall experiences. The need for timely and adequate support is vital to their overall well-being and future participation in organ procurement surgery. These findings have the potential to guide further research with implications for clinical initiatives and practices, looking at new ways of supporting perioperative nurses within the clinical environment both locally and internationally. Healthcare organisations need to acknowledge the emotional, psychosocial and psychological health and well-being of nurses impacted by these surgical procedures and provide appropriate and timely clinical support within the work environment. © 2016

  8. The support needs of patients waiting for publicly funded bariatric surgery - implications for health service planners.

    Science.gov (United States)

    Sharman, M J; Venn, A J; Jose, K A; Williams, D; Hensher, M; Palmer, A J; Wilkinson, S; Ezzy, D

    2017-02-01

    The objective of this study was to investigate the experience of waiting for publicly funded bariatric surgery in an Australian tertiary healthcare setting. Focus groups and individual interviews involving people waiting for or who had undergone publicly funded bariatric surgery were audio-recorded, transcribed and analysed thematically. A total of 11 women and 6 men engaged in one of six focus groups in 2014, and an additional 10 women and 9 men were interviewed in 2015. Mean age was 53 years (range 23-66); mean waiting time was 6 years (range 0-12), and mean time since surgery was 4 years (range 0-11). Waiting was commonly reported as emotionally challenging (e.g. frustrating, depressing, stressful) and often associated with weight gain (despite weight-loss attempts) and deteriorating physical health (e.g. development of new or worsening obesity-related comorbidity or decline in mobility) or psychological health (e.g. development of or worsening depression). Peer support, health and mental health counselling, integrated care and better communication about waitlist position and management (e.g. patient prioritization) were identified support needs. Even if wait times cannot be reduced, better peer and health professional supports, together with better communication from health departments, may improve the experience or outcomes of waiting and confer quality-of-life gains irrespective of weight loss. © 2016 World Obesity Federation.

  9. Obstructive sleep apnea in Down syndrome: Benefits of surgery and noninvasive respiratory support.

    Science.gov (United States)

    Dudoignon, Benjamin; Amaddeo, Alessandro; Frapin, Annick; Thierry, Briac; de Sanctis, Livio; Arroyo, Jorge Olmo; Khirani, Sonia; Fauroux, Brigitte

    2017-08-01

    Children with Down syndrome are at increased risk of obstructive sleep apnea (OSA). The aim of the study was to describe the management of OSA in a large cohort of children with Down syndrome. A retrospective analysis of sleep studies and consequent management was performed for all consecutive Down syndrome patients evaluated between September 2013 and April 2016. The data of 57 patients were analyzed: 51/53 had an interpretable overnight polygraphy and 4 the recording of nocturnal gas exchange. Mean age at baseline sleep study was 6.2 ± 5.9 years. Eighteen patients (32%) had prior upper airway surgery. Mean apnea-hypopnea index (AHI) was 14 ± 16 events/hr with 41 of the 51 (80%) patients having OSA with an AHI >1 event/hr and 20 patients (39%) having an AHI ≥10 events/hr. Consequently, eight patients (14%) had upper airway surgery. OSA improved in all patients except two who needed noninvasive respiratory support. Nineteen (33%) patients required noninvasive respiratory support. Mean age at noninvasive respiratory support initiation was 7 ± 7 years. On 11 patients with objective adherence data available, mean compliance at 2 ± 1 years of treatment was excellent with an average use per night of 8 hr46 ± 3 hr59 and 9 patients using the noninvasive respiratory support >4 hr/night. Noninvasive respiratory support was associated with an improvement of nocturnal gas exchange. The prevalence of OSA is high in Down syndrome. Upper airway surgery is not always able to correct OSA. Noninvasive respiratory support represents then an effective treatment for OSA and good compliance may be achieved in a majority of patients. © 2017 Wiley Periodicals, Inc.

  10. Acute systemic inflammatory response after cardiac surgery in ...

    African Journals Online (AJOL)

    2017-09-03

    Sep 3, 2017 ... valve(s) replacement were enrolled, from a single center hospital, after informed consent was obtained. C-reactive ... Cite as: Gojo MKE, Prakaschandra R. Acute systemic inflammatory response after cardiac surgery in patients infected with human im- ..... Arroyo-Espliguero R, Avanzas P, Cosín-Sales J, Al-.

  11. Support system of a structure on a support base

    International Nuclear Information System (INIS)

    Arene, G.; Renaux, C.; Minguet, J.L.; Chantot, H.

    1984-01-01

    Two series of strips are fixed to the structure to be supported and to the base to define each one a closed convex envelope; the strips are flexible in the radial direction with regard to the envelope. The two series of strips are connected by a treillis of rigid bars set to form juxtaposed V or X. A good transversal rigidity and a certain radial flexibility are obtained. The invention can be applied to a fast neutron nuclear reactor, the reactor comprising a vertical axis vessel filled with liquid metal; the vessel rests on a support foundation by means of the support system proposed by the invention. The support system allows the supported structure to resist the effects of an eventual earthquake and brutal temperature variations [fr

  12. Mathematical model of bone drilling for virtual surgery system

    Science.gov (United States)

    Alaytsev, Innokentiy K.; Danilova, Tatyana V.; Manturov, Alexey O.; Mareev, Gleb O.; Mareev, Oleg V.

    2018-04-01

    The bone drilling is an essential part of surgeries in ENT and Dentistry. A proper training of drilling machine handling skills is impossible without proper modelling of the drilling process. Utilization of high precision methods like FEM is limited due to the requirement of 1000 Hz update rate for haptic feedback. The study presents a mathematical model of the drilling process that accounts the properties of materials, the geometry and the rotation rate of a burr to compute the removed material volume. The simplicity of the model allows for integrating it in the high-frequency haptic thread. The precision of the model is enough for a virtual surgery system targeted on the training of the basic surgery skills.

  13. Adaptive Collaboration Support Systems : Designing Collaboration Support for Dynamic Environments

    NARCIS (Netherlands)

    Janeiro, J.; Knoll, S.W.; Lukosch, S.G.; Kolfschoten, G.L.

    2012-01-01

    Today, engineering systems offer a variety of local and webbased applications to support collaboration by assisting groups in structuring activities, generating and sharing data, and improving group communication. To ensure the quality of collaboration, engineering system design needs to analyze and

  14. Professional Growth & Support System Self-Assessment

    Science.gov (United States)

    Education Resource Strategies, 2013

    2013-01-01

    The "Professional Growth & Support System Self-Assessment" is designed to help school systems evaluate their current Professional Growth & Support strategy. The self-assessment is organized around the "Eight Principles of Strategic Professional Growth & Support." Each section allows school leaders to identify the…

  15. Endoscopic endonasal transsphenoidal surgery using the iArmS operation support robot: initial experience in 43 patients.

    Science.gov (United States)

    Ogiwara, Toshihiro; Goto, Tetsuya; Nagm, Alhusain; Hongo, Kazuhiro

    2017-05-01

    Objective The intelligent arm-support system, iArmS, which follows the surgeon's arm and automatically fixes it at an adequate position, was developed as an operation support robot. iArmS was designed to support the surgeon's forearm to prevent hand trembling and to alleviate fatigue during surgery with a microscope. In this study, the authors report on application of this robotic device to endoscopic endonasal transsphenoidal surgery (ETSS) and evaluate their initial experiences. Methods The study population consisted of 43 patients: 29 with pituitary adenoma, 3 with meningioma, 3 with Rathke's cleft cyst, 2 with craniopharyngioma, 2 with chordoma, and 4 with other conditions. All patients underwent surgery via the endonasal transsphenoidal approach using a rigid endoscope. During the nasal and sphenoid phases, iArmS was used to support the surgeon's nondominant arm, which held the endoscope. The details of the iArmS and clinical results were collected. Results iArmS followed the surgeon's arm movement automatically. It reduced the surgeon's fatigue and stabilized the surgeon's hand during ETSS. Shaking of the video image decreased due to the steadying of the surgeon's scope-holding hand with iArmS. There were no complications related to use of the device. Conclusions The intelligent armrest, iArmS, seems to be safe and effective during ETSS. iArmS is helpful for improving the precision and safety not only for microscopic neurosurgery, but also for ETSS. Ongoing advances in robotics ensure the continued evolution of neurosurgery.

  16. Support Systems for Treatment Integrity

    NARCIS (Netherlands)

    Goense, Pauline Brigitta; Boendermaker, Leonieke; van Yperen, Tom

    Objective: This systematic review evaluates the content of effective support provided to practitioners of evidence-based interventions in order to establish and maintain treatment integrity. Method: Four articles covering six outcome studies are included in this review, these studies (1) adequately

  17. Developing Information Systems for Competitive Intelligence Support.

    Science.gov (United States)

    Hohhof, Bonnie

    1994-01-01

    Discusses issues connected with developing information systems for competitive intelligence support; defines the elements of an effective competitive information system; and summarizes issues affecting system design and implementation. Highlights include intelligence information; information needs; information sources; decision making; and…

  18. A method for making a glass supported system, such glass supported system, and the use of a glass support therefor

    NARCIS (Netherlands)

    Unnikrishnan, S.; Jansen, Henricus V.; Berenschot, Johan W.; Fazal, I.; Louwerse, M.C.; Mogulkoc, B.; Sanders, Remco G.P.; de Boer, Meint J.; Elwenspoek, Michael Curt

    2008-01-01

    The invention relates to a method for making a glass supported micro or nano system, comprising the steps of: i) providing a glass support; ii) mounting at least one system on at least one glass support; and iii) bonding the system to the glass support, such that the system is circumferentially

  19. Unmanned systems win unexpected support

    Energy Technology Data Exchange (ETDEWEB)

    Schneiderman, R.

    1991-09-01

    A review of unmanned aerial vehicles (UAVs) is presented in which emphasis is given to recent mission accomplishments and current directions of research. Existing and new military UAV programs are listed with reference to funding, the type of vehicle, and level of development. Several trends are established including the reliance of UVAs on global positioning satellites and advanced electronics and the growth of the UVA industry. UVAs that are in advanced stages of development or have been deployed include short-range UAV such as the Pioneer, the Pointer, the Sky Owl, and the Hunter. Key UAV systems are described such as the Advanced Tactical Airborne Reconnaissance System, the Maritime Vertical Takeoff and Landing, and other VTOL systems. Very small UVAs and Exdrones are also discussed, and a weather reconnaissance system and surveillance systems are mentioned.

  20. Travel patterns of cancer surgery patients in a regionalized system.

    Science.gov (United States)

    Smith, Andrew K; Shara, Nawar M; Zeymo, Alexander; Harris, Katherine; Estes, Randy; Johnson, Lynt B; Al-Refaie, Waddah B

    2015-11-01

    Regionalization of complex surgeries has increased patient travel distances possibly leaving a substantial burden on those at risk for poorer surgical outcomes. To date, little is known about travel patterns of cancer surgery patients in regionalized settings. To inform this issue, we sought to assess travel patterns of those undergoing a major cancer surgery within a regionalized system. We identified 4733 patients who underwent lung, esophageal, gastric, liver, pancreatic, and colorectal resections from 2002-2014 within a multihospital system in the Mid-Atlantic region of the United States. Patient age, race and/or ethnicity, and insurance status were extracted from electronic health records. We used Geographical Information System capabilities in R software to estimate travel distance and map patient addresses based on cancer surgery type and these characteristics. We used visual inspection, analysis of variance, and interaction analyses to assess the distribution of travel distances between patient populations. A total of 48.2% of patients were non-white, 49.9% were aged >65 y, and 54.9% had private insurance. Increased travel distance was associated with decreasing age and those undergoing pancreatic and esophageal resections. Also, black patients tend to travel shorter distances than other racial and/or ethnic groups. These maps offer a preliminary understanding into variations of geospatial travel patterns among patients receiving major cancer surgery in a Mid-Atlantic regionalized setting. Future research should focus on the impact of regionalization on timely delivery of surgical care and other quality metrics. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Oral and maxillofacial surgery with computer-assisted navigation system.

    Science.gov (United States)

    Kawachi, Homare; Kawachi, Yasuyuki; Ikeda, Chihaya; Takagi, Ryo; Katakura, Akira; Shibahara, Takahiko

    2010-01-01

    Intraoperative computer-assisted navigation has gained acceptance in maxillofacial surgery with applications in an increasing number of indications. We adapted a commercially available wireless passive marker system which allows calibration and tracking of virtually every instrument in maxillofacial surgery. Virtual computer-generated anatomical structures are displayed intraoperatively in a semi-immersive head-up display. Continuous observation of the operating field facilitated by computer assistance enables surgical navigation in accordance with the physician's preoperative plans. This case report documents the potential for augmented visualization concepts in surgical resection of tumors in the oral and maxillofacial region. We report a case of T3N2bM0 carcinoma of the maxillary gingival which was surgically resected with the assistance of the Stryker Navigation Cart System. This system was found to be useful in assisting preoperative planning and intraoperative monitoring.

  2. Dynamism in Electronic Performance Support Systems.

    Science.gov (United States)

    Laffey, James

    1995-01-01

    Describes a model for dynamic electronic performance support systems based on NNAble, a system developed by the training group at Apple Computer. Principles for designing dynamic performance support are discussed, including a systems approach, performer-centered design, awareness of situated cognition, organizational memory, and technology use.…

  3. Experiences of social support among women presenting for obstetric fistula repair surgery in Tanzania

    Directory of Open Access Journals (Sweden)

    Dennis AC

    2016-09-01

    Full Text Available Alexis C Dennis1 Sarah M Wilson1–3 Mary V Mosha4 Gileard G Masenga4 Kathleen J Sikkema1,5,6 Korrine E Terroso1 Melissa H Watt1 1Duke Global Health Institute, Duke University, 2Department of Veterans Affairs, Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3Durham Veterans Affairs Medical Center, Durham, NC, USA; 4Kilimanjaro Christian Medical Center, Moshi, Tanzania; 5Department of Psychology and Neuroscience, Duke University, Durham, NC, USA; 6Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa Objective: An obstetric fistula is a childbirth injury resulting in uncontrollable leakage of urine and/or feces and can lead to physical and psychological challenges, including social isolation. Prior to and after fistula repair surgery, social support can help a woman to reintegrate into her community. The aim of this study was to preliminarily examine the experiences of social support among Tanzanian women presenting with obstetric fistula in the periods immediately preceding obstetric fistula repair surgery and following reintegration.Patients and methods: The study used a mixed-methods design to analyze cross-sectional surveys (n=59 and in-depth interviews (n=20.Results: Women reported widely varying levels of social support from family members and partners, with half of the sample reporting overall high levels of social support. For women experiencing lower levels of support, fistula often exacerbated existing problems in relationships, sometimes directly causing separation or divorce. Many women were assertive and resilient with regard to advocating for their fistula care and relationship needs.Conclusion: Our data suggest that while some women endure negative social experiences following an obstetric fistula and require additional resources and services, many women report high levels of social support from family members and partners, which may be harnessed to improve the holistic

  4. GH Travel & Mission Support System

    Data.gov (United States)

    US Agency for International Development — HTRAMS is a travel data collection system for GH that collects information on both the basic details of an employee's trips (destination, length, purpose, etc.) and...

  5. PPL Travel & Mission Support System

    Data.gov (United States)

    US Agency for International Development — PTRAMS is a travel data collection system for PPL that collects information on both the basic details of an employee's trips (destination, length, purpose, etc.) and...

  6. DCHA Travel & Mission Support System

    Data.gov (United States)

    US Agency for International Development — DTRAMS is a travel data collection system for DCHA that collects information on both the basic details of an employee's trips (destination, length, purpose, etc.)...

  7. A customized head and neck support system

    International Nuclear Information System (INIS)

    Bentel, Gunilla C.; Marks, Lawrence B.; Sherouse, George W.; Spencer, David P.

    1995-01-01

    Purpose: To describe a customized head and neck immobilization system for patients receiving radiotherapy including a head support that conforms to the posterior contour of the head and neck. Methods: The system includes a customized headrest to support the posterior head and neck. This is fixed to a thermoplastic face mask that molds to the anterior head/face contours. The shape of these customized head and neck supports were compared to 'standard' supports. Results: This system is comfortable for the patients and appears to be effective in reproducing the setup of the treatment. Conclusions: The variability in the size and shape of the customized posterior supports exceeded that of 'standard' headrests. It is our clinical impression that the customized supports improve reproducibility and are now a standard part of our immobilization system. The quantitative analysis of the customized headrests and some commonly used 'standard' headrests suggests that the customized supports are better able to address variabilities in patient shape

  8. Surgery of the eloquent area using neuronavigation system

    International Nuclear Information System (INIS)

    Nakai, Hirofumi; Tanaka, Tatsuya; Hashizume, Kiyotaka; Hodozuka, Akira

    2001-01-01

    The efficacy of a neuronavigation system for surgery of lesions near Broca's area (6 patients), skull base (5 patients), or paracentral sulcus (10 patients) was evaluated in this study. Using the neuronavigation system, three-dimensional (3D) brain images were reconstructed by plotting cerebral sulcus obtained by MRI and CT. For paracentral sulcus lesions, patients underwent blood oxygen level-dependent fMRI while performing a finger-tapping motor paradigm. 3D reconstructed images were demonstrated to be useful for understanding the anatomical relationship between the lesions and the surrounding vital structures. The precentral gyri identified by 3D reconstructed brain images coincided well with that identified by fMRI. In lesions near Broca's area, skull base, and paracentral sulcus, 3D reconstructed brain images were very useful for both the preoperative surgical simulation and the intraoperative neuronavigation to preserve the postoperative neurological function and to perform less invasive surgery. (author)

  9. Tongue motor training support system.

    Science.gov (United States)

    Sasaki, Makoto; Onishi, Kohei; Nakayama, Atsushi; Kamata, Katsuhiro; Stefanov, Dimitar; Yamaguchi, Masaki

    2014-01-01

    In this paper, we introduce a new tongue-training system that can be used for improvement of the tongue's range of motion and muscle strength after dysphagia. The training process is organized in game-like manner. Initially, we analyzed surface electromyography (EMG) signals of the suprahyoid muscles of five subjects during tongue-training motions. This test revealed that four types tongue training motions and a swallowing motion could be classified with 93.5% accuracy. Recognized EMG signals during tongue motions were designed to allow control of a mouse cursor via intentional tongue motions. Results demonstrated that simple PC games could be played by tongue motions, achieving in this way efficient, enjoyable and pleasant tongue training. Using the proposed method, dysphagia patients can choose games that suit their preferences and/or state of mind. It is expected that the proposed system will be an efficient tool for long-term tongue motor training and maintaining patients' motivation.

  10. Supporting Multiple Cognitive Processing Styles Using Tailored Support Systems

    International Nuclear Information System (INIS)

    Tuan Q. Tran; Karen M. Feigh; Amy R. Pritchett

    2007-01-01

    According to theories of cognitive processing style or cognitive control mode, human performance is more effective when an individual's cognitive state (e.g., intuition/scramble vs. deliberate/strategic) matches his/her ecological constraints or context (e.g., utilize intuition to strive for a 'good-enough' response instead of deliberating for the 'best' response under high time pressure). Ill-mapping between cognitive state and ecological constraints are believed to lead to degraded task performance. Consequently, incorporating support systems which are designed to specifically address multiple cognitive and functional states e.g., high workload, stress, boredom, and initiate appropriate mitigation strategies (e.g., reduce information load) is essential to reduce plant risk. Utilizing the concept of Cognitive Control Models, this paper will discuss the importance of tailoring support systems to match an operator's cognitive state, and will further discuss the importance of these ecological constraints in selecting and implementing mitigation strategies for safe and effective system performance. An example from the nuclear power plant industry illustrating how a support system might be tailored to support different cognitive states is included

  11. Life Support Systems: Oxygen Generation and Recovery

    Data.gov (United States)

    National Aeronautics and Space Administration — The Advanced Exploration Systems (AES) Life Support Systems project Oxygen Generation and Recovery technology development area encompasses several sub-tasks in an...

  12. MINDS - Medical Information Network Decision Support System

    National Research Council Canada - National Science Library

    Armenian, H. K

    2008-01-01

    .... The increase in and complexity of medical data at various levels of resolution has increased the need for system level advancements in clinical decision support systems that provide computer-aided...

  13. Operating-System Support for Distributed Multimedia

    NARCIS (Netherlands)

    Mullender, Sape J.; Leslie, Ian M.; McAuley, Derek

    1994-01-01

    Multimedia applications place new demands upon processors, networks and operating systems. While some network designers, through ATM for example, have considered revolutionary approaches to supporting multimedia, the same cannot be said for operating systems designers. Most work is evolutionary in

  14. An intelligent interlock design support system

    International Nuclear Information System (INIS)

    Hayashi, Toshifumi; Kamiyama, Masahiko

    1990-01-01

    This paper presents an intelligent interlock design support system, called Handy. BWR plant interlocks have been designed on a conventional CAD system operating on a mini-computer based time sharing system. However, its ability to support interlock designers is limited, mainly due to the system not being capable of manipulating the interlock logic. Handy improves the design efficiency with consistent manipulation of the logic and drawings, interlock simulation, versatile database management, object oriented user interface, high resolution high speed graphics, and automatic interlock outlining with a design support expert system. Handy is now being tested by designers, and is expected to greatly contribute to their efficiency. (author)

  15. Developing Sustainable Life Support System Concepts

    Science.gov (United States)

    Thomas, Evan A.

    2010-01-01

    Sustainable spacecraft life support concepts may allow the development of more reliable technologies for long duration space missions. Currently, life support technologies at different levels of development are not well evaluated against each other, and evaluation methods do not account for long term reliability and sustainability of the hardware. This paper presents point-of-departure sustainability evaluation criteria for life support systems, that may allow more robust technology development, testing and comparison. An example sustainable water recovery system concept is presented.

  16. Business Management System Support Analysis

    Science.gov (United States)

    Parikh, Jay

    2008-01-01

    The purpose of this research project was to develop a searchable database compiled with internal and external audit findings/observations. The data will correspond to the findings and observations from the date of Center-wide implementation of the ISO 9001-2000 standard to the present (2003-2008). It was derived and extracted from several sources and was in multiple formats. Once extracted, categorization of the findings/observations would be possible. The final data was mapped to the ISO 9001-2000 standard with the understanding that it will be displayed graphically. The data will be used to verify trends, associate risks, and establish timelines to identify strengths and weaknesses to determine areas of improvement in the Kennedy Space Center Business Management System Internal Audit Program.

  17. Climate data system supports FIRE

    Science.gov (United States)

    Olsen, Lola M.; Iascone, Dominick; Reph, Mary G.

    1990-01-01

    The NASA Climate Data System (NCDS) at Goddard Space Flight Center is serving as the FIRE Central Archive, providing a centralized data holding and data cataloging service for the FIRE project. NCDS members are carrying out their responsibilities by holding all reduced observations and data analysis products submitted by individual principal investigators in the agreed upon format, by holding all satellite data sets required for FIRE, by providing copies of any of these data sets to FIRE investigators, and by producing and updating a catalog with information about the FIRE holdings. FIRE researchers were requested to provide their reduced data sets in the Standard Data Format (SDF) to the FIRE Central Archive. This standard format is proving to be of value. An improved SDF document is now available. The document provides an example from an actual FIRE SDF data set and clearly states the guidelines for formatting data in SDF. NCDS has received SDF tapes from a number of investigators. These tapes were analyzed and comments provided to the producers. One product which is now available is William J. Syrett's sodar data product from the Stratocumulus Intensive Field Observation. Sample plots from all SDF tapes submitted to the archive will be available to FSET members. Related cloud products are also available through NCDS. Entries describing the FIRE data sets are being provided for the NCDS on-line catalog. Detailed information for the Extended Time Observations is available in the general FIRE catalog entry. Separate catalog entries are being written for the Cirrus Intensive Field Observation (IFO) and for the Marine Stratocumulus IFO. Short descriptions of each FIRE data set will be installed into the NCDS Summary Catalog.

  18. An evidence-based approach to perioperative nutrition support in the elective surgery patient.

    Science.gov (United States)

    Miller, Keith R; Wischmeyer, Paul E; Taylor, Beth; McClave, Stephen A

    2013-09-01

    In surgical practice, great attention is given to the perioperative management of the elective surgical patient with regard to surgical planning, stratification of cardiopulmonary risk, and postoperative assessment for complication. However, growing evidence supports the beneficial role for implementation of a consistent and literature-based approach to perioperative nutrition therapy. Determining nutrition risk should be a routine component of the preoperative evaluation. As with the above issues, this concept begins with the clinician's first visit with the patient as risk is assessed and the severity of the surgical insult considered. If the patient is an appropriate candidate for benefit from preoperative support, a plan for initiation and reassessment should be implemented. Once appropriate nutrition end points have been achieved, special consideration should be given to beneficial practices the immediate day preceding surgery that may better prepare the patient for the intervention from a metabolic standpoint. In the operating room, consideration should be given to the potential placement of enteral access during the index operation as well as judicious and targeted intraoperative resuscitation. Immediately following the intervention, adequate resuscitation and glycemic control are key concepts, as is an evidence-based approach to the early advancement of an enteral/oral diet in the postoperative patient. Through the implementation of perioperative nutrition therapy plans in the elective surgery setting, outcomes can be improved.

  19. Mitral Valve Surgery in Patients with Systemic Lupus Erythematosus

    Science.gov (United States)

    Hekmat, Manouchehr; Ghorbani, Mohsen; Ghaderi, Hamid; Majidi, Masoud; Beheshti, Mahmood

    2014-01-01

    Valvular heart disease is the common cardiac manifestation of systemic lupus erythematosus (SLE) with a tendency for mitral valve regurgitation. In this study we report a case of mitral valve replacement for mitral stenosis caused by Libman-Sacks endocarditis in the setting of SLE. In addition, we provide a systematic review of the literature on mitral valve surgery in the presence of Libman-Sacks endocarditis because its challenge on surgical options continues. Surgical decision depends on structural involvement of mitral valve and presence of active lupus nephritis and antiphospholipid antibody syndrome. Review of the literature has also shown that outcome is good in most SLE patients who have undergone valvular surgery, but association of antiphospholipid antibody syndrome with SLE has negative impact on the outcome. PMID:25401131

  20. Network support for system initiated checkpoints

    Science.gov (United States)

    Chen, Dong; Heidelberger, Philip

    2013-01-29

    A system, method and computer program product for supporting system initiated checkpoints in parallel computing systems. The system and method generates selective control signals to perform checkpointing of system related data in presence of messaging activity associated with a user application running at the node. The checkpointing is initiated by the system such that checkpoint data of a plurality of network nodes may be obtained even in the presence of user applications running on highly parallel computers that include ongoing user messaging activity.

  1. [Orthopedic and trauma surgery in the German DRG system 2008].

    Science.gov (United States)

    Franz, D; Kaufmann, M; Siebert, C H; Windolf, J; Roeder, N

    2008-04-01

    The German DRG (diagnosis-related groups) system has been modified and updated into version 2008. For orthopedic and trauma surgery significant changes concerning coding of diagnoses, medical procedures and the DRG structure were made. The modified version has been analyzed in order to ascertain whether the DRG system is suitably qualified to fulfill the demands of the reimbursement system or whether further improvements are necessary. Analysis of the severity of relevant side-effect diagnoses, medical procedures and G-DRGs in the versions 2007 and 2008 was carried out based on the publications of the German DRG institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2008 focused on the development of DRG structure, DRG validation and codes for medical procedures. The outcome of these changes for German hospitals may vary depending on the range of activities. G-DRG system has become even more complex and the new regulations have also resulted in new problems associated with complications.. High demands are made on correct and complete coding of complex orthopedic and trauma surgery cases. Quality of case allocation within the G-DRG system has been improved. Nevertheless, further improvements of the G-DRG system are necessary, especially for cases with severe injuries.

  2. [Publication rate of Deutsche Forschungsgemeinschaft (DFG)-supported research projects. An analysis of the "fate" of DFG-support methods in anesthesia, surgery and internal medicine].

    Science.gov (United States)

    Boldt, J; Maleck, W

    2000-09-22

    Outstanding medical research is not possible without financial support. The success of supported research projects have been evaluated only rarely. The publication rate of research projects supported by the German Research Council (Deutsche Forschungsgemeinschaft [DFG]) was assessed separately for internal medicine, surgery, and anesthesiology. Based on the "Figures and Facts" published by the DFG all supported projects of 1996 for all three specialities were included. In a Medline-based analysis all published papers dealing with the supported project and all papers published by the supported persons from 1996 to may 2000 were documented. A total of 315 grants were analysed (internal medicine: 234; surgery: 63; anesthesiology: 18). Projects with clinical topics were less often supported (n = 80) than experimental projects (n = 235). 162 (69.3%) of the grants in internal medicine, 41 (65.1) in surgery, and 14 (77.8%) of the grants in anesthesiology were published. In anesthesiology all published projects were in English language (internal medicine: 98.2%; surgery: 95%). Independent of the topic of the grant, several supported persons in internal medicine and surgery did not publish any papers between 1996 and may 2000, whereas all supported anesthesiologists published papers in peer reviewed journals in this time period. The publication rate of DFG supported projects is not sufficient. Except for a final internal report after finishing the research project no quality control exists for DFG grants. Unfortunately, not all supported projects were published. A better feedback between the financial support by the DFG and the publication rate of DFG grants is desirable.

  3. NASA Advanced Exploration Systems: Advancements in Life Support Systems

    Science.gov (United States)

    Shull, Sarah A.; Schneider, Walter F.

    2016-01-01

    The NASA Advanced Exploration Systems (AES) Life Support Systems (LSS) project strives to develop reliable, energy-efficient, and low-mass spacecraft systems to provide environmental control and life support systems (ECLSS) critical to enabling long duration human missions beyond low Earth orbit (LEO). Highly reliable, closed-loop life support systems are among the capabilities required for the longer duration human space exploration missions assessed by NASA’s Habitability Architecture Team.

  4. A goggle navigation system for cancer resection surgery

    Science.gov (United States)

    Xu, Junbin; Shao, Pengfei; Yue, Ting; Zhang, Shiwu; Ding, Houzhu; Wang, Jinkun; Xu, Ronald

    2014-02-01

    We describe a portable fluorescence goggle navigation system for cancer margin assessment during oncologic surgeries. The system consists of a computer, a head mount display (HMD) device, a near infrared (NIR) CCD camera, a miniature CMOS camera, and a 780 nm laser diode excitation light source. The fluorescence and the background images of the surgical scene are acquired by the CCD camera and the CMOS camera respectively, co-registered, and displayed on the HMD device in real-time. The spatial resolution and the co-registration deviation of the goggle navigation system are evaluated quantitatively. The technical feasibility of the proposed goggle system is tested in an ex vivo tumor model. Our experiments demonstrate the feasibility of using a goggle navigation system for intraoperative margin detection and surgical guidance.

  5. Mathematical Modeling Of Life-Support Systems

    Science.gov (United States)

    Seshan, Panchalam K.; Ganapathi, Balasubramanian; Jan, Darrell L.; Ferrall, Joseph F.; Rohatgi, Naresh K.

    1994-01-01

    Generic hierarchical model of life-support system developed to facilitate comparisons of options in design of system. Model represents combinations of interdependent subsystems supporting microbes, plants, fish, and land animals (including humans). Generic model enables rapid configuration of variety of specific life support component models for tradeoff studies culminating in single system design. Enables rapid evaluation of effects of substituting alternate technologies and even entire groups of technologies and subsystems. Used to synthesize and analyze life-support systems ranging from relatively simple, nonregenerative units like aquariums to complex closed-loop systems aboard submarines or spacecraft. Model, called Generic Modular Flow Schematic (GMFS), coded in such chemical-process-simulation languages as Aspen Plus and expressed as three-dimensional spreadsheet.

  6. Design Rules for Life Support Systems

    Science.gov (United States)

    Jones, Harry

    2002-01-01

    This paper considers some of the common assumptions and engineering rules of thumb used in life support system design. One general design rule is that the longer the mission, the more the life support system should use recycling and regenerable technologies. A more specific rule is that, if the system grows more than half the food, the food plants will supply all the oxygen needed for the crew life support. There are many such design rules that help in planning the analysis of life support systems and in checking results. These rules are typically if-then statements describing the results of steady-state, "back of the envelope," mass flow calculations. They are useful in identifying plausible candidate life support system designs and in rough allocations between resupply and resource recovery. Life support system designers should always review the design rules and make quick steady state calculations before doing detailed design and dynamic simulation. This paper develops the basis for the different assumptions and design rules and discusses how they should be used. We start top-down, with the highest level requirement to sustain human beings in a closed environment off Earth. We consider the crew needs for air, water, and food. We then discuss atmosphere leakage and recycling losses. The needs to support the crew and to make up losses define the fundamental life support system requirements. We consider the trade-offs between resupplying and recycling oxygen, water, and food. The specific choices between resupply and recycling are determined by mission duration, presence of in-situ resources, etc., and are defining parameters of life support system design.

  7. A Hyperknowledge Framework of Decision Support Systems.

    Science.gov (United States)

    Chang, Ai-Mei; And Others

    1994-01-01

    Presents a hyperknowledge framework of decision support systems (DSS). This framework formalizes specifics about system functionality, representation of knowledge, navigation of the knowledge system, and user-interface traits as elements of a DSS environment that conforms closely to human cognitive processes in decision making. (Contains 52…

  8. Decision support system for Wamakersvallei Winery

    CSIR Research Space (South Africa)

    Van Der Merwe, A

    2007-09-01

    Full Text Available The goal of the study is to lend decision support to management a a wine cellar in three areas of expertise, with Wamakersvallei Winery serving as a special case study. This decision support system is to be delivered in the form of Excel spreadsheet...

  9. Axiomatic Design of Space Life Support Systems

    Science.gov (United States)

    Jones, Harry W.

    2017-01-01

    Systems engineering is an organized way to design and develop systems, but the initial system design concepts are usually seen as the products of unexplained but highly creative intuition. Axiomatic design is a mathematical approach to produce and compare system architectures. The two axioms are:- Maintain the independence of the functional requirements.- Minimize the information content (or complexity) of the design. The first axiom generates good system design structures and the second axiom ranks them. The closed system human life support architecture now implemented in the International Space Station has been essentially unchanged for fifty years. In contrast, brief missions such as Apollo and Shuttle have used open loop life support. As mission length increases, greater system closure and increased recycling become more cost-effective.Closure can be gradually increased, first recycling humidity condensate, then hygiene wastewater, urine, carbon dioxide, and water recovery brine. A long term space station or planetary base could implement nearly full closure, including food production. Dynamic systems theory supports the axioms by showing that fewer requirements, fewer subsystems, and fewer interconnections all increase system stability. If systems are too complex and interconnected, reliability is reduced and operations and maintenance become more difficult. Using axiomatic design shows how the mission duration and other requirements determine the best life support system design including the degree of closure.

  10. QA CLASSIFICATION ANALYSIS OF GROUND SUPPORT SYSTEMS

    International Nuclear Information System (INIS)

    D. W. Gwyn

    1996-01-01

    The purpose and objective of this analysis is to determine if the permanent function Ground Support Systems (CI: BABEEOOOO) are quality-affecting items and if so, to establish the appropriate Quality Assurance (QA) classification

  11. AI User Support System for SAP ERP

    Science.gov (United States)

    Vlasov, Vladimir; Chebotareva, Victoria; Rakhimov, Marat; Kruglikov, Sergey

    2017-10-01

    An intelligent system for SAP ERP user support is proposed in this paper. It enables automatic replies on users’ requests for support, saving time for problem analysis and resolution and improving responsiveness for end users. The system is based on an ensemble of machine learning algorithms of multiclass text classification, providing efficient question understanding, and a special framework for evidence retrieval, providing the best answer derivation.

  12. Development of a simplified piping support system

    International Nuclear Information System (INIS)

    Leung, J.; Anderson, P.H.; Tang, Y.K.; Kassawara, R.P.; Tang, H.T.

    1987-01-01

    This paper presents the results of experimental and analytical studies for developing a simplified piping support system (SPSS) for nuclear power piping in place of snubbers. The basic concept of the SPSS is a passive seismic support system consisting of limit stops. Large gaps are provided to allow for free thermal expansion during normal plant operation while preventing excessive displacement during a seismic event. The results are part of a research and development program sponsored by EPRI. (orig./HP)

  13. Development of a simplified piping support system

    International Nuclear Information System (INIS)

    Leung, J.; Anderson, P.H.; Tang, Y.K.; Kassawara, R.P.; Tang, H.T.

    1987-01-01

    This paper presents the results of experimental and analytical studies for developing a simplified piping support system (SPSS) for nuclear power piping in place of snubbers. The basic concept of the SPSS is a passive seismic support system consisting of limit stops. Large gaps are provided to allow for free thermal expansion during normal plant operation while preventing excessive displacement during a seismic event. The results are part of a research and development program sponsored by the Electric Power Research Institute

  14. Airport Information Retrieval System (AIRS) System Support Manual

    Science.gov (United States)

    1973-01-01

    This handbook is a support manual for prototype air traffic flow control automation system developed for the FAA's Systems Command Center. The system is implemented on a time-sharing computer and is designed to provide airport traffic load prediction...

  15. Image-guided stereotactic surgery using ultrasonography and reconstructive three-dimensional CT-imaging system

    International Nuclear Information System (INIS)

    Kawamura, Hirotsune; Iseki, Hiroshi; Umezawa, Yoshihiro

    1991-01-01

    A new simulation and navigation system utilizing three-dimensional CT images has been developed for image-guided stereotactic surgery. Preoperative CT images are not always useful in predicting the intraoperative location of lesions, for cerebral lesions are easily displaced or distorted by gravity, brain retraction, and/or CSF aspiration during operative procedure. This new system, however, has the advantage that the intraoperative locations of intracranial lesions or the anatomical structures of the brain can be precisely confirmed during stereotactic surgery. Serial CT images were obtained from a patient whose head had been fixed to the ISEKI CT-guided stereotactic frame. The data of serial CT images were saved on a floppy disc and then transferred to the work station (IRIS) using the off line. In order to find the best approach angle for ultrasound-guided stereotactic surgery, three-dimenstional CT images were reconstructed using the work station. The site of the craniotomy or the angle of the trajectory of the ultrasound probe was measured preoperatively based on the three-dimensional CT images. Then, in the operating room, the patient's head was fixed to the ISEKI frame with the subframe at the same position as before according to the measurement of the CT images. In a case of cystic glioma, the predicable ultrasonograms from three-dimensional reconstructive CT images were ascertained to correspond well to the actual ultrasound images during ultrasound-guided stereotactic surgery. Therefore, the new simulation and navigation system can be judged to be a powerful operative supporting modality for correcting the locations of cerebral lesions; it allows one to perform stereotactic surgery more accurately and less invasively. (author)

  16. Panorama of recommender systems to support learning

    OpenAIRE

    Drachsler, Hendrik; Verbert, Katrien; Santos, Olga; Manouselis, Nikos

    2015-01-01

    This chapter presents an analysis of recommender systems in Technology-Enhanced Learning along their 15 years existence (2000-2014). All recommender systems considered for the review aim to support educational stakeholders by personalising the learning process. In this meta-review 82 recommender systems from 35 different countries have been investigated and categorised according to a given classification framework. The reviewed systems have been classified into 7 clusters according to their c...

  17. Toward the Modularization of Decision Support Systems

    Science.gov (United States)

    Raskin, R. G.

    2009-12-01

    Decision support systems are typically developed entirely from scratch without the use of modular components. This “stovepiped” approach is inefficient and costly because it prevents a developer from leveraging the data, models, tools, and services of other developers. Even when a decision support component is made available, it is difficult to know what problem it solves, how it relates to other components, or even that the component exists, The Spatial Decision Support (SDS) Consortium was formed in 2008 to organize the body of knowledge in SDS within a common portal. The portal identifies the canonical steps in the decision process and enables decision support components to be registered, categorized, and searched. This presentation describes how a decision support system can be assembled from modular models, data, tools and services, based on the needs of the Earth science application.

  18. Postoperative serum levels of Endocan are associated with the duration of norepinephrine support after coronary artery bypass surgery.

    Science.gov (United States)

    Bouglé, Adrien; Allain, Pierre-Antoine; Favard, Séverine; Ait Hamou, Nora; Carillion, Aude; Leprince, Pascal; Granger, Benjamin; Amour, Julien

    2018-02-21

    Cardiopulmonary bypass (CPB) is associated with a systemic inflammatory response and an endothelial dysfunction, whose qualitative assessment appears to be a major issue. Endocan (ESM-1, endothelial cell specific molecule-1) is a protein preferentially expressed by the endothelium and previously associated with prognosis of septic shock or acute respiratory distress syndrome. In this pilot study, we investigated the kinetic of Endocan in planned coronary artery bypass grafting (CABG) surgery with CPB. We conducted an observational, prospective, mono centre study. All adult patients with left systolic ejection fraction>50%, undergoing planned on-pump CABG, were screened for inclusion. A written informed consent was obtained. Measurements and main results Serum Endocan concentrations were respectively 2.4 [2.1-3.0] ng. mL -1 , 10.4 [7.4-13.9] ng.mL -1 , 5.7 [4.4-8.2] ng.mL -1 , and 5.4 [4.1-7.5] ng.mL -1 at day 0, day 1, day 3 and day 5. Endocan concentrations increased at day 1, day 3, and day 5 in comparison with preoperative concentration (P<0.001). In the multivariate analysis, age (P=0.002), history of acute coronary syndrome (P=0.024) and the catecholamine-free days at day 28 (P=0.007) were associated to the increase of perioperative Endocan concentrations. Serum Endocan concentration increases after CABG surgery with CPB until day 1. The norepinephrine support increases the risk of Endocan release, suggesting a relationship between the kinetic of Endocan and the vasoplegic syndrome. At day 3, Endocan concentration decreases slowly but is not normalised at day 5. Further studies should investigate the prognostic value of the magnitude of postoperative Endocan concentration after cardiac surgery. Copyright © 2018 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

  19. Operator support systems activities at EPRI

    International Nuclear Information System (INIS)

    Naser, J.A.

    1993-01-01

    The integration of operator support systems supports the nuclear power plant goals of improved availability and reliability, enhanced safety, reduced operations and maintenance costs, and improved productivity. Two major aspects which supports this integration are discussed in this paper. The first is the plant communications and computing architecture which provides the infrastructure that allows the integration to exist in a easy to implement manner. Open systems concepts are utilized to guarantee interoperability of systems and interchangeability of equipment. The second is the EPRI Plant-Window System which supplies the interface between the human and the plant systems. It implements common human-machine interfaces amongst systems and supports the implementation of diagnostic and decision aids. Work in both of these areas is being done as part of the EPRI Instrumentation and Control Upgrade Program. A number of operator support systems have been developed and are in various stages of implementation, testing and utilization. Two of these, the RWCU and the EOPTS, are described here. 5 refs, 14 figs

  20. Learning to Control Advanced Life Support Systems

    Science.gov (United States)

    Subramanian, Devika

    2004-01-01

    Advanced life support systems have many interacting processes and limited resources. Controlling and optimizing advanced life support systems presents unique challenges. In particular, advanced life support systems are nonlinear coupled dynamical systems and it is difficult for humans to take all interactions into account to design an effective control strategy. In this project. we developed several reinforcement learning controllers that actively explore the space of possible control strategies, guided by rewards from a user specified long term objective function. We evaluated these controllers using a discrete event simulation of an advanced life support system. This simulation, called BioSim, designed by Nasa scientists David Kortenkamp and Scott Bell has multiple, interacting life support modules including crew, food production, air revitalization, water recovery, solid waste incineration and power. They are implemented in a consumer/producer relationship in which certain modules produce resources that are consumed by other modules. Stores hold resources between modules. Control of this simulation is via adjusting flows of resources between modules and into/out of stores. We developed adaptive algorithms that control the flow of resources in BioSim. Our learning algorithms discovered several ingenious strategies for maximizing mission length by controlling the air and water recycling systems as well as crop planting schedules. By exploiting non-linearities in the overall system dynamics, the learned controllers easily out- performed controllers written by human experts. In sum, we accomplished three goals. We (1) developed foundations for learning models of coupled dynamical systems by active exploration of the state space, (2) developed and tested algorithms that learn to efficiently control air and water recycling processes as well as crop scheduling in Biosim, and (3) developed an understanding of the role machine learning in designing control systems for

  1. Assessment of the Mexican Board of Pediatric Surgery Certification System.

    Science.gov (United States)

    Porras-Hernandez, Juan D; Mora-Fol, Jose R; Lezama-Del Valle, Pablo; Yanowsky-Reyes, Guillermo; Perez-Lorenzana, Hector; Ortega-Salgado, Arturo; Aguirre-Jauregui, Oscar; Bracho-Blanchet, Eduardo; Sanchez-Mendiola, Melchor

    2015-01-01

    To evaluate the quality of the Mexican Board of Pediatric Surgery (MBPS) certifying system, using contemporary international guidelines. Retrospective assessment of evidence collected during the design and implementation processes of 2 consecutive applications of the MBPS certifying examination, using Cizek's checklist for evaluating credential-testing programs. It includes the relevant guidelines from the American Education Research Association, the American Psychological Association, the National Council on Measurement in Education, and the National Commission for Certifying Agencies. Four independent and previously trained raters used the checklist. They underwent a 2-week training using frame-of-reference and performance dimensions methodologies. Certification examinations of MBPS. The 2013 and 2014 MBPS certification examinations, with 111 evidence items of the processes, followed for the assessment of 86 examinees. The checklist internal consistency was 0.89. Absolute interrater agreement was 0.34 for the 2013 and 0.66 for the 2014 editions of the examination. The 2013 examination complied with 55 (64%) of the checklist 86 items, in 2014 with 72 (84%). In 2014, the certifying system reached a quality of 84%. For optimal fulfillment of its social responsibility, the MBPS is required to maintain its level of quality and attempt to improve its performance. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  2. Panorama of Recommender Systems to Support Learning

    NARCIS (Netherlands)

    Drachsler, Hendrik; Verbert, Katrien; Santos, Olga C.; Manouselis, Nikos

    2015-01-01

    This chapter presents an analysis of recommender systems in TechnologyEnhanced Learning along their 15 years existence (2000-2014). All recommender systems considered for the review aim to support educational stakeholders by personalising the learning process. In this meta-review 82 recommender

  3. A review of lateral driver support systems

    NARCIS (Netherlands)

    Tideman, Martijn; van der Voort, Mascha C.; van Arem, Bart; Tillema, Frans; Dailey, D.

    2007-01-01

    Lateral driver support systems have the potential to reduce the number of accidents associated with -both intentional and unintentional -lane departures. Additionally, such systems may increase driving comfort and stimulate a more efficient traffic flow, thereby reducing traffic emissions and the

  4. Intelligent tactical asset allocation support system

    NARCIS (Netherlands)

    Hiemstra, Y.

    1995-01-01

    This paper presents an advanced support system for Tactical Asset Allocation. Asset allocation explains over 90% of portfolio performance (Brinson, Hood and Beebower, 1988). Tactical asset allocation adjusts a strategic portfolio on the basis of short term market outlooks. The system includes

  5. A SWOT analysis of Planning Support Systems

    NARCIS (Netherlands)

    Vonk, G.; Geertman, S.; Schot, P.P.

    2007-01-01

    Insight into the strengths, weaknesses, opportunities, and threats (SWOT) of planning support systems (PSS) is fragmented between users and system developers. The lack of combined insights blocks development in the right direction and makes potential users hesitant to apply PSS in planning. This

  6. Nutritional support for the infant's immune system

    NARCIS (Netherlands)

    Niers, L.; Stasse-Wolthuis, M.; Rombouts, F.M.; Rijkers, G.T.

    2007-01-01

    Newborn babies possess a functional but immature immune system as a defense against a world teeming with microorganisms. Breast milk contains a number of biological, active compounds that support the infant's immune system. These include secretory immunoglobulin A (IgA), which confers specific

  7. Support system for Neutron Activation Analysis

    International Nuclear Information System (INIS)

    Sasajima, Fumio; Ohtomo, Akitoshi; Sakurai, Fumio; Onizawa, Koji

    1999-01-01

    In the research reactor of JAERI, the Neutron Activation Analysis (NAA) has been utilized as a major part of an irradiation usage. To utilize NAA, research participants are always required to learn necessary technique. Therefore, we started to examine a support system that will enable to carry out INAA easily even by beginners. The system is composed of irradiation device, gamma-ray spectrometer and data analyzing instruments. The element concentration is calculated by using KAYZERO/SOLCOI software with the K 0 standardization method. In this paper, we review on a construction of this INAA support system in JRR-3M of JAERI. (author)

  8. Implementation of Enhanced Recovery After Surgery: a strategy to transform surgical care across a health system.

    Science.gov (United States)

    Gramlich, Leah M; Sheppard, Caroline E; Wasylak, Tracy; Gilmour, Loreen E; Ljungqvist, Olle; Basualdo-Hammond, Carlota; Nelson, Gregg

    2017-05-19

    Enhanced Recovery After Surgery (ERAS) programs have been shown to have a positive impact on outcome. The ERAS care system includes an evidence-based guideline, an implementation program, and an interactive audit system to support practice change. The purpose of this study is to describe the use of the Theoretic Domains Framework (TDF) in changing surgical care and application of the Quality Enhancement Research Initiative (QUERI) model to analyze end-to-end implementation of ERAS in colorectal surgery across multiple sites within a single health system. The ultimate intent of this work is to allow for the development of a model for spread, scale, and sustainability of ERAS in Alberta Health Services (AHS). ERAS for colorectal surgery was implemented at two sites and then spread to four additional sites. The ERAS Interactive Audit System (EIAS) was used to assess compliance with the guidelines, length of stay, readmissions, and complications. Data sources informing knowledge translation included surveys, focus groups, interviews, and other qualitative data sources such as minutes and status updates. The QUERI model and TDF were used to thematically analyze 189 documents with 2188 quotes meeting the inclusion criteria. Data sources were analyzed for barriers or enablers, organized into a framework that included individual to organization impact, and areas of focus for guideline implementation. Compliance with the evidence-based guidelines for ERAS in colorectal surgery at baseline was 40%. Post implementation compliance, consistent with adoption of best practice, improved to 65%. Barriers and enablers were categorized as clinical practice (22%), individual provider (26%), organization (19%), external environment (7%), and patients (25%). In the Alberta context, 26% of barriers and enablers to ERAS implementation occurred at the site and unit levels, with a provider focus 26% of the time, a patient focus 26% of the time, and a system focus 22% of the time. Using the

  9. Preparing for a decision support system.

    Science.gov (United States)

    Callan, K

    2000-08-01

    The increasing pressure to reduce costs and improve outcomes is driving the health care industry to view information as a competitive advantage. Timely information is required to help reduce inefficiencies and improve patient care. Numerous disparate operational or transactional information systems with inconsistent and often conflicting data are no longer adequate to meet the information needs of integrated care delivery systems and networks in competitive managed care environments. This article reviews decision support system characteristics and describes a process to assess the preparedness of an organization to implement and use decision support systems to achieve a more effective, information-based decision process. Decision support tools included in this article range from reports to data mining.

  10. Operator Support System for Pressurized Water Reactor

    International Nuclear Information System (INIS)

    Wei Renjie; Shen Shifei

    1996-01-01

    Operator Support System for Pressurized Water Reactor (OSSPWR) has been developed under the sponsorship of IAEA from August 1994. The project is being carried out by the Department of Engineering Physics, Tsinghua University, Beijing, China. The Design concepts of the operator support functions have been established. The prototype systems of OSSPWR has been developed as well. The primary goal of the project is to create an advanced operator support system by applying new technologies such as artificial intelligence (AI) techniques, advanced communication technologies, etc. Recently, the advanced man-machine interface for nuclear power plant operators has been developed. It is connected to the modern computer systems and utilizes new high performance graphic displays. (author). 6 refs, 4 figs

  11. Dose calculation system for remotely supporting radiotherapy

    International Nuclear Information System (INIS)

    Saito, K.; Kunieda, E.; Narita, Y.; Kimura, H.; Hirai, M.; Deloar, H. M.; Kaneko, K.; Ozaki, M.; Fujisaki, T.; Myojoyama, A.; Saitoh, H.

    2005-01-01

    The dose calculation system IMAGINE is being developed keeping in mind remotely supporting external radiation therapy using photon beams. The system is expected to provide an accurate picture of the dose distribution in a patient body, using a Monte Carlo calculation that employs precise models of the patient body and irradiation head. The dose calculation will be performed utilising super-parallel computing at the dose calculation centre, which is equipped with the ITBL computer, and the calculated results will be transferred through a network. The system is intended to support the quality assurance of current, widely carried out radiotherapy and, further, to promote the prevalence of advanced radiotherapy. Prototypes of the modules constituting the system have already been constructed and used to obtain basic data that are necessary in order to decide on the concrete design of the system. The final system will be completed in 2007. (authors)

  12. Infrastructure Support for Collaborative Pervasive Computing Systems

    DEFF Research Database (Denmark)

    Vestergaard Mogensen, Martin

    Collaborative Pervasive Computing Systems (CPCS) are currently being deployed to support areas such as clinical work, emergency situations, education, ad-hoc meetings, and other areas involving information sharing and collaboration.These systems allow the users to work together synchronously......, but from different places, by sharing information and coordinating activities. Several researchers have shown the value of such distributed collaborative systems. However, building these systems is by no means a trivial task and introduces a lot of yet unanswered questions. The aforementioned areas......, are all characterized by unstable, volatile environments, either due to the underlying components changing or the nomadic work habits of users. A major challenge, for the creators of collaborative pervasive computing systems, is the construction of infrastructures supporting the system. The complexity...

  13. Operator support system for nuclear power plants

    International Nuclear Information System (INIS)

    Mori, Nobuyuki; Tai, Ichiro; Sudo, Osamu; Naito, Norio.

    1987-01-01

    The nuclear power generation in Japan maintains the high capacity factor, and its proportion taken in the total generated electric power exceeded 1/4, thus it has become the indispensable energy source. Recently moreover, the nuclear power plants which are harmonious with operators and easy to operate are demanded. For realizing this, the technical development such as the heightening of operation watching performance, the adoption of automation, and the improvement of various man-machine systems for reducing the burden of operators has been advanced by utilizing electronic techniques. In this paper, the trend of the man-machine systems in nuclear power plants, the positioning of operation support system, the support in the aspects of information, action and knowledge, the example of a new central control board, the operation support system using a computer, an operation support expert system and the problems hereafter are described. As the development of the man-machine system in nuclear power plants, the upgrading from a present new central control board system PODIA through A-PODIA, in which the operational function to deal with various phenomena arising in plants and safety control function are added, to 1-PODIA, in which knowledge engineering technology is adopted, is expected. (Kako, I.)

  14. Support system for ATLAS distributed computing operations

    CERN Document Server

    Kishimoto, Tomoe; The ATLAS collaboration

    2018-01-01

    The ATLAS distributed computing system has allowed the experiment to successfully meet the challenges of LHC Run 2. In order for distributed computing to operate smoothly and efficiently, several support teams are organized in the ATLAS experiment. The ADCoS (ATLAS Distributed Computing Operation Shifts) is a dedicated group of shifters who follow and report failing jobs, failing data transfers between sites, degradation of ATLAS central computing services, and more. The DAST (Distributed Analysis Support Team) provides user support to resolve issues related to running distributed analysis on the grid. The CRC (Computing Run Coordinator) maintains a global view of the day-to-day operations. In this presentation, the status and operational experience of the support system for ATLAS distributed computing in LHC Run 2 will be reported. This report also includes operations experience from the grid site point of view, and an analysis of the errors that create the biggest waste of wallclock time. The report of oper...

  15. System Design for Transitional Aircraft Support

    Directory of Open Access Journals (Sweden)

    John P.T. Mo

    2014-01-01

    Full Text Available The Australian Defence Force and industry are undergoing significant changes in the way they work together in capability enhancement programs. There are capability gaps in maintaining and supporting current obligations during major asset acquisition, which has migrated into the front line of Royal Air Force Fighter Groups as a new capability. This paper examines a steady state support solution and argues that in order to interchange from one support solution to a new architecture there must be a period for transition, which may need its own interim business model and operational service. A preliminary study of several existing support solutions reveals the generic elements that need to be parameterized and traced through the support system architecture trajectory.

  16. Risk-adjusted scoring systems in colorectal surgery.

    Science.gov (United States)

    Leung, Edmund; McArdle, Kirsten; Wong, Ling S

    2011-01-01

    Consequent to recent advances in surgical techniques and management, survival rate has increased substantially over the last 25 years, particularly in colorectal cancer patients. However, post-operative morbidity and mortality from colorectal cancer vary widely across the country. Therefore, standardised outcome measures are emphasised not only for professional accountability, but also for comparison between treatment units and regions. In a heterogeneous population, the use of crude mortality as an outcome measure for patients undergoing surgery is simply misleading. Meaningful comparisons, however, require accurate risk stratification of patients being analysed before conclusions can be reached regarding the outcomes recorded. Sub-specialised colorectal surgical units usually dedicated to more complex and high-risk operations. The need for accurate risk prediction is necessary in these units as both mortality and morbidity often are tools to justify the practice of high-risk surgery. The Acute Physiology And Chronic Health Evaluation (APACHE) is a system for classifying patients in the intensive care unit. However, APACHE score was considered too complex for general surgical use. The American Society of Anaesthesiologists (ASA) grade has been considered useful as an adjunct to informed consent and for monitoring surgical performance through time. ASA grade is simple but too subjective. The Physiological & Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and its variant Portsmouth POSSUM (P-POSSUM) were devised to predict outcomes in surgical patients in general, taking into account of the variables in the case-mix. POSSUM has two parts, which include assessment of physiological parameters and operative scores. There are 12 physiological parameters and 6 operative measures. The physiological parameters are taken at the time of surgery. Each physiological parameter or operative variable is sub-divided into three or four levels with

  17. Monitoring support system for nuclear power plant

    International Nuclear Information System (INIS)

    Higashikawa, Yuichi; Kubota, Rhuji; Tanaka, Keiji; Takano, Yoshiyuki

    1996-01-01

    The nuclear power plants in Japan reach to 49 plants and supply 41.19 million kW in their installed capacities, which is equal to about 31% of total electric power generation and has occupied an important situation as a stable energy supplying source. As an aim to keeping safe operation and working rate of the power plants, various monitoring support systems using computer technology, optical information technology and robot technology each advanced rapidly in recent year have been developed to apply to the actual plants for a plant state monitoring system of operators in normal operation. Furthermore, introduction of the emergent support system supposed on accidental formation of abnormal state of the power plants is also investigated. In this paper, as a monitoring system in the recent nuclear power plants, design of control panel of recent central control room, introduction to its actual plant and monitoring support system in development were described in viewpoints of improvement of human interface, upgrade of sensor and signal processing techniques, and promotion of information service technique. And, trend of research and development of portable miniature detector and emergent monitoring support system are also introduced in a viewpoint of labor saving and upgrade of the operating field. (G.K.)

  18. PLM system support for modular product development

    DEFF Research Database (Denmark)

    Bruun, Hans Peter Lomholt; Mortensen, Niels Henrik; Harlou, Ulf

    2015-01-01

    A modular design strategy both enables, but also demands, parallelism in design activities and collaboration between a diversity of disciplines in companies, which often involves supporting computer-based tools for enhancing interaction, design management, and communication. Product data management...... (PDM) and product lifecycle management (PLM) systems offer support by automating and managing some of the operational complexity of modular design activities. PLM system tools are used for handling a variety of product definitions, to manage workflow of development activities, and to measure relational...... properties such as cost and performance. Companies often use a PLM tool for management of CAD files, documents, and drawings, but they do not take advantage of the full potential of the PLM system to support the development activities of modular product designs. The key result of this paper...

  19. Lunar Surface Systems Supportability Technology Development Roadmap

    Science.gov (United States)

    Oeftering, Richard C.; Struk, Peter M.; Green, Jennifer L.; Chau, Savio N.; Curell, Philip C.; Dempsey, Cathy A.; Patterson, Linda P.; Robbins, William; Steele, Michael A.; DAnnunzio, Anthony; hide

    2011-01-01

    The Lunar Surface Systems Supportability Technology Development Roadmap is a guide for developing the technologies needed to enable the supportable, sustainable, and affordable exploration of the Moon and other destinations beyond Earth. Supportability is defined in terms of space maintenance, repair, and related logistics. This report considers the supportability lessons learned from NASA and the Department of Defense. Lunar Outpost supportability needs are summarized, and a supportability technology strategy is established to make the transition from high logistics dependence to logistics independence. This strategy will enable flight crews to act effectively to respond to problems and exploit opportunities in an environment of extreme resource scarcity and isolation. The supportability roadmap defines the general technology selection criteria. Technologies are organized into three categories: diagnostics, test, and verification; maintenance and repair; and scavenge and recycle. Furthermore, "embedded technologies" and "process technologies" are used to designate distinct technology types with different development cycles. The roadmap examines the current technology readiness level and lays out a four-phase incremental development schedule with selection decision gates. The supportability technology roadmap is intended to develop technologies with the widest possible capability and utility while minimizing the impact on crew time and training and remaining within the time and cost constraints of the program.

  20. Using Visualization in Cockpit Decision Support Systems

    Energy Technology Data Exchange (ETDEWEB)

    Aragon, Cecilia R.

    2005-07-01

    In order to safely operate their aircraft, pilots must makerapid decisions based on integrating and processing large amounts ofheterogeneous information. Visual displays are often the most efficientmethod of presenting safety-critical data to pilots in real time.However, care must be taken to ensure the pilot is provided with theappropriate amount of information to make effective decisions and notbecome cognitively overloaded. The results of two usability studies of aprototype airflow hazard visualization cockpit decision support systemare summarized. The studies demonstrate that such a system significantlyimproves the performance of helicopter pilots landing under turbulentconditions. Based on these results, design principles and implicationsfor cockpit decision support systems using visualization arepresented.

  1. Initial evaluation of a femtosecond laser system in cataract surgery.

    Science.gov (United States)

    Chang, John S M; Chen, Ivan N; Chan, Wai-Man; Ng, Jack C M; Chan, Vincent K C; Law, Antony K P

    2014-01-01

    To report the early experience and complications during cataract surgery with a noncontact femtosecond laser system. Hong Kong Sanatorium and Hospital, Hong Kong Special Administrative Region, China. Retrospective case series. All patients had anterior capsulotomy or combined anterior capsulotomy and lens fragmentation using a noncontact femtosecond laser system (Lensar) before phacoemulsification. Chart and video reviews were performed retrospectively to determine the intraoperative complication rate. Risk factors associated with the complications were also analyzed. One hundred seventy eyes were included. Free-floating capsule buttons were found in 151 eyes (88.8%). No suction break occurred in any case. Radial anterior capsule tears occurred in 9 eyes (5.3%); they did not extend to the equator or posterior capsule. One eye (0.6%) had a posterior capsule tear. No capsular block syndrome developed, and no nuclei were dropped during irrigation/aspiration (I/A). Anterior capsule tags and miosis occurred in 4 eyes (2.4%) and 17 eyes (10.0%), respectively. Different severities of subconjunctival hemorrhages developed in 71 (43.8%) of 162 eyes after the laser procedure. The mean surgical time from the beginning to the end of suction was 6.72 minutes ± 4.57 (SD) (range 2 to 28 minutes). Cataract surgery with the noncontact femtosecond laser system was safe. No eye lost vision because of complications. Caution should be taken during phacoemulsification and I/A to avoid radial anterior capsule tears and posterior capsule tears. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  2. Intelligent systems supporting the control room operators

    International Nuclear Information System (INIS)

    Berger, E.

    1997-01-01

    The operational experience obtained with the various applications of the systems discussed in this paper shows that more consequent use of the systems will make detection and management of disturbances still more efficient and faster. This holds true both for a low level of process automation and for power plants with a high level of automation. As for conventional power plants, the trend clearly is towards higher degrees of automation and consequent application of supporting systems. Thus, higher availability and rapid failure management are achieved, at low effects on normal operation. These systems are monitoring and process control systems, expert systems, and systems for optimal use of the equipment, or systems for post-incident analyses and computer-assisted on-shift protocols, or operating manuals. (orig./CB) [de

  3. National review of use of extracorporeal membrane oxygenation as respiratory support in thoracic surgery excluding lung transplantation.

    Science.gov (United States)

    Rinieri, Philippe; Peillon, Christophe; Bessou, Jean-Paul; Veber, Benoît; Falcoz, Pierre-Emmanuel; Melki, Jean; Baste, Jean-Marc

    2015-01-01

    Extracorporeal membrane oxygenation (ECMO) for respiratory support is increasingly used in intensive care units (ICU), but rarely during thoracic surgical procedures outside the transplantation setting. ECMO can be an alternative to cardiopulmonary bypass for major trachea-bronchial surgery and single-lung procedures without in-field ventilation. Our aim was to evaluate the intraoperative use of ECMO as respiratory support in thoracic surgery: benefits, indications and complications. This was a multicentre retrospective study (questionnaire) of use of ECMO as respiratory support during the thoracic surgical procedure. Lung transplantation and lung resection for tumour invading the great vessels and/or the left atrium were excluded, because they concern respiratory and circulatory support. From March 2009 to September 2012, 17 of the 34 centres in France applied ECMO within veno-venous (VV) (n=20) or veno-arterial (VA) (n=16) indications in 36 patients. Ten VA ECMO were performed with peripheral cannulation and 6 with central cannulation; all VV ECMO were achieved through peripheral cannulation. Group 1 (total respiratory support) was composed of 28 patients without mechanical ventilation, involving 23 tracheo-bronchial and 5 single-lung procedures. Group 2 (partial respiratory support) was made up of 5 patients with respiratory insufficiency. Group 3 was made up of 3 patients who underwent thoracic surgery in a setting of acute respiratory distress syndrome (ARDS) with preoperative ECMO. Mortality at 30 days in Groups 1, 2 and 3 was 7, 40 and 67%, respectively (P<0.05). In Group 1, ECMO was weaned intraoperatively or within 24 h in 75% of patients. In Group 2, ECMO was weaned in ICU over several days. In Group 1, 2 patients with VA support were converted to VV support for chronic respiratory indications. Bleeding was the major complication with 17% of patients requiring return to theatre for haemostasis. There were two cannulation-related complications (6%). VV or

  4. ACADEMIC INTEGRITY SUPPORT SYSTEM FOR UKRAINIAN UNIVERSITIES

    Directory of Open Access Journals (Sweden)

    V. G. Sherstjuk

    2017-04-01

    Full Text Available Purpose. Developing the methodology for providing academic integrity in the university. The methodology is based on Web-oriented academic integrity support system, developed by the authors, which enters into the information system of learning process control. Academic integrity support system is aimed at maintaining academic integrity as a basic institutional value, which will help to reduce corruption, plagiarism and other types of academic dishonesty. Methodology. The methodology of problem to solve is based on the development of the information system of education process control with the integral elements of quality control. The information subsystem of academic integrity support is its basic part. Findings. The proposed information system allows us to fulfill the following levels: educational process monitoring; audit of internal processes, which is necessary for developing the effective quality control system; assessment of achievements of educational process participants; formalization of the interaction of educational process participants. The system is aimed at the development of new academic society based on the following principles: open access to the information, at which the access of wide audience to the information provides participation, forming the sense of responsibility and social control; transparency of the information, by which its relevance, quality, reliability are meant; responsibility of all members of educational process; measurability, at which any action in educational process should be measured; detail of describing the actions, results and processes; support, which is meant by automatic tools of the realization of the principles of open access to the information, transparency of the information, responsibility of all participants of educational process, measurability, detail, support. The practical realization of information system is based on the development of a common repository of university information. The

  5. Support for User Interfaces for Distributed Systems

    Science.gov (United States)

    Eychaner, Glenn; Niessner, Albert

    2005-01-01

    An extensible Java(TradeMark) software framework supports the construction and operation of graphical user interfaces (GUIs) for distributed computing systems typified by ground control systems that send commands to, and receive telemetric data from, spacecraft. Heretofore, such GUIs have been custom built for each new system at considerable expense. In contrast, the present framework affords generic capabilities that can be shared by different distributed systems. Dynamic class loading, reflection, and other run-time capabilities of the Java language and JavaBeans component architecture enable the creation of a GUI for each new distributed computing system with a minimum of custom effort. By use of this framework, GUI components in control panels and menus can send commands to a particular distributed system with a minimum of system-specific code. The framework receives, decodes, processes, and displays telemetry data; custom telemetry data handling can be added for a particular system. The framework supports saving and later restoration of users configurations of control panels and telemetry displays with a minimum of effort in writing system-specific code. GUIs constructed within this framework can be deployed in any operating system with a Java run-time environment, without recompilation or code changes.

  6. Compactly Supported Curvelet-Type Systems

    DEFF Research Database (Denmark)

    Rasmussen, Kenneth Niemann; Nielsen, Morten

    2012-01-01

    We study a flexible method for constructing curvelet-type frames. These curvelet-type systems have the same sparse representation properties as curvelets for appropriate classes of smooth functions, and the flexibility of the method allows us to give a constructive description of how to construct...... curvelet-type systems with a prescribed nature such as compact support in direct space. The method consists of using the machinery of almost diagonal matrices to show that a system of curvelet molecules which is sufficiently close to curvelets constitutes a frame for curvelet-type spaces. Such a system...

  7. Decision Support System for Fighter Pilots

    DEFF Research Database (Denmark)

    Randleff, Lars Rosenberg

    2007-01-01

    During a mission over enemy territory a fighter aircraft may be engaged by ground based threats. The pilot can use different measures to avoid the aircraft from being detected by e.g. enemy radar systems. If the enemy detects the aircraft a missile may be fired to seek and destroy the aircraft...... and countermeasures that can be applied to mitigate threats. This work is concerned with finding proper evasive actions when a fighter aircraft is engaged by ground based threats. To help the pilot in deciding on these actions a decision support system may be implemented. The environment in which such a system must....... When new threats occur the decision support system must be able to provide suggestions within a fraction of a second. Since the time it takes to find an optimal solution to the mathematical model can not comply with this requirement solutions are sought using a metaheuristic....

  8. Decision support system for surface irrigation design

    OpenAIRE

    Gonçalves, José M.; Pereira, L.S.

    2009-01-01

    The SADREG decision support system was developed to help decision makers in the process of design and selection of farm surface irrigation systems to respond to requirements of modernization of surface irrigation—furrow, basin, and border irrigation. It includes a database, simulation models, user-friendly interfaces, and multicriteria analysis models. SADREG is comprised of two components: design and selection. The first component applies database information, and through several si...

  9. A decision support system for forensic entomology

    OpenAIRE

    Morvan , Gildas; Jolly , Daniel; Dupont , Daniel; Kubiak , Philippe

    2007-01-01

    International audience; This paper presents a multiagent-based model of insect development on a dead body and a three layers Decision Support System architecture able to perform retrodictive (abductive) reasoning from multiagent-based models or more generally, complex systems models. This architecture is used in order to compute post-mortem intervals from entomological data sampled on cadavers. Knowing the exact time of a death is fundamental in criminal investigations. Thus, it is necessary ...

  10. Intelligent tactical asset allocation support system

    OpenAIRE

    Hiemstra, Y.

    1995-01-01

    This paper presents an advanced support system for Tactical Asset Allocation. Asset allocation explains over 90% of portfolio performance (Brinson, Hood and Beebower, 1988). Tactical asset allocation adjusts a strategic portfolio on the basis of short term market outlooks. The system includes aprediction model that forecasts quarterly excess returns on the S and PSOO, an optimization model that adjusts a user-specified strategic portfolio on thebasis of the excess return forecast, and a compo...

  11. Life Support Systems: Wastewater Processing and Water Management

    Data.gov (United States)

    National Aeronautics and Space Administration — Advanced Exploration Systems (AES) Life Support Systems project Wastewater Processing and Water Management task: Within an integrated life support system, water...

  12. Requirements by the operator of supporting systems

    International Nuclear Information System (INIS)

    Grimm, E.; Lot, L.

    1996-01-01

    Requirements by the nuclear power station operator on computer support orient themselves to the various operating situations which can arise in the plant. Event-oriented or system-oriented methods of handling determine the type of support by the computer. Pure plant information in situations with few events, an intelligent alarm system in situations with many events and a guide by means of pre-prepared procedures are an aspect of the operator requirements of computer solutions. These are the themes dealt with in this paper. A further theme is the support of the operator by the ergonomics of the control room in the areas of working place, lighting, air conditioning and acoustics. (author) 4 figs

  13. Operator decision support system for sodium loop

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kwang Hyeang; Park, Kyu Ho; Kim, Tak Kon; Jo, Choong Ho; Seong, Kyeong A; Lee, Keon Myeong; Kim, Yeong Dal; Kim, Chang Beom; Kim, Jong Kyu; Jo, Hee Chang; Lee, Ji Hyeong; Jeong, Yoon Soo; Chio, Jong Hyeong; Jeong, Bong Joon; Hong, Joon Seong; Kim, Bong Wan; Seong, Byeong Hak [Korea Advanced Institute Science and Technology, Taejon (Korea, Republic of)

    1994-07-01

    The objective of this study is to develop an operator decision support system by computerizing the sodium circuit. This study developed graphical display interface for the control panel which provides the safety control of equipment, the recognition of experimental process states and sodium circuit states. In this study, basic work to develop an operator decision support real-time expert system for sodium loop was carried out. Simplification of control commands and effective operation of various real-time data and signals by equipment code standardization are studied. The cost ineffectiveness of the single processor structure provides the ground for the development of cost effective parallel processing system. The important tasks of this study are (1) design and implementation of control state surveillance panel of sodium loop, (2) requirement analysis of operator support real-time expert system for sodium loop, (3) design of standard code rule for operating equipment and research on the cost effective all purpose parallel processing system and (4) requirement analysis of expert system and design of control state variables and user interface for experimental process. 10 refs., 36 figs., 20 tabs.

  14. Development of an ecological decision support system

    NARCIS (Netherlands)

    van Beusekom, Frits; Brazier, Frances; Schipper, Piet; Treur, Jan; del Pobil, A.P.

    1998-01-01

    In this paper a knowledge-based decision support system is described that determines the abiotic (chemical and physical) characteristics of a site on the basis of in-homogeneous samples of plant species. Techniques from the area of non-monotonic reasoning are applied to model multi-interpretable

  15. Support system of electronic health cards

    Directory of Open Access Journals (Sweden)

    Yu. L. Nechiporenko

    2013-02-01

    Full Text Available Made the survey online sources regarding the specification of functions of systems support electronic medical records. Given the tendency to attract mobile devices to conduct an array of medical data expedient development of EHR, which can be installed on a personal mobile device.

  16. Robot-Assisted Fracture Surgery: Surgical Requirements and System Design.

    Science.gov (United States)

    Georgilas, Ioannis; Dagnino, Giulio; Tarassoli, Payam; Atkins, Roger; Dogramadzi, Sanja

    2018-03-09

    The design of medical devices is a complex and crucial process to ensure patient safety. It has been shown that improperly designed devices lead to errors and associated accidents and costs. A key element for a successful design is incorporating the views of the primary and secondary stakeholders early in the development process. They provide insights into current practice and point out specific issues with the current processes and equipment in use. This work presents how information from a user-study conducted in the early stages of the RAFS (Robot Assisted Fracture Surgery) project informed the subsequent development and testing of the system. The user needs were captured using qualitative methods and converted to operational, functional, and non-functional requirements based on the methods derived from product design and development. This work presents how the requirements inform a new workflow for intra-articular joint fracture reduction using a robotic system. It is also shown how the various elements of the system are developed to explicitly address one or more of the requirements identified, and how intermediate verification tests are conducted to ensure conformity. Finally, a validation test in the form of a cadaveric trial confirms the ability of the designed system to satisfy the aims set by the original research question and the needs of the users.

  17. Application and development of non contact angle-wide viewing system in vitreous retinal surgery

    Directory of Open Access Journals (Sweden)

    Rong-Hua He

    2016-07-01

    Full Text Available Wide-angle viewing system as an important auxiliary device can clearly observe the whole fundus field of vision in vitreous surgery, which enable vitreoretinal surgery more efficient, safer and more effective. So it has very high application value in ophthalmologic operation. In this paper, we studied the development and application of wide-angle viewing system in vitreoretinal surgery in recent years, from which we summed up the advantage of non-contact wide-angle viewing system in clinical field, and pointed out the shortcomings. The ultimate goal is to make the non-contact wide-angle viewing system better applied in vitreous surgery.

  18. Remote mobile communication in safety support system

    International Nuclear Information System (INIS)

    Inagaki, Kanji; Kobayashi, Hiroyuki; Hatanaka, Takahiro; Sakuma, Akira; Fukumoto, Akira; Ikeda, Jun

    1999-01-01

    Safety Support System (SSS) is a computerized operator support system for nuclear power plants, which is now under development. The concept of SSS covers 1) earlier detection of failure symptom and prediction of its influence to the plant operation, 2) improved transparency and robustness of plant control systems, 3) advanced human-machine interface and communication. The authors have been working on the third concept and proposed a remote mobile communication system called Plant Communication System (PCS). PCS aims to realize convenient communication between main control room and other areas such as plant local areas and site offices, using Personal Handyphone System (PHS) and wireless LAN (Local Area Network). PCS can transmit not only data but also graphic displays and dynamic video displays between the main control room and plant local areas. MPEG4 (Moving Picture Experts Group 4) technology is utilized in video data compression and decompression. The authors have developed the special multiplexing unit that connects PHS Cell Stations (CSs) and exiting coaxial cables. Voice recognition and announcement capability is also realized in the system, which enables verbal retrieval of information in the computer systems in the main control room from local areas. (author)

  19. Operator support system using computational intelligence techniques

    Energy Technology Data Exchange (ETDEWEB)

    Bueno, Elaine Inacio, E-mail: ebueno@ifsp.edu.br [Instituto Federal de Educacao, Ciencia e Tecnologia de Sao Paulo (IFSP), Sao Paulo, SP (Brazil); Pereira, Iraci Martinez, E-mail: martinez@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    Computational Intelligence Systems have been widely applied in Monitoring and Fault Detection Systems in several processes and in different kinds of applications. These systems use interdependent components ordered in modules. It is a typical behavior of such systems to ensure early detection and diagnosis of faults. Monitoring and Fault Detection Techniques can be divided into two categories: estimative and pattern recognition methods. The estimative methods use a mathematical model, which describes the process behavior. The pattern recognition methods use a database to describe the process. In this work, an operator support system using Computational Intelligence Techniques was developed. This system will show the information obtained by different CI techniques in order to help operators to take decision in real time and guide them in the fault diagnosis before the normal alarm limits are reached. (author)

  20. Operator support system using computational intelligence techniques

    International Nuclear Information System (INIS)

    Bueno, Elaine Inacio; Pereira, Iraci Martinez

    2015-01-01

    Computational Intelligence Systems have been widely applied in Monitoring and Fault Detection Systems in several processes and in different kinds of applications. These systems use interdependent components ordered in modules. It is a typical behavior of such systems to ensure early detection and diagnosis of faults. Monitoring and Fault Detection Techniques can be divided into two categories: estimative and pattern recognition methods. The estimative methods use a mathematical model, which describes the process behavior. The pattern recognition methods use a database to describe the process. In this work, an operator support system using Computational Intelligence Techniques was developed. This system will show the information obtained by different CI techniques in order to help operators to take decision in real time and guide them in the fault diagnosis before the normal alarm limits are reached. (author)

  1. Development of JRR-4 operation support system

    International Nuclear Information System (INIS)

    Takahashi, Hiroki; Yamamoto, Kazuyoshi; Yoritsune, Tsutomu; Arai, Nobuyoshi; Birumachi, Takashi

    1999-03-01

    The Japan Research Reactor No.4 (JRR-4) is a light water moderated and cooled, graphite reflected, pool-type reactor with the thermal output of 3500 kW. In February 1996, a work on core modification from high-enriched fuels to low-enriched ones was started and the work on modification was completed in May 1998. As a part of the work, Operation Support System (OSS) was adopted for the purpose of reducing load of operator, preventing operator's error and supplying operation data to users. In this paper, JRR-4 Operation Support System's configuration, characteristics and development process are described. OSS consists mainly of a workstation (WS), μXL and Personal Computer (PC). WS is used for collection of operation data. μXL is used for cooling system control and PC is used for operators' support. All of the program applications used in WS, μXL and PC are designed to make sure of high flexibility for the demands on modification from operators and new operation modes. The result of adopting this system, the consolidation monitoring, automation of part of reactor operation and data management were realized. In addition, the cooling control system was compacted. (author)

  2. The Impact of Early Involvement in a Postdischarge Support Program for Ostomy Surgery Patients on Preventable Healthcare Utilization

    OpenAIRE

    Rojanasarot, Sirikan

    2017-01-01

    PURPOSE: To evaluate the impact of a postdischarge ostomy support program as an adjunct to nurse-led ostomy care on preventable healthcare utilization. DESIGN: A cross-sectional study. SUBJECTS AND SETTING: A postdischarge support program offered by an ostomy product's manufacturer provides persons living with an ostomy with patient-centered and easily accessible assistance. Individuals who underwent ostomy surgery within 18 months prior to the survey date were selected from an ostomy patient...

  3. Development of decommissioning engineering support system for fugen. Development of support system during actual dismantlement works

    International Nuclear Information System (INIS)

    Masanori Izumi; Yukihiro Iguchi; Yoshiki Kannehira

    2005-01-01

    The Advanced Thermal Reactor, Fugen Nuclear Power Station was permanently shut down in March 2003, and is now preparing for decommissioning. We have been developing Decommissioning Engineering Support System (DEXUS) aimed at planning optimal dismantlement process and carrying out dismantlement work safely and precisely. DEXUS consists of 'decommissioning planning support system' and 'dismantling support system'. The dismantling support system is developed aiming at using during actual dismantling work. It consists of three subsystems such as 'Worksite Visualization System', 'Dismantling Data Collection System' and 'Generated Waste Management System'. 'Worksite Visualization System' is a support system designed to provide the necessary information to workers during actual dismantlement works. And this system adopts AR (Augmented Reality) technology, overlapping calculation information into real world. 'Dismantling Data Collection System' is to collect necessary data for improving accuracy of decommissioning planning by evaluating work content and worker equipage, work time for dismantlement works. 'Generated Waste Management system' is a system recording necessary information by attaching the barcode to dismantled wastes or the containers. We can get the information of generated waste by recording generation place, generated time, treatment method and the contents. These subsystems enable to carry out reasonable and safe decommissioning of Fugen. In addition, we expect that those systems will be used for decommissioning of other nuclear facilities in the future. (authors)

  4. Knowledge representation for decision support systems

    International Nuclear Information System (INIS)

    Methlie, L.B.

    1985-01-01

    This book is organized into three sections in accordance with the structure of the conference program. First section contains four major papers which were commissioned by the Programme Committee to set the tone for the conference and to provide a structured source of relevant material from contributing disciplines. The second section contains specific papers submitted to the conference, and concerned with the following topics of specific interest: epistemological issues for decision support systems (DSS), capturing organizational knowledge for DSS, complementarity between human and formal DSS, and representations for adaption. The third section contains the short papers on any topic of relevance to the theme of the conference. It is hoped that the two working conferences organized by WG 8.3 will contribute to the development of a coherent knowledge and understanding of the class of computerized information systems called Decision Support Systems. (Auth.)

  5. BASIC STUDY ON TAILORMADE BRAKING SUPPORT SYSTEM

    Directory of Open Access Journals (Sweden)

    Toshiya HIROSE, M.S.

    2004-01-01

    This research reviewed the construction of models of a Tailormade Braking Support System (TBSS for braking to stop vehicles and the evaluation of drivers. As a result, the following conclusions were drawn. (1 Braking factors were found to change in the period from the start of braking to stopping; (2 Changes in braking factors can be logically incorporated into the control elements of braking support system; (3 Readymade Driver Model is effective as a model to be incorporated into the base system of TBSS; (4 Tailormade Driver Model built on Neural Network is effective as a main model to construct TBSS; (5 As for TBSS, both subjective and objective ratings on the timing and magnitude of braking are favorable, and its safety and sense of security are improved.

  6. Using Visualization in Cockpit Decision Support Systems

    Science.gov (United States)

    Aragon, Cecilia R.

    2005-01-01

    In order to safely operate their aircraft, pilots must make rapid decisions based on integrating and processing large amounts of heterogeneous information. Visual displays are often the most efficient method of presenting safety-critical data to pilots in real time. However, care must be taken to ensure the pilot is provided with the appropriate amount of information to make effective decisions and not become cognitively overloaded. The results of two usability studies of a prototype airflow hazard visualization cockpit decision support system are summarized. The studies demonstrate that such a system significantly improves the performance of helicopter pilots landing under turbulent conditions. Based on these results, design principles and implications for cockpit decision support systems using visualization are presented.

  7. Implementation of Business Game Activity Support System

    Institute of Scientific and Technical Information of China (English)

    TANABU Motonari

    2004-01-01

    Business game can be used not only as an educational tool for the development of decision making ability, but also can be used for supporting the knowledge creation activity in organizations. In this paper, some conceptual considerations to meanings of the business game in the knowledge creation activity by using the knowledge creation theory and other related theories are given,and business game activity concept which refers to game play and development is proposed. Then focusing on the business game activity as an instantiation of the knowledge creation activity, and a Web based gaming activity support system based on the former system called YBG that enables us to play and develop many business games through the standard web browser is proposed. This system also provides us a lot of opportunities to play and develop the business games over business game communities.

  8. Impulse: Memory System Support for Scientific Applications

    Directory of Open Access Journals (Sweden)

    John B. Carter

    1999-01-01

    Full Text Available Impulse is a new memory system architecture that adds two important features to a traditional memory controller. First, Impulse supports application‐specific optimizations through configurable physical address remapping. By remapping physical addresses, applications control how their data is accessed and cached, improving their cache and bus utilization. Second, Impulse supports prefetching at the memory controller, which can hide much of the latency of DRAM accesses. Because it requires no modification to processor, cache, or bus designs, Impulse can be adopted in conventional systems. In this paper we describe the design of the Impulse architecture, and show how an Impulse memory system can improve the performance of memory‐bound scientific applications. For instance, Impulse decreases the running time of the NAS conjugate gradient benchmark by 67%. We expect that Impulse will also benefit regularly strided, memory‐bound applications of commercial importance, such as database and multimedia programs.

  9. Supporting multiple control systems at Fermilab

    Energy Technology Data Exchange (ETDEWEB)

    Nicklaus, Dennis J.; /Fermilab

    2009-10-01

    The Fermilab control system, ACNET, is used for controlling the Tevatron and all of its pre-accelerators. However, other smaller experiments at Fermilab have been using different controls systems, in particular DOOCS and EPICS. This paper reports some of the steps taken at Fermilab to integrate support for these outside systems. We will describe specific tools that we have built or adapted to facilitate interaction between the architectures. We also examine some of the difficulties that arise from managing this heterogeneous environment. Incompatibilities as well as common elements will be described.

  10. Design of JRR-4 operation Supporting System

    International Nuclear Information System (INIS)

    Takahashi, Hiroki; Arai, Nobuyoshi; Yamamoto, Kazuyoshi; Yoritsune, Tsutomu

    1999-01-01

    A work on the Japan Research Reactor No. 4 (JRR-4) core modification from high-enriched fuels to low-enriched ones was started in 1996 and completed in May 1998. As a part of the work, Operation Supporting System (OSS) was adopted for the purpose of reducing load of operator, preventing operator's error and supplying operation data to users. As the result of adopting this system, integrated monitoring, automation of part of reactor operation and data management were realized. In addition, the cooling control system was compacted. (author)

  11. Impact of an Event Reporting System on Resident Complication Reporting in Plastic Surgery Training: Addressing an ACGME and Plastic Surgery Milestone Project Core Competency.

    Science.gov (United States)

    Parikh, Rajiv P; Snyder-Warwick, Alison; Naidoo, Sybill; Skolnick, Gary B; Patel, Kamlesh B

    2017-11-01

    The Accreditation Council for Graduate Medical Education and Plastic Surgery Milestone Project has identified practice-based learning and improvement, which involves systematically analyzing current practices and implementing changes, as a core competency in residency education. In surgical care, complication reporting is an essential component of practice-based learning and improvement as complications are analyzed in morbidity and mortality conference for quality improvement. Unfortunately, current methods for capturing a comprehensive profile of complications may significantly underestimate the true occurrence of complications. Therefore, the objectives of this study are to evaluate an intervention for complication reporting and compare this to current practice, in a plastic surgery training program. This is a preintervention and postintervention study evaluating resident reporting of complications on a plastic surgery service. The intervention was an online event reporting system developed by department leadership and patient safety experts. The cohorts consisted of all patients undergoing surgery during two separate 3-month blocks bridged by an implementation period. A trained reviewer recorded complications, and this served as the reference standard. Fisher's exact test was used for binary comparisons. There were 32 complications detected in 219 patients from June to August of 2015 and 35 complications in 202 patients from October to December of 2015. The proportion of complications reported in the preintervention group was nine of 32 (28.1 percent). After the intervention, this significantly increased to 32 of 35 (91.4 percent) (p < 0.001). An intervention using an event reporting system, supported by departmental leadership, led to significant improvements in complication reporting by plastic surgery residents.

  12. Web-Based Learning Support System

    Science.gov (United States)

    Fan, Lisa

    Web-based learning support system offers many benefits over traditional learning environments and has become very popular. The Web is a powerful environment for distributing information and delivering knowledge to an increasingly wide and diverse audience. Typical Web-based learning environments, such as Web-CT, Blackboard, include course content delivery tools, quiz modules, grade reporting systems, assignment submission components, etc. They are powerful integrated learning management systems (LMS) that support a number of activities performed by teachers and students during the learning process [1]. However, students who study a course on the Internet tend to be more heterogeneously distributed than those found in a traditional classroom situation. In order to achieve optimal efficiency in a learning process, an individual learner needs his or her own personalized assistance. For a web-based open and dynamic learning environment, personalized support for learners becomes more important. This chapter demonstrates how to realize personalized learning support in dynamic and heterogeneous learning environments by utilizing Adaptive Web technologies. It focuses on course personalization in terms of contents and teaching materials that is according to each student's needs and capabilities. An example of using Rough Set to analyze student personal information to assist students with effective learning and predict student performance is presented.

  13. Development of a medical robot system for minimally invasive surgery.

    Science.gov (United States)

    Feng, Mei; Fu, Yili; Pan, Bo; Liu, Chang

    2012-03-01

    Robot-assisted systems have been widely used in minimally invasive surgery (MIS) practice, and with them the precision and accuracy of surgical procedures can be significantly improved. Promoting the development of robot technology in MIS will improve robot performance and help in tackling problems from complex surgical procedures. A medical robot system with a new mechanism for MIS was proposed to achieve a two-dimensional (2D) remote centre of motion (RCM). An improved surgical instrument was designed to enhance manipulability and eliminate the coupling motion between the wrist and the grippers. The control subsystem adopted a master-slave control mode, upon which a new method with error compensation of repetitive feedback can be based for the inverse kinematics solution. A unique solution with less computation and higher satisfactory accuracy was also obtained. Tremor filtration and trajectory planning were also addressed with regard to the smoothness of the surgical instrument movement. The robot system was tested on pigs weighing 30-45 kg. The experimental results show that the robot can successfully complete a cholecystectomy and meet the demands of MIS. The results of the animal experiments were excellent, indicating a promising clinical application of the robot with high manipulability. Copyright © 2011 John Wiley & Sons, Ltd.

  14. Graphic and haptic simulation system for virtual laparoscopic rectum surgery.

    Science.gov (United States)

    Pan, Jun J; Chang, Jian; Yang, Xiaosong; Zhang, Jian J; Qureshi, Tahseen; Howell, Robert; Hickish, Tamas

    2011-09-01

    Medical simulators with vision and haptic feedback techniques offer a cost-effective and efficient alternative to the traditional medical trainings. They have been used to train doctors in many specialties of medicine, allowing tasks to be practised in a safe and repetitive manner. This paper describes a virtual-reality (VR) system which will help to influence surgeons' learning curves in the technically challenging field of laparoscopic surgery of the rectum. Data from MRI of the rectum and real operation videos are used to construct the virtual models. A haptic force filter based on radial basis functions is designed to offer realistic and smooth force feedback. To handle collision detection efficiently, a hybrid model is presented to compute the deformation of intestines. Finally, a real-time cutting technique based on mesh is employed to represent the incision operation. Despite numerous research efforts, fast and realistic solutions of soft tissues with large deformation, such as intestines, prove extremely challenging. This paper introduces our latest contribution to this endeavour. With this system, the user can haptically operate with the virtual rectum and simultaneously watch the soft tissue deformation. Our system has been tested by colorectal surgeons who believe that the simulated tactile and visual feedbacks are realistic. It could replace the traditional training process and effectively transfer surgical skills to novices. Copyright © 2011 John Wiley & Sons, Ltd.

  15. Understanding how orthopaedic surgery practices generate value for healthcare systems.

    Science.gov (United States)

    Olson, Steven A; Mather, Richard C

    2013-06-01

    Orthopaedic surgery practices can provide substantial value to healthcare systems. Increasingly, healthcare administrators are speaking of the need for alignment between physicians and healthcare systems. However, physicians often do not understand what healthcare administrators value and therefore have difficulty articulating the value they create in discussions with their hospital or healthcare organization. Many health systems and hospitals use service lines as an organizational structure to track the relevant data and manage the resources associated with a particular type of care, such as musculoskeletal care. Understanding service lines and their management can be useful for orthopaedic surgeons interested in interacting with their hospital systems. We provide an overview of two basic types of value orthopaedic surgeons create for healthcare systems: financial or volume-driven benefits and nonfinancial quality or value-driven patient care benefits. We performed a search of PubMed from 1965 to 2012 using the term "service line." Of the 351 citations identified, 18 citations specifically involved the use of service lines to improve patient care in both nursing and medical journals. A service line is a structure used in healthcare organizations to enable management of a subset of activities or resources in a focused area of patient care delivery. There is not a consistent definition of what resources are managed within a service line from hospital to hospital. Physicians can positively impact patient care through engaging in service line management. There is increasing pressure for healthcare systems and hospitals to partner with orthopaedic surgeons. The peer-reviewed literature demonstrates there are limited resources for physicians to understand the value they create when attempting to negotiate with their hospital or healthcare organization. To effectively negotiate for resources to provide the best care for patients, orthopaedic surgeons need to claim and

  16. Consultation system for image diagnosis: Report formation support system

    International Nuclear Information System (INIS)

    Ikeda, M.; Sakuma, S.; Ishigaki, T.; Suzuki, K.; Oikawa, K.

    1987-01-01

    The authors developed a consultation system for image diagnosis, involving artificial intelligence ideas. In this system, the authors proposed a new report formation support system and implemented it in lymphangiography. This support system starts with the input of image interpretation. The input process is made mainly by selecting items. This system encodes the input findings into the semantic network, which is represented as a directed graph, and it reserves them into the knowledge database in the above structure. Finally, the output (report) is made in the near natural language, which corresponds to the input findings

  17. [Curative effect analysis of bile reinfusion combined with enteral nutrition support before surgery of hilar cholangiocarcinoma].

    Science.gov (United States)

    Song, P; Mao, L; Bian, X J; Zhou, T; Fan, Y Y; Zhang, J; Xie, M; Qiu, Y D

    2018-05-01

    Objective: To investigate the clinical effect of bile reinfusion combined with enteral nutrition support before surgery for hilar cholangiocarcinoma. Methods: A retrospective analysis of patients with hilar cholangiocarcinoma who underwent surgical treatment at Nanjing Drum Tower Hospital Hepato-biliary-pancreatic Surgery Department from July 2010 to August 2017 was completed.A total of 52 cases were finally enrolled in our study.All the patients included, on the basis of whether they received preoperative drainage and bile reinfusion, were divided into non-drainage group( n =15) and drainage group( n =37). Differences of clinical indicators, including operation time, intraoperative bleeding and serum liver function index levels at day 1, 3, 7 postoperative, postoperative complications(liver failure, biliary fistula, pleural effusion, peritoneal effusion, abdominal cavity infection, death in hospital), tumor classification, R0 resection, postoperative hospitalization time between the 2 groups were analyzed. At the same time, in the drainage group, patients were divided into non-enteral nutrition subgroup( n =13) and enteral nutrition subgroup( n =24) according to whether they received enteral nutrition before operation. The normal distribution data of the group was statistically analyzed by independent sample t test, the non-normal distribution data of the group was statistically analyzed by rank-sum test. The count data was statistically analyzed by non-calibration and correction of the square test. Results: There was no statistically significant difference in general infomation such as age, gender, and serum liver function between non-drainage group and drainage group( P >0.05). There was no statistically significant difference in general information such as age, gender, and serum liver function between non-enteral nutrition group and enteral nutrition group( P >0.05). The rate of vascular resection and reconstruction(33.3%) and operating time(10.8(2.2)h) in

  18. Decommissioning support system, using RFID and USN

    Energy Technology Data Exchange (ETDEWEB)

    Cho, W. H.; Park, S. K.; Choi, Y. D.; Lee, K. I.; Moon, J. K. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2012-05-15

    RFID and USN are key technology in the ubiquitous computing systems. Actual physical environmental information can be used to remote control systems and management using various sensor technology and wireless network. These are used to managing physical distribution systems, complex monitoring environments such as fire detecting and various environments in the field of u-healthcare. Recently, decontamination and dismantling for nuclear plant have increasing interest after Fucushima nuclear accident. In this paper, a decommissioning support system is suggested for an effective management and control of work efficiency and of worker's status. This system makes effective real-time monitoring worker's location, work status and radiation exposure and effective response for worker's safety and emergency situation

  19. Decommissioning support system, using RFID and USN

    International Nuclear Information System (INIS)

    Cho, W. H.; Park, S. K.; Choi, Y. D.; Lee, K. I.; Moon, J. K.

    2012-01-01

    RFID and USN are key technology in the ubiquitous computing systems. Actual physical environmental information can be used to remote control systems and management using various sensor technology and wireless network. These are used to managing physical distribution systems, complex monitoring environments such as fire detecting and various environments in the field of u-healthcare. Recently, decontamination and dismantling for nuclear plant have increasing interest after Fucushima nuclear accident. In this paper, a decommissioning support system is suggested for an effective management and control of work efficiency and of worker's status. This system makes effective real-time monitoring worker's location, work status and radiation exposure and effective response for worker's safety and emergency situation

  20. A novel risk classification system for 30-day mortality in children undergoing surgery

    Science.gov (United States)

    Walter, Arianne I.; Jones, Tamekia L.; Huang, Eunice Y.; Davis, Robert L.

    2018-01-01

    A simple, objective and accurate way of grouping children undergoing surgery into clinically relevant risk groups is needed. The purpose of this study, is to develop and validate a preoperative risk classification system for postsurgical 30-day mortality for children undergoing a wide variety of operations. The National Surgical Quality Improvement Project-Pediatric participant use file data for calendar years 2012–2014 was analyzed to determine preoperative variables most associated with death within 30 days of operation (D30). Risk groups were created using classification tree analysis based on these preoperative variables. The resulting risk groups were validated using 2015 data, and applied to neonates and higher risk CPT codes to determine validity in high-risk subpopulations. A five-level risk classification was found to be most accurate. The preoperative need for ventilation, oxygen support, inotropic support, sepsis, the need for emergent surgery and a do not resuscitate order defined non-overlapping groups with observed rates of D30 that vary from 0.075% (Very Low Risk) to 38.6% (Very High Risk). When CPT codes where death was never observed are eliminated or when the system is applied to neonates, the groupings remained predictive of death in an ordinal manner. PMID:29351327

  1. Modem: data exchange among decision support systems

    International Nuclear Information System (INIS)

    Baig, S.; Zaehringer, M.

    2003-01-01

    The aim of the European Research and Development project MODEM (Monitoring Data and Information Exchange Among Decision Support Systems) is to achieve practical improvements for data exchange among decision support systems (DSS). Hence, the results of model calculations become comparable. This is a precondition for harmonised decision making. Based on the analysis of existing procedures, it was decided to use the PUSH-PULL concept. Notifications are actively and automatically sent by the DSS (PUSH). The data can then be downloaded form an in-formation server (PULL). The format of the data is defined in XML (extended markup language). Participants of the project are the DSS: RODOS, ARGOS and RECASS. First, the data is comprised of the source term and meteorological information. Results of the prognoses and measurement data are also to be exchanged. Exercises testing and improving the pro-cedures form an integral part of the project. (orig.)

  2. Modeling a support system for the evaluator

    International Nuclear Information System (INIS)

    Lozano Lima, B.; Ilizastegui Perez, F; Barnet Izquierdo, B.

    1998-01-01

    This work gives evaluators a tool they can employ to give more soundness to their review of operational limits and conditions. The system will establish the most adequate method to carry out the evaluation, as well as to evaluate the basis for technical operational specifications. It also includes the attainment of alternative questions to be supplied to the operating entity to support it in decision-making activities

  3. Surgery of the eloquent area using neuronavigation system

    Energy Technology Data Exchange (ETDEWEB)

    Nakai, Hirofumi; Tanaka, Tatsuya; Hashizume, Kiyotaka; Hodozuka, Akira; Ono, Hidetoshi; Goto, Takumi; Aburano, Tamio [Asahikawa Medical Coll., Hokkaido (Japan)

    2001-03-01

    The purpose of this minimally invasive study was to evaluate the efficacy of a neuronavigation system for surgery of lesions near Broca's area, skull base, or paracentral sulcus. With regards to paracentral sulcus lesions, precise localization of the precentral gyrus was evaluated not only with preoperative 3D images of the brain but also confirmed by the combination of fMRI and intraoperative SEP. Using the neuronavigation system, Viewing Wand (ISG Technologies), three-dimensional (3D) brain images were reconstructed by plotting cerebral sulcus and skull representations obtained by MRI and CT. Six patients with lesions near Broca's area, 5 patients with skull base lesions, and 9 patients with lesions near the central sulcus were analyzed. For paracentral sulcus lesions, patients underwent blood oxygen level-dependent fMRI while performing a finger-tapping motor paradigm, which was composed of repetition of rest-task every in 30 seconds for 150 seconds, in a 1.5-tesla echo-speed MR imager (Signa Horizon; General Electric Medical Systems, Milwaukee, WI). Statistical cross-correlation functional maps were generated and overlaid onto high-resolution anatomical MR images. Presurgical assessment of 3D reconstructed brain images were performed in all cases. They were analyzed in Broca's lesions, skull base lesions and paracentral sulcus lesions and were demonstrated to be useful for understanding the anatomical relationship between the lesions and the surrounding vital structures. In fMRI, motor activation sites were obtained on both ipsilateral and contralateral hemispheres in all patients except for one patient with a hemorrhagic cyst. Locations of precentral gyri were predicted preoperatively. In all patients except for one case, fMRI was obtained even in tumor patient in whom intraoperative SEP was technically not feasible due to severe cortical brain damage from the paracentral tumor. The precentral gyri identified by 3D reconstructed brain images

  4. Surgery of the eloquent area using neuronavigation system

    International Nuclear Information System (INIS)

    Nakai, Hirofumi; Tanaka, Tatsuya; Hashizume, Kiyotaka; Hodozuka, Akira; Ono, Hidetoshi; Goto, Takumi; Aburano, Tamio

    2001-01-01

    The purpose of this minimally invasive study was to evaluate the efficacy of a neuronavigation system for surgery of lesions near Broca's area, skull base, or paracentral sulcus. With regards to paracentral sulcus lesions, precise localization of the precentral gyrus was evaluated not only with preoperative 3D images of the brain but also confirmed by the combination of fMRI and intraoperative SEP. Using the neuronavigation system, Viewing Wand (ISG Technologies), three-dimensional (3D) brain images were reconstructed by plotting cerebral sulcus and skull representations obtained by MRI and CT. Six patients with lesions near Broca's area, 5 patients with skull base lesions, and 9 patients with lesions near the central sulcus were analyzed. For paracentral sulcus lesions, patients underwent blood oxygen level-dependent fMRI while performing a finger-tapping motor paradigm, which was composed of repetition of rest-task every in 30 seconds for 150 seconds, in a 1.5-tesla echo-speed MR imager (Signa Horizon; General Electric Medical Systems, Milwaukee, WI). Statistical cross-correlation functional maps were generated and overlaid onto high-resolution anatomical MR images. Presurgical assessment of 3D reconstructed brain images were performed in all cases. They were analyzed in Broca's lesions, skull base lesions and paracentral sulcus lesions and were demonstrated to be useful for understanding the anatomical relationship between the lesions and the surrounding vital structures. In fMRI, motor activation sites were obtained on both ipsilateral and contralateral hemispheres in all patients except for one patient with a hemorrhagic cyst. Locations of precentral gyri were predicted preoperatively. In all patients except for one case, fMRI was obtained even in tumor patient in whom intraoperative SEP was technically not feasible due to severe cortical brain damage from the paracentral tumor. The precentral gyri identified by 3D reconstructed brain images coincided well

  5. IFSS: The IAEA's inspection field support system

    International Nuclear Information System (INIS)

    Muller, R.; Heinonen, O.J.; Schriefer, D.

    1990-01-01

    Recently, highly automated nuclear facilities with enormous volumes of nuclear material accounting data have come into operation. A few others will become operational shortly. Analysis and verification of the data for safeguards purposes is manageable only with improved computer support in the field. To assist its safeguards inspectors, the IAEA has developed the Inspection Field Support System (IFSS). It allows safeguards inspectors to collect, maintain, analyse, and evaluate inspection data on site at nuclear facilities. Previously, field computer support to safeguards inspectors concentrated on providing measurement instrumentation with data storage, but data analysis capabilities were elementary. Also, generic statistical tools were available to handle data that inspectors could (usually manually) input into a computer. Electronic links between these two directions were rudimentary. IFSS integrates the data required for verification and accounting so that inspectors will be able to devote more time to measurements and to derive conclusions at the site in a more timely manner. The system operates on stationary personal computers as well as on portable ones. Its introduction reflects the IAEA Department of Safeguards determination to further improve operational efficiency. It should be emphasized that IFSS implementation is still under development. Several field installations have been made to obtain practical experience and to determine the system's effectiveness

  6. A COMPUTERIZED OPERATOR SUPPORT SYSTEM PROTOTYPE

    Energy Technology Data Exchange (ETDEWEB)

    Thomas A. Ulrich; Roger Lew; Ronald L. Boring; Ken Thomas

    2015-03-01

    A computerized operator support system (COSS) is proposed for use in nuclear power plants to assist control room operators in addressing time-critical plant upsets. A COSS is a collection of technologies to assist operators in monitoring overall plant performance and making timely, informed decisions on appropriate control actions for the projected plant condition. A prototype COSS was developed in order to demonstrate the concept and provide a test bed for further research. The prototype is based on four underlying elements consisting of a digital alarm system, computer-based procedures, piping and instrumentation diagram system representations, and a recommender module for mitigation actions. The initial version of the prototype is now operational at the Idaho National Laboratory using the Human System Simulation Laboratory.

  7. A systematic review of online resources to support patient decision-making for full-thickness rectal prolapse surgery.

    Science.gov (United States)

    Fowler, G E; Baker, D M; Lee, M J; Brown, S R

    2017-11-01

    The internet is becoming an increasingly popular resource to support patient decision-making outside of the clinical encounter. The quality of online health information is variable and largely unregulated. The aim of this study was to assess the quality of online resources to support patient decision-making for full-thickness rectal prolapse surgery. This systematic review was registered on the PROSPERO database (CRD42017058319). Searches were performed on Google and specialist decision aid repositories using a pre-defined search strategy. Sources were analysed according to three measures: (1) their readability using the Flesch-Kincaid Reading Ease score, (2) DISCERN score and (3) International Patient Decision Aids Standards (IPDAS) minimum standards criteria score (IPDASi, v4.0). Overall, 95 sources were from Google and the specialist decision aid repositories. There were 53 duplicates removed, and 18 sources did not meet the pre-defined eligibility criteria, leaving 24 sources included in the full-text analysis. The mean Flesch-Kincaid Reading Ease score was higher than recommended for patient education materials (48.8 ± 15.6, range 25.2-85.3). Overall quality of sources supporting patient decision-making for full-thickness rectal prolapse surgery was poor (median DISCERN score 1/5 ± 1.18, range 1-5). No sources met minimum decision-making standards (median IPDASi score 5/12 ± 2.01, range 1-8). Currently, easily accessible online health information to support patient decision-making for rectal surgery is of poor quality, difficult to read and does not support shared decision-making. It is recommended that professional bodies and medical professionals seek to develop decision aids to support decision-making for full-thickness rectal prolapse surgery.

  8. Post Disaster Assessment with Decision Support System

    Directory of Open Access Journals (Sweden)

    May Florence J. Franco

    2016-05-01

    Full Text Available The study aimed to develop an online system that would expedite the response of agencies after disaster strikes; generate a list of the kinds and volume of relief aids needed per family affected for a fair, precise and timely distribution; implement community-based ICT by remotely gathering all the necessary data needed for disaster assessment; and adhere to ISO 9126 standards. The system was designed to calculate the effects of disaster in human lives and economy. Integrated into the system were Goggle Maps, Mines and GeoSciences Bureau Hazard Maps, SMS sending features, best passable routes calculations, and decision support on the needs that has to be addressed. The system was made live at pdrrmcguimaras.herokuapp.com to allow remote data entry. The functionality and usability of the system were evaluated by 19 potential users by computing for the arithmetic Mean and Standard Deviation of the survey. The result showed that most of them strongly agreed that the system is acceptable based on these criteria. A group of IT experts also evaluated the system’s conformance to ISO 9126 standards using the same method. The result showed that majority of them strongly agreed that the system conforms to this international standard. The system is seen as a valuable tool for the Provincial Disaster Risk Reduction Management Council (PDRRMC and the National Disaster Risk Reduction Management Council (NDRRMC for it could help expedite the assessment of the effects of disasters and the formulation of response plans and strategies.

  9. Full Scale 3D Preoperative Planning System of the Ankle Joint Replacement Surgery with Multimedia System

    Directory of Open Access Journals (Sweden)

    Shuh-Ping Sun

    2014-05-01

    Full Text Available This study is intended to develop a computer-aided pre-surgical planning and simulating system in a multimedia environment for ankle joint replacement surgery. This system uses full-scale 3D reverse engineering techniques in design and development of the pre-surgical planning modules for ankle joint replacement surgery. This planning system not only develops the real-scale 3D image of the artificial ankle joint but also provides a detailed interior measurement of the ankle joint from various cutting planes. In this study, we apply the multimedia user interface to integrate different software functions into a surgical planning system with integrated functions. The functions include 3D model image acquisition, cutting, horizontal shifting and rotation of related bones (tibia and talus of the ankle joint in the predetermined time. For related bones of the ankle joint, it can also be used to design artificial ankle joints for adults in Taiwan. Those planning procedures can be recorded in this system for further research and investigation. Furthermore, since this system is a multimedia user interface, surgeons can use this system to plan and find a better and more efficient surgical approach before surgery. A database is available for this system to update and expand, which can provide different users with clinical cases as per their experience and learning.

  10. 76 FR 71980 - SEDASYS Computer-Assisted Personalized Sedation System; Ethicon Endo-Surgery, Incorporated's...

    Science.gov (United States)

    2011-11-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-P-0176] SEDASYS Computer-Assisted Personalized Sedation System; Ethicon Endo-Surgery, Incorporated's Petition for... SEDASYS computer-assisted personalized sedation system (SEDASYS) submitted by Ethicon Endo-Surgery Inc...

  11. 76 FR 75887 - SEDASYS Computer-Assisted Personalized Sedation System; Ethicon Endo-Surgery, Incorporated's...

    Science.gov (United States)

    2011-12-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-P-0176] SEDASYS Computer-Assisted Personalized Sedation System; Ethicon Endo-Surgery, Incorporated's Petition for... system (SEDASYS) submitted by Ethicon Endo-Surgery Inc. (EES), the sponsor for SEDASYS. This meeting has...

  12. Virtual Surgery for the Nasal Airway: A Preliminary Report on Decision Support and Technology Acceptance.

    Science.gov (United States)

    Vanhille, Derek L; Garcia, Guilherme J M; Asan, Onur; Borojeni, Azadeh A T; Frank-Ito, Dennis O; Kimbell, Julia S; Pawar, Sachin S; Rhee, John S

    2018-01-01

    Nasal airway obstruction (NAO) is a common problem that affects patient quality of life. Surgical success for NAO correction is variable. Virtual surgery planning via computational fluid dynamics (CFD) has the potential to improve the success rates of NAO surgery. To elicit surgeon feedback of a virtual surgery planning tool for NAO and to determine if this tool affects surgeon decision making. For this cross-sectional study, 60-minute face-to-face interviews with board-certified otolaryngologists were conducted at a single academic otolaryngology department from September 16, 2016, through October 7, 2016. Virtual surgery methods were introduced, and surgeons were able to interact with the virtual surgery planning tool interface. Surgeons were provided with a patient case of NAO, and open feedback of the platform was obtained, with emphasis on surgical decision making. Likert scale responses and qualitative feedback were collected for the virtual surgery planning tool and its influence on surgeon decision making. Our 9 study participants were all male, board-certified otolaryngologists with a mean (range) 15 (4-28) number of years in practice and a mean (range) number of nasal surgeries per month at 2.2 (0.0-6.0). When examined on a scale of 1 (not at all) to 5 (completely), surgeon mean (SD) score was 3.4 (0.5) for how realistic the virtual models were compared with actual surgery. On the same scale, when asked how much the virtual surgery planning tool changed surgeon decision making, mean (SD) score was 2.6 (1.6). On a scale of 1 (strongly disagree) to 7 (strongly agree), surgeon scores for perceived usefulness of the technology and attitude toward using it were 5.1 (1.1) and 5.7 (0.9), respectively. Our study shows positive surgeon experience with a virtual surgery planning tool for NAO based on CFD simulations. Surgeons felt that future applications and areas of study of the virtual surgery planning tool include its potential role for patient counseling

  13. IGENPRO knowledge-based operator support system

    International Nuclear Information System (INIS)

    Morman, J. A.

    1998-01-01

    Research and development is being performed on the knowledge-based IGENPRO operator support package for plant transient diagnostics and management to provide operator assistance during off-normal plant transient conditions. A generic thermal-hydraulic (T-H) first-principles approach is being implemented using automated reasoning, artificial neural networks and fuzzy logic to produce a generic T-H system-independent/plant-independent package. The IGENPRO package has a modular structure composed of three modules: the transient trend analysis module PROTREN, the process diagnostics module PRODIAG and the process management module PROMANA. Cooperative research and development work has focused on the PRODIAG diagnostic module of the IGENPRO package and the operator training matrix of transients used at the Braidwood Pressurized Water Reactor station. Promising simulator testing results with PRODIAG have been obtained for the Braidwood Chemical and Volume Control System (CVCS), and the Component Cooling Water System. Initial CVCS test results have also been obtained for the PROTREN module. The PROMANA effort also involves the CVCS. Future work will be focused on the long-term, slow and mild degradation transients where diagnoses of incipient T-H component failure prior to forced outage events is required. This will enhance the capability of the IGENPRO system as a predictive maintenance tool for plant staff and operator support

  14. Hail Disrometer Array for Launch Systems Support

    Science.gov (United States)

    Lane, John E.; Sharp, David W.; Kasparis, Takis C.; Doesken, Nolan J.

    2008-01-01

    Prior to launch, the space shuttle might be described as a very large thermos bottle containing substantial quantities of cryogenic fuels. Because thermal insulation is a critical design requirement, the external wall of the launch vehicle fuel tank is covered with an insulating foam layer. This foam is fragile and can be damaged by very minor impacts, such as that from small- to medium-size hail, which may go unnoticed. In May 1999, hail damage to the top of the External Tank (ET) of STS-96 required a rollback from the launch pad to the Vehicle Assembly Building (VAB) for repair of the insulating foam. Because of the potential for hail damage to the ET while exposed to the weather, a vigilant hail sentry system using impact transducers was developed as a hail damage warning system and to record and quantify hail events. The Kennedy Space Center (KSC) Hail Monitor System, a joint effort of the NASA and University Affiliated Spaceport Technology Development Contract (USTDC) Physics Labs, was first deployed for operational testing in the fall of 2006. Volunteers from the Community Collaborative Rain. Hail, and Snow Network (CoCoRaHS) in conjunction with Colorado State University were and continue to be active in testing duplicate hail monitor systems at sites in the hail prone high plains of Colorado. The KSC Hail Monitor System (HMS), consisting of three stations positioned approximately 500 ft from the launch pad and forming an approximate equilateral triangle (see Figure 1), was deployed to Pad 39B for support of STS-115. Two months later, the HMS was deployed to Pad 39A for support of STS-116. During support of STS-117 in late February 2007, an unusual hail event occurred in the immediate vicinity of the exposed space shuttle and launch pad. Hail data of this event was collected by the HMS and analyzed. Support of STS-118 revealed another important application of the hail monitor system. Ground Instrumentation personnel check the hail monitors daily when a

  15. Profitability analysis of a femtosecond laser system for cataract surgery using a fuzzy logic approach.

    Science.gov (United States)

    Trigueros, José Antonio; Piñero, David P; Ismail, Mahmoud M

    2016-01-01

    To define the financial and management conditions required to introduce a femtosecond laser system for cataract surgery in a clinic using a fuzzy logic approach. In the simulation performed in the current study, the costs associated to the acquisition and use of a commercially available femtosecond laser platform for cataract surgery (VICTUS, TECHNOLAS Perfect Vision GmbH, Bausch & Lomb, Munich, Germany) during a period of 5y were considered. A sensitivity analysis was performed considering such costs and the countable amortization of the system during this 5y period. Furthermore, a fuzzy logic analysis was used to obtain an estimation of the money income associated to each femtosecond laser-assisted cataract surgery (G). According to the sensitivity analysis, the femtosecond laser system under evaluation can be profitable if 1400 cataract surgeries are performed per year and if each surgery can be invoiced more than $500. In contrast, the fuzzy logic analysis confirmed that the patient had to pay more per surgery, between $661.8 and $667.4 per surgery, without considering the cost of the intraocular lens (IOL). A profitability of femtosecond laser systems for cataract surgery can be obtained after a detailed financial analysis, especially in those centers with large volumes of patients. The cost of the surgery for patients should be adapted to the real flow of patients with the ability of paying a reasonable range of cost.

  16. Reactive Software Agent Anesthesia Decision Support System

    Directory of Open Access Journals (Sweden)

    Grant H. Kruger

    2011-12-01

    Full Text Available Information overload of the anesthesiologist through technological advances have threatened the safety of patients under anesthesia in the operating room (OR. Traditional monitoring and alarm systems provide independent, spatially distributed indices of patient physiological state. This creates the potential to distract caregivers from direct patient care tasks. To address this situation, a novel reactive agent decision support system with graphical human machine interface was developed. The system integrates the disparate data sources available in the operating room, passes the data though a decision matrix comprising a deterministic physiologic rule base established through medical research. Patient care is improved by effecting change to the care environment by displaying risk factors and alerts as an intuitive color coded animation. The system presents a unified, contextually appropriate snapshot of the patient state including current and potential risk factors, and alerts of critical patient events to the operating room team without requiring any user intervention. To validate the efficacy of the system, a retrospective analysis focusing on the hypotension rules were performed. Results show that even with vigilant and highly trained clinicians, deviations from ideal patient care exist and it is here that the proposed system may allow more standardized and improved patient care and potentially outcomes.

  17. The university münster model surgery system for orthognathic surgery. Part II – KD-MMS

    Directory of Open Access Journals (Sweden)

    Ehmer Ulrike

    2013-01-01

    Full Text Available Abstract Background Model surgery is an integral part of the planning procedure in orthognathic surgery. Most concepts comprise cutting the dental cast off its socket. The standardized spacer plates of the KD-MMS provide for a non-destructive, reversible and reproducible means of maxillary and/or mandibular plaster cast separation. Methods In the course of development of the system various articulator types were evaluated with regard to their capability to provide a means of realizing the concepts comprised of the KD-MMS. Special attention was dedicated to the ability to perform three-dimensional displacements without cutting of plaster casts. Various utilities were developed to facilitate maxillary displacement in accordance to the planning. Objectives of this development comprised the ability to implement the values established in the course of two-dimensional ceph planning. Results The system - KD-MMS comprises a set of hardware components as well as a defined procedure. Essential hardware components are red spacer and blue mounting plates. The blue mounting plates replace the standard yellow SAM mounting elements. The red spacers provide for a defined leeway of 8 mm for three-dimensional movements. The non-destructive approach of the KD-MMS makes it possible to conduct different model surgeries with the same plaster casts as well as to restore the initial, pre-surgical situation at any time. Thereby, surgical protocol generation and gnathologic splint construction are facilitated. Conclusions The KD-MMS hardware components in conjunction with the defined procedures are capable of increasing efficiency and accuracy of model surgery and splint construction. In cases where different surgical approaches need to be evaluated in the course of model surgery, a significant reduction of chair time may be achieved.

  18. Orthognathic positioning system: intraoperative system to transfer virtual surgical plan to operating field during orthognathic surgery.

    Science.gov (United States)

    Polley, John W; Figueroa, Alvaro A

    2013-05-01

    To introduce the concept and use of an occlusal-based "orthognathic positioning system" (OPS) to be used during orthognathic surgery. The OPS consists of intraoperative occlusal-based devices that transfer virtual surgical planning to the operating field for repositioning of the osteotomized dentoskeletal segments. The system uses detachable guides connected to an occlusal splint. An initial drilling guide is used to establish stable references or landmarks. These are drilled on the bone that will not be repositioned adjacent to the osteotomy line. After mobilization of the skeletal segment, a final positioning guide, referenced to the drilled landmarks, is used to transfer the skeletal segment according to the virtual surgical planning. The OPS is digitally designed using 3-dimensional computer-aided design/computer-aided manufacturing technology and manufactured with stereolithographic techniques. Virtual surgical planning has improved the preoperative assessment and, in conjunction with the OPS, the execution of orthognathic surgery. The OPS has the possibility to eliminate the inaccuracies commonly associated with traditional orthognathic surgery planning and to simplify the execution by eliminating surgical steps such as intraoperative measuring, determining the condylar position, the use of bulky intermediate splints, and the use of intermaxillary wire fixation. The OPS attempts precise translation of the virtual plan to the operating field, bridging the gap between virtual and actual surgery. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  19. [RESEARCH PROGRESS OF PERIPHERAL NERVE SURGERY ASSISTED BY Da Vinci ROBOTIC SYSTEM].

    Science.gov (United States)

    Shen, Jie; Song, Diyu; Wang, Xiaoyu; Wang, Changjiang; Zhang, Shuming

    2016-02-01

    To summarize the research progress of peripheral nerve surgery assisted by Da Vinci robotic system. The recent domestic and international articles about peripheral nerve surgery assisted by Da Vinci robotic system were reviewed and summarized. Compared with conventional microsurgery, peripheral nerve surgery assisted by Da Vinci robotic system has distinctive advantages, such as elimination of physiological tremors and three-dimensional high-resolution vision. It is possible to perform robot assisted limb nerve surgery using either the traditional brachial plexus approach or the mini-invasive approach. The development of Da Vinci robotic system has revealed new perspectives in peripheral nerve surgery. But it has still been at the initial stage, more basic and clinical researches are still needed.

  20. The Needs of Hybrid Systems Configuration for Real - Time Decision - Making Process in Surgery

    National Research Council Canada - National Science Library

    Tritto, G

    2001-01-01

    ...: sensors, actuators, mechatronic systems and tools in Minimally Invasive Surgery (MIS) and Microsurgery require nonlinear interpretation and control systems to interface with the computer-assisted decision making process of the surgeon at work...

  1. System of Consciousness Contextual as Learning Support

    Directory of Open Access Journals (Sweden)

    Jorge Eliseo Gómez Gómez

    2016-08-01

    Full Text Available With the inclusion of ubiquitous computing in education, it is intended that the student is an active agent in its formation process and interacts with its context. This paper presents the design and implementation of architecture for ubiquitous learning environments in which they integrate physical spaces with applications which are then executed by users. The system supports objects augmented with RFID tags, NFC and QR Code. Each tag contains data that uniquely identifies the resource. To validate the proposed architecture is developed experimentally tested a prototype at the end of it is done to verify that the proposed architecture improves the academic performance of students.

  2. DECISION SUPPORT SYSTEM TO SUPPORT DECISION PROCESSES WITH DATA MINING

    OpenAIRE

    Rupnik, Rok; Kukar, Matjaž

    2007-01-01

    Traditional techniques of data analysis do not enable the solution of all kind of problems and for that reason they have become insufficient. This caused a newinterdisciplinary field of data mining to arise, encompassing both classical statistical, and modern machine learning techniques to support the data analysis and knowledge discovery from data. Data mining methods are powerful in dealing with large quantities of data, but on the other hand they are difficult to master by business users t...

  3. Intelligence system for reactor operator informational support

    International Nuclear Information System (INIS)

    Prangishvili, I.V.; Pashchenko, F.F.; Saprykin, E.M.

    1989-01-01

    Problems related to creation and introduction at NPP of highly efficient and reliable systems for monitoring and control of working processes and intelligence-endowed systems of operator informational support (ISOIS) are considered. The main units included in ISOIS are considered. The main units included in ISOIS are described. The unit of current state monitoring provides information for the operator, which is necessary under concrete conditions for the process monitoring and control, so as to avoid emergencies and affers a program of actions in a dialogue mode for the operator. The identification unit is designed for the obtaining of assessed values of process parameters (neutron fields, temperatures, pressures) and basic equipment (reactivity coefficients, fuel rod weights, time of delay). The prediction unit evaluates the behaviour of process parameters and process state in various situations. 9 refs

  4. Semantic technologies in a decision support system

    Science.gov (United States)

    Wasielewska, K.; Ganzha, M.; Paprzycki, M.; Bǎdicǎ, C.; Ivanovic, M.; Lirkov, I.

    2015-10-01

    The aim of our work is to design a decision support system based on ontological representation of domain(s) and semantic technologies. Specifically, we consider the case when Grid / Cloud user describes his/her requirements regarding a "resource" as a class expression from an ontology, while the instances of (the same) ontology represent available resources. The goal is to help the user to find the best option with respect to his/her requirements, while remembering that user's knowledge may be "limited." In this context, we discuss multiple approaches based on semantic data processing, which involve different "forms" of user interaction with the system. Specifically, we consider: (a) ontological matchmaking based on SPARQL queries and class expression, (b) graph-based semantic closeness of instances representing user requirements (constructed from the class expression) and available resources, and (c) multicriterial analysis based on the AHP method, which utilizes expert domain knowledge (also ontologically represented).

  5. THE DECISION SUPPORT SYSTEM IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Ana V.Monica POP

    2013-10-01

    Full Text Available In the present paper we will try to analyze the Decision Support System (DSS and the way in which it is applied or not in the Romanian Small and Medium Sized Enterprises (SMEs (with examples. We also will see if the system is beneficial for these Romanian Enterprises. We analyzed through interviews 50 small and medium-sized Romanian enterprises. They do not accept their name to be published. As a consequence, we will present only the results. It is underlined in the conclusions the differences between the small and the medium size enterprises in respect of the models they are using. The most important benefits of DSS (generally are represented by increased efficiency, competitive advantages and better managerial process.

  6. Licensing Support System: Preliminary data scope analysis

    International Nuclear Information System (INIS)

    1989-01-01

    The purpose of this analysis is to determine the content and scope of the Licensing Support System (LSS) data base. Both user needs and currently available data bases that, at least in part, address those needs have been analyzed. This analysis, together with the Preliminary Needs Analysis (DOE, 1988d) is a first effort under the LSS Design and Implementation Contract toward developing a sound requirements foundation for subsequent design work. These reports are preliminary. Further refinements must be made before requirements can be specified in sufficient detail to provide a basis for suitably specific system specifications. This document provides a baseline for what is known at this time. Additional analyses, currently being conducted, will provide more precise information on the content and scope of the LSS data base. 23 refs., 4 figs., 8 tabs

  7. Development and validation of a tool for non-technical skills evaluation in robotic surgery-the ICARS system.

    Science.gov (United States)

    Raison, Nicholas; Wood, Thomas; Brunckhorst, Oliver; Abe, Takashige; Ross, Talisa; Challacombe, Ben; Khan, Mohammed Shamim; Novara, Giacomo; Buffi, Nicolo; Van Der Poel, Henk; McIlhenny, Craig; Dasgupta, Prokar; Ahmed, Kamran

    2017-12-01

    Non-technical skills (NTS) are being increasingly recognised as vital for safe surgical practice. Numerous NTS rating systems have been developed to support effective training and assessment. Yet despite the additional challenges posed by robotic surgery, no NTS rating systems have been developed for this unique surgical environment. This study reports the development and validation of the first NTS behavioural rating system for robotic surgery. A comprehensive index of all relevant NTS behaviours in robotic surgery was developed through observation of robotic theatre and interviews with robotic surgeons. Using a Delphi methodology, a panel of 16 expert surgeons was consulted to identify behaviours important to NTS assessment. These behaviours were organised into an appropriate assessment template. Experts were consulted on the feasibility, applicability and educational impact of ICARS. An observational trial was used to validate ICARS. 73 novice, intermediate and expert robotic surgeons completed a urethrovesical anastomosis within a simulated operating room. NTS were tested using four scripted scenarios of increasing difficulty. Performances were video recorded. Robotic and NTS experts assessed the videos post hoc using ICARS and the standard behavioural rating system, NOn-Technical Skills for Surgeons (NOTSS). 28 key non-technical behaviours were identified by the expert panel. The finalised behavioural rating system was organised into four principle domains and seven categories. Expert opinion strongly supported its implementation. ICARS was found to be equivalent to NOTSS on Bland-Altman analysis and accurately differentiated between novice, intermediate and expert participants, p = 0.01. Moderate agreement was found between raters, Krippendorff's alpha = 0.4. The internal structure of ICARS was shown to be consistent and reliable (median Cronbach alpha = 0.92, range 0.85-0.94). ICARS is the first NTS behavioural rating system developed for robotic

  8. Infrastructure to Support Hydrologic Research: Information Systems

    Science.gov (United States)

    Lall, U.; Duffy, C j

    2001-12-01

    Hydrologic Sciences are inherently interdisciplinary. Consequently, a myriad state variables are of interest to hydrologists. Hydrologic processes transcend many spatial and temporal scales, and their measurements reflect a variety of scales of support. The global water cycle is continuously modified by human activity through changes in land use, alteration of rivers, irrigation and groundwater pumping and through a modification of atmospheric composition. Since water is a solvent and a medium of transport, the water cycle fundamentally influences other material and energy cycles. This metaphor extends to the function that a hydrologic research information system needs to provide, to facilitate discovery in earth systems science, and to improve our capability to manage resources and hazards in a sustainable manner. At present, we have a variety of sources that provide data useful for hydrologic analyses, that range from massive remote sensed data sets, to sparsely sampled historical and paleo data. Consequently, the first objective of the Hydrologic Information Systems (HIS) group is to design a data services system that makes these data accessible in a uniform and useful way for specific, prioritized research goals. The design will include protocols for archiving and disseminating data from the Long Term Hydrologic Observatories (LTHOs), and comprehensive modeling experiments. Hydrology has a rich tradition of mathematical and statistical modeling of processes. However, given limited data and access to it, and a narrow focus that has not exploited connections to climatic and ecologic processes (among others), there have been only a few forays into diagnostic analyses of hydrologic fields, to identify and evaluate spatial and process teleconnections and an appropriate reduced space for modeling and understanding systems. The HIS initiative consequently proposes an investment in research and the provision of toolboxes to facilitate such analyses using the data

  9. Complexity in electronic negotiation support systems.

    Science.gov (United States)

    Griessmair, Michele; Strunk, Guido; Vetschera, Rudolf; Koeszegi, Sabine T

    2011-10-01

    It is generally acknowledged that the medium influences the way we communicate and negotiation research directs considerable attention to the impact of different electronic communication modes on the negotiation process and outcomes. Complexity theories offer models and methods that allow the investigation of how pattern and temporal sequences unfold over time in negotiation interactions. By focusing on the dynamic and interactive quality of negotiations as well as the information, choice, and uncertainty contained in the negotiation process, the complexity perspective addresses several issues of central interest in classical negotiation research. In the present study we compare the complexity of the negotiation communication process among synchronous and asynchronous negotiations (IM vs. e-mail) as well as an electronic negotiation support system including a decision support system (DSS). For this purpose, transcripts of 145 negotiations have been coded and analyzed with the Shannon entropy and the grammar complexity. Our results show that negotiating asynchronically via e-mail as well as including a DSS significantly reduces the complexity of the negotiation process. Furthermore, a reduction of the complexity increases the probability of reaching an agreement.

  10. A distributed clinical decision support system architecture

    Directory of Open Access Journals (Sweden)

    Shaker H. El-Sappagh

    2014-01-01

    Full Text Available This paper proposes an open and distributed clinical decision support system architecture. This technical architecture takes advantage of Electronic Health Record (EHR, data mining techniques, clinical databases, domain expert knowledge bases, available technologies and standards to provide decision-making support for healthcare professionals. The architecture will work extremely well in distributed EHR environments in which each hospital has its own local EHR, and it satisfies the compatibility, interoperability and scalability objectives of an EHR. The system will also have a set of distributed knowledge bases. Each knowledge base will be specialized in a specific domain (i.e., heart disease, and the model achieves cooperation, integration and interoperability between these knowledge bases. Moreover, the model ensures that all knowledge bases are up-to-date by connecting data mining engines to each local knowledge base. These data mining engines continuously mine EHR databases to extract the most recent knowledge, to standardize it and to add it to the knowledge bases. This framework is expected to improve the quality of healthcare, reducing medical errors and guaranteeing the safety of patients by helping clinicians to make correct, accurate, knowledgeable and timely decisions.

  11. Cognitive System Engineering Approach to Design of Work Support Systems

    DEFF Research Database (Denmark)

    Rasmussen, Jens

    1995-01-01

    The problem of designing work support systems for flexible, dynamic work environments is discussed and a framework for analysis of work in terms of behavior shaping constraints is described. The application of 'ecological interfaces' presenting to the user a map of the relational structure...... of the work space is advocated from the thesis that a map is a better guidance of discretionary tasks than is a route instruction. For the same reason, support of system design is proposed in terms of maps of the design territory, rather than in terms of guidelines....

  12. Computer control versus manual control of systemic hypertension during cardiac surgery

    NARCIS (Netherlands)

    Hoeksel, S.A.A.P.; Blom, J.A.; Jansen, J.R.C.; Maessen, J.G.; Schreuder, J.J.

    2001-01-01

    Keywords:Cardiac surgery;hypertension;closed-loop controlBackground: We recently demonstrated the feasibility of computer controlled infusion of vasoactive drugs for the control of systemic hypertension during cardiac surgery. The objective of the current study was to investigate the effects of

  13. Creation of closed life support systems

    Science.gov (United States)

    Gitelson, I.

    The 40-year-long experience in devising ecological systems with a significantly closed material cycling (CES), which are intended for human life support outside the Earth's biosphere, allows us to state that this problem has been largely solved technically. To test the terrestrial prototypes of these systems: Bios in Krasnoyarsk, the Terrestrial Ecological System (TES) in Moscow, and Bioplex in Houston, crews of humans stayed inside them over long periods of time. In Bios-3 humans could be fully (100%) provided with regenerated air and water and with a vegetable part (80%) of their diet. One human requires 4.5 kW of light energy, which is equal to the light energy incident on an 8-m2 surface perpendicular to solar rays in the Earth's orbit. The regeneration of air and water can be alternatively performed by a 17-L2 microalgal cultivator with a light-receiving surface of 8 m at 2 kW of light energy or by a conveyer culture of agricultural plants. To regenerate the vegetable part of2 the diet to the full, the area must increase to 31.5 m per person. Similar values have been obtained in the TES and in Bioplex. It can be concluded that the system is ready to be implemented in the engineering-technical designs of specific versions: for orbital flights, for missions to Mars and other planets, and for stations on the Moon and Mars. To improve the CES further, a number of new key problems should be resolved. The first of them are: to robotize the technological processes and to establish an optimized system of the internal control of the CES by the crew working in it; to develop a hybrid physicochemical-biological technology for returning the dead-end products of biosynthesis into the system's cycling; to solve the fundamental problem of regenerating the human ration completely inside the CES by the autotrophic chemo - and photosynthesis. Once this problem is solved, the energy requirements for life support in space will be significantly reduced. This will also considerably

  14. MOODLE – COMPUTERIZED DISTANT LEARNING SUPPORT SYSTEM

    Directory of Open Access Journals (Sweden)

    V. A. Tunda

    2014-01-01

    Full Text Available Moodle (Modular Object-Oriented Dynamic Learning Environment is the system developed by the English-speaking community around the world for more than 10 years, supports both, offline and online training. In most cases, Moodle is used to support and connect learning face-to-face with online training, as well as with other types of learning. Moodle allows you to ask all sorts of questions and assess responses in a variety of ways. The central concept of Moodle is a course in which one or more teachers offer students resources (such as files, folders, Web pages and participate in interactive activities (such as forums, wikis, blogging, lessons, seminars, assignments, examinations. Students and teachers can change roles, mutually assess each other, share knowledge on the topics of study in the glossary and database system.In the English-speaking world, there are public sites with detailed documentation on Moodle, which is constantly verified and modified in accordance with emerging new versions of the system; Russian versions do not have public sites with detailed translation of the English-language documentation. On what and to whom you want to perform actions in the daily practice of the modern versions, only the barest of outlines on paid seminars and presentations to those who started the implementation of Moodle in your organization are given. And this despite the fact that the system has a great variety of Moodle (over 500 settings with different levels of functionality to be performed, to maintain and develop specially organized by the team of specialists. The question is not only about creating a training course in Moodle. It's about maintaining the health of the system within the institution, such as a University. Under the "health maintenance" means: availability and preservation of up-to-date documentation on system and manuals on Moodle separately for administrators, managers, teachers and students at their level, training consultants

  15. NASA Advanced Explorations Systems: Advancements in Life Support Systems

    Science.gov (United States)

    Shull, Sarah A.; Schneider, Walter F.

    2016-01-01

    The NASA Advanced Exploration Systems (AES) Life Support Systems (LSS) project strives to develop reliable, energy-efficient, and low-mass spacecraft systems to provide environmental control and life support systems (ECLSS) critical to enabling long duration human missions beyond low Earth orbit (LEO). Highly reliable, closed-loop life support systems are among the capabilities required for the longer duration human space exploration missions assessed by NASA's Habitability Architecture Team (HAT). The LSS project is focused on four areas: architecture and systems engineering for life support systems, environmental monitoring, air revitalization, and wastewater processing and water management. Starting with the international space station (ISS) LSS systems as a point of departure (where applicable), the mission of the LSS project is three-fold: 1. Address discrete LSS technology gaps 2. Improve the reliability of LSS systems 3. Advance LSS systems towards integrated testing on the ISS. This paper summarized the work being done in the four areas listed above to meet these objectives. Details will be given on the following focus areas: Systems Engineering and Architecture- With so many complex systems comprising life support in space, it is important to understand the overall system requirements to define life support system architectures for different space mission classes, ensure that all the components integrate well together and verify that testing is as representative of destination environments as possible. Environmental Monitoring- In an enclosed spacecraft that is constantly operating complex machinery for its own basic functionality as well as science experiments and technology demonstrations, it's possible for the environment to become compromised. While current environmental monitors aboard the ISS will alert crew members and mission control if there is an emergency, long-duration environmental monitoring cannot be done in-orbit as current methodologies

  16. Safety implications of electronic driving support systems : an orientation.

    OpenAIRE

    Gundy, C.M. Steyvers, F.J.J.M. & Kaptein, N.A.

    1995-01-01

    This report focuses on traffic safety aspects of driving support systems. The report consists of two parts. First of all, the report discusses a number of topics, relevant for the implementation and evaluation of driving support systems. These topics include: (1) safety research into driving support systems: (2) the importance of research into driver models and the driving task; (3) horizontal integration of driving support systems; (4) vertical integration of driving support systems; (5) tas...

  17. Development of an online information and support resource for adolescent idiopathic scoliosis patients considering surgery: perspectives of health care providers.

    Science.gov (United States)

    Macculloch, Radha; Nyhof-Young, Joyce; Nicholas, David; Donaldson, Sandra; Wright, James G

    2010-06-29

    Adolescents with idiopathic scoliosis who are considering spinal surgery face a major decision that requires access to in-depth information and support. Unfortunately, most online resources provide incomplete and inconsistent information and minimal social support. The aim of this study was to develop an online information and support resource for adolescent idiopathic scoliosis (AIS) patients considering spinal surgery. Prior to website development, a user-based needs assessment was conducted. The needs assessment involved a total of six focus groups with three stakeholder groups: (1) post-operative AIS patients or surgical candidates (10-18 years) (n = 11), (2) their parents (n = 6) and (3) health care providers (n = 11). This paper reports on the findings from focus groups with health care providers. Focus group methodology was used to invite a range of perspectives and stimulate discussion. During audio-recorded focus groups, an emergent table of website content was presented to participants for assessment of relevance, viability and comprehensiveness in targeting global domains of need. Specifically, effective presentation of content, desired aspects of information and support, and discussions about the value of peer support and the role of health professionals were addressed. Focus group transcripts were then subject to content analysis through a constant comparative review and analysis. Two focus groups were held with health care providers, consisting of 5 and 6 members respectively. Clinicians provided their perceptions of the information and support needs of surgical patients and their families and how this information and support should be delivered using internet technology. Health care providers proposed four key suggestions to consider in the development of this online resource: (1) create the website with the target audience in mind; (2) clearly state the purpose of the website and organize website content to support the user; (3) offer a

  18. Embedded systems for supporting computer accessibility.

    Science.gov (United States)

    Mulfari, Davide; Celesti, Antonio; Fazio, Maria; Villari, Massimo; Puliafito, Antonio

    2015-01-01

    Nowadays, customized AT software solutions allow their users to interact with various kinds of computer systems. Such tools are generally available on personal devices (e.g., smartphones, laptops and so on) commonly used by a person with a disability. In this paper, we investigate a way of using the aforementioned AT equipments in order to access many different devices without assistive preferences. The solution takes advantage of open source hardware and its core component consists of an affordable Linux embedded system: it grabs data coming from the assistive software, which runs on the user's personal device, then, after processing, it generates native keyboard and mouse HID commands for the target computing device controlled by the end user. This process supports any operating system available on the target machine and it requires no specialized software installation; therefore the user with a disability can rely on a single assistive tool to control a wide range of computing platforms, including conventional computers and many kinds of mobile devices, which receive input commands through the USB HID protocol.

  19. Modular robotic system for forensic investigation support

    Science.gov (United States)

    Kowalski, Grzegorz; Główka, Jakub; Maciaś, Mateusz; Puchalski, Sławomir

    2017-10-01

    Forensic investigation on the crime scene is an activity that requires not only knowledge about the ways of searching for evidence, collecting and processing them. In some cases the area of operation might not be properly secured and poses threat to human health or life. Some devices or materials may be left intentionally or not to injure potential investigators. Besides conventional explosives, threats can be in form of CBRN materials, which have not only immediate effect on the exposed personnel, but can contaminate further people, when being transferred for example on clothes or unsecured equipment. In this case a risk evaluation should be performed, that can lead to conclusions that it is too dangerous for investigators to work. In that kind of situation remote devices, which are able to examine the crime scene and secure samples, can be used. In the course of R&D activities PIAP developed a system, which is based on small UGV capable of carrying out inspection of suspicious places and securing evidence, when needed. The system consists of remotely controlled mobile robot, its control console and a set of various inspection and support tools, that enable detection of CBRN threats as well as revelation, documentation and securing of the evidence. This paper will present main features of the system, like mission adjustment possibilities and communication aspects, and also examples of the forensic accessories.

  20. Supporting Space Systems Design via Systems Dependency Analysis Methodology

    Science.gov (United States)

    Guariniello, Cesare

    assess the behavior of each system based on its internal status and on the topology of its dependencies on systems connected to it. Designers and decision makers can therefore quickly analyze and explore the behavior of complex systems and evaluate different architectures under various working conditions. The methods support educated decision making both in the design and in the update process of systems architecture, reducing the need to execute extensive simulations. In particular, in the phase of concept generation and selection, the information given by the methods can be used to identify promising architectures to be further tested and improved, while discarding architectures that do not show the required level of global features. The methods, when used in conjunction with appropriate metrics, also allow for improved reliability and risk analysis, as well as for automatic scheduling and re-scheduling based on the features of the dependencies and on the accepted level of risk. This dissertation illustrates the use of the two methods in sample aerospace applications, both in the operational and in the developmental domain. The applications show how to use the developed methodology to evaluate the impact of failures, assess the criticality of systems, quantify metrics of interest, quantify the impact of delays, support informed decision making when scheduling the development of systems and evaluate the achievement of partial capabilities. A larger, well-framed case study illustrates how the Systems Operational Dependency Analysis method and the Systems Developmental Dependency Analysis method can support analysis and decision making, at the mid and high level, in the design process of architectures for the exploration of Mars. The case study also shows how the methods do not replace the classical systems engineering methodologies, but support and improve them.

  1. Towards a generic user support system (GUS)

    International Nuclear Information System (INIS)

    Garland, W.J.; Wilson, R.J.

    1993-01-01

    One relevant issue confronting the operator of a nuclear power plant is information and task overload. The goal, then, of the various developers is to improve the current situations by creating an environment where the operator can perform at optimum capacity. This is to be accomplished by providing tools and techniques which reduce operator involvement in low level tasks (freeing up time for higher level cognitive tasks) and assist in information and knowledge manipulation so that high level tasks can be performed more efficiently. This paper reviews the operational environment of nuclear plants from the viewpoint of engineering design and from the viewpoint of the operators and technical support staff. Principles are advanced for a generic operator companion. These design principles are being applied to a test case: the Point Lepreau NGS secondary side central sampling system. 6 refs., 6 figs

  2. An Isolator System for minimally invasive surgery : The new design

    NARCIS (Netherlands)

    Horeman, T.; Jansen, F.W.; Dankelman, J.

    2010-01-01

    Background - The risk of obtaining a postsurgical infection depends highly on the air quality surrounding the exposed tissue, surgical instruments, and materials. Many isolators for open surgery have been invented to create a contained sterile volume around the exposed tissue. With the use of an

  3. Database system selection for marketing strategies support in information systems

    Directory of Open Access Journals (Sweden)

    František Dařena

    2007-01-01

    Full Text Available In today’s dynamically changing environment marketing has a significant role. Creating successful marketing strategies requires large amount of high quality information of various kinds and data types. A powerful database management system is a necessary condition for marketing strategies creation support. The paper briefly describes the field of marketing strategies and specifies the features that should be provided by database systems in connection with these strategies support. Major commercial (Oracle, DB2, MS SQL, Sybase and open-source (PostgreSQL, MySQL, Firebird databases are than examined from the point of view of accordance with these characteristics and their comparison in made. The results are useful for making the decision before acquisition of a database system during information system’s hardware architecture specification.

  4. Defense Contract Management Command Support to System Acquisition Program Managers

    National Research Council Canada - National Science Library

    1999-01-01

    .... This report discusses the planning of contract administration office support to system acquisition program managers through the program integration process and the customer support outreach program...

  5. Follow the light: projector-based augmented reality intracorporeal system for laparoscopic surgery.

    Science.gov (United States)

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

    2018-04-01

    A projector-based augmented reality intracorporeal system (PARIS) is presented that includes a miniature tracked projector, tracked marker, and laparoscopic ultrasound (LUS) transducer. PARIS was developed to improve the efficacy and safety of laparoscopic partial nephrectomy (LPN). In particular, it has been demonstrated to effectively assist in the identification of tumor boundaries during surgery and to improve the surgeon's understanding of the underlying anatomy. PARIS achieves this by displaying the orthographic projection of the cancerous tumor on the kidney's surface. The performance of PARIS was evaluated in a user study with two surgeons who performed 32 simulated robot-assisted partial nephrectomies. They performed 16 simulated partial nephrectomies with PARIS for guidance and 16 simulated partial nephrectomies with only an LUS transducer for guidance. With PARIS, there was a significant reduction [30% ([Formula: see text])] in the amount of healthy tissue excised and a trend toward a more accurate dissection around the tumor and more negative margins. The combined point tracking and reprojection root-mean-square error of PARIS was 0.8 mm. PARIS' proven ability to improve key metrics of LPN surgery and qualitative feedback from surgeons about PARIS supports the hypothesis that it is an effective surgical navigation tool.

  6. A Support Database System for Integrated System Health Management (ISHM)

    Science.gov (United States)

    Schmalzel, John; Figueroa, Jorge F.; Turowski, Mark; Morris, John

    2007-01-01

    The development, deployment, operation and maintenance of Integrated Systems Health Management (ISHM) applications require the storage and processing of tremendous amounts of low-level data. This data must be shared in a secure and cost-effective manner between developers, and processed within several heterogeneous architectures. Modern database technology allows this data to be organized efficiently, while ensuring the integrity and security of the data. The extensibility and interoperability of the current database technologies also allows for the creation of an associated support database system. A support database system provides additional capabilities by building applications on top of the database structure. These applications can then be used to support the various technologies in an ISHM architecture. This presentation and paper propose a detailed structure and application description for a support database system, called the Health Assessment Database System (HADS). The HADS provides a shared context for organizing and distributing data as well as a definition of the applications that provide the required data-driven support to ISHM. This approach provides another powerful tool for ISHM developers, while also enabling novel functionality. This functionality includes: automated firmware updating and deployment, algorithm development assistance and electronic datasheet generation. The architecture for the HADS has been developed as part of the ISHM toolset at Stennis Space Center for rocket engine testing. A detailed implementation has begun for the Methane Thruster Testbed Project (MTTP) in order to assist in developing health assessment and anomaly detection algorithms for ISHM. The structure of this implementation is shown in Figure 1. The database structure consists of three primary components: the system hierarchy model, the historical data archive and the firmware codebase. The system hierarchy model replicates the physical relationships between

  7. Resection of Gliomas with and without Neuropsychological Support during Awake Craniotomy—Effects on Surgery and Clinical Outcome

    Directory of Open Access Journals (Sweden)

    Anna Kelm

    2017-08-01

    Full Text Available BackgroundDuring awake craniotomy for tumor resection, a neuropsychologist (NP is regarded as a highly valuable partner for neurosurgeons. However, some centers do not routinely involve an NP, and data to support the high influence of the NP on the perioperative course of patients are mostly lacking.ObjectiveThe aim of this study was to investigate whether there is a difference in clinical outcomes between patients who underwent awake craniotomy with and without the attendance of an NP.MethodsOur analysis included 61 patients, all operated on for resection of a presumably language-eloquent glioma during an awake procedure. Of these 61 cases, 47 surgeries were done with neuropsychological support (NP group, whereas 14 surgeries were performed without an NP (non-NP group due to a language barrier between the NP and the patient. For these patients, neuropsychological assessment was provided by a bilingual resident.ResultsBoth groups were highly comparable regarding age, gender, preoperative language function, and tumor grades (glioma WHO grades 1–4. Gross total resection (GTR was achieved more frequently in the NP group (NP vs. non-NP: 61.7 vs. 28.6%, P = 0.04, which also had shorter durations of surgery (NP vs. non-NP: 240.7 ± 45.7 vs. 286.6 ± 54.8 min, P < 0.01. Furthermore, the rate of unexpected tumor residuals (estimation of the intraoperative extent of resection vs. postoperative imaging was lower in the NP group (NP vs. non-NP: 19.1 vs. 42.9%, P = 0.09, but no difference was observed in terms of permanent surgery-related language deterioration (NP vs. non-NP: 6.4 vs. 14.3%, P = 0.48.ConclusionWe need professional neuropsychological evaluation during awake craniotomies for removal of presumably language-eloquent gliomas. Although these procedures are routinely carried out with an NP, this is one of the first studies to provide data supporting the NP’s crucial role. Despite the small group size, our study shows

  8. Marketing analysis support system; Marketing bunseki shien system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-01-10

    Fuji Electric Co., Ltd., in collaboration with Shitashion Japan and Arthur Andersen Ltd., developed a 'marketing analysis support system' which integrally analyzes evaluation factors of various dimensions explaining consumers' purchasing behaviors and which supports business for the efficient operation of product development and demand prediction. This system breaks down products into each evaluation factor from psychological and physical viewpoints, and carries out various kinds of multivariate analysis, thereby making it easy to understand visually, for example, what evaluation factors decide relative positional relations between evaluation factors or between products as well as the position of a product in the whole. Further, more precise marketing analysis and prediction become possible by visually grasping blank areas of products, extent of competition, distribution of products, composition of product series, etc. (translated by NEDO)

  9. Trends in biomedical engineering: focus on Patient Specific Modeling and Life Support Systems.

    Science.gov (United States)

    Dubini, Gabriele; Ambrosi, Davide; Bagnoli, Paola; Boschetti, Federica; Caiani, Enrico G; Chiastra, Claudio; Conti, Carlo A; Corsini, Chiara; Costantino, Maria Laura; D'Angelo, Carlo; Formaggia, Luca; Fumero, Roberto; Gastaldi, Dario; Migliavacca, Francesco; Morlacchi, Stefano; Nobile, Fabio; Pennati, Giancarlo; Petrini, Lorenza; Quarteroni, Alfio; Redaelli, Alberto; Stevanella, Marco; Veneziani, Alessandro; Vergara, Christian; Votta, Emiliano; Wu, Wei; Zunino, Paolo

    2011-01-01

    Over the last twenty years major advancements have taken place in the design of medical devices and personalized therapies. They have paralleled the impressive evolution of three-dimensional, non invasive, medical imaging techniques and have been continuously fuelled by increasing computing power and the emergence of novel and sophisticated software tools. This paper aims to showcase a number of major contributions to the advancements of modeling of surgical and interventional procedures and to the design of life support systems. The selected examples will span from pediatric cardiac surgery procedures to valve and ventricle repair techniques, from stent design and endovascular procedures to life support systems and innovative ventilation techniques.

  10. Control system upgrades support better plant economics

    International Nuclear Information System (INIS)

    De Grosbois, J.; Hepburn, A.; Storey, H.; Basso, R.; Kumar, V.

    2002-01-01

    This paper (second in the series, see [1]) provides insight on how nuclear plants can achieve better efficiencies and reduced operations and maintenance (O and M) costs through focused control system upgrades. An understanding of this relationship is necessary to properly assess the economics of plant refurbishment decisions. Traditional economic feasibility assessment methods such as benefit cost analysis (BCA), internal rate of return (IRR), benefit cost ratios (B/C), or payback analysis are often performed without full consideration of project alternatives, quantified benefits, and life cycle costing. Consideration must be given to not only capital cost and project risk, but also to the potential economic benefits of new technology and added functionality offered by plant upgrades. Recent experience shows that if upgrades are focused on priority objectives, and are effectively implemented, they can deliver significant payback over the life of the plant, sometimes orders of magnitude higher than their initial capital cost. The following discussion explores some of the key issues and rationale behind upgrade decisions and their impact on improved plant efficiency and reduced O and M costs. A subsequent paper will explain how the justification for these improvements can be captured in an economic analysis and feasibility study to support strategic decision-making in a plant refurbishment context. (author)

  11. Development of Multivariable Models to Predict and Benchmark Transfusion in Elective Surgery Supporting Patient Blood Management.

    Science.gov (United States)

    Hayn, Dieter; Kreiner, Karl; Ebner, Hubert; Kastner, Peter; Breznik, Nada; Rzepka, Angelika; Hofmann, Axel; Gombotz, Hans; Schreier, Günter

    2017-06-14

    Blood transfusion is a highly prevalent procedure in hospitalized patients and in some clinical scenarios it has lifesaving potential. However, in most cases transfusion is administered to hemodynamically stable patients with no benefit, but increased odds of adverse patient outcomes and substantial direct and indirect cost. Therefore, the concept of Patient Blood Management has increasingly gained importance to pre-empt and reduce transfusion and to identify the optimal transfusion volume for an individual patient when transfusion is indicated. It was our aim to describe, how predictive modeling and machine learning tools applied on pre-operative data can be used to predict the amount of red blood cells to be transfused during surgery and to prospectively optimize blood ordering schedules. In addition, the data derived from the predictive models should be used to benchmark different hospitals concerning their blood transfusion patterns. 6,530 case records obtained for elective surgeries from 16 centers taking part in two studies conducted in 2004-2005 and 2009-2010 were analyzed. Transfused red blood cell volume was predicted using random forests. Separate models were trained for overall data, for each center and for each of the two studies. Important characteristics of different models were compared with one another. Our results indicate that predictive modeling applied prior surgery can predict the transfused volume of red blood cells more accurately (correlation coefficient cc = 0.61) than state of the art algorithms (cc = 0.39). We found significantly different patterns of feature importance a) in different hospitals and b) between study 1 and study 2. We conclude that predictive modeling can be used to benchmark the importance of different features on the models derived with data from different hospitals. This might help to optimize crucial processes in a specific hospital, even in other scenarios beyond Patient Blood Management.

  12. PACS for surgery and interventional radiology: Features of a Therapy Imaging and Model Management System (TIMMS)

    International Nuclear Information System (INIS)

    Lemke, Heinz U.; Berliner, Leonard

    2011-01-01

    Appropriate use of information and communication technology (ICT) and mechatronic (MT) systems is viewed by many experts as a means to improve workflow and quality of care in the operating room (OR). This will require a suitable information technology (IT) infrastructure, as well as communication and interface standards, such as specialized extensions of DICOM, to allow data interchange between surgical system components in the OR. A design of such an infrastructure, sometimes referred to as surgical PACS, but better defined as a Therapy Imaging and Model Management System (TIMMS), will be introduced in this article. A TIMMS should support the essential functions that enable and advance image guided therapy, and in the future, a more comprehensive form of patient-model guided therapy. Within this concept, the 'image-centric world view' of the classical PACS technology is complemented by an IT 'model-centric world view'. Such a view is founded in the special patient modelling needs of an increasing number of modern surgical interventions as compared to the imaging intensive working mode of diagnostic radiology, for which PACS was originally conceptualised and developed. The modelling aspects refer to both patient information and workflow modelling. Standards for creating and integrating information about patients, equipment, and procedures are vitally needed when planning for an efficient OR. The DICOM Working Group 24 (WG-24) has been established to develop DICOM objects and services related to image and model guided surgery. To determine these standards, it is important to define step-by-step surgical workflow practices and create interventional workflow models per procedures or per variable cases. As the boundaries between radiation therapy, surgery and interventional radiology are becoming less well-defined, precise patient models will become the greatest common denominator for all therapeutic disciplines. In addition to imaging, the focus of WG-24 is to serve

  13. PACS for surgery and interventional radiology: features of a Therapy Imaging and Model Management System (TIMMS).

    Science.gov (United States)

    Lemke, Heinz U; Berliner, Leonard

    2011-05-01

    Appropriate use of information and communication technology (ICT) and mechatronic (MT) systems is viewed by many experts as a means to improve workflow and quality of care in the operating room (OR). This will require a suitable information technology (IT) infrastructure, as well as communication and interface standards, such as specialized extensions of DICOM, to allow data interchange between surgical system components in the OR. A design of such an infrastructure, sometimes referred to as surgical PACS, but better defined as a Therapy Imaging and Model Management System (TIMMS), will be introduced in this article. A TIMMS should support the essential functions that enable and advance image guided therapy, and in the future, a more comprehensive form of patient-model guided therapy. Within this concept, the "image-centric world view" of the classical PACS technology is complemented by an IT "model-centric world view". Such a view is founded in the special patient modelling needs of an increasing number of modern surgical interventions as compared to the imaging intensive working mode of diagnostic radiology, for which PACS was originally conceptualised and developed. The modelling aspects refer to both patient information and workflow modelling. Standards for creating and integrating information about patients, equipment, and procedures are vitally needed when planning for an efficient OR. The DICOM Working Group 24 (WG-24) has been established to develop DICOM objects and services related to image and model guided surgery. To determine these standards, it is important to define step-by-step surgical workflow practices and create interventional workflow models per procedures or per variable cases. As the boundaries between radiation therapy, surgery and interventional radiology are becoming less well-defined, precise patient models will become the greatest common denominator for all therapeutic disciplines. In addition to imaging, the focus of WG-24 is to serve

  14. Recommendations on future development of decision support systems

    DEFF Research Database (Denmark)

    MCarthur, Stephen; Chen, Minjiang; Marinelli, Mattia

    Deliverable 8.3 reports on the consolidation of experiences from visualisation, decision support prototypes experiments and recommendations on future developments of decision support systems......Deliverable 8.3 reports on the consolidation of experiences from visualisation, decision support prototypes experiments and recommendations on future developments of decision support systems...

  15. A Computuerized Operator Support System Prototype

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, Ken [Idaho National Lab. (INL), Idaho Falls, ID (United States); Boring, Ronald [Idaho National Lab. (INL), Idaho Falls, ID (United States); Lew, Roger [Idaho National Lab. (INL), Idaho Falls, ID (United States); Ulrich, Tom [Idaho National Lab. (INL), Idaho Falls, ID (United States); Villim, Richard [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2013-11-01

    A report was published by the Idaho National Laboratory in September of 2012, entitled Design to Achieve Fault Tolerance and Resilience, which described the benefits of automating operator actions for transients. The report identified situations in which providing additional automation in lieu of operator actions would be advantageous. It recognized that managing certain plant upsets is sometimes limited by the operator’s ability to quickly diagnose the fault and to take the needed actions in the time available. Undoubtedly, technology is underutilized in the nuclear power industry for operator assistance during plant faults and operating transients. In contrast, other industry sectors have amply demonstrated that various forms of operator advisory systems can enhance operator performance while maintaining the role and responsibility of the operator as the independent and ultimate decision-maker. A computerized operator support system (COSS) is proposed for use in nuclear power plants to assist control room operators in addressing time-critical plant upsets. A COSS is a collection of technologies to assist operators in monitoring overall plant performance and making timely, informed decisions on appropriate control actions for the projected plant condition. The COSS does not supplant the role of the operator, but rather provides rapid assessments, computations, and recommendations to reduce workload and augment operator judgment and decision-making during fast-moving, complex events. This project proposes a general model for a control room COSS that addresses a sequence of general tasks required to manage any plant upset: detection, validation, diagnosis, recommendation, monitoring, and recovery. The model serves as a framework for assembling a set of technologies that can be interrelated to assist with each of these tasks. A prototype COSS has been developed in order to demonstrate the concept and provide a test bed for further research. The prototype is based

  16. A Computuerized Operator Support System Prototype

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, Ken [Idaho National Lab. (INL), Idaho Falls, ID (United States); Boring, Ronald [Idaho National Lab. (INL), Idaho Falls, ID (United States); Lew, Roger [Idaho National Lab. (INL), Idaho Falls, ID (United States); Ulrich, Tom [Idaho National Lab. (INL), Idaho Falls, ID (United States); Villim, Richard [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2013-08-01

    A report was published by the Idaho National Laboratory in September of 2012, entitled Design to Achieve Fault Tolerance and Resilience, which described the benefits of automating operator actions for transients. The report identified situations in which providing additional automation in lieu of operator actions would be advantageous. It recognized that managing certain plant upsets is sometimes limited by the operator’s ability to quickly diagnose the fault and to take the needed actions in the time available. Undoubtedly, technology is underutilized in the nuclear power industry for operator assistance during plant faults and operating transients. In contrast, other industry sectors have amply demonstrated that various forms of operator advisory systems can enhance operator performance while maintaining the role and responsibility of the operator as the independent and ultimate decision-maker. A computerized operator support system (COSS) is proposed for use in nuclear power plants to assist control room operators in addressing time-critical plant upsets. A COSS is a collection of technologies to assist operators in monitoring overall plant performance and making timely, informed decisions on appropriate control actions for the projected plant condition. The COSS does not supplant the role of the operator, but rather provides rapid assessments, computations, and recommendations to reduce workload and augment operator judgment and decision-making during fast-moving, complex events. This project proposes a general model for a control room COSS that addresses a sequence of general tasks required to manage any plant upset: detection, validation, diagnosis, recommendation, monitoring, and recovery. The model serves as a framework for assembling a set of technologies that can be interrelated to assist with each of these tasks. A prototype COSS has been developed in order to demonstrate the concept and provide a test bed for further research. The prototype is based

  17. MOIDSS?- Mobile Online Intelligent Decision Support System, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — GRID has had a successfully completed Phase I 'Mobile Online Intelligent Decision Support System' (MOIDSS). The system developed into a total solution that supports...

  18. The minyan as a psychological support system.

    Science.gov (United States)

    Scheidlinger, S

    1997-08-01

    Most individuals participate in some of the rituals and/or regular activities of religious institutions such as churches or synagogues. Through such involvements, people are offered vital assistance in dealing with developmental changes, opportunities for personal development and for group support, and more generally, a sense of continuity and of meaning in life. This paper deals with only one small aspect of Jewish observance, an aspect of the centuries-old required weekly prayer groups-the minyan. The prime emphasis resides in the rarely recognized, nonliturgical dimension of this small group experience. Using psychoanalysis in the sense of a general psychology as background, I have considered the minyan as combining elements of a psychological support system and of a small group. In addition to the gratification of affiliative needs (social hunger) and the countering of loneliness and of isolation, this group experience helps its members maintain an intergenerational sense of personal identity and of self-esteem. In the face of marked life stressors such as death in the family, religious institutions such as the minyan, with its prescribed ritual steps for grieving (i.e., kaddish), fulfill especially significant preventive and restitutive mental health functions. I have also hypothesized that on a covert, fantasy level, the caring and nurturing family-like weekday minyan may even represent a mother-symbol (mother group) in line with people's universal need to establish a psychological union with others, thus restoring an earlier, conflict-free state of the child-mother bond. In an extended societal sense, the earlier emphasis in Western cultures on the virtual worship of individuality, autonomy, and independence has given way recently to a renewed appreciation of cooperation, communalism, and altruism. The minyan, as a small religious communal aggregate with its inherent climate of mutuality, reciprocity, and continuity, has, in a sense, anticipated these new

  19. Using systems thinking to support clinical system transformation.

    Science.gov (United States)

    Best, Allan; Berland, Alex; Herbert, Carol; Bitz, Jennifer; van Dijk, Marlies W; Krause, Christina; Cochrane, Douglas; Noel, Kevin; Marsden, Julian; McKeown, Shari; Millar, John

    2016-05-16

    Purpose - The British Columbia Ministry of Health's Clinical Care Management initiative was used as a case study to better understand large-scale change (LSC) within BC's health system. Using a complex system framework, the purpose of this paper is to examine mechanisms that enable and constrain the implementation of clinical guidelines across various clinical settings. Design/methodology/approach - Researchers applied a general model of complex adaptive systems plus two specific conceptual frameworks (realist evaluation and system dynamics mapping) to define and study enablers and constraints. Focus group sessions and interviews with clinicians, executives, managers and board members were validated through an online survey. Findings - The functional themes for managing large-scale clinical change included: creating a context to prepare clinicians for health system transformation initiatives; promoting shared clinical leadership; strengthening knowledge management, strategic communications and opportunities for networking; and clearing pathways through the complexity of a multilevel, dynamic system. Research limitations/implications - The action research methodology was designed to guide continuing improvement of implementation. A sample of initiatives was selected; it was not intended to compare and contrast facilitators and barriers across all initiatives and regions. Similarly, evaluating the results or process of guideline implementation was outside the scope; the methods were designed to enable conversations at multiple levels - policy, management and practice - about how to improve implementation. The study is best seen as a case study of LSC, offering a possible model for replication by others and a tool to shape further dialogue. Practical implications - Recommended action-oriented strategies included engaging local champions; supporting local adaptation for implementation of clinical guidelines; strengthening local teams to guide implementation; reducing

  20. Understanding surgery choices for breast cancer: how might the Theory of Planned Behaviour and the Common Sense Model contribute to decision support interventions?

    Science.gov (United States)

    Sivell, Stephanie; Edwards, Adrian; Elwyn, Glyn; Manstead, Antony S. R.

    2010-01-01

    Abstract Objective  To describe the evidence about factors influencing breast cancer patients’ surgery choices and the implications for designing decision support in reference to an extended Theory of Planned Behaviour (TPB) and the Common Sense Model of Illness Representations (CSM). Background  A wide range of factors are known to influence the surgery choices of women diagnosed with early breast cancer facing the choice of mastectomy or breast conservation surgery with radiotherapy. However, research does not always reflect the complexities of decision making and is often atheoretical. A theoretical approach, as provided by the CSM and the TPB, could help to identify and tailor support by focusing on patients’ representations of their breast cancer and predicting surgery choices. Design  Literature search and narrative synthesis of data. Synthesis  Twenty‐six studies reported women’s surgery choices to be influenced by perceived clinical outcomes of surgery, appearance and body image, treatment concerns, involvement in decision making and preferences of clinicians. These factors can be mapped onto the key constructs of both the TPB and CSM and used to inform the design and development of decision support interventions to ensure accurate information is provided in areas most important to patients. Conclusions  The TPB and CSM have the potential to inform the design of decision support for breast cancer patients, with accurate and clear information that avoids leading patients to make decisions they may come to regret. Further research is needed examining how the components of the extended TPB and CSM account for patients’ surgery choices. PMID:20579123

  1. Supporting of mine workings and design of support systems. Madenlerde tahkimat isleri ve tasarmi

    Energy Technology Data Exchange (ETDEWEB)

    Biron, C; Arioglu, E; (Istanbul Teknik Universitesi, Maden Fakultesi)

    1980-01-01

    This article deals with elements of elasticity in rocks and examines the engineering properties of rocks. It includes stress distributions around mine openings and deformations of mine openings. Strata control concept in coal mining is explained. Support systems in stone drifts, gateways, shafts and longwalls are discussed; timber supports, steel arches, articulated arches, roof bolting, concrete supports, supports on mechanized faces are detailed. Emphasis is placed upon engineering properties of materials of support systems. The design concepts of mine support systems are described. The objects of the design are expressed with several numerical examples. It concludes with stowing: pneumatic stowing, and hydraulic stowing in metal and coal mining.

  2. System support software for TSTA [Tritium Systems Test Assembly

    International Nuclear Information System (INIS)

    Claborn, G.W.; Mann, L.W.; Nielson, C.W.

    1987-10-01

    The fact that Tritium Systems Test Assembly (TSTA) is an experimental facility makes it impossible and undesirable to try to forecast the exact software requirements. Thus the software had to be written in a manner that would allow modifications without compromising the safety requirements imposed by the handling of tritium. This suggested a multi-level approach to the software. In this approach (much like the ISO network model) each level is isolated from the level below and above by cleanly defined interfaces. For example, the subsystem support level interfaces with the subsystem hardware through the software support level. Routines in the software support level provide operations like ''OPEN VALVE'' and CLOSE VALVE'' to the subsystem level. This isolates the subsystem level from the actual hardware. This is advantageous because changes can occur in any level without the need for propagating the change to any other level. The TSTA control system consists of the hardware level, the data conversion level, the operator interface level, and the subsystem process level. These levels are described

  3. 30 CFR 75.817 - Cable handling and support systems.

    Science.gov (United States)

    2010-07-01

    ... High-Voltage Longwalls § 75.817 Cable handling and support systems. Longwall mining equipment must be provided with cable-handling and support systems that are constructed, installed and maintained to minimize... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Cable handling and support systems. 75.817...

  4. Nutritional support in patients with systemic sclerosis.

    Science.gov (United States)

    Ortiz-Santamaria, Vera; Puig, Celia; Soldevillla, Cristina; Barata, Anna; Cuquet, Jordi; Recasens, Asunción

    2014-01-01

    Systemic sclerosis (SSc) is a chronic multisystem autoimmune disease which involves the gastrointestinal tract in about 90% of cases. It may contribute to nutritional deterioration. To assess whether the application of a nutritional support protocol to these patients could improve their nutritional status and quality of life. Single center prospective study, performed on an outpatient basis, in a county hospital. The Malnutrition Universal Screening Tool (MUST) was used to screen risk for malnutrition. Health questionnaire SF-36 and the Hospital Anxiety and Depression Scale were used to assess quality of life and psychopathology respectively. Weight, height, energy and protein requirements, macronutrient intake and nutritional biochemical parameters were evaluated. Nutritional intervention was performed in patients at risk for malnutrition. Of the 72 patients, 12.5% were at risk for malnutrition. Iron deficiency anemia (18.35%) and vitamin D deficiency (54%) were the most frequently observed nutritional deficits. The questionnaires on psychopathology and quality of life showed a high prevalence of anxiety and depression, and lower level poor quality of life in the physical and mental component. No significant improvements were observed in the weight, food intake, nutritional biochemical parameters, psychopathology and quality of life follow-up. Dietary intervention was able to maintain body weight and food intake. Iron deficiency anemia and vitamin D deficiency improved with iron and vitamine D supplements. No deterioration was observed in psychological assessment or quality of life. Studies with larger numbers of patients are needed to assess the efficacy of this intervention. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  5. An online infertility clinical decision support system

    Directory of Open Access Journals (Sweden)

    Fabio Diniz de Souza

    2017-01-01

    Full Text Available Objective: To explore some possibilities of computer applications in medicine, and to discuss an online infertility clinical decision support system.Methods: Retrospective data were obtained from 52 couples, and then entered into the online tool. Both its results and the initial diagnoses obtained by the treating physicians were compared with the final diagnoses established by laparoscopy and other diagnostic tests (semen analysis, hormone analysis, endometrial biopsy, ultrasound and hysteroscopy. The initial hypothesis of the research was that the online tool's output was statistically associated with the final diagnoses. In order to verify that hypothesis, a chi-square (χ2 test with Yates' correction for continuity (P<0.05 was performed to verify if the online tool's and the doctor's diagnoses were statistically associated with the final diagnoses.Results: Four etiological factors were present in more than 50% of the couples (ovarian, tubal-peritoneal, uterine, and endometriosis. The statistical results confirmed the research hypothesis for eight out of the nine etiological factors (ovarian, tubal-peritoneal, uterine, cervical, male, vaginal, psychosomatic, and endometriosis; P<0.05. Since there were no cases related to the immune factor in the sample, further clinical data are necessary in order to assess the online tool's performance for that factor.Conclusions: The online tool tends to present more false-positives than false-negatives, whereas the expert physician tends to present more false-negatives than false-positives. Therefore, the online tool and the doctor seem to complement each other. Finally, the obtained results suggest that the infertility online tool discussed herein might be a useful research and instructional tool.

  6. An online infertility clinical decision support system

    Directory of Open Access Journals (Sweden)

    Fabio Diniz de Souza

    2017-09-01

    Full Text Available Objective: To explore some possibilities of computer applications in medicine, and to discuss an online infertility clinical decision support system. Methods: Retrospective data were obtained from 52 couples, and then entered into the online tool. Both its results and the initial diagnoses obtained by the treating physicians were compared with the final diagnoses established by laparoscopy and other diagnostic tests (semen analysis, hormone analysis, endometrial biopsy, ultrasound and hysteroscopy. The initial hypothesis of the research was that the online tool’s output was statistically associated with the final diagnoses. In order to verify that hypothesis, a chi-square (氈2 test with Yates’ correction for continuity (P<0.05 was performed to verify if the online tool’s and the doctor’s diagnoses were statistically associated with the final diagnoses. Results: Four etiological factors were present in more than 50% of the couples (ovarian, tubal-peritoneal, uterine, and endometriosis. The statistical results confirmed the research hypothesis for eight out of the nine etiological factors (ovarian, tubal-peritoneal, uterine, cervical, male, vaginal, psychosomatic, and endometriosis; P<0.05. Since there were no cases related to the immune factor in the sample, further clinical data are necessary in order to assess the online tool’s performance for that factor. Conclusions: The online tool tends to present more false-positives than false negatives, whereas the expert physician tends to present more false-negatives than false-positives. Therefore, the online tool and the doctor seem to complement each other. Finally, the obtained results suggest that the infertility online tool discussed herein might be a useful research and instructional tool.

  7. Alternatives of ITER vacuum vessel support system

    International Nuclear Information System (INIS)

    Ohmori, Junji; Kitamura, Kazunori; Araki, Masanori; Ohno, Isamu; Shoji, Teruaki

    2002-07-01

    Optional designs of vacuum vessel (VV) support have been performed for the International Thermonuclear Experimental Reactor (ITER) to reduce stresses and buckling concern of the flexible plate structure in ITER-FDR. One of the optional designs is hanging type VV support concept that consists of top hanging supports at the top of VV and middle radial stoppers in the middle of outboard VV. The hanging supports are located at the toroidal field (TF) coil inboard top region (R∼5400 mm) using the narrow window space surrounded by a poloidal field coil (PF1) and TF coil. The radial stoppers are located inside TF coil cases in the TF coil outboard middle region (R∼9300 mm). The upper flange connection of the radial stoppers should slide in vertical direction to eliminate thermal stress produced by relative thermal displacement between VV wall and TF coil case. Both supports consist of flexible plates and are mounted on 18 locations in toroidal direction. The radial and toroidal reaction forces are shared with the hanging supports and the radial stoppers. However, the vertical force is sustained by only the hanging supports. The others are compressive type support concept that consists of nine VV supports located in alternate divertor port regions in toroidal direction. Two designs have been performed for the VV support concept. One is mounted on TF inter-coil structures (OIS) and the other is on cryostat ring. The compressive support on TF coil OIS is dependent on TF coil movement but that on cryostat is independent. In the optional designs, the bending stress due to the relative thermal displacement between TF coil and VV is classified to primary stress according to ASME Sec. III NF. The stress due to TF coil displacement is also considered as primary stress. The stress due to non-uniform temperature distribution of the flexible plate is classified to secondary stress. The preliminary structural assessments for the optional designs have been performed for all load

  8. [Orthopedic and trauma surgery in the German DRG system. Recent developments].

    Science.gov (United States)

    Franz, D; Schemmann, F; Selter, D D; Wirtz, D C; Roeder, N; Siebert, H; Mahlke, L

    2012-07-01

    Orthopedics and trauma surgery are subject to continuous medical advancement. The correct and performance-based case allocation by German diagnosis-related groups (G-DRG) is a major challenge. This article analyzes and assesses current developments in orthopedics and trauma surgery in the areas of coding of diagnoses and medical procedures and the development of the 2012 G-DRG system. The relevant diagnoses, medical procedures and G-DRGs in the versions 2011 and 2012 were analyzed based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes were made for the International Classification of Diseases (ICD) coding of complex cases with medical complications, the procedure coding for spinal surgery and for hand and foot surgery. The G-DRG structures were modified for endoprosthetic surgery on ankle, shoulder and elbow joints. The definition of modular structured endoprostheses was clarified. The G-DRG system for orthopedic and trauma surgery appears to be largely consolidated. The current phase of the evolution of the G-DRG system is primarily aimed at developing most exact descriptions and definitions of the content and mutual delimitation of operation and procedures coding (OPS). This is an essential prerequisite for a correct and performance-based case allocation in the G-DRG system.

  9. Screening of Nutritional Risk and Nutritional Support in General Surgery Patients: A Survey from Shanghai, China

    Science.gov (United States)

    Jia, Zhen-Yi; Yang, Jun; Tong, Da-Nian; Peng, Jia-Yuan; Zhang, Zhong-Wei; Liu, Wei-Jie; Xia, Yang; Qin, Huan-long

    2015-01-01

    To determine the prevalence of nutritional risk in surgical departments and to evaluate the impact of nutritional support on clinical outcomes. The nutritional risk in different surgical diseases and the different way of nutritional support on clinical outcomes in patients at nutritional risk remain unclear. Hospitalized patients from general surgical departments were screened using the Nutritional Risk Screening (NRS) 2002 questionnaire on admission. Data were collected on nutritional risk, complications, and length of stay (LOS). Overall, 5034 patients were recruited; the overall prevalence of nutritional risk on admission were 19.2%. The highest prevalence was found among patients with gastric cancer. At-risk patients had more complications and longer LOS than nonrisk patients. Of the at-risk patients, the complication rate was significantly lower and LOS was significantly shorter in the nutritional-support group than in the no-support group (20.9 versus 30.0%, P nutrition or who received support for 5 to 7 days, or daily support entailing 16 to 25 kcal/kg of nonprotein energy. Different surgical diseases have different levels of nutritional risk. The provision of nutritional support was associated with a lower complication rate and a shorter LOS for gastric, colorectal, and HPB cancer patients at nutritional risk. The improper use of nutritional support may not improve outcomes for at-risk patients. PMID:26011204

  10. Impact of preoperative change in physical function on postoperative recovery: argument supporting prehabilitation for colorectal surgery.

    Science.gov (United States)

    Mayo, Nancy E; Feldman, Liane; Scott, Susan; Zavorsky, Gerald; Kim, Do Jun; Charlebois, Patrick; Stein, Barry; Carli, Francesco

    2011-09-01

    Abdominal surgery represents a physiologic stress and is associated with a period of recovery during which functional capacity is often diminished. "Prehabilitation" is a program to increase functional capacity in anticipation of an upcoming stressor. We reported recently the results of a randomized trial comparing 2 prehabilitation programs before colorectal surgery (stationary cycling plus weight training versus a recommendation to increase walking coupled with breathing exercises); however, adherence to the programs was low. The objectives of this study were to estimate: (1) the extent to which physical function could be improved with either prehabilitation program and identify variables associated with response; and (2) the impact of change in preoperative function on postoperative recovery. This study involved a reanalysis of data arising from a randomized trial. The primary outcome measure was functional walking capacity measured by the Six-Minute Walk Test; secondary outcomes were anxiety, depression, health-related quality of life, and complications (Clavien classification). Multiple linear regression was used to estimate the extent to which key variables predicted change in functional walking capacity over the prehabilitation and follow-up periods. We included 95 people who completed the prehabilitation phase (median, 38 days; interquartile range, 22-60), and 75 who were also evaluated postoperatively (mean, 9 weeks). During prehabilitation, 33% improved their physical function, 38% stayed within 20 m of their baseline score, and 29% deteriorated. Among those who improved, mental health, vitality, self-perceived health, and peak exercise capacity also increased significantly. Women were less likely to improve; low baseline walking capacity, anxiety, and the belief that fitness aids recovery were associated with improvements during prehabilitation. In the postoperative phase, the patients who had improved during prehabilitation were also more likely to have

  11. A 20-year multicentre outcome analysis of salvage mechanical circulatory support for refractory cardiogenic shock after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Maziar Khorsandi

    2016-11-01

    Full Text Available Abstract Background Refractory post-cardiotomy cardiogenic shock (PCCS is a relatively rare phenomenon that can lead to rapid multi-organ dysfunction syndrome and is almost invariably fatal without advanced mechanical circulatory support (AMCS, namely extra-corporeal membrane oxygenation (ECMO or ventricular assist devices (VAD. In this multicentre observational study we retrospectively analyzed the outcomes of salvage venoarterial ECMO (VA ECMO and VAD for refractory PCCS in the 3 adult cardiothoracic surgery centres in Scotland over a 20-year period. Methods The data was obtained through the Edinburgh, Glasgow and Aberdeen cardiac surgery databases. Our inclusion criteria included any adult patient from April 1995 to April 2015 who had received salvage VA ECMO or VAD for PCCS refractory to intra-aortic balloon pump (IABP and maximal inotropic support following adult cardiac surgery. Results A total of 27 patients met the inclusion criteria. Age range was 34–83 years (median 51 years. There was a large male predominance (n = 23, 85 %. Overall 23 patients (85 % received VA ECMO of which 14 (61 % had central ECMO and 9 (39 % had peripheral ECMO. Four patients (15 % were treated with short-term VAD (BiVAD = 1, RVAD = 1 and LVAD = 2. The most common procedure-related complication was major haemorrhage (n = 10. Renal failure requiring renal replacement therapy (n = 7, fatal stroke (n = 5, septic shock (n = 2, and a pseudo-aneurysm at the femoral artery cannulation site (n = 1 were also observed. Overall survival to hospital discharge was 40.7 %. All survivors were NYHA class I-II at 12 months’ follow-up. Conclusion AMCS for refractory PCCS carries a survival benefit and achieves acceptable functional recovery despite a significant complication rate.

  12. Percutaneous cardiopulmonary support to treat suspected venous air embolism with cardiac arrest during open eye surgery: a case report.

    Science.gov (United States)

    Shin, Seokyung; Nam, Bokyung; Soh, Sarah; Koo, Bon-Nyeo

    2014-11-01

    We report a case of possible venous air embolism (VAE) during trans pars plana vitrectomy with air-fluid exchange of the vitreous cavity. Shortly after initiation of air-fluid exchange, decreases in end-tidal CO2, oxygen saturation, and blood pressure were observed. The patient rapidly progressed to cardiac arrest unresponsive to cardiopulmonary resuscitation, and recovered after the application of percutaneous cardiopulmonary support. Prompt termination of air infusion is needed when VAE is suspected during air-fluid exchange, and extracorporeal life support should be considered in fatal cases. Although the incidence is rare the possibility of VAE during ophthalmic surgery clearly exists, and therefore awareness and vigilant monitoring seem critical.

  13. Systemic and Topical Use of Tranexamic Acid in Spinal Surgery: A Systematic Review

    Science.gov (United States)

    Winter, Sebastian F.; Santaguida, Carlo; Wong, Jean; Fehlings, Michael G.

    2015-01-01

    Study Design Combination of narrative and systematic literature reviews. Objectives Massive perioperative blood loss in complex spinal surgery often requires blood transfusions and can negatively affect patient outcome. Systemic use of the antifibrinolytic agent tranexamic acid (TXA) has become widely used in the management of surgical bleeding. We review the clinical evidence for the use of intravenous TXA as a hemostatic agent in spinal surgery and discuss the emerging role for its complementary use as a topical agent to reduce perioperative blood loss from the surgical site. Through a systematic review of published and ongoing investigations on topical TXA for spinal surgery, we wish to make spine practitioners aware of this option and to suggest opportunities for further investigation in the field. Methods A narrative review of systemic TXA in spinal surgery and topical TXA in surgery was conducted. Furthermore, a systematic search (using PRISMA guidelines) of PubMed (MEDLINE), EMBASE, and Cochrane CENTRAL databases as well as World Health Organization International Clinical Trials Registry Platform, ClinicalTrials.gov (National Institutes of Health), and International Standard Randomized Controlled Trial Number registries was conducted to identify both published literature and ongoing clinical trials on topical TXA in spinal surgery. Results Of 1,631 preliminary search results, 2 published studies were included in the systematic review. Out of 285 ongoing clinical trials matching the search criteria, a total of 4 relevant studies were included and reviewed. Conclusion Intravenous TXA is established as an efficacious hemostatic agent in spinal surgery. Use of topical TXA in surgery suggests similar hemostatic efficacy and potentially improved safety as compared with intravenous TXA. For spinal surgery, the literature on topical TXA is sparse but promising, warranting further clinical investigation and consideration as a clinical option in cases with

  14. Hybrid Life Support System Technology Demonstrations

    Science.gov (United States)

    Morrow, R. C.; Wetzel, J. P.; Richter, R. C.

    2018-02-01

    Demonstration of plant-based hybrid life support technologies in deep space will validate the function of these technologies for long duration missions, such as Mars transit, while providing dietary variety to improve habitability.

  15. Distributed System for Spaceflight Biomedical Support

    Data.gov (United States)

    National Aeronautics and Space Administration — Our project investigated whether a software platform could integrate as wide a variety of devices and data types as needed for spaceflight biomedical support. The...

  16. Perceived Child Weight Status, Family Structure and Functioning, and Support for Health Behaviors in a Sample of Bariatric Surgery Patients.

    Science.gov (United States)

    Pratt, Keeley J; Ferriby, Megan; Noria, Sabrena; Skelton, Joseph; Taylor, Christopher; Needleman, Bradley

    2018-01-29

    The purpose of this study is to describe the associations between bariatric surgery patients' perspectives of their child's weight status, family support for eating and exercise behavior change, and family structure and functioning. A cross-sectional descriptive design with pre- and postsurgery (N = 224) patients was used. Demographics, perceptions of child weight status, family support for eating habits and exercise, and family functioning were assessed from patients at a University Bariatric Clinic. Patients who perceived their child to be overweight/obese reported more impaired family functioning, less family exercise participation, and more discouragement for eating habit change in the family compared to patients who did not perceive their child to be overweight/obese. Single parents more often perceived their children to be overweight/obese, and had more impaired family functioning, and less support for changing eating habits and family exercise participation. Patients with impaired family functioning reported less support for changing eating habits and family exercise participation. Bariatric patients who perceived their child to be overweight/obese and identified as single parents reported more impaired family functioning and less support for eating habits and family participation in exercise. Assessing pre- and postsurgery measures from parents and children will allow the further identification of relationship variables that can be targeted to promote positive family changes that benefit parents and children long-term. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  17. Emprego de sistemas robóticos na cirurgia cardiovascular Robotic systems in cardiovascular surgery

    Directory of Open Access Journals (Sweden)

    Roberto T. Sant'Anna

    2004-06-01

    field hospitals with surgeons in a distant location (tele-presence. But the first human application of robotic surgery occurred years later in a transurethral resection for benign prostatic hyperplasia. Cardiac surgeons were attracted to the robotic techniques because of the potential reduction in the invasive character of the procedures. This results in reduced trauma, a reduction of pain and morbidity, a faster recovery and lower cost of surgery. Robotic systems were developed, allowing totally thoracoscopic cardiac surgery for myocardial revascularization and multi-site pacemaker implantation in selected cases. Video-thoracoscopic support systems for internal thoracic artery harvesting, mitral valve reconstruction and correction of congenital heart defects also exist. We used the AESOP® system with HERMES® voice control to harvest the internal thoracic artery, trans-thoracic implantation of the left ventricular electrode and as an approach to congenital heart defects for surgical repair. In spite of scientific enthusiasm related to robotic surgery, there is no clear evidence of superiority of this technique when compared to conventional procedures in terms of results. The same is true with the cost of the procedures, and even if a single robotic surgery is less expensive, the initial investment for a complete robotic system (console, video control, instruments can be compensated only with many procedures over the long term. But there is no doubt that robotic surgery will have a place in the future of surgery, providing tele-presence of the surgeon, enabling teaching and training and performing less invasive surgical procedures.

  18. [Congenital adrenal hyperplasia: a qualitative study on sex definition and redesignation dilation surgery and psychological support (part II)].

    Science.gov (United States)

    Telles-Silveira, Mariana; Tonetto-Fernandes, Vânia F; Schiller, Paulo; Kater, Claudio E

    2009-12-01

    To identify relevant questions related to sex definition and re-designation and reconstructive surgery in patients with congenital adrenal hyperplasia (CAH), and to understand the role of the psychologist in providing care for these patients. We selected 21 subjects: 7 pediatric endocrinologists from 5 Brazilian Public Health System institutions, 9 parents and 6 patients with CAH, according to a qualitative research model. In this paper, 3 of the studied categories are analyzed: 'sex definition and re-designation', 'reconstructive surgery/vaginal dilation', and 'psychology'. Parents' main anguish relates to the situation of an unnamed sex at birth, whereas sex re-designation was distressful to physicians. A sense of loneliness when dealing with the disease and treatment was a common anguish among patients; dilation procedures were the major complaint. In general, physicians recommend that genital reconstructive surgery be performed early on to avoid future trauma. In such a complex scenario, it is remarkable that not all the reference service staff have a psychologist on duty. Difficulties to deal with questions involving sexuality were evident and dilation procedures are an additional source of trauma for these patients.

  19. Accuracy of the all patient refined diagnosis related groups classification system in congenital heart surgery.

    Science.gov (United States)

    Parnell, Aimee S; Shults, Justine; Gaynor, J William; Leonard, Mary B; Dai, Dingwei; Feudtner, Chris

    2014-02-01

    Administrative data are increasingly used to evaluate clinical outcomes and quality of care in pediatric congenital heart surgery (CHS) programs. Several published analyses of large pediatric administrative data sets have relied on the All Patient Refined Diagnosis Related Groups (APR-DRG, version 24) diagnostic classification system. The accuracy of this classification system for patients undergoing CHS is unclear. We performed a retrospective cohort study of all 14,098 patients 0 to 5 years of age undergoing any of six selected congenital heart operations, ranging in complexity from isolated closure of a ventricular septal defect to single-ventricle palliation, at 40 tertiary-care pediatric centers in the Pediatric Health Information Systems database between 2007 and 2010. Assigned APR-DRGs (cardiac versus noncardiac) were compared using χ2 or Fisher's exact tests between those patients admitted during the first day of life versus later and between those receiving extracorporeal membrane oxygenation support versus those not. Recursive partitioning was used to assess the greatest determinants of APR-DRG type in the model. Every patient admitted on day 1 of life was assigned to a noncardiac APR-DRG (pDRG (pDRG experienced a significantly increased mortality (pDRG coding has systematic misclassifications, which may result in inaccurate reporting of CHS case volumes and mortality. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Space Launch System Vibration Analysis Support

    Science.gov (United States)

    Johnson, Katie

    2016-01-01

    The ultimate goal for my efforts during this internship was to help prepare for the Space Launch System (SLS) integrated modal test (IMT) with Rodney Rocha. In 2018, the Structural Engineering Loads and Dynamics Team will have 10 days to perform the IMT on the SLS Integrated Launch Vehicle. After that 10 day period, we will have about two months to analyze the test data and determine whether the integrated vehicle modes/frequencies are adequate for launching the vehicle. Because of the time constraints, NASA must have newly developed post-test analysis methods proven well and with technical confidence before testing. NASA civil servants along with help from rotational interns are working with novel techniques developed and applied external to Johnson Space Center (JSC) to uncover issues in applying this technique to much larger scales than ever before. We intend to use modal decoupling methods to separate the entangled vibrations coming from the SLS and its support structure during the IMT. This new approach is still under development. The primary goal of my internship was to learn the basics of structural dynamics and physical vibrations. I was able to accomplish this by working on two experimental test set ups, the Simple Beam and TAURUS-T, and by doing some light analytical and post-processing work. Within the Simple Beam project, my role involves changing the data acquisition system, reconfiguration of the test set up, transducer calibration, data collection, data file recovery, and post-processing analysis. Within the TAURUS-T project, my duties included cataloging and removing the 30+ triaxial accelerometers, coordinating the removal of the structure from the current rolling cart to a sturdy billet for further testing, preparing the accelerometers for remounting, accurately calibrating, mounting, and mapping of all accelerometer channels, and some testing. Hammer and shaker tests will be performed to easily visualize mode shapes at low frequencies. Short

  1. Desicion Support System For Natural Hazards

    Science.gov (United States)

    Vyazilov, E.

    2009-04-01

    recommendations should be reasonable. To resolve the above problems or to make them less significant it is necessary to develop decision support systems (DSS). DMs need not tables with initial data, analytical, forecasting and climatic information, but messages containing warnings on critical value accidence, information on probability of hazards, information on potential losses, and information on hazardous impacts and recommendations on decision making. DSS can do the following: take into account impacts on specific points and on the total area under consideration; allow for the effects of the environment on economic entities (objects) in any geographical region to be analyzed; distinguish impacts and changes caused both by different phenomena and by their combination; signal when objects are or can be in adverse environmental conditions, e.g. in the area affected by fog, storm, tropical cyclone or in the area where the probability of hazardous ice events is very high, etc. The main component of DSS is a knowledge base based on the following concept: if we know environmental conditions it is possible to predict potential impacts on the economy; if we know impacts it is possible to give a set of recommendations on how to prevent (reduce) losses or how to use natural resources most efficiently. Decision making criteria are safety of people and property, reduction of losses, increase of profit, materials saving, etc. Knowledge base is a set of rules formulated in a formalized way using if, that, else. If "Water level in S.-Petersburg >150 cm" that "To give out warning information "Hazards for building on coastal river Neva is possible" and recommendations "The valuable goods carry out in second floor" else "To switch another rule". To have a knowledge base in place it is necessary to: develop tools of identifying and getting knowledge from experts; arrange the information flow from available information systems (operational data, analyses, forecasts, climatic information) through

  2. The Impact of Early Involvement in a Postdischarge Support Program for Ostomy Surgery Patients on Preventable Healthcare Utilization.

    Science.gov (United States)

    Rojanasarot, Sirikan

    To evaluate the impact of a postdischarge ostomy support program as an adjunct to nurse-led ostomy care on preventable healthcare utilization. A cross-sectional study. A postdischarge support program offered by an ostomy product's manufacturer provides persons living with an ostomy with patient-centered and easily accessible assistance. Individuals who underwent ostomy surgery within 18 months prior to the survey date were selected from an ostomy patient database maintained by the ostomy patient support program provider. Of 7026 surveys sent to program enrollees, 493 (7%) responded, compared with 225 (5%) out of 4149 surveys sent to individuals in a comparison group. The 2 groups were similar in demographics. A majority of the survey respondents were female (60% of program enrollees vs 55% of respondents in the comparison group). Among the program enrollees, 44% had colostomy, 43% had ileostomy, 10% had urostomy, and 4% had at least 2 types of ostomy surgery compared with 52%, 32%, 12%, and 4% of the respondents in a comparison group, respectively. The study compared hospital readmission and emergency room (ER) visit rates attributable to ostomy complications between program enrollees and respondents in the comparison group. The event rates were measured in 2 study periods: within the first month of discharge and after the first month of discharge. Eligible individuals received an online survey that included the following domains: characteristics of ostomy surgery; readmissions and ER visits within the first month or after the first month of discharge, including reasons for preventable events; and level of health care access. Multivariate logistic regressions controlling for covariates were applied to investigate associations between program enrollment and ostomy-related readmission or ER visit rates. Logistic regression analyses showed that, when compared with respondents in the comparison group, program enrollees had a significantly lower likelihood of being

  3. ISABELLE magnet support and adjustment system

    International Nuclear Information System (INIS)

    Buchanan, V.; Kassner, D.; Polk, I.

    1979-01-01

    The ISABELLE superconducting is supported at the quarter points within a carbon steel vacuum vessel by four fiberglass straps. These are positioned at a small angle to the vertical so that contraction of both the magnet core and the suspension straps do not change the position of the magnet centerline. Two smaller fiberglass straps at each support provide horizontal position location. The fiberglass straps are fabricated of uniaxial epoxy fiberglass tape. Creep tests at room temperature and 1.3 times design load show no extension after one year and there was a factor of safety of 5 in breaking strength. An Engineering Test Model was constructed and cycled to 5 0 K. Heat leak for the eight straps was less than 0.5 W and position stability was within +-0.005''. The vacuum vessel is vertically positioned by means of three jack screws with sliding pads and spherical washers between the top of the jacks and the support boxes. Longitudinal and lateral positioning is done by three horizontal screws at each support box. Three shim plates on the top of the support boxes are used to set the magnetic plane and sockets in two of these are used to set the lateral plane

  4. Current use of navigation system in ACL surgery: a historical review.

    Science.gov (United States)

    Zaffagnini, S; Urrizola, F; Signorelli, C; Grassi, A; Di Sarsina, T Roberti; Lucidi, G A; Marcheggiani Muccioli, G M; Bonanzinga, T; Marcacci, M

    2016-11-01

    The present review aims to analyse the available literature regarding the use of navigation systems in ACL reconstructive surgery underling the evolution during the years. A research of indexed scientific papers was performed on PubMed and Cochrane Library database. The research was performed in December 2015 with no publication year restriction. Only English-written papers and related to the terms ACL, NAVIGATION, CAOS and CAS were considered. Two reviewers independently selected only those manuscripts that presented at least the application of navigation system for ACL reconstructive surgery. One hundred and forty-six of 394 articles were finally selected. In this analysis, it was possible to review the main uses of navigation system in ACL surgery including tunnel positioning for primary and revision surgery and kinematic assessment of knee laxity before and after different surgical procedures. In the early years, until 2006, navigation system was mainly used to improve tunnel positioning, but since the last decade, this tool has been principally used for kinematics evaluation. Increased accuracy of tunnel placement was observed using navigation surgery, especially, regarding femoral, 42 of 146 articles used navigation to guide tunnel positioning. During the following years, 82 of 146 articles have used navigation system to evaluate intraoperative knee kinematic. In particular, the importance of controlling rotatory laxity to achieve better surgical outcomes has been underlined. Several applications have been described and despite the contribution of navigation systems, its potential uses and theoretical advantages, there are still controversies about its clinical benefit. The present papers summarize the most relevant studies that have used navigation system in ACL reconstruction. In particular, the analysis identified four main applications of the navigation systems during ACL reconstructive surgery have been identified: (1) technical assistance for tunnel

  5. 76 FR 15321 - SEDASYS Computer-Assisted Personalized Sedation System; Ethicon Endo-Surgery, Inc.'s, Petition...

    Science.gov (United States)

    2011-03-21

    ...] SEDASYS Computer-Assisted Personalized Sedation System; Ethicon Endo-Surgery, Inc.'s, Petition for Review... an advisory committee Ethicon Endo- Surgery Inc.'s (EES's), petition for review of the Agency's... Foreman, FDA, CDRH, to Ken Charak, Ethicon Endo-Surgery, Inc., containing the order denying approval of...

  6. A Novel Augmented Reality Navigation System for Endoscopic Sinus and Skull Base Surgery: A Feasibility Study.

    Directory of Open Access Journals (Sweden)

    Liang Li

    Full Text Available To verify the reliability and clinical feasibility of a self-developed navigation system based on an augmented reality technique for endoscopic sinus and skull base surgery.In this study we performed a head phantom and cadaver experiment to determine the display effect and accuracy of our navigational system. We compared cadaver head-based simulated operations, the target registration error, operation time, and National Aeronautics and Space Administration Task Load Index scores of our navigation system to conventional navigation systems.The navigation system developed in this study has a novel display mode capable of fusing endoscopic images to three-dimensional (3-D virtual images. In the cadaver head experiment, the target registration error was 1.28 ± 0.45 mm, which met the accepted standards of a navigation system used for nasal endoscopic surgery. Compared with conventional navigation systems, the new system was more effective in terms of operation time and the mental workload of surgeons, which is especially important for less experienced surgeons.The self-developed augmented reality navigation system for endoscopic sinus and skull base surgery appears to have advantages that outweigh those of conventional navigation systems. We conclude that this navigational system will provide rhinologists with more intuitive and more detailed imaging information, thus reducing the judgment time and mental workload of surgeons when performing complex sinus and skull base surgeries. Ultimately, this new navigational system has potential to increase the quality of surgeries. In addition, the augmented reality navigational system could be of interest to junior doctors being trained in endoscopic techniques because it could speed up their learning. However, it should be noted that the navigation system serves as an adjunct to a surgeon's skills and knowledge, not as a substitute.

  7. A Novel Augmented Reality Navigation System for Endoscopic Sinus and Skull Base Surgery: A Feasibility Study

    Science.gov (United States)

    Li, Liang; Yang, Jian; Chu, Yakui; Wu, Wenbo; Xue, Jin; Liang, Ping; Chen, Lei

    2016-01-01

    Objective To verify the reliability and clinical feasibility of a self-developed navigation system based on an augmented reality technique for endoscopic sinus and skull base surgery. Materials and Methods In this study we performed a head phantom and cadaver experiment to determine the display effect and accuracy of our navigational system. We compared cadaver head-based simulated operations, the target registration error, operation time, and National Aeronautics and Space Administration Task Load Index scores of our navigation system to conventional navigation systems. Results The navigation system developed in this study has a novel display mode capable of fusing endoscopic images to three-dimensional (3-D) virtual images. In the cadaver head experiment, the target registration error was 1.28 ± 0.45 mm, which met the accepted standards of a navigation system used for nasal endoscopic surgery. Compared with conventional navigation systems, the new system was more effective in terms of operation time and the mental workload of surgeons, which is especially important for less experienced surgeons. Conclusion The self-developed augmented reality navigation system for endoscopic sinus and skull base surgery appears to have advantages that outweigh those of conventional navigation systems. We conclude that this navigational system will provide rhinologists with more intuitive and more detailed imaging information, thus reducing the judgment time and mental workload of surgeons when performing complex sinus and skull base surgeries. Ultimately, this new navigational system has potential to increase the quality of surgeries. In addition, the augmented reality navigational system could be of interest to junior doctors being trained in endoscopic techniques because it could speed up their learning. However, it should be noted that the navigation system serves as an adjunct to a surgeon’s skills and knowledge, not as a substitute. PMID:26757365

  8. Reexamining Operating System Support for Database Management

    OpenAIRE

    Vasil, Tim

    2003-01-01

    In 1981, Michael Stonebraker [21] observed that database management systems written for commodity operating systems could not effectively take advantage of key operating system services, such as buffer pool management and process scheduling, due to expensive overhead and lack of customizability. The “not quite right” fit between these kernel services and the demands of database systems forced database designers to work around such limitations or re-implement some kernel functionality in user ...

  9. Maintenance Decision Support System, Phase III

    Science.gov (United States)

    2017-09-01

    The main goal of the project was to address barriers that limit NDOTs ability to implement MDSS and MMS systems. The four project tasks included: Task 1: Develop system for tracking sand and/or deicing material usage: A system that tracks where and w...

  10. Safety implications of electronic driving support systems : an orientation.

    NARCIS (Netherlands)

    Gundy, C.M. Steyvers, F.J.J.M. & Kaptein, N.A.

    1995-01-01

    This report focuses on traffic safety aspects of driving support systems. The report consists of two parts. First of all, the report discusses a number of topics, relevant for the implementation and evaluation of driving support systems. These topics include: (1) safety research into driving support

  11. An advance care plan decision support video before major surgery: a patient- and family-centred approach.

    Science.gov (United States)

    Isenberg, Sarina R; Crossnohere, Norah L; Patel, Manali I; Conca-Cheng, Alison; Bridges, John F P; Swoboda, Sandy M; Smith, Thomas J; Pawlik, Timothy M; Weiss, Matthew; Volandes, Angelo E; Schuster, Anne; Miller, Judith A; Pastorini, Carolyn; Roter, Debra L; Aslakson, Rebecca A

    2018-06-01

    Video-based advanc care planning (ACP) tools have been studied in varied medical contexts; however, none have been developed for patients undergoing major surgery. Using a patient- and family-centredness approach, our objective was to implement human-centred design (HCD) to develop an ACP decision support video for patients and their family members when preparing for major surgery. The study investigators partnered with surgical patients and their family members, surgeons and other health professionals to design an ACP decision support video using key HCD principles. Adapting Maguire's HCD stages from computer science to the surgical context, while also incorporating Elwyn et al 's specifications for patient-oriented decision support tool development, we used a six-stage HCD process to develop the video: (1) plan HCD process; (2) specify where video will be used; (3) specify user and organisational requirements; (4) produce and test prototypes; (5) carry out user-based assessment; (6) field test with end users. Over 450 stakeholders were engaged in the development process contributing to setting objectives, applying for funding, providing feedback on the storyboard and iterations of the decision tool video. Throughout the HCD process, stakeholders' opinions were compiled and conflicting approaches negotiated resulting in a tool that addressed stakeholders' concerns. Our patient- and family-centred approach using HCD facilitated discussion and the ability to elicit and balance sometimes competing viewpoints. The early engagement of users and stakeholders throughout the development process may help to ensure tools address the stated needs of these individuals. NCT02489799. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. Bitot’s Spots following Bariatric Surgery: An Ocular Manifestation of a Systemic Disease

    Directory of Open Access Journals (Sweden)

    Amanda R. Crum

    2017-12-01

    Full Text Available Background: To present a case of ocular complications from vitamin A deficiency following bariatric surgery. Case Report: A 41-year-old woman presented with symptoms of dryness and diminished night vision. Examination revealed corneal punctate staining, keratinization of the conjunctiva, and multiple mid-peripheral white lesions at the level of the retinal pigment epithelium. Given the patient’s history of bariatric surgery, anemia, and vitamin D deficiency, further investigation into micronutrient levels was performed and indicated a severe vitamin A deficiency. Oral vitamin A supplementation resulted in the complete resolution of her symptoms within two months. Conclusions: Nutritional deficiencies following bariatric surgery are common and can be disruptive to normal systemic health and visual function. Given that the number of patients pursuing bariatric surgery for weight loss management has increased over the past 50 years, eye care professionals should be aware of the ophthalmic manifestations associated with micronutrient deficiency.

  13. Preoperative multidisciplinary program for bariatric surgery: a proposal for the Brazilian Public Health System

    Directory of Open Access Journals (Sweden)

    Elinton Adami CHAIM

    Full Text Available ABSTRACT BACKGROUND Bariatric surgery has become the gold standard treatment for morbid obesity, but access to surgery remains difficult and low compliance to postoperative follow-up is common. To improve outcomes, enable access and optimize follow-up, we developed a multidisciplinary preoperative approach for bariatric surgery. OBJECTIVE To determine the impact of this program in the outcomes of bariatric surgery in the Brazilian public health system. METHODS A prospective evaluation of the individuals who underwent a preoperative multidisciplinary program for bariatric surgery and comparison of their surgical outcomes with those observed in the prospectively collected historical database of the individuals who underwent surgery before the beginning of the program. RESULTS There were 176 individuals who underwent the multidisciplinary program and 226 who did not. Individuals who underwent the program had significantly lower occurrence of the following variables: hospital stay; wound dehiscence; wound infection; pulmonary complications; anastomotic leaks; pulmonary thromboembolism; sepsis; incisional hernias; eventrations; reoperations; and mortality. Both loss of follow-up and weight loss failure were also significantly lower in the program group. CONCLUSION The adoption of a comprehensive preoperative multidisciplinary approach led to significant improvements in the postoperative outcomes and also in the compliance to the postoperative follow-up. It represents a reproducible and potentially beneficial approach within the context of the Brazilian public health system.

  14. Postoperative Cardiac Arrest after Heart Surgery: Does Extracorporeal Perfusion Support a Paradigm Change in Management?

    Directory of Open Access Journals (Sweden)

    Edward Gologorsky

    2010-01-01

    Full Text Available Early institution of extracorporeal perfusion support (ECPS may improve survival after cardiac arrest. Two patients sustained unexpected cardiac arrest in the Intensive Care Unit (ICU following cardiac interventions. ECPS was initiated due to failure to restore hemodynamics after prolonged (over 60 minutes advanced cardiac life support (ACLS protocol-guided cardiopulmonary resuscitation. Despite relatively late institution of ECPS, both patients survived with preserved neurological function. This communication focuses on the utility of ECPS in the ICU as a part of resuscitative efforts.

  15. BIM Anatomy II: Standardisation Needs & Support Systems

    OpenAIRE

    Hooper, Martin

    2015-01-01

    This thesis presents the results of an investigation into BIM standardisation needs and procedural supporting mechanisms that may enable design, construction and operating (DCO) organisations to advance their deployment of Building Information Modelling (BIM) technology, and improve construction project outcomes. To achieve sustainable development requires effective information management. Building Information Modelling is of strategic importance for the development of effi...

  16. Comparison of two modes of ventilation after fast-track cardiac surgery: Adaptive support ventilation versus synchronized intermittent mandatory ventilation

    International Nuclear Information System (INIS)

    Aghadavoudi, O.

    2012-01-01

    Objective: There is substantial debate regarding the appropriate protocol for ventilatory management in fast-track cardiac anesthesia (FTCA). This study was carried out to assess and compare the risks and benefits of respiratory weaning based on adaptive support ventilation (ASV) and synchronized intermittent mandatory ventilation (SIMV) after uncomplicated cardiac surgery. Methodology: In a randomized clinical trial, after receiving approval of the Department Research Committee and informed consent from study subjects, 100 patients undergoing elective coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) were enrolled during a 4-month period at a university-based hospital. After surgery and admission to the intensive care unit (ICU), patients were randomized to ASV and SIMV groups. Arterial blood gas (ABG) and hemodynamic variables, respiratory and ventilator characteristics including lung compliance, rapid shallow breathing index (RSBI), tidal volume (TV), respiratory rate (RR), peak inspiratory pressure (P peak), mean airway pressure (p mean), Pao2/FIo2, duration of mechanical ventilation and tracheal intubation, and length of ICU stay were recorded and compared between the two groups. The data were analyzed in 82 patients after considering the exclusion criteria. Results: There were no differences between ASV and SIMV groups in demographics and preoperative characteristics. The duration of tracheal intubation and the length of ICU stay were similar in both groups. There were no statistically and clinically relevant differences between the two groups in ABG, hemodynamic changes, and respiratory and ventilator characteristics during ICU stay. Conclusion: Although ASV may facilitate postoperative respiratory management in FTCA, both ASV and SIMV provide similarly safe and practicable respiratory weaning in the cardiac ICU. The evaluation of potential advantages in patient outcomes and resource utilization of respiratory weaning based on ASV

  17. A spatial decision support system for pipe-break susceptibility ...

    African Journals Online (AJOL)

    lying properties. Existing decision support systems available in the field of water distribution system maintenance mainly focus on leak detection and pipe rehabilitation/replacement strategies. These existing systems, however, do not address the ...

  18. Banding together: an investigation of post-surgery support groups for laparoscopic adjustable gastric banding patients

    Directory of Open Access Journals (Sweden)

    Melissa Opolski

    2014-09-01

    Full Text Available Though advocated as useful for patients, there is little in the literature regarding the use and effectiveness of bariatric support groups. This study investigated characteristics and experiences of bariatric patients who did and did not attend offered groups. Seventy-eight postoperative laparoscopic adjustable gastric banding patients from a private bariatric clinic completed mailed self-report questionnaires. Almost 60% reported having attended the clinic groups, with most wanting to meet other patients and obtain information rather than access psychological assistance. Participants reported generally positive experiences of attending. Nonattendance was often attributed to practical barriers. Satisfaction with support from others was not related to past or predicted future attendance, but higher psychological distress was related to and predictive of greater intention to attend future groups. Likely future attenders also held more positive beliefs about the groups than those who were unlikely to attend. Further research is required into potential positive and negative consequences of attendance, and characteristics of those who are likely to benefit or be harmed by attending. Interventions addressing stereotypes about support groups may help patients make informed decisions about whether to attend a bariatric support group.

  19. [Financing of inpatient orthopaedics and trauma surgery in the 2011 G-DRG System].

    Science.gov (United States)

    Franz, D; Schemmann, F; Roeder, N; Siebert, H; Mahlke, L

    2011-09-01

    The German DRG system forms the basis for billing inpatient hospital services. It includes not only the case groups (G-DRGs), but also copayments. This paper analyses and evaluates the relevant developments of the 2011 G-DRG system for orthopaedics and traumatology from the medical and classificatory perspective. An analysis was performed of relevant diagnoses, medical procedures and G-DRGs in the 2010 and 2011 versions based on the publications of the German DRG Institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). A number of codes for surgical measures have been newly established or modified - above all in foot surgery, arthroscopic surgery and wound surgery. Here, the identification and the correct and performance-based mapping of complex and elaborate scenarios was again the focus of the restructuring of the G-DRG system. The G-DRG structure in orthopaedics and traumatology is changed, especially for polytraumata. The allocation of common cases with a standardized treatment pattern appears to be appropriate and the reimbursement adequate. For the less common and more complex cases the 2011 G-DRG system still shows need for further modification (e.g. polytraumata, joint replacement, spine surgery). The proper integration of the modified OPS classification for foot surgery to the appropriate G-DRGs will be essential to maintain the high quality of the reimbursement structure for the future.

  20. A spatial registration method for navigation system combining O-arm with spinal surgery robot

    Science.gov (United States)

    Bai, H.; Song, G. L.; Zhao, Y. W.; Liu, X. Z.; Jiang, Y. X.

    2018-05-01

    The minimally invasive surgery in spinal surgery has become increasingly popular in recent years as it reduces the chances of complications during post-operation. However, the procedure of spinal surgery is complicated and the surgical vision of minimally invasive surgery is limited. In order to increase the quality of percutaneous pedicle screw placement, the O-arm that is a mobile intraoperative imaging system is used to assist surgery. The robot navigation system combined with O-arm is also increasing, with the extensive use of O-arm. One of the major problems in the surgical navigation system is to associate the patient space with the intra-operation image space. This study proposes a spatial registration method of spinal surgical robot navigation system, which uses the O-arm to scan a calibration phantom with metal calibration spheres. First, the metal artifacts were reduced in the CT slices and then the circles in the images based on the moments invariant could be identified. Further, the position of the calibration sphere in the image space was obtained. Moreover, the registration matrix is obtained based on the ICP algorithm. Finally, the position error is calculated to verify the feasibility and accuracy of the registration method.

  1. SOCOM Training and Rehearsal System (STRS) Process Improvement and Decision Support System (DSS) Development

    National Research Council Canada - National Science Library

    Crossland, Neal; Broussard, Steve

    2005-01-01

    ...) Process Improvement and Decision Support System (DSS) Development. Discussion sequence is: Why the study? Objectives; Areas of inquiry; Study products; Observations; Recommendations; Decision Support System.

  2. Validity, reliability and support for implementation of independence-scaled procedural assessment in laparoscopic surgery.

    Science.gov (United States)

    Kramp, Kelvin H; van Det, Marc J; Veeger, Nic J G M; Pierie, Jean-Pierre E N

    2016-06-01

    There is no widely used method to evaluate procedure-specific laparoscopic skills. The first aim of this study was to develop a procedure-based assessment method. The second aim was to compare its validity, reliability and feasibility with currently available global rating scales (GRSs). An independence-scaled procedural assessment was created by linking the procedural key steps of the laparoscopic cholecystectomy to an independence scale. Subtitled and blinded videos of a novice, an intermediate and an almost competent trainee, were evaluated with GRSs (OSATS and GOALS) and the independence-scaled procedural assessment by seven surgeons, three senior trainees and six scrub nurses. Participants received a short introduction to the GRSs and independence-scaled procedural assessment before assessment. The validity was estimated with the Friedman and Wilcoxon test and the reliability with the intra-class correlation coefficient (ICC). A questionnaire was used to evaluate user opinion. Independence-scaled procedural assessment and GRS scores improved significantly with surgical experience (OSATS p = 0.001, GOALS p < 0.001, independence-scaled procedural assessment p < 0.001). The ICCs of the OSATS, GOALS and independence-scaled procedural assessment were 0.78, 0.74 and 0.84, respectively, among surgeons. The ICCs increased when the ratings of scrub nurses were added to those of the surgeons. The independence-scaled procedural assessment was not considered more of an administrative burden than the GRSs (p = 0.692). A procedural assessment created by combining procedural key steps to an independence scale is a valid, reliable and acceptable assessment instrument in surgery. In contrast to the GRSs, the reliability of the independence-scaled procedural assessment exceeded the threshold of 0.8, indicating that it can also be used for summative assessment. It furthermore seems that scrub nurses can assess the operative competence of surgical trainees.

  3. Tidal ventilation distribution during pressure-controlled ventilation and pressure support ventilation in post-cardiac surgery patients.

    Science.gov (United States)

    Blankman, P; VAN DER Kreeft, S M; Gommers, D

    2014-09-01

    Inhomogeneous ventilation is an important contributor to ventilator-induced lung injury. Therefore, this study examines homogeneity of lung ventilation by means of electrical impedance tomography (EIT) measurements during pressure-controlled ventilation (PCV) and pressure support ventilation (PSV) using the same ventilation pressures. Twenty mechanically ventilated patients were studied after cardiac surgery. On arrival at the intensive care unit, ventilation distribution was measured with EIT just above the diaphragm for 15 min. After awakening, PCV was switched to PSV and EIT measurements were again recorded. Tidal impedance variation, a measure of tidal volume, increased during PSV compared with PCV, despite using the same ventilation pressures (P = 0.045). The distribution of tidal ventilation to the dependent lung region was more pronounced during PSV compared with PCV, especially during the first half of the inspiration. An even distribution of tidal ventilation between the dependent and non-dependent lung regions was seen during PCV at lower tidal volumes (tidal volumes (≥ 8 ml/kg). In addition, the distribution of tidal ventilation was predominantly distributed to the dependent lung during PSV at low tidal volumes. In post-cardiac surgery patients, PSV showed improved ventilation of the dependent lung region due to the contribution of the diaphragm activity, which is even more pronounced during lower assist levels. © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  4. The value of participatory development to support antimicrobial stewardship with a clinical decision support system

    NARCIS (Netherlands)

    Beerlage-de Jong, Nienke; Wentzel, Jobke; Hendrix, Ron; van Gemert-Pijnen, Lisette

    2017-01-01

    Background: Current clinical decision support systems (CDSSs) for antimicrobial stewardship programs (ASPs) are guideline- or expert-driven. They are focused on (clinical) content, not on supporting real-time workflow. Thus, CDSSs fail to optimally support prudent antimicrobial prescribing in daily

  5. The value of participatory development to support antimicrobial stewardship with a clinical decision support system

    NARCIS (Netherlands)

    Beerlage-de Jong, Nienke; Wentzel, M.J.; Hendrix, Ron; van Gemert-Pijnen, Julia E.W.C.

    Background Current clinical decision support systems (CDSSs) for antimicrobial stewardship programs (ASPs) are guideline- or expert-driven. They are focused on (clinical) content, not on supporting real-time workflow. Thus, CDSSs fail to optimally support prudent antimicrobial prescribing in daily

  6. A diagnosis system for plant operation support

    International Nuclear Information System (INIS)

    Sundheimer, S.; Lorenzetti, J.; Lamana, C.

    1990-01-01

    The present article describes a diagnosis system for abnormal power plant events. The design is modular and uses a shell written in C languaje and a knowledge basis that can be changed easily. At present the system works with a reduced knowledge for primary and secondery leacks. The mitigation procedure is being written with the help of operation staff

  7. Design breakthrough in roof support systems

    Energy Technology Data Exchange (ETDEWEB)

    1984-01-01

    The technical experts of the Mining Services sections of Monier Resources Australia have designed and developed a superior roof system for installation in underground mines. The Monier Big Bag Grout Chock is a patented system utilising pumped grout. The advantages of grout chocks over conventional timber chocks are many and varied.

  8. Expert system support and juridical quality

    NARCIS (Netherlands)

    Groothuis, Marga M.; Svensson, Jorgen S.; Breuker, J.; Leenes, R.E.; Winkels, R.

    2000-01-01

    This article discusses the use of expert systems as a means of achieving juridical quality within administrative organisations. Do these systems really improve the quality of decision making and provide the desired guarantees with respect to the correct treatment of clients?

  9. The da Vinci telerobotic surgical system: the virtual operative field and telepresence surgery.

    Science.gov (United States)

    Ballantyne, Garth H; Moll, Fred

    2003-12-01

    The United States Department of Defense developed the telepresence surgery concept to meet battlefield demands. The da Vinci telerobotic surgery system evolved from these efforts. In this article, the authors describe the components of the da Vinci system and explain how the surgeon sits at a computer console, views a three-dimensional virtual operative field, and performs the operation by controlling robotic arms that hold the stereoscopic video telescope and surgical instruments that simulate hand motions with seven degrees of freedom. The three-dimensional imaging and handlike motions of the system facilitate advanced minimally invasive thoracic, cardiac, and abdominal procedures. da Vinci has recently released a second generation of telerobots with four arms and will continue to meet the evolving challenges of surgery.

  10. Supporting patients in obtaining and oncologists in providing evidence-based health-related quality of life information prior to and after esophageal cancer surgery

    OpenAIRE

    Jacobs, M.

    2015-01-01

    The overall aim of this thesis was to support patients in obtaining and oncologists in providing evidence-based HRQL data prior to and following esophageal cancer surgery. This thesis is divided in two parts. In Part I, we addressed the information needs of esophageal cancer patients prior to and following esophageal surgery, the barriers and facilitators patients experienced when discussing their information needs with their oncologist, and the development of a web-based question prompt shee...

  11. Achievement report for fiscal 1999 on research and development of technologies for medical welfare equipment. Surgery support system for brain tumors and other conditions (Rationalization for energy profit); 1999 nendo iryo fukushi kiki gijutsu kenkyu kaihatsu seika hokokusho. Noshuyo nado shujutsu shien system (energy shiyo gorika)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-05-01

    In the second phase of experimental micro-manipulator fabrication, insertion parts equipped with three manipulators and operation input units are built and evaluated. The system comprises three input units and a console with a built-in controller etc., and the console is checked for shape and operability. A high resolution and high brightness stereoscopic viewer is developed for clinical use by surgical operators, and is examined for practicality. The positioning system for the intraoperative vision instrument are improved relative to its attachment method, accuracy, and sterilization tolerance. The result is evaluated, and then further improvement is made. Some functions are added to the surgical planning software program. Software programs are constructed for the real-time control and operation of the viewing system. For the micro-manipulator system to serve as a total system, the forceps are extended, tips are developed for the suction device and incision device, and their functions as members of the system are evaluated. (NEDO)

  12. A low-cost multimodal head-mounted display system for neuroendoscopic surgery.

    Science.gov (United States)

    Xu, Xinghua; Zheng, Yi; Yao, Shujing; Sun, Guochen; Xu, Bainan; Chen, Xiaolei

    2018-01-01

    With rapid advances in technology, wearable devices as head-mounted display (HMD) have been adopted for various uses in medical science, ranging from simply aiding in fitness to assisting surgery. We aimed to investigate the feasibility and practicability of a low-cost multimodal HMD system in neuroendoscopic surgery. A multimodal HMD system, mainly consisted of a HMD with two built-in displays, an action camera, and a laptop computer displaying reconstructed medical images, was developed to assist neuroendoscopic surgery. With this intensively integrated system, the neurosurgeon could freely switch between endoscopic image, three-dimensional (3D) reconstructed virtual endoscopy images, and surrounding environment images. Using a leap motion controller, the neurosurgeon could adjust or rotate the 3D virtual endoscopic images at a distance to better understand the positional relation between lesions and normal tissues at will. A total of 21 consecutive patients with ventricular system diseases underwent neuroendoscopic surgery with the aid of this system. All operations were accomplished successfully, and no system-related complications occurred. The HMD was comfortable to wear and easy to operate. Screen resolution of the HMD was high enough for the neurosurgeon to operate carefully. With the system, the neurosurgeon might get a better comprehension on lesions by freely switching among images of different modalities. The system had a steep learning curve, which meant a quick increment of skill with it. Compared with commercially available surgical assistant instruments, this system was relatively low-cost. The multimodal HMD system is feasible, practical, helpful, and relatively cost efficient in neuroendoscopic surgery.

  13. Overview of Actuated Arm Support Systems and Their Applications

    Directory of Open Access Journals (Sweden)

    E.A. Lomonova

    2013-10-01

    Full Text Available Arm support systems provide support throughout daily tasks, training or in an industrial environment. During the last decades a large diversity of actuated arm support systems have been developed. To analyze the actuation principles in these systems, an overview of actuated arm support systems is provided. This overview visualizes the current trends on research and development of these support systems and distinguishes three categories. These categories depend mainly on the functional status of the user environment, which defines the specifications. Therefore, the actuated arm support systems are classified according to their user environment, namely: ambulatory, rehabilitation and industrial. Furthermore, three main actuation principles and three mechanical construction principles have been identified.

  14. Reversal of neuromuscular blockade by sugammadex in laparoscopic bariatric surgery: In support of dose reduction.

    Science.gov (United States)

    Badaoui, Rachid; Cabaret, Aurélie; Alami, Youssef; Zogheib, Elie; Popov, Ivan; Lorne, Emmanuel; Dupont, Hervé

    2016-02-01

    Sugammadex is the first molecule able to antagonize steroidal muscle relaxants with few adverse effects. Doses are adjusted to body weight and the level of neuromuscular blockade. Sleeve gastrectomy is becoming a very popular form of bariatric surgery. It requires deep muscle relaxation followed by complete and rapid reversal to decrease postoperative and especially post-anaesthetic morbidity. Sugammadex is therefore particularly indicated in this setting. The objective of this study was to evaluate the deep neuromuscular blockade reversal time after administration of various doses of sugammadex (based on real weight or at lower doses). Secondary endpoints were the interval between the sugammadex injection and extubation and transfer from the operating room to the recovery room. We then investigated any complications observed in the recovery room. This pilot, prospective, observational, clinical practice evaluation study was conducted in the Amiens University Hospital. Neuromuscular blockade was induced by rocuronium. At the end of the operation, deep neuromuscular blockade was reversed by sugammadex at the dose of 4mg/kg. Sixty-four patients were included: 31 patients received sugammadex at a dosage based on their real weight (RW) and 33 patients received a lower dose (based on ideal weight [IW]). For identical rocuronium doses calculated based on IBW, sugammadex doses were significantly lower in the IW group: 349 (± 65) mg versus 508 (± 75) mg (Psugammadex and extubation (P=0.07) and transfer from the operating room to the recovery room (P=0.68) were also non-significantly longer in the IW group. The mean dose of sugammadex used by anaesthetists in the IW group was 4mg/kg of ideal weight increased by 35% to 50% (n=20; 351±34mg). No sugammadex adverse effects and no residual neuromuscular blockades were observed. Postoperative nausea and vomiting (PONV) was observed in 19.4% of patients in the real weight group versus 27.3% in the ideal weight group (P

  15. Quality education as quality system support

    International Nuclear Information System (INIS)

    Crnoshia, L.; Gavriloska, M.; Denkovska, J.; Dimitrovski, A.

    1999-01-01

    Within the last ten years we are witnesses of the political and economical system transformation, that imposed the need for changing the way of thinking and work planning. The quality has become the imperative of working and a precondition for survival in the market. Solving the quality problems seeks planned and systematic approach that supposed appropriate personnel with adequate knowledge in the field of quality management and implementation of the quality system. Having in mind the need for documented quality system and quality management OKTA, has already started with personnel educational process for quality as a precondition for successful establishment of quality system. In this paper we present quality education approach and manner of its realization in OKTA Crude Oil Refinery - Skopje, Macedonia. (Original)

  16. E3 Travel & Mission Support System

    Data.gov (United States)

    US Agency for International Development — ETRAMS is a travel data collection system developed by the CKM team in E3 that collects information on both the basic details of an employee's trips (destination,...

  17. Control Systems Cyber Security Standards Support Activities

    Energy Technology Data Exchange (ETDEWEB)

    Robert Evans

    2009-01-01

    The Department of Homeland Security’s Control Systems Security Program (CSSP) is working with industry to secure critical infrastructure sectors from cyber intrusions that could compromise control systems. This document describes CSSP’s current activities with industry organizations in developing cyber security standards for control systems. In addition, it summarizes the standards work being conducted by organizations within the sector and provides a brief listing of sector meetings and conferences that might be of interest for each sector. Control systems cyber security standards are part of a rapidly changing environment. The participation of CSSP in the development effort for these standards has provided consistency in the technical content of the standards while ensuring that information developed by CSSP is included.

  18. Nuclear-fueled circulatory support systems

    Energy Technology Data Exchange (ETDEWEB)

    Norman, J C [Texas Heart Inst. (USA)

    1975-08-01

    Experiments on calves using two types of systems for nuclear left ventricular assist pumps are described. These two systems use a nuclear heat source containing 120 g, 1600 Ci Pu-238 in the form of plutonium oxide. The heat source for the first system is the tidal regenerator engine with no valve or seal and is controlled using a hall effect displacement sensor. The second left ventricular assist system uses heat generated by nuclear decay for producing high gas pressure which is converted into a high hydraulic pressure for pumping. The engine efficiency amounts to 7 to 16%, and the measurement value of the pump efficiency obtained is 85%. How these two systems are synchronized with the left ventricle of vital body is described. IN a transplant experiment for a short period (175 hours) in the initial stage, the possibility of the present method was demonstrated. A long-term performance experiment and improvement of the systems are anticipated. However, there still remain many problems, such as improvement of efficiency, reliability, and performance and diminution of the size.

  19. Fault Detection for Shipboard Monitoring and Decision Support Systems

    DEFF Research Database (Denmark)

    Lajic, Zoran; Nielsen, Ulrik Dam

    2009-01-01

    In this paper a basic idea of a fault-tolerant monitoring and decision support system will be explained. Fault detection is an important part of the fault-tolerant design for in-service monitoring and decision support systems for ships. In the paper, a virtual example of fault detection...... will be presented for a containership with a real decision support system onboard. All possible faults can be simulated and detected using residuals and the generalized likelihood ratio (GLR) algorithm....

  20. Optimal support arrangement of piping systems using genetic algorithm

    International Nuclear Information System (INIS)

    Chiba, T.; Okado, S.; Fujii, I.; Itami, K.

    1996-01-01

    The support arrangement is one of the important factors in the design of piping systems. Much time is required to decide the arrangement of the supports. The authors applied a genetic algorithm to find the optimum support arrangement for piping systems. Examples are provided to illustrate the effectiveness of the genetic algorithm. Good results are obtained when applying the genetic algorithm to the actual designing of the piping system

  1. Anterior capsular support for posterior chamber intraocular lenses following vitreous loss in endocapsular surgery

    Directory of Open Access Journals (Sweden)

    Jacob Pushpa

    1993-01-01

    Full Text Available We used anterior capsular support for posterior chamber intraocular lenses (PC IOLs in fourteen eyes with large posterior capsular ruptures. An endocapsular technique preserved the anterior capsule and facilitated implantation. With a median follow up of 8.5 months, all patients had a visual acuity of 6/9 or better. One lens was lost in the vitreous and one patient had a clinically significant cystoid macular edema. In the event of a posterior capsular rupture we suggest this technique as an alternative to anterior chamber or scleral-fixated lenses

  2. [First experience in the thyroid and parathyroid surgery using the da Vinci® system].

    Science.gov (United States)

    Al Kadah, B; Siemer, S; Schick, B

    2014-01-01

    Endoscopic surgery for the treatment of thyroid and parathyroid pathologies is gaining increasing attention. The da Vinci® system has been already widely used in different fields of medicine including recently thyroid and parathyroid surgery. Herein we report our first experiences in endoscopic surgery of thyroid and parathyroid pathologies using the da Vinci® system. 8 patients presenting with struma nodosa in 6 cases and parathyroid adenomas in 2 cases have been treated using the da Vinci® system at the ENT department of Homburg/Saar University. The skin incision to introduce the instruments with the da Vinci® system were axilar or at the lateral segment of the clavicle. The neurovascular structures like inferior laryngeal nerve as well as the pathologies were clearly 3-dimensional visualized in all 8 cases. No paralysis of the vocal cord was observed. All patients had in histological examination a benign pathology. The endoscopic surgery of the thyroid and parathyroid gland can be performed using the da Vinci® system and offers an excellent, intraoperative, 3-dimensional visualization of the neurovascular structures. Additionally the da Vinci® system enables skin incisions within considerable distance from the thyroid and parathyroid gland. © Georg Thieme Verlag KG Stuttgart · New York.

  3. A maintenance support system with document handling capability

    International Nuclear Information System (INIS)

    Fukumoto, A.; Tsumura, K.; Fujii, M.; Tai, I.; Makimo, M.; Watanabe, T.

    1990-01-01

    An operation and maintenance support system, called 'Advanced Man-Machine System for Nuclear Power Plants' (MMS-NPP) is under development with the support of the Japanese Government. Taking full advantage of Artificial Intelligence technology, the system aims to enhance the capability of already developed 'Computerized Operator Support System (COSS)' and gives wider and more advanced support for operation and maintenance. With a brief overview of MMS-NPP, this paper describes a support system for plant patrol and equipment inspection. The system gives guidance for plant patrol and for equipment inspection and provides easy access to plant drawings and documents. A unique knowledge acquisition method, utilizing image processing technology, was proposed in building the system

  4. Social Network Supported Process Recommender System

    Directory of Open Access Journals (Sweden)

    Yanming Ye

    2014-01-01

    Full Text Available Process recommendation technologies have gained more and more attention in the field of intelligent business process modeling to assist the process modeling. However, most of the existing technologies only use the process structure analysis and do not take the social features of processes into account, while the process modeling is complex and comprehensive in most situations. This paper studies the feasibility of social network research technologies on process recommendation and builds a social network system of processes based on the features similarities. Then, three process matching degree measurements are presented and the system implementation is discussed subsequently. Finally, experimental evaluations and future works are introduced.

  5. Social network supported process recommender system.

    Science.gov (United States)

    Ye, Yanming; Yin, Jianwei; Xu, Yueshen

    2014-01-01

    Process recommendation technologies have gained more and more attention in the field of intelligent business process modeling to assist the process modeling. However, most of the existing technologies only use the process structure analysis and do not take the social features of processes into account, while the process modeling is complex and comprehensive in most situations. This paper studies the feasibility of social network research technologies on process recommendation and builds a social network system of processes based on the features similarities. Then, three process matching degree measurements are presented and the system implementation is discussed subsequently. Finally, experimental evaluations and future works are introduced.

  6. Stability design considerations for mirror support systems in ICF lasers

    International Nuclear Information System (INIS)

    Tietbohl, G.L.; Sommer, S.C.

    1996-10-01

    Some of the major components of laser systems used for Inertial Confinement Fusion (ICF) are the large aperture mirrors which direct the path of the laser. These mirrors are typically supported by systems which consist of mirror mounts, mirror enclosures, superstructures, and foundations. Stability design considerations for the support systems of large aperture mirrors have been developed based on the experience of designing and evaluating similar systems at the Lawrence Livermore National Laboratory (LLNL). Examples of the systems developed at LLNL include Nova, the Petawatt laser, Beamlet, and the National Ignition Facility (NIF). The structural design of support systems of large aperture mirrors has typically been controlled by stability considerations in order for the large laser system to meet its performance requirements for alignment and positioning. This paper will discuss the influence of stability considerations and will provide guidance on the structural design and evaluation of mirror support systems in ICF lasers so that this information can be used on similar systems

  7. Supporting the Architecting Process of Adaptive Systems

    NARCIS (Netherlands)

    Komoto, H.; Hamberg, R.; Tomiyama, T.

    2013-01-01

    Full flexible use of inkjet printhead units in printing systems requires consistent generation of drops with any given volume and velocity at any moment and place desired. True drop-on-demand is currently hampered by physical phenomena in the printhead. These are residual vibrations and crosstalk

  8. Supporting Continuous Improvement in California's Education System

    Science.gov (United States)

    Darling-Hammond, Linda; Plank, David N.

    2015-01-01

    California's new accountability system originated in the radical decentralization of power and authority from Sacramento to local schools and their communities brought about by the Legislature's adoption of the Local Control Funding Formula (LCFF) in 2013. Under California's previous accountability policies and the federal "No Child Left…

  9. Statistical modeling to support power system planning

    Science.gov (United States)

    Staid, Andrea

    This dissertation focuses on data-analytic approaches that improve our understanding of power system applications to promote better decision-making. It tackles issues of risk analysis, uncertainty management, resource estimation, and the impacts of climate change. Tools of data mining and statistical modeling are used to bring new insight to a variety of complex problems facing today's power system. The overarching goal of this research is to improve the understanding of the power system risk environment for improved operation, investment, and planning decisions. The first chapter introduces some challenges faced in planning for a sustainable power system. Chapter 2 analyzes the driving factors behind the disparity in wind energy investments among states with a goal of determining the impact that state-level policies have on incentivizing wind energy. Findings show that policy differences do not explain the disparities; physical and geographical factors are more important. Chapter 3 extends conventional wind forecasting to a risk-based focus of predicting maximum wind speeds, which are dangerous for offshore operations. Statistical models are presented that issue probabilistic predictions for the highest wind speed expected in a three-hour interval. These models achieve a high degree of accuracy and their use can improve safety and reliability in practice. Chapter 4 examines the challenges of wind power estimation for onshore wind farms. Several methods for wind power resource assessment are compared, and the weaknesses of the Jensen model are demonstrated. For two onshore farms, statistical models outperform other methods, even when very little information is known about the wind farm. Lastly, chapter 5 focuses on the power system more broadly in the context of the risks expected from tropical cyclones in a changing climate. Risks to U.S. power system infrastructure are simulated under different scenarios of tropical cyclone behavior that may result from climate

  10. EPICS: operating system independent device/driver support

    International Nuclear Information System (INIS)

    Kraimer, M.R.

    2003-01-01

    Originally EPICS input/output controllers (IOCs) were only supported on VME-based systems running the vxWorks operating system. Now IOCs are supported on many systems: vxWorks, RTEMS, Solaris, HPUX, Linux, WIN32, and Darwin. A challenge is to provide operating-system-independent device and driver support. This paper presents some techniques for providing such support. EPICS (Experimental Physics and Industrial Control System) is a set of software tools, libraries, and applications developed collaboratively and used worldwide to create distributed, real-time control systems for scientific instruments such as particle accelerators, telescopes, and other large scientific experiments. An important component of all EPICS-based control systems is a collection of input/output controllers (IOCs). An IOC has three primary components: (1) a real-time database; (2) channel access, which provides network access to the database; and (3) device/driver support for interfacing to equipment. This paper describes some projects related to providing device/driver support on non-vxWorks systems. In order to support IOCs on platforms other than vxWorks, operating-system-independent (OSI) application program interfaces (APIs) were defined for threads, semaphores, timers, etc. Providing support for a new platform consists of providing an operating-system-dependent implementation of the OSI APIs.

  11. Bidirectional Frontoparietal Oscillatory Systems Support Working Memory.

    Science.gov (United States)

    Johnson, Elizabeth L; Dewar, Callum D; Solbakk, Anne-Kristin; Endestad, Tor; Meling, Torstein R; Knight, Robert T

    2017-06-19

    The ability to represent and select information in working memory provides the neurobiological infrastructure for human cognition. For 80 years, dominant views of working memory have focused on the key role of prefrontal cortex (PFC) [1-8]. However, more recent work has implicated posterior cortical regions [9-12], suggesting that PFC engagement during working memory is dependent on the degree of executive demand. We provide evidence from neurological patients with discrete PFC damage that challenges the dominant models attributing working memory to PFC-dependent systems. We show that neural oscillations, which provide a mechanism for PFC to communicate with posterior cortical regions [13], independently subserve communications both to and from PFC-uncovering parallel oscillatory mechanisms for working memory. Fourteen PFC patients and 20 healthy, age-matched controls performed a working memory task where they encoded, maintained, and actively processed information about pairs of common shapes. In controls, the electroencephalogram (EEG) exhibited oscillatory activity in the low-theta range over PFC and directional connectivity from PFC to parieto-occipital regions commensurate with executive processing demands. Concurrent alpha-beta oscillations were observed over parieto-occipital regions, with directional connectivity from parieto-occipital regions to PFC, regardless of processing demands. Accuracy, PFC low-theta activity, and PFC → parieto-occipital connectivity were attenuated in patients, revealing a PFC-independent, alpha-beta system. The PFC patients still demonstrated task proficiency, which indicates that the posterior alpha-beta system provides sufficient resources for working memory. Taken together, our findings reveal neurologically dissociable PFC and parieto-occipital systems and suggest that parallel, bidirectional oscillatory systems form the basis of working memory. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. The need for intra aortic balloon pump support following open heart surgery: risk analysis and outcome.

    LENUS (Irish Health Repository)

    Parissis, Haralabos

    2010-01-01

    BACKGROUND: The early and intermediate outcome of patients requiring intraaortic balloon pump (IABP) was studied in a cohort of 2697 adult cardiac surgical patients. METHODS: 136 patients requiring IABP (5.04%) support analysed over a 4 year period. Prospective data collection, obtained. RESULTS: The overall operative mortality was 35.3%. The "operation specific" mortality was higher on the Valve population.The mortality (%) as per time of balloon insertion was: Preoperative 18.2, Intraoperative 33.3, postoperative 58.3 (p < 0.05).The incremental risk factors for death were: Female gender (Odds Ratio (OR) = 3.87 with Confidence Intervals (CI) = 1.3-11.6), Smoking (OR = 4.88, CI = 1.23- 19.37), Preoperative Creatinine>120 (OR = 3.3, CI = 1.14-9.7), Cross Clamp time>80 min (OR = 4.16, CI = 1.73-9.98) and IABP insertion postoperatively (OR = 19.19, CI = 3.16-116.47).The incremental risk factors for the development of complications were: Poor EF (OR = 3.16, CI = 0.87-11.52), Euroscore >7 (OR = 2.99, CI = 1.14-7.88), history of PVD (OR = 4.99, CI = 1.32-18.86).The 5 years survival was 79.2% for the CABG population and 71.5% for the valve group. (Hazard ratio = 1.78, CI = 0.92-3.46). CONCLUSIONS: IABP represents a safe option of supporting the failing heart. The need for IABP especially in a high risk Valve population is associated with early unfavourable outcome, however the positive mid term results further justify its use.

  13. The need for intra aortic balloon pump support following open heart surgery: risk analysis and outcome

    Directory of Open Access Journals (Sweden)

    Apostolakis Efstratios

    2010-04-01

    Full Text Available Abstract Background The early and intermediate outcome of patients requiring intraaortic balloon pump (IABP was studied in a cohort of 2697 adult cardiac surgical patients. Methods 136 patients requiring IABP (5.04% support analysed over a 4 year period. Prospective data collection, obtained. Results The overall operative mortality was 35.3%. The "operation specific" mortality was higher on the Valve population. The mortality (% as per time of balloon insertion was: Preoperative 18.2, Intraopeartive 33.3, postoperative 58.3 (p The incremental risk factors for death were: Female gender (Odds Ratio (OR = 3.87 with Confidence Intervals (CI = 1.3-11.6, Smoking (OR = 4.88, CI = 1.23- 19.37, Preoperative Creatinine>120 (OR = 3.3, CI = 1.14-9.7, Cross Clamp time>80 min (OR = 4.16, CI = 1.73-9.98 and IABP insertion postoperatively (OR = 19.19, CI = 3.16-116.47. The incremental risk factors for the development of complications were: Poor EF (OR = 3.16, CI = 0.87-11.52, Euroscore >7 (OR = 2.99, CI = 1.14-7.88, history of PVD (OR = 4.99, CI = 1.32-18.86. The 5 years survival was 79.2% for the CABG population and 71.5% for the valve group. (Hazard ratio = 1.78, CI = 0.92-3.46. Conclusions IABP represents a safe option of supporting the failing heart. The need for IABP especially in a high risk Valve population is associated with early unfavourable outcome, however the positive mid term results further justify its use.

  14. A VidEo-Based Intelligent Recognition and Decision System for the Phacoemulsification Cataract Surgery

    Directory of Open Access Journals (Sweden)

    Shu Tian

    2015-01-01

    Full Text Available The phacoemulsification surgery is one of the most advanced surgeries to treat cataract. However, the conventional surgeries are always with low automatic level of operation and over reliance on the ability of surgeons. Alternatively, one imaginative scene is to use video processing and pattern recognition technologies to automatically detect the cataract grade and intelligently control the release of the ultrasonic energy while operating. Unlike cataract grading in the diagnosis system with static images, complicated background, unexpected noise, and varied information are always introduced in dynamic videos of the surgery. Here we develop a VidEo-Based Intelligent Recognitionand Decision (VEBIRD system, which breaks new ground by providing a generic framework for automatically tracking the operation process and classifying the cataract grade in microscope videos of the phacoemulsification cataract surgery. VEBIRD comprises a robust eye (iris detector with randomized Hough transform to precisely locate the eye in the noise background, an effective probe tracker with Tracking-Learning-Detection to thereafter track the operation probe in the dynamic process, and an intelligent decider with discriminative learning to finally recognize the cataract grade in the complicated video. Experiments with a variety of real microscope videos of phacoemulsification verify VEBIRD’s effectiveness.

  15. Design and Validation of an Augmented Reality System for Laparoscopic Surgery in a Real Environment

    Science.gov (United States)

    López-Mir, F.; Naranjo, V.; Fuertes, J. J.; Alcañiz, M.; Bueno, J.; Pareja, E.

    2013-01-01

    Purpose. This work presents the protocol carried out in the development and validation of an augmented reality system which was installed in an operating theatre to help surgeons with trocar placement during laparoscopic surgery. The purpose of this validation is to demonstrate the improvements that this system can provide to the field of medicine, particularly surgery. Method. Two experiments that were noninvasive for both the patient and the surgeon were designed. In one of these experiments the augmented reality system was used, the other one was the control experiment, and the system was not used. The type of operation selected for all cases was a cholecystectomy due to the low degree of complexity and complications before, during, and after the surgery. The technique used in the placement of trocars was the French technique, but the results can be extrapolated to any other technique and operation. Results and Conclusion. Four clinicians and ninety-six measurements obtained of twenty-four patients (randomly assigned in each experiment) were involved in these experiments. The final results show an improvement in accuracy and variability of 33% and 63%, respectively, in comparison to traditional methods, demonstrating that the use of an augmented reality system offers advantages for trocar placement in laparoscopic surgery. PMID:24236293

  16. Development and application of stent-based image guided navigation system for oral and maxillofacial surgery

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Woo Jin; Kim, Dae Seung [Interdisciplinary Program in Radiation Applied Life Science, Dental Research Institute and BK21, College of Medicine, Seoul National University, Seoul (Korea, Republic of); Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul; Heo, Min Suk; Huh, Kyung Hoe; Kim, Myung Jin; Lee, Jee Ho [Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2009-09-15

    The purpose of this study was to develop a stent-based image guided surgery system and to apply it to oral and maxillofacial surgeries for anatomically complex sites. We devised a patient-specific stent for patient-to-image registration and navigation. Three dimensional positions of the reference probe and the tool probe were tracked by an optical camera system and the relative position of the handpiece drill tip to the reference probe was monitored continuously on the monitor of a PC. Using 8 landmarks for measuring accuracy, the spatial discrepancy between CT image coordinate and physical coordinate was calculated for testing the normality. The accuracy over 8 anatomical landmarks showed an overall mean of 0.56 {+-} 0.16 mm. The developed system was applied to a surgery for a vertical alveolar bone augmentation in right mandibular posterior area and possible interior alveolar nerve injury case of an impacted third molar. The developed system provided continuous monitoring of invisible anatomical structures during operation and 3D information for operation sites. The clinical challenge showed sufficient accuracy and availability of anatomically complex operation sites. The developed system showed sufficient accuracy and availability in oral and maxillofacial surgeries for anatomically complex sites.

  17. Design and Validation of an Augmented Reality System for Laparoscopic Surgery in a Real Environment

    Directory of Open Access Journals (Sweden)

    F. López-Mir

    2013-01-01

    Full Text Available Purpose. This work presents the protocol carried out in the development and validation of an augmented reality system which was installed in an operating theatre to help surgeons with trocar placement during laparoscopic surgery. The purpose of this validation is to demonstrate the improvements that this system can provide to the field of medicine, particularly surgery. Method. Two experiments that were noninvasive for both the patient and the surgeon were designed. In one of these experiments the augmented reality system was used, the other one was the control experiment, and the system was not used. The type of operation selected for all cases was a cholecystectomy due to the low degree of complexity and complications before, during, and after the surgery. The technique used in the placement of trocars was the French technique, but the results can be extrapolated to any other technique and operation. Results and Conclusion. Four clinicians and ninety-six measurements obtained of twenty-four patients (randomly assigned in each experiment were involved in these experiments. The final results show an improvement in accuracy and variability of 33% and 63%, respectively, in comparison to traditional methods, demonstrating that the use of an augmented reality system offers advantages for trocar placement in laparoscopic surgery.

  18. Development and application of stent-based image guided navigation system for oral and maxillofacial surgery

    International Nuclear Information System (INIS)

    Lee, Woo Jin; Kim, Dae Seung; Yi, Won Jin; Lee, Sam Sun; Choi, Soon Chul; Heo, Min Suk; Huh, Kyung Hoe; Kim, Myung Jin; Lee, Jee Ho

    2009-01-01

    The purpose of this study was to develop a stent-based image guided surgery system and to apply it to oral and maxillofacial surgeries for anatomically complex sites. We devised a patient-specific stent for patient-to-image registration and navigation. Three dimensional positions of the reference probe and the tool probe were tracked by an optical camera system and the relative position of the handpiece drill tip to the reference probe was monitored continuously on the monitor of a PC. Using 8 landmarks for measuring accuracy, the spatial discrepancy between CT image coordinate and physical coordinate was calculated for testing the normality. The accuracy over 8 anatomical landmarks showed an overall mean of 0.56 ± 0.16 mm. The developed system was applied to a surgery for a vertical alveolar bone augmentation in right mandibular posterior area and possible interior alveolar nerve injury case of an impacted third molar. The developed system provided continuous monitoring of invisible anatomical structures during operation and 3D information for operation sites. The clinical challenge showed sufficient accuracy and availability of anatomically complex operation sites. The developed system showed sufficient accuracy and availability in oral and maxillofacial surgeries for anatomically complex sites.

  19. Radioisotope heaters for spacecraft life support systems

    International Nuclear Information System (INIS)

    Shivers, R.W.; Murray, R.W.

    1974-01-01

    Future manned space flight requires the sanitary collection and disposal of biological wastes to minimize microbial contamination hazard. The recovery and reuse of water from such wastes are also necessary to reduce the weight of vehicles at launching and resupply logistics. The development and test of an engineering model, i.e. the completely integrated waste management-water system using radioisotopes for thermal energy, are described. This is capable of collecting and processing the wastes from four men during 180-day simulated space mission. The sub-systems include collection of feces, trash and urine, water reclamation, the storage, heating and dispensing of the water, and the disposal of feces, urine residue and other non-metallic waste material by incineration. (Mori, K.)

  20. Mobile 3D Viewer Supporting RFID System

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J J; Yang, S W; Choi, Y [Chungang Univ., Seoul (Korea, Republic of)

    2007-07-01

    As hardware capabilities of mobile devices are being rapidly enhanced, applications based upon mobile devices are also being developed in wider areas. In this paper, a prototype mobile 3D viewer with the object identification through RFID system is presented. To visualize 3D engineering data such as CAD data, we need a process to compute triangulated data from boundary based surface like B-rep solid or trimmed surfaces. Since existing rendering engines on mobile devices do not provide triangulation capability, mobile 3D programs have focused only on an efficient handling with pre-tessellated geometry. We have developed a light and fast triangulation process based on constrained Delaunay triangulation suitable for mobile devices in the previous research. This triangulation software is used as a core for the mobile 3D viewer on a PDA with RFID system that may have potentially wide applications in many areas.

  1. Mobile 3D Viewer Supporting RFID System

    International Nuclear Information System (INIS)

    Kim, J. J.; Yang, S. W.; Choi, Y.

    2007-01-01

    As hardware capabilities of mobile devices are being rapidly enhanced, applications based upon mobile devices are also being developed in wider areas. In this paper, a prototype mobile 3D viewer with the object identification through RFID system is presented. To visualize 3D engineering data such as CAD data, we need a process to compute triangulated data from boundary based surface like B-rep solid or trimmed surfaces. Since existing rendering engines on mobile devices do not provide triangulation capability, mobile 3D programs have focused only on an efficient handling with pre-tessellated geometry. We have developed a light and fast triangulation process based on constrained Delaunay triangulation suitable for mobile devices in the previous research. This triangulation software is used as a core for the mobile 3D viewer on a PDA with RFID system that may have potentially wide applications in many areas

  2. Reliability Growth in Space Life Support Systems

    Science.gov (United States)

    Jones, Harry W.

    2014-01-01

    A hardware system's failure rate often increases over time due to wear and aging, but not always. Some systems instead show reliability growth, a decreasing failure rate with time, due to effective failure analysis and remedial hardware upgrades. Reliability grows when failure causes are removed by improved design. A mathematical reliability growth model allows the reliability growth rate to be computed from the failure data. The space shuttle was extensively maintained, refurbished, and upgraded after each flight and it experienced significant reliability growth during its operational life. In contrast, the International Space Station (ISS) is much more difficult to maintain and upgrade and its failure rate has been constant over time. The ISS Carbon Dioxide Removal Assembly (CDRA) reliability has slightly decreased. Failures on ISS and with the ISS CDRA continue to be a challenge.

  3. System Administration Support/SWORDS G2

    Science.gov (United States)

    Dito, Scott Joseph

    2014-01-01

    The Soldier-Warfighter Operationally Responsive Deployer for Space (SWORDS) rocket is a dedicated small satellite launcher that will minimize danger and complexity in order to allow soldiers in the field to put payloads of up to 25kg into orbit from the field. The SWORDSG2 project is the development of a model, simulation, and ultimately a working application that will control and monitor the cryogenic fluid delivery to the SWORDS rocket for testing purposes. To accomplish this, the project is using the programming language environment Gensym G2. The environment is an all-inclusive application that allows development, testing, modeling, and finally operation of the unique application through graphical and programmatic methods. In addition, observation of the current cryogenic fluid delivery system in the Kennedy Space Center Cry Lab has allowed me to gain valuable experience of fluid systems and propelant delivery that is valuable to our team when developing amd modeling our own system.The ultimate goal of having a test-ready application to show to the heads of the project, and demonstrating G2's capabilities, by late 2014 will require hard work and intense study and understanding of not only the programming aspect but also the physical phenomena we want to model, observe, and control.

  4. Intelligent Information System to support decision making.

    Directory of Open Access Journals (Sweden)

    Kathrin Rodríguez Llanes

    2010-06-01

    Full Text Available Making decisions is complicated in a generalized way, the materials and humans resources of the entity we belong to depends on it, such as the fulfillment of its goals. But when the situations are complex, making decisions turns into a very difficult work, due to the great amount of aspects to consider when making the right choice. To make this efficiently the administration must to consult an important volume of information, which generally, is scattered and in any different formats. That’s why appears the need of developing software that crowd together all that information and be capable of, by using powerful search engines and process algorithms improve the good decisions making process. Considering previous explanation, a complete freeware developed product is proposed, this constitutes a generic and multi-platform solution, that using artificial intelligence techniques, specifically the cases based reasoning, gives the possibility to leaders of any institution or organism of making the right choice in any situation.With client-server architecture, this system is consumed from web as a service and it can be perfectly integrated with a management system or the geographic information system to facilitate the business process.

  5. Fusion-supported decentralized nuclear energy system

    International Nuclear Information System (INIS)

    Jassby, D.L.

    1979-04-01

    A decentralized nuclear energy system is proposed comprising mass-produced pressurized water reactors in the size range 10 to 300 MW (thermal), to be used for the production of process heat, space heat, and electricity in applications where petroleum and natural gas are presently used. Special attention is given to maximizing the refueling interval with no interim batch shuffling in order to minimize fuel transport, reactor downtime, and opportunity for fissile diversion. These objectives demand a substantial fissile enrichment (7 to 15%). The preferred fissile fuel is U-233, which offers an order of magnitude savings in ore requirements (compared with U-235 fuel), and whose higher conversion ratio in thermal reactors serves to extend the period of useful reactivity and relieve demand on the fissile breeding plants (compared with Pu-239 fuel). Application of the neutral-beam-driven tokamak fusion-neutron source to a U-233 breeding pilot plant is examined. This scheme can be extended in part to a decentralized fusion energy system, wherein remotely located large fusion reactors supply excess tritium to a distributed system of relatively small nonbreeding D-T reactors

  6. Support for Quality Assurance in End-User Systems.

    Science.gov (United States)

    Klepper, Robert; McKenna, Edward G.

    1989-01-01

    Suggests an approach that organizations can take to provide centralized support services for quality assurance in end-user information systems, based on the experiences of a support group at Citicorp Mortgage, Inc. The functions of the support group include user education, software selection, and assistance in testing, implementation, and support…

  7. Evaluation on usefulness of stereotactic radio surgery using Fraxion system

    International Nuclear Information System (INIS)

    Kim, Tae Won; Park, Kwang Woo; Ha, Jin Sook; Jeon, Mi Jin; Cho, Yoon Jin; Kim, Sei Joon; Kim, Jong Dae; Shin, Dong Bong

    2014-01-01

    We evaluated the usefulness of Fraxion system and s-thermoplastic mask by analyzing setup error when stereotactic radiousurgery (SRS) was treated for brain metastasis. 6 patients who received definite diagnosis as brain metastasis between May 2014 and October 2014 were selected. 3 patients were immobilized s-thermoplastic mask and mouthpiece (group1), while Fraxion system was used for the other 3 patients (group 2). Cone Beam Computerized Tomography (CBCT) scan was acquired to register planning CT scan. The registration offset was compared for each group. We compared and reported the errors using maximum, minimum, mean, and standard deviation of registration offsets. Furthermore, We used the same method as patient specific quality assurance to verify absorbed dose of PTV. The setup error which is registration offset was reduced 83% in x, 40% in y, and 92% in z-direction when Fraxion system was used compared to the case of using s-thermoplastic mask and mouthpiece. In addition, using Fraxion system showed improved results in rotational components, pitch (rotation along x-axis), roll (y), and yaw (z) which were reduced 64, 88, and 87% respectively compared to the case of using s-thermoplastic mask and mouthpiece. In dosimetry results, when sthermoplastic mask and mouthpiece used, absorbed dose was reduce 83% compared to before and after registration. However, using Fraxion system showed only 1.9%. All percentage were calculated with respect to average value. Using Fraxion system including mouthpiece, Fraxion frame, front piece, and thermoplastic mask, showed better repeatability and precision compared to using s-thermoplastic mask and mouthpiece, which is consequently considered as more improved immobilization system

  8. Evaluation on usefulness of stereotactic radio surgery using Fraxion system

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Won; Park, Kwang Woo; Ha, Jin Sook; Jeon, Mi Jin; Cho, Yoon Jin; Kim, Sei Joon; Kim, Jong Dae; Shin, Dong Bong [Dept. of Radiation Oncology, Gangnam Severance Hospital, Seoul (Korea, Republic of)

    2014-12-15

    We evaluated the usefulness of Fraxion system and s-thermoplastic mask by analyzing setup error when stereotactic radiousurgery (SRS) was treated for brain metastasis. 6 patients who received definite diagnosis as brain metastasis between May 2014 and October 2014 were selected. 3 patients were immobilized s-thermoplastic mask and mouthpiece (group1), while Fraxion system was used for the other 3 patients (group 2). Cone Beam Computerized Tomography (CBCT) scan was acquired to register planning CT scan. The registration offset was compared for each group. We compared and reported the errors using maximum, minimum, mean, and standard deviation of registration offsets. Furthermore, We used the same method as patient specific quality assurance to verify absorbed dose of PTV. The setup error which is registration offset was reduced 83% in x, 40% in y, and 92% in z-direction when Fraxion system was used compared to the case of using s-thermoplastic mask and mouthpiece. In addition, using Fraxion system showed improved results in rotational components, pitch (rotation along x-axis), roll (y), and yaw (z) which were reduced 64, 88, and 87% respectively compared to the case of using s-thermoplastic mask and mouthpiece. In dosimetry results, when sthermoplastic mask and mouthpiece used, absorbed dose was reduce 83% compared to before and after registration. However, using Fraxion system showed only 1.9%. All percentage were calculated with respect to average value. Using Fraxion system including mouthpiece, Fraxion frame, front piece, and thermoplastic mask, showed better repeatability and precision compared to using s-thermoplastic mask and mouthpiece, which is consequently considered as more improved immobilization system.

  9. Evaluation of decision support systems for nuclear accidents

    International Nuclear Information System (INIS)

    Sdouz, G.; Mueck, K.

    1998-05-01

    In order to adopt countermeasures to protect the public after an accident in a nuclear power plant in an appropriate and optimum way, decision support systems offer a valuable assistance in supporting the decision maker in choosing and optimizing protective actions. Such decision support systems may range from simple systems to accumulate relevant parameters for the evaluation of the situation over prediction models for the rapid evaluation of the dose to be expected to systems which permit the evaluation and comparison of possible countermeasures. Since the establishment of a decision support systems obviously is also required in Austria, an evaluation of systems available or in the state of development in other countries or unions was performed. The aim was to determine the availability of decision support systems in various countries and to evaluate them with regard to depth and extent of the system. The evaluation showed that in most industrialized countries the requirement for a decision support system was realized, but in only few countries actual systems are readily available and operable. Most systems are limited to early phase consequences, i.e. dispersion calculations of calculated source terms and the estimation of exposure in the vicinity of the plant. Only few systems offer the possibility to predict long-term exposures by ingestion. Few systems permit also an evaluation of potential countermeasures, in most cases, however, limited to a few short-term countermeasures. Only one system which is presently not operable allows the evaluation of a large number of agricultural countermeasures. In this report the different systems are compared. The requirements with regard to an Austrian decision support system are defined and consequences for a possible utilization of a DSS or parts thereof for the Austrian decision support system are derived. (author)

  10. Implementation of an Anesthesia Information Management System in an Ambulatory Surgery Center.

    Science.gov (United States)

    Mudumbai, Seshadri C

    2016-01-01

    Anesthesia information management systems (AIMS) are increasingly being implemented throughout the United States. However, little information exists on the implementation process for AIMS within ambulatory surgery centers (ASC). The objectives of this descriptive study are to document: 1) the phases of implementation of an AIMS at an ASC; and 2) lessons learnt from a socio-technical perspective. The ASC, within the Veterans Health Administration (VHA), has hosted an AIMS since 2008. As a quality improvement effort, we implemented a new version of the AIMS. This new version involved fundamental software changes to enhance clinical care such as real-time importing of laboratory data and total hardware exchange. The pre-implementation phase involved coordinated preparation over six months between multiple informatics teams along with local leadership. During this time, we conducted component, integration, and validation testing to ensure correct data flow from medical devices to AIMS and centralized databases. The implementation phase occurred in September 2014 over three days and was successful. Over the next several months, during post-implementation phase, we addressed residual items like latency of the application. Important lessons learnt from the implementation included the utility of partnering early with executive leadership; ensuring end user acceptance of new clinical workflow; continuous testing of data flow; use of a staged rollout; and providing additional personnel throughout implementation. Implementation of an AIMS at an ASC can utilize methods developed for large hospitals. However, issues unique to an ASC such as limited number of support personnel and distinctive workflows must be considered.

  11. Impact of robot-assisted spine surgery on health care quality and neurosurgical economics: A systemic review.

    Science.gov (United States)

    Fiani, Brian; Quadri, Syed A; Farooqui, Mudassir; Cathel, Alessandra; Berman, Blake; Noel, Jerry; Siddiqi, Javed

    2018-04-03

    Whenever any new technology is introduced into the healthcare system, it should satisfy all three pillars of the iron triangle of health care, which are quality, cost-effectiveness, and accessibility. There has been quite advancement in the field of spine surgery in the last two decades with introduction of new technological modalities such as CAN and surgical robotic devices. MAZOR SpineAssist/Renaissance was the first robotic system to be approved for the use in spine surgeries in the USA in 2004. In this review, the authors sought to determine if the current literature supports this technology to be cost-effective, accessible, and improve the quality of care for individuals and populations by increasing the likelihood of desired health outcomes. Robotic-assisted surgery seems to provide perfection in surgical ergonomics and surgical dexterity, consequently improving patient outcomes. A lot of data is present on the accuracy, effectiveness, and safety of the robotic-guided technology which reflects remarkable improvements in quality of care, making its utility convincingly undisputable. The technology has been claimed to be cost-effective but there seems to be lack of data in the literature on this topic to validate this claim. Apart from just the outcome parameters, there is an immense need of studies on real-time cost-efficacy, patient perspective, surgeon and resident learning curve, and their experience with this new technology. Furthermore, new studies looking into increased utilities of this technology, such as brain and spine tumor resection, deep brain stimulation procedures, and osteotomies in deformity surgery, might authenticate the cost of the equipment.

  12. Metabolic phenotype-microRNA data fusion analysis of the systemic consequences of Roux-en-Y gastric bypass surgery.

    Science.gov (United States)

    Wu, Q; Li, J V; Seyfried, F; le Roux, C W; Ashrafian, H; Athanasiou, T; Fenske, W; Darzi, A; Nicholson, J K; Holmes, E; Gooderham, N J

    2015-07-01

    Bariatric surgery offers sustained marked weight loss and often remission of type 2 diabetes, yet the mechanisms of establishment of these health benefits are not clear. We mapped the coordinated systemic responses of gut hormones, the circulating miRNAome and the metabolome in a rat model of Roux-en-Y gastric bypass (RYGB) surgery. The response of circulating microRNAs (miRNAs) to RYGB was striking and selective. Analysis of 14 significantly altered circulating miRNAs within a pathway context was suggestive of modulation of signaling pathways including G protein signaling, neurodegeneration, inflammation, and growth and apoptosis responses. Concomitant alterations in the metabolome indicated increased glucose transport, accelerated glycolysis and inhibited gluconeogenesis in the liver. Of particular significance, we show significantly decreased circulating miRNA-122 levels and a more modest decline in hepatic levels, following surgery. In mechanistic studies, manipulation of miRNA-122 levels in a cell model induced changes in the activity of key enzymes involved in hepatic energy metabolism, glucose transport, glycolysis, tricarboxylic acid cycle, pentose phosphate shunt, fatty-acid oxidation and gluconeogenesis, consistent with the findings of the in vivo surgery-mediated responses, indicating the powerful homeostatic activity of the miRNAs. The close association between energy metabolism, neuronal signaling and gut microbial metabolites derived from the circulating miRNA, plasma, urine and liver metabolite and gut hormone correlations further supports an enhanced gut-brain signaling, which we suggest is hormonally mediated by both traditional gut hormones and miRNAs. This transomic approach to map the crosstalk between the circulating miRNAome and metabolome offers opportunities to understand complex systems biology within a disease and interventional treatment setting.

  13. Review of Operation and Maintenance Support Systems for Research Reactors

    International Nuclear Information System (INIS)

    Jin, Kyungho; Heo, Gyunyoung; Park, Jaekwan

    2014-01-01

    Operation support systems do not directly control the plant but it can aid decision making itself by obtaining and analyzing large amounts of data. Recently, the demand of research reactor is growing and the need for operation support systems is increasing, but it has not been applied for research reactors. This study analyzes operation and maintenance support systems of NPPs and suggests appropriate systems for research reactors based on analysis. In this paper, operation support systems for research reactors are suggested by comparing with those of power reactors. Currently, research reactors do not cover special systems in order to improve safety and operability in comparison with power reactors. Therefore we expect to improve worth to use by introducing appropriate systems for research reactors. In further research, we will develop an appropriate system such as applications or tools that can be applied to the research reactor

  14. Analysis of Intel IA-64 Processor Support for Secure Systems

    National Research Council Canada - National Science Library

    Unalmis, Bugra

    2001-01-01

    .... Systems could be constructed for which serious security threats would be eliminated. This thesis explores the Intel IA-64 processor's hardware support and its relationship to software for building a secure system...

  15. Life Support Systems: Trace Contaminant and Particulate Control

    Data.gov (United States)

    National Aeronautics and Space Administration — Advanced Exploration Systems (AES) Life Support Systems project Trace Contaminant and Particulate Control task: Work in the area of trace contamination and...

  16. Licensing Support Network: An Electronic Discovery System

    International Nuclear Information System (INIS)

    Gil, A. V.; Jensen, D.; McKinnon, B.

    2002-01-01

    The necessary authorization for the U. S. Department of Energy's (DOE) Office of Civilian Radioactive Waste Management (OCRWM) to submit a License Application (LA) is contingent upon the policy process defined in the Nuclear Waste Policy Act, as amended (NWPA), with some steps yet to occur. In spite of this uncertainty, the DOE must take prudent and appropriate action now, and over the next several years, to prepare for submittal of an application and to facilitate the U. S. Nuclear Regulatory Commission (NRC) review of this application, if the Yucca Mountain site is recommended and approved for repository development. One of these steps the DOE has taken involves working with the NRC's Advisory Review Panel to develop Licensing Support Network (LSN) requirements and guidelines. The NRC has made a prototype of the LSN web page available at www.LSNNET.gov. The OCRWM part of the LSN currently has an indefinite life cycle and may need to remain in existence until the repository is closed, which could be as long as 325 years

  17. The impact of a preloaded intraocular lens delivery system on operating room efficiency in routine cataract surgery.

    Science.gov (United States)

    Jones, Jason J; Chu, Jeffrey; Graham, Jacob; Zaluski, Serge; Rocha, Guillermo

    2016-01-01

    The aim of this study was to evaluate the operational impact of using preloaded intraocular lens (IOL) delivery systems compared with manually loaded IOL delivery processes during routine cataract surgeries. Time and motion data, staff and surgery schedules, and cost accounting reports were collected across three sites located in the US, France, and Canada. Time and motion data were collected for manually loaded IOL processes and preloaded IOL delivery systems over four surgery days. Staff and surgery schedules and cost accounting reports were collected during the 2 months prior and after introduction of the preloaded IOL delivery system. The study included a total of 154 routine cataract surgeries across all three sites. Of these, 77 surgeries were performed using a preloaded IOL delivery system, and the remaining 77 surgeries were performed using a manual IOL delivery process. Across all three sites, use of the preloaded IOL delivery system significantly decreased mean total case time by 6.2%-12.0% (Psystem also decreased surgeon lens time, surgeon delays, and eliminated lens touches during IOL preparation. Compared to a manual IOL delivery process, use of a preloaded IOL delivery system for cataract surgery reduced total case time, total surgeon lens time, surgeon delays, and eliminated IOL touches. The time savings provided by the preloaded IOL delivery system provide an opportunity for sites to improve routine cataract surgery throughput without impacting surgeon or staff capacity.

  18. Optimal support systems for patients with stomas – an opinion piece

    Directory of Open Access Journals (Sweden)

    Burch J

    2014-06-01

    Full Text Available Jennie BurchSt Marks Hospital, Surgery, London, UKAbstract: Coping with a stoma is physically and emotionally difficult. This adaptation process can be hindered by various factors, including complications associated with the stoma, such as appliance leakage, and comorbidities, such as arthritis. There are many ways of learning to live successfully with a stoma, which may be influenced by family, health care professionals, and spiritual support. There is some evidence that a good social support network can result in a positive coping mechanism for people with a newly formed stoma. Difficulty in accepting the stoma has been shown to slow down the adaptation process. This article explores the basic issues related to stomas and the general preoperative and postoperative support that is supplied by health care professionals. There was no optimal support system protocol discovered in the review of the literature. However, some of the published data related to stoma care were extrapolated to enable the reader to understand the important role that support systems can play in the acceptance of the stoma. Health care professionals provide support in a variety of ways, including the provision of telephone advice, clinics, and “open days”, to assist the patient to come to terms with their newly formed stoma. Care includes training on the practical aspects of the stoma, supporting empowerment and self-efficacy of people with a stoma (ostomates, and providing assistance when problems arise. Other support systems that are available are support groups, which may be local or national. It can be seen that the adaptation process takes many months or longer, but by utilizing various means of support, people with a stoma can have a good quality of life. The optimal support systems for patients with a stoma are discussed in relation to the literature and the personal experience of the author.Keywords: colostomy, ileostomy, urostomy

  19. A Knowledge Dictionary System for Scheduling Support

    Science.gov (United States)

    1988-10-01

    quantity of the resource is allocated; (g) two (or more) activities that conflict temporall , can only proceed if one or more of the activities are re...does not allow any parameter substitution but merely processes the contents of the file as a series of I:eystrokes. To create a macro, simply type...bytes in the system. When the hardware actually uses such a struc- ture (e.g., the Motorola 68000 series CPU) the OS will almost always present it that

  20. Development of support system for nuclear power plant piping

    International Nuclear Information System (INIS)

    Horino, Satoshi

    1987-01-01

    Ishikawajima-Harima Heavy Industries Co., Ltd. has advanced the development of Integrated Nuclear Plant Piping System (INUPPS) for nuclear power plants since 1980, and continued its improvement up to now. This time as its component, a piping support system (PISUP) has been developed. The piping support system deals with the structures such as piping supports and the stands for maintenance and inspection, and as for standard supporting structures, it builds up automatically the structures including the selection of optimum members by utilizing the standard patterns in cooperation with the piping design system including piping stress analysis. As for the supporting structures deviating from the standard, by amending a part of the standard patterns in dialogue from, structures can be built up. By using the data produced in this way, this system draws up consistently a design book, production management data and so on. From the viewpoint of safety, particular consideration is given to the aseismatic capability of nuclear power plants, and piping is fundamentally designed regidly to avoid resonance. It is necessary to make piping supports so as to have sufficient strength and rigidity. The features of the design of piping supports for nuclear power plant, the basic concept of piping support system, the constitution of the software and hardware, the standard patterns and the structural patterns of piping support system and so on are described. (Kako, I.)

  1. Important issues for perioperative systemic antimicrobial prophylaxis in surgery

    NARCIS (Netherlands)

    Sinha, Bhanu; van Assen, Sander; Friedrich, Alexander W.

    PURPOSE OF REVIEW: Prevention of surgical site infections is a key issue to patient safety and the success of surgical interventions. Systemic antimicrobial prophylaxis is one important component of a perioperative infection prevention bundle. This review focuses on selected recent developments and

  2. An Innovate Robotic Endoscope Guidance System for Transnasal Sinus and Skull Base Surgery: Proof of Concept.

    Science.gov (United States)

    Friedrich, D T; Sommer, F; Scheithauer, M O; Greve, J; Hoffmann, T K; Schuler, P J

    2017-12-01

    Objective  Advanced transnasal sinus and skull base surgery remains a challenging discipline for head and neck surgeons. Restricted access and space for instrumentation can impede advanced interventions. Thus, we present the combination of an innovative robotic endoscope guidance system and a specific endoscope with adjustable viewing angle to facilitate transnasal surgery in a human cadaver model. Materials and Methods  The applicability of the robotic endoscope guidance system with custom foot pedal controller was tested for advanced transnasal surgery on a fresh frozen human cadaver head. Visualization was enabled using a commercially available endoscope with adjustable viewing angle (15-90 degrees). Results  Visualization and instrumentation of all paranasal sinuses, including the anterior and middle skull base, were feasible with the presented setup. Controlling the robotic endoscope guidance system was effectively precise, and the adjustable endoscope lens extended the view in the surgical field without the common change of fixed viewing angle endoscopes. Conclusion  The combination of a robotic endoscope guidance system and an advanced endoscope with adjustable viewing angle enables bimanual surgery in transnasal interventions of the paranasal sinuses and the anterior skull base in a human cadaver model. The adjustable lens allows for the abandonment of fixed-angle endoscopes, saving time and resources, without reducing the quality of imaging.

  3. Age and other perioperative risk factors for postoperative systemic inflammatory response syndrome after cardiac surgery

    NARCIS (Netherlands)

    Dieleman, J. M.; Peelen, L. M.; Coulson, T. G.; Tran, L.; Reid, C. M.; Smith, Jennifer A.; Myles, P. S.; Pilcher, C.D.

    2017-01-01

    Background The inflammatory response to surgery varies considerably between individual patients. Age might be a substantial factor in this variability. Our objective was to examine the association of patient age and other potential risk factors with the occurrence of a postoperative systemic

  4. A benefit-risk review of systemic haemostatic agents - Part 1 : In major surgery

    NARCIS (Netherlands)

    Fraser, Ian S.; Porte, Robert J.; Kouides, Peter A.; Lukes, Andrea S.

    2008-01-01

    Systemic haemostatic agents play an important role in the management of blood loss during major surgery where significant blood loss is likely and their use has increased in recent times as a consequence of demand for blood products outstripping supply and the risks associated with transfusions.

  5. 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.

  6. A Comparative Study of Electronic Performance Support Systems

    Science.gov (United States)

    Nguyen, Frank; Klein, James D.; Sullivan, Howard

    2005-01-01

    Electronic performance support systems (EPSS) deliver relevant support information to users while they are performing tasks. The present study examined the effect of different types of EPSS on user performance, attitudes, system use and time on task. Employees at a manufacturing company were asked to complete a procedural software task and…

  7. Artificial and bioartificial support systems for liver failure

    DEFF Research Database (Denmark)

    Liu, J P; Gluud, L L; Als-Nielsen, B

    2004-01-01

    Artificial and bioartificial liver support systems may 'bridge' patients with acute or acute-on-chronic liver failure to liver transplantation or recovery.......Artificial and bioartificial liver support systems may 'bridge' patients with acute or acute-on-chronic liver failure to liver transplantation or recovery....

  8. Intelligent decision support system for operators of the supply ...

    African Journals Online (AJOL)

    Intelligent decision support system for operators of the supply department of oil and gas extracting industry. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... abnormal situations, pre-crash sensing, industrial drilling, decision-making support systems. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

  9. Expanding the research area of behavior change support systems

    NARCIS (Netherlands)

    van Gemert-Pijnen, Julia E.W.C.; Reitberger, Wolfgang; Langrial, Sitwat; Ploderer, Bernd; Oinas-Kukkonen, Harri; Berkovsky, Shlomo; Freyne, Jill

    2013-01-01

    The First International Workshop on Behavior Change Support Systems attracted a great research interest. The selected papers focused on abstraction, implementation and evaluation of Behavior Change Support Systems. The workshop is an evidence of how researchers from around the globe have their own

  10. Theory, Software and Testing Examples for Decision Support Systems

    OpenAIRE

    Lewandowski, A.; Wierzbicki, A.P.

    1987-01-01

    Research in methodology of Decision Support Systems is one of the activities within the System and Decision Sciences Program which was initiated seven years ago and is still in the center of interests of SDS. During these years several methodological approaches and software tools have been developed; among others the DIDAS (Dynamic Interactive Decision Analysis and Support) and SCDAS (Selection Committed Decision Analysis and Support). Both methodologies gained a certain level of popularity a...

  11. Multiple excitation of supports - Part 2 : Implementation in TUBO system

    International Nuclear Information System (INIS)

    Galeao, A.C.N.R.; Barbosa, H.J.C.

    1980-12-01

    From the formulation of multiple excitation support problem, discussed in the first part of this work, and with the use of numerical techniques presented there, we discuss in this second part, the implementation in TUBO system, the follow procedure: Direct integration, Modal overlap, Spectral response emphasizing the aspects related to supports excitation. Finally, we present two numerical examples of TUBO system utilization in the solution of support movement problem. The several implemented computational procedures are compared. (E.G.) [pt

  12. Development of the robot system to assist CT-guided brain surgery

    International Nuclear Information System (INIS)

    Koyama, H.; Funakubo, H.; Komeda, T.; Uchida, T.; Takakura, K.

    1999-01-01

    The robot technology was introduced into the stereotactic neurosurgery for application to biopsy, blind surgery, and functional neurosurgery. The authors have developed a newly designed the robot system to assist CT-guided brain surgery, designed to allow a biopsy needle to reach the targget such as a cerebral tumor within a brain automatically on the basis of the X,Y, and Z coordinates obtained by CT scanner. In this paper we describe construction of the robot, the control of the robot by CT image, robot simulation, and investigated a phantom experiment using CT image. (author)

  13. The role of surgery in primary central nervous system lymphomas

    Directory of Open Access Journals (Sweden)

    Juan Francisco Villalonga

    Full Text Available ABSTRACT Background Primary central nervous system lymphomas (PCNSL are infrequent. The traditional treatment of choice is chemotherapy. Complete resections have generally not been recommended, because of the risk of permanent central nervous system deficits with no proven improvement in survival. The aim of the current study was to compare survival among patients with PCNSL who underwent biopsy versus surgical resection. Methods A retrospective study was conducted on 50 patients with a confirmed diagnosis of PCNSL treated at our center from January 1994 to July 2015. Results Patients in the resection group exhibited significantly longer median survival time, relative to the biopsy group, surviving a median 31 months versus 14.5 months; p = 0.016. Conclusions In our series, patients who had surgical resection of their tumor survived a median 16.5 months longer than patients who underwent biopsy alone.

  14. Using HFACS-Healthcare to Identify Systemic Vulnerabilities During Surgery.

    Science.gov (United States)

    Cohen, Tara N; Francis, Sarah E; Wiegmann, Douglas A; Shappell, Scott A; Gewertz, Bruce L

    2018-03-01

    The Human Factors Analysis and Classification System for Healthcare (HFACS-Healthcare) was used to classify surgical near miss events reported via a hospital's event reporting system over the course of 1 year. Two trained analysts identified causal factors within each event narrative and subsequently categorized the events using HFACS-Healthcare. Of 910 original events, 592 could be analyzed further using HFACS-Healthcare, resulting in the identification of 726 causal factors. Most issues (n = 436, 60.00%) involved preconditions for unsafe acts, followed by unsafe acts (n = 257, 35.39%), organizational influences (n = 27, 3.72%), and supervisory factors (n = 6, 0.82%). These findings go beyond the traditional methods of trending incident data that typically focus on documenting the frequency of their occurrence. Analyzing near misses based on their underlying contributing human factors affords a greater opportunity to develop process improvements to reduce reoccurrence and better provide patient safety approaches.

  15. Intraoperative implant rod three-dimensional geometry measured by dual camera system during scoliosis surgery.

    Science.gov (United States)

    Salmingo, Remel Alingalan; Tadano, Shigeru; Abe, Yuichiro; Ito, Manabu

    2016-05-12

    Treatment for severe scoliosis is usually attained when the scoliotic spine is deformed and fixed by implant rods. Investigation of the intraoperative changes of implant rod shape in three-dimensions is necessary to understand the biomechanics of scoliosis correction, establish consensus of the treatment, and achieve the optimal outcome. The objective of this study was to measure the intraoperative three-dimensional geometry and deformation of implant rod during scoliosis corrective surgery.A pair of images was obtained intraoperatively by the dual camera system before rotation and after rotation of rods during scoliosis surgery. The three-dimensional implant rod geometry before implantation was measured directly by the surgeon and after surgery using a CT scanner. The images of rods were reconstructed in three-dimensions using quintic polynomial functions. The implant rod deformation was evaluated using the angle between the two three-dimensional tangent vectors measured at the ends of the implant rod.The implant rods at the concave side were significantly deformed during surgery. The highest rod deformation was found after the rotation of rods. The implant curvature regained after the surgical treatment.Careful intraoperative rod maneuver is important to achieve a safe clinical outcome because the intraoperative forces could be higher than the postoperative forces. Continuous scoliosis correction was observed as indicated by the regain of the implant rod curvature after surgery.

  16. Radioecology and Environmental Decision Support Systems

    International Nuclear Information System (INIS)

    Semioshkina, N.; Voigt, G.; Fiedler, I.

    2015-01-01

    According to Wikipedia Radioecology is a branch of ecology, which studies how radioactive substances interact with nature; how different mechanisms affect the substances’ migration and uptake in food chains and ecosystems. Investigations in radioecology might include aspects of field sampling, designed field and laboratory experiments and the development of predictive simulation models. This science combines techniques from some of the more basic, traditional fields, such as physics, chemistry, mathematics, biology, and ecology, with applied concepts in radiation protection. Radioecological studies form the basis for estimating doses and assessing the consequences of radioactive pollution for human health and the environment. Significant economic and social disruptions arise after radioactive contamination of land as a result of releases of radioactivity into the environment be it from accidents, routine and war operations or during decommissioning and waste management of nuclear facilities. Measures carried out to reduce and minimise radiation doses to the public can give rise to even more concerns as often they are not understood and the stakeholders are often not involved into the decision making process. Countermeasures are needed to reduce population exposure, at the same time minimising economic and social costs. The effectiveness of countermeasures is not only highly dependent on factors which are connected to environmental transfer, but also to special behaviour and consumption behaviours in varying food production systems. A central aspect of radioecology is the identification of vulnerable areas which, by virtue of the processes governing the transfer of radiocaesium through food chains, deliver high individual, or collective doses to man. Social factors (e.g. dietary preferences) and agricultural production techniques also contribute to vulnerability. (author)

  17. A highly articulated robotic surgical system for minimally invasive surgery.

    Science.gov (United States)

    Ota, Takeyoshi; Degani, Amir; Schwartzman, David; Zubiate, Brett; McGarvey, Jeremy; Choset, Howie; Zenati, Marco A

    2009-04-01

    We developed a novel, highly articulated robotic surgical system (CardioARM) to enable minimally invasive intrapericardial therapeutic delivery through a subxiphoid approach. We performed preliminary proof of concept studies in a porcine preparation by performing epicardial ablation. CardioARM is a robotic surgical system having an articulated design to provide unlimited but controllable flexibility. The CardioARM consists of serially connected, rigid cyclindrical links housing flexible working ports through which catheter-based tools for therapy and imaging can be advanced. The CardioARM is controlled by a computer-driven, user interface, which is operated outside the operative field. In six experimental subjects, the CardioARM was introduced percutaneously through a subxiphoid access. A commercial 5-French radiofrequency ablation catheter was introduced through the working port, which was then used to guide deployment. In all subjects, regional ("linear") left atrial ablation was successfully achieved without complications. Based on these preliminary studies, we believe that the CardioARM promises to enable deployment of a number of epicardium-based therapies. Improvements in imaging techniques will likely facilitate increasingly complex procedures.

  18. Enabling or Cultivating? The Role of Prostate Cancer Patients' Received Partner Support and Self-Efficacy in the Maintenance of Pelvic Floor Exercise Following Tumor Surgery.

    Science.gov (United States)

    Hohl, Diana Hilda; Knoll, Nina; Wiedemann, Amelie; Keller, Jan; Scholz, Urte; Schrader, Mark; Burkert, Silke

    2016-04-01

    To manage incontinence following tumor surgery, prostate cancer patients are advised to perform pelvic floor exercise (PFE). Patients' self-efficacy and support from partners were shown to facilitate PFE. Whereas support may enhance self-efficacy (enabling function), self-efficacy may also cultivate support (cultivation function). Cross-lagged inter-relationships among self-efficacy, support, and PFE were investigated. Post-surgery patient-reported received support, self-efficacy, PFE, and partner-reported provided support were assessed from 175 couples at four times. Autoregressive models tested interrelations among variables, using either patients' or partners' reports of support. Models using patients' data revealed positive associations between self-efficacy and changes in received support, which predicted increased PFE. Using partners' accounts of support provided, these associations were partially cross-validated. Furthermore, partner-provided support was related with increases in patients' self-efficacy. Patients' self-efficacy may cultivate partners' support provision for patients' PFE, whereas evidence of an enabling function of support as a predictor of self-efficacy was inconsistent.

  19. [ENT and head and neck surgery in the German DRG system 2007].

    Science.gov (United States)

    Franz, D; Roeder, N; Hörmann, K; Alberty, J

    2007-07-01

    The German DRG system has been further developed into version 2007. For ENT and head and neck surgery, significant changes in the coding of diagnoses and medical operations as well as in the the DRG structure have been made. New ICD codes for sleep apnoea and acquired tracheal stenosis have been implemented. Surgery on the acoustic meatus, removal of auricle hyaline cartilage for transplantation (e. g. rhinosurgery) and tonsillotomy have been coded in the 2007 version. In addition, the DRG structure has been improved. Case allocation of more than one significant operation has been established. The G-DRG system has gained in complexity. High demands are made on the coding of complex cases, whereas standard cases require mostly only one specific diagnosis and one specific OPS code. The quality of case allocation for ENT patients within the G-DRG system has been improved. Nevertheless, further adjustments of the G-DRG system are necessary.

  20. Intelligent Flight Support System (IFSS): A Real-time Intelligent Decision Support Prototype, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The integration of the analysis tools with the advanced visualization capabilities in The Intelligent Flight Support System (IFSS) can provide a unique method for...

  1. Selecting effective persuasive strategies in behavior change support systems: Third International Workshop on Behavior Change Support Systems (BCSS 2015)

    NARCIS (Netherlands)

    Kelders, Saskia Marion; Kulyk, Olga Anatoliyivna; van Gemert-Pijnen, Julia E.W.C.; Oinas-Kukkonen, Harri; Kelders, Saskia; Kulyk, Olga; van Gemert-Pijnen, Lisette; Oinas-Kukkonen, Harri

    2015-01-01

    The Third International Workshop on Behavior Change Support Systems provides a place to discuss recent advances in BCSS research. The selected papers show that research into behavior change support systems is expanding: not only by trying to reach more and other people, but also by expanding the

  2. A Panoramic Wireless Endoscope System Design for the Application of Minimally Invasive Surgery

    Directory of Open Access Journals (Sweden)

    Chun-Hsiang Peng

    2014-05-01

    Full Text Available Minimally Invasive Surgery (MIS is the current trend in surgery. Compared to traditional surgery, MIS can substantially decrease recovery time and expenses needed by patients after surgeries, reduce pain during surgical procedures, and is highly regarded by physicians and patients. An endoscope is widely used in the diagnosis and treatments of various medical disciplines, such as hysteroscopy, laparoscopy, and colonoscopy, and have been adopted by many branches of medicine. However, the limited image field of MIS is often the most difficult obstacles faced by surgeons and medical students, especially to less experienced physicians and difficult surgical procedures; the limited field of view of endoscopic imaging does not provide a whole picture of the surgery area, making the procedures difficult and full of uncertainty. In light of this problem, we proposed a "Panoramic Wireless Endoscope System design", hoping to provide physicians with a wide field of view of the endoscopic image. We combine images captured from two parallel-mounted endoscope lenses into a single, wide-angle image, giving physicians a wider field of view and easier access to the surgical area. In addition, we developed a wireless transmission system so the image can be transmitted to various display platforms, eliminating the needs for excessive cabling on surgical tools and enable physicians to better operate on the patient. Finally, our system allows surgical assistants a better view of the operation process, and enables other physicians and nurses to remotely observe the process. Our experiment results have shown that we can increase the image to 152% of its original size. We used the PandaBoard ES platform with an ARM9 processor and 1G of onboard RAM, and continuously implementing animal trials to verify the reliability of our system.

  3. Effects of realistic force feedback in a robotic assisted minimally invasive surgery system.

    Science.gov (United States)

    Moradi Dalvand, Mohsen; Shirinzadeh, Bijan; Nahavandi, Saeid; Smith, Julian

    2014-06-01

    Robotic assisted minimally invasive surgery systems not only have the advantages of traditional laparoscopic procedures but also restore the surgeon's hand-eye coordination and improve the surgeon's precision by filtering hand tremors. Unfortunately, these benefits have come at the expense of the surgeon's ability to feel. Several research efforts have already attempted to restore this feature and study the effects of force feedback in robotic systems. The proposed methods and studies have some shortcomings. The main focus of this research is to overcome some of these limitations and to study the effects of force feedback in palpation in a more realistic fashion. A parallel robot assisted minimally invasive surgery system (PRAMiSS) with force feedback capabilities was employed to study the effects of realistic force feedback in palpation of artificial tissue samples. PRAMiSS is capable of actually measuring the tip/tissue interaction forces directly from the surgery site. Four sets of experiments using only vision feedback, only force feedback, simultaneous force and vision feedback and direct manipulation were conducted to evaluate the role of sensory feedback from sideways tip/tissue interaction forces with a scale factor of 100% in characterising tissues of varying stiffness. Twenty human subjects were involved in the experiments for at least 1440 trials. Friedman and Wilcoxon signed-rank tests were employed to statistically analyse the experimental results. Providing realistic force feedback in robotic assisted surgery systems improves the quality of tissue characterization procedures. Force feedback capability also increases the certainty of characterizing soft tissues compared with direct palpation using the lateral sides of index fingers. The force feedback capability can improve the quality of palpation and characterization of soft tissues of varying stiffness by restoring sense of touch in robotic assisted minimally invasive surgery operations.

  4. Establishing a portfolio of quality-improvement projects in pediatric surgery through advanced improvement leadership systems.

    Science.gov (United States)

    Gerrein, Betsy T; Williams, Christina E; Von Allmen, Daniel

    2013-01-01

    Formal quality-improvement (QI) projects require that participants are educated in QI methods to provide them with the capability to carry out successful, meaningful work. However, orchestrating a portfolio of projects that addresses the strategic mission of the institution requires an extension of basic QI training to provide the division or business unit with the capacity to successfully develop and manage the portfolio. Advanced Improvement Leadership Systems is a program to help units create a meaningful portfolio. This program, used by the Division of Pediatric General and Thoracic Surgery at Cincinnati Children's Hospital Medical Center, helped establish a portfolio of targeted QI projects designed to achieve outstanding outcomes at competitive costs in multiple clinical areas aligned with the institution's strategic goals (improve disease-based outcomes, patient safety, flow, and patient and family experience). These objectives are addressed in an institutional strategic plan built around 5 core areas: Safety, Productivity, Care Coordination and Outcomes, Patient and Family Experience, and Value. By combining the portfolio of QI projects with improvements in the divisional infrastructure, effective improvement efforts were realized throughout the division. In the 9 months following the program, divisional capability resulted in a 16.5% increase (5.7% to 22.2%) of formally trained staff working on 10 QI teams. Concurrently, a leadership team, designed to coordinate projects, remove barriers, and provide technical support, provided the capacity to pursue this ongoing effort. The Advanced Improvement Leadership Systems program increased the Division's efficiency and effectiveness in pursing the QI mission that is integral at our hospital.

  5. Establishing a Portfolio of Quality-Improvement Projects in Pediatric Surgery through Advanced Improvement Leadership Systems

    Science.gov (United States)

    Gerrein, Betsy T; Williams, Christina E; von Allmen, Daniel

    2013-01-01

    Formal quality-improvement (QI) projects require that participants are educated in QI methods to provide them with the capability to carry out successful, meaningful work. However, orchestrating a portfolio of projects that addresses the strategic mission of the institution requires an extension of basic QI training to provide the division or business unit with the capacity to successfully develop and manage the portfolio. Advanced Improvement Leadership Systems is a program to help units create a meaningful portfolio. This program, used by the Division of Pediatric General and Thoracic Surgery at Cincinnati Children’s Hospital Medical Center, helped establish a portfolio of targeted QI projects designed to achieve outstanding outcomes at competitive costs in multiple clinical areas aligned with the institution’s strategic goals (improve disease-based outcomes, patient safety, flow, and patient and family experience). These objectives are addressed in an institutional strategic plan built around 5 core areas: Safety, Productivity, Care Coordination and Outcomes, Patient and Family Experience, and Value. By combining the portfolio of QI projects with improvements in the divisional infrastructure, effective improvement efforts were realized throughout the division. In the 9 months following the program, divisional capability resulted in a 16.5% increase (5.7% to 22.2%) of formally trained staff working on 10 QI teams. Concurrently, a leadership team, designed to coordinate projects, remove barriers, and provide technical support, provided the capacity to pursue this ongoing effort. The Advanced Improvement Leadership Systems program increased the Division’s efficiency and effectiveness in pursing the QI mission that is integral at our hospital. PMID:24361020

  6. Systems analysis support to the waste management technology center

    International Nuclear Information System (INIS)

    Rivera, A.L.; Osborne-Lee, I.W.; DePaoli, S.M.

    1988-01-01

    This paper describes a systems analysis concept being developed in support of waste management planning and analysis activities for Martin Marietta Energy Systems, Inc. (Energy Systems), sites. This integrated systems model serves as a focus for the accumulation and documentation of technical and economic information from current waste management practices, improved operations projects, remedial actions, and new system development activities. The approach is generic and could be applied to a larger group of sites. This integrated model is a source of technical support to waste management groups in the Energy Systems complex for integrated waste management planning and related technology assessment activities. This problem-solving methodology for low-level waste (LLW) management is being developed through the Waste Management Technology Center (WMTC) for the Low-Level Waste Disposal, Development, and Demonstration (LLWDDD) Program. In support of long-range planning activities, this capability will include the development of management support tools such as specialized systems models, data bases, and information systems. These management support tools will provide continuing support in the identification and definition of technical and economic uncertainties to be addressed by technology demonstration programs. Technical planning activities and current efforts in the development of this system analysis capability for the LLWDDD Program are presented in this paper

  7. Tourniquet-induced systemic inflammatory response in extremity surgery.

    LENUS (Irish Health Repository)

    Wakai, A

    2012-02-03

    BACKGROUND: Tourniquet-induced reperfusion injury in animals produces significant systemic inflammatory effects. This study investigated whether a biologic response occurs in a clinically relevant model of tourniquet-induced reperfusion injury. METHODS: Patients undergoing elective knee arthroscopy were prospectively randomized into controls (no tourniquet) and subjects (tourniquet-controlled). The effects of tourniquet-induced reperfusion on monocyte activation state, neutrophil activation state, and transendothelial migration (TEM) were studied. Changes in the cytokines implicated in reperfusion injury, tumor necrosis factor-alpha, interleukin (IL)-1beta, and IL-10 were also determined. RESULTS: After 15 minutes of reperfusion, neutrophil and monocyte activation were significantly increased. Pretreatment of neutrophils with pooled subject (ischemia-primed) plasma significantly increased TEM. In contrast, TEM was not significantly altered by ischemia-primed plasma pretreatment of the endothelial monolayer. Significant elevation of tumor necrosis factor-alpha and IL-1beta were observed in subjects compared with controls after 15 minutes of reperfusion. There was no significant difference in serum IL-10 levels between the groups at all the time points studied. CONCLUSION: These results indicate a transient neutrophil and monocyte activation after tourniquet-ischemia that translates into enhanced neutrophil transendothelial migration with potential for tissue injury.

  8. A novel augmented reality system for displaying inferior alveolar nerve bundles in maxillofacial surgery.

    Science.gov (United States)

    Zhu, Ming; Liu, Fei; Chai, Gang; Pan, Jun J; Jiang, Taoran; Lin, Li; Xin, Yu; Zhang, Yan; Li, Qingfeng

    2017-02-15

    Augmented reality systems can combine virtual images with a real environment to ensure accurate surgery with lower risk. This study aimed to develop a novel registration and tracking technique to establish a navigation system based on augmented reality for maxillofacial surgery. Specifically, a virtual image is reconstructed from CT data using 3D software. The real environment is tracked by the augmented reality (AR) software. The novel registration strategy that we created uses an occlusal splint compounded with a fiducial marker (OSM) to establish a relationship between the virtual image and the real object. After the fiducial marker is recognized, the virtual image is superimposed onto the real environment, forming the "integrated image" on semi-transparent glass. Via the registration process, the integral image, which combines the virtual image with the real scene, is successfully presented on the semi-transparent helmet. The position error of this navigation system is 0.96 ± 0.51 mm. This augmented reality system was applied in the clinic and good surgical outcomes were obtained. The augmented reality system that we established for maxillofacial surgery has the advantages of easy manipulation and high accuracy, which can improve surgical outcomes. Thus, this system exhibits significant potential in clinical applications.

  9. Instrumentation and control activities at the electric power research institute to support computerized support systems

    International Nuclear Information System (INIS)

    Naser, J.

    1996-01-01

    Most nuclear power plants in the United States are operating with their original analog I and C equipment. This equipment requires increasing maintenance efforts to sustain systems performance. Decreasing availability of replacement parts and support organization for analog technology accentuate obsolescence problems and resultant O and M cost increases. Modern technology, especially digital systems, offers improved functionality, performance, and reliability; solutions to obsolescence of equipment; reduction in O and M costs; and the potential to enhance safety. Digital systems, including computerized support systems, with their inherent advantages will be implemented only if reliable and cost-effective implementation and licensing acceptance is achieved and if the upgraded systems supports reduced power production costs. EPRI and its member utilities are working together under the Integrated I and C Upgrade Initiative to address I and C issues. (author). 23 refs

  10. Supporting patients in obtaining and oncologists in providing evidence-based health-related quality of life information prior to and after esophageal cancer surgery

    NARCIS (Netherlands)

    Jacobs, M.

    2015-01-01

    The overall aim of this thesis was to support patients in obtaining and oncologists in providing evidence-based HRQL data prior to and following esophageal cancer surgery. This thesis is divided in two parts. In Part I, we addressed the information needs of esophageal cancer patients prior to and

  11. Instrumentation and control activities at the Electric Power Research Institute to support operator support systems

    International Nuclear Information System (INIS)

    Naser, J.

    1995-01-01

    Most nuclear power plants in the United States continue to operate with analog instrumentation and control (I and C) technology designed 20 to 40 years ago. This equipment is approaching or exceeding its life expectancy, resulting in increasing maintenance efforts to sustain system performance. Decreasing availability of replacement parts and the accelerating deterioration of the infrastructure of manufacturers that support analog technology exacerbate obsolescence problems and resultant operation and maintenance (O and M) cost increases. Modern digital technology holds a significant potential to improve the safety, cost-effectiveness, productivity, and, therefore, competitiveness of nuclear power plants. Operator support systems provide the tools to help achieve this potential. Reliable, integrated information is a critical element for protecting the utility's capital investment and increasing availability, reliability, and productivity. Integrated operator support systems with integrated information can perform more effectively to increase productivity, to enhance safety, and to reduce O and M costs. The plant communications and computing architecture is the infrastructure needed to allow the implementation of I and C systems and associated operator support systems in an integrated manner. Current technology for distributed digital systems, plant process computers, and plant communications and computing networks support the integration of systems and information. (author). 16 refs

  12. Preoperative renin-angiotensin system inhibitors protect renal function in aging patients undergoing cardiac surgery.

    Science.gov (United States)

    Barodka, Viachaslau; Silvestry, Scott; Zhao, Ning; Jiao, Xiangyin; Whellan, David J; Diehl, James; Sun, Jian-Zhong

    2011-05-15

    Renal failure (RF) represents a major postoperative complication for elderly patients undergoing cardiac surgery. This observational cohort study examines effects of preoperative use of renin-angiotensin system (RAS) inhibitors on postoperative renal failure in aging patients undergoing cardiac surgery. We retrospectively analyzed a cohort of 1287 patients who underwent cardiac surgery at this institution (2003-2007). The patients included were ≥65 years old, scheduled for elective cardiac surgery, and without preexisting RF (defined by the criteria of the Society of Thoracic Surgeons as described in Method). Of all patients evaluated, 346 patients met the inclusion criteria and were divided into two groups: using (n = 122) or not using (n = 224) preoperative RAS inhibitors. A comparison of the two groups showed no significant differences in baseline parameters, including creatinine clearance, body mass index, history of diabetes and smoking, preoperative medicines (except that more patients with RAS inhibitors had a history of hypertension or congestive heart failure, fewer RAS inhibitor patients had chronic lung disease), in intraoperative perfusion and aortic cross-clamp time, and in postoperative complications and 30-d mortality. Multivariate logistic regression analysis demonstrated, however, that preoperative RAS inhibitors significantly and independently reduced the incidence of postoperative RF in the patients undergoing cardiac surgery compared with those not taking RAS inhibitors: 1.6% versus 7.6%, yielding an odds ratio of 0.19 (95 % CI 0.04-0.84, P = 0.029). Preoperative RAS inhibitors may have significant renoprotective effects for aging patients undergoing elective cardiac surgery. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Argentina's operator support systems in nuclear power plants

    International Nuclear Information System (INIS)

    Goldstein, M.; Palamidessi, H.

    1996-01-01

    The development of operator support systems for nuclear power plants started in Argentina a few years ago. Four systems are at present deployed or under development. The participation of utility personnel in the co-ordinated research program has helped in revising the current experience and in selecting and specifying the systems to be developed and the resources needed for their implementation. Main efforts will be aimed to the selection of those systems that can be more easily implemented, to improve the data retrieval and handling, to develop diverse supplies of software products and to promote the understanding of support systems among the potential end users. (author). 12 refs

  14. Dynamic MRI confirms support of the mid-urethra by TVT and TVT-O surgery for stress incontinence.

    Science.gov (United States)

    Rinne, Kirsi; Kainulainen, Sakari; Aukee, Sinikka; Heinonen, Seppo; Nilsson, Carl G

    2011-06-01

    To study changes in mid-urethral function with dynamic MRI in stress urinary incontinent women undergoing either tension-free vaginal tape (TVT) or TVT-obturator sling operations. Prospective clinical study. University hospital. Forty-two parous women with stress urinary incontinence recruited to dynamic magnetic resonance imaging before and after mid-urethral sling surgery. Control group of 16 healthy women. Dynamic magnetic resonance imaging at rest, during pelvic floor muscle contraction, coughing and voiding with a bladder volume of 200-300 ml. X- and Y- coordinates were used to determine the location of the mid-urethra during these activities. Changes in mid-urethral position after TVT and TVT-obturator operations during the different activities. Postoperatively the women could elevate their mid-urethra by pelvic floor muscle contraction significantly higher than before the operation (pTVT and the TVT-O mid-urethral slings, we could not see any differences in the movement patterns. Mid-urethral slings support the mid-urethra and restrict downward movement during different activities. Movement patterns are similar after TVT and TVT-O operations. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

  15. Integration of a satellite ground support system based on analysis of the satellite ground support domain

    Science.gov (United States)

    Pendley, R. D.; Scheidker, E. J.; Levitt, D. S.; Myers, C. R.; Werking, R. D.

    1994-11-01

    This analysis defines a complete set of ground support functions based on those practiced in real space flight operations during the on-orbit phase of a mission. These functions are mapped against ground support functions currently in use by NASA and DOD. Software components to provide these functions can be hosted on RISC-based work stations and integrated to provide a modular, integrated ground support system. Such modular systems can be configured to provide as much ground support functionality as desired. This approach to ground systems has been widely proposed and prototyped both by government institutions and commercial vendors. The combined set of ground support functions we describe can be used as a standard to evaluate candidate ground systems. This approach has also been used to develop a prototype of a modular, loosely-integrated ground support system, which is discussed briefly. A crucial benefit to a potential user is that all the components are flight-qualified, thus giving high confidence in their accuracy and reliability.

  16. Development of the Supported Decision Making Inventory System.

    Science.gov (United States)

    Shogren, Karrie A; Wehmeyer, Michael L; Uyanik, Hatice; Heidrich, Megan

    2017-12-01

    Supported decision making has received increased attention as an alternative to guardianship and a means to enable people with intellectual and developmental disabilities to exercise their right to legal capacity. Assessments are needed that can used by people with disabilities and their systems of supports to identify and plan for needed supports to enable decision making. This article describes the steps taken to develop such an assessment tool, the Supported Decision Making Inventory System (SDMIS), and initial feedback received from self-advocates with intellectual disability. The three sections of the SDMIS (Supported Decision Making Personal Factors Inventory, Supported Decision Making Environmental Demands Inventory, and Decision Making Autonomy Inventory) are described and implications for future research, policy, and practice are discussed.

  17. The Application of Three-Dimensional Surface Imaging System in Plastic and Reconstructive Surgery.

    Science.gov (United States)

    Li, Yanqi; Yang, Xin; Li, Dong

    2016-02-01

    Three-dimensional (3D) surface imaging system has gained popularity worldwide in clinical application. Unlike computed tomography and magnetic resonance imaging, it has the ability to capture 3D images with both shape and texture information. This feature has made it quite useful for plastic surgeons. This review article is mainly focusing on demonstrating the current status and analyzing the future of the application of 3D surface imaging systems in plastic and reconstructive surgery.Currently, 3D surface imaging system is mainly used in plastic and reconstructive surgery to help improve the reliability of surgical planning and assessing surgical outcome objectively. There have already been reports of its using on plastic and reconstructive surgery from head to toe. Studies on facial aging process, online applications development, and so on, have also been done through the use of 3D surface imaging system.Because different types of 3D surface imaging devices have their own advantages and disadvantages, a basic knowledge of their features is required and careful thought should be taken to choose the one that best fits a surgeon's demand.In the future, by integrating with other imaging tools and the 3D printing technology, 3D surface imaging system will play an important role in individualized surgical planning, implants production, meticulous surgical simulation, operative techniques training, and patient education.

  18. The Logistics Management Decision Support System (LMDSS) : an effective tool to reduce life cycle support costs of aviation systems

    OpenAIRE

    Moore, Ellen E.; Snyder, Carolynn M.

    1998-01-01

    Approved for public release; distribution is unlimited This thesis assesses the capability of the Logistics Management Decision Support System (LMDSS) to meet the information needs of Naval Air Systems Command (NAVAIR) logistics managers based on surveys of logistics managers and interviews with LMDSS program representatives. The LMDSS is being introduced as a tool to facilitate action by NAVAIR logistics managers to reduce the life cycle support costs of aviation systems while protecting ...

  19. 75 FR 76757 - Licensing Support System Advisory Review Panel

    Science.gov (United States)

    2010-12-09

    ... provide advice on the fundamental issues of design and development of an electronic information management... the disposal of high-level radioactive waste, and on the operation and maintenance of the system. This electronic information management system was known as the Licensing Support System (LSS). In November, 1998...

  20. Designing, Modeling and Evaluating Influence Strategiesfor Behavior Change Support Systems

    NARCIS (Netherlands)

    Öörni, Anssi; Kelders, Saskia Marion; van Gemert-Pijnen, Julia E.W.C.; Oinas-Kukkonen, Harri

    2014-01-01

    Behavior change support systems (BCSS) research is an evolving area. While the systems have been demonstrated to work to the effect, there is still a lot of work to be done to better understand the influence mechanisms of behavior change, and work out their influence on the systems architecture. The

  1. Measuring the Latency of an Augmented Reality System for Robot-Assisted Minimally Invasive Surgery

    DEFF Research Database (Denmark)

    Jørgensen, Martin Kibsgaard; Kraus, Martin

    2017-01-01

    visual communication in training for robot-assisted minimally invasive surgery with da Vinci surgical systems. To make sure that our augmented reality system provides the best possible user experience, we investigated the video latency of the da Vinci surgical system and how the components of our system...... affect the overall latency. To measure the photon-to-photon latency, we used a microcontroller to determine the time between the activation of a lightemitting diode in front of the endoscopic camera and the corresponding increase in intensity of the surgeon's display as measured by a phototransistor...

  2. IAEA activity on operator support systems in nuclear power plants

    International Nuclear Information System (INIS)

    Dounaev, V.; Fujita, Y.; Juslin, K.; Haugset, K.; Lux, I.; Naser, J.

    1994-01-01

    Various operator support systems for nuclear power plants are already operational or under development in the IAEA Member States. Operator support systems are based on intelligent data processing and, in addition to plant operation, they are also becoming more important for safety. A key feature of operator support systems is their availability to restructure data to increase its relevance for a given situation. This can improve the user's ability to identify plant mode, system state, and component state and to identify and diagnose faults. Operator support systems can also assist the user in planning and implementing corrective actions to improve the nuclear power plant's availability and safety. In September 1991, the IAEA Committee for Contractual Scientific Services approved the Co-ordinated Research Programme (CRP) on ''Operator Support Systems in Nuclear Power Plants'' in the framework of the Project ''Man-Machine Interface Studies''. The main objective of this programme is to provide guidance and technology transfer for the development and implementation of operator support systems. This includes the experience with human-machine interfaces and closely related issues such as instrumentation and control, the use of computers in nuclear power plants, and operator qualification. (author)

  3. A Review of Decisions Support Systems for Manufacturing Systems

    OpenAIRE

    Felsberger, Andreas; Oberegger, Bernhard; Reiner, Gerald

    2017-01-01

    In the field of manufacturing systems automated data acquisition and development of technological innovations like manufacturing execution systems (MES), Enterprise Resource Planning (ERP), Advanced Planning Systems (APS) and new trends in Big Data and Business Intelligence (BI) have given rise to new applications and methods of existing decisionsupport technologies. Today manufacturers need an adaptive system that helps to react and adapt to the constantly changing business environment. The ...

  4. Decision Support Systems for Research and Management in Advanced Life Support

    Science.gov (United States)

    Rodriquez, Luis F.

    2004-01-01

    Decision support systems have been implemented in many applications including strategic planning for battlefield scenarios, corporate decision making for business planning, production planning and control systems, and recommendation generators like those on Amazon.com(Registered TradeMark). Such tools are reviewed for developing a similar tool for NASA's ALS Program. DSS are considered concurrently with the development of the OPIS system, a database designed for chronicling of research and development in ALS. By utilizing the OPIS database, it is anticipated that decision support can be provided to increase the quality of decisions by ALS managers and researchers.

  5. Creating a Structured Support System for Postsecondary Success

    Science.gov (United States)

    White, Carol Cutler

    2018-01-01

    For numerous reasons, it can be difficult for foster youth to succeed in postsecondary education. This chapter offers insight into state-level policies and programs, community college programs dedicating to supporting foster youth, and a framework for creating a structured support system to increase student success.

  6. A sustainable and affordable support system for rural healthcare delivery

    CSIR Research Space (South Africa)

    Barjis, J

    2013-12-01

    Full Text Available . The proposed system is decision support driven in that it supports medical staff (nurses, doctors) to decide on the course of intervention or further treatment based on the vital signs of the patients that are tele-monitored on a regular basis. This patient...

  7. System for Selection of Relevant Information for Decision Support

    Czech Academy of Sciences Publication Activity Database

    Kalina, Jan; Seidl, L.; Zvára, K.; Grünfeldová, H.; Slovák, Dalibor; Zvárová, Jana

    2013-01-01

    Roč. 1, č. 1 (2013), s. 46-46 ISSN 1805-8698. [EFMI 2013 Special Topic Conference. 17.04.2013-19.04.2013, Prague] Institutional support: RVO:67985807 Keywords : decision support system * web-service * information extraction * high-dimension * gene expressions Subject RIV: IN - Informatics, Computer Science

  8. Need for Cost Optimization of Space Life Support Systems

    Science.gov (United States)

    Jones, Harry W.; Anderson, Grant

    2017-01-01

    As the nation plans manned missions that go far beyond Earth orbit to Mars, there is an urgent need for a robust, disciplined systems engineering methodology that can identify an optimized Environmental Control and Life Support (ECLSS) architecture for long duration deep space missions. But unlike the previously used Equivalent System Mass (ESM), the method must be inclusive of all driving parameters and emphasize the economic analysis of life support system design. The key parameter for this analysis is Life Cycle Cost (LCC). LCC takes into account the cost for development and qualification of the system, launch costs, operational costs, maintenance costs and all other relevant and associated costs. Additionally, an effective methodology must consider system technical performance, safety, reliability, maintainability, crew time, and other factors that could affect the overall merit of the life support system.

  9. Research on operation support system for nuclear power plants

    International Nuclear Information System (INIS)

    Wakabayashi, Jiro

    1989-01-01

    Nuclear power plants are the typical, complex, large scale engineering system, and at the time of accidents, there is the possibility to extend disasters to wide range beyond borders, therefore, it is the feature that the requirement for their reliability and safety is much severe as compared with other engineering systems. The fact that human errors become the major cause of large accidents is in common in large scale engineering systems, and the development of the operation support system for preventing it has become an important research subject. Also the research on design support system and maintenance support system is in progress to prevent human errors. Operation support system is composed of diagnostic system, operation guide system, man-machine interface and knowledge data base, and throughout these, the research on the human errors arising in the process of human decision making becomes the basis. Rasmussen's model for decision making, the classification of human errors and the reliability analysis for men, the factors affecting human errors, the acquisition of knowledge, the compilation and management of knowledge data base, the diagnostic system, operation guide system and man-machine interface are described. (K.I.)

  10. AHMCT Intelligent Roadway Information System (IRIS) technical support and testing

    Science.gov (United States)

    2011-12-31

    This report documents the research project AHMCT IRIS Technical Support and Testing, : performed under contract 65A0275, Task ID 1777. It presents an overview of the Intelligent : Roadway Information System (IRIS), and its design and function. ...

  11. Marketing Decision Support Systems: Adoption, Use and Satisfaction

    NARCIS (Netherlands)

    B. Wierenga (Berend); P.A.M. Oude Ophuis (Peter)

    1997-01-01

    textabstractThis paper deals with marketing decision support systems (MDSS) in companies. In a conceptual framework five categories of factors are distinguished that potentially affect adoption, use, and satisfaction: external environment factors, organizational factors, task environment factors,

  12. A decision support system-based procedure for evaluation and ...

    Indian Academy of Sciences (India)

    with an overview of the web-based Decision Support System (DSS) developed to facilitate its wide adop- tion. .... contributes significant catchment management and water supply functions .... experience in engagement and facilitation methods.

  13. Improving lives through a bioartificial liver support system

    CSIR Research Space (South Africa)

    Naidoo, K

    2008-11-01

    Full Text Available This poster covers the development of a technology towards a novel bioartificial liver support system (BALSS) that is capable of providing liver functions, in patients with acute liver failure, while housed outside the body (extra corporeal...

  14. Novel Composite Membrane for Space Life Supporting System, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Space life-supporting systems require effective removal of metabolic CO2 from the cabin atmosphere with minimal loss of O2. Conventional techniques, using either...

  15. Marketing decision support systems: Adoption, use and satisfaction.

    NARCIS (Netherlands)

    Wierenga, B.; Oude Ophuis, P.A.M.

    1997-01-01

    This paper deals with marketing decision support systems (MDSS) in companies. In a conceptual framework five categories of factors are distinguished that potentially affect adoption, use, and satisfaction: external environment factors, organizational factors, task environment factors, user factors

  16. Enhanced digital library system that supports sustainable knowledge

    African Journals Online (AJOL)

    Enhanced digital library system that supports sustainable knowledge: A focus ... This research work provides a Web-Based University library, ability to access the ... and generates pins to authorize bonafide students and staff of the University.

  17. The Systems Engineering Process for Human Support Technology Development

    Science.gov (United States)

    Jones, Harry

    2005-01-01

    Systems engineering is designing and optimizing systems. This paper reviews the systems engineering process and indicates how it can be applied in the development of advanced human support systems. Systems engineering develops the performance requirements, subsystem specifications, and detailed designs needed to construct a desired system. Systems design is difficult, requiring both art and science and balancing human and technical considerations. The essential systems engineering activity is trading off and compromising between competing objectives such as performance and cost, schedule and risk. Systems engineering is not a complete independent process. It usually supports a system development project. This review emphasizes the NASA project management process as described in NASA Procedural Requirement (NPR) 7120.5B. The process is a top down phased approach that includes the most fundamental activities of systems engineering - requirements definition, systems analysis, and design. NPR 7120.5B also requires projects to perform the engineering analyses needed to ensure that the system will operate correctly with regard to reliability, safety, risk, cost, and human factors. We review the system development project process, the standard systems engineering design methodology, and some of the specialized systems analysis techniques. We will discuss how they could apply to advanced human support systems development. The purpose of advanced systems development is not directly to supply human space flight hardware, but rather to provide superior candidate systems that will be selected for implementation by future missions. The most direct application of systems engineering is in guiding the development of prototype and flight experiment hardware. However, anticipatory systems engineering of possible future flight systems would be useful in identifying the most promising development projects.

  18. [Severity of disease scoring systems and mortality after non-cardiac surgery].

    Science.gov (United States)

    Reis, Pedro Videira; Sousa, Gabriela; Lopes, Ana Martins; Costa, Ana Vera; Santos, Alice; Abelha, Fernando José

    2018-04-05

    Mortality after surgery is frequent and severity of disease scoring systems are used for prediction. Our aim was to evaluate predictors for mortality after non-cardiac surgery. Adult patients admitted at our surgical intensive care unit between January 2006 and July 2013 was included. Univariate analysis was carried using Mann-Whitney, Chi-square or Fisher's exact test. Logistic regression was performed to assess independent factors with calculation of odds ratio and 95% confidence interval (95% CI). 4398 patients were included. Mortality was 1.4% in surgical intensive care unit and 7.4% during hospital stay. Independent predictors of mortality in surgical intensive care unit were APACHE II (OR=1.24); emergent surgery (OR=4.10), serum sodium (OR=1.06) and FiO 2 at admission (OR=14.31). Serum bicarbonate at admission (OR=0.89) was considered a protective factor. Independent predictors of hospital mortality were age (OR=1.02), APACHE II (OR=1.09), emergency surgery (OR=1.82), high-risk surgery (OR=1.61), FiO 2 at admission (OR=1.02), postoperative acute renal failure (OR=1.96), heart rate (OR=1.01) and serum sodium (OR=1.04). Dying patients had higher scores in severity of disease scoring systems and longer surgical intensive care unit stay. Some factors influenced both surgical intensive care unit and hospital mortality. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  19. Robotic Gastric Bypass Surgery in the Swiss Health Care System: Analysis of Hospital Costs and Reimbursement.

    Science.gov (United States)

    Hagen, Monika E; Rohner, Peter; Jung, Minoa K; Amirghasemi, Nicolas; Buchs, Nicolas C; Fakhro, Jassim; Buehler, Leo; Morel, Philippe

    2017-08-01

    Robotic technology shows some promising early outcomes indicating potentially improved outcomes particularly for challenging bariatric procedures. Still, health care providers face significant clinical and economic challenges when introducing innovations. Prospectively derived administrative cost data of patients who were coded with a primary diagnosis of obesity (ICD-10 code E.66.X), a procedure of gastric bypass surgery (CHOP code 44.3), and a robotic identifier (CHOP codes 00.90.50 or 00.39) during the years 2012 to 2015 was analyzed and compared to the triggered reimbursement for this patient cohort. A total of 348 patients were identified. The mean number of diagnoses was 2.7 and the mean length of stay was 5.9 days. The overall mean cost per patients was Swiss Francs (CHF) from 2012 to 2014 that was 21,527, with a mean reimbursement of CHF 24,917. Cost of the surgery in 2015 was comparable to the previous years with CHF 22,550.0 (p = 0.6618), but reimbursement decreased significantly to CHF 20,499.0 (0.0001). The average cost for robotic gastric bypass surgery fell well below the average reimbursement within the Swiss DRG system between 2012 and 2014, and this robotic procedure was a DRG winner for that period. However, the Swiss DRG system has matured over the years with a significant decrease resulting in a deficit for robotic gastric bypass surgery in 2015. This stipulates a discussion as to how health care providers should continue offering robotic gastric bypass surgery, particularly in the light of developing clinical evidence.

  20. AN EFFICIENT SELF-UPDATING FACE RECOGNITION SYSTEM FOR PLASTIC SURGERY FACE

    Directory of Open Access Journals (Sweden)

    A. Devi

    2016-08-01

    Full Text Available Facial recognition system is fundamental a computer application for the automatic identification of a person through a digitized image or a video source. The major cause for the overall poor performance is related to the transformations in appearance of the user based on the aspects akin to ageing, beard growth, sun-tan etc. In order to overcome the above drawback, Self-update process has been developed in which, the system learns the biometric attributes of the user every time the user interacts with the system and the information gets updated automatically. The procedures of Plastic surgery yield a skilled and endurable means of enhancing the facial appearance by means of correcting the anomalies in the feature and then treating the facial skin with the aim of getting a youthful look. When plastic surgery is performed on an individual, the features of the face undergo reconstruction either locally or globally. But, the changes which are introduced new by plastic surgery remain hard to get modeled by the available face recognition systems and they deteriorate the performances of the face recognition algorithm. Hence the Facial plastic surgery produces changes in the facial features to larger extent and thereby creates a significant challenge to the face recognition system. This work introduces a fresh Multimodal Biometric approach making use of novel approaches to boost the rate of recognition and security. The proposed method consists of various processes like Face segmentation using Active Appearance Model (AAM, Face Normalization using Kernel Density Estimate/ Point Distribution Model (KDE-PDM, Feature extraction using Local Gabor XOR Patterns (LGXP and Classification using Independent Component Analysis (ICA. Efficient techniques have been used in each phase of the FRAS in order to obtain improved results.

  1. Simple Scoring System to Predict In-Hospital Mortality After Surgery for Infective Endocarditis.

    Science.gov (United States)

    Gatti, Giuseppe; Perrotti, Andrea; Obadia, Jean-François; Duval, Xavier; Iung, Bernard; Alla, François; Chirouze, Catherine; Selton-Suty, Christine; Hoen, Bruno; Sinagra, Gianfranco; Delahaye, François; Tattevin, Pierre; Le Moing, Vincent; Pappalardo, Aniello; Chocron, Sidney

    2017-07-20

    Aspecific scoring systems are used to predict the risk of death postsurgery in patients with infective endocarditis (IE). The purpose of the present study was both to analyze the risk factors for in-hospital death, which complicates surgery for IE, and to create a mortality risk score based on the results of this analysis. Outcomes of 361 consecutive patients (mean age, 59.1±15.4 years) who had undergone surgery for IE in 8 European centers of cardiac surgery were recorded prospectively, and a risk factor analysis (multivariable logistic regression) for in-hospital death was performed. The discriminatory power of a new predictive scoring system was assessed with the receiver operating characteristic curve analysis. Score validation procedures were carried out. Fifty-six (15.5%) patients died postsurgery. BMI >27 kg/m 2 (odds ratio [OR], 1.79; P =0.049), estimated glomerular filtration rate 55 mm Hg (OR, 1.78; P =0.032), and critical state (OR, 2.37; P =0.017) were independent predictors of in-hospital death. A scoring system was devised to predict in-hospital death postsurgery for IE (area under the receiver operating characteristic curve, 0.780; 95% CI, 0.734-0.822). The score performed better than 5 of 6 scoring systems for in-hospital death after cardiac surgery that were considered. A simple scoring system based on risk factors for in-hospital death was specifically created to predict mortality risk postsurgery in patients with IE. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  2. A decision support system for on-line leakage localization

    OpenAIRE

    Meseguer, Jordi; Mirats-Tur, Josep M.; Cembrano, Gabriela; Puig, Vicenç; Quevedo, Joseba; Pérez, Ramon; Sanz, Gerard; Ibarra, David

    2014-01-01

    This paper describes a model-driven decision-support system (software tool) implementing a model-based methodology for on-line leakage detection and localization which is useful for a large class of water distribution networks. Since these methods present a certain degree of complexity which limits their use to experts, the proposed software tool focuses on the integration of a method emphasizing its use by water network managers as a decision support system. The proposed software tool integr...

  3. [ENT medicine and head and neck surgery in the G-DRG system 2008].

    Science.gov (United States)

    Franz, D; Roeder, N; Hörmann, K; Alberty, J

    2008-09-01

    Further developments in the German DRG system have been incorporated into the 2008 version. For ENT medicine and head and neck surgery significant changes concerning coding of diagnoses, medical procedures and concerning the DRG-structure were made. Analysis of relevant diagnoses, medical procedures and G-DRGs in the versions 2007 and 2008 based on the publications of the German DRG institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2008 focussed on the development of DRG structure, DRG validation and codes for medical procedures. The outcome of these changes for German hospitals may vary depending on the range of activities. The G-DRG system has gained in complexity again. High demands are made on correct and complete coding of complex ENT and head and neck surgery cases. Quality of case allocation within the G-DRG system has been improved. For standard cases quality of case allocation is adequate. Nevertheless, further adjustments of the G-DRG system especially for cases with complex neck surgery are necessary.

  4. Intelligent car guidance system (parking support system); Chiteki sharyo yudo system (chusha shien system)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-03-01

    This system enables a driver to park the car at a predetermined spot without the driver seeing the outside scene. The system shows on a driver seat display the steps that the driver is to follow and thereby supports the driver when visibility is poor, when the parking space is difficult to approach, when the driver is a novice, or when the driver is aged. The system ensures accurate positioning of the car by showing the steering direction and angle, the car speed, and the force of braking to the driver. For this purpose, the system knows the absolute car position by the use of an RFID (Radio Frequency Identification) tag which is a kind of IC (Integrated Circuit) card and D-GPS (Differential-Global Positioning System), grasps the relative car position by the use of a gyroscope, and collects data from plural sensors, which are complementary to each other, such as a car-speed sensor and a steering sensor. (translated by NEDO)

  5. Prediction of Banking Systemic Risk Based on Support Vector Machine

    Directory of Open Access Journals (Sweden)

    Shouwei Li

    2013-01-01

    Full Text Available Banking systemic risk is a complex nonlinear phenomenon and has shed light on the importance of safeguarding financial stability by recent financial crisis. According to the complex nonlinear characteristics of banking systemic risk, in this paper we apply support vector machine (SVM to the prediction of banking systemic risk in an attempt to suggest a new model with better explanatory power and stability. We conduct a case study of an SVM-based prediction model for Chinese banking systemic risk and find the experiment results showing that support vector machine is an efficient method in such case.

  6. Fault-Tolerant Onboard Monitoring and Decision Support Systems

    DEFF Research Database (Denmark)

    Lajic, Zoran

    a crude and simple estimation of the actual sea state (Hs and Tz), information about the longitudinal hull girder loading, seakeeping performance of the ship, and decision support on how to operate the ship within acceptable limits. The system is able to identify critical forthcoming events and to give...... advice regarding speed and course changes to decrease the wave-induced loads. The SeaSense system is based on the combined use of a mathematical model and measurements from a set of sensors. The overall dependability of a shipboard monitoring and decision support system such as the SeaSense system can...

  7. ARCHITECTURE SOFTWARE SOLUTION TO SUPPORT AND DOCUMENT MANAGEMENT QUALITY SYSTEM

    Directory of Open Access Journals (Sweden)

    Milan Eric

    2010-12-01

    Full Text Available One of the basis of a series of standards JUS ISO 9000 is quality system documentation. An architecture of the quality system documentation depends on the complexity of business system. An establishment of an efficient management documentation of system of quality is of a great importance for the business system, as well as in the phase of introducing the quality system and in further stages of its improvement. The study describes the architecture and capability of software solutions to support and manage the quality system documentation in accordance with the requirements of standards ISO 9001:2001, ISO 14001:2005 HACCP etc.

  8. LOKI: a practical modelling and support system for telepresence systems

    International Nuclear Information System (INIS)

    Griffin, M.; Bridgewater, C.E.

    1993-01-01

    The use of Virtual Reality headset systems, in combination with a tele-presence ''head'' is discussed. The system is attached to a Unimate Puma robot arm and manipulated by the operator, using information gathered by the camera and auditory system, displayed via the Virtual Reality helmet. Operator commands are cross checked by using a modelling system, held on the Virtual Reality system. This system was found to supply a good sense of spacial awareness of the robot's domain. Actions which might move the robot outside its suitable operating envelope, or create a collision with the environment, were successfully blocked. This approach is seen as useful within the area of tele-operation. (author)

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

    Directory of Open Access Journals (Sweden)

    Xudong Zhang

    2012-01-01

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

  10. Municipal solid waste management system: decision support through systems analysis

    OpenAIRE

    Pires, Ana Lúcia Lourenço

    2010-01-01

    Thesis submitted to the Universidade Nova de Lisboa, Faculdade de Ciências e Tecnologia for the degree of Doctor of Philosophy in Environmental Engineering The present study intends to show the development of systems analysis model applied to solid waste management system, applied into AMARSUL, a solid waste management system responsible for the management of municipal solid waste produced in Setúbal peninsula, Portugal. The model developed intended to promote sustainable decision making, ...

  11. Pipe support for use in a nuclear system

    International Nuclear Information System (INIS)

    Pollono, L.P.; Mello, R.M.

    1976-01-01

    Description is given of a vertical pipe support system. It comprises a tubular pipe support structure having the same inside diameter and the same wall thickness as the pipe, the pipe support structure having a generally triangularly shaped extension formed integral with and extending circumferentially around its outward side, the bottom side of this extension generally forming a ledge; an annular load-bearing insulation formed adjacent to the extension; means for clamping the load-bearing insulation to extension; and means for providing constant vertical support to means for clamping [fr

  12. Cloud-Based Service Information System for Evaluating Quality of Life after Breast Cancer Surgery.

    Directory of Open Access Journals (Sweden)

    Hao-Yun Kao

    Full Text Available Although recent studies have improved understanding of quality of life (QOL outcomes of breast conserving surgery, few have used longitudinal data for more than two time points, and few have examined predictors of QOL over two years. Additionally, the longitudinal data analyses in such studies rarely apply the appropriate statistical methodology to control for censoring and inter-correlations arising from repeated measures obtained from the same patient pool. This study evaluated an internet-based system for measuring longitudinal changes in QOL and developed a cloud-based system for managing patients after breast conserving surgery.This prospective study analyzed 657 breast cancer patients treated at three tertiary academic hospitals. Related hospital personnel such as surgeons and other healthcare professionals were also interviewed to determine the requirements for an effective cloud-based system for surveying QOL in breast cancer patients. All patients completed the SF-36, Quality of Life Questionnaire (QLQ-C30 and its supplementary breast cancer measure (QLQ-BR23 at baseline, 6 months, 1 year, and 2 years postoperatively. The 95% confidence intervals for differences in responsiveness estimates were derived by bootstrap estimation. Scores derived by these instruments were interpreted by generalized estimating equation before and after surgery.All breast cancer surgery patients had significantly improved QLQ-C30 and QLQ-BR23 subscale scores throughout the 2-year follow-up period (p<0.05. During the study period, QOL generally had a negative association with advanced age, high Charlson comorbidity index score, tumor stage III or IV, previous chemotherapy, and long post-operative LOS. Conversely, QOL was positively associated with previous radiotherapy and hormone therapy. Additionally, patients with high scores for preoperative QOL tended to have high scores for QLQ-C30, QLQ-BR23 and SF-36 subscales. Based on the results of usability testing

  13. Customer Decision Support Systems: Resources for Student Decision Making

    Directory of Open Access Journals (Sweden)

    Cara Okleshen Peters, Ph.D.

    2005-07-01

    Full Text Available This paper highlights the potential of customer decision support systems (CDSS to assist students in education-related decision making. Faculty can use these resources to more effectively advise students on various elements of college life, while students can employ them to more actively participate in their own learning and improve their academic experience. This conceptual paper summarizes consumer decision support systems (CDSS concepts and presents exemplar websites students could utilize to support their education-related decision making. Finally, the authors discuss the potential benefits and drawbacks such resources engender from a student perspective and conclude with directions for future research.

  14. Intelligent Decision Support System for Bank Loans Risk Classification

    Institute of Scientific and Technical Information of China (English)

    杨保安; 马云飞; 俞莲

    2001-01-01

    Intelligent Decision Support System (IISS) for Bank Loans Risk Classification (BLRC), based on the way of integration Artificial Neural Network (ANN) and Expert System (ES), is proposed. According to the feature of BLRC, the key financial and non-financial factors are analyzed. Meanwhile, ES and Model Base (MB) which contain ANN are designed . The general framework,interaction and integration of the system are given. In addition, how the system realizes BLRC is elucidated in detail.

  15. Measuring the Latency of an Augmented Reality System for Robot-Assisted Minimally Invasive Surgery

    DEFF Research Database (Denmark)

    Jørgensen, Martin Kibsgaard; Kraus, Martin

    2017-01-01

    Minimal latency is important for augmented reality systems and teleoperation interfaces as even small increases in latency can affect user performance. Previously, we have developed an augmented reality system that can overlay stereoscopic video streams with computer graphics in order to improve....... The latency of the da Vinci S surgical system was on average 62 ms. None of the components of our overlay system (separately or combined) significantly affected the latency. However, the latency of the assistant's monitor increased by 14 ms. Passing the video streams through CPU or GPU memory increased...... visual communication in training for robot-assisted minimally invasive surgery with da Vinci surgical systems. To make sure that our augmented reality system provides the best possible user experience, we investigated the video latency of the da Vinci surgical system and how the components of our system...

  16. Decisions at hand: a decision support system on handhelds.

    Science.gov (United States)

    Zupan, B; Porenta, A; Vidmar, G; Aoki, N; Bratko, I; Beck, J R

    2001-01-01

    One of the applications of clinical information systems is decision support. Although the advantages of utilizing such aids have never been theoretically disputed, they have been rarely used in practice. The factor that probably often limits the utility of clinical decision support systems is the need for computing power at the very site of decision making--at the place where the patient is interviewed, in discussion rooms, etc. The paper reports on a possible solution to this problem. A decision-support shell LogReg is presented, which runs on a handheld computer. A general schema for handheld-based decision support is also proposed, where decision models are developed on personal computers/workstations, encoded in XML and then transferred to handhelds, where the models are used within a decision support shell. A use case where LogReg has been applied to clinical outcome prediction in crush injury is presented.

  17. Evolution of Decision Support Systems Research Field in Numbers

    Directory of Open Access Journals (Sweden)

    Ana-Maria SUDUC

    2010-01-01

    Full Text Available The scientific production in a certain field shows, in great extent, the research interests in that field. Decision Support Systems are a particular class of information systems which are gaining more popularity in various domains. In order to identify the evolution in time of the publications number, authors, subjects, publications in the Decision Support Systems (DSS field, and therefore the scientific world interest for this field, in November 2010 there have been organized a series of queries on three major international scientific databases: ScienceDirect, IEEE Xplore Digital Library and ACM Digital Library. The results presented in this paper shows that, even the decision support systems research field started in 1960s, the interests for this type of systems grew exponentially with each year in the last decades.

  18. Web-Based Group Decision Support System: an Economic Application

    Directory of Open Access Journals (Sweden)

    Ion ISTUDOR

    2010-01-01

    Full Text Available Decision Support Systems (DSS form a specific class of computerized information systems that support business and managerial decision-making activities. Making the right decision in business primarily depends on the quality of data. It also depends on the ability to analyze the data with a view to identifying trends that can suggest solutions and strategies. A “cooperative” decision support system means the data are collected, analyzed and then provided to a human agent who can help the system to revise or refine the data. It means that both a human component and computer component work together to come up with the best solution. This paper describes the usage of a software product (Vanguard System to a specific economic application (evaluating the financial risk assuming that the rate of the economic profitability can be under the value of the interest rate.

  19. Neuronavigation in brain tumor surgery:clinical beta-phase of the Oulu Neuronavigator System

    OpenAIRE

    Schiffbauer, H. (Hagen)

    1999-01-01

    Abstract Interactive image-guided neurosurgery for the resection of brain tumors was developed within the last 10 years at different neurosurgical centers around the world to improve the safety of the surgery and the functional outcome of the patients. Since 1987, the Oulu Neuronavigator System, consisting mainly of a mechanical arm, visualization software, an ultrasound transducer and a computer, was developed at the Neurosurgical Research Unit, University of Oulu, Finland. It was the fir...

  20. Systemic assessment of patients undergoing dental implant surgeries: A trans- and post-operative analysis

    OpenAIRE

    Sanjay Byakodi; Sachin Kumar; Rajesh Kumar Reddy; Vipin Kumar; Shipra Sepolia; Shivangi Gupta; Harkanwal Preet Singh

    2017-01-01

    Background: Procedure-related and patient-related factors influence the prognosis of dental implants to a major extent. Hence, we aimed to evaluate and analyze various systemic factors in patients receiving dental implants. Materials and Methods: Fifty-one patients were included in the study, in which a total of 110 dental implants were placed. Complete examination of the subjects was done before and after placement of dental implants. Implant surgery was planned, and osseointegrated dental i...

  1. MPI support in the DIRAC Pilot Job Workload Management System

    International Nuclear Information System (INIS)

    Tsaregorodtsev, A; Hamar, V

    2012-01-01

    Parallel job execution in the grid environment using MPI technology presents a number of challenges for the sites providing this support. Multiple flavors of the MPI libraries, shared working directories required by certain applications, special settings for the batch systems make the MPI support difficult for the site managers. On the other hand the workload management systems with Pilot Jobs became ubiquitous although the support for the MPI applications in the Pilot frameworks was not available. This support was recently added in the DIRAC Project in the context of the GISELA Latin American Grid Initiative. Special services for dynamic allocation of virtual computer pools on the grid sites were developed in order to deploy MPI rings corresponding to the requirements of the jobs in the central task queue of the DIRAC Workload Management System. Pilot Jobs using user space file system techniques install the required MPI software automatically. The same technique is used to emulate shared working directories for the parallel MPI processes. This makes it possible to execute MPI jobs even on the sites not supporting them officially. Reusing so constructed MPI rings for execution of a series of parallel jobs increases dramatically their efficiency and turnaround. In this contribution we describe the design and implementation of the DIRAC MPI Service as well as its support for various types of MPI libraries. Advantages of coupling the MPI support with the Pilot frameworks are outlined and examples of usage with real applications are presented.

  2. Experiences from the Architectural Migration of a Joint Replacement Surgery Information System

    Directory of Open Access Journals (Sweden)

    Samuli Niiranen

    2008-01-01

    Full Text Available The goal of this study is to present the experiences gathered from the migration of an existing and deployed joint replacement surgery information system from a classical 2-tier architecture to a 4-tier architecture. These include discussion on the motivation for the migration and on the technical benefits of the chosen technical migration path and an evaluation of user experiences. The results from the analysis of clinical end-user and administrator experiences show an increase in the perceived performance and maintainability of the system and a high level of acceptance for the new system version.

  3. A new scenario based approach for designing driver support systems applied to the design of a lane change support system

    NARCIS (Netherlands)

    Tideman, M.; Voort, M.C. van der; Arem, B. van

    2008-01-01

    Designing a new driver support system that meets the expectations of drivers is a difficult and time-consuming process. Despite the availability of various types of design support, it has essentially remained a process in which designers are forced to make assumptions about what other people want.

  4. A new scenario based approach for designing driver support systems applied to the design of a lane change support system

    NARCIS (Netherlands)

    Tideman, Martijn; van der Voort, Mascha C.; van Arem, Bart

    2010-01-01

    Designing a new driver support system that meets the expectations of drivers is a difficult and time-consuming process. Despite the availability of various types of design support, it has essentially remained a process in which designers are forced to make assumptions about what other people want.

  5. Computerised decision support systems for healthcare professionals: an interpretative review.

    Science.gov (United States)

    Cresswell, Kathrin; Majeed, Azeem; Bates, David W; Sheikh, Aziz

    2012-01-01

    Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted. We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997-2010). The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS) Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations. Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits. Whilst the potential of clinical decision support systems in improving, in particular, practitioner performance is considerable, such technology may

  6. Decision Support System for Hepatitis Disease Diagnosis using Bayesian Network

    Directory of Open Access Journals (Sweden)

    Shamshad Lakho

    2017-12-01

    Full Text Available Medical judgments are tough and challenging as the decisions are often based on the deficient and ambiguous information. Moreover, the result of decision process has direct effects on human lives. The act of human decision declines in emergency situations due to the complication, time limit, and high risks. Therefore, provision of medical diagnosis plays a dynamic role, specifically in the preliminary stage when a physician has limited diagnosis experience and identifies the directions to be taken for the treatment process. Computerized Decision Support Systems have brought a revolution in the medical diagnosis. These automatic systems support the diagnosticians in the course of diagnosis. The major role of Decision Support Systems is to support the medical personnel in decision-making procedures regarding disease diagnosis and treatment recommendation. The proposed system provides easy support in Hepatitis disease recognition. The system is developed using the Bayesian network model. The physician provides the input to the system in the form of symptoms stated by the patient. These signs and symptoms match with the casual relationships present in the knowledge model. The Bayesian network infers conclusion from the knowledge model and calculates the probability of occurrence of Hepatitis B, C and D disorders.

  7. The impact of a preloaded intraocular lens delivery system on operating room efficiency in routine cataract surgery

    Directory of Open Access Journals (Sweden)

    Jones JJ

    2016-06-01

    Full Text Available Jason J Jones,1 Jeffrey Chu,2 Jacob Graham,2 Serge Zaluski,3 Guillermo Rocha4 1Jones Eye Clinic, Sioux City, IA, 2Quorum Consulting Inc., San Francisco, CA, USA; 3VISIS, Perpignan, France; 4Ocular Microsurgery & Laser Centre, Brandon, MB, Canada Purpose: The aim of this study was to evaluate the operational impact of using preloaded intraocular lens (IOL delivery systems compared with manually loaded IOL delivery processes during routine cataract surgeries. Methods: Time and motion data, staff and surgery schedules, and cost accounting reports were collected across three sites located in the US, France, and Canada. Time and motion data were collected for manually loaded IOL processes and preloaded IOL delivery systems over four surgery days. Staff and surgery schedules and cost accounting reports were collected during the 2 months prior and after introduction of the preloaded IOL delivery system. Results: The study included a total of 154 routine cataract surgeries across all three sites. Of these, 77 surgeries were performed using a preloaded IOL delivery system, and the remaining 77 surgeries were performed using a manual IOL delivery process. Across all three sites, use of the preloaded IOL delivery system significantly decreased mean total case time by 6.2%–12.0% (P<0.001 for data from Canada and the US and P<0.05 for data from France. Use of the preloaded delivery system also decreased surgeon lens time, surgeon delays, and eliminated lens touches during IOL preparation. Conclusion: Compared to a manual IOL delivery process, use of a preloaded IOL delivery system for cataract surgery reduced total case time, total surgeon lens time, surgeon delays, and eliminated IOL touches. The time savings provided by the preloaded IOL delivery system provide an opportunity for sites to improve routine cataract surgery throughput without impacting surgeon or staff capacity. Keywords: time and motion, provider impact, surgical throughput, IOL

  8. Feasibility of real-time location systems in monitoring recovery after major abdominal surgery.

    Science.gov (United States)

    Dorrell, Robert D; Vermillion, Sarah A; Clark, Clancy J

    2017-12-01

    Early mobilization after major abdominal surgery decreases postoperative complications and length of stay, and has become a key component of enhanced recovery pathways. However, objective measures of patient movement after surgery are limited. Real-time location systems (RTLS), typically used for asset tracking, provide a novel approach to monitoring in-hospital patient activity. The current study investigates the feasibility of using RTLS to objectively track postoperative patient mobilization. The real-time location system employs a meshed network of infrared and RFID sensors and detectors that sample device locations every 3 s resulting in over 1 million data points per day. RTLS tracking was evaluated systematically in three phases: (1) sensitivity and specificity of the tracking device using simulated patient scenarios, (2) retrospective passive movement analysis of patient-linked equipment, and (3) prospective observational analysis of a patient-attached tracking device. RTLS tracking detected a simulated movement out of a room with sensitivity of 91% and specificity 100%. Specificity decreased to 75% if time out of room was less than 3 min. All RTLS-tagged patient-linked equipment was identified for 18 patients, but measurable patient movement associated with equipment was detected for only 2 patients (11%) with 1-8 out-of-room walks per day. Ten patients were prospectively monitored using RTLS badges following major abdominal surgery. Patient movement was recorded using patient diaries, direct observation, and an accelerometer. Sensitivity and specificity of RTLS patient tracking were both 100% in detecting out-of-room ambulation and correlated well with direct observation and patient-reported ambulation. Real-time location systems are a novel technology capable of objectively and accurately monitoring patient movement and provide an innovative approach to promoting early mobilization after surgery.

  9. Software Application for Supporting the Education of Database Systems

    Science.gov (United States)

    Vágner, Anikó

    2015-01-01

    The article introduces an application which supports the education of database systems, particularly the teaching of SQL and PL/SQL in Oracle Database Management System environment. The application has two parts, one is the database schema and its content, and the other is a C# application. The schema is to administrate and store the tasks and the…

  10. Revisiting the dose calculation methodologies in European decision support systems

    DEFF Research Database (Denmark)

    Andersson, Kasper Grann; Roos, Per; Hou, Xiaolin

    2012-01-01

    The paper presents examples of current needs for improvement and extended applicability of the European decision support systems. The systems were originally created for prediction of the radiological consequences of accidents at nuclear installations. They could however also be of great value in...... for, to introduce new knowledge and thereby improve prognoses....

  11. An intelligent operator support system for dynamic positioning

    NARCIS (Netherlands)

    Diggelen, J. van; Broek, J. van den; Schraagen, J.M.C.; Waa, J.S. van der

    2018-01-01

    This paper proposes a human-centered approach to Dynamic Position-ing systems which combines multiple technologies in an intelligent operator sup-port system (IOSS). IOSS allows the operator to be roaming and do other tasks in quiet conditions. When conditions become more demanding, the IOSS calls

  12. Information Systems to Support Surveillance for Malaria Elimination

    Science.gov (United States)

    Ohrt, Colin; Roberts, Kathryn W.; Sturrock, Hugh J. W.; Wegbreit, Jennifer; Lee, Bruce Y.; Gosling, Roly D.

    2015-01-01

    Robust and responsive surveillance systems are critical for malaria elimination. The ideal information system that supports malaria elimination includes: rapid and complete case reporting, incorporation of related data, such as census or health survey information, central data storage and management, automated and expert data analysis, and customized outputs and feedback that lead to timely and targeted responses. Spatial information enhances such a system, ensuring cases are tracked and mapped over time. Data sharing and coordination across borders are vital and new technologies can improve data speed, accuracy, and quality. Parts of this ideal information system exist and are in use, but have yet to be linked together coherently. Malaria elimination programs should support the implementation and refinement of information systems to support surveillance and response and ensure political and financial commitment to maintain the systems and the human resources needed to run them. National malaria programs should strive to improve the access and utility of these information systems and establish cross-border data sharing mechanisms through the use of standard indicators for malaria surveillance. Ultimately, investment in the information technologies that support a timely and targeted surveillance and response system is essential for malaria elimination. PMID:26013378

  13. A Textual Case-Based Mobile Phone Diagnosis Support System ...

    African Journals Online (AJOL)

    In this paper, a Mobile Phone Diagnosis Support System is presented as an extension to jCOLIBRI which accepts a problem and reasons with cases to provide a solution related to a new given problem. Experimental evaluation using some set of problems shows that the developed system predicts the solution that is ...

  14. Information systems to support surveillance for malaria elimination.

    Science.gov (United States)

    Ohrt, Colin; Roberts, Kathryn W; Sturrock, Hugh J W; Wegbreit, Jennifer; Lee, Bruce Y; Gosling, Roly D

    2015-07-01

    Robust and responsive surveillance systems are critical for malaria elimination. The ideal information system that supports malaria elimination includes: rapid and complete case reporting, incorporation of related data, such as census or health survey information, central data storage and management, automated and expert data analysis, and customized outputs and feedback that lead to timely and targeted responses. Spatial information enhances such a system, ensuring cases are tracked and mapped over time. Data sharing and coordination across borders are vital and new technologies can improve data speed, accuracy, and quality. Parts of this ideal information system exist and are in use, but have yet to be linked together coherently. Malaria elimination programs should support the implementation and refinement of information systems to support surveillance and response and ensure political and financial commitment to maintain the systems and the human resources needed to run them. National malaria programs should strive to improve the access and utility of these information systems and establish cross-border data sharing mechanisms through the use of standard indicators for malaria surveillance. Ultimately, investment in the information technologies that support a timely and targeted surveillance and response system is essential for malaria elimination. © The American Society of Tropical Medicine and Hygiene.

  15. A Portable Shoulder-Mounted Camera System for Surgical Education in Spine Surgery.

    Science.gov (United States)

    Pham, Martin H; Ohiorhenuan, Ifije E; Patel, Neil N; Jakoi, Andre M; Hsieh, Patrick C; Acosta, Frank L; Wang, Jeffrey C; Liu, John C

    2017-02-07

    The past several years have demonstrated an increased recognition of operative videos as an important adjunct for resident education. Currently lacking, however, are effective methods to record video for the purposes of illustrating the techniques of minimally invasive (MIS) and complex spine surgery. We describe here our experiences developing and using a shoulder-mounted camera system for recording surgical video. Our requirements for an effective camera system included wireless portability to allow for movement around the operating room, camera mount location for comfort and loupes/headlight usage, battery life for long operative days, and sterile control of on/off recording. With this in mind, we created a shoulder-mounted camera system utilizing a GoPro™ HERO3+, its Smart Remote (GoPro, Inc., San Mateo, California), a high-capacity external battery pack, and a commercially available shoulder-mount harness. This shoulder-mounted system was more comfortable to wear for long periods of time in comparison to existing head-mounted and loupe-mounted systems. Without requiring any wired connections, the surgeon was free to move around the room as needed. Over the past several years, we have recorded numerous MIS and complex spine surgeries for the purposes of surgical video creation for resident education. Surgical videos serve as a platform to distribute important operative nuances in rich multimedia. Effective and practical camera system setups are needed to encourage the continued creation of videos to illustrate the surgical maneuvers in minimally invasive and complex spinal surgery. We describe here a novel portable shoulder-mounted camera system setup specifically designed to be worn and used for long periods of time in the operating room.

  16. Early clinical experience with the da Vinci Xi Surgical System in general surgery.

    Science.gov (United States)

    Hagen, Monika E; Jung, Minoa K; Ris, Frederic; Fakhro, Jassim; Buchs, Nicolas C; Buehler, Leo; Morel, Philippe

    2017-09-01

    The da Vinci Xi Surgical System (Intuitive Surgical Inc., Sunnyvale, CA, USA) has been released in 2014 to facilitate minimally invasive surgery. Novel features are targeted towards facilitating complex multi-quadrant procedures, but data is scarce so far. Perioperative data of patients who underwent robotic general surgery with the da Vinci Xi system within the first 6 month after installation were collected and analyzed. The gastric bypass procedures performed with the da Vinci Xi Surgical System were compared to an equal amount of the last procedures with the da Vinci Si Surgical System. Thirty-one foregut (28 Roux-en-Y gastric bypasses), 6 colorectal procedures and 1 revisional biliary procedure were performed. The mean operating room (OR) time was 221.8 (±69.0) minutes for gastric bypasses and 306.5 (±48.8) for colorectal procedures with mean docking time of 9.4 (±3.8) minutes. The gastric bypass procedure was transitioned from a hybrid to a fully robotic approach. In comparison to the last 28 gastric bypass procedures performed with the da Vinci Si Surgical System, the OR time was comparable (226.9 versus 230.6 min, p = 0.8094), but the docking time significantly longer with the da Vinci Xi Surgical System (8.5 versus 6.1 min, p = 0.0415). All colorectal procedures were performed with a single robotic docking. No intraoperative and two postoperative complications occurred. The da Vinci Xi might facilitate single-setups of totally robotic gastric bypass and colorectal surgeries. However, further comparable research is needed to clearly determine the significance of this latest version of the da Vinci Surgical System.

  17. A cable-driven soft robot surgical system for cardiothoracic endoscopic surgery: preclinical tests in animals.

    Science.gov (United States)

    Wang, Hesheng; Zhang, Runxi; Chen, Weidong; Wang, Xiaozhou; Pfeifer, Rolf

    2017-08-01

    Minimally invasive surgery attracts more and more attention because of the advantages of minimal trauma, less bleeding and pain and low complication rate. However, minimally invasive surgery for beating hearts is still a challenge. Our goal is to develop a soft robot surgical system for single-port minimally invasive surgery on a beating heart. The soft robot described in this paper is inspired by the octopus arm. Although the octopus arm is soft and has more degrees of freedom (DOFs), it can be controlled flexibly. The soft robot is driven by cables that are embedded into the soft robot manipulator and can control the direction of the end and middle of the soft robot manipulator. The forward, backward and rotation movement of the soft robot is driven by a propulsion plant. The soft robot can move freely by properly controlling the cables and the propulsion plant. The soft surgical robot system can perform different thoracic operations by changing surgical instruments. To evaluate the flexibility, controllability and reachability of the designed soft robot surgical system, some testing experiments have been conducted in vivo on a swine. Through the subxiphoid, the soft robot manipulator could enter into the thoracic cavity and pericardial cavity smoothly and perform some operations such as biopsy, ligation and ablation. The operations were performed successfully and did not cause any damage to the surrounding soft tissues. From the experiments, the flexibility, controllability and reachability of the soft robot surgical system have been verified. Also, it has been shown that this system can be used in the thoracic and pericardial cavity for different operations. Compared with other endoscopy robots, the soft robot surgical system is safer, has more DOFs and is more flexible for control. When performing operations in a beating heart, this system maybe more suitable than traditional endoscopy robots.

  18. [Habitability and biological life support systems for man].

    Science.gov (United States)

    Gazenko, O G; Grigor'ev, A I; Meleshko, G I; Shepelev, E Ia

    1990-01-01

    This paper discusses general concepts and specific details of the habitability of space stations and planetary bases completely isolated from the Earth for long periods of time. It emphasizes inadequacy of the present-day knowledge about natural conditions that provide a biologically acceptable environment on the Earth as well as lack of information about life support systems as a source of consumables (oxygen, water, food) and a tool for waste management. The habitability of advanced space vehicles is closely related to closed bioregenerative systems used as life support systems.

  19. AN EXPERT SYSTEM FOR SUPPORTING THE PRODUCTION OF PLEASURE BOATS

    Directory of Open Access Journals (Sweden)

    Tomasz GONCIARZ

    2013-07-01

    Full Text Available Expert systems can be defined as computer programs, whose main task is to simulate a human expert, usually in a narrow field of expertise. Possible applications of modern information technology are very extensive, ranging from medicine, geology and technology to applications in the field of economic and financial decision support. The purpose of this paper is to present the practical application of an expert system that supports the process of managing the production of yachts and has a high suitability for use in this application. Using the expert system described in the paper reduces the time during the design and production preparation process.

  20. Considering Intermittent Dormancy in an Advanced Life Support Systems Architecture

    Science.gov (United States)

    Sargusingh, Miriam J.; Perry, Jay L.

    2017-01-01

    Many advanced human space exploration missions being considered by the National Aeronautics and Space Administration (NASA) include concepts in which in-space systems cycle between inhabited and uninhabited states. Managing the life support system (LSS) may be particularly challenged during these periods of intermittent dormancy. A study to identify LSS management challenges and considerations relating to dormancy is described. The study seeks to define concepts suitable for addressing intermittent dormancy states and to evaluate whether the reference LSS architectures being considered by the Advanced Exploration Systems (AES) Life Support Systems Project (LSSP) are sufficient to support this operational state. The primary focus of the study is the mission concept considered to be the most challenging-a crewed Mars mission with an extensive surface stay. Results from this study are presented and discussed.

  1. Unmanned systems to support the human exploration of Mars

    Science.gov (United States)

    Gage, Douglas W.

    2010-04-01

    Robots and other unmanned systems will play many critical roles in support of a human presence on Mars, including surveying candidate landing sites, locating ice and mineral resources, establishing power and other infrastructure, performing construction tasks, and transporting equipment and supplies. Many of these systems will require much more strength and power than exploration rovers. The presence of humans on Mars will permit proactive maintenance and repair, and allow teleoperation and operator intervention, supporting multiple dynamic levels of autonomy, so the critical challenges to the use of unmanned systems will occur before humans arrive on Mars. Nevertheless, installed communications and navigation infrastructure should be able to support structured and/or repetitive operations (such as excavation, drilling, or construction) within a "familiar" area with an acceptable level of remote operator intervention. This paper discusses some of the factors involved in developing and deploying unmanned systems to make humans' time on Mars safer and more productive, efficient, and enjoyable.

  2. User's manual of a support system for human reliability analysis

    International Nuclear Information System (INIS)

    Yokobayashi, Masao; Tamura, Kazuo.

    1995-10-01

    Many kinds of human reliability analysis (HRA) methods have been developed. However, users are required to be skillful so as to use them, and also required complicated works such as drawing event tree (ET) and calculation of uncertainty bounds. Moreover, each method is not so complete that only one method of them is not enough to evaluate human reliability. Therefore, a personal computer (PC) based support system for HRA has been developed to execute HRA practically and efficiently. The system consists of two methods, namely, simple method and detailed one. The former uses ASEP that is a simplified THERP-technique, and combined method of OAT and HRA-ET/DeBDA is used for the latter. Users can select a suitable method for their purpose. Human error probability (HEP) data were collected and a database of them was built to use for the support system. This paper describes outline of the HRA methods, support functions and user's guide of the system. (author)

  3. Classification of nuclear power plant operator support systems

    International Nuclear Information System (INIS)

    Alpeev, A.S.

    1994-01-01

    The objective of this survey was to examine the general characteristics of modern nuclear power plant process monitoring/control systems and to apply developing technology (intellectual automation) in order to improve the man-machine interface. The support systems that implement each phase of the control function...information, assessment, decision-making, and implementation...were discussed, and where applicable, intellectual automation was applied to the support system. It was concluded that the application of intellectual automation, as well as other (undefined) possibilities for improving the man-machine interface, would relieve the operator of many routine activities and allow him to readily apply high potential to those poorly-formalized scenarios in which the operator's work can't be automated. It was also concluded that the development of such support systems would not be without problems, i.e. software certification, traning, and jurisdictional questions

  4. A Lunar Surface System Supportability Technology Development Roadmap

    Science.gov (United States)

    Oeftering, Richard C.; Struk, Peter M.; Taleghani, barmac K.

    2011-01-01

    This paper discusses the establishment of a Supportability Technology Development Roadmap as a guide for developing capabilities intended to allow NASA s Constellation program to enable a supportable, sustainable and affordable exploration of the Moon and Mars. Presented is a discussion of supportability, in terms of space facility maintenance, repair and related logistics and a comparison of how lunar outpost supportability differs from the International Space Station. Supportability lessons learned from NASA and Department of Defense experience and their impact on a future lunar outpost is discussed. A supportability concept for future missions to the Moon and Mars that involves a transition from a highly logistics dependent to a logistically independent operation is discussed. Lunar outpost supportability capability needs are summarized and a supportability technology development strategy is established. The resulting Lunar Surface Systems Supportability Strategy defines general criteria that will be used to select technologies that will enable future flight crews to act effectively to respond to problems and exploit opportunities in an environment of extreme resource scarcity and isolation. This strategy also introduces the concept of exploiting flight hardware as a supportability resource. The technology roadmap involves development of three mutually supporting technology categories, Diagnostics Test and Verification, Maintenance and Repair, and Scavenging and Recycling. The technology roadmap establishes two distinct technology types, "Embedded" and "Process" technologies, with different implementation and thus different criteria and development approaches. The supportability technology roadmap addresses the technology readiness level, and estimated development schedule for technology groups that includes down-selection decision gates that correlate with the lunar program milestones. The resulting supportability technology roadmap is intended to develop a set

  5. Strengthening Health Systems of Developing Countries: Inclusion of Surgery in Universal Health Coverage.

    Science.gov (United States)

    Okoroh, Juliet S; Chia, Victoria; Oliver, Emily A; Dharmawardene, Marisa; Riviello, Robert

    2015-08-01

    Universal health coverage (UHC) has its roots in the Universal Declaration of Human Rights and has recently gained momentum. Out-of-pocket payments (OPP) remain a significant barrier to care. There is an increasing global prevalence of non-communicable diseases, many of which are surgically treatable. We sought to provide a comparative analysis of the inclusion of surgical care in operating plans for UHC in low- and middle-income countries (LMIC). We systematically searched PubMed and Google Scholar using pre-defined criteria for articles published in English, Spanish, or French between January 1991 and November 2013. Keywords included "insurance," "OPP," "surgery," "trauma," "cancer," and "congenital anomalies." World Health Organization (WHO), World Bank, and Joint Learning Network for UHC websites were searched for supporting documents. Ministries of Health were contacted to provide further information on the inclusion of surgery. We found 696 articles and selected 265 for full-text review based on our criteria. Some countries enumerated surgical conditions in detail (India, 947 conditions). Other countries mentioned surgery broadly. Obstetric care was most commonly covered (19 countries). Solid organ transplantation was least covered. Cancer care was mentioned broadly, often without specifying the therapeutic modality. No countries were identified where hospitals are required to provide emergency care regardless of insurance coverage. OPP varied greatly between countries. Eighty percent of countries had OPP of 60% or more, making these services, even if partially covered, largely inaccessible. While OPP, delivery, and utilization continue to represent challenges to health care access in many LMICs, the inclusion of surgery in many UHC policies sets an important precedent in addressing a growing global prevalence of surgically treatable conditions. Barriers to access, including inequalities in financial protection in the form of high OPP, remain a fundamental

  6. Integrated training support system for PWR operator training simulator

    International Nuclear Information System (INIS)

    Sakaguchi, Junichi; Komatsu, Yasuki

    1999-01-01

    The importance of operator training using operator training simulator has been recognized intensively. Since 1986, we have been developing and providing many PWR simulators in Japan. We also have developed some training support systems connected with the simulator and the integrated training support system to improve training effect and to reduce instructor's workload. This paper describes the concept and the effect of the integrated training support system and of the following sub-systems. We have PES (Performance Enhancement System) that evaluates training performance automatically by analyzing many plant parameters and operation data. It can reduce the deviation of training performance evaluation between instructors. PEL (Parameter and Event data Logging system), that is the subset of PES, has some data-logging functions. And we also have TPES (Team Performance Enhancement System) that is used aiming to improve trainees' ability for communication between operators. Trainee can have conversation with virtual trainees that TPES plays automatically. After that, TPES automatically display some advice to be improved. RVD (Reactor coolant system Visual Display) displays the distributed hydraulic-thermal condition of the reactor coolant system in real-time graphically. It can make trainees understand the inside plant condition in more detail. These sub-systems have been used in a training center and have contributed the improvement of operator training and have gained in popularity. (author)

  7. Couple-Based Psychosexual Support Following Prostate Cancer Surgery: Results of a Feasibility Pilot Randomized Control Trial.

    Science.gov (United States)

    Robertson, Jane; McNamee, Phillip; Molloy, Gerry; Hubbard, Gill; McNeill, Alan; Bollina, Prasad; Kelly, Daniel; Forbat, Liz

    2016-08-01

    Surgery for prostate cancer can result in distressing side effects such as sexual difficulties, which are associated with lower levels of dyadic functioning. The study developed and tested an intervention to address sexual, relational, and emotional aspects of the relationship after prostate cancer by incorporating elements of family systems theory and sex therapy. To develop and test the feasibility and acceptability of relational psychosexual treatment for couples with prostate cancer, determine whether a relational-psychosexual intervention is feasible and acceptable for couples affected by prostate cancer, and determine the parameters for a full-scale trial. Forty-three couples were recruited for this pilot randomized controlled trial and received a six-session manual-based psychosexual intervention or usual care. Outcomes were measured before, after, and 6 months after the intervention. Acceptability and feasibility were established from recruitment and retention rates and adherence to the manual. The primary outcome measurement was the sexual bother subdomain of the Expanded Prostate Cancer Index Composite. The Hospital Anxiety and Depression Scale and the 15-item Systemic Clinical Outcome and Routine Evaluation (SCORE-15) were used to measure emotional and relational functioning, respectively. The intervention was feasible and acceptable. The trial achieved adequate recruitment (38%) and retention (74%) rates. The intervention had a clinically and statistically significant effect on sexual bother immediately after the intervention. Small decreases in anxiety and depression were observed for the intervention couples, although these were not statistically significant. Practitioners reported high levels of adherence to the manual. The clinically significant impact on sexual bother and positive feedback on the study's feasibility and acceptability indicate that the intervention should be tested in a multicenter trial. The SCORE-15 lacked specificity for this

  8. Development of the bedridden person support system using hand gesture.

    Science.gov (United States)

    Ichimura, Kouhei; Magatani, Kazushige

    2015-08-01

    The purpose of this study is to support the bedridden and physically handicapped person who live independently. In this study, we developed Electric appliances control system that can be used on the bed. The subject can control Electric appliances using hand motion. Infrared sensors of a Kinect are used for the hand motion detection. Our developed system was tested with some normal subjects and results of the experiment were evaluated. In this experiment, all subjects laid on the bed and tried to control our system. As results, most of subjects were able to control our developed system perfectly. However, motion tracking of some subject's hand was reset forcibly. It was difficult for these subjects to make the system recognize his opened hand. From these results, we think if this problem will be improved our support system will be useful for the bedridden and physically handicapped persons.

  9. Effects of Topical Phenylephrine HCl 2.5% used before Cataract Surgery on Systemic Blood Pressure

    Directory of Open Access Journals (Sweden)

    Emre Ayıntap

    2011-06-01

    Full Text Available Purpose: To evaluate the effect of topical phenylephrine HCl 2.5% (Mydfrin, used as a fast and effective mydriatic before cataract surgery, on systemic blood pressure. Material and Method: Topical phenylephrine HCl 2.5% was administered 3 times with 5-minute intervals before cataract surgery to 44 eyes of 44 patients. The systemic blood pressure was measured preoperatively and at 15 and 30 minutes. Results: The mean systolic blood pressure before the topical administration of phenylephrine HCl 2.5% was 119.7mmHg, while 15 and 30 minutes later, it was 125.3 mmHg and 121.2 mmHg, respectively. The mean diastolic blood pressure before the topical administration of phenylephrine HCl 2.5% was 75.9 mmHg; 15 and 30 minutes later, it was 76.9 mmHg and 75.3 mmHg, respectively. The increase in systolic blood pressure at 15 and 30 minutes was statistically significant (p=0.003 and p=0.042. The change in diastolic blood pressure was not statistically significant. Discussion: Phenylephrine HCl 2.5%, which is used preoperatively as a fast and effective mydriatic for cataract surgery, can increase the systolic blood pressure. This effect is most significant at 15 minutes and lasts at least 30 minutes. This agent should be used with care in hypertensive patients. (Turk J Ophthalmol 2011; 41: 164-6

  10. The design of intelligent support systems for nuclear reactor operators

    International Nuclear Information System (INIS)

    Bernard, J.A.

    1992-01-01

    This paper identifies factors relevant to the design of intelligent support systems and their use for the provision of real-time diagnostic information. As such, it constitutes a followup to the state-of-the-art review that was previously published by Bernard and Washio on the utilization of expert systems within the nuclear industry. Some major differences between intelligent-support tools and conventional expert systems are enumerated. In summary, conventional expert systems that encode experimental knowledge in production rules are not suitable vehicle for the creation of operator support systems. The principal difficulty is the need for real-time operation. This in turn means that intelligent support systems will have knowledge bases derived from temporally accurate plant models, inference engines that permit revisions in the search process to accommodate revised data, and man-machine interfaces that do not require any human input. Such systems will be heavily instrumented, and the associated knowledge bases will require a hierarchical organization to emulate human approaches to analysis

  11. Review of fluorescence guided surgery systems: identification of key performance capabilities beyond indocyanine green imaging

    Science.gov (United States)

    DSouza, Alisha V.; Lin, Huiyun; Henderson, Eric R.; Samkoe, Kimberley S.; Pogue, Brian W.

    2016-08-01

    There is growing interest in using fluorescence imaging instruments to guide surgery, and the leading options for open-field imaging are reviewed here. While the clinical fluorescence-guided surgery (FGS) field has been focused predominantly on indocyanine green (ICG) imaging, there is accelerated development of more specific molecular tracers. These agents should help advance new indications for which FGS presents a paradigm shift in how molecular information is provided for resection decisions. There has been a steady growth in commercially marketed FGS systems, each with their own differentiated performance characteristics and specifications. A set of desirable criteria is presented to guide the evaluation of instruments, including: (i) real-time overlay of white-light and fluorescence images, (ii) operation within ambient room lighting, (iii) nanomolar-level sensitivity, (iv) quantitative capabilities, (v) simultaneous multiple fluorophore imaging, and (vi) ergonomic utility for open surgery. In this review, United States Food and Drug Administration 510(k) cleared commercial systems and some leading premarket FGS research systems were evaluated to illustrate the continual increase in this performance feature base. Generally, the systems designed for ICG-only imaging have sufficient sensitivity to ICG, but a fraction of the other desired features listed above, with both lower sensitivity and dynamic range. In comparison, the emerging research systems targeted for use with molecular agents have unique capabilities that will be essential for successful clinical imaging studies with low-concentration agents or where superior rejection of ambient light is needed. There is no perfect imaging system, but the feature differences among them are important differentiators in their utility, as outlined in the data and tables here.

  12. Review of fluorescence guided surgery systems: identification of key performance capabilities beyond indocyanine green imaging

    Science.gov (United States)

    DSouza, Alisha V.; Lin, Huiyun; Henderson, Eric R.; Samkoe, Kimberley S.; Pogue, Brian W.

    2016-01-01

    Abstract. There is growing interest in using fluorescence imaging instruments to guide surgery, and the leading options for open-field imaging are reviewed here. While the clinical fluorescence-guided surgery (FGS) field has been focused predominantly on indocyanine green (ICG) imaging, there is accelerated development of more specific molecular tracers. These agents should help advance new indications for which FGS presents a paradigm shift in how molecular information is provided for resection decisions. There has been a steady growth in commercially marketed FGS systems, each with their own differentiated performance characteristics and specifications. A set of desirable criteria is presented to guide the evaluation of instruments, including: (i) real-time overlay of white-light and fluorescence images, (ii) operation within ambient room lighting, (iii) nanomolar-level sensitivity, (iv) quantitative capabilities, (v) simultaneous multiple fluorophore imaging, and (vi) ergonomic utility for open surgery. In this review, United States Food and Drug Administration 510(k) cleared commercial systems and some leading premarket FGS research systems were evaluated to illustrate the continual increase in this performance feature base. Generally, the systems designed for ICG-only imaging have sufficient sensitivity to ICG, but a fraction of the other desired features listed above, with both lower sensitivity and dynamic range. In comparison, the emerging research systems targeted for use with molecular agents have unique capabilities that will be essential for successful clinical imaging studies with low-concentration agents or where superior rejection of ambient light is needed. There is no perfect imaging system, but the feature differences among them are important differentiators in their utility, as outlined in the data and tables here. PMID:27533438

  13. A Mechanized Decision Support System for Academic Scheduling.

    Science.gov (United States)

    1986-03-01

    an operational system called software. The first step in the development phase is Design . Designers destribute software control by factoring the Data...SUBJECT TERMS (Continue on reverse if necessary and identify by block number) ELD GROUP SUB-GROUP Scheduling, Decision Support System , Software Design ...scheduling system . It will also examine software - design techniques to identify the most appropriate method- ology for this problem. " - Chapter 3 will

  14. Relational Algebra in Spatial Decision Support Systems Ontologies.

    Science.gov (United States)

    Diomidous, Marianna; Chardalias, Kostis; Koutonias, Panagiotis; Magnita, Adrianna; Andrianopoulos, Charalampos; Zimeras, Stelios; Mechili, Enkeleint Aggelos

    2017-01-01

    Decision Support Systems (DSS) is a powerful tool, for facilitates researchers to choose the correct decision based on their final results. Especially in medical cases where doctors could use these systems, to overcome the problem with the clinical misunderstanding. Based on these systems, queries must be constructed based on the particular questions that doctors must answer. In this work, combination between questions and queries would be presented via relational algebra.

  15. Support system for loop device operator. Analysis of technological processes

    International Nuclear Information System (INIS)

    Yakovlev, V.V.; Mozhaev, A.A.; Lyadin, A.V.

    1988-01-01

    The paper presents the results obtained from the analysis of controlling the loops of a research reactor. A method of optimized interaction of the operator and hardware of the control system by computeraided identification of the cause of regime violation is considered. The equipment diagnostics based on use of the expert system methods and tuzzy algorithms enables to propose a support system for application in new generation of loops

  16. Support mechanisms and risk: Implications on the Nordic electricity system

    DEFF Research Database (Denmark)

    Kitzing, Lena; Ravn, Hans

    2013-01-01

    a stochastic analysis for the Nordic electricity system by conducting simulations with the energy system model Balmorel and by applying the mean-standard deviation approach of modern portfolio theory to quantify risk implications of policy instruments for an exemplary offshore wind park. The analysis reveals......Investments in renewable energy projects, such as offshore wind parks, are very much dependent on financial support. The type of policy instrument chosen for such support determines investors' exposure to market risk, and thus influences which rate of return they expect to achieve. We make...... that the two support policy schemes Feed-in Tariffs and Feed-in Premiums provide different risk-return relationships. In the investigated case, a Feed-in Premium scheme would require a 13% higher support level, because of a 6% higher exposure of investors to market risk. Our findings can help when designing...

  17. A novel navigation system for maxillary positioning in orthognathic surgery: Preclinical evaluation.

    Science.gov (United States)

    Lutz, Jean-Christophe; Nicolau, Stéphane; Agnus, Vincent; Bodin, Frédéric; Wilk, Astrid; Bruant-Rodier, Catherine; Rémond, Yves; Soler, Luc

    2015-11-01

    Appropriate positioning of the maxilla is critical in orthognathic surgery. As opposed to splint-based positioning, navigation systems are versatile and appropriate in assessing the vertical dimension. Bulk and disruption to the line of sight are drawbacks of optical navigation systems. Our aim was to develop and assess a novel navigation system based on electromagnetic tracking of the maxilla, including real-time registration of head movements. Since the software interface has proved to greatly influence the accuracy of the procedure, we purposely designed and evaluated an original, user-friendly interface. A sample of 12 surgeons had to navigate the phantom osteotomized maxilla to eight given target positions using the software we have developed. Time and accuracy (translational error and angular error) were compared between a conventional and a navigated session. A questionnaire provided qualitative evaluation. Our system definitely allows a reduction in variability of time and accuracy among different operators. Accuracy was improved in all surgeons (mean terror difference = 1.11 mm, mean aerror difference = 1.32°). Operative time was decreased in trainees. Therefore, they would benefit from such a system that could also serve for educational purposes. The majority of surgeons who strongly agreed that such a navigation system would prove very helpful in complex deformities, also stated that it would be helpful in everyday orthognathic procedures. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  18. Marketing Decision Making and Decision Support: Challenges and Perspectives for Successful Marketing Management Support Systems

    NARCIS (Netherlands)

    G.H. van Bruggen (Gerrit); B. Wierenga (Berend)

    2009-01-01

    textabstractMarketing management support systems (MMSS) are computer-enabled devices that help marketers to make better decisions. Marketing processes can be quite complex, involving large numbers of variables and mostly outcomes are the results of the actions of many different stakeholders (e.g.,

  19. Comparison of multiple support excitation solution techniques for piping systems

    International Nuclear Information System (INIS)

    Sterkel, H.P.; Leimbach, K.R.

    1980-01-01

    Design and analysis of nuclear power plant piping systems exposed to a variety of dynamic loads often require multiple support excitation analysis by modal or direct time integration methods. Both methods have recently been implemented in the computer program KWUROHR for static and dynamic analysis of piping systems, following the previous implementation of the multiple support excitation response spectrum method (see papers K 6/15 and K 6/15a of the SMiRT-4 Conference). The results of multiple support excitation response spectrum analyses can be examined by carrying out the equivalent time history analyses which do not distort the time phase relationship between the excitations at different support points. A frequent point of discussion is multiple versus single support excitation. A single support excitation analysis is computationally straightforward and tends to be on the conservative side, as the numerical results show. A multiple support excitation analysis, however, does not incur much more additional computer cost than the expenditure for an initial static solution involving three times the number, L, of excitation levels, i.e. 3L static load cases. The results are more realistic than those from a single support excitation analysis. A number of typical nuclear plant piping systems have been analyzed using single and multiple support excitation algorithms for: (1) the response spectrum method, (2) the modal time history method via the Wilson, Newmark and Goldberg integration operators and (3) the direct time history method via the Wilson integration operator. Characteristic results are presented to compare the computational quality of all three methods. (orig.)

  20. Tactical decision making under stress (TADMUS) decision support system

    OpenAIRE

    Morrison, Jeffrey G.; Kelly, Richard T.; Moore, Ronald A.; Hutchins, Susan G.

    1996-01-01

    A prototype decision support system (DSS) was developed to enhance Navy tactical decision making based on naturalistic decision processes. Displays were developed to support critical decision making tasks through recognition-primed and explanation-based reasoning processes and cognitive analysis of the decision making problems faced by Navy tactical officers in a shipboard Combat Information Center. Baseline testing in high intensity, peace keeping, littoral scenarios indicated...

  1. Behavior-aware decision support systems : LDRD final report.

    Energy Technology Data Exchange (ETDEWEB)

    Hirsch, Gary B.; Homer, Jack (Homer Consulting); Chenoweth, Brooke N.; Backus, George A.; Strip, David R.

    2007-11-01

    As Sandia National Laboratories serves its mission to provide support for the security-related interests of the United States, it is faced with considering the behavioral responses that drive problems, mitigate interventions, or lead to unintended consequences. The effort described here expands earlier works in using healthcare simulation to develop behavior-aware decision support systems. This report focuses on using qualitative choice techniques and enhancing two analysis models developed in a sister project.

  2. Effect of portal access system and surgery type on surgery times during laparoscopic ovariectomy and salpingectomy in captive African lions and cheetahs.

    Science.gov (United States)

    Hartman, Marthinus Jacobus; Monnet, Eric; Kirberger, Robert Murco; Schoeman, Johan Petrus

    2016-03-02

    A prospective randomized study was used to compare surgery times for laparoscopic ovariectomy and salpingectomy in female African lion (Panthera leo) (n = 14) and cheetah (Acinonyx jubatus) (n = 20) and to compare the use of a multiple portal access system (MPAS) and single portal access system (SPAS) between groups. Two different portal techniques were used, namely MPAS (three separate ports) in lions and SPAS (SILS™ port) in cheetahs, using standard straight laparoscopic instruments. Portal access system and first ovary was not randomized. Five different surgery times were compared for the two different procedures as well as evaluating the use and application of MPAS and SPAS. Carbon dioxide volumes for lions were recorded. In adult lionesses operative time (OPT) (P = 0.016) and total surgical time (TST) (P = 0.032) were significantly shorter for salpingectomy compared to ovariectomy. Similarly in cheetahs OPT (P = 0.001) and TST (P = 0.005) were also shorter for salpingectomy compared to ovariectomy. In contrast, in lion cubs no difference was found in surgery times for ovariectomy and salpingectomy. Total unilateral procedure time was shorter than the respective bilateral time for both procedures (P = 0.019 and P = 0.001) respectively and unilateral salpingectomy was also faster than unilateral ovariectomy (P = 0.035) in cheetahs. Port placement time, suturing time and TST were significantly shorter for SPAS compared to MPAS (P = 0.008). There was, however, no difference in OPT between SPAS and MPAS. Instrument cluttering with SPAS was found to be negligible. There was no difference in mean volume CO2 required to complete ovariectomy in lions but the correlation between bodyweight and total volume of CO2 in lions was significant (rs = 0.867; P = 0.002). Laparoscopic salpingectomy was faster than ovariectomy in both adult lions and cheetahs. Using SPAS, both unilateral procedures were faster than bilateral procedures in cheetahs

  3. Decision support system for containment and release management

    Energy Technology Data Exchange (ETDEWEB)

    Oosterhuis, B [Twente Univ., Enschede (Netherlands). Computer Science Dept.

    1995-09-01

    The Containment and Release Management project was carried out within the Reinforced Concerted Action Programme for Accident Management Support and partly financed by the European Union. In this report a prototype of an accident management support system is presented. The support system integrates several concepts from accident management research, like safety objective trees, severe accident phenomena, calculation models and an emergency response data system. These concepts are provided by the prototype in such a way that the decision making process of accident management is supported. The prototype application is demonstrated by process data taken from a severe accident scenario for a pressurized water reactor (PWR) that was simulated with the thermohydraulic computer program MAAP. The prototype was derived from a decision support framework based on a decision theory. For established and innovative concepts from accident management research it is pointed out in which way these concepts can support accident management and how these concepts can be integrated. This approach is generic in two ways; it applies to both pressurized and boiling water reactors and it applies to both in vessel management and containment and release management. The prototype application was developed in Multimedia Toolbox 3.0 and requires at least a 386 PC with 4 MB memory, 6 MB free disk space and MS Windows 3.1. (orig.).

  4. Decision support system for containment and release management

    International Nuclear Information System (INIS)

    Oosterhuis, B.

    1995-09-01

    The Containment and Release Management project was carried out within the Reinforced Concerted Action Programme for Accident Management Support and partly financed by the European Union. In this report a prototype of an accident management support system is presented. The support system integrates several concepts from accident management research, like safety objective trees, severe accident phenomena, calculation models and an emergency response data system. These concepts are provided by the prototype in such a way that the decision making process of accident management is supported. The prototype application is demonstrated by process data taken from a severe accident scenario for a pressurized water reactor (PWR) that was simulated with the thermohydraulic computer program MAAP. The prototype was derived from a decision support framework based on a decision theory. For established and innovative concepts from accident management research it is pointed out in which way these concepts can support accident management and how these concepts can be integrated. This approach is generic in two ways; it applies to both pressurized and boiling water reactors and it applies to both in vessel management and containment and release management. The prototype application was developed in Multimedia Toolbox 3.0 and requires at least a 386 PC with 4 MB memory, 6 MB free disk space and MS Windows 3.1. (orig.)

  5. RTEMS CENTRE- Support and Maintenance CENTRE to RTEMS Operating System

    Science.gov (United States)

    Silva, H.; Constantino, A.; Coutunho, M.; Freitas, D.; Faustino, S.; Mota, M.; Colaço, P.; Zulianello, M.

    2008-08-01

    RTEMS stands for Real-Time Operating System for Multiprocessor Systems. It is a full featured Real Time Operating System that supports a variety of open APIs and interface standards. It provides a high performance environment for embedded applications, including a fixed-priority preemptive/non-preemptive scheduler, a comprehensive set of multitasking operations and a large range of supported architectures. Support and maintenance CENTRE to RTEMS operating system (RTEMS CENTRE) is a joint initiative of ESA-Portugal Task force, aiming to build a strong technical competence in the space flight (on- board) software, to offer support, maintenance and improvements to RTEMS. This paper provides a high level description of the current and future activities of the RTEMS CENTRE. It presents a brief description of the RTEMS operating system, a description of the tools developed and distributed to the community [1] and the improvements to be made to the operating system, including facilitation for the qualification of RTEMS (4.8.0) [2] for the space missions.

  6. [Financing of inpatient orthopedics and trauma surgery in the G-DRG system 2010].

    Science.gov (United States)

    Franz, D; Schemmann, F; Roeder, N; Mahlke, L

    2010-08-01

    The German DRG (diagnosis-related groups) system forms the basis for billing inpatient hospital services. It includes not only the case groups (G-DRGs), but also additional and innovation payments. This paper analyzes and evaluates the relevant developments of the G-DRG System 2010 for orthopedics and traumatology from the medical and classification perspectives. Analyses of relevant diagnoses, medical procedures and G-DRGs in the versions 2009 and 2010 based on the publications of the German DRG institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI) were carried out. The DRG catalog is has grown from 8 to 1,200 G-DRGs. A number of codes for surgical measures have been newly established or modified. Here, the identification and the correct and performance-based mapping of complex and elaborate scenarios was again the focus of the restructuring of the G-DRG system. The G-DRG structure in orthopedics and traumatology has been changed, especially in the areas of spinal surgery and surgery of the upper and lower extremities. The actual impact of the changes may vary depending on the individual hospital services. For the first time since the introduction of the G-DRG system, the pure numerical changes at the level of DRGs themselves are so marginal that only part of the DRG users in the hospitals will register them. The changes implemented not only a high selectivity between complex and less complex scenarios, but partly also unintended and unjustified revaluation of less complex measures. The G-DRG system has gained complexity again. Especially the G-DRG allocation of spinal surgery and multiple surgical interventions of the upper and/or lower extremities have reached such a complexity that only a few DRG users can follow them.

  7. Portable, space-saving medical patient support system

    Science.gov (United States)

    Bzorgi,; Fariborz, [Knoxville, TN

    2011-02-01

    A support platform having a stowed configuration and a deployed configuration on a floor. The support platform is related to stretcher devices that are used for transporting, confining, or conducting medical procedures on medical patients in medical emergencies. The support platform typically includes a work surface that has a geometric extent. A base that typically includes a plurality of frame members is provided, and the frame members are disposed across the geometric extent of, and proximal to, the work surface in the stowed configuration. The frame members are typically disposed on the floor in the deployed configuration. There is a foldable bracing system engaged with the work surface and engaged with the base. At least a portion of the foldable bracing system is disposed substantially inside at least a portion of the plurality of frame members in the stowed configuration. Further, the foldable bracing system is configured for translocation of the work surface distal from the base in the deployed configuration.

  8. System for selecting relevant information for decision support.

    Science.gov (United States)

    Kalina, Jan; Seidl, Libor; Zvára, Karel; Grünfeldová, Hana; Slovák, Dalibor; Zvárová, Jana

    2013-01-01

    We implemented a prototype of a decision support system called SIR which has a form of a web-based classification service for diagnostic decision support. The system has the ability to select the most relevant variables and to learn a classification rule, which is guaranteed to be suitable also for high-dimensional measurements. The classification system can be useful for clinicians in primary care to support their decision-making tasks with relevant information extracted from any available clinical study. The implemented prototype was tested on a sample of patients in a cardiological study and performs an information extraction from a high-dimensional set containing both clinical and gene expression data.

  9. 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.

  10. Information security requirements in patient-centred healthcare support systems.

    Science.gov (United States)

    Alsalamah, Shada; Gray, W Alex; Hilton, Jeremy; Alsalamah, Hessah

    2013-01-01

    Enabling Patient-Centred (PC) care in modern healthcare requires the flow of medical information with the patient between different healthcare providers as they follow the patient's treatment plan. However, PC care threatens the stability of the balance of information security in the support systems since legacy systems fall short of attaining a security balance when sharing their information due to compromises made between its availability, integrity, and confidentiality. Results show that the main reason for this is that information security implementation in discrete legacy systems focused mainly on information confidentiality and integrity leaving availability a challenge in collaboration. Through an empirical study using domain analysis, observations, and interviews, this paper identifies a need for six information security requirements in legacy systems to cope with this situation in order to attain the security balance in systems supporting PC care implementation in modern healthcare.

  11. Structural support system for a superconducting magnet coil

    International Nuclear Information System (INIS)

    Meuser, R.B.

    1977-01-01

    The purpose of the ESCAR (Experimental Superconducting Accelerator Ring) project, now under way at the Lawrence Berkeley Laboratory, is to gather data and experience in the design and operation of a relatively small synchrotron employing superconducting magnets. Such data are essential to ensure that the design of future large accelerators may proceed in a knowledgeable and responsible manner. One of the many engineering problems associated with a superconducting magnet is the design of the coil suspension system. The coil, maintained at the temperature of liquid helium, must be held rigidly by a structure that does not conduct too much heat into the liquid helium system. The suspension system used on the ESCAR magnets is described. Topics covered include the coil support system requirements, ESCAR magnet support system, and operating experience

  12. Computational intelligence for decision support in cyber-physical systems

    CERN Document Server

    Ali, A; Riaz, Zahid

    2014-01-01

    This book is dedicated to applied computational intelligence and soft computing techniques with special reference to decision support in Cyber Physical Systems (CPS), where the physical as well as the communication segment of the networked entities interact with each other. The joint dynamics of such systems result in a complex combination of computers, software, networks and physical processes all combined to establish a process flow at system level. This volume provides the audience with an in-depth vision about how to ensure dependability, safety, security and efficiency in real time by making use of computational intelligence in various CPS applications ranging from the nano-world to large scale wide area systems of systems. Key application areas include healthcare, transportation, energy, process control and robotics where intelligent decision support has key significance in establishing dynamic, ever-changing and high confidence future technologies. A recommended text for graduate students and researche...

  13. ERP System Audit a Control Support For Knowledge Management

    Directory of Open Access Journals (Sweden)

    Traian SURCEL

    2008-01-01

    Full Text Available The ERP system supports most of the business system that maintains in a single database the data needed for a variety of business functions such as Manufacturing, SCM, Financials, Projects, Human Resources and CRM; the audit of this systems is necessary in order to give reasonable assurance to the company on its core system. Obtained evidence evaluation can ensure whether the organization's IT&C system safeguard assets, maintains data integrity, and is operating effectively and efficiently to achieve the organization's goals or objectives. The audit process respecting the methodology based on: gathering information and plan; obtaining an understanding of internal controls; performing test of controls and substantive tests, develop a control support on quality of flow of information and knowledge from formal perspective, for Knowledge Management in large enterprises.

  14. Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for ambulatory surgical centers - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of ambulatory surgical center ratings for the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey....

  15. Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS) survey for hospital outpatient departments - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital outpatient department ratings for the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS)...

  16. Cloud Computing Application on Transport Dispatching Informational Support Systems

    Directory of Open Access Journals (Sweden)

    Dmitry Olegovich Gusenitsa

    2015-05-01

    Full Text Available Transport dispatching informational support systems has received widespread attention due to high quality information density, strong coherence and applicable visualization features. Nevertheless, because of large volume of data, complex integration requirements and the need for information exchange between different users, time costs of the development and implementation of the informational support systems, problems associated with various data formats compatibility, security protocols and high maintenance cost, the opportunities for the application of such systems are significantly reduced. This article reviews the possibility of creating a cloud storage data system for transport dispatching informational support system (TDIS using modern computer technology to meet the challenges of mass data processing, information security and reduce operational costs. The system is expected to make full use of the advantages offered by the technology of cloud storage. Integrated cloud will increase the amount of data available to the system, reduce the speed processing requirements and reduce the overall cost of system implementation. Creation and integration of cloud storage is one of the most important areas of TDIS development, which is stimulating and promoting the further development of TDIS to ensure the requirements of its users.

  17. Strategy generator in computerized accident management support system

    International Nuclear Information System (INIS)

    Sirola, M.

    1994-02-01

    An increased interest for research in the field of accident management of nuclear power plants can be noted. Several international programmes have been started in order to be able to understand the basic physical and chemical phenomena in accident conditions. A feasibility study has shown that it would be possible to design and develop a computerized support system for plant staff in accident situations. To achieve this goal the Halden Project has initiated a research programme on Computerized Accident Management Support (CAMS project). The aim is to utilize the capabilities of computerized tools to support the plant staff during the various accident stages. The system will include identification of the accident state, assessment of the future development of the accident and planning of accident mitigation strategies. A prototype is developed to support operators and the Technical Support Centre in decision making during serious accidents in nuclear power plants. A rule based system has been built to take care of the strategy generation. This system assists plant personnel in planning control proposals and mitigation strategies from normal operation to severe accident conditions. The idea of a safety objective tree and knowledge from the emergency procedures have been used. Future prediction requires good state identification of the plant status and some knowledge about the history of some critical variables. The information needs to be validated as well. Accurate calculations in simulators and a large database including all important information from the plant will help the strategy planning. (orig.). (40 refs., 20 figs.)

  18. The systems psychodynamic experiences of organisational transformation amongst support staff

    Directory of Open Access Journals (Sweden)

    Martin Steyn

    2016-10-01

    Full Text Available Orientation: The unconscious impact of organisational transformation is often neglected and even denied. This research revealed the manifestation and impact of high levels and different forms of anxiety experienced by employees during transformation. Research objective: The objective was to study and describe the manifesting systems psychodynamic behaviour amongst support staff during organisational transformation. Motivation for the study: Organisational transformation is mostly researched from a leadership viewpoint. Little research data are available on the experiences of support staff on the receiving end of decisions about and implementation of transformation. Research design, approach and method: A qualitative approach within the phenomenological hermeneutic interpretive stance was used. The research was set in a government organisation. A semi-structured interview with four conveniently and purposefully chosen support staff members was thematically analysed using systems psychodynamics as theoretical paradigm. Main findings: Four themes manifested, namely de-authorisation and detachment, being bullied and seduced by leadership, the organisation in the mind as incompetent, and a dangerous and persecutory system. In the discussion, the basic assumptions and relevant constructs are interpreted. Practical implications: Understanding the transformation experiences of support staff could assist the industrial psychologist to facilitate appropriate support in coaching more junior staff towards increasing wellness and work performance. Contribution: Organisational transformation is highlighted as an anxiety provoking experience especially on the lower levels of the organisation. Its potentially deep and complex psychological impact could possibly derail parts of the system if not managed in a psychologically contained manner.

  19. Environmental Control and Life Support System (ECLSS) System Engineering Workshop

    Science.gov (United States)

    Peterson, Laurie J.

    2009-01-01

    This slide presentation begins with a recap on a previous lecture on the ECLSS subsystems, and the various types (i.e., Non-regenerative vs Regenerative, open loop vs closed loop, and physical-chemical vs bioregenerative) It also recaps the Equivalent system mass (ESM) metric. The presentation continues with a review of the ECLSS of the various NASA manned space exploration programs from Mercury, to the current planned Altair lunar landing, and Lunar base operations. There is also a team project to establish the ESM of two conceptualized missions.

  20. An early validation of the Society for Vascular Surgery lower extremity threatened limb classification system.

    Science.gov (United States)

    Cull, David L; Manos, Ginger; Hartley, Michael C; Taylor, Spence M; Langan, Eugene M; Eidt, John F; Johnson, Brent L

    2014-12-01

    The Society for Vascular Surgery (SVS) recently established the Lower Extremity Threatened Limb Classification System, a staging system using Wound characteristic, Ischemia, and foot Infection (WIfI) to stratify the risk for limb amputation at 1 year. Although intuitive in nature, this new system has not been validated. The purpose of the following study was to determine whether the WIfI system is predictive of limb amputation and wound healing. Between 2007 and 2010, we prospectively obtained data related to wound characteristics, extent of infection, and degree of postrevascularization ischemia in 139 patients with foot wounds who presented for lower extremity revascularization (158 revascularization procedures). After adapting those data to the WIfI classifications, we analyzed the influence of wound characteristics, extent of infection, and degree of ischemia on time to wound healing; empirical Kaplan-Meier survival curves were compared with theoretical outcomes predicted by WIfI expert consensus opinion. Of the 158 foot wounds, 125 (79%) healed. The median time to wound healing was 2.7 months (range, 1-18 months). Factors associated with wound healing included presence of diabetes mellitus (P = .013), wound location (P = .049), wound size (P = .007), wound depth (P = .004), and degree of ischemia (P valid. Further validation of the WIfI classification system with multicenter data is justified. Copyright © 2014 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  1. Data warehouse based decision support system in nuclear power plants

    International Nuclear Information System (INIS)

    Nadinic, B.

    2004-01-01

    Safety is an important element in business decision making processes in nuclear power plants. Information about component reliability, structures and systems, data recorded during the nuclear power plant's operation and outage periods, as well as experiences from other power plants are located in different database systems throughout the power plant. It would be possible to create a decision support system which would collect data, transform it into a standardized form and store it in a single location in a format more suitable for analyses and knowledge discovery. This single location where the data would be stored would be a data warehouse. Such data warehouse based decision support system could help make decision making processes more efficient by providing more information about business processes and predicting possible consequences of different decisions. Two main functionalities in this decision support system would be an OLAP (On Line Analytical Processing) and a data mining system. An OLAP system would enable the users to perform fast, simple and efficient multidimensional analysis of existing data and identify trends. Data mining techniques and algorithms would help discover new, previously unknown information from the data as well as hidden dependencies between various parameters. Data mining would also enable analysts to create relevant prediction models that could predict behaviour of different systems during operation and inspection results during outages. The basic characteristics and theoretical foundations of such decision support system are described and the reasons for choosing a data warehouse as the underlying structure are explained. The article analyzes obvious business benefits of such system as well as potential uses of OLAP and data mining technologies. Possible implementation methodologies and problems that may arise, especially in the field of data integration, are discussed and analyzed.(author)

  2. A ferromagnetic surgical system reduces phrenic nerve injury in redo congenital cardiac surgery.

    Science.gov (United States)

    Shinkawa, Takeshi; Holloway, Jessica; Tang, Xinyu; Gossett, Jeffrey M; Imamura, Michiaki

    2017-05-01

    A ferromagnetic surgical system (FMwand®) is a new type of dissection device expected to reduce the risk of adjacent tissue damage. We reviewed 426 congenital cardiac operations with cardiopulmonary bypass through redo sternotomy to assess if this device prevented phrenic nerve injury. The ferromagnetic surgical system was used in 203 operations (47.7%) with regular electrocautery and scissors. The preoperative and operative details were similar between the operations with or without the ferromagnetic surgical system. The incidence of phrenic nerve injury was significantly lower with the ferromagnetic surgical system (0% vs 2.7%, P = 0.031). A logistic regression model showed that the use of the ferromagnetic surgical system was significantly associated with reduced odds of phrenic nerve injury (P < 0.001). © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  3. Approach to Health Supporting System Using Traditional Chinese Medicine

    Science.gov (United States)

    Watsuji, Tadashi; Shinohara, Shoji; Arita, Seizaburo

    The primary prevention of disease related to the lifestyle is an essential theme in medical research. Preventing before it arises is the important concept in traditional Chinese medicine (TCM). Since TCM, which emphasizes individual physical condition in medical treatment, has recently attracted considerable attention globally, objective diagnostic methods in TCM have been investigated in this work. Firstly, the fuzzy theory was applied to develop a tongue diagnosis supporting system based on the tongue diagnosis in TCM. Secondly, the usefulness of TCM health questionnaire was examined to identify individual physical condition. Our results suggest that the TCM health questionnaire is useful in the construction of a health supporting system based on TCM.

  4. An information system supporting design for reliability and maintenance

    Energy Technology Data Exchange (ETDEWEB)

    Rit, J.F.; Beraud, M.T

    1997-12-31

    EDF is currently developing a methodology to integrate availability, operating experience and maintenance in the design of power plants. This involves studies that depend closely on the results and assumptions of each other about the reliability and operations of the plant. Therefore a support information system must be carefully designed. Concurrently with development of the methodology, a research oriented information system was designed and built. It is based on the database model of a logistic support repository that we tailored to our needs. (K.A.) 10 refs.

  5. An information system supporting design for reliability and maintenance

    International Nuclear Information System (INIS)

    Rit, J.F.; Beraud, M.T.

    1997-01-01

    EDF is currently developing a methodology to integrate availability, operating experience and maintenance in the design of power plants. This involves studies that depend closely on the results and assumptions of each other about the reliability and operations of the plant. Therefore a support information system must be carefully designed. Concurrently with development of the methodology, a research oriented information system was designed and built. It is based on the database model of a logistic support repository that we tailored to our needs. (K.A.)

  6. Seismic analysis of piping systems subjected to multiple support excitations

    International Nuclear Information System (INIS)

    Sundararajan, C.; Vaish, A.K.; Slagis, G.C.

    1981-01-01

    The paper presents the results of a comparative study between the multiple response spectrum method and the time-history method for the seismic analysis of nuclear piping systems subjected to different excitation at different supports or support groups. First, the necessary equations for the above analysis procedures are derived. Then, three actual nuclear piping systems subjected to single and multiple excitations are analyzed by the different methods, and extensive comparisons of the results (stresses) are made. Based on the results, it is concluded that the multiple response spectrum analysis gives acceptable results as compared to the ''exact'', but much more costly, time-history analysis. 6 refs

  7. Development of the decision make supporting system on incident management

    International Nuclear Information System (INIS)

    Kasamatsu, Mizuki; Hanada, Satoshi; Noda, Eisuke

    2017-01-01

    Decision Make Supporting System is designed to support appropriate decision made by top management in the nuclear severe conditions. With crisis response in nuclear power plant (NPP), information entanglement between sites and control centers during intense situations interfere with prompt and accurate decision making. This research started with that kind of background. In order to solve the issue of the information entanglement, Mitsubishi Heavy Industries, Inc. (MHI) carried out the development of the Decision Make Supporting System and the system applies the technology combining the human factors engineering (HFE) and information and communication technology (ICT). During the crisis response, various commands, reactions and communications in a human system need to be managed. Therefore, the combined HFE method including detailed task analysis, user experience (UX), graphic user interface (GUI) and related human-system interface (HSI) design method is applied to the design of the system. These design results systematize the functions that prevent interference with decision-making in the headquarters for incident management. This new solution as a system enhances the safety improvement of the NPP and contributes to develop the skills and abilities of the resources in the NPP. The system has three key features for supporting emergency situations: 'understanding the situation', 'planning the next action', and 'managing resources'. The system helps commanders and responders to grasp the whole situation and allows them to share information in real time to get a whole picture, and the system accumulates the data of the past events in the chronological order to understand correctly how they happened and plan the next action by using a knowledge database that MHI has been developed. If the unexpected event happens which are not in the incident scenario, the system provides support to formulate alternative strategies and measures. With this

  8. Long-term Mechanical Circulatory Support System reliability recommendation by the National Clinical Trial Initiative subcommittee.

    Science.gov (United States)

    Lee, James

    2009-01-01

    The Long-Term Mechanical Circulatory Support (MCS) System Reliability Recommendation was published in the American Society for Artificial Internal Organs (ASAIO) Journal and the Annals of Thoracic Surgery in 1998. At that time, it was stated that the document would be periodically reviewed to assess its timeliness and appropriateness within 5 years. Given the wealth of clinical experience in MCS systems, a new recommendation has been drafted by consensus of a group of representatives from the medical community, academia, industry, and government. The new recommendation describes a reliability test methodology and provides detailed reliability recommendations. In addition, the new recommendation provides additional information and clinical data in appendices that are intended to assist the reliability test engineer in the development of a reliability test that is expected to give improved predictions of clinical reliability compared with past test methods. The appendices are available for download at the ASAIO journal web site at www.asaiojournal.com.

  9. Field Support System (FS-AID) and Working Capital Fund Tracking System (WCF-TS)

    Data.gov (United States)

    US Agency for International Development — The Field Support System (FS-AID) and Working Capital Fund Tracking System (WCF-TS) are two modules of a single data management system that share common tables and...

  10. Alternate seismic support for pipeline systems in nuclear power plants

    International Nuclear Information System (INIS)

    Muthumani, K.; Gopalakrishnan, N.; Sathish Kumar, K.; Sreekala, R.; Rama Rao, G.V.; Reddy, G.R.; Parulekar, Y.M.

    2008-01-01

    Failure free design of supporting systems for pipe lines carrying highly toxic or radioactive liquids at very high temperature is an important issue in the safety aspect for a nuclear power plant installation which is a key topic for researchers all around the world. Generally, these pipeline systems are designed to be held rigid by conventional snubber supports for protection from earthquakes. The piping design must balance seismic deformations and other deformations due to thermal effect. A rigid pipeline system using conventional snubber supports always leads to an increase in thermal stresses; hence a rational seismic design for pipeline supporting systems becomes essential. Contrary to this rigid design, it is possible to design a flexible pipeline system and to decrease the seismic response by increasing the damping through the use of passive energy absorbing elements, which dissipate vibration energy. This paper presents the experimental and analytical studies carried out on modeling yielding type elasto-plastic passive energy-absorbing elements to be used in a passive energy-dissipating device for the control of large seismic deformations of pipelines subjected to earthquake loading. (author)

  11. Refurbishment of the IEAR1 primary coolant system piping supports

    International Nuclear Information System (INIS)

    Fainer, Gerson; Faloppa, Altair A.; Oliveira, Carlos A. de; Mattar Neto, Miguel

    2015-01-01

    A partial replacement of the IEA-R1 piping system was concluded in 2014. This paper presents the study and the structural analysis of the IEA-R1 primary circuit piping supports, considering all the changes involved in the replacement. The IEA-R1 is a nuclear reactor for research purposes designed by Babcox-Willcox that is operated by IPEN since 1957. The reactor life management and modernization program is being conducted for the last two decades and already resulted in a series of changes, especially on the reactor coolant system. This set of components, divided in primary and secondary circuit, is responsible for the circulation of water into the core to remove heat. In the ageing management program that includes regular inspection, some degradation was observed in the primary piping system. As result, the renewing of the piping system was conducted in 2014. Moreover the poor condition of some original piping supports gave rise to the refurbishment of all piping supports. The aim of the present work is to review the design of the primary system piping supports taking into account the current conditions after the changes and refurbishment. (author)

  12. Comparing the effects of adaptive support ventilation and synchronized intermittent mandatory ventilation on intubation duration and hospital stay after coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Ahmadreza Yazdannik

    2016-01-01

    Full Text Available Background: Different modes of mechanical ventilation are used for respiratory support after coronary artery bypass graft (CABG. This study aimed to compare the effect(s of using adaptive support ventilation (ASV and synchronized intermittent mandatory ventilation (SIMV on the length of mechanical ventilation (intubation duration and hospital stay after coronary artery bypass graft surgery. Materials and Methods: In a randomized control trial, 64 patients were ventilated with ASV as the experiment group or with SIMV as the control group after CABG surgery in Chamran Hospital of Isfahan University of Medical Sciences. The time of tracheal intubation and the length of hospital stay were compared between the two groups. Data were analyzed and described using statistical analysis (independent t-test. Results: The mean time of intubation duration was significantly lower in ASV group compared with SIMV group. (4.83 h vs 6.71 h, P < 0.001. The lengths of hospital stay in the ASV and the SIMV groups were 140.6 h and 145.1 h, respectively. This difference was significant between the two groups (P = 0.006. Conclusions: According to the results of this study, using ASV mode for mechanical ventilation after CABG led to a decrease in intubation duration and also hospital stay in comparison with the SIMV group. It is recommended to use ASV mode on ventilators for respiratory support of patients undergoing coronary artery bypass graft surgery.

  13. Systemic Assessment of Patients Undergoing Dental Implant Surgeries: A Trans- and Post-operative Analysis.

    Science.gov (United States)

    Byakodi, Sanjay; Kumar, Sachin; Reddy, Rajesh Kumar; Kumar, Vipin; Sepolia, Shipra; Gupta, Shivangi; Singh, Harkanwal Preet

    2017-01-01

    Procedure-related and patient-related factors influence the prognosis of dental implants to a major extent. Hence, we aimed to evaluate and analyze various systemic factors in patients receiving dental implants. Fifty-one patients were included in the study, in which a total of 110 dental implants were placed. Complete examination of the subjects was done before and after placement of dental implants. Implant surgery was planned, and osseointegrated dental implants were placed in the subjects. Postoperative evaluation of the dental implant patients was done after 3 weeks. Anxiety levels were determined using State-Trait Anxiety Inventory (STAI) questionnaire on the surgery day and after 1 week of surgery. The participant describes how they feel at the moment by responding to twenty items as follows: (1) absolutely not, (2) slightly, (3) somewhat, or (4) very much. All the results were recorded and statistical analyzed by SPSS software. Out of 51, 29 patients were males while 22 were females, with ratio of 1.32:1. Female patients' mean age was 50.18 years while male patients' mean age was 52.71 years, with statistically nonsignificant difference between them. Functional rehabilitation was the main purpose of choosing dental implants in more than 90% of the subjects. Diameter of 3.75 mm was the shortest implants to be placed in the present study, whereas in terms of length, 8.5 mm was the shortest length of dental implant used in the present study. Tooth area in which maximum implants were placed in our study was 36 tooth region. Maximum implants were placed in Type II bone quality ( n = 38). Implants installed in the mandible were clamped more efficiently than implants placed in the maxilla ( P < 0.001). The difference of average STAI-State subscore before and after the surgery was statistically significant ( P < 0.05; significant). Mandibular dental implants show more clamping (torque) than maxillary dental implants.

  14. Space Station Environmental Control/Life Support System engineering

    Science.gov (United States)

    Miller, C. W.; Heppner, D. B.

    1985-01-01

    The present paper is concerned with a systems engineering study which has provided an understanding of the overall Space Station ECLSS (Environmental Control and Life Support System). ECLSS/functional partitioning is considered along with function criticality, technology alternatives, a technology description, single thread systems, Space Station architectures, ECLSS distribution, mechanical schematics per space station, and Space Station ECLSS characteristics. Attention is given to trade studies and system synergism. The Space Station functional description had been defined by NASA. The ECLSS will utilize technologies which embody regenerative concepts to minimize the use of expendables.

  15. Methodology and Supporting Toolset Advancing Embedded Systems Quality

    DEFF Research Database (Denmark)

    Berger, Michael Stübert; Soler, José; Brewka, Lukasz Jerzy

    2013-01-01

    Software quality is of primary importance in the development of embedded systems that are often used in safety-critical applications. Moreover, as the life cycle of embedded products becomes increasingly tighter, productivity and quality are simultaneously required and closely interrelated towards...... delivering competitive products. In this context, the MODUS (Methodology and supporting toolset advancing embedded systems quality) project aims to provide a pragmatic and viable solution that will allow SMEs to substantially improve their positioning in the embedded-systems development market. This paper...... will describe the MODUS project with focus on the technical methodologies that will be developed advancing embedded system quality....

  16. [Orthopedic and trauma surgery in the German-DRG-System 2009].

    Science.gov (United States)

    Franz, D; Windolf, J; Siebert, C H; Roeder, N

    2009-01-01

    The German DRG-System was advanced into version 2009. For orthopedic and trauma surgery significant changes concerning coding of diagnoses, medical procedures and concerning the DRG-structure were made. Analysis of relevant diagnoses, medical procedures and G-DRGs in the versions 2008 and 2009 based on the publications of the German DRG-institute (InEK) and the German Institute of Medical Documentation and Information (DIMDI). Changes for 2009 focussed on the development of DRG-structure, DRG-validation and codes for medical procedures to be used for very complex cases. The outcome of these changes for German hospitals may vary depending in the range of activities. G-DRG-System gained complexity again. High demands are made on correct and complete coding of complex orthopedic and trauma surgery cases. Quality of case-allocation within the G-DRG-System was improved. Nevertheless, further adjustments of the G-DRG-System especially for cases with severe injuries are necessary.

  17. Separations technologies supporting the development of a deployable ATW system

    International Nuclear Information System (INIS)

    Laidler, J. J.

    2000-01-01

    A program has been initiated for the purpose of developing the chemical separations technologies necessary to support a large Accelerator Transmutation of Waste (ATW) system capable of dealing with the projected inventory of spent fuel from the commercial nuclear power stations in the United States. The first several years of the program will be directed toward an elucidation of related technical issues and to the establishment, by means of comprehensive trade studies, of an optimum configuration of the elements of the chemical processing infrastructure required for support of the total ATW system. By adopting this sort of disciplined systems engineering approach, it is expected that development and demonstration costs can be minimized and that it will be possible to deploy an ATW system that is an environmentally sound and economically viable venture

  18. Study on the Support Systems for Corporate Governance

    Directory of Open Access Journals (Sweden)

    Claudiu BRANDAS

    2011-01-01

    Full Text Available The problems generated by the information asymmetry within the agency relationships at corporation level, governments and capital markets led to a higher necessity for corporate governance (CG. The information system of corporate governance is a very complex one, which involves a series of actors, decision-making and transactional processes, technologies, procedures and good practice codes. In order to ensure the efficiency and efficacy of corporate governance as a premise for increasing company’s performance and position consolidation for the company on the capital market, it is necessary to analyze the way information technology could contribute to this undertaking. The purpose of this study is to analyze the architecture of the corporate governance systems and to identify and classify the systems and technologies involved in ensuring CG support in order to underlie the basis for developing a conceptual model for a hybrid and collaborative support system for corporate governance.

  19. Group decision support system for customer-driven product design

    Science.gov (United States)

    Lin, Zhihang; Chen, Hang; Chen, Kuen; Che, Ada

    2000-10-01

    This paper describes the work on the development of a group decision support system for customer driven product design. The customer driven is to develop products, which meet all customer requirements in whole life cycle of products. A process model of decision during product primary design is proposed to formulate the structured, semi-structured and unstructured decision problems. The framework for the decision support system is presented that integrated both advances in the group decision making and distributed artificial intelligent. The system consists of the product primary design tool kit and the collaborative platform with multi-agent structure. The collaborative platform of the system and the product primary design tool kit, including the VOC (Voice of Customer) tool, QFD (Quality Function Deployment) tool, the Conceptual design tool, Reliability analysis tool and the cost and profit forecasting tool, are indicated.

  20. Alternate design of ITER cryostat skirt support system

    International Nuclear Information System (INIS)

    Pandey, Manish Kumar; Gupta, Girish Kumar; Bhardwaj, Anil Kumar; Jha, Saroj Kumar

    2015-01-01

    The skirt support of ITER cryostat is a support system which takes all the load of cryostat cylinder and dome during normal and operational condition. The present design of skirt support has full penetration weld joints at the bottom (shell to horizontal plate joint). To fulfill the requirements of tolerances and control the welding distortions, we have proposed to change the full penetration weld into fillet weld. A detail calculation is done to check the feasibility and structural impact due to proposed design. The calculations provide the size requirements of fillet weld. To verify the structural integrity during most severe load case, finite element analysis (FEA) has been done in line with ASME section VIII division 2. By FEA 'Plastic Collapse' and 'Local Failure' modes has been assessed. 5° sector of skirt clamp has been modeled in CATIA V5 R21 and used in FEA. Fillet weld at shell to horizontal plate joint has been modeled and symmetry boundary condition at ± 2.5° applied. 'Elastic Plastic Analysis' has been performed for the most severe loading case i.e. Category IV loading. The alternate design of Cryostat Skirt support system has been found safe by analysis against Plastic collapse and Local Failure Modes with load proportionality factor 2.3. Alternate design of Cryostat skirt support system has been done and validated by FEA. As per alternate design, the proposal of fillet weld has been implemented in manufacturing. (author)