Surgical Care Required for Populations Affected by Climate-related Natural Disasters: A Global Estimation.

Science.gov (United States)

Lee, Eugenia E; Stewart, Barclay; Zha, Yuanting A; Groen, Thomas A; Burkle, Frederick M; Kushner, Adam L

2016-08-10

Climate extremes will increase the frequency and severity of natural disasters worldwide.  Climate-related natural disasters were anticipated to affect 375 million people in 2015, more than 50% greater than the yearly average in the previous decade. To inform surgical assistance preparedness, we estimated the number of surgical procedures needed.   The numbers of people affected by climate-related disasters from 2004 to 2014 were obtained from the Centre for Research of the Epidemiology of Disasters database. Using 5,000 procedures per 100,000 persons as the minimum, baseline estimates were calculated. A linear regression of the number of surgical procedures performed annually and the estimated number of surgical procedures required for climate-related natural disasters was performed. Approximately 140 million people were affected by climate-related natural disasters annually requiring 7.0 million surgical procedures. The greatest need for surgical care was in the People's Republic of China, India, and the Philippines. Linear regression demonstrated a poor relationship between national surgical capacity and estimated need for surgical care resulting from natural disaster, but countries with the least surgical capacity will have the greatest need for surgical care for persons affected by climate-related natural disasters. As climate extremes increase the frequency and severity of natural disasters, millions will need surgical care beyond baseline needs. Countries with insufficient surgical capacity will have the most need for surgical care for persons affected by climate-related natural disasters. Estimates of surgical are particularly important for countries least equipped to meet surgical care demands given critical human and physical resource deficiencies.

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

NARCIS (Netherlands)

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

2018-01-01

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

Surgical protocol for confirmed or suspected cases of Ebola and other highly transmissible diseases.

Science.gov (United States)

Badia, Josep M; Rubio-Pérez, Inés; Arias Díaz, Javier; Guirao Garriga, Xavier; Serrablo, Alejandro; Jover Navalón, José M

2016-01-01

Outbreaks of viral haemorrhagic fevers such as Ebola can lead to imported cases in Europe and America. The eventuality of surgery in the setting of Ebola Virus Disease (EVD) is low, but the Spanish Association of Surgeons elaborated a surgical protocol for EVD. Elective surgical procedures are not indicated. Emergency cases can be considered in: persons under investigation, possible cases and early confirmed cases. In some conditions usually treated by surgery a medical treatment can be tested. All cases must be treated in high technology hospitals. These hospitals must be equipped with adequate means for healthcare provider's protection. All members of the healthcare team should practice thorough simulation prior to caring for a possible Ebola patient. This protocol is based on international guidelines on use of Personal Protective Equipment, protocols of other scientific societies, and specific recommendations for the operating room environment. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Selection of equipment for equipment qualification

International Nuclear Information System (INIS)

Torr, K.G.

1989-01-01

This report describes the methodology applied in selecting equipment in the special safety systems for equipment qualification in the CANDU 600 MW nuclear generating stations at Gentilly 2 and Point Lepreau. Included is an explanation of the selection procedure adopted and the rationale behind the criteria used in identifying the equipment. The equipment items on the list have been grouped into three priority categories as a planning aid to AECB staff for a review of the qualification status of the special safety systems

Development of a penetration friction apparatus (PFA) to measure the frictional performance of surgical suture.

Science.gov (United States)

Zhang, Gangqiang; Ren, Tianhui; Lette, Walter; Zeng, Xiangqiong; van der Heide, Emile

2017-10-01

Nowadays there is a wide variety of surgical sutures available in the market. Surgical sutures have different sizes, structures, materials and coatings, whereas they are being used for various surgeries. The frictional performances of surgical sutures have been found to play a vital role in their functionality. The high friction force of surgical sutures in the suturing process may cause inflammation and pain to the person, leading to a longer recovery time, and the second trauma of soft or fragile tissue. Thus, the investigation into the frictional performance of surgical suture is essential. Despite the unquestionable fact, little is actually known on the friction performances of surgical suture-tissue due to the lack of appropriate test equipment. This study presents a new penetration friction apparatus (PFA) that allowed for the evaluation of the friction performances of various surgical needles and sutures during the suturing process, under different contact conditions. It considered the deformation of tissue and can realize the puncture force measurements of surgical needles as well as the friction force of surgical sutures. The developed PFA could accurately evaluate and understand the frictional behaviour of surgical suture-tissue in the simulating clinical conditions. The forces measured by the PFA showed the same trend as that reported in literatures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Medical Officers in Sierra Leone: Surgical Training Opportunities, Challenges and Aspirations.

Science.gov (United States)

Wilks, Lucy; Leather, Andrew; George, Peter Matthew; Kamara, Thaim Bay

2018-02-05

The critical shortage of human resources for healthcare falls most heavily on sub-Saharan nations such as Sierra Leone, where such workforce deficits have grave impacts on its burden of surgical disease. An important aspect in retention and development of the workforce is training. This study focuses on postgraduate surgical training (formal and short course) and perceptions of opportunities, challenges and aspirations, in a country where more than half of surgical procedures are performed by medical officers. The study presents findings from 12 in-depth semi-structured interviews conducted with medical officers by the primary investigator in Sierra Leone between April and June 2017. Each interview was transcribed alongside an introspective reflexive journal to acknowledge and account for researcher biases. Two interviewees had accessed postgraduate surgical training and 10 (83%) had accessed short course surgically relevant training. The number of short courses accessed grew higher the more recently the medical officers had graduated. Supervision, short length and international standards were the most appreciated aspects of short training courses. Some medical officers perceived the formal postgraduate surgical training programme to be ill-equipped, doubting its credibility. This demotivated some from applying. Training is an essential aspect of developing an adequate surgical workforce. Faith must be restored in the capabilities of Sierra Leone's Ministry of Health and Sanitation to provide adequate and sustainable training. This study advocates for the use of short courses to restore this faith and the expansion of postgraduate surgical training to the districts through developing a regional teaching complex to provide short courses and eventually formal postgraduate training in the future. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Surgical waste audit of 5 total knee arthroplasties.

Science.gov (United States)

Stall, Nathan M; Kagoma, Yoan M; Bondy, Jennifer N; Naudie, Douglas

2013-04-01

Operating rooms (ORs) are estimated to generate up to one-third of hospital waste. At the London Health Sciences Centre, prosthetics and implants represent 17% of the institution's ecological footprint. To investigate waste production associated with total knee arthroplasties (TKAs), we performed a surgical waste audit to gauge the environmental impact of this procedure and generate strategies to improve waste management. We conducted a waste audit of 5 primary TKAs performed by a single surgeon in February 2010. Waste was categorized into 6 streams: regular solid waste, recyclable plastics, biohazard waste, laundered linens, sharps and blue sterile wrap. Volume and weight of each stream was quantified. We used Canadian Joint Replacement Registry data (2008-2009) to estimate annual weight and volume totals of waste from all TKAs performed in Canada. The average surgical waste (excluding laundered linens) per TKA was 13.3 kg, of which 8.6 kg (64.5%) was normal solid waste, 2.5 kg (19.2%) was biohazard waste, 1.6 kg (12.1%) was blue sterile wrap, 0.3 kg (2.2%) was recyclables and 0.3 kg (2.2%) was sharps. Plastic wrappers, disposable surgical linens and personal protective equipment contributed considerably to total waste. We estimated that landfill waste from all 47 429 TKAs performed in Canada in 2008-2009 was 407 889 kg by weight and 15 272 m3 by volume. Total knee arthroplasties produce substantial amounts of surgical waste. Environmentally friendly surgical products and waste management strategies may allow ORs to reduce the negative impacts of waste production without compromising patient care. Level IV, case series.

Abortion - surgical

Science.gov (United States)

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

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

African Journals Online (AJOL)

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

Achievement report for fiscal 1999 on the development of total evaluation research laboratory system for the medical welfare equipment technology research and development project; 1999 nendo iryo fukushi kiki gijutsu kenkyu kaihatsu project yo sogo hyoka kenkyu rabo system kaihatsu jigyo seika hokokusho

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-05-01

A laboratory system named above has been developed to propel forward efficiently the efforts to develop medical welfare technologies through close coordination between medicine and engineering. Six laboratories are linked with each other in a network for the realization of an environment in which general support is extended to all the stages of equipment development from basic through clinical assessment. The biomedical engineering laboratory is constituted of various analyzing devices, and is capable of in vitro assessment of bioingredients. The therapeutic laboratory is provided with bioinformation/NMR (nuclear magnetic resonance) measurement equipment, animal surgical operation equipment, etc., and performs the assessment of test animals at the first stage of clinical assessment. The diagnostic laboratory acquires various image data necessary for the development of medical equipment at the same level as that of the site of clinical diagnosis. The intelligent surgical operation room takes in real-time diagnostic images while a surgical operation is under way and, at the same time, assesses surgical devices in the same environment as that of the surgical operation room. The medical information laboratory accumulates medical and image data from the other laboratories, and integrates the accumulated data. The data management center manages the laboratories in a unified way and enables comprehensive assessment and research. (NEDO)

Characterizing pediatric surgical capacity in the Eastern Democratic Republic of Congo: results of a pilot study.

Science.gov (United States)

Cairo, Sarah B; Kalisya, Luc Malemo; Bigabwa, Richard; Rothstein, David H

2018-03-01

Characterize pediatric surgical capacity in the eastern Democratic Republic of Congo (DRC) to identify areas of potential improvement. The Pediatric Personnel, Infrastructure, Procedures, Equipment, and Supplies (PediPIPES) survey was used in two representative eastern DRC provinces to assess existing surgical infrastructure and capacity. We compared our results to previously published reports from other sub-Saharan African countries. Fourteen hospitals in the eastern DRC and 37 in 19 sub-Saharan African (SSA) countries were compared. The average PediPIPES index for the DRC was 7.7 compared to 13.5 for SSAs. The greatest disparities existed in the areas of personnel and infrastructure. Running water was reportedly available to 57.1% of the hospitals in the DRC, and the majority of hospitals (78.6%) were dependent on generators and solar panels for electricity. Only two hospitals in the DRC (14.3%) reported a pediatric surgeon equivalent on staff, compared to 86.5% of facilities sampled in SSA reporting ≥ 1 pediatric surgeon. Significant barriers in personnel, infrastructure, procedures, equipment, and supplies impede the provision of adequate surgical care to children. Further work is needed to assess allocation and utilization of existing resources, and to enhance training of personnel with specific attention to pediatric surgery.

A quantitative analysis of surgical capacity in Santa Cruz, Bolivia.

Science.gov (United States)

Markin, Abraham; Barbero, Roxana; Leow, Jeffrey J; Groen, Reinou S; Skow, Evan J; Apelgren, Keith N; Kushner, Adam L; Nwomeh, Benedict C

2013-11-01

This investigation aimed to document surgical capacity at public medical centers in a middle-income Latin American country using the Surgeons OverSeas (SOS) Personnel, Infrastructure, Procedures, Equipment, and Supplies (PIPES) survey tool. We applied the PIPES tool at six urban and 25 rural facilities in Santa Cruz, Bolivia. Outcome measures included the availability of items in five domains (Personnel, Infrastructure, Procedures, Equipment, and Supplies) and the PIPES index. PIPES indices were calculated by summing scores from each domain, dividing by the total number of survey items, and multiplying by 10. Thirty-one of the 32 public facilities that provide surgical care in Santa Cruz were assessed. Santa Cruz had at least 7.8 surgeons and 2.8 anesthesiologists per 100,000 population. However, these providers were unequally distributed, such that nine rural sites had no anesthesiologist. Few rural facilities had blood banking (4/25), anesthesia machines (11/25), postoperative care (11/25), or intensive care units (1/25). PIPES indices ranged from 5.7-13.2, and were significantly higher in urban (median 12.6) than rural (median 7.8) areas (P Bolivia's development status. Unfortunately, surgeons are limited in rural areas by deficits in anesthesia and perioperative services. These results are currently being used to target local quality improvement initiatives. Copyright © 2013 Elsevier Inc. All rights reserved.

Surgical lighting

NARCIS (Netherlands)

Knulst, A.J.

2017-01-01

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

Surgical smoke.

Science.gov (United States)

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

2009-10-01

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

Improving access to surgery in a developing country: experience from a surgical collaboration in Sierra Leone.

Science.gov (United States)

Kushner, Adam L; Kamara, Thaim B; Groen, Reinou S; Fadlu-Deen, Betsy D; Doah, Kisito S; Kingham, T Peter

2010-01-01

Although surgery is increasingly recognized as an essential component of primary health care, there has been little documentation of surgical programs in low- and middle-income countries. Surgeons OverSeas (SOS) is a New York-based organization with a mission to save lives in developing countries by improving surgical care. This article highlights the surgical program in Sierra Leone as a possible model to improve access to surgery. An SOS team conducted a needs assessment of surgical capacity in Sierra Leone in February 2008. Interventions were then developed and programs were implemented. A follow-up assessment was conducted in December 2009, which included interviews of key Sierra Leone hospital personnel and a review of operating room log books. Based on an initial needs assessment, a program was developed that included training, salary support, and the provision of surgical supplies and equipment. Two 3-day workshops were conducted for a total of 44 health workers, salary support given to over 100 staff, and 2 containers of supplies and equipment were donated. Access to surgery, as measured by the number of major operations at Connaught Hospital, increased from 460 cases in 2007 to 768 cases in 2009. The SOS program in Sierra Leone highlights a method for improving access to surgery that incorporates an initial needs assessment with minimal external support and local staff collaboration. The program functions as a catalyst by providing training, salary support, and supplies. The beneficial results of the program can then be used to advocate for additional resources for surgery from policy makers. This model could be beneficial in other resource-poor countries in which improved access to surgery is desired. Copyright 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Access to Orthopaedic Surgical Care in Northern Tanzania: A Modelling Study.

Science.gov (United States)

Premkumar, Ajay; Ying, Xiaohan; Mack Hardaker, W; Massawe, Honest H; Mshahaba, David J; Mandari, Faiton; Pallangyo, Anthony; Temu, Rogers; Masenga, Gileard; Spiegel, David A; Sheth, Neil P

2018-04-25

The global burden of musculoskeletal disease and resulting disability is enormous and is expected to increase over the next few decades. In the world's poorest regions, the paucity of information defining and quantifying the current state of access to orthopaedic surgical care is a major problem in developing effective solutions. This study estimates the number of individuals in Northern Tanzania without adequate access to orthopaedic surgical services. A chance tree was created to model the probability of access to orthopaedic surgical services in the Northern Tanzanian regions of Arusha, Kilimanjaro, Tanga, Singida, and Manyara, with respect to four dimensions: timeliness, surgical capacity, safety, and affordability. Timeliness was estimated by the proportion of people living within a 4-h driving distance from a hospital with an orthopaedic surgeon, capacity by comparing number of surgeries performed to the number of surgeries indicated, safety by applying WHO Emergency and Essential Surgical Care infrastructure and equipment checklists, and affordability by approximating the proportion of the population protected from catastrophic out-of-pocket healthcare expenditure. We accounted for uncertainty in our model with one-way and probabilistic sensitivity analyses. Data sources included the Tanzanian National Bureau of Statistics and Ministry of Finance, World Bank, World Health Organization, New Zealand Ministry of Health, Google Corporation, NASA population estimator, and 2015 hospital records from Kilimanjaro Christian Medical Center, Machame Hospital, Nkoroanga Hospital, Mt. Meru Hospital, and Arusha Lutheran Medical Center. Under the most conservative assumptions, more than 90% of the Northern Tanzanian population does not have access to orthopaedic surgical services. There is a near absence of access to orthopaedic surgical care in Northern Tanzania. These findings utilize more precise country and region-specific data and are consistent with prior published

Image-guided neurosurgery. Global concept of a surgical tele-assistance using obstacle detection robotics

International Nuclear Information System (INIS)

Desgeorges, M.; Bellegou, N.; Faillot, Th.; Cordoliani, Y.S.; Dutertre, G.; Blondet, E.; Soultrait, F. de; Boissy, J.M.

2000-01-01

Surgical tele-assistance significantly increases accuracy of surgical gestures, especially in the case of brain tumor neurosurgery. The robotic device is tele-operated through a microscope and the surgeon's gestures are guided by real-time overlaying of the X-ray imagery in the microscope. During the device's progression inside the brain, the focus is ensured by the microscope auto-focus feature. The surgeon can thus constantly check his position on the field workstation. Obstacles to avoid or dangerous areas can be previewed in the operation field. This system is routinely used for 5 years in the neurosurgery division of the Val de Grace hospital. More than 400 brain surgery operations have been done using it. An adaptation is used for rachis surgery. Other military hospitals begin to be equipped with similar systems. It will be possible to link them for data transfer. When it will be operational, such a network it will show what could be, in the future, a medical/surgical remote-assistance system designed to take care of wounded/critical conditions people, including assistance to surgical gestures. (authors)

Surgical Assisting

Science.gov (United States)

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

Paediatric Abdominal Surgical Emergencies in a General Surgical ...

African Journals Online (AJOL)

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

Augmented reality in laparoscopic surgical oncology.

Science.gov (United States)

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

2011-09-01

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

Mobile surgical services in primary care in a rural and remote setting: Experience and evidence from Yala, Cross River State, Nigeria

Directory of Open Access Journals (Sweden)

Emmanuel Monjok

2009-07-01

Full Text Available Surgical conditions account for 11 to 15% of the global burden of disease. Yet, surgical services are very scarce in the rural areas of Nigeria where approximately 60 to 80% of the population resides. Among other basic contributing factors is the shortage of surgical workforce, since Nigeria’s few surgeons practise in the urban centre of the major cities. One way to respond to this acute shortage of surgeons is the training of generalist medical doctors to undertake surgery in rural areas. The introduction of mobile surgical services in rural populations as part of the existing primary health care activities in the Local Government Areas (districts can reduce surgical morbidity and mortality in Nigeria. This can be done by the generalist physician with training and experience in surgery using local health staff and simple surgical equipment. A number of recommendations are made.

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

Science.gov (United States)

Dydykin, Sergey; Kapitonova, Marina

2015-01-01

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

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

Science.gov (United States)

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

2015-08-01

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

Generation of equipment response spectrum considering equipment-structure interaction

International Nuclear Information System (INIS)

Lee, Sang Hoon; Yoo, Kwang Hoon

2005-01-01

Floor response spectra for dynamic response of subsystem such as equipment, or piping in nuclear power plant are usually generated without considering dynamic interaction between main structure and subsystem. Since the dynamic structural response generally has the narrow-banded shapes, the resulting floor response spectra developed for various locations in the structure usually have high spectral peak amplitudes in the narrow frequency bands corresponding to the natural frequencies of the structural system. The application of such spectra for design of subsystems often leads to excessive design conservatisms, especially when the equipment frequency and structure are at resonance condition. Thus, in order to provide a rational and realistic design input for dynamic analysis and design of equipment, dynamic equipment-structure interaction (ESI) should be considered in developing equipment response spectrum which is particularly important for equipment at the resonance condition. Many analytical methods have been proposed in the past for developing equipment response spectra considering ESI. However, most of these methods have not been adapted to the practical applications because of either the complexities or the lack of rigorousness of the methods. At one hand, mass ratio among the equipment and structure was used as an important parameter to obtain equipment response spectra. Similarly, Tseng has also proposed the analytical method for developing equipment response spectra using mass ratio in the frequency domain. This method is analytically rigorous and can be easily validated. It is based on the dynamic substructuring method as applied to the dynamic soil-structure interaction (SSI) analysis, and can relatively easily be implemented for practical applications without to change the current dynamic analysis and design practice for subsystems. The equipment response spectra derived in this study are also based on Tseng's proposed method

O preparo da equipe cirúrgica: aspecto relevante no controle da contaminação ambiental La preparación del equipo quirúrgico: aspecto relevante en el control de la contaminación ambiental The preparation of the surgical team: significant aspect in the control of environmental contamination

Directory of Open Access Journals (Sweden)

Caroline Cataneo

2004-04-01

Full Text Available O controle da contaminação ambiental tem sido considerado como medida racional para a prevenção da infecção do sítio cirúrgico. O objetivo deste estudo é apresentar as atuais recomendações relacionadas ao preparo da equipe cirúrgica e tecer considerações sobre o papel do enfermeiro no controle da contaminação ambiental. Baseados na literatura atual, abordamos pontos relacionados à paramentação cirúrgica e a escovação das mãos. Os estudos apontam que o preparo da equipe cirúrgica constitui barreira de proteção importante para a prevenção da infecção do sítio cirúrgico; entretanto salientam a necessidade dos profissionais de saúde realizarem os procedimentos de forma adequada.El control de la contaminación ambiental ha sido considerado como una medida racional para la prevención de la infección en el sitio quirúrgico. El objetivo de este estudio es presentar las recomendaciones actuales con respecto a la preparación del equipo quirúrgico y hacer consideraciones acerca del papel del enfermero en el control de la contaminación ambiental. Basados en la literatura actual, tratamos puntos relacionados con el vestuario quirúrgico y al cepillado de las manos. Estudios indican que la preparación del equipo quirúrgico sirve como una importante barrera de protección en la prevención de la infección en el sitio quirúrgico; sin embargo, destacan que los profesionales de salud necesitan realizar los procedimientos de manera adecuada.The control of environmental contamination has been considered a rational measure for preventing surgical site infection. This study aims to present the current recommendations related to the preparation of the surgical team and to discuss the role of nurses in controlling environmental contamination. On the basis of current literature, we treat issues related to surgical garment and hand brushing. Studies indicate that the preparation of the surgical team constitutes an important

Alcohol based surgical prep solution and the risk of fire in the operating room: a case report

Directory of Open Access Journals (Sweden)

Gupta Rajiv

2008-04-01

Full Text Available Abstract A few cases of fire in the operating room are reported in the literature. The factors that may initiate these fires are many and include alcohol based surgical prep solutions, electrosurgical equipment, flammable drapes etc. We are reporting a case of fire in the operating room while operating on a patient with burst fracture C6 vertebra with quadriplegia. The cause of the fire was due to incomplete drying of the covering drapes with an alcohol based surgical prep solution. This paper discusses potential preventive measures to minimize the incidence of fire in the operating room.

9 CFR 590.502 - Equipment and utensils; PCB-containing equipment.

Science.gov (United States)

2010-01-01

... Sanitary Standards and accepted practices currently in effect for such equipment. (c) New or replacement equipment or machinery (including any replacement parts) brought onto the premises of any official plant... equipment and machinery, and any replacement parts for such equipment and machinery. Totally enclosed...

Surgical sutures filled with adipose-derived stem cells promote wound healing.

Directory of Open Access Journals (Sweden)

Ann Katharin Reckhenrich

Full Text Available Delayed wound healing and scar formation are among the most frequent complications after surgical interventions. Although biodegradable surgical sutures present an excellent drug delivery opportunity, their primary function is tissue fixation. Mesenchymal stem cells (MSC act as trophic mediators and are successful in activating biomaterials. Here biodegradable sutures were filled with adipose-derived mesenchymal stem cells (ASC to provide a pro-regenerative environment at the injured site. Results showed that after filling, ASCs attach to the suture material, distribute equally throughout the filaments, and remain viable in the suture. Among a broad panel of cytokines, cell-filled sutures constantly release vascular endothelial growth factor to supernatants. Such conditioned media was evaluated in an in vitro wound healing assay and showed a significant decrease in the open wound area compared to controls. After suturing in an ex vivo wound model, cells remained in the suture and maintained their metabolic activity. Furthermore, cell-filled sutures can be cryopreserved without losing their viability. This study presents an innovative approach to equip surgical sutures with pro-regenerative features and allows the treatment and fixation of wounds in one step, therefore representing a promising tool to promote wound healing after injury.

Surgical orthodontics.

Science.gov (United States)

Strohl, Alexis M; Vitkus, Lauren

2017-08-01

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

Equipment considerations

International Nuclear Information System (INIS)

Anon.

1992-01-01

Trace or ultratrace analyses require that the HPLC equipment used, including the detector, be optimal for such determinations. HPLC detectors are discussed at length in Chapter 4; discussion here is limited to the rest of the equipment. In general, commercial equipment is adequate for trace analysis; however, as the authors approach ultratrace analysis, it becomes very important to examine the equipment thoroughly and optimize it, where possible. For this reason they will review the equipment commonly used in HPLC and discuss the optimization steps. Detectability in HPLC is influenced by two factors (1): (a) baseline noise or other interferences that lead to errors in assigning the baseline absorbance; (b) peak width. 87 refs

Medical Issues: Equipment

Science.gov (United States)

... Information Packets Equipment Pool Living With SMA Medical Issues Palliative Breathing Orthopedics Nutrition Equipment Daily Life At ... curesma.org > support & care > living with sma > medical issues > equipment Equipment Individuals with SMA often require a ...

An adaptive transmission protocol for managing dynamic shared states in collaborative surgical simulation.

Science.gov (United States)

Qin, J; Choi, K S; Ho, Simon S M; Heng, P A

2008-01-01

A force prediction algorithm is proposed to facilitate virtual-reality (VR) based collaborative surgical simulation by reducing the effect of network latencies. State regeneration is used to correct the estimated prediction. This algorithm is incorporated into an adaptive transmission protocol in which auxiliary features such as view synchronization and coupling control are equipped to ensure the system consistency. We implemented this protocol using multi-threaded technique on a cluster-based network architecture.

Micro-surgical endodontics.

Science.gov (United States)

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

2014-02-01

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

Semiconductor Manufacturing equipment introduction

International Nuclear Information System (INIS)

Im, Jong Sun

2001-02-01

This book deals with semiconductor manufacturing equipment. It is comprised of nine chapters, which are manufacturing process of semiconductor device, history of semiconductor manufacturing equipment, kinds and role of semiconductor manufacturing equipment, construction and method of semiconductor manufacturing equipment, introduction of various semiconductor manufacturing equipment, spots of semiconductor manufacturing, technical elements of semiconductor manufacturing equipment, road map of technology of semiconductor manufacturing equipment and semiconductor manufacturing equipment in the 21st century.

Can Economic Performance Predict Pediatric Surgical Capacity in Sub-Saharan Africa?

Science.gov (United States)

Okoye, Mekam T; Nguyen, Evelyn T; Kushner, Adam L; Ameh, Emmanuel A; Nwomeh, Benedict C

2016-06-01

The relationship between economic status and pediatric surgical capacity in low- and middle-income countries (LMICs) is poorly understood. In sub-Saharan Africa (SSA), Nigeria accounts for 20 % of the population and has the highest Gross Domestic Product (GDP), but whether this economic advantage translates to increased pediatric surgical capacity is unknown. This study compares the pediatric surgical capacity between Nigeria and other countries within the region. The Pediatric Personnel, Infrastructure, Procedures, Equipment and Supplies (PediPIPES) survey, a recent tool that is useful in assessing and comparing the capacity of health facilities to deliver essential and emergency surgical care (EESC) to children in LMICs, was used for this evaluation. Data from hospitals in Nigeria (n = 24) and hospitals in 17 other sub-Saharan African countries (n = 25) were compared. The GDP of Nigeria was approximately twenty-five times the average GDP of the 17 other countries represented in our survey. Running water was unavailable in 58 % of the hospitals in Nigeria compared to 20 % of the hospitals in the other countries. Most hospitals in Nigeria and in the other countries did not have a CT scan (67 and 60 %, respectively). Endoscopes were unavailable in 58 % of the hospitals in Nigeria and 44 % of the hospitals in the other countries. Despite better economic indicators in Nigeria, there were no distinct advantages over the other countries in the ability to deliver EESC to children. Our findings highlighted the urgent need for specific allocation of more resources to pediatric surgical capacity building efforts across the entire region.

Electrical equipment qualification

International Nuclear Information System (INIS)

Farmer, W.S.

1983-01-01

Electrical equipment qualification research programs being carried out by CEA, JAERI, and Sandia Laboratories are discussed. Objectives of the program are: (1) assessment of accident simulation methods for electrical equipment qualification testing; lower coarse (2) evaluation of equipment aging and accelerated aging methods; (3) determine radiation dose spectrum to electrical equipment and assess simulation methods for qualification; (4) identify inadequacies in electrical equipment qualification procedures and standards and potential failure modes; and (5) provide data for verifying and improving standards, rules and regulatory guides

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

OpenAIRE

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

2018-01-01

Background: The use of motion tracking has been proved to provide an objective assessment in surgical skills training. Current systems, however, require the use of additional equipment or specialised laparoscopic instruments and cameras to extract the data. The aim of this study was to determine the possibility of using a software-based solution to extract the data. Methods: 6 expert and 23 novice participants performed a basic laparoscopic cholecystectomy procedure in the operating room. The...

Mobile surgical skills education unit: a new concept in surgical training.

Science.gov (United States)

Shaikh, Faisal M; Hseino, Hazem; Hill, Arnold D K; Kavanagh, Eamon; Traynor, Oscar

2011-08-01

Basic surgical skills are an integral part of surgical training. Simulation-based surgical training offers an opportunity both to trainees and trainers to learn and teach surgical skills outside the operating room in a nonpatient, nonstressed environment. However, widespread adoption of simulation technology especially in medical education is prohibited by its inherent higher cost, limited space, and interruptions to clinical duties. Mobile skills laboratory has been proposed as a means to address some of these limitations. A new program is designed by the Royal College of Surgeons in Ireland (RCSI), in an approach to teach its postgraduate basic surgical trainees the necessary surgical skills, by making the use of mobile innovative simulation technology in their own hospital settings. In this article, authors describe the program and students response to the mobile surgical skills being delivered in the region of their training hospitals and by their own regional consultant trainers.

Space Heating Equipment

Energy Technology Data Exchange (ETDEWEB)

Rafferty, Kevin D.

1998-01-01

The performance evaluation of space heating equipment for a geothermal application is generally considered from either of two perspectives: (a) selecting equipment for installation in new construction, or (b) evaluating the performance and retrofit requirements of an existing system. With regard to new construction, the procedure is relatively straightforward. Once the heating requirements are determined, the process need only involve the selection of appropriately sized hot water heating equipment based on the available water temperature. It is important to remember that space heating equipment for geothermal applications is the same equipment used in non-geothermal applications. What makes geothermal applications unique is that the equipment is generally applied at temperatures and flow rates that depart significantly from traditional heating system design. This chapter presents general considerations for the performance of heating equipment at non-standard temperature and flow conditions, retrofit of existing systems, and aspects of domestic hot water heating.

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

Science.gov (United States)

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

2014-01-01

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

Novel approaches for the surgical treatment of atrial fibrillation: Time for a guideline revision?

Directory of Open Access Journals (Sweden)

Carlo Nicola De Cecco

2010-06-01

Full Text Available Carlo Nicola De Cecco1,2, Vitaliano Buffa1, Vincenzo David2, Stefano Fedeli11Department of Cardiovascular Radiology, San Camillo-Forlanini Hospital, 2Department of Radiological Sciences, University of Rome, St Andrea Hospital, Rome, ItalyAbstract: Atrial fibrillation is a major health problem in Western countries, and is associated with considerable morbidity and resource consumption. Safe and reliable surgical techniques for the termination of this arrhythmia have been developed since the time of the original Cox “maze I” procedure. Novel equipment based on radiofrequency and microwave technologies can be employed to create transmural atrial lesions, even in the context of minimally invasive surgery to the atrioventricular valves via right minithoracotomy. The aim of this paper is to review the recent literature on this approach, and the clinical results in terms of arrhythmia termination and postoperative morbidity. With the aim to substantiate the practice of a simple, yet reliable, surgical ablation during minimally invasive heart valve surgery, we discuss the results of different patterns of atrial lesions having different degrees of surgical complexity. Finally, minimally invasive epicardial ablation for lone atrial fibrillation represents an emerging surgical indication. The results of state-of-the-art transcatheter ablation represent now its benchmark of comparison.Keywords: atrial fibrillation, surgery, minimally invasive, outcomes

Open surgical simulation--a review.

Science.gov (United States)

Davies, Jennifer; Khatib, Manaf; Bello, Fernando

2013-01-01

Surgical simulation has benefited from a surge in interest over the last decade as a result of the increasing need for a change in the traditional apprentice model of teaching surgery. However, despite the recent interest in surgical simulation as an adjunct to surgical training, most of the literature focuses on laparoscopic, endovascular, and endoscopic surgical simulation with very few studies scrutinizing open surgical simulation and its benefit to surgical trainees. The aim of this review is to summarize the current standard of available open surgical simulators and to review the literature on the benefits of open surgical simulation. Open surgical simulators currently used include live animals, cadavers, bench models, virtual reality, and software-based computer simulators. In the current literature, there are 18 different studies (including 6 randomized controlled trials and 12 cohort studies) investigating the efficacy of open surgical simulation using live animal, bench, and cadaveric models in many surgical specialties including general, cardiac, trauma, vascular, urologic, and gynecologic surgery. The current open surgical simulation studies show, in general, a significant benefit of open surgical simulation in developing the surgical skills of surgical trainees. However, these studies have their limitations including a low number of participants, variable assessment standards, and a focus on short-term results often with no follow-up assessment. The skills needed for open surgical procedures are the essential basis that a surgical trainee needs to grasp before attempting more technical procedures such as laparoscopic procedures. In this current climate of medical practice with reduced hours of surgical exposure for trainees and where the patient's safety and outcome is key, open surgical simulation is a promising adjunct to modern surgical training, filling the void between surgeons being trained in a technique and a surgeon achieving fluency in that

Anxiety in veterinary surgical students

DEFF Research Database (Denmark)

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

2012-01-01

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

Opportunities and improvisations: a pediatric surgeon's suggestions for successful short-term surgical volunteer work in resource-poor areas.

Science.gov (United States)

Meier, Donald

2010-05-01

There is a paucity of trained pediatric surgeons in resource-poor areas, and many children never receive care for debilitating problems that could readily be managed by surgeons with proper training, supplies, and instrumentation. This article, written from the perspective of a surgeon who has been both the recipient of and the provider of volunteer surgical services, is intended to encourage surgeons in technologically advanced locations to volunteer in underserved areas and to assist them in the implementation of such endeavors. Concepts are presented with an emphasis on pediatric surgery, but most are relevant for volunteers in all surgical specialties. Volunteer paradigms include, but are not limited to, the "surgical brigade" model, where a large group of health care professionals take all needed equipment and supplies for the duration of their stint, and the "minimalist" model, where a single volunteer works with local personnel using locally available equipment. For a successful volunteer endeavor the host needs to have a perceived need for the volunteer's services, and the volunteer must be flexible in adapting to meet overwhelming needs with limited resources. It is suggested that appropriate technology, such as the inexpensive anal stimulator presented herein, should be employed whenever possible. With proper planning, realistic expectations, and a cooperative and helpful attitude, volunteer trips can be rewarding experiences for both volunteers and host physicians and lead to lasting relationships that improve children's lives globally.

The Virtual Surgical Pelvis : Anatomy Visualization for Education and Surgical Planning

NARCIS (Netherlands)

Smit, N.N.

2016-01-01

This thesis deals with visualizing anatomical data for medical education and surgical planning purposes. To this end, we have developed a detailed virtual atlas, the Virtual Surgical Pelvis (VSP),which unifies surgically relevant knowledge on pelvic anatomy. We provide methods to share the knowledge

Surgical skills simulation in trauma and orthopaedic training.

Science.gov (United States)

Stirling, Euan R B; Lewis, Thomas L; Ferran, Nicholas A

2014-12-19

Changing patterns of health care delivery and the rapid evolution of orthopaedic surgical techniques have made it increasingly difficult for trainees to develop expertise in their craft. Working hour restrictions and a drive towards senior led care demands that proficiency be gained in a shorter period of time whilst requiring a greater skill set than that in the past. The resulting conflict between service provision and training has necessitated the development of alternative methods in order to compensate for the reduction in 'hands-on' experience. Simulation training provides the opportunity to develop surgical skills in a controlled environment whilst minimising risks to patient safety, operating theatre usage and financial expenditure. Many options for simulation exist within orthopaedics from cadaveric or prosthetic models, to arthroscopic simulators, to advanced virtual reality and three-dimensional software tools. There are limitations to this form of training, but it has significant potential for trainees to achieve competence in procedures prior to real-life practice. The evidence for its direct transferability to operating theatre performance is limited but there are clear benefits such as increasing trainee confidence and familiarity with equipment. With progressively improving methods of simulation available, it is likely to become more important in the ongoing and future training and assessment of orthopaedic surgeons.

Deriving DICOM surgical extensions from surgical workflows

Science.gov (United States)

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

2007-03-01

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

RETRIEVAL EQUIPMENT DESCRIPTIONS

International Nuclear Information System (INIS)

J. Steinhoff

1997-01-01

The objective and the scope of this document are to list and briefly describe the major mobile equipment necessary for waste package (WP) retrieval from the proposed subsurface nuclear waste repository at Yucca Mountain. Primary performance characteristics and some specialized design features of the equipment are explained and summarized in the individual subsections of this document. There are no quality assurance requirements or QA controls in this document. Retrieval under normal conditions is accomplished with the same fleet of equipment as is used for emplacement. Descriptions of equipment used for retrieval under normal conditions is found in Emplacement Equipment Descriptions, DI: BCAF00000-01717-5705-00002 (a document in progress). Equipment used for retrieval under abnormal conditions is addressed in this document and consists of the following: (1) Inclined Plane Hauler; (2) Bottom Lift Transporter; (3) Load Haul Dump (LHD) Loader; (4) Heavy Duty Forklift for Emplacement Drifts; (5) Covered Shuttle Car; (6) Multipurpose Vehicle; and (7) Scaler

Data communication equipment

International Nuclear Information System (INIS)

Kim, Hak Seon; Lee, Sang Mok

1998-02-01

The contents of this book are introduction of data communication on definition, purpose and history, information terminal about data communication system and data transmission system, data transmit equipment of summary, transmission cable, data port, concentrator and front-end processor, audio communication equipment like phones, radio communication equipment of summary on foundation of electromagnetic waves, AM transmitter, AM receiver, FM receiver and FM transmitter, a satellite and mobile communication equipment such as earth station, TT and C and Cellular phone, video telephone and new media apparatus.

Medical equipment management

CERN Document Server

Willson, Keith; Tabakov, Slavik

2013-01-01

Know What to Expect When Managing Medical Equipment and Healthcare Technology in Your Organization As medical technology in clinical care becomes more complex, clinical professionals and support staff must know how to keep patients safe and equipment working in the clinical environment. Accessible to all healthcare professionals and managers, Medical Equipment Management presents an integrated approach to managing medical equipment in healthcare organizations. The book explains the underlying principles and requirements and raises awareness of what needs to be done and what questions to ask. I

Establishing a surgical outreach program in the developing world: pediatric strabismus surgery in Guatemala City, Guatemala.

Science.gov (United States)

Ditta, Lauren C; Pereiras, Lilia Ana; Graves, Emily T; Devould, Chantel; Murchison, Ebony; Figueroa, Ligia; Kerr, Natalie C

2015-12-01

To report our experince in establishing a sustainable pediatric surgical outreach mission to an underserved population in Guatemala for treatment of strabismic disorders. A pediatric ophthalmic surgical outreach mission was established. Children were evaluated for surgical intervention by 3 pediatric ophthalmologists and 2 orthoptists. Surgical care was provided at the Moore Pediatric Surgery Center, Guatemala City, over 4 days. Postoperative care was facilitated by Guatemalan physicians during the second year. In year 1, patients 1-17 years of age were referred by local healthcare providers. In year 2, more than 60% of patients were prescreened by a local pediatric ophthalmologist. We screened 47% more patients in year 2 (132 vs 90). Diagnoses included congenital and acquired esotropia, consecutive and acquired exotropia, congenital nystagmus, Duane syndrome, Brown syndrome, cranial nerve palsy, dissociated vertical deviation, and oblique muscle dysfunction. Overall, 42% of the patients who were screened underwent surgery. We performed 21 more surgeries in our second year (58 vs 37), a 57% increase. There were no significant intra- or postoperative complications. Surgical outreach programs for children with strabismic disorders in the developing world can be established through international cooperation, a multidisciplinary team of healthcare providers, and medical equipment allocations. Coordinating care with local pediatric ophthalmologists and medical directors facilitates best practice management for sustainability. Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

Disposable surgical face masks for preventing surgical wound infection in clean surgery

Directory of Open Access Journals (Sweden)

Allyson Lipp

Full Text Available BACKGROUND: Surgical face masks were originally developed to contain and filter droplets containing microorganisms expelled from the mouth and nasopharynx of healthcare workers during surgery, thereby providing protection for the patient. However, there are several ways in which surgical face masks could potentially contribute to contamination of the surgical wound, e.g. by incorrect wear or by leaking air from the side of the mask due to poor string tension. OBJECTIVES: To determine whether disposable surgical face masks worn by the surgical team during clean surgery prevent postoperative surgical wound infection. SEARCH METHODS: We searched The Cochrane Wounds Group Specialised Register (searched 14 September 2011; The Cochrane Central Register of Controlled Trials (CENTRAL (The Cochrane Library 2011, Issue 3; Ovid MEDLINE (2008 to August Week 5 2011; Ovid MEDLINE (In-Process &Other Non-Indexed Citations September 13, 2011; Ovid EMBASE (2008 to 2011 Week 35; and EBSCO CINAHL (2008 to 9 September 2011. SELECTION CRITERIA: Randomized controlled trials (RCTs and quasi-randomized controlled trials comparing the use of disposable surgical masks with the use of no mask. DATA COLLECTION AND ANALYSIS: Two review authors extracted data independently. MAIN RESULTS: Three trials were included, involving a total of 2113 participants. There was no statistically significant difference in infection rates between the masked and unmasked group in any of the trials. AUTHORS' CONCLUSIONS: From the limited results it is unclear whether the wearing of surgical face masks by members of the surgical team has any impact on surgical wound infection rates for patients undergoing clean surgery.

Assessment of Surgical and Trauma Capacity in Potosí, Bolivia.

Science.gov (United States)

Blair, Kevin J; Boeck, Marissa A; Gallardo Barrientos, José Luis; Hidalgo López, José Luis; Helenowski, Irene B; Nwomeh, Benedict C; Shapiro, Michael B; Swaroop, Mamta

Scaling up surgical and trauma care in low- and middle-income countries could prevent nearly 2 million annual deaths. Various survey instruments exist to measure surgical and trauma capacity, including Personnel, Infrastructure, Procedures, Equipment, and Supplies (PIPES) and International Assessment of Capacity for Trauma (INTACT). We sought to evaluate surgical and trauma capacity in the Bolivian department of Potosí using a combined PIPES and INTACT tool, with additional questions to further inform intervention targets. In June and July 2014 a combined PIPES and INTACT survey was administered to 20 government facilities in Potosí with a minimum of 1 operating room: 2 third-level, 10 second-level, and 8 first-level facilities. A surgeon, head physician, director, or obstetrician-gynecologist completed the survey. Additional personnel responded to 4 short-answer questions. Survey items were divided into subsections, and PIPES and INTACT indices calculated. Medians were compared via Wilcoxon rank sum and Kruskal-Wallis tests. Six of 20 facilities were located in the capital city and designated urban. Urban establishments had higher median PIPES (8.5 vs 6.7, P = .11) and INTACT (8.5 vs 6.9, P = .16) indices compared with rural. More than half of surgeons and anesthesiologists worked in urban hospitals. Urban facilities had higher median infrastructure and procedure scores compared with rural. Fifty-three individuals completed short-answer questions. Training was most desired in laparoscopic surgery and trauma management; less than half of establishments reported staff with trauma training. Surgical and trauma capacity in Potosí was most limited in personnel, infrastructure, and procedures at rural facilities, with greater personnel deficiencies than previously reported. Interventions should focus on increasing the number of surgical and anesthesia personnel in rural areas, with a particular focus on the reported desire for trauma management training. Results

A refined surgical treatment modality for bromhidrosis: Subcutaneous scissor with micropore.

Science.gov (United States)

Dai, Yeqin; Xu, Ai-E; He, Junhua

2017-05-01

Axillary bromhidrosis has a strong negative effect on one's social life. A high success rate and few complications are criteria for a surgical treatment. The objective of this study was to evaluate a new surgical treatment modality for bromhidrosis: subcutaneous scissor with micropore. Twenty patients with bromhidrosis were treated. Patients were placed in a supine position with their treated arms abducted to 110°. After injection of 60 mL of tumescent solution into each axilla, one small incision was made at the middle axillary of the hair-bearing area. The whole hair-bearing skin was undermined at the level of the superficial fat to obtain adequate skin eversion. The flaps were everted to offer full exposure of the apocrine glands, and meticulous excision of each gland was performed. Both sides were punctured with scalpel. The micropore was used for drainage, and whose width was just 3 mm. Finally, the incisions were re-approximated, and bulky compressive dressings were applied to the area for 72 hours. Of the 40 axillae (20 patients), 34 (85.0%) showed excellent results, and six (15.0%) had good results. Malodor was significantly decreased. There were no serious complications. This technique can produce excellent results with a lower complication rate than most other surgical modalities and can be performed without costly equipment. © 2017 Wiley Periodicals, Inc.

Renewal of radiological equipment.

Science.gov (United States)

2014-10-01

In this century, medical imaging is at the heart of medical practice. Besides providing fast and accurate diagnosis, advances in radiology equipment offer new and previously non-existing options for treatment guidance with quite low morbidity, resulting in the improvement of health outcomes and quality of life for the patients. Although rapid technological development created new medical imaging modalities and methods, the same progress speed resulted in accelerated technical and functional obsolescence of the same medical imaging equipment, consequently creating a need for renewal. Older equipment has a high risk of failures and breakdowns, which might cause delays in diagnosis and treatment of the patient, and safety problems both for the patient and the medical staff. The European Society of Radiology is promoting the use of up-to-date equipment, especially in the context of the EuroSafe Imaging Campaign, as the use of up-to-date equipment will improve quality and safety in medical imaging. Every healthcare institution or authority should have a plan for medical imaging equipment upgrade or renewal. This plan should look forward a minimum of 5 years, with annual updates. Teaching points • Radiological equipment has a definite life cycle span, resulting in unavoidable breakdown and decrease or loss of image quality which renders equipment useless after a certain time period.• Equipment older than 10 years is no longer state-of-the art equipment and replacement is essential. Operating costs of older equipment will be high when compared with new equipment, and sometimes maintenance will be impossible if no spare parts are available.• Older equipment has a high risk of failure and breakdown, causing delays in diagnosis and treatment of the patient and safety problems both for the patient and the medical staff.• Every healthcare institution or authority should have a plan for medical imaging equipment upgrade or replacement. This plan should look forward a

Have Case Loads of Radical Surgery for Prostate Cancer Been Concentrated in Hospitals with Robotic Equipment ?―Analyses with Questionnaire Survey and Diagnostic Procedure Combination (DPC) Data―

OpenAIRE

塚本, 泰司; 田中, 滋

2016-01-01

We investigated whether installation of robot-assisted surgical equipment in hospitals resulted in concentration of the case loads of radical prostatectomy. We selected 11 areas with populations of around 1 million or more where there were one or more hospitals with robotic equipment and 4 or more without it. In addition, annual changes of case loads for prostatectomy over 4 years from 2010 to 2013 were clearly determined in these areas. The case loads were determined based on the results of ...

The use of a cognitive task analysis-based multimedia program to teach surgical decision making in flexor tendon repair.

Science.gov (United States)

Luker, Kali R; Sullivan, Maura E; Peyre, Sarah E; Sherman, Randy; Grunwald, Tiffany

2008-01-01

The aim of this study was to compare the surgical knowledge of residents before and after receiving a cognitive task analysis-based multimedia teaching module. Ten plastic surgery residents were evaluated performing flexor tendon repair on 3 occasions. Traditional learning occurred between the first and second trial and served as the control. A teaching module was introduced as an intervention between the second and third trial using cognitive task analysis to illustrate decision-making skills. All residents showed improvement in their decision-making ability when performing flexor tendon repair after each surgical procedure. The group improved through traditional methods as well as exposure to our talk-aloud protocol (P > .01). After being trained using the cognitive task analysis curriculum the group displayed a statistically significant knowledge expansion (P multimedia surgical curriculum instruction achieved greater command of problem solving and are better equipped to make correct decisions in flexor tendon repair.

Minimizing surgical skin incision scars with a latex surgical glove.

Science.gov (United States)

Han, So-Eun; Ryoo, Suk-Tae; Lim, So Young; Pyon, Jai-Kyung; Bang, Sa-Ik; Oh, Kap-Sung; Mun, Goo-Hyun

2013-04-01

The current trend in minimally invasive surgery is to make a small surgical incision. However, the excessive tensile stress applied by the retractors to the skin surrounding the incision often results in a long wound healing time and extensive scarring. To minimize these types of wound problems, the authors evaluated a simple and cost-effective method to minimize surgical incision scars based on the use of a latex surgical glove. The tunnel-shaped part of a powder-free latex surgical glove was applied to the incision and the dissection plane. It was fixed to the full layer of the dissection plane with sutures. The glove on the skin surface then was sealed with Ioban (3 M Health Care, St. Paul, MN, USA) to prevent movement. The operation proceeded as usual, with the retractor running through the tunnel of the latex glove. It was possible to complete the operation without any disturbance of the visual field by the surgical glove, and the glove was neither torn nor separated by the retractors. The retractors caused traction and friction during the operation, but the extent of damage to the postoperative skin incision margin was remarkably less than when the operation was performed without a glove. This simple and cost-effective method is based on the use of a latex surgical glove to protect the surgical skin incision site and improve the appearance of the postoperative scar. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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

Directory of Open Access Journals (Sweden)

Heiko T. Santana

2016-09-01

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

29 CFR 97.32 - Equipment.

Science.gov (United States)

2010-07-01

...) When acquiring replacement equipment, the grantee or subgrantee may use the equipment to be replaced as... equipment (including replacement equipment), whether acquired in whole or in part with grant funds, until... established to ensure the highest possible return. (e) Disposition. When original or replacement equipment...

44 CFR 13.32 - Equipment.

Science.gov (United States)

2010-10-01

...) When acquiring replacement equipment, the grantee or subgrantee may use the equipment to be replaced as... equipment (including replacement equipment), whether acquired in whole or in part with grant funds, until... established to ensure the highest possible return. (e) Disposition. When original or replacement equipment...

24 CFR 85.32 - Equipment.

Science.gov (United States)

2010-04-01

...) When acquiring replacement equipment, the grantee or subgrantee may use the equipment to be replaced as... equipment (including replacement equipment), whether acquired in whole or in part with grant funds, until... established to ensure the highest possible return. (e) Disposition. When original or replacement equipment...

43 CFR 12.72 - Equipment.

Science.gov (United States)

2010-10-01

...) When acquiring replacement equipment, the grantee or subgrantee may use the equipment to be replaced as... equipment (including replacement equipment), whether acquired in whole or in part with grant funds, until... established to ensure the highest possible return. (e) Disposition. When original or replacement equipment...

Bacterial migration through punctured surgical gloves under real surgical conditions

Directory of Open Access Journals (Sweden)

Heidecke Claus-Dieter

2010-07-01

Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

You pray to your God: A qualitative analysis of challenges in the provision of safe, timely, and affordable surgical care in Uganda.

Science.gov (United States)

Albutt, Katherine; Yorlets, Rachel R; Punchak, Maria; Kayima, Peter; Namanya, Didacus B; Anderson, Geoffrey A; Shrime, Mark G

2018-01-01

Five billion people lack access to safe, affordable, and timely surgical and anesthesia care. Significant challenges remain in the provision of surgical care in low-resource settings. Uganda is no exception. From September to November 2016, we conducted a mixed-methods countrywide surgical capacity assessment at 17 randomly selected public hospitals in Uganda. Researchers conducted 35 semi-structured interviews with key stakeholders to understand factors related to the provision of surgical care. The framework approach was used for thematic and explanatory data analysis. The Ugandan public health care sector continues to face significant challenges in the provision of safe, timely, and affordable surgical care. These challenges can be broadly grouped into preparedness and policy, service delivery, and the financial burden of surgical care. Hospital staff reported challenges including: (1) significant delays in accessing surgical care, compounded by a malfunctioning referral system; (2) critical workforce shortages; (3) operative capacity that is limited by inadequate infrastructure and overwhelmed by emergency and obstetric volume; (4) supply chain difficulties pertaining to provision of essential medications, equipment, supplies, and blood; (5) significant, variable, and sometimes catastrophic expenditures for surgical patients and their families; and (6) a lack of surgery-specific policies and priorities. Despite these challenges, innovative strategies are being used in the public to provide surgical care to those most in need. Barriers to the provision of surgical care are cross-cutting and involve constraints in infrastructure, service delivery, workforce, and financing. Understanding current strengths and shortfalls of Uganda's surgical system is a critical first step in developing effective, targeted policy and programming that will build and strengthen its surgical capacity.

Surgical experts: born or made?

Science.gov (United States)

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

2013-01-01

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

Challenges for the surgical capacity building of township hospitals among the Central China: a retrospective study.

Science.gov (United States)

Li, Zhong; Yang, Jian; Wu, Yue; Pan, Zijin; He, Xiaoqun; Li, Boyang; Zhang, Liang

2018-05-02

China's rapid transition in healthcare service system has posed considerable challenges for the primary care system. Little is known regarding the capacity of township hospitals (THs) to deliver surgical care in rural China with over 600 million lives. We aimed to ascertain its current performance, barriers, and summary lessons for its re-building in central China. This study was conducted in four counties from two provinces in central China. The New Rural Cooperative Medical System (NRCMS) claim data from two counties in Hubei province was analyzed to describe the current situation of surgical care provision. Based on previous studies, self-administered questionnaire was established to collect key indicators from 60 THs from 2011 to 2015, and social and economic statuses of the sampling townships were collected from the local statistical yearbook. Semi-structured interviews were conducted among seven key administrators in the THs that did not provide appendectomy care in 2015. Determinants of appendectomy care provision were examined using a negative binominal regression model. First, with the rapid increase in inpatient services provided by the THs, their proportion of surgical service provision has been nibbled by out-of-county facilities. Second, although DY achieved a stable performance, the total amount of appendectomy provided by the 60 THs decreased to 589 in 2015 from 1389 in 2011. Moreover, their proportion reduced to 26.77% in 2015 from 41.84% in 2012. Third, an increasing number of THs did not provide appendectomy in 2015, with the shortage of anesthesiologists and equipment as the most mentioned reasons (46.43%). Estimation results from the negative binomial model indicated that the annual average per capita disposable income and tightly integrated delivery networks (IDNs) negatively affected the amount of appendectomy provided by THs. By contrast, the probability of appendectomy provision by THs was increased by performance-related payment (PRP). Out

WE-G-204-08: Optimized Digital Radiographic Technique for Lost Surgical Devices/Needle Identification

International Nuclear Information System (INIS)

Gorman, A; Seabrook, G; Brakken, A; Dubois, M; Marn, C; Wilson, C; Jacobson, D; Liu, Y

2015-01-01

Purpose: Small surgical devices and needles are used in many surgical procedures. Conventionally, an x-ray film is taken to identify missing devices/needles if post procedure count is incorrect. There is no data to indicate smallest surgical devices/needles that can be identified with digital radiography (DR), and its optimized acquisition technique. Methods: In this study, the DR equipment used is a Canon RadPro mobile with CXDI-70c wireless DR plate, and the same DR plate on a fixed Siemens Multix unit. Small surgical devices and needles tested include Rubber Shod, Bulldog, Fogarty Hydrogrip, and needles with sizes 3-0 C-T1 through 8-0 BV175-6. They are imaged with PMMA block phantoms with thickness of 2–8 inch, and an abdomen phantom. Various DR techniques are used. Images are reviewed on the portable x-ray acquisition display, a clinical workstation, and a diagnostic workstation. Results: all small surgical devices and needles are visible in portable DR images with 2–8 inch of PMMA. However, when they are imaged with the abdomen phantom plus 2 inch of PMMA, needles smaller than 9.3 mm length can not be visualized at the optimized technique of 81 kV and 16 mAs. There is no significant difference in visualization with various techniques, or between mobile and fixed radiography unit. However, there is noticeable difference in visualizing the smallest needle on a diagnostic reading workstation compared to the acquisition display on a portable x-ray unit. Conclusion: DR images should be reviewed on a diagnostic reading workstation. Using optimized DR techniques, the smallest needle that can be identified on all phantom studies is 9.3 mm. Sample DR images of various small surgical devices/needles available on diagnostic workstation for comparison may improve their identification. Further in vivo study is needed to confirm the optimized digital radiography technique for identification of lost small surgical devices and needles

Remote handling equipment

International Nuclear Information System (INIS)

Clement, G.

1984-01-01

After a definition of intervention, problems encountered for working in an adverse environment are briefly analyzed for development of various remote handling equipments. Some examples of existing equipments are given [fr

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

Directory of Open Access Journals (Sweden)

Leila Abdollahi

2017-09-01

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

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

Science.gov (United States)

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

2017-01-01

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

Global curriculum in surgical oncology.

Science.gov (United States)

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

2016-06-01

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

Capping of the radicular exposed surface (part II). Surgical and not surgical treatment

OpenAIRE

Grados Pomarino, Sixto; Estrada, Andrew Alejandro; Maetahara Rubio, Denis Miguel; Guzmán Vera, Yanina Sara; Tello Barbarán, Javier

2014-01-01

The gingival recession treatment can be made surgical1y with a high predictability of success due to the great advance during the last ones of the mucogingival surgical techniques. The use of connective grafts in coverage of recessions has obtained high rates of success reason why these procedures are common within the modern periodontal surgical practice. Knowing that all patients do not accept the surgical treatment, many investigators have come studying the possibility of treating non-surg...

Applying the WHO conceptual framework for the International Classification for Patient Safety to a surgical population.

Science.gov (United States)

McElroy, L M; Woods, D M; Yanes, A F; Skaro, A I; Daud, A; Curtis, T; Wymore, E; Holl, J L; Abecassis, M M; Ladner, D P

2016-04-01

Efforts to improve patient safety are challenged by the lack of universally agreed upon terms. The International Classification for Patient Safety (ICPS) was developed by the World Health Organization for this purpose. This study aimed to test the applicability of the ICPS to a surgical population. A web-based safety debriefing was sent to clinicians involved in surgical care of abdominal organ transplant patients. A multidisciplinary team of patient safety experts, surgeons and researchers used the data to develop a system of classification based on the ICPS. Disagreements were reconciled via consensus, and a codebook was developed for future use by researchers. A total of 320 debriefing responses were used for the initial review and codebook development. In total, the 320 debriefing responses contained 227 patient safety incidents (range: 0-7 per debriefing) and 156 contributing factors/hazards (0-5 per response). The most common severity classification was 'reportable circumstance,' followed by 'near miss.' The most common incident types were 'resources/organizational management,' followed by 'medical device/equipment.' Several aspects of surgical care were encompassed by more than one classification, including operating room scheduling, delays in care, trainee-related incidents, interruptions and handoffs. This study demonstrates that a framework for patient safety can be applied to facilitate the organization and analysis of surgical safety data. Several unique aspects of surgical care require consideration, and by using a standardized framework for describing concepts, research findings can be compared and disseminated across surgical specialties. The codebook is intended for use as a framework for other specialties and institutions. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Abortion - surgical - aftercare

Science.gov (United States)

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

Emergency removal of football equipment: a cadaveric cervical spine injury model.

Science.gov (United States)

Gastel, J A; Palumbo, M A; Hulstyn, M J; Fadale, P D; Lucas, P

1998-10-01

To determine the influence of football helmet and shoulder pads, alone or in combination, on alignment of the unstable cervical spine. The alignment of the intact cervical spine in 8 cadavers was assessed radiographically under 4 different football equipment conditions: (1) no equipment, (2) helmet only, (3) helmet and shoulder pads, and (4) shoulder pads only. Each specimen was then surgically destabilized at C5-C6 to simulate a flexion-distraction injury. Repeat radiographs were obtained under the same 4 equipment conditions, and alignment of the unstable segment was analyzed. Before the destabilization, neutral alignment was maintained when both helmet and shoulder pads were in place. The "helmet only" condition caused a significant decrease in lordosis (mean, 9.6 +/- 4.7 degrees), whereas the "shoulder pads only" condition caused increased lordosis (13.6 +/- 6.3 degrees). After destabilization, the "helmet-only" condition demonstrated significant mean increases in C5-C6 forward angulation (16.5 +/- 8.6 degrees), posterior disc space height (3.8 +/- 2.3 mm), and dorsal element distraction (8.3 +/- 5.4 mm). Our flexion-distraction model demonstrated that immobilization of the neck-injured football player with only the helmet in place violates the principle of splinting the cervical spine in neutral alignment. By extrapolation to an extension-type injury, immobilization with only the shoulder pads left in place similarly violates this principle. In order to maintain a neutral position and minimize secondary injury to the cervical neural elements, the helmet and shoulder pads should be either both left on or both removed in the emergency setting.

Used energy-related laboratory equipment grant program for institutions of higher learning. Eligible equipment catalog

Energy Technology Data Exchange (ETDEWEB)

1994-07-01

This is a listing of energy related equipment available through the Energy-Related Laboratory Equipment Grant Program which grants used equipment to institutions of higher education for energy-related research. Information included is an overview of the program, how to apply for a grant of equipment, eligibility requirements, types of equipment available, and the costs for the institution.

Equipment repair in coal mines

Energy Technology Data Exchange (ETDEWEB)

Zhang, S

1982-01-01

Most equipment in Chinese coal mines consists of machinery and equipment produced in the 1950s; the efficiency of 4-62, CTD-57 and 70B/sub 2/ ventilators is 15% lower than that of new ones; that of SSM and AYaP pumps, 10% lower than of modern ones. Equipment renovation is done in three ways: replacing obsolete equipment with new equipment of the same type; improving the performance of existing equipment by introducing efficiency and reconstruction; and replacing obsolete equipment with advanced equipment. It is indicated that the second way, for example, replacement of 4-62 ventilator blades with a maximum efficiency of 73% by 4-72 ventilator blades raises its efficiency to 90%. Replacing the 8DA-8x3 water pump, having a maximum efficiency of 63%, with the 200D 43x3 pump with a maximum efficiency of 78%, enables an electricity savings of 7000 yuan per year, which exceeds all replacement costs (600 yuan). The need to improve equipment maintenance and preventive work to increase equipment service life and to introduce new techniques and efficiency is noted.

Pelvic control following external beam radiation for surgical Stage I endometrial adenocarcinoma

International Nuclear Information System (INIS)

Rush, Stephen; Gal, David; Potters, Louis; Bosworth, Jay; Lovecchio, John

1995-01-01

Purpose: To determine if postoperative external pelvic radiation (EBRT), without vaginal brachytherapy, is sufficient to prevent vaginal cuff and pelvic recurrences in patients with surgical Stage I endometrial adenocarcinoma (ACA). Methods and Materials: The records of 122 patients with surgical Stage I endometrial cancer were reviewed. There were 87 patients with ACA who received EBRT alone and are the subject of this study. Their radiation records were reviewed. All patients underwent exploration, total abdominal hysterectomy, and bilateral salpingo-oophorectomy (TAH BSO), and pelvic and paraaortic lymph node sampling. They were staged according to the FIGO 1988 surgical staging system recommendations. Postoperatively, pelvic EBRT was administered by megavoltage equipment using four fields, to a total dose of 45 to 50.4 Gy. Actuarial survival and disease free survival were calculated according to Kaplan-Meier Method. Results: Twenty-seven patients with Stage IA Grade 1 or 2 ACA with less than one-third myometrial invasion, who did not receive EBRT, and eight patients with histology other than adenocarcinoma (i.e., serous papillary, mucinous, etc.) were not included in the study. For the remaining 87 patients who are in the study group, the median follow-up was 52 months (range: 12-82 months). The 5-year overall survival for these 87 patients was 92%, with a disease-free survival of 83%. There were no tumor recurrences in the upper vagina or in the pelvis. Two patients developed small bowel obstruction (no surgery required), and one patient developed chronic enteritis. Conclusion: Adjuvant external pelvic radiation, without vaginal brachytherapy, prevents pelvic and vaginal cuff recurrences in surgical Stage I endometrial ACA

BP volume reduction equipment

International Nuclear Information System (INIS)

Kitamura, Yoshinori; Muroo, Yoji; Hamanaka, Isao

2003-01-01

A new type of burnable poison (BP) volume reduction system is currently being developed. Many BP rods, a subcomponent of spent fuel assemblies are discharged from nuclear power reactors. This new system reduces the overall volume of BP rods. The main system consists of BP rod cutting equipment, equipment for the recovery of BP cut pieces, and special transport equipment for the cut rods. The equipment is all operated by hydraulic press cylinders in water to reduce operator exposure to radioactivity. (author)

Exercise Equipment: Neutral Buoyancy

Science.gov (United States)

Shackelford, Linda; Valle, Paul

2016-01-01

Load Bearing Equipment for Neutral Buoyancy (LBE-NB) is an exercise frame that holds two exercising subjects in position as they apply counter forces to each other for lower extremity and spine loading resistance exercises. Resistance exercise prevents bone loss on ISS, but the ISS equipment is too massive for use in exploration craft. Integrating the human into the load directing, load generating, and motion control functions of the exercise equipment generates safe exercise loads with less equipment mass and volume.

22 CFR 135.32 - Equipment.

Science.gov (United States)

2010-04-01

... specifically permitted or contemplated by Federal statute. (4) When acquiring replacement equipment, the...) Management requirements. Procedures for managing equipment (including replacement equipment), whether... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no...

21 CFR 1403.32 - Equipment.

Science.gov (United States)

2010-04-01

... specifically permitted or contemplated by Federal statute. (4) When acquiring replacement equipment, the...) Management requirements. Procedures for managing equipment (including replacement equipment), whether... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no...

45 CFR 602.32 - Equipment.

Science.gov (United States)

2010-10-01

... specifically permitted or contemplated by Federal statute. (4) When acquiring replacement equipment, the...) Management requirements. Procedures for managing equipment (including replacement equipment), whether... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no...

49 CFR 18.32 - Equipment.

Science.gov (United States)

2010-10-01

... specifically permitted or contemplated by Federal statute. (4) When acquiring replacement equipment, the...) Management requirements. Procedures for managing equipment (including replacement equipment), whether... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no...

34 CFR 80.32 - Equipment.

Science.gov (United States)

2010-07-01

... specifically permitted or contemplated by Federal statute. (4) When acquiring replacement equipment, the...) Management requirements. Procedures for managing equipment (including replacement equipment), whether... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no...

10 CFR 600.232 - Equipment.

Science.gov (United States)

2010-01-01

... specifically permitted or contemplated by Federal statute. (4) When acquiring replacement equipment, the...) Management requirements. Procedures for managing equipment (including replacement equipment), whether... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no...

45 CFR 1183.32 - Equipment.

Science.gov (United States)

2010-10-01

... specifically permitted or contemplated by Federal statute. (4) When acquiring replacement equipment, the...) Management requirements. Procedures for managing equipment (including replacement equipment), whether... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no...

Development of manufacturing equipment and QC equipment for DUPIC fuel

International Nuclear Information System (INIS)

Yang, Myung Seung; Park, J.J.; Lee, J.W.; Kim, S.S.; Yim, S.P.; Kim, J.H.; Kim, K.H.; Na, S.H.; Kim, W.K.; Shin, J.M.; Lee, D.Y.; Cho, K.H.; Lee, Y.S.; Sohn, J.S.; Kim, M.J.

1999-05-01

In this study, DUPIC powder and pellet fabrication equipment, welding system, QC equipment, and fission gas treatment are developed to fabricate DUPIC fuel at IMEF M6 hot cell. The systems are improved to be suitable for remote operation and maintenance with the manipulator at hot cell. Powder and pellet fabrication equipment have been recently developed. The systems are under performance test to check remote operation and maintenance. Welding chamber and jigs are designed and developed to remotely weld DUPIC fuel rod with manipulators at hot cell. Remote quality control equipment are being tested for analysis and inspection of DUPIC fuel characteristics at hot cell. And trapping characteristics is analyzed for cesium and ruthenium released under oxidation/reduction and sintering processes. The design criteria and process flow diagram of fission gas treatment system are prepared incorporating the experimental results. The fission gas treatment system has been successfully manufactured. (Author). 33 refs., 14 tabs., 91 figs

Surgical competence.

Science.gov (United States)

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

2003-08-01

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

45 CFR 1174.32 - Equipment.

Science.gov (United States)

2010-10-01

... contemplated by Federal statute. (4) When acquiring replacement equipment, the grantee or subgrantee may use... requirements. Procedures for managing equipment (including replacement equipment), whether acquired in whole or... original or replacement equipment acquired under a grant or subgrant is no longer needed for the original...

45 CFR 1157.32 - Equipment.

Science.gov (United States)

2010-10-01

... contemplated by Federal statute. (4) When acquiring replacement equipment, the grantee or subgrantee may use... requirements. Procedures for managing equipment (including replacement equipment), whether acquired in whole or... original or replacement equipment acquired under a grant or subgrant is no longer needed for the original...

SAGES TAVAC safety and effectiveness analysis: da Vinci ® Surgical System (Intuitive Surgical, Sunnyvale, CA).

Science.gov (United States)

Tsuda, Shawn; Oleynikov, Dmitry; Gould, Jon; Azagury, Dan; Sandler, Bryan; Hutter, Matthew; Ross, Sharona; Haas, Eric; Brody, Fred; Satava, Richard

2015-10-01

The da Vinci(®) Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) is a computer-assisted (robotic) surgical system designed to enable and enhance minimally invasive surgery. The Food and Drug Administration (FDA) has cleared computer-assisted surgical systems for use by trained physicians in an operating room environment for laparoscopic surgical procedures in general, cardiac, colorectal, gynecologic, head and neck, thoracic and urologic surgical procedures. There are substantial numbers of peer-reviewed papers regarding the da Vinci(®) Surgical System, and a thoughtful assessment of evidence framed by clinical opinion is warranted. The SAGES da Vinci(®) TAVAC sub-committee performed a literature review of the da Vinci(®) Surgical System regarding gastrointestinal surgery. Conclusions by the sub-committee were vetted by the SAGES TAVAC Committee and SAGES Executive Board. Following revisions, the document was evaluated by the TAVAC Committee and Executive Board again for final approval. Several conclusions were drawn based on expert opinion organized by safety, efficacy, and cost for robotic foregut, bariatric, hepatobiliary/pancreatic, colorectal surgery, and single-incision cholecystectomy. Gastrointestinal surgery with the da Vinci(®) Surgical System is safe and comparable, but not superior to standard laparoscopic approaches. Although clinically acceptable, its use may be costly for select gastrointestinal procedures. Current data are limited to the da Vinci(®) Surgical System; further analyses are needed.

PROBLEMS PERTAINING TO DIVERSIFICATION OF CIVIL EQUIPMENT IN EQUIPMENT OF MILITARY PURPOSE

OpenAIRE

A. I. Kotlabay; V. A. Korobkin; V. F. Tamelo; I. V. Kostko; S. V. Kondratiev

2009-01-01

Study of directions concerning development of military equipment, its modernization with the purpose to improve its military efficiency is an actual problem for the Armed Forces, military science, designers and researchers.The paper analyzes and estimates possibilities to use civil equipment for military purpose. Problems pertaining to technologies of double application, diversification of civil equipment in military engineering machinery are considered in the paper.

20 CFR 437.32 - Equipment.

Science.gov (United States)

2010-04-01

... contemplated by Federal statute. (4) When acquiring replacement equipment, the grantee or subgrantee may use.... Procedures for managing equipment (including replacement equipment), whether acquired in whole or in part... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Equipment. 437.32 Section 437.32 Employees...

Free-world microelectronic manufacturing equipment

Science.gov (United States)

Kilby, J. S.; Arnold, W. H.; Booth, W. T.; Cunningham, J. A.; Hutcheson, J. D.; Owen, R. W.; Runyan, W. R.; McKenney, Barbara L.; McGrain, Moira; Taub, Renee G.

1988-12-01

Equipment is examined and evaluated for the manufacture of microelectronic integrated circuit devices and sources for that equipment within the Free World. Equipment suitable for the following are examined: single-crystal silicon slice manufacturing and processing; required lithographic processes; wafer processing; device packaging; and test of digital integrated circuits. Availability of the equipment is also discussed, now and in the near future. Very adequate equipment for most stages of the integrated circuit manufacturing process is available from several sources, in different countries, although the best and most widely used versions of most manufacturing equipment are made in the United States or Japan. There is also an active market in used equipment, suitable for manufacture of capable integrated circuits with performance somewhat short of the present state of the art.

34 CFR 74.34 - Equipment.

Science.gov (United States)

2010-07-01

... as program income. (e) When acquiring replacement equipment, the recipient may use the equipment to... replacement equipment subject to the approval of the Secretary. (f) The recipient's property management... 34 Education 1 2010-07-01 2010-07-01 false Equipment. 74.34 Section 74.34 Education Office of the...

45 CFR 2541.320 - Equipment.

Science.gov (United States)

2010-10-01

... replacement equipment, the grantee or subgrantee may use the equipment to be replaced as a trade-in or sell... replacement equipment), whether acquired in whole or in part with grant funds, until disposition takes place... ensure the highest possible return. (e) Disposition. When original or replacement equipment acquired...

Visual communication and terminal equipment

International Nuclear Information System (INIS)

Kang, Cheol Hui

1988-06-01

This book is divided two parts about visual communication and terminal equipment. The first part introduces visual communication, which deals with foundation of visual communication, technique of visual communication, equipment of visual communication, a facsimile and pictorial image system. The second part contains terminal equipment such as telephone, terminal equipment for data transmission on constitution and constituent of terminal equipment for data transmission, input device and output device, terminal device and up-to-date terminal device.

Visual communication and terminal equipment

Energy Technology Data Exchange (ETDEWEB)

Kang, Cheol Hui

1988-06-15

This book is divided two parts about visual communication and terminal equipment. The first part introduces visual communication, which deals with foundation of visual communication, technique of visual communication, equipment of visual communication, a facsimile and pictorial image system. The second part contains terminal equipment such as telephone, terminal equipment for data transmission on constitution and constituent of terminal equipment for data transmission, input device and output device, terminal device and up-to-date terminal device.

Recognizing surgical patterns

NARCIS (Netherlands)

Bouarfa, L.

2012-01-01

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

Equipment design guidance document for flammable gas waste storage tank new equipment

International Nuclear Information System (INIS)

Smet, D.B.

1996-01-01

This document is intended to be used as guidance for design engineers who are involved in design of new equipment slated for use in Flammable Gas Waste Storage Tanks. The purpose of this document is to provide design guidance for all new equipment intended for application into those Hanford storage tanks in which flammable gas controls are required to be addressed as part of the equipment design. These design criteria are to be used as guidance. The design of each specific piece of new equipment shall be required, as a minimum to be reviewed by qualified Unreviewed Safety Question evaluators as an integral part of the final design approval. Further Safety Assessment may be also needed. This guidance is intended to be used in conjunction with the Operating Specifications Documents (OSDs) established for defining work controls in the waste storage tanks. The criteria set forth should be reviewed for applicability if the equipment will be required to operate in locations containing unacceptable concentrations of flammable gas

Environmental/dynamic mechanical equipment qualification and dynamic electrical equipment qualification program (EDQP)

International Nuclear Information System (INIS)

Hunter, J.A.

1984-01-01

Equipment qualification research is being conducted to investigate acceptable criteria, requirements, and methodologies for the dynamic (including seismic) and environmental qualification of mechanical equipment and for the dynamic (including seismic) qualification of electrical equipment. The program is organized into three elements: (1) General Research, (2) Environmental Research, and (3) Dynamic Research. This paper presents the highlights of the results to date in these three elements of the program

Rapid determination of resistance to antibiotics in surgical clinical practice based on the measurement of radioactive carbon dioxide

International Nuclear Information System (INIS)

Alant, O.; Jaszsagi-Nagy, E.; Lendvay, J.; Schmidt, M.

1978-01-01

For the objective choice of an antibiotic a method is needed which is capable of giving informations with an essentially shorter time delay than that of the conventional bacteriological tests i.e. practically in a few hours concerning the sensitivity to the tested antibiotic of the pathogen germ cultured from the sample withdrawn from the patient under surgical treatment. The new measurement method is based on the incubation of the test material in an adequate medium containing glucose labelled with C-14 as only sugar source. The amount of the formed 14 CO 2 is proportional to the multiplication rate of the bacterium. Experience observed with 312 surgical patients indicated that the sensitivity to an antibiotic agent can be determined in 4-6 hours from the septic intergrowth or from the discharge obtained during the surgical action and in the case of chronical diseases the successfulness of the treatment with the antibiotic can be established precisely. The equipment needed for the tests is simple and the measurements can be carried out readily in hospital laboratories. (P.J.)

Use of Equipment Information System (EQUIS) to determine priority for purchasing safeguards equipment

International Nuclear Information System (INIS)

Silberberg, S.

1988-01-01

To manage its large world-wide inventory of safeguards equipment, the IAEA Safeguards department uses a computerized Equipment Information System (EQUIS). EQUIS data have been analyzed using Queueing Theory to determine if inventory is adequate to meet inspector demands and in those cases where it is inadequate, to indicate how many additional units should be procured. Results are tabulated for various types of non-destructive analysis (NDA) equipment. For equipment where there is a high turnover and hence a large amount of data, the analysis provides a powerful tool for assisting procurement decisions

Imaging of foreign bodies in the face and ultrasound guided surgical removal; Diagnostico por imagem de corpos estranhos da face e retirada cirurgica guiada por ultra-sonografia

Energy Technology Data Exchange (ETDEWEB)

Lima, Claudio Marcio Amaral de Oliveira; Gambin, Moises; Ribeiro, Erica Barreiros; Amarante Junior, Jose Luiz de Medeiros [Hospital Naval Marcilio Dias, Rio de Janeiro, RJ (Brazil)]. E-mail: cmaol@br.inter.net; cmaolima@hotmail.com; Monteiro, Alexandra Maria Vieira [Pontificia Univ. Catolica do Rio de Janeiro (PUC/Rio), RJ (Brazil). Curso de Pos-Graduacao em Radiologia

2006-10-15

The identification and surgical removal of foreign bodies is a complex procedure in medical practice, principally when the involved material is radiolucent. The technological advent of the ultrasonography equipment comes enlarging the field of application of this method more and more, in medical practice. The authors describe a case of an ultrasound guided surgical removal of glass fragments from the face of a patient. The foreign bodies were previously diagnosed by ultrasound and computed tomography. The guided technic showed secure, less invasive and efficient, allowing the retreat of all the fragments. (author)

[Comparative effectiveness of surgical and non-surgical treatment for pediatric mandibular condylar fractures].

Science.gov (United States)

Hu, Min; Wang, Yanyi; Zhang, Lihai; Yao, Jun

2010-12-01

To compare the effectiveness of open reduction and conservative treatment for pediatric mandibular condylar fractures and to provide the evidence for the selection of clinical therapy. The clinical data were retrospectively analyzed from 25 patients with the mandibular condylar fractures between January 1988 and December 2006. Of them, 8 patients (11 fractures) were treated with surgical treatment (surgical group) and 17 patients (22 fractures) with non-surgical treatment (non-surgical group). In surgical group, there were 6 males (9 fractures) and 2 females (2 fractures) with an age range of 8-13 years; fracture was caused by tumbling in 7 cases and by traffic accident in 1 with an interval of 1-6 days between injury and hospitalization; and 5 cases were identified as unilateral condylar fractures (3 complicated by mental fractures) and 3 cases as bilateral condylar fractures complicated by mental fractures. In non-surgical group, there were 12 males (15 fractures) and 5 females (7 fractures) with an age range of 3-12 years; fracture was caused by falling from height in 4 cases, by tumbling in 10, and by traffic accident in 3 with an interval of 1-25 days between injury and hospitalization; and 12 cases were identified as unilateral condylar fractures (3 complicated by mental fractures) and 5 cases as bilateral condylar fractures (1 complicated by mental fracture). Incision healed by first intention in surgical group, and 25 cases were followed up 1-6 years with an average of 3.5 years. At 12 months after treatment, no temporomandibular joint pain, eating disorder, or limited mandibular movement occurred in 2 groups. No significant difference was observed in opening mouth extent, protrusive and lateral movements between 2 groups at 6 and 12 months (P > 0.05). During centric occlusion, mental point located at the midline with symmetric face figure. Two patients in surgical group and 3 in non-surgical group had slight snap when opening their mouths. Mandible

Overall Equipment Effectiveness Implementation Criteria

Science.gov (United States)

Abramova, I. G.; Abramov, D. A.

2018-01-01

This article documents the methods applied in production control technics specifically focused on commonly used parameter OEE (Overall Equipment Effectiveness). The indicators of extensive and intensive use of equipment are considered. Their appointment this is comparison in the same type of production within the industry and comparison of single-type and / or different types of equipment in terms of capacity. However, it is shown that there is no possibility of revealing the reasons for the machine’s operation: productive / unproductive, with disturbances. Therefore, in the article reveals the approaches to calculating the indicator characterizing the direct operation of the equipment. The Machine Load coefficient is approaching closely to the indicator of the efficiency of the use of equipment. Methods analysis is proceeded through the historically applied techniques such as “Stopwatch” and “Motion” studies. Was performed the analysis of the efficiency index of OEE equipment using the comparable indexes performance of equipment in the Russian practice. An important indicator of OEE contains three components. The meaning of each of them reflects historically applicable indicators. The value of the availability of equipment indicator is close to the value of the equipment extensibility index. The value of the indicator of the efficiency of work can be compared with the characteristic of the capacity of the equipment and the indicator of the quality level can meet the requirements for compliance with the manufacturing technology. Shown that the sum of the values of the coefficient of “Availability” of the equipment and the value of the “Factor of compaction of working hours” are one. As well as the total value of the indicator “level of quality” and the coefficient of marriage given in the result unit. The measurability of the indicators makes it possible to make a prediction about efficiency of the equipment.

Surgical versus non-surgical management for pleural empyema.

Science.gov (United States)

Redden, Mark D; Chin, Tze Yang; van Driel, Mieke L

2017-03-17

Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment. To assess the effectiveness and safety of surgical versus non-surgical treatments for complicated parapneumonic effusion or pleural empyema. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 9), MEDLINE (Ebscohost) (1946 to July week 3 2013, July 2015 to October 2016) and MEDLINE (Ovid) (1 May 2013 to July week 1 2015), Embase (2010 to October 2016), CINAHL (1981 to October 2016) and LILACS (1982 to October 2016) on 20 October 2016. We searched ClinicalTrials.gov and WHO International Clinical Trials Registry Platform for ongoing studies (December 2016). Randomised controlled trials that compared a surgical with a non-surgical method of management for all age groups with pleural empyema. Two review authors independently assessed trials for inclusion and risk of bias, extracted data, and checked the data for accuracy. We contacted trial authors for additional information. We assessed the quality of the evidence using the GRADE approach. We included eight randomised controlled trials with a total of 391 participants. Six trials focused on children and two on adults. Trials compared tube thoracostomy drainage (non-surgical), with or without intrapleural fibrinolytics, to either VATS or thoracotomy (surgical) for the management of pleural empyema. Assessment of risk of bias for the included studies was generally unclear for selection and blinding but low for attrition and reporting bias. Data analyses compared

Chapter 12. Space Heating Equipment

Energy Technology Data Exchange (ETDEWEB)

Rafferty, Kevin D.

1998-01-01

The performance evaluation of space heating equipment for a geothermal application is generally considered from either of two perspectives: (a) selecting equipment for installation in new construction, or (b) evaluating the performance and retrofit requirements of an existing system. With regard to new construction, the procedure is relatively straightforward. Once the heating requirements are determined, the process need only involve the selection of appropriately sized hot water heating equipment based on the available water temperature. It is important to remember that space heating equipment for geothermal applications is the same equipment used in non-geothermal applications. What makes geothermal applications unique is that the equipment is generally applied at temperatures and flow rates that depart significantly from traditional heating system design. This chapter presents general considerations for the performance of heating equipment at non-standard temperature and flow conditions, retrofit of existing systems, and aspects of domestic hot water heating.

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

Science.gov (United States)

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

2011-03-01

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

Surgical virtual reality - highlights in developing a high performance surgical haptic device.

Science.gov (United States)

Custură-Crăciun, D; Cochior, D; Constantinoiu, S; Neagu, C

2013-01-01

Just like simulators are a standard in aviation and aerospace sciences, we expect for surgical simulators to soon become a standard in medical applications. These will correctly instruct future doctors in surgical techniques without there being a need for hands on patient instruction. Using virtual reality by digitally transposing surgical procedures changes surgery in are volutionary manner by offering possibilities for implementing new, much more efficient, learning methods, by allowing the practice of new surgical techniques and by improving surgeon abilities and skills. Perfecting haptic devices has opened the door to a series of opportunities in the fields of research,industry, nuclear science and medicine. Concepts purely theoretical at first, such as telerobotics, telepresence or telerepresentation,have become a practical reality as calculus techniques, telecommunications and haptic devices evolved,virtual reality taking a new leap. In the field of surgery barrier sand controversies still remain, regarding implementation and generalization of surgical virtual simulators. These obstacles remain connected to the high costs of this yet fully sufficiently developed technology, especially in the domain of haptic devices. Celsius.

Acquiring minimally invasive surgical skills

OpenAIRE

Hiemstra, Ellen

2012-01-01

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

Alcohol skin preparation causes surgical fires.

Science.gov (United States)

Rocos, B; Donaldson, L J

2012-03-01

Surgical fires are a rare but serious preventable safety risk in modern hospitals. Data from the US show that up to 650 surgical fires occur each year, with up to 5% causing death or serious harm. This study used the National Reporting and Learning Service (NRLS) database at the National Patient Safety Agency to explore whether spirit-based surgical skin preparation fluid contributes to the cause of surgical fires. The NRLS database was interrogated for all incidents of surgical fires reported between 1 March 2004 and 1 March 2011. Each report was scrutinised manually to discover the cause of the fire. Thirteen surgical fires were reported during the study period. Of these, 11 were found to be directly related to spirit-based surgical skin preparation or preparation soaked swabs and drapes. Despite manufacturer's instructions and warnings, surgical fires continue to occur. Guidance published in the UK and US states that spirit-based skin preparation solutions should continue to be used but sets out some precautions. It may be that fire risk should be included in pre-surgical World Health Organization checklists or in the surgical training curriculum. Surgical staff should be aware of the risk that spirit-based skin preparation fluids pose and should take action to minimise the chance of fire occurring.

Effects of Frequent Glove Change on Outcomes of Orthopaedic Surgical Procedures - A Multicenter Study on Surgical Gloves

Directory of Open Access Journals (Sweden)

Nishit Palo

2017-10-01

Full Text Available Introduction: Intact surgical gloves are a barrier to microorganisms migration between surgical team members and the patient. The surgical gloves are changed at various junctures but the effects of changing gloves during surgical procedures on various surgical parameters or clinical outcomes are not established. Aim: To determine rationale of glove change during orthopaedic procedures, differences amongst surgical parameters with and without changing the surgical gloves and whether frequent glove change affected surgical parameters or clinical outcomes. Materials and Methods: A prospective multicenter study conducted at three centers from January 2014 to January 2016. A 250 patients were divided into 2 groups (n=125 each in Group 1, surgical team operated with regular changing of gloves. In Group 2, only 1 set of double gloves were worn throughout the procedure. Surgical parameters or clinical outcomes were assessed for both the groups. Statistical analyses included the median, mode, range, Interquartile Range (IQR and sample standard deviation (s and independent-samples t-test. Bacterial counts were expressed as median with (IQR. Results: Surgical Timing Difference was 10 (S.D.- 4.2 minutes more in Group-1 (<0.05, Surgical Cost was higher in Group-1 by Rs.150-450 (<0.05. Outer glove micro-perforation rate was 5.85% and 8.15% in group-1 and 2 respectively with no inner glove perforation or Surgical Site Infections. Outer glove micro perforations were proportional to duration of surgery; operations lasting 120-210 and 61-120 minutes had 66.6% and 37.2% micro perforation rates respectively (p<0.05. Conclusion: Under standard operating conditions, procedures performed without glove change are shorter and cost effective than procedures performed with regular glove change with similar surgical and functional results. Judicious use of surgical gloves is a patient and environment friendly option, thereby reducing the hospital’s biomedical waste load.

Surgical medical record

DEFF Research Database (Denmark)

Bulow, S.

2008-01-01

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

An Observational Assessment of Anesthesia Capacity in Madagascar as a Prerequisite to the Development of a National Surgical Plan.

Science.gov (United States)

Baxter, Linden S; Ravelojaona, Vaonandianina A; Rakotoarison, Hasiniaina N; Herbert, Alison; Bruno, Emily; Close, Kristin L; Andean, Vanessa; Andriamanjato, Hery H; Shrime, Mark G; White, Michelle C

2017-06-01

The global lack of anesthesia capacity is well described, but country-specific data are needed to provide country-specific solutions. We aimed to assess anesthesia capacity in Madagascar as part of the development of a Ministry of Health national surgical plan. As part of a nationwide surgical safety quality improvement project, we surveyed 19 of 22 regional hospitals, representing surgical facilities caring for 75% of the total population. The assessment was divided into 3 areas: anesthesia workforce density, infrastructure and equipment, and medications. Data were obtained by semistructured interviews with Ministry of Health officials, hospital directors, technical directors, statisticians, pharmacists, and anesthesia providers and through on-site observations. Interview questions were adapted from the World Health Organization Situational Analysis Tool and the World Federation of Societies of Anaesthesiologists International Standards for Safe Practice of Anaesthesia. Additional data on workforce density were collected from the 3 remaining regions so that workforce density data are representative of all 22 regions. Anesthesia physician workforce density is 0.26 per 100,000 population and 0.19 per 100,000 outside of the capital region. Less than 50% of hospitals surveyed reported having a reliable electricity and oxygen supply. The majority of anesthesia providers work without pulse oximetry (52%) or a functioning vaporizer (52%). All the hospitals surveyed had very basic pediatric supplies, and none had a pediatric pulse oximetry probe. Ketamine is universally available but more than 50% of hospitals lack access to opioids. None of the 19 regional hospitals surveyed was able to completely meet the World Federation of Societies of Anaesthesiologists' standards for monitoring. Improving anesthesia care is complex. Capacity assessment is a first step that would enable progress to be tracked against specific targets. In Madagascar, scale-up of the anesthesia

41 CFR 105-71.132 - Equipment.

Science.gov (United States)

2010-07-01

.... (4) When acquiring replacement equipment, the grantee or subgrantee may use the equipment to be... managing equipment (including replacement equipment), whether acquired in whole or in part with grant funds... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Equipment. 105-71.132...

1968 Listing of Swimming Pool Equipment.

Science.gov (United States)

National Sanitation Foundation, Ann Arbor, MI. Testing Lab.

An up-to-date listing of swimming pool equipment including--(1) companies authorized to display the National Sanitation Foundation seal of approval, (2) equipment listed as meeting NSF swimming pool equipment standards relating to diatomite type filters, (3) equipment listed as meeting NSF swimming pool equipment standard relating to sand type…

A new virtual-reality training module for laparoscopic surgical skills and equipment handling: can multitasking be trained? A randomized controlled trial

NARCIS (Netherlands)

Bongers, P.J.; van Hove, P.D.; Stassen, L.P.S.; Schreuder, HWR; Dankelman, J.

Objective During laparoscopic surgery distractions often occur and multitasking between surgery and other tasks, such as technical equipment handling, is a necessary competence. In psychological research, reduction of adverse effects of distraction is demonstrated when specifically multitasking is

29 CFR 1926.952 - Mechanical equipment.

Science.gov (United States)

2010-07-01

... equipment that are not covered with insulating protective equipment. (c) Derrick trucks, cranes and other lifting equipment. (1) All derrick trucks, cranes and other lifting equipment shall comply with subpart N...

Pediatric abdominal non-Hodgkin's lymphoma: diagnosis through surgical and non-surgical procedures.

Science.gov (United States)

Aguiar, Arthur Almeida; Lima, Luciana Cavalvanti; Araújo, Cláudia Corrêa de; Gallindo, Rodrigo Melo

2017-12-29

To describe the success rate and the complications after procedures to diagnose abdominal non-Hodgkin's lymphoma in children and adolescents. A retrospective cross-sectional study was conducted with a population consisting of children and adolescents with abdominal non-Hodgkin's lymphoma diagnosed between September 1994 and December 2012. The sample comprised of 100 patients who underwent 113 diagnostic procedures, including urgent surgery (n=21), elective surgery (n=36), and non-surgical diagnosis (n=56). The most frequent procedures were laparotomy (46.9%) and ultrasound-guided core biopsy (25.6%). The rate of diagnostic success was 95.2% for urgent surgeries; 100% for elective surgeries and 82.1% for non-surgical procedures (p<0.05). The rates of complication during the three diagnosis procedures considered were significant (p<0.001; 95.2% of the urgent surgeries, 83.8% of the elective surgeries, and 10.7% of the non-surgical procedures). The length of time before resuming a full diet and starting chemotherapy was significantly reduced for patients who underwent non-surgical procedures when compared with the other procedures (p<0.001). Non-surgical procedures for the diagnosis of pediatric abdominal non-Hodgkin's lymphoma are an effective option with low morbidity rate, allowing an earlier resumption of a full diet and chemotherapy initiation. Furthermore, non-surgical procedures should also be considered for obtaining tumor samples from patients with extensive disease. Copyright © 2017. Published by Elsevier Editora Ltda.

Equipment Operational Requirements

Energy Technology Data Exchange (ETDEWEB)

Greenwalt, B; Henderer, B; Hibbard, W; Mercer, M

2009-06-11

The Iraq Department of Border Enforcement is rich in personnel, but poor in equipment. An effective border control system must include detection, discrimination, decision, tracking and interdiction, capture, identification, and disposition. An equipment solution that addresses only a part of this will not succeed, likewise equipment by itself is not the answer without considering the personnel and how they would employ the equipment. The solution should take advantage of the existing in-place system and address all of the critical functions. The solutions are envisioned as being implemented in a phased manner, where Solution 1 is followed by Solution 2 and eventually by Solution 3. This allows adequate time for training and gaining operational experience for successively more complex equipment. Detailed descriptions of the components follow the solution descriptions. Solution 1 - This solution is based on changes to CONOPs, and does not have a technology component. It consists of observers at the forts and annexes, forward patrols along the swamp edge, in depth patrols approximately 10 kilometers inland from the swamp, and checkpoints on major roads. Solution 2 - This solution adds a ground sensor array to the Solution 1 system. Solution 3 - This solution is based around installing a radar/video camera system on each fort. It employs the CONOPS from Solution 1, but uses minimal ground sensors deployed only in areas with poor radar/video camera coverage (such as canals and streams shielded by vegetation), or by roads covered by radar but outside the range of the radar associated cameras. This document provides broad operational requirements for major equipment components along with sufficient operational details to allow the technical community to identify potential hardware candidates. Continuing analysis will develop quantities required and more detailed tactics, techniques, and procedures.

Characterization equipment essential drawing plan

International Nuclear Information System (INIS)

WILSON, G.W.

1999-01-01

The purpose of this document is to list the Characterization equipment drawings that are classified as Essential Drawings. Essential Drawings: Are those drawings identified by the facility staff as necessary to directly support the safe operation of the facility or equipment (HNF 1997a). The Characterization equipment drawings identified in this report are deemed essential drawings as defined in HNF-PRO-242, Engineering Drawing Requirements (HNF 1997a). These drawings will be prepared, revised, and maintained per HNF-PRO-440, Engineering Document Change Control (HNF 1997b). All other Characterization equipment drawings not identified in this document will be considered Support drawings until the Characterization Equipment Drawing Evaluation Report is completed

Employment of the equipment for laser physiotherapy Fisser 21 in dehiscent wounds of aesthetic surgery

International Nuclear Information System (INIS)

Lopez Bannos, Miguel; Combarro Romero, Andres M.; Cunill Rodriguez, Margarita; Orellana Molina, Alina A.; Larrea Cox, Pedro J.; Hernandez Diaz, Adel; Fernandez Yanes, Sandra

2009-01-01

The results achieved on the clinical assay, which took place on the 'Miguel Enrique' Surgical and Clinical Hospital, are presented. The main objective is to evaluate the therapeutic efficacy of the equipment for laser physiotherapy Fisser 21, over the healing of dehiscent wounds after the aesthetic surgery, comparing them with the most common treatment with antibiotics. All data obtained between two groups were analyzed, the first one with laser therapy (21 patients), and the other one with conventional treatment (18 patients). Taking into account such comparison, the dependence of the speed of reduction of the dehiscence width from the time of healing of this kind of wounds is proposed. (Author)

Difficult airway equipment in departments of emergency medicine in Ireland: results of a national survey.

LENUS (Irish Health Repository)

Walsh, K

2012-02-03

BACKGROUND AND OBJECTIVE: Adverse effects associated with difficult airway management can be catastrophic and include death, brain injury and myocardial injury. Closed-malpractice claims have shown prolonged and persistent attempts at endotracheal intubation to be the most common situation leading to disastrous respiratory events. To date, there has been no evaluation of the types of difficult airway equipment currently available in Irish departments of emergency medicine. The objective of this survey was to identify the difficult airway equipment available in Irish departments of emergency medicine. METHODS: Departments of emergency medicine in the Republic of Ireland with at least one dedicated Emergency Medicine consultant were surveyed via telephone. RESULTS: All of the departments contacted held at least one alternative device on site for both ventilation and intubation. The most common alternative ventilation device was the laryngeal mask airway (89%). The most common alternative intubating device was the surgical airway device (100%). CONCLUSIONS: Irish departments of emergency medicine compare well with those in the UK and USA, when surveyed concerning difficult airway equipment. However, we believe that this situation could be further improved by training inexperienced healthcare providers in the use of the laryngeal mask airway and intubating laryngeal mask airway, by placing greater emphasis on the ready availability of capnography and by the increased use of portable difficult airway storage units.

Energy to the Edge (E2E) Equipment Assessment U.S. Army Rapid Equipping Force

Science.gov (United States)

2015-05-01

84 Contents Energy to the Edge • U.S. Army Rapid Equipping Force U.S. Army Rapid Equipping Force 1.0 Executive Summary Executive Summary U.S. Army... audiovisual equipment. • Once radiant barrier liner is inserted, the process of subsequent setups • Cables for lighting and outlets are located...behind the internal barrier • The shelter comes with organic audiovisual equipment. b. • • This shelter has a different setup and tear down process

Information technology equipment cooling method

Science.gov (United States)

Schultz, Mark D.

2015-10-20

According to one embodiment, a system for removing heat from a rack of information technology equipment may include a sidecar indoor air to liquid heat exchanger that cools air utilized by the rack of information technology equipment to cool the rack of information technology equipment. The system may also include a liquid to liquid heat exchanger and an outdoor heat exchanger. The system may further include configurable pathways to connect and control fluid flow through the sidecar heat exchanger, the liquid to liquid heat exchanger, the rack of information technology equipment, and the outdoor heat exchanger based upon ambient temperature and/or ambient humidity to remove heat generated by the rack of information technology equipment.

Equipment abnormality monitoring device

International Nuclear Information System (INIS)

Ando, Yasumasa

1991-01-01

When an operator hears sounds in a plantsite, the operator compares normal sounds of equipment which he previously heard and remembered with sounds he actually hears, to judge if they are normal or abnormal. According to the method, there is a worry that abnormal conditions can not be appropriately judged in a case where the number of objective equipments is increased and in a case that the sounds are changed gradually slightly. Then, the device of the present invention comprises a plurality of monitors for monitoring the operation sound of equipments, a recording/reproducing device for recording and reproducing the signals, a selection device for selecting the reproducing signals among the recorded signals, an acoustic device for converting the signals to sounds, a switching device for switching the signals to be transmitted to the acoustic device between to signals of the monitor and the recording/reproducing signals. The abnormality of the equipments can be determined easily by comparing the sounds representing the operation conditions of equipments for controlling the plant operation and the sounds recorded in their normal conditions. (N.H.)

40 CFR 31.32 - Equipment.

Science.gov (United States)

2010-07-01

... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Equipment. 31.32 Section 31.32...

14 CFR 1273.32 - Equipment.

Science.gov (United States)

2010-01-01

... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Equipment. 1273.32 Section 1273.32...

29 CFR 1470.32 - Equipment.

Science.gov (United States)

2010-07-01

... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 29 Labor 4 2010-07-01 2010-07-01 false Equipment. 1470.32 Section 1470.32 Labor Regulations...

38 CFR 43.32 - Equipment.

Science.gov (United States)

2010-07-01

... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Equipment. 43.32 Section...

Using dummies for surgical skills training

DEFF Research Database (Denmark)

Langebæk, Rikke

2011-01-01

Effective acquisition of a skill requires practise. Therefore it is of great importance to provide veterinary students with opportunities to practice their surgical skills before carrying out surgical procedures on live patients. Some veterinary schools let students perform entire surgical...... procedures on research animals, in order to learn the basic skills along the way. From an ethical point of view it is questionable however to use live research animals for the sole purpose of practising surgery, and also, research animals are very costly. It is therefore necessary to identify alternative...... teaching methods for veterinary surgical training. At the Department of Small Animal Clinical Sciences, Faculty of Life Sciences, a number of low fidelity, stuffed toy animal dummies was developed for the Surgical Skills Lab in order to teach 4th year students the basic surgical skills. In the Surgical...

Making petroleum equipment safe, a priority

International Nuclear Information System (INIS)

1999-01-01

Changes to the 'Act respecting the use of petroleum products' have been announced effective May 1, 1999. The changes have been made to reduce problems which can be attributed to petroleum product leaks. The new regulations will make owners and users of petroleum equipment, including underground and above-ground storage equipment and commercial storage tanks, more accountable for the use of their own equipment. The emphasis in the new regulations is based upon the storage capacity of petroleum equipment and the risks associated with this equipment, rather than the on the activities of the owners concerned. Accordingly, the new regulations call for stricter requirements for high-risk equipment, a private equipment inspection plan, a two-year operating permit, replacing the current permits and certificates, a tariff structure based on the risks associated with the equipment, and deregulation of commercial activities involving petroleum products that require no equipment. Additionally, the amendments to the Act transfer responsibility for administration to the Regie du batiment and to the Ministere des Transports. Details of each of these changes are explained

Surgical navigation with QR codes

Directory of Open Access Journals (Sweden)

Katanacho Manuel

2016-09-01

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

13 CFR 143.32 - Equipment.

Science.gov (United States)

2010-01-01

... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Equipment. 143.32 Section 143.32...

32 CFR 33.32 - Equipment.

Science.gov (United States)

2010-07-01

... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 32 National Defense 1 2010-07-01 2010-07-01 false Equipment. 33.32 Section 33.32 National Defense...

45 CFR 92.32 - Equipment.

Science.gov (United States)

2010-10-01

... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 45 Public Welfare 1 2010-10-01 2010-10-01 false Equipment. 92.32 Section 92.32 Public Welfare...

15 CFR 24.32 - Equipment.

Science.gov (United States)

2010-01-01

... awarding agency. (d) Management requirements. Procedures for managing equipment (including replacement... return. (e) Disposition. When original or replacement equipment acquired under a grant or subgrant is no... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Equipment. 24.32 Section 24.32...

Seismic qualification of non-safety class equipment whose failure would damage safety class equipment

International Nuclear Information System (INIS)

LaSalle, F.R.

1991-01-01

Both Code of Federal Regulations, Title 10, Part 50, and US Department of Energy Order 6340.1A have requirements to assess the interaction of non-safety and safety class structures and equipment during a seismic event to maintain the safety function. At the Hanford Site, a cost effective program has been developed to perform the evaluation of non-safety class equipment. Seismic qualification is performed by analysis, test, or upgrading of the equipment to ensure the integrity of safety class structures and equipment. This paper gives a brief overview and synopsis that address design analysis guidelines including applied loading, damping values, component anchorage, allowable loads, and stresses. Test qualification of equipment and walkdown acceptance criteria for heating ampersand ventilation (H ampersand V) ducting, conduit, cable tray, missile zone of influence, as well as energy criteria are presented

Days individual equipment of protection and professional risks; Equipements de protection individuelle et risques professionnelles

Energy Technology Data Exchange (ETDEWEB)

NONE

2007-07-01

The personal protection equipment is studied in the legal way (legal liabilities, certification, European texts), technical way (ergonomics, painfulness of ventilated equipment wearing, reliability of a respirable air line, protection gloves against the chemical risk, exposure to nano particulates, working in hot area), human factors (hostile area and emotion management), studies on personal equipment such evaluation, efficiency, conception of new equipment, physiological tolerance, limit of use, and some general safety studies on the working places. (N.C.)

The Settings, Pros and Cons of the New Surgical Robot da Vinci Xi System for Transoral Robotic Surgery (TORS): A Comparison With the Popular da Vinci Si System.

Science.gov (United States)

Kim, Da Hee; Kim, Hwan; Kwak, Sanghyun; Baek, Kwangha; Na, Gina; Kim, Ji Hoon; Kim, Se Heon

2016-10-01

The da Vinci system (da Vinci Surgical System; Intuitive Surgical Inc.) has rapidly developed in several years from the S system to the Si system and now the Xi System. To investigate the surgical feasibility and to provide workflow guidance for the newly released system, we used the new da Vinci Xi system for transoral robotic surgery (TORS) on a cadaveric specimen. Bilateral supraglottic partial laryngectomy, hypopharyngectomy, lateral oropharyngectomy, and base of the tongue resection were serially performed in search of the optimal procedures with the new system. The new surgical robotic system has been upgraded in all respects. The telescope and camera were incorporated into one system, with a digital end-mounted camera. Overhead boom rotation allows multiquadrant access without axis limitation, the arms are now thinner and longer with grabbing movements for easy adjustments. The patient clearance button dramatically reduces external collisions. The new surgical robotic system has been optimized for improved anatomic access, with better-equipped appurtenances. This cadaveric study of TORS offers guidance on the best protocol for surgical workflow with the new Xi system leading to improvements in the functional results of TORS.

Equipment standards for interventional cardiology

International Nuclear Information System (INIS)

Dowling, A.; Gallagher, A.; Walsh, C.; Malone, J.

2005-01-01

Interventional radiology has seen rapid growth in cardiology and represents an alternative to hazardous surgery. Recently there has been a substantial growth in the number of procedures being performed and interventional cardiology (IC) procedures are the most common interventional procedures in Europe. Advances in imaging technology have facilitated the development of increasingly complex radiological IC equipment. Currently, the technology is developing at a rate ahead of supporting research, equipment standards and a regulatory framework. International standards play a key role in the design, manufacture and performance of radiological IC equipment. A survey of 12 IC systems (15 imaging chains) was conducted in Irish hospitals. The aim of the study was to assess the imbalance between rapidly advancing technology and existing standards and to propose recommendations for new IC equipment standards. The results demonstrate the need for definitive equipment requirements and standardisation in the design, manufacture, acceptance and maintenance of IC equipment. (authors)

Development and participant assessment of a practical quality improvement educational initiative for surgical residents.

Science.gov (United States)

Sellers, Morgan M; Hanson, Kristi; Schuller, Mary; Sherman, Karen; Kelz, Rachel R; Fryer, Jonathan; DaRosa, Debra; Bilimoria, Karl Y

2013-06-01

As patient-safety and quality efforts spread throughout health care, the need for physician involvement is critical, yet structured training programs during surgical residency are still uncommon. Our objective was to develop an extended quality-improvement curriculum for surgical residents that included formal didactics and structured practical experience. Surgical trainees completed an 8-hour didactic program in quality-improvement methodology at the start of PGY3. Small teams developed practical quality-improvement projects based on needs identified during clinical experience. With the assistance of the hospital's process-improvement team and surgical faculty, residents worked through their selected projects during the following year. Residents were anonymously surveyed after their participation to assess the experience. During the first 3 years of the program, 17 residents participated, with 100% survey completion. Seven quality-improvement projects were developed, with 57% completing all DMAIC (Define, Measure, Analyze, Improve, Control) phases. Initial projects involved issues of clinical efficiency and later projects increasingly focused on clinical care questions. Residents found the experience educationally important (65%) and believed they were well equipped to lead similar initiatives in the future (70%). Based on feedback, the timeline was expanded from 12 to 24 months and changed to start in PGY2. Developing an extended curriculum using both didactic sessions and applied projects to teach residents the theory and implementation of quality improvement is possible and effective. It addresses the ACGME competencies of practice-based improvement and learning and systems-based practice. Our iterative experience during the past 3 years can serve as a guide for other programs. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Combined Surgical Treatment of Gynecomastia

Directory of Open Access Journals (Sweden)

Yordanov Y.

2015-05-01

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

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

Science.gov (United States)

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

2015-12-01

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

Equipment for hydraulic testing

International Nuclear Information System (INIS)

Jacobsson, L.; Norlander, H.

1981-07-01

Hydraulic testing in boreholes is one major task of the hydrogeological program in the Stripa Project. A new testing equipment for this purpose was constructed. It consists of a downhole part and a surface part. The downhole part consists of two packers enclosing two test-sections when inflated; one between the packers and one between the bottom packer and the bottom of the borehole. A probe for downhole electronics is also included in the downhole equipment together with electrical cable and nylon tubing. In order to perform shut-in and pulse tests with high accuracy a surface controlled downhole valve was constructed. The surface equipment consists of the data acquisition system, transducer amplifier and surface gauges. In the report detailed descriptions of each component in the whole testing equipment are given. (Auth.)

Nigerian Journal of Surgical Research

African Journals Online (AJOL)

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

Access to emergency and surgical care in sub-Saharan Africa: the infrastructure gap.

Science.gov (United States)

Hsia, Renee Y; Mbembati, Naboth A; Macfarlane, Sarah; Kruk, Margaret E

2012-05-01

The effort to increase access to emergency and surgical care in low-income countries has received global attention. While most of the literature on this issue focuses on workforce challenges, it is critical to recognize infrastructure gaps that hinder the ability of health systems to make emergency and surgical care a reality. This study reviews key barriers to the provision of emergency and surgical care in sub-Saharan Africa using aggregate data from the Service Provision Assessments and Demographic and Health Surveys of five countries: Ghana, Kenya, Rwanda, Tanzania and Uganda. For hospitals and health centres, competency was assessed in six areas: basic infrastructure, equipment, medicine storage, infection control, education and quality control. Percentage of compliant facilities in each country was calculated for each of the six areas to facilitate comparison of hospitals and health centres across the five countries. The percentage of hospitals with dependable running water and electricity ranged from 22% to 46%. In countries analysed, only 19-50% of hospitals had the ability to provide 24-hour emergency care. For storage of medication, only 18% to 41% of facilities had unexpired drugs and current inventories. Availability of supplies to control infection and safely dispose of hazardous waste was generally poor (less than 50%) across all facilities. As few as 14% of hospitals (and as high as 76%) among those surveyed had training and supervision in place. No surveyed hospital had enough infrastructure to follow minimum standards and practices that the World Health Organization has deemed essential for the provision of emergency and surgical care. The countries where these hospitals are located may be representative of other low-income countries in sub-Saharan Africa. Thus, the results suggest that increased attention to building up the infrastructure within struggling health systems is necessary for improvements in global access to medical care.

American Pediatric Surgical Association

Science.gov (United States)

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

Shipboard and laboratory equipment

Digital Repository Service at National Institute of Oceanography (India)

Shyamprasad, M.; Ramaswamy, V.

The polymetallic nodules occur at an average depth of 4500 m. Adequate equipment and techniques are required for the exploration at such depths. Shipboard and various laboratory equipments for the sampling of polymetallic nodules is described...

40 CFR 792.61 - Equipment design.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Equipment design. 792.61 Section 792.61...) GOOD LABORATORY PRACTICE STANDARDS Equipment § 792.61 Equipment design. Equipment used in the... of appropriate design and adequate capacity to function according to the protocol and shall be...

40 CFR 160.61 - Equipment design.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Equipment design. 160.61 Section 160... LABORATORY PRACTICE STANDARDS Equipment § 160.61 Equipment design. Equipment used in the generation... appropriate design and adequate capacity to function according to the protocol and shall be suitably located...

Equipment installation structure of roof slab for tank type FBR and method of equipment installation

International Nuclear Information System (INIS)

Sakai, Takao; Yamakawa, Masanori; Otsuka, Masaya; Sekine, Katsuhisa

1986-01-01

Purpose: To reduce equipment thermal stress and deformation by eliminating uneven temperature distribution caused at the equipment through section of the roof slab for the tank FBR, and at the same time, simplify the structure installation. Method: Multiple number of vertical fin projects are fit on the equipment through-section inside wall for the roof slab and the cylindrical equipment peripheral wall, and with these projected fins, the ring space of the through section is vertically divided into multiple sections in the circumferential direction. The vertical fins on the through-section inside wall and the fins on the equipment peripheral wall are contacted with each other by revolving them in the lateral direction. As a result, the natural convection caused by the difference of temperatures in the vertical direction of the ring space becomes a convection within each sector divided, and never generates circumferential circulation, which reduce uneven temperature distribution caused at the equipment through section. (Kawakami, Y.)

Urogynecologic Surgical Mesh Implants

Science.gov (United States)

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

Management methodology for pressure equipment

Science.gov (United States)

Bletchly, P. J.

Pressure equipment constitutes a significant investment in capital and a major proportion of potential high-risk plant in many operations and this is particularly so in an alumina refinery. In many jurisdictions pressure equipment is also subject to statutory regulation that imposes obligations on Owners of the equipment with respect to workplace safety. Most modern technical standards and industry codes of practice employ a risk-based approach to support better decision making with respect to pressure equipment. For a management system to be effective it must demonstrate that risk is being managed within acceptable limits.

Surgical therapy in chronic pancreatitis.

Science.gov (United States)

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

2012-12-01

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

21 CFR 58.61 - Equipment design.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Equipment design. 58.61 Section 58.61 Food and... PRACTICE FOR NONCLINICAL LABORATORY STUDIES Equipment § 58.61 Equipment design. Equipment used in the... of appropriate design and adequate capacity to function according to the protocol and shall be...

Accomplishments and challenges of surgical simulation.

Science.gov (United States)

Satava, R M

2001-03-01

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

21 CFR 866.4540 - Immunonephelometer equipment.

Science.gov (United States)

2010-04-01

...) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents § 866.4540 Immunonephelometer equipment. (a) Identification. Immunonephelometer equipment for clinical use...

Maintenance program guidelines for programmatic equipment

International Nuclear Information System (INIS)

1994-11-01

The Division Directors at Lawrence Berkeley Laboratory are responsible for implementing a maintenance program for research equipment (also referred to as programmatic equipment) assigned to them. The program must allow maintenance to be accomplished in a manner that promotes operational safety, environmental protection and compliance, and cost effectiveness; that preserves the intended functions of the facilities and equipment; and that supports the programmatic mission of the Laboratory. Programmatic equipment -- such as accelerators, lasers, radiation detection equipment, and glove boxes -- is dedicated specifically to research. Installed equipment, by contrast, includes the mechanical and electrical systems installed as part of basic building construction, equipment essential to the normal functioning of the facility and its intended use. Examples of installed equipment are heating, ventilating, and air conditioning systems; elevators; and communications systems. The LBL Operating and Assurance Program Plan (PUB-3111, Revision 4) requires that a maintenance program be prepared for programmatic equipment and defines the basic maintenance program elements. Such a program of regular, documented maintenance is vital to the safety and quality of research activities. As a part of that support, this document offers guidance to Laboratory organizations for developing their maintenance programs. It clarifies the maintenance requirements of the Operating and Assurance Program (OAP) and presents an approach that, while not the only possibility, can be expected to produce an effective maintenance program for research equipment belonging to the Laboratory's organizations

Development of Turbulence-Measuring Equipment

Science.gov (United States)

Kovasznay, Leslie S G

1954-01-01

Hot wire turbulence-measuring equipment has been developed to meet the more stringent requirements involved in the measurement of fluctuations in flow parameters at supersonic velocities. The higher mean speed necessitates the resolution of higher frequency components than at low speed, and the relatively low turbulence level present at supersonic speed makes necessary an improved noise level for the equipment. The equipment covers the frequency range from 2 to about 70,000 cycles per second. Constant-current operation is employed. Compensation for hot-wire lag is adjusted manually using square-wave testing to indicate proper setting. These and other features make the equipment adaptable to all-purpose turbulence work with improved utility and accuracy over that of older types of equipment. Sample measurements are given to demonstrate the performance.

21 CFR 866.4520 - Immunofluorometer equipment.

Science.gov (United States)

2010-04-01

...) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Immunology Laboratory Equipment and Reagents § 866.4520 Immunofluorometer equipment. (a) Identification. Immunofluorometer equipment for clinical use with...

Surgical Space Suits Increase Particle and Microbiological Emission Rates in a Simulated Surgical Environment.

Science.gov (United States)

Vijaysegaran, Praveen; Knibbs, Luke D; Morawska, Lidia; Crawford, Ross W

2018-05-01

The role of space suits in the prevention of orthopedic prosthetic joint infection remains unclear. Recent evidence suggests that space suits may in fact contribute to increased infection rates, with bioaerosol emissions from space suits identified as a potential cause. This study aimed to compare the particle and microbiological emission rates (PER and MER) of space suits and standard surgical clothing. A comparison of emission rates between space suits and standard surgical clothing was performed in a simulated surgical environment during 5 separate experiments. Particle counts were analyzed with 2 separate particle counters capable of detecting particles between 0.1 and 20 μm. An Andersen impactor was used to sample bacteria, with culture counts performed at 24 and 48 hours. Four experiments consistently showed statistically significant increases in both PER and MER when space suits are used compared with standard surgical clothing. One experiment showed inconsistent results, with a trend toward increases in both PER and MER when space suits are used compared with standard surgical clothing. Space suits cause increased PER and MER compared with standard surgical clothing. This finding provides mechanistic evidence to support the increased prosthetic joint infection rates observed in clinical studies. Copyright © 2017 Elsevier Inc. All rights reserved.

Teaching surgical exposures to undergraduate medical students: an integration concept for anatomical and surgical education.

Science.gov (United States)

Hammer, Niels; Hepp, Pierre; Löffler, Sabine; Schleifenbaum, Stefan; Steinke, Hanno; Klima, Stefan

2015-06-01

Decreasing numbers of students are interested in starting a surgical career, posing substantial challenges to patient care in the next years. The anatomy course is one of the key subjects in medical training, especially in surgical disciplines. Innovative teaching concepts that integrate surgically relevant anatomy and manual dexterity might help boost student interest in surgery. A preclinical workshop entitled "Surgical exposures" was developed. A team of anatomists and surgeons introduced the surgical exposures, demonstrating the procedures on Thiel-fixed body donors. Following this introduction, students practiced the exposures in an operating room-like manner. A six-point Likert scale was used to evaluate the workshop and to compare it to the first-year dissection course. The overall evaluation result for the surgical exposures was excellent, proving to be a significantly better result when compared to the first-year dissection course. The students were more satisfied with the teaching time invested by the peers and regarded the workshop as clinically highly relevant. Furthermore, they felt that questions were addressed better and that the overall atmosphere was better than in the gross anatomy course. Subject to criticism was the course size and practicing time in both cases. The surgical exposures workshop provides preclinical students with clinically relevant anatomy and manual dexterity. It may positively influence the decision to follow a surgical career. This course, however, requires extensive teaching resources. The given concept may help implement practical medical skills in the preclinical curriculum, strengthening the professional identity of surgeons and anatomists.

Cost Comparison of Fundamentals of Laparoscopic Surgery Training Completed With Standard Fundamentals of Laparoscopic Surgery Equipment versus Low-Cost Equipment.

Science.gov (United States)

Franklin, Brenton R; Placek, Sarah B; Wagner, Mercy D; Haviland, Sarah M; O'Donnell, Mary T; Ritter, E Matthew

Training for the Fundamentals of Laparoscopic Surgery (FLS) skills test can be expensive. Previous work demonstrated that training on an ergonomically different, low-cost platform does not affect FLS skills test outcomes. This study compares the average training cost with standard FLS equipment and medical-grade consumables versus training on a lower cost platform with non-medical-grade consumables. Subjects were prospectively randomized to either the standard FLS training platform (n = 19) with medical-grade consumables (S-FLS), or the low-cost platform (n = 20) with training-grade products (LC-FLS). Both groups trained to proficiency using previously established mastery learning standards on the 5 FLS tasks. The fixed and consumable cost differences were compared. Training occurred in a surgical simulation center. Laparoscopic novice medical student and resident physician health care professionals who had not completed the national FLS proficiency curriculum and who had performed less than 10 laparoscopic cases. The fixed cost of the platform was considerably higher in the S-FLS group (S-FLS, $3360; LC-FLS, $879), and the average consumable training cost was significantly higher for the S-FLS group (S-FLS, $1384.52; LC-FLS, $153.79; p group had a statistically discernable cost reduction for each consumable (Gauze $9.24 vs. $0.39, p = 0.002; EndoLoop $540.00 vs. $40.60, p group versus $1647.95 in the LC-FLS group. This study shows that the average cost to train a single trainee to proficiency using a lower fixed-cost platform and non-medical-grade equipment results in significant financial savings. A 5-resident program will save approximately $8500 annually. Residency programs should consider adopting this strategy to reduce the cost of FLS training. Published by Elsevier Inc.

Data Center Equipment Location and Monitoring System

DEFF Research Database (Denmark)

2013-01-01

Abstract: Data center equipment location systems include hardware and software to provide information on the location, monitoring, and security of servers and other equipment in equipment racks. The systems provide a wired alternative to the wireless RFID tag system by using electronic ID tags...... connected to each piece of equipment, each electronic ID tag connected directly by wires to an equipment rack controller on the equipment rack. The equipment rack controllers link to a central control computer that provides an operator ...

Surgical ethics: surgical virtue and more.

Science.gov (United States)

Vercler, Christian J

2015-01-01

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

Duration of orthognathic-surgical treatment.

Science.gov (United States)

Paunonen, Jaakko; Helminen, Mika; Peltomäki, Timo

2017-07-01

The objective of this study was to determine the duration of orthognathic-surgical treatment conducted with conventional pre- and post-surgical orthodontic treatment phases. The study material was comprised of the files of 185 consecutive patients treated in Oral and Maxillofacial Unit, Tampere University Hospital, Finland, in 2007-2014. The files were reviewed and the following data was obtained: gender and age of patients, ICD-10 diagnosis, type of malocclusion, duration of pre- and post-surgical orthodontic treatment and type of operation. Total treatment duration (median) from placement of separating rings for banding until fixed orthodontic appliances were removed and retention period started was 31.1 months, of which pre-surgical orthodontics took 24.4 months and postsurgical 6.4 months. Treatment duration (median) was in BSSO was 32.1, LeFort 1 30.1 and bimaxillary osteotomy 29.7 months. Orthodontic extractions were performed in 35 patients (19%). If the orthodontic treatment included tooth extraction, the duration of pre-surgical treatment was on average 10 months longer, which is a statistically highly significant difference (p pre-surgical orthodontic treatment prolong treatment time by an average of 8-9 months.

Equipment Reliability Process in Krsko NPP

International Nuclear Information System (INIS)

Gluhak, M.

2016-01-01

To ensure long-term safe and reliable plant operation, equipment operability and availability must also be ensured by setting a group of processes to be established within the nuclear power plant. Equipment reliability process represents the integration and coordination of important equipment reliability activities into one process, which enables equipment performance and condition monitoring, preventive maintenance activities development, implementation and optimization, continuous improvement of the processes and long term planning. The initiative for introducing systematic approach for equipment reliability assuring came from US nuclear industry guided by INPO (Institute of Nuclear Power Operations) and by participation of several US nuclear utilities. As a result of the initiative, first edition of INPO document AP-913, 'Equipment Reliability Process Description' was issued and it became a basic document for implementation of equipment reliability process for the whole nuclear industry. The scope of equipment reliability process in Krsko NPP consists of following programs: equipment criticality classification, preventive maintenance program, corrective action program, system health reports and long-term investment plan. By implementation, supervision and continuous improvement of those programs, guided by more than thirty years of operating experience, Krsko NPP will continue to be on a track of safe and reliable operation until the end of prolonged life time. (author).

Aggressive surgical management of craniopharyngiomas

Directory of Open Access Journals (Sweden)

Manmohan Singh

2013-01-01

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

Data center equipment location and monitoring system

DEFF Research Database (Denmark)

2011-01-01

A data center equipment location system includes both hardware and software to provide for location, monitoring, security and identification of servers and other equipment in equipment racks. The system provides a wired alternative to the wireless RFID tag system by using electronic ID tags...... connected to each piece of equipment, each electronic ID tag connected directly by wires to a equipment rack controller on the equipment rack. The equipment rack controllers then link over a local area network to a central control computer. The central control computer provides an operator interface......, and runs a software application program that communicates with the equipment rack controllers. The software application program of the central control computer stores IDs of the equipment rack controllers and each of its connected electronic ID tags in a database.; The software application program...

7 CFR 3015.167 - Replacement of equipment.

Science.gov (United States)

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Replacement of equipment. 3015.167 Section 3015.167..., DEPARTMENT OF AGRICULTURE UNIFORM FEDERAL ASSISTANCE REGULATIONS Property § 3015.167 Replacement of equipment. (a) If needed, equipment may be exchanged for replacement equipment. Replacement of equipment may be...

Three-Dimensional Printing Surgical Applications.

Science.gov (United States)

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

2015-01-01

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

Use of commercial grade equipment and industrial standards for equipment qualification

International Nuclear Information System (INIS)

Gradin, L.P.; Muller, E.S.

1984-01-01

One of the most controversial issues is the proper application of Arrhenius aging methodology. Naturally and artificially aged equipment used in type test programs are often costly and burdensome tasks. Appropriate use of non-nuclear industrial standards and comparison to past history can demonstrate, with reasonable assurance, that equipment is qualified with proper consideration of aging. Specific review of the industrial standards available and application examples are provided

A challenge-response endoscopic sinus surgery specific checklist as an add-on to standard surgical checklist: an evaluation of potential safety and quality improvement issues.

Science.gov (United States)

Sommer, Doron D; Arbab-Tafti, Sadaf; Farrokhyar, Forough; Tewfik, Marc; Vescan, Allan; Witterick, Ian J; Rotenberg, Brian; Chandra, Rakesh; Weitzel, Erik K; Wright, Erin; Ramakrishna, Jayant

2018-02-27

The goal of this study was to develop and evaluate the impact of an aviation-style challenge and response sinus surgery-specific checklist on potential safety and equipment issues during sinus surgery at a tertiary academic health center. The secondary goal was to assess the potential impact of use of the checklist on surgical times during, before, and after surgery. This initiative is designed to be utilized in conjunction with the "standard" World Health Organization (WHO) surgical checklist. Although endoscopic sinus surgery is generally considered a safe procedure, avoidable complications and potential safety concerns continue to occur. The WHO surgical checklist does not directly address certain surgery-specific issues, which may be of particular relevance for endoscopic sinus surgery. This prospective observational pilot study monitored compliance with and compared the occurrence of safety and equipment issues before and after implementation of the checklist. Forty-seven consecutive endoscopic surgeries were audited; the first 8 without the checklist and the following 39 with the checklist. The checklist was compiled by evaluating the patient journey, utilizing the available literature, expert consensus, and finally reevaluation with audit type cases. The final checklist was developed with all relevant stakeholders involved in a Delphi method. Implementing this specific surgical checklist in 39 cases at our institution, allowed us to identify and rectify 35 separate instances of potentially unsafe, improper or inefficient preoperative setup. These incidents included issues with labeling of topical vasoconstrictor or injectable anesthetics (3, 7.7%) and availability, function and/or position of video monitors (2, 5.1%), endoscope (6, 15.4%), microdebrider (6, 15.4%), bipolar cautery (6, 15.4%), and suctions (12, 30.8%). The design and integration of this checklist for endoscopic sinus surgery, has helped improve efficiency and patient safety in the operating

Cooling of electronic equipment

DEFF Research Database (Denmark)

A. Kristensen, Anders Schmidt

2003-01-01

Cooling of electronic equipment is studied. The design size of electronic equipment decrease causing the thermal density to increase. This affect the cooling which can cause for example failures of critical components due to overheating or thermal induced stresses. Initially a pin fin heat sink...

46 CFR 180.175 - Survival craft equipment.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Survival craft equipment. 180.175 Section 180.175... TONS) LIFESAVING EQUIPMENT AND ARRANGEMENTS Survival Craft Arrangements and Equipment § 180.175 Survival craft equipment. (a) General. Each item of survival craft equipment must be of good quality, and...

Reduced medical and occupational exposures by optimizing working procedures in fluoroscopy equipment in the University Hospital of Santa Maria (RS)

International Nuclear Information System (INIS)

Weis, Guilherme L.; Claus, Thiago V.; Baumhardt, Tadeu; Shuch, Luiz A.

2013-01-01

This work seeks to reduce medical (patient) and occupational (workers) exposure by standardizing resources available in fluoroscopy equipment used in interventional procedures. Such procedures use transportable surgical arch type fluoroscopy equipment, with applications in orthopedics, angiography and pacemaker implantation. Improper use of these devices generates excessive radiation doses in both patients and the medical staff. It is observed that the equipment after being connected to the grid, is pre-selected to work in continuous fluoroscopy and no additional filtration, producing higher doses of radiation. For specific applications, changes in protocols should be undertaken according to medical indication. This work used a fluoroscopy equipment Shimadzu Active Opescope two radiation monitoring equipment, brand Radcal, models 9010 and 9015, two ionization chambers, of 60 cc and 180 cc and a low contrast phantom and a catheter, information that simulate the human body. Incidences were performed by changing the conditions of exposure as frame rates (fps - frames per second) and additional filtration. For each composition parameters was generated and filed an image, with the extent of their respective doses. These images were evaluated by radiologists. In more extreme cases we obtained a reduction of a factor 25 in occupational exposure (medical personnel) using the pulsed with the greatest 2 fps additional filter (0.3 mm Cu) compared to continuous system without any additional filtration. In medical exposure (of patients), decreased by a factor 39, the same conditions described above. With these arguments it is justified the optimization and standardization of the equipment used in fluoroscopy, which besides providing a dose reduction the patient and the medical personnel, increases the life of the X-ray tube while maintaining the quality of medical diagnosis. (author)

Prioritizing equipment for replacement.

Science.gov (United States)

Capuano, Mike

2010-01-01

It is suggested that clinical engineers take the lead in formulating evaluation processes to recommend equipment replacement. Their skill, knowledge, and experience, combined with access to equipment databases, make them a logical choice. Based on ideas from Fennigkoh's scheme, elements such as age, vendor support, accumulated maintenance cost, and function/risk were used.6 Other more subjective criteria such as cost benefits and efficacy of newer technology were not used. The element of downtime was also omitted due to the data element not being available. The resulting Periop Master Equipment List and its rationale was presented to the Perioperative Services Program Council. They deemed the criteria to be robust and provided overwhelming acceptance of the list. It was quickly put to use to estimate required capital funding, justify items already thought to need replacement, and identify high-priority ranked items for replacement. Incorporating prioritization criteria into an existing equipment database would be ideal. Some commercially available systems do have the basic elements of this. Maintaining replacement data can be labor-intensive regardless of the method used. There is usually little time to perform the tasks necessary for prioritizing equipment. However, where appropriate, a clinical engineering department might be able to conduct such an exercise as shown in the following case study.

Surgical Management of Hemorrhoids

Science.gov (United States)

Agbo, S. P.

2011-01-01

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

[Simulation in surgical training].

Science.gov (United States)

Nabavi, A; Schipper, J

2017-01-01

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

46 CFR 108.719 - Pilot boarding equipment.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Pilot boarding equipment. 108.719 Section 108.719... AND EQUIPMENT Miscellaneous Equipment § 108.719 Pilot boarding equipment. (a) This section applies to... vessel must have suitable pilot boarding equipment available for use on each side of the vessel. If a...

46 CFR 109.347 - Pilot boarding equipment.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Pilot boarding equipment. 109.347 Section 109.347... OPERATIONS Operation and Stowage of Safety Equipment § 109.347 Pilot boarding equipment. (a) The master or person in charge shall ensure that pilot boarding equipment is maintained as follows: (1) The equipment...

Incorporating simulation into gynecologic surgical training.

Science.gov (United States)

Wohlrab, Kyle; Jelovsek, J Eric; Myers, Deborah

2017-11-01

Today's educational environment has made it more difficult to rely on the Halstedian model of "see one, do one, teach one" in gynecologic surgical training. There is decreased surgical volume, but an increased number of surgical modalities. Fortunately, surgical simulation has evolved to fill the educational void. Whether it is through skill generalization or skill transfer, surgical simulation has shifted learning from the operating room back to the classroom. This article explores the principles of surgical education and ways to introduce simulation as an adjunct to residency training. We review high- and low-fidelity surgical simulators, discuss the progression of surgical skills, and provide options for skills competency assessment. Time and money are major hurdles when designing a simulation curriculum, but low-fidelity models, intradepartmental cost sharing, and utilizing local experts for simulation proctoring can aid in developing a simulation program. Copyright © 2017 Elsevier Inc. All rights reserved.

Establishment of nuclear equipment qualification system

International Nuclear Information System (INIS)

Joo, Po Kook; Lim, Nam Jin; Lee, Young Gun

2003-04-01

This study is carried out by KEARI(Korea Atomic Energy Research Institute) as the lead organization in cooperation with KIMM(Korea Institute of Machinery and Materials), KTL(Korea Testing Laboratory) and KRISS(Korea Research Institute of Standards and Science) to construct a basis of efficient management of nuclear equipment qualification business by expanding test equipment of each of participating organization, and developing qualification technologies. As for KIMM, control system of large scale shaker was replaced with advanced system, and LOCA(Loss of Coolant Accident) test facility was installed. KTL is now capable of conducting seismic tests of nuclear I and C as a result of installation of seismic test equipment during the first two project years. KRISS participated in the Project with a view to have large scale EMI test equipment and related technologies. In parallel with expansion of test equipment, a industrial-educational-research cooperation committee, as an intermediate step toward integrated equipment qualification system to maximize the usage of test equipment, was established and cooperation methods were investigated. As a result, Korea Nuclear Equipment Qualification Association, an corporate juridical person, was established. Research on development of thermal and radiation aging test technology of nuclear materials was carried out by Hanyang University and SECO(Saehan Engineering and Qualification Co., Ltd.). Integrated Equipment Qualification Database was developed which contains material test data, equipment qualification data and other EQ related informations. Standard qualification procedures were developed in order for test laboratories and manufacturers to establish design requirements and to efficiently perform tests

Surgical education and training in an outer metropolitan hospital: a qualitative study of surgical trainers and trainees.

Science.gov (United States)

Nestel, Debra; Harlim, Jennifer; Bryant, Melanie; Rampersad, Rajay; Hunter-Smith, David; Spychal, Bob

2017-08-01

The landscape of surgical training is changing. The anticipated increase in the numbers of surgical trainees and the shift to competency-based surgical training places pressures on an already stretched health service. With these pressures in mind, we explored trainers' and trainees' experiences of surgical training in a less traditional rotation, an outer metropolitan hospital. We considered practice-based learning theories to make meaning of surgical training in this setting, in particular Actor-network theory. We adopted a qualitative approach and purposively sampled surgical trainers and trainees to participate in individual interviews and focus groups respectively. Transcripts were made and thematically analysed. Institutional human research ethics approval was obtained. Four surgical trainers and fourteen trainees participated. Almost without exception, participants' report training needs to be well met. Emergent inter-related themes were: learning as social activity; learning and programmatic factors; learning and physical infrastructure; and, learning and organizational structure. This outer metropolitan hospital is suited to the provision of surgical training with the current rotational system for trainees. The setting offers experiences that enable consolidation of learning providing a rich and varied overall surgical training program. Although relational elements of learning were paramount they occurred within a complex environment. Actor-network theory was used to give meaning to emergent themes acknowledging that actors (both people and objects) and their interactions combine to influence training quality, shifting the focus of responsibility for learning away from individuals to the complex interactions in which they work and learn.

Information technology equipment cooling system

Science.gov (United States)

Schultz, Mark D.

2014-06-10

According to one embodiment, a system for removing heat from a rack of information technology equipment may include a sidecar indoor air to liquid heat exchanger that cools warm air generated by the rack of information technology equipment. The system may also include a liquid to liquid heat exchanger and an outdoor heat exchanger. The system may further include configurable pathways to connect and control fluid flow through the sidecar heat exchanger, the liquid to liquid heat exchanger, the rack of information technology equipment, and the outdoor heat exchanger based upon ambient temperature and/or ambient humidity to remove heat from the rack of information technology equipment.

Isotope-equipped measuring instruments

International Nuclear Information System (INIS)

Miyagawa, Kazuo; Amano, Hiroshi

1980-01-01

In the steel industry, though the investment in isotope-equipped measuring instruments is small as compared with that in machinery, they play important role in the moisture measurement in sintering and blast furnaces, the thickness measurement in rolling process and others in automatic control systems. The economic aspect of the isotope-equipped measuring instruments is described on the basis of the practices in Kimitsu Works of Nippon Steel Corporation: distribution of such instruments, evaluation of economic effects, usefulness evaluation in view of raising the accuracy, and usefulness evaluation viewed from the failure of the isotope instruments. The evaluation of economic effects was made under the premise that the isotope-equipped measuring instruments are not employed. Then, the effects of raising the accuracy are evaluated for a γ-ray plate thickness gauge and a neutron moisture gauge for coke in a blast furnace. Finally, the usefulness was evaluated, assuming possible failure of the isotope-equipped measuring instruments. (J.P.N.)

Electronic equipment packaging technology

CERN Document Server

Ginsberg, Gerald L

1992-01-01

The last twenty years have seen major advances in the electronics industry. Perhaps the most significant aspect of these advances has been the significant role that electronic equipment plays in almost all product markets. Even though electronic equipment is used in a broad base of applications, many future applications have yet to be conceived. This versatility of electron­ ics has been brought about primarily by the significant advances that have been made in integrated circuit technology. The electronic product user is rarely aware of the integrated circuits within the equipment. However, the user is often very aware of the size, weight, mod­ ularity, maintainability, aesthetics, and human interface features of the product. In fact, these are aspects of the products that often are instrumental in deter­ mining its success or failure in the marketplace. Optimizing these and other product features is the primary role of Electronic Equipment Packaging Technology. As the electronics industry continues to pr...

Improved servicing equipment for steam generators

International Nuclear Information System (INIS)

Hedtke, James C.

1998-01-01

To help keep personnel exposure as low as reasonably achievable and reduce critical path outage time, most nuclear plants of PWR design in the USA are now using improved equipment to service their steam generators (SGs) during outages. Because of the success of this equipment in the USA, two Belgian plants and one English plant have purchased this equipment, and other nuclear plants in Europe are also considering procurement. The improved SG servicing equipment discussed in this paper discusses consists of nozzle dams, segmented multi-stud tensioner, primary manway cover handling tool set, shield door and fastener cleaner. This equipment is specifically designed for the individual plant application and can also be specified for replacement SG projects. All of the equipment can be used without modification of the existing SGs. (author)

Multimodal strategies to improve surgical outcome

DEFF Research Database (Denmark)

Kehlet, Henrik; Wilmore, Douglas W

2002-01-01

OBJECTIVE: To evaluate the effect of modifying perioperative care in noncardiac surgical patients on morbidity, mortality, and other outcome measures. BACKGROUND: New approaches in pain control, introduction of techniques that reduce the perioperative stress response, and the more frequent use...... anesthesia in elective operations, and pilot studies of fast track surgical procedures using the multimodality approach. RESULTS: The introduction of newer approaches to perioperative care has reduced both morbidity and mortality in surgical patients. In the future, most elective operations will become day...... surgical procedures or require only 1 to 2 days of postoperative hospitalization. Reorganization of the perioperative team (anesthesiologists, surgeons, nurses, and physical therapists) will be essential to achieve successful fast track surgical programs. CONCLUSIONS: Understanding perioperative...

Cost-Effective Surgical Management of Liver Disease Amidst a Financial Crisis.

Science.gov (United States)

Arkadopoulos, Nikolaos; Gemenetzis, Georgios; Danias, Nikolaos; Kokoropoulos, Panagiotis; Koukopoulou, Ioanna; Bartsokas, Christos; Kostopanagiotou, Georgia; Smyrniotis, Vassilios

2016-07-01

Intraoperative use of specialized equipment and disposables contributes to the increasing cost of modern liver surgery. As a response to the recent severe financial crisis in our country we have employed a highly standardized protocol of liver resection that minimizes intraoperative and postoperative costs. Our goal is to evaluate cost-effectiveness of this protocol. We evaluated retrospectively all patients who underwent open hepatic resections for 4 years. All resections were performed by the same surgical team under selective hepatic vascular exclusion, i.e., occlusion of the hepatoduodenal ligament and the major hepatic veins, occasionally combined with extrahepatic ligation of the ipsilateral portal vein. Sharp parenchymal transection was performed with a scalpel and hemostasis was achieved with sutures without the use of energy devices. In each case we performed a detailed analysis of costs and surgical outcomes. Our cohort included 146 patients (median age 63 years). 113 patients were operated for primary or metastatic malignancies and 33 for benign lesions. Operating time was 121 ± 21 min (mean ± SD), estimated blood loss was 310 ± 159 ml (mean ± SD), and hospital stay was 7 ± 5 days (mean ± SD). Six patients required admission in the ICU postoperatively. 90-day mortality was 2.74 %, and 8.9 % of patients developed grade III/IV postoperative complications (Clavien-Dindo classification). Total in-hospital cost excluding physician fees was 6987.63 ± 3838.51 USD (mean ± SD). Our analysis suggests that, under pressing economic conditions, the proposed surgical protocol can significantly lessen the financial burden of liver surgery without compromising patient outcomes.

3D Surgical Simulation

Science.gov (United States)

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

2009-01-01

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

Three-dimensional surgical simulation.

Science.gov (United States)

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

2010-09-01

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

Instituting a Surgical Skills Competition Increases Technical Performance of Surgical Clerkship Students Over Time.

Science.gov (United States)

Leraas, Harold J; Cox, Morgan L; Bendersky, Victoria A; Sprinkle, Shanna S; Gilmore, Brian F; Gunasingha, Rathnayaka M; Tracy, Elisabeth T; Sudan, Ranjan

2017-10-04

Surgical skills training varies greatly between institutions and is often left to students to approach independently. Although many studies have examined single interventions of skills training, no data currently exists about the implementation of surgical skills assessment as a component of the medical student surgical curriculum. We created a technical skills competition and evaluated its effect on student surgical skill development. Second-year medical students enrolled in the surgery clerkship voluntarily participated in a surgical skills competition consisting of knot tying, laparoscopic peg transfer, and laparoscopic pattern cut. Winning students were awarded dinner with the chair of surgery and a resident of their choice. Individual event times and combined times were recorded and compared for students who completed without disqualification. Disqualification included compromising cutting pattern, dropping a peg out of the field of vision, and incorrect knot tying technique. Timed performance was compared for 2 subsequent academic years using Mann-Whitney U test. Overall, 175 students competed and 71 students met qualification criteria. When compared by academic year, 2015 to 2016 students (n = 34) performed better than 2014 to 2015 students (n = 37) in pattern cut (133s vs 167s, p = 0.040), peg transfer (66s vs 101s, p skills competition improves student technical performance. Further research is needed regarding long-term benefits of surgical competitions for medical students. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Proceedings of FED remote maintenance equipment workshop

International Nuclear Information System (INIS)

Sager, P.; Garin, J.; Hager, E.R.; Spampinato, P.T.; Tobias, D.; Young, N.

1981-11-01

A workshop was convened in two sessions in January and March 1981, on the remote maintenance equipment for the Fusion Engineering Device (FED). The objectives of the first session were to familiarize the participants with the status of the design of the FED and to develop a remote maintenance equipment list for the FED. The objective of the second session was to have the participants present design concepts for the equipment which had been identified in the first session. The equipment list was developed for general purpose and special purpose equipment. The general purpose equipment was categorized as manipulators and other, while the special purpose equipment was subdivided according to the reactor subsystem it serviced: electrical, magnetic, and nuclear. Both mobile and fixed base manipulators were identified. Handling machines were identified as the major requirement for special purpose equipment

Capital Equipment Replacement Decisions

OpenAIRE

Batterham, Robert L.; Fraser, K.I.

1995-01-01

This paper reviews the literature on the optimal replacement of capital equipment, especially farm machinery. It also considers the influence of taxation and capital rationing on replacement decisions. It concludes that special taxation provisions such as accelerated depreciation and investment allowances are unlikely to greatly influence farmers' capital equipment replacement decisions in Australia.

Orthodontic-orthognathic interventions in orthognathic surgical cases: "Paper surgery" and "model surgery" concepts in surgical orthodontics

Directory of Open Access Journals (Sweden)

Narayan H Gandedkar

2016-01-01

Full Text Available Thorough planning and execution is the key for successful treatment of dentofacial deformity involving surgical orthodontics. Presurgical planning (paper surgery and model surgery are the most essential prerequisites of orthognathic surgery, and orthodontist is the one who carries out this procedure by evaluating diagnostic aids such as crucial clinical findings and radiographic assessments. However, literature pertaining to step-by-step orthognathic surgical guidelines is limited. Hence, this article makes an attempt to provide an insight and nuances involved in the planning and execution. The diagnostic information revealed from clinical findings and radiographic assessments is integrated in the "paper surgery" to establish "surgical-plan." Furthermore, the "paper surgery" is emulated in "model surgery" such that surgical bite-wafers are created, which aid surgeon to preview the final outcome and make surgical movements that are deemed essential for the desired skeletal and dental outcomes. Skeletal complexities are corrected by performing "paper surgery" and an occlusion is set up during "model surgery" for the fabrication of surgical bite-wafers. Further, orthodontics is carried out for the proper settling and finishing of occlusion. Article describes the nuances involved in the treatment of Class III skeletal deformity individuals treated with orthognathic surgical approach and illustrates orthodontic-orthognathic step-by-step procedures from "treatment planning" to "execution" for successful management of aforementioned dentofacial deformity.

Alternative Fuels Data Center: Biodiesel Equipment Options

Science.gov (United States)

Equipment Options to someone by E-mail Share Alternative Fuels Data Center: Biodiesel Equipment Options on Facebook Tweet about Alternative Fuels Data Center: Biodiesel Equipment Options on Twitter Bookmark Alternative Fuels Data Center: Biodiesel Equipment Options on Google Bookmark Alternative Fuels

21 CFR 880.2740 - Surgical sponge scale.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Surgical sponge scale. 880.2740 Section 880.2740... Devices § 880.2740 Surgical sponge scale. (a) Identification. A surgical sponge scale is a nonelectrically powered device used to weigh surgical sponges that have been used to absorb blood during surgery so that...

Real-time inextensible surgical thread simulation.

Science.gov (United States)

Xu, Lang; Liu, Qian

2018-03-27

This paper discusses a real-time simulation method of inextensible surgical thread based on the Cosserat rod theory using position-based dynamics (PBD). The method realizes stable twining and knotting of surgical thread while including inextensibility, bending, twisting and coupling effects. The Cosserat rod theory is used to model the nonlinear elastic behavior of surgical thread. The surgical thread model is solved with PBD to achieve a real-time, extremely stable simulation. Due to the one-dimensional linear structure of surgical thread, the direct solution of the distance constraint based on tridiagonal matrix algorithm is used to enhance stretching resistance in every constraint projection iteration. In addition, continuous collision detection and collision response guarantee a large time step and high performance. Furthermore, friction is integrated into the constraint projection process to stabilize the twining of multiple threads and complex contact situations. Through comparisons with existing methods, the surgical thread maintains constant length under large deformation after applying the direct distance constraint in our method. The twining and knotting of multiple threads correspond to stable solutions to contact and friction forces. A surgical suture scene is also modeled to demonstrate the practicality and simplicity of our method. Our method achieves stable and fast simulation of inextensible surgical thread. Benefiting from the unified particle framework, the rigid body, elastic rod, and soft body can be simultaneously simulated. The method is appropriate for applications in virtual surgery that require multiple dynamic bodies.

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

Science.gov (United States)

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

2017-03-01

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

SURGICAL SITE INFECTION: REVIEW

Directory of Open Access Journals (Sweden)

P. H. M. Bonai

2016-07-01

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

7 CFR 1753.68 - Purchasing special equipment.

Science.gov (United States)

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Purchasing special equipment. 1753.68 Section 1753.68... AGRICULTURE TELECOMMUNICATIONS SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Purchase and Installation of Special Equipment § 1753.68 Purchasing special equipment. (a) General. (1) Equipment purchases are...

Lifetime of Mechanical Equipment

Energy Technology Data Exchange (ETDEWEB)

Leland, K.

1999-07-01

The gas plant at Kaarstoe was built as part of the Statpipe gas transport system and went on stream in 1985. In 1993 another line was routed from the Sleipner field to carry condensate, and the plant was extended accordingly. Today heavy additional supply- and export lines are under construction, and the plant is extended more than ever. The main role of the factory is to separate the raw gas into commercial products and to pump or ship it to the markets. The site covers a large number of well-known mechanical equipment. This presentation deals with piping, mechanical and structural disciplines. The lifetime of mechanical equipment is often difficult to predict as it depends on many factors, and the subject is complex. Mechanical equipment has been kept in-house, which provides detailed knowledge of the stages from a new to a 14 years old plant. The production regularity has always been very high, as required. The standard of the equipment is well kept, support systems are efficient, and human improvisation is extremely valuable.

Surgical versus non-surgical management of abdominal injury.

Science.gov (United States)

Oyo-Ita, Angela; Chinnock, Paul; Ikpeme, Ikpeme A

2015-11-13

Injury to the abdomen can be blunt or penetrating. Abdominal injury can damage internal organs such as the liver, spleen, kidneys, intestine, and large blood vessels. There are controversies about the best approach to manage abdominal injuries. To assess the effects of surgical and non-surgical interventions in the management of abdominal trauma in a haemodynamically stable and non-peritonitic abdomen. We searched the Cochrane Injuries Group's Specialised Register, The Cochrane Library, Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), EMBASE Classic+EMBASE (Ovid), ISI WOS (SCI-EXPANDED, SSCI, CPCI-S & CPSI-SSH), CINAHL Plus (EBSCO), and clinical trials registers, and screened reference lists. We ran the most recent search on 17 September 2015. Randomised controlled trials of surgical interventions and non-surgical interventions involving people with abdominal injury who were haemodynamically stable with no signs of peritonitis. The abdominal injury could be blunt or penetrating. Two review authors independently applied the selection criteria. Data were extracted by two authors using a standard data extraction form, and are reported narratively. Two studies are included, which involved a total of 114 people with penetrating abdominal injuries. Both studies are at moderate risk of bias because the randomisation methods are not fully described, and the original study protocols are no longer available. The studies were undertaken in Finland between 1992 and 2002, by the same two researchers.In one study, 51 people were randomised to surgery or an observation protocol. None of the participants in the study died. Seven people had complications: 5 (18.5%) in the surgical group and 2 (8.3%) in the observation group; the difference was not statistically significant (P = 0.42; Fischer's exact). Among the 27 people who had surgery, 6 (22.2%) surgeries were negative laparotomies, and 15 (55.6%) were non

Surgical techniques for the treatment of ankyloglossia in children: a case series

Directory of Open Access Journals (Sweden)

Marina Azevedo JUNQUEIRA

2014-06-01

Full Text Available This paper reports a series of clinical cases of ankyloglossia in children, which were approached by different techniques: frenotomy and frenectomy with the use of one hemostat, two hemostats, a groove director or laser. Information on the indications, contraindications, advantages and disadvantages of the techniques was also presented. Children diagnosed with ankyloglossia were subjected to different surgical procedures. The choice of the techniques was based on the age of the patient, length of the frenulum and availability of the instruments and equipment. All the techniques presented are successful for the treatment of ankyloglossia and require a skilled professional. Laser may be considered a simple and safe alternative for children while reducing the amount of local anesthetics needed, the bleeding and the chances of infection, swelling and discomfort.

Sequelas pós-intubação e traqueostomia cirúrgica aberta: devemos sempre fazer a istmectomia? Postintubation injuries and open surgical tracheostomy: should we always perform isthmectomy?

Directory of Open Access Journals (Sweden)

Alexandre Garcia de Lima

2009-03-01

Full Text Available OBJETIVO: Avaliar a influência da equipe cirúrgica (cirurgia geral ou cirurgia torácica e da técnica operatória utilizada (com ou sem istmectomia sobre a incidência de injúrias pós-intubação nas vias aéreas em pacientes traqueostomizados. MÉTODOS: Foram prospectivamente incluídos neste estudo 164 pacientes admitidos na unidade de terapia intensiva para adultos do Hospital Estadual Sumaré e que ficaram sob intubação traqueal por mais de 24 h, no período entre 1º de janeiro e 31 de agosto de 2007. Quando foi necessária a realização de traqueostomia, os pacientes foram aleatorizados para as equipes de cirurgia geral e torácica. Todos os pacientes foram submetidos à traqueoscopia flexível para a decanulação e/ou a avaliação tardia da via aérea. RESULTADOS: Dos 164 pacientes no estudo, 90 (54,88% faleceram (sem relação com o procedimento, 67 (40,85% completaram o seguimento e 7 (4,27% tiveram seguimento parcial. Dos 67 pacientes com seguimento completo, 32 foram traqueostomizados (21 pela equipe de cirurgia geral e 11 pela equipe de cirurgia torácica. A istmectomia foi realizada em 22 pacientes (11 pela equipe de cirurgia geral e 11 pela equipe de cirurgia torácica. Não houve diferença entre o índice de complicações estomais quando se comparou as equipes, mas sim quando se comparou as técnicas (com e sem istmectomia. CONCLUSÕES: A não realização da istmectomia paralelamente à traqueostomia faz com que o cirurgião realize o óstio traqueal mais distalmente do que supõe. Nestes casos, houve um maior índice de complicações do estoma traqueal.OBJECTIVE: To evaluate the influence of the surgical team (general surgery or thoracic surgery and the surgical technique (with or without isthmectomy on the incidence of postintubation injuries in the airways of tracheostomized patients. METHODS: Between January 1st and August 31st, 2007, 164 patients admitted to the adult intensive care unit and tracheally intubated

Performance monitoring of safeguards equipment

International Nuclear Information System (INIS)

Sirisena, K.; Peltoranta, M.; Goussarov, V.; Vodrazka, P.

1999-01-01

SGTCS is responsible for monitoring and reporting the performance of the SG equipment. Performance monitoring (PM) has been implemented in most important safeguards equipment operating unattended in nuclear facilities. Inspectors acquire equipment performance data in facilities. After inspection, the data package is submitted to SGTCS for processing and analysis. The performance data is used for identification of systems or components, which should be changed in the field and for identification of modules which, should be diagnosed at HQ in order to determine the cause of failure. Moreover, the performance data is used for preventive maintenance and spares distribution planning, and to provide statistics for official reports and management decision making. An important part of the performance monitoring is reporting. Equipment performance reports contain information about equipment inventory, utilization, failure types, failure distribution, and reliability. Trends in performance are given in graphical form in cases, where past data is available. Reliability estimates such as expected times between failures are provided. The automated reporting tools are obtainable through EMIS database application. (author)

46 CFR 184.210 - Heating equipment.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Heating equipment. 184.210 Section 184.210 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS (UNDER 100 GROSS TONS) VESSEL CONTROL AND MISCELLANEOUS SYSTEMS AND EQUIPMENT Cooking and Heating § 184.210 Heating equipment...

Retained surgical sponge

International Nuclear Information System (INIS)

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

1993-01-01

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

Comprehensive Surgical Coaching Enhances Surgical Skill in the Operating Room: A Randomized Controlled Trial.

Science.gov (United States)

Bonrath, Esther M; Dedy, Nicolas J; Gordon, Lauren E; Grantcharov, Teodor P

2015-08-01

The aim of the study was to determine whether individualized coaching improved surgical technical skill in the operating room to a higher degree than current residency training. Clinical training in the operating room is a valuable opportunity for surgeons to acquire skill and knowledge; however, it often remains underutilized. Coaching has been successfully used in various industries to enhance performance, but its role in surgery has been insufficiently investigated. This randomized controlled trial was conducted at one surgical training program. Trainees undergoing a minimally invasive surgery rotation were randomized to either conventional training (CT) or comprehensive surgical coaching (CSC). CT included ward and operating room duties, and regular departmental teaching sessions. CSC comprised performance analysis, debriefing, feedback, and behavior modeling. Primary outcome measures were technical performance as measured on global and procedure-specific rating scales, and surgical safety parameters, measured by error count. Operative performance was assessed by blinded video analysis of the first and last cases recorded by the participants during their rotation. Twenty residents were randomized and 18 completed the study. At posttraining the CSC group (n = 9) scored significantly higher on a procedure-specific skill scale compared with the CT group (n = 9) [median, 3.90 (interquartile range, 3.68-4.30) vs 3.60 (2.98-3.70), P = 0.017], and made fewer technical errors [10 (7-13) vs 18 (13-21), P = 0.003]. Significant within-group improvements for all skill metrics were only noted in the CSC group. Comprehensive surgical coaching enhances surgical training and results in skill acquisition superior to conventional training.

Surgical simulation in orthopaedic skills training.

Science.gov (United States)

Atesok, Kivanc; Mabrey, Jay D; Jazrawi, Laith M; Egol, Kenneth A

2012-07-01

Mastering rapidly evolving orthopaedic surgical techniques requires a lengthy period of training. Current work-hour restrictions and cost pressures force trainees to face the challenge of acquiring more complex surgical skills in a shorter amount of time. As a result, alternative methods to improve the surgical skills of orthopaedic trainees outside the operating room have been developed. These methods include hands-on training in a laboratory setting using synthetic bones or cadaver models as well as software tools and computerized simulators that enable trainees to plan and simulate orthopaedic operations in a three-dimensional virtual environment. Laboratory-based training offers potential benefits in the development of basic surgical skills, such as using surgical tools and implants appropriately, achieving competency in procedures that have a steep learning curve, and assessing already acquired skills while minimizing concerns for patient safety, operating room time, and financial constraints. Current evidence supporting the educational advantages of surgical simulation in orthopaedic skills training is limited. Despite this, positive effects on the overall education of orthopaedic residents, and on maintaining the proficiency of practicing orthopaedic surgeons, are anticipated.

Surgical procedures performed in the neonatal intensive care unit on critically ill neonates: feasibility and safety

International Nuclear Information System (INIS)

Mallick, M.S.; Jado, A.M.; Al-Bassam, A.R.

2008-01-01

Transferring unstable, ill neonates to and from the operating rooms carries significant risks and can lead to morbidity. We report on our experience in performing certain procedures in critically ill neonates in the neonatal intensive care unit (NICU). We examined the feasibility and safety for such an approach. All surgical procedures performed in the NICU between January 1999 and December 2005 were analyzed in terms of demographic data, diagnosis, preoperative stability of the patient, procedures performed, complications and outcome. Operations were performed at beside in the NICU in critically ill, unstable neonates who needed emergency surgery, in neonates of low birth weight (<1000 gm) and in neonates on special equipments like higher frequency ventilators and nitrous oxide. Thirty-seven surgical procedures were performed including 12 laparotomies, bowel resection and stomies, 7 repairs of congenital diaphragmatic hernias, 4 ligations of patent ductus arteriosus and various others. Birth weights ranged between 850 gm and 3500 gm (mean 2000 gm). Gestational age ranged between 25 to 42 weeks (mean, 33 weeks). Age at surgery was between 1 to 30 days (mean, 30 days). Preoperatively, 19 patients (51.3%) were on inotropic support and all were intubated and mechanically ventilated. There was no mortality related to surgical procedures. Postoperatively, one patient developed wound infection and disruption. Performing major surgical procedures in the NICU is both feasible and safe. It is useful in very low birth weight, critically ill neonates who have definite risk attached to transfer to the operating room. No special area is needed in the NICU to perform complication-free surgery, but designing an operating room within the NICU will be ideal. (author)

40 CFR 1054.626 - What special provisions apply to equipment imported under the Transition Program for Equipment...

Science.gov (United States)

2010-07-01

... EMISSIONS FROM NEW, SMALL NONROAD SPARK-IGNITION ENGINES AND EQUIPMENT Special Compliance Provisions § 1054... provisions of this section and send us an annual report, as follows: (1) Notify the Designated Compliance... and manufacturing equipment. Companies that import equipment into the United States without meeting...

46 CFR 184.220 - Cooking equipment.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Cooking equipment. 184.220 Section 184.220 Shipping...) VESSEL CONTROL AND MISCELLANEOUS SYSTEMS AND EQUIPMENT Cooking and Heating § 184.220 Cooking equipment. (a) Doors on a cooking appliance must be provided with hinges and locking devices to prevent...

46 CFR 121.210 - Heating equipment.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Heating equipment. 121.210 Section 121.210 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) SMALL PASSENGER VESSELS CARRYING MORE THAN 150... SYSTEMS AND EQUIPMENT Cooking and Heating § 121.210 Heating equipment. (a) Each heater must be so...

Immersive virtual reality used as a platform for perioperative training for surgical residents.

Science.gov (United States)

Witzke, D B; Hoskins, J D; Mastrangelo, M J; Witzke, W O; Chu, U B; Pande, S; Park, A E

2001-01-01

Perioperative preparations such as operating room setup, patient and equipment positioning, and operating port placement are essential to operative success in minimally invasive surgery. We developed an immersive virtual reality-based training system (REMIS) to provide residents (and other health professionals) with training and evaluation in these perioperative skills. Our program uses the qualities of immersive VR that are available today for inclusion in an ongoing training curriculum for surgical residents. The current application consists of a primary platform for patient positioning for a laparoscopic cholecystectomy. Having completed this module we can create many different simulated problems for other procedures. As a part of the simulation, we have devised a computer-driven real-time data collection system to help us in evaluating trainees and providing feedback during the simulation. The REMIS program trains and evaluates surgical residents and obviates the need to use expensive operating room and surgeon time. It also allows residents to train based on their schedule and does not put patients at increased risk. The method is standardized, allows for repetition if needed, evaluates individual performance, provides the possible complications of incorrect choices, provides training in 3-D environment, and has the capability of being used for various scenarios and professions.

30 CFR 72.520 - Diesel equipment inventory.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Diesel equipment inventory. 72.520 Section 72... Mines § 72.520 Diesel equipment inventory. (a) The operator of each mine that utilizes diesel equipment underground, shall prepare and submit in writing to the District Manager, an inventory of diesel equipment...

46 CFR 117.175 - Survival craft equipment.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Survival craft equipment. 117.175 Section 117.175... AND ARRANGEMENTS Survival Craft Arrangements and Equipment § 117.175 Survival craft equipment. (a) General. Each item of survival craft equipment must be of good quality, and efficient for the purpose it...

Evaluation of adherence to measures for the prevention of surgical site infections by the surgical team

Directory of Open Access Journals (Sweden)

Adriana Cristina de Oliveira

2015-10-01

Full Text Available AbstractOBJECTIVEEvaluate pre- and intraoperative practices adopted by medical and nursing teams for the prevention of surgical infections.METHODA prospective study carried out in the period of April to May 2013, in a surgical center of a university hospital in Belo Horizonte, Minas Gerais.RESULTS18 surgeries were followed and 214 surgical gloves were analyzed, of which 23 (10.7% had postoperative glove perforation detected, with 52.2% being perceived by users. Hair removal was performed on 27.7% of patients in the operating room, with the use of blades in 80% of the cases. Antibiotic prophylaxis was administered to 81.8% of patients up to 60 minutes prior to surgical incision. An average of nine professionals were present during surgery and the surgery room door remained open in 94.4% of the procedures.CONCLUSIONPartial adhesion to the recommended measures was identified, reaffirming a need for greater attention to these critical steps/actions in order to prevent surgical site infection.

Surgical strategies in childhood craniopharyngioma

Directory of Open Access Journals (Sweden)

Jörg eFlitsch

2011-12-01

Full Text Available Craniopharyngiomas are biologically benign lesions (WHO Grade 1 of the sellar and suprasellar region, associated with a serious morbidity. About 50% of these tumors become clinically apparent during childhood. Clinical symptoms include headaches, chiasm syndrome, hydrocephalus, pituitary insufficiencies, and obesity. Growth arrest is a typical symptom in children. The treatment of craniopharyngiomas includes surgery as well as radiotherapy. The goal of surgery varies according to the tumor location and extension and may range from complete resection to biopsy. Surgical complications are well known and cause constant evaluation of surgical strategies. Diencephalic obesity is related to surgical manipulation of hypothalamic tissue. Therefore, a classification system for craniopharyngiomas based on preoperative MRI is suggested by the authors, which may help assess the surgical risk. Recurrences are frequent in craniopharyngiomas, even after complete or gross-total resection. Radiotherapy is therefore recommended to patients with incomplete resections. However, the ideal time for radiotherapy after surgery is under discussion.The treatment of craniopharyngiomas requires an interdisciplinary and multimodal approach. Each patient should receive an individually tailored treatment. Surgically, different approaches as well as different degrees of resection can be considered, depending on tumor location and tumor extension.

The Cost of Maintaining Educational Communications Equipment.

Science.gov (United States)

Humphrey, David A.

Tentative formulas for calculating the cost of maintaining educational communications equipment are proposed. The formulas are based on a survey of campuses of the State University of New York. The survey analyzed the types of equipment to be maintained, types of maintenance, who uses the equipment, who services the equipment, and the cost…

Protective equipment use among female rugby players.

Science.gov (United States)

Comstock, R Dawn; Fields, Sarah K; Knox, Christy L

2005-07-01

Our objective was to assess the prevalence of protective equipment use and the motivation for using protective equipment among a sample of US female rugby players. We surveyed a convenience sample of 234 current US female rugby players from 14 teams participating in a US women's rugby tournament, obtaining self-reported demographic, rugby exposure, and protective equipment use information. Mouthguards were the most commonly used piece of protective equipment: 90.8% of players reported having always worn a mouthguard while playing or practicing rugby within their most recent 3 months of play. Fewer than 15% of players reported having always worn other types of protective equipment. Equipment use varied by playing position. Whereas over 80% of players in all other positions always wore a mouthguard, 66.7% of scrum halves reported always wearing one. Both backs and forwards reported wearing shoulder pads, but only forwards reported always wearing padded headgear. Mouthguards, padded headgear, and shoulder pads were worn "to prevent injury," whereas ankle braces, neoprene sleeves, and athletic tape on joints were worn "to protect a current/recent injury." This is the first study of female rugby players to assess the prevalence of protective equipment use by playing position and the motivation for using protective equipment. With the exception of mouthguards, US female rugby players infrequently use protective equipment. Protective equipment use varies by playing position. Some types of protective equipment appear to be used as primary prevention mechanisms, whereas others are used as secondary or tertiary prevention mechanisms.

The impact of a surgical boot camp on early acquisition of technical and nontechnical skills by novice surgical trainees.

Science.gov (United States)

Heskin, Leonie; Mansour, Ehab; Lane, Brian; Kavanagh, Dara; Dicker, Pat; Ryan, Donncha; Gildea-Byrne, Kate; Pawlikowska, Teresa; Tierney, Sean; Traynor, Oscar

2015-09-01

Acquisition of skills early in surgical training represents a significant challenge at present because of training time constraints. The aim of this study was to investigate if an intensive surgical boot camp was effective in transferring skills at the beginning of a surgical training program. New core surgical trainees (n = 58) took part in a 5-day boot camp. There were pretest and posttest assessments of knowledge, technical skills, and confidence levels. The boot camp used simulation and senior surgical faculty to teach a defined range of technical and nontechnical skills. The scores for knowledge (53.8% vs 68.4%, P technical skills (35.9% to 60.6% vs 50.6% to 78.2%, P Skills improvements were still present a year later. The 5-day surgical boot camp proved to be an effective way to rapidly acquire surgical knowledge and skills while increasing the confidence levels of trainees. Copyright © 2015 Elsevier Inc. All rights reserved.

Surgical camps: the Ugandan experience

African Journals Online (AJOL)

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

Equipment available for automating rig operations

International Nuclear Information System (INIS)

McNair, W.L.

1990-01-01

Several manufacturers are producing automated rig equipment, from complete systems to individual functions for existing drilling rigs. Significant improvements in well site time, costs of operations, and improved drilling performance have led drilling contractors to install this equipment on their rigs. This paper details some of the equipment available for automating rigs

14 CFR 121.605 - Airplane equipment.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Airplane equipment. 121.605 Section 121.605..., FLAG, AND SUPPLEMENTAL OPERATIONS Dispatching and Flight Release Rules § 121.605 Airplane equipment. No person may dispatch or release an airplane unless it is airworthy and is equipped as prescribed in § 121...

Executive Summary of the American College of Surgeons/Surgical Infection Society Surgical Site Infection Guidelines-2016 Update.

Science.gov (United States)

Ban, Kristen A; Minei, Joseph P; Laronga, Christine; Harbrecht, Brian G; Jensen, Eric H; Fry, Donald E; Itani, Kamal M F; Dellinger, E Patchen; Ko, Clifford Y; Duane, Therese M

Guidelines regarding the prevention, detection, and management of surgical site infections (SSIs) have been published previously by a variety of organizations. The American College of Surgeons (ACS)/Surgical Infection Society (SIS) Surgical Site Infection (SSI) Guidelines 2016 Update is intended to update these guidelines based on the current literature and to provide a concise summary of relevant topics.

Equipment Reliability Program in NPP Krsko

International Nuclear Information System (INIS)

Skaler, F.; Djetelic, N.

2006-01-01

Operation that is safe, reliable, effective and acceptable to public is the common message in a mission statement of commercial nuclear power plants (NPPs). To fulfill these goals, nuclear industry, among other areas, has to focus on: 1 Human Performance (HU) and 2 Equipment Reliability (EQ). The performance objective of HU is as follows: The behaviors of all personnel result in safe and reliable station operation. While unwanted human behaviors in operations mostly result directly in the event, the behavior flaws either in the area of maintenance or engineering usually cause decreased equipment reliability. Unsatisfied Human performance leads even the best designed power plants into significant operating events, which can be found as well-known examples in nuclear industry. Equipment reliability is today recognized as the key to success. While the human performance at most NPPs has been improving since the start of WANO / INPO / IAEA evaluations, the open energy market has forced the nuclear plants to reduce production costs and operate more reliably and effectively. The balance between these two (opposite) goals has made equipment reliability even more important for safe, reliable and efficient production. Insisting on on-line operation by ignoring some principles of safety could nowadays in a well-developed safety culture and human performance environment exceed the cost of electricity losses. In last decade the leading USA nuclear companies put a lot of effort to improve equipment reliability primarily based on INPO Equipment Reliability Program AP-913 at their NPP stations. The Equipment Reliability Program is the key program not only for safe and reliable operation, but also for the Life Cycle Management and Aging Management on the way to the nuclear power plant life extension. The purpose of Equipment Reliability process is to identify, organize, integrate and coordinate equipment reliability activities (preventive and predictive maintenance, maintenance

[Surgical therapy of gynecomastia].

Science.gov (United States)

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

2011-09-01

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

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

Institute of Scientific and Technical Information of China (English)

刘萍; 张娟; 潘文琴; 戴榕娟

2017-01-01

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

Comparison of CDE data in phacoemulsification between an open hospital-based ambulatory surgical center and a free-standing ambulatory surgical center

Directory of Open Access Journals (Sweden)

Ming Chen

2010-11-01

Full Text Available Ming Chen1, Mindy Chen21University of Hawaii, Honolulu, HI, USA; 2University of California, Irvine, CA, USAAbstract: Mean CDE (cumulative dissipated energy values were compared for an open hospital-based surgical center and a free-standing surgical center. The same model of phacoemulsifier (Alcon Infiniti Ozil was used. Mean CDE values showed that surgeons (individual private practice at the free-standing surgical center were more efficient than surgeons (individual private practice at the open hospital-based surgical center (mean CDE at the hospital-based surgical center 18.96 seconds [SD = 12.51]; mean CDE at the free-standing surgical center 13.2 seconds [SD = 9.5]. CDE can be used to monitor the efficiency of a cataract surgeon and surgical center in phacoemulsification. The CDE value may be used by institutions as one of the indicators for quality control and audit in phacoemulsification.Keywords: CDE (cumulative dissipated energy, open hospital-based ambulatory surgical center, free-standing surgical center, phacoemulsification 

Requirements for industrial x-ray equipment

International Nuclear Information System (INIS)

1987-01-01

This safety code is concerned with the protection of all individuals who may be exposed to radiation emitted by X-ray equipment operating at energies up to 1 MeV as used in industrial radiography. This code presents basic radiation safety information for the protection of personnel operating and servicing X-ray equipment and other workers and the general public in the vicinity of areas where X-ray equipment is in operation. It specifies general safety features of design, construction and functioning of X-ray equipment and facilities; describes the responsibilities of the user, operator and maintenance personnel; contains recommendations to ensure that the X-ray equipment is used and maintained in accordance with the ALARA principle; and describes a program of personnel monitoring and radiation safety surveys. ( 6 refs., 5 tabs., 4 figs.)

30 CFR 250.602 - Equipment movement.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Equipment movement. 250.602 Section 250.602... OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Well-Workover Operations § 250.602 Equipment movement. The movement of well-workover rigs and related equipment on and off a platform or from well to well on...

30 CFR 250.502 - Equipment movement.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Equipment movement. 250.502 Section 250.502... OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Well-Completion Operations § 250.502 Equipment movement. The movement of well-completion rigs and related equipment on and off a platform or from well to well...

46 CFR 121.220 - Cooking equipment.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Cooking equipment. 121.220 Section 121.220 Shipping... SYSTEMS AND EQUIPMENT Cooking and Heating § 121.220 Cooking equipment. (a) Doors on a cooking appliance... cooking appliance must be installed to prevent movement in heavy seas. (c) For a grill or similar type of...

Californium-252 Program Equipment Evaluation

Energy Technology Data Exchange (ETDEWEB)

Chattin, Fred Rhea [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Wilson, Kenton [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Ezold, Julie G. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2017-12-01

To successfully continue the ²⁵²Cf production and meet the needs of the customers, a comprehensive evaluation of the Building 7920 processing equipment was requested to identify equipment critical to the operational continuity of the program.

After-hours Power Status of Office Equipment and Inventory of Miscellaneous Plug-load Equipment

Energy Technology Data Exchange (ETDEWEB)

Roberson, Judy A.; Webber, Carrie A.; McWhinney, Marla C.; Brown, Richard E.; Pinckard, Margaret J.; Busch, John F.

2004-01-22

This research was conducted in support of two branches of the EPA ENERGY STAR program, whose overall goal is to reduce, through voluntary market-based means, the amount of carbon dioxide emitted in the U.S. The primary objective was to collect data for the ENERGY STAR Office Equipment program on the after-hours power state of computers, monitors, printers, copiers, scanners, fax machines, and multi-function devices. We also collected data for the ENERGY STAR Commercial Buildings branch on the types and amounts of ''miscellaneous'' plug-load equipment, a significant and growing end use that is not usually accounted for by building energy managers. This data set is the first of its kind that we know of, and is an important first step in characterizing miscellaneous plug loads in commercial buildings. The main purpose of this study is to supplement and update previous data we collected on the extent to which electronic office equipment is turned off or automatically enters a low power state when not in active use. In addition, it provides data on numbers and types of office equipment, and helps identify trends in office equipment usage patterns. These data improve our estimates of typical unit energy consumption and savings for each equipment type, and enables the ENERGY STAR Office Equipment program to focus future effort on products with the highest energy savings potential. This study expands our previous sample of office buildings in California and Washington DC to include education and health care facilities, and buildings in other states. We report data from twelve commercial buildings in California, Georgia, and Pennsylvania: two health care buildings, two large offices (> 500 employees each), three medium offices (50-500 employees), four education buildings, and one ''small office'' that is actually an aggregate of five small businesses. Two buildings are in the San Francisco Bay area of California, five are in

Review of emerging surgical robotic technology.

Science.gov (United States)

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

2018-04-01

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

AVM branch vibration test equipment

International Nuclear Information System (INIS)

Anne, J.P.

1995-01-01

An inventory of the test equipment of the AVM Branch ''Acoustic and Vibratory Mechanics Analysis Methods'' group has been undertaken. The purpose of this inventory is to enable better acquaintance with the technical characteristics of the equipment, providing an accurate definition of their functionalities, ad to inform potential users of the possibilities and equipment available in this field. The report first summarizes the various experimental surveys conduced. Then, using the AVM equipment database to draw up an exhaustive list of available equipment, it provides a full-scope picture of the vibration measurement systems (sensors, conditioners and exciters) and data processing resources commonly used on industrial sites and in laboratories. A definition is also given of a mobile test unit, called 'shelter', and a test bench used for the testing and performance rating of the experimental analysis methods developed by the group. The report concludes with a description of two fixed installations: - the calibration bench ensuring the requisite quality level for the vibration measurement systems ; - the training bench, whereby know-how acquired in the field in the field of measurement and experimental analysis processes is made available to others. (author). 27 refs., 15 figs., 2 appends

Quality assurance for radiodiagnostic equipment in Uruguay

International Nuclear Information System (INIS)

Cotelo, Elena D.

2001-01-01

Since Uruguay did not have an study on X-ray equipment, students of Radiation Protection course (RP) made this field work throughout the country. The objective is to obtain information on the number and kind of X-ray radiodiagnostic equipment. Some of the results are: there are 666 radiodiagnostic equipment. The ratio of population to equipment is 4.515 to 1 in the capital and the mean rate in the rest of the country is 4.383 to one, with a minimum of 1.707 and a maximum of 8.220. The Public Health Ministry (MSP) and the Instituciones de Asistencia Medica Colectiva (a kind of private heath assurance) (IAMC) have less equipment in the capital than in the rest of the country. The 37% of the capital population receives assistance through the IAMC , with a 42.5 % of the equipment. Uruguay except the capital has 18 districts and 17 computed tomography equipment, from which only 3 belong to the MSP. Five districts do not have any. In Montevideo, there are 11.500 females over forty years of age per X-ray mammography equipment, and this relation in the rest of the country is 13.900. There are 21 X-ray Interventional radiology equipment, 16 of them are in the capital. Is from relating the radiodiagnostic equipment, the population and the procedures, that quality assistance indicators emerge. This owns high importance on the way to create a RP National Programme. (author)

Surgical treatment of gynecomastia: complications and outcomes.

Science.gov (United States)

Li, Chun-Chang; Fu, Ju-Peng; Chang, Shun-Cheng; Chen, Tim-Mo; Chen, Shyi-Gen

2012-11-01

Gynecomastia is defined as the benign enlargement of the male breast. Multiple surgical options have been used to improve outcomes. The aim of this study was to analyze the surgical approaches to the treatment of gynecomastia and their outcomes over a 10-year period. All patients undergoing surgical correction of gynecomastia in our department between 2000 and 2010 were included for retrospective evaluation. The data were analyzed for etiology, stage of gynecomastia, surgical technique, complications, risk factors, and revision rate. The surgical result was evaluated with self-assessment questionnaires. A total of 41 patients with 75 operations were included. Techniques included subcutaneous mastectomy alone or with additional ultrasound-assisted liposuction (UAL) and isolated UAL. The surgical revision rate for all patients was 4.8%. The skin-sparing procedure gave good surgical results in grade IIb and grade III gynecomastia with low revision and complication rates. The self-assessment report revealed a good level of overall satisfaction and improvement in self-confidence (average scores 9.4 and 9.2, respectively, on a 10-point scale). The treatment of gynecomastia requires an individualized approach. Subcutaneous mastectomy combined with UAL could be used as the first choice for surgical treatment of grade II and III gynecomastia.

TRANSPORT AND EMPLACEMENT EQUIPMENT DESCRIPTIONS

International Nuclear Information System (INIS)

1997-01-01

The objective and the scope of this document are to list and briefly describe the major mobile equipment necessary for waste package (WP) Transport and Emplacement in the proposed subsurface nuclear waste repository at Yucca Mountain. Primary performance characteristics and some specialized design features of the equipment are explained and summarized in the individual subsections of this document. The Transport and Emplacement equipment described in this document consists of the following: (1) WP Transporter; (2) Reusable Rail Car; (3) Emplacement Gantry; (4) Gantry Carrier; and (5) Transport Locomotive

Robotic surgical training.

Science.gov (United States)

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

2013-01-01

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

Evolving Educational Techniques in Surgical Training.

Science.gov (United States)

Evans, Charity H; Schenarts, Kimberly D

2016-02-01

Training competent and professional surgeons efficiently and effectively requires innovation and modernization of educational methods. Today's medical learner is quite adept at using multiple platforms to gain information, providing surgical educators with numerous innovative avenues to promote learning. With the growth of technology, and the restriction of work hours in surgical education, there has been an increase in use of simulation, including virtual reality, robotics, telemedicine, and gaming. The use of simulation has shifted the learning of basic surgical skills to the laboratory, reserving limited time in the operating room for the acquisition of complex surgical skills". Copyright © 2016 Elsevier Inc. All rights reserved.

Plant-wide integrated equipment monitoring and analysis system

International Nuclear Information System (INIS)

Morimoto, C.N.; Hunter, T.A.; Chiang, S.C.

2004-01-01

A nuclear power plant equipment monitoring system monitors plant equipment and reports deteriorating equipment conditions. The more advanced equipment monitoring systems can also provide information for understanding the symptoms and diagnosing the root cause of a problem. Maximizing the equipment availability and minimizing or eliminating consequential damages are the ultimate goals of equipment monitoring systems. GE Integrated Equipment Monitoring System (GEIEMS) is designed as an integrated intelligent monitoring and analysis system for plant-wide application for BWR plants. This approach reduces system maintenance efforts and equipment monitoring costs and provides information for integrated planning. This paper describes GEIEMS and how the current system is being upgraded to meet General Electric's vision for plant-wide decision support. (author)

Sample-related peripheral equipment at IPNS

International Nuclear Information System (INIS)

Bohringer, D.E.; Crawford, R.K.

1985-01-01

This paper describes samples environment equipment provided by IPNS to visiting users and staff scientists. Of the twelve horizontal neutron beam stations, (ten now operational, two under construction) all use one or more form of such support equipment. An in-house support group devotes a significant fraction of its time to development, calibration, and maintenance of this equipment

Surgical reimplantation of penile glans amputation in children during circumcision

Directory of Open Access Journals (Sweden)

Bouassida Khaireddine

2014-01-01

Full Text Available Circumcision is one of the oldest and most commonly performed surgical procedures. Unfortunately, various complications may occur during circumcision, ranging from trivial to tragic such as penile amputation which is a serious complication and a challenging injury to treat. We describe two cases of non-microsurgical successful reattachment of a distal penile glans which were amputated during circumcision. In the first case, a 5-year-old child underwent circumcision by an urologist under local anesthesia. In the second one, a 3-year-old child underwent circumcision by a general practitioner who used to make circumcision. In this article, the literature is reviewed; results and potential complications of this surgery are also discussed. Glans sensation was present, early morning erection was maintained, and there was an erectile response during penile manipulation in both cases. Although circumcision is not technically difficult, it should be taken seriously. The use of microsurgical reattachment is not always possible, especially in pediatric cases; it also requires special equipment and training.

Surgical innovations in canine gonadectomy

NARCIS (Netherlands)

Van Goethem, Bart

2016-01-01

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

Charging equipment. Ladegeraet

Energy Technology Data Exchange (ETDEWEB)

Neumann, E

1981-09-17

The invention refers to a charging equipment, particularly on board charging equipment for charging traction batteries of an electric vehicle from the AC mains supply, consisting of a DC converter, which contains a controlled power transistor, a switching off unloading circuit and a power transmitter, where the secondary winding is connected in series with a rectifier diode, and a smoothing capacitor is connected in parallel with this series circuit. A converter module is provided, which consists of two DC voltage converters, whose power transistors are controlled by a control circuit in opposition with a phase displacement of 180/sup 0/.

Large Variability in the Diversity of Physiologically Complex Surgical Procedures Exists Nationwide Among All Hospitals Including Among Large Teaching Hospitals.

Science.gov (United States)

Dexter, Franklin; Epstein, Richard H; Thenuwara, Kokila; Lubarsky, David A

2017-11-22

Multiple previous studies have shown that having a large diversity of procedures has a substantial impact on quality management of hospital surgical suites. At hospitals with substantial diversity, unless sophisticated statistical methods suitable for rare events are used, anesthesiologists working in surgical suites will have inaccurate predictions of surgical blood usage, case durations, cost accounting and price transparency, times remaining in late running cases, and use of intraoperative equipment. What is unknown is whether large diversity is a feature of only a few very unique set of hospitals nationwide (eg, the largest hospitals in each state or province). The 2013 United States Nationwide Readmissions Database was used to study heterogeneity among 1981 hospitals in their diversities of physiologically complex surgical procedures (ie, the procedure codes). The diversity of surgical procedures performed at each hospital was quantified using a summary measure, the number of different physiologically complex surgical procedures commonly performed at the hospital (ie, 1/Herfindahl). A total of 53.9% of all hospitals commonly performed 3-fold larger diversity (ie, >30 commonly performed physiologically complex procedures). Larger hospitals had greater diversity than the small- and medium-sized hospitals (P 30 procedures (lower 99% CL, 71.9% of hospitals). However, there was considerable variability among the large teaching hospitals in their diversity (interquartile range of the numbers of commonly performed physiologically complex procedures = 19.3; lower 99% CL, 12.8 procedures). The diversity of procedures represents a substantive differentiator among hospitals. Thus, the usefulness of statistical methods for operating room management should be expected to be heterogeneous among hospitals. Our results also show that "large teaching hospital" alone is an insufficient description for accurate prediction of the extent to which a hospital sustains the

7 CFR 58.229 - Filler and packaging equipment.

Science.gov (United States)

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Filler and packaging equipment. 58.229 Section 58.229....229 Filler and packaging equipment. All filling and packaging equipment shall be of sanitary... equipment should comply with the 3-A Sanitary Standards for equipment for Packaging Dry Milk and Dry Milk...

WP EMPLACEMENT CONTROL AND COMMUNICATION EQUIPMENT DESCRIPTIONS

International Nuclear Information System (INIS)

Raczka, N.T.

1997-01-01

The objective and scope of this document are to list and briefly describe the major control and communication equipment necessary for waste package emplacement at the proposed nuclear waste repository at Yucca Mountain. Primary performance characteristics and some specialized design features of the required equipment are explained and summarized in the individual subsections of this document. This task was evaluated in accordance with QAP-2-0 and found not to be quality affecting. Therefore, this document was prepared in accordance with NAP-MG-012. The following control and communication equipment are addressed in this document: (1) Programmable Logic Controllers (PLC's); (2) Leaky Feeder Radio Frequency Communication Equipment; (3) Slotted Microwave guide Communication Equipment; (4) Vision Systems; (5) Radio Control Equipment; and (6) Enclosure Cooling Systems

Automatic monitoring of vibration welding equipment

Science.gov (United States)

Spicer, John Patrick; Chakraborty, Debejyo; Wincek, Michael Anthony; Wang, Hui; Abell, Jeffrey A; Bracey, Jennifer; Cai, Wayne W

2014-10-14

A vibration welding system includes vibration welding equipment having a welding horn and anvil, a host device, a check station, and a robot. The robot moves the horn and anvil via an arm to the check station. Sensors, e.g., temperature sensors, are positioned with respect to the welding equipment. Additional sensors are positioned with respect to the check station, including a pressure-sensitive array. The host device, which monitors a condition of the welding equipment, measures signals via the sensors positioned with respect to the welding equipment when the horn is actively forming a weld. The robot moves the horn and anvil to the check station, activates the check station sensors at the check station, and determines a condition of the welding equipment by processing the received signals. Acoustic, force, temperature, displacement, amplitude, and/or attitude/gyroscopic sensors may be used.

Mastoidectomy: anatomical parameters x surgical difficulty

Directory of Open Access Journals (Sweden)

Pereira Júnior, Anastácio Rodrigues

2012-01-01

Full Text Available Introduction: The lowered temporal meninges and/ or anterior sigmoid sinus are contiditions that can determine surgical difficulties in performing mastoidectomy. Objective: To correlate in the tomography the extent of the prolapse of the sigmoid sinus and of temporal meninges with the surgical difficulty in the mastoidectomy. Method: The tomographic measurements of prolapse sigmoid and of temporal meninges were correlated with the presence or non-presence of the surgical difficulty observed during the mastoidectomy procedure in patients with ostomatoiditis chronic (n=30. Form of study: Contemporary cohort transverse. Results: In 10 patients were observed surgical difficulty distributed as: due to prolapse of the sigmoid sinus (n = 2 or temporal meninges prolapse (n = 7 or both (n = 1. In patients in which the surgical difficulty was due to sigmoid sinus prolapse, the tomography distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm. In patients in which surgical difficulty was due to temporal meninges prolapse, the tomographic distance to the upper plane of the petrous bone was 7 mm. Conclusion: The computerized tomography distance between the temporal meninges and the upper plane of the petrous bone 7 mm and the distance of the anterior border of the sigmoid sinus to posterior wall of external auditory canal was lower than 9 mm are predictive to the surgical difficulties to perform mastoidectomy.

Changing nature of equipment and parts qualification

International Nuclear Information System (INIS)

Bucci, R.M.

1988-01-01

Ideally, the original supplier of a piece of nuclear safety-related equipment has performed a qualification program and will continue to support that equipment throughout the lifetime of the nuclear power plants in which in equipment is installed. The supplier's nuclear quality assurance program will be maintained and he will continue to offer all necessary replacement parts. These parts will be identical to the original parts, certified to the original purchase order requirements, and the parts will be offered at competitive prices. Due to the changing nature of the nuclear plant equipment market, however, one or more of those ideal features are frequently unavailable when safety-related replacement equipment or parts are required. Thus, the process of equipment and parts qualification has had to adjust in order to ensure obtaining qualified replacements when needed. This paper presents some new directions taken in the qualification of replacement equipment and parts to meet changes in the marketplace

Advanced surgical skills for exposure in trauma: a new surgical skills cadaver course for surgery residents and fellows.

Science.gov (United States)

Kuhls, Deborah A; Risucci, Donald A; Bowyer, Mark W; Luchette, Fred A

2013-02-01

Surgical education is changing owing to workforce and economic demands. Simulation and other technical teaching methods are used to acquire skills transferable to the operating room. Operative management of traumatic injuries has declined, making it difficult to acquire and maintain competence. The ASSET course was developed by the Committee on Trauma's Surgical Skills Committee to fill a surgical skills need in resident and fellow education. Using a human cadaver, standardized rapid exposure of vital structures in the extremities, neck, thorax, abdomen, retroperitoneum, and pelvis is taught. A retrospective analysis of 79 participants in four ASSET courses was performed. Operative experience data were collected, and self-efficacy questionnaires (SEQs) were administered before and after the course. Course evaluations and instructor evaluation data were analyzed. Student's and paired samples t tests as well as analysis of variance and Spearman ρ correlation coefficient analysis were performed using α at p ASSET course would teach new surgical techniques and that learner self-assessed ability would improve. Participants included 27 PGY-4, 20 PGY-5, 24 PGY-6 or PGY-7 and PGY-8 at other levels of training. Self-assessed confidence improved in all body regions (p knowledge rated at 4.8 and learning new techniques at 4.72. A standardized cadaver-based surgical exposures course offered to senior surgical residents adds new surgical skills and improves participant self-assessed ability to perform emergent surgical exposure of vital structures.

Implementation of surgical quality improvement: auditing tool for surgical site infection prevention practices.

Science.gov (United States)

Hechenbleikner, Elizabeth M; Hobson, Deborah B; Bennett, Jennifer L; Wick, Elizabeth C

2015-01-01

Surgical site infections are a potentially preventable patient harm. Emerging evidence suggests that the implementation of evidence-based process measures for infection reduction is highly variable. The purpose of this work was to develop an auditing tool to assess compliance with infection-related process measures and establish a system for identifying and addressing defects in measure implementation. This was a retrospective cohort study using electronic medical records. We used the auditing tool to assess compliance with 10 process measures in a sample of colorectal surgery patients with and without postoperative infections at an academic medical center (January 2012 to March 2013). We investigated 59 patients with surgical site infections and 49 patients without surgical site infections. First, overall compliance rates for the 10 process measures were compared between patients with infection vs patients without infection to assess if compliance was lower among patients with surgical site infections. Then, because of the burden of data collection, the tool was used exclusively to evaluate quarterly compliance rates among patients with infection. The results were reviewed, and the key factors contributing to noncompliance were identified and addressed. Ninety percent of process measures had lower compliance rates among patients with infection. Detailed review of infection cases identified many defects that improved following the implementation of system-level changes: correct cefotetan redosing (education of anesthesia personnel), temperature at surgical incision >36.0°C (flags used to identify patients for preoperative warming), and the use of preoperative mechanical bowel preparation with oral antibiotics (laxative solutions and antibiotics distributed in clinic before surgery). Quarterly compliance improved for 80% of process measures by the end of the study period. This study was conducted on a small surgical cohort within a select subspecialty. The

Special equipment for etching nitrocellulose film

International Nuclear Information System (INIS)

Domanus, J.C.

1983-08-01

Nitrocellulose film and converter screens used for neutron radiography are described. Difficulties in visualization of radiographs on those films are mentioned. Because there is no equipment for etching nitrocellulose film available on the market Risoe has designed and produced such equipment at an estimated cost of Dkr. 15,000. Design criteria for this equipment are given and its performance described

An on-line monitoring system for navigation equipment

Science.gov (United States)

Wang, Bo; Yang, Ping; Liu, Jing; Yang, Zhengbo; Liang, Fei

2017-10-01

Civil air navigation equipment is the most important infrastructure of Civil Aviation, which is closely related to flight safety. In addition to regular flight inspection, navigation equipment's patrol measuring, maintenance measuring, running measuring under special weather conditions are the important means of ensuring aviation flight safety. According to the safety maintenance requirements of Civil Aviation Air Traffic Control navigation equipment, this paper developed one on-line monitoring system with independent intellectual property rights for navigation equipment, the system breakthroughs the key technologies of measuring navigation equipment on-line including Instrument Landing System (ILS) and VHF Omni-directional Range (VOR), which also meets the requirements of navigation equipment ground measurement set by the ICAO DOC 8071, it provides technical means of the ground on-line measurement for navigation equipment, improves the safety of navigation equipment operation, and reduces the impact of measuring navigation equipment on airport operation.

7 CFR 550.38 - Equipment.

Science.gov (United States)

2010-01-01

... Regulations of the Department of Agriculture (Continued) AGRICULTURAL RESEARCH SERVICE, DEPARTMENT OF AGRICULTURE GENERAL ADMINISTRATIVE POLICY FOR NON-ASSISTANCE COOPERATIVE AGREEMENTS Management of Agreements... Agency, the Cooperator shall use the equipment to be replaced as trade-in or sell the equipment and use...

46 CFR 77.40-1 - Pilot boarding equipment.

Science.gov (United States)

2010-10-01

... 46 Shipping 3 2010-10-01 2010-10-01 false Pilot boarding equipment. 77.40-1 Section 77.40-1... MISCELLANEOUS SYSTEMS AND EQUIPMENT Pilot Boarding Equipment § 77.40-1 Pilot boarding equipment. (a) This... vessel. (b) Each vessel must have suitable pilot boarding equipment available for use on each side of the...

Improving core surgical training in a major trauma centre.

Science.gov (United States)

Morris, Daniel L J; Bryson, David J; Ollivere, Ben J; Forward, Daren P

2016-06-01

English Major Trauma Centres (MTCs) were established in April 2012. Increased case volume and complexity has influenced trauma and orthopaedic (T&O) core surgical training in these centres. To determine if T&O core surgical training in MTCs meets Joint Committee on Surgical Training (JCST) quality indicators including performance of T&O operative procedures and consultant supervised session attendance. An audit cycle assessing the impact of a weekly departmental core surgical trainee rota. The rota included allocated timetabled sessions that optimised clinical and surgical learning opportunities. Intercollegiate Surgical Curriculum Programme (ISCP) records for T&O core surgical trainees at a single MTC were analysed for 8 months pre and post rota introduction. Outcome measures were electronic surgical logbook evidence of leading T&O operative procedures and consultant validated work-based assessments (WBAs). Nine core surgical trainees completed a 4 month MTC placement pre and post introduction of the core surgical trainee rota. Introduction of core surgical trainee rota significantly increased the mean number of T&O operative procedures led by a core surgical trainee during a 4 month MTC placement from 20.2 to 34.0 (pcore surgical trainee during a 4 month MTC placement was significantly increased (0.3 vs 2.4 [p=0.04]). Those of dynamic hip screw fixation (2.3 vs 3.6) and ankle fracture fixation (0.7 vs 1.6) were not. Introduction of a core surgical trainee rota significantly increased the mean number of consultant validated WBAs completed by a core surgical trainee during a 4 month MTC placement from 1.7 to 6.6 (pcore surgical trainee rota utilising a 'problem-based' model can significantly improve T&O core surgical training in MTCs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Operation monitor for plant equipment

International Nuclear Information System (INIS)

Kondo, Tetsufumi; Kanemoto, Shigeru.

1991-01-01

In a nuclear power plant, states of each of equipment in the plant are monitored accurately even under such a operation condition that the power is changed. That is, the fundamental idea is based on a model comparison method. A deviation between an output signal upon normal plant state obtained in a forecasting model device and that of the objective equipment in the plant are compared with a predetermined value. The result of the comparison is inputted to an alarm device to alarm the abnormality of the states of the equipment to an operator. The device of the present invention thus constituted can monitor the abnormality of the operation of equipment accurately even under such a condition that a power level fluctuates. As a result, it can remarkably contribute to mitigate operator's monitoring operation under the condition such as during load following operation. (I.S.)

Comparison of CDE data in phacoemulsification between an open hospital-based ambulatory surgical center and a free-standing ambulatory surgical center.

Science.gov (United States)

Chen, Ming; Chen, Mindy

2010-11-12

Mean CDE (cumulative dissipated energy) values were compared for an open hospital- based surgical center and a free-standing surgical center. The same model of phacoemulsifier (Alcon Infiniti Ozil) was used. Mean CDE values showed that surgeons (individual private practice) at the free-standing surgical center were more efficient than surgeons (individual private practice) at the open hospital-based surgical center (mean CDE at the hospital-based surgical center 18.96 seconds [SD = 12.51]; mean CDE at the free-standing surgical center 13.2 seconds [SD = 9.5]). CDE can be used to monitor the efficiency of a cataract surgeon and surgical center in phacoemulsification. The CDE value may be used by institutions as one of the indicators for quality control and audit in phacoemulsification.

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

Science.gov (United States)

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

2011-12-01

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

New multimedia advances in surgical information.

Science.gov (United States)

Glenn, Ian C; Abdulhai, Sophia; Lamoshi, Abdulraouf; Ponsky, Todd A

2018-06-01

When discussing new trends in pediatric surgery, the tendency is to focus on novel surgical technology and techniques. However, it is equally important to examine how the practicing surgeon stays abreast in an ever-changing field. This article serves as a brief guide to the future of surgical education for the attending surgeon. Broadly, advances in surgical education consist of new methods of filtration and delivery of knowledge.

Surgical treatment for residual or recurrent strabismus

Directory of Open Access Journals (Sweden)

Tao Wang

2014-12-01

Full Text Available Although the surgical treatment is a relatively effective and predictable method for correcting residual or recurrent strabismus, such as posterior fixation sutures, medial rectus marginal myotomy, unilateral or bilateral rectus re-recession and resection, unilateral lateral rectus recession and adjustable suture, no standard protocol is established for the surgical style. Different surgical approaches have been recommended for correcting residual or recurrent strabismus. The choice of the surgical procedure depends on the former operation pattern and the surgical dosages applied on the patients, residual or recurrent angle of deviation and the operator''s preference and experience. This review attempts to outline recent publications and current opinion in the management of residual or recurrent esotropia and exotropia.

Procurement strategic analysis of nuclear safety equipment

International Nuclear Information System (INIS)

Wu Caixia; Yang Haifeng; Li Xiaoyang; Li Shixin

2013-01-01

The nuclear power development plan in China puts forward a challenge on procurement of nuclear safety equipment. Based on the characteristics of the procurement of nuclear safety equipment, requirements are raised for procurement process, including further clarification of equipment technical specification, establishment and improvement of the expert database of the nuclear power industry, adoption of more reasonable evaluation method and establishment of a unified platform for nuclear power plants to procure nuclear safety equipment. This paper makes recommendation of procurement strategy for nuclear power production enterprises from following aspects, making a plan of procurement progress, dividing procurement packages rationally, establishing supplier database through qualification review and implementing classified management, promoting localization process of key equipment continually and further improving the system and mechanism of procurement of nuclear safety equipment. (authors)

Fighting surgical site infections in small animals

DEFF Research Database (Denmark)

Verwilghen, Denis; Singh, Ameet

2015-01-01

A diverse array of pathogen-related, patient-related, and caretaker-related issues influence risk and prevention of surgical site infections (SSIs). The entire surgical team involved in health care settings in which surgical procedures are performed play a pivotal role in the prevention of SSIs. ...

Equipment qualification research program: program plan

International Nuclear Information System (INIS)

Dong, R.G.; Smith, P.D.

1982-01-01

The Lawrence Livermore National Laboratory (LLNL) under the sponsorship of the US Nuclear Regulatory Commission (NRC) has developed this program plan for research in equipment qualification (EQA). In this report the research program which will be executed in accordance with this plan will be referred to as the Equipment Qualification Research Program (EQRP). Covered are electrical and mechanical equipment under the conditions described in the OBJECTIVE section of this report. The EQRP has two phases; Phase I is primarily to produce early results and to develop information for Phase II. Phase I will last 18 months and consists of six projects. The first project is program management. The second project is responsible for in-depth evaluation and review of EQ issues and EQ processes. The third project is responsible for detailed planning to initiate Phase II. The remaining three projects address specific equipment; i.e., valves, electrical equipment, and a pump

Weight/balance portable test equipment

International Nuclear Information System (INIS)

Whitlock, R.W.

1994-01-01

This document shows the general layout, and gives a part description for the weight/balance test equipment. This equipment will aid in the regulation of the leachate loading of tanker trucks. The report contains four drawings with part specifications. The leachate originates from lined trenches

Food Service Equipment and Appurtenances.

Science.gov (United States)

National Sanitation Foundation, Ann Arbor, MI.

Equipment design specifications are presented relating to tables of all kinds, counters, sinks and drainboards, bins, shelves, drawers, hoods and similar kitchen appurtenances, not including baking, roasting, toasting, broiling or frying equipment, food preparation machinery such as slicers, choppers, and cutters, mixers and grinders, steam…

Case Based Asset Maintenance for the Electric Equipment

International Nuclear Information System (INIS)

Kim, Ji-Hyeon; Jung, Jae-Cheon; Chang, Young-Woo; Chang, Hoon-Seon; Kim, Jae-Cheol; Kim, Hang-Bae; Kim, Kyu-Ho; Hur, Yong; Lee, Dong-Chul

2006-01-01

The electric equipment maintenance strategies are changing from PM(Preventive Maintenance) or CM(Corrective Maintenance) to CBM(Condition Based Maintenance). The main benefits of CBM are reduced possibility of service failures of critical equipment and reduced costs or maintenance work. In CBM, the equipment status need to be monitored continuously and a decision should be made whether an equipment need to be repaired or replaced. For the maintenance decision making, the CBR(Case Base Reasoning) system is introduced. The CBR system receives the current equipment status and retrieves the case based historic database to determine any possible equipment failure under current conditions. In retrieving the case based historic data, the suggested DSS(Decision Support System) uses a reasoning engine with an equipment/asset ontology that describes the equipment subsumption relationships

Effect of surgical skill on surgically-induced astigmatism in cataract surgery

Directory of Open Access Journals (Sweden)

Numan Eraslan

2015-12-01

Full Text Available AIM:To evaluate the effect of surgical experience on surgically-induced astigmatism(SIAin patients with uncomplicated phacoemulsification surgery.METHODS:Fifty-three eyes of fifty patients, mean age 64.5±10.8y, were randomly divided into two groups(23 eyes and 30 eyes. First group was underwent surgery by cataract specialists and the second was by residents. At baseline all the patients were underwent a complete opthalmological examination including keratometry and autorefractometer measurements. Vector analysis programme including the Alpins' method was used for the calculation of SIA. All the measurements were repeated postoperative first day, first month and second month and changes were recorded. Shapiro Wilk and Mann-Whitney tests were applied for determining the statistical differences between the SIA with two groups.RESULTS:There were no significant differences in demographic data of the groups. Intergroup analysis showed, first group was more effective results in SIA postoperative first day(P=0.002, first month(P=0.004and the second month(P=0.001. For the first group, SIA were 0.79±0.41 diopter(Dat the first postoperative day, 0.54±0.41 D at the first postoperative month and 0.47±0.37 D at the second postoperative month. Second one was 1.27±0.66 D, 0.98±0.56 D and 0.94±0.54 D, respectively.CONCLUSION:According to the results, surgical experience was one of the factors that affects SIA. Residents would perform more phacoemilcification surgery to obtain more surgical experience.

Containment and Surveillance Equipment Compendium

International Nuclear Information System (INIS)

Luetters, F.O.

1980-02-01

The Containment and Surveillance Equipment Compendium contains information sections describing the application and status of seals, optical surveillance systems, and monitors for international safeguards systems. The Compendium is a collection of information on equipment in use (generally by the IAEA) or under development in the US in diverse programs being conducted at numerous facilities under different sponsors. The Compendium establishes a baseline for the status and applications of C/S equipment and is a tool to assist in the planning of future C/S hardware development activities. The Appendix contains design concepts which can be developed to meet future goals

Automatic dose-rate controlling equipment

International Nuclear Information System (INIS)

Szasz, T.; Nagy Czirok, Cs.; Batki, L.; Antal, S.

1977-01-01

The patent of a dose-rate controlling equipment that can be attached to X-ray image-amplifiers is presented. In the new equipment the current of the photocatode of the image-amplifier is led into the regulating unit, which controls the X-ray generator automatically. The advantages of the equipment are the following: it can be simply attached to any type of X-ray image-amplifier, it accomplishes fast and sensitive regulation, it makes possible the control of both the mA and the kV values, it is attached to the most reliable point of the image-transmission chain. (L.E.)

Surgical Masculinization of the Breast: Clinical Classification and Surgical Procedures.

Science.gov (United States)

Cardenas-Camarena, Lazaro; Dorado, Carlos; Guerrero, Maria Teresa; Nava, Rosa

2017-06-01

Aesthetic breast area improvements for gynecomastia and gender dysphoria patients who seek a more masculine appearance have increased recently. We present our clinical experience in breast masculinization and a classification for these patients. From July 2003 to May 2014, 68 patients seeking a more masculine thorax underwent surgery. They were divided into five groups depending on three factors: excess fatty tissue, breast tissue, and skin. A specific surgical treatment was assigned according to each group. The surgical treatments included thoracic liposuction, subcutaneous mastectomy, periareolar skin resection in one or two stages, and mastectomy with a nipple areola complex graft. The evaluation was performed 6 months after surgery to determine the degree of satisfaction and presence of complications. Surgery was performed on a total of 68 patients, 45 male and 22 female, with ages ranging from 18 to 49 years, and an average age of 33 years. Liposuction alone was performed on five patients; subcutaneous mastectomy was performed on eight patients; subcutaneous mastectomy combined with liposuction was performed on 27 patients; periareolar skin resection was performed on 11 patients; and mastectomy with NAC free grafts was performed on 16 patients. The surgical procedure satisfied 94% of the patients, with very few complications. All patients who wish to obtain a masculine breast shape should be treated with only one objective regardless patient's gender: to obtain a masculine thorax. We recommend a simple mammary gland classification for determining the best surgical treatment for these patients LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A complex method of equipment replacement planning. An advanced plan for the replacement of medical equipment.

Science.gov (United States)

Dondelinger, Robert M

2004-01-01

This complex method of equipment replacement planning is a methodology; it is a means to an end, a process that focuses on equipment most in need of replacement, rather than the end itself. It uses data available from the maintenance management database, and attempts to quantify those subjective items important [figure: see text] in making equipment replacement decisions. Like the simple method of the last issue, it is a starting point--albeit an advanced starting point--which the user can modify to fit their particular organization, but the complex method leaves room for expansion. It is based on sound logic, documented facts, and is fully defensible during the decision-making process and will serve your organization well as provide a structure for your equipment replacement planning decisions.

After-hours power status of office equipment and energy use of miscellaneous plug-load equipment

Energy Technology Data Exchange (ETDEWEB)

Roberson, Judy A.; Webber, Carrie A.; McWhinney, Marla C.; Brown, Richard E.; Pinckard, Marageret J.; Busch, John F.

2004-05-27

This research was conducted in support of two branches of the EPA ENERGY STAR program, whose overall goal is to reduce, through voluntary market-based means, the amount of carbon dioxide emitted in the U.S. The primary objective was to collect data for the ENERGY STAR Office Equipment program on the after-hours power state of computers, monitors, printers, copiers, scanners, fax machines, and multi-function devices. We also collected data for the ENERGY STAR Commercial Buildings branch on the types and amounts of miscellaneous plug-load equipment, a significant and growing end use that is not usually accounted for by building energy managers. For most types of miscellaneous equipment, we also estimated typical unit energy consumption in order to estimate total energy consumption of the miscellaneous devices within our sample. This data set is the first of its kind that we know of, and is an important first step in characterizing miscellaneous plug loads in commercial buildings. The main purpose of this study is to supplement and update previous data we collected on the extent to which electronic office equipment is turned off or automatically enters a low power state when not in active use. In addition, it provides data on numbers and types of office equipment, and helps identify trends in office equipment usage patterns. These data improve our estimates of typical unit energy consumption and savings for each equipment type, and enables the ENERGY STAR Office Equipment program to focus future effort on products with the highest energy savings potential. This study expands our previous sample of office buildings in California and Washington DC to include education and health care facilities, and buildings in other states. We report data from sixteen commercial buildings in California, Georgia, and Pennsylvania: four education buildings, two medical buildings, two large offices (> 500 employees each), three medium offices (50-500 employees each), and five small

Journal of Surgical Technique and Case Report: Editorial Policies

African Journals Online (AJOL)

Focus and Scope. The aim of Journal of Surgical Technique and Case Report is to advance surgical knowledge and practice by promoting the reporting of innovative and reproducible surgical techniques and illustrative surgical cases on various surgical disciplines. The journal encourages authoritative synthesis of current ...

Double gloving to reduce surgical cross-infection.

Science.gov (United States)

Tanner, J; Parkinson, H

2006-07-19

The invasive nature of surgery, with its increased exposure to blood, means that during surgery there is a high risk of transfer of pathogens. Pathogens can be transferred through contact between surgical patients and the surgical team, resulting in post-operative or blood borne infections in patients or blood borne infections in the surgical team. Both patients and the surgical team need to be protected from this risk. This risk can be reduced by implementing protective barriers such as wearing surgical gloves. Wearing two pairs of surgical gloves, triple gloves, glove liners or cloth outer gloves, as opposed to one pair, is considered to provide an additional barrier and further reduce the risk of contamination. The primary objective of this review was to determine if additional glove protection reduces the number of surgical site or blood borne infections in patients or the surgical team. The secondary objective was to determine if additional glove protection reduces the number of perforations to the innermost pair of surgical gloves. The innermost gloves (next to skin) compared with the outermost gloves are considered to be the last barrier between the patient and the surgical team. We searched the Cochrane Wounds Group Specialised Register (January 2006), and the Cochrane Central Register of Controlled Trials (CENTRAL)(The Cochrane Library Issue 4, 2005). We also contacted glove manufacturing companies and professional organisations. Randomised controlled trials involving: single gloving, double gloving, triple gloving, glove liners, knitted outer gloves, steel weave outer gloves and perforation indicator systems. Both authors independently assessed the relevance and quality of each trial. Data was extracted by one author and cross checked for accuracy by the second author. Two trials were found which addressed the primary outcome, namely, surgical site infections in patients. Both trials reported no infections. Thirty one randomised controlled trials

Acquiring minimally invasive surgical skills

NARCIS (Netherlands)

Hiemstra, Ellen

2012-01-01

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

Journal of Surgical Technique and Case Report

African Journals Online (AJOL)

The aim of Journal of Surgical Technique and Case Report is to advance surgical knowledge and practice by promoting the reporting of innovative and reproducible surgical techniques ... Anterior palatal island advancement flap for bone graft coverage: technical note · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT

Computer-Assisted Technique for Surgical Tooth Extraction

Directory of Open Access Journals (Sweden)

Hosamuddin Hamza

2016-01-01

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

PROMSYS, Plant Equipment Maintenance and Inspection Scheduling

International Nuclear Information System (INIS)

Morgan, D.L.; Srite, B.E.

1986-01-01

1 - Description of problem or function: PROMSYS is a computer system designed to automate the scheduling of routine maintenance and inspection of plant equipment. This 'programmed maintenance' provides the detailed planning and accomplishment of lubrication, inspection, and similar repetitive maintenance activities which can be scheduled at specified predetermined intervals throughout the year. The equipment items included are the typical pumps, blowers, motors, compressors, automotive equipment, refrigeration units, filtering systems, machine shop equipment, cranes, elevators, motor-generator sets, and electrical switchgear found throughout industry, as well as cell ventilation, shielding, containment, and material handling equipment unique to nuclear research and development facilities. Four related programs are used to produce sorted schedule lists, delinquent work lists, and optional master lists. Five additional programs are used to create and maintain records of all scheduled and unscheduled maintenance history. 2 - Method of solution: Service specifications and frequency are established and stored. The computer program reviews schedules weekly and prints, on schedule cards, instructions for service that is due the following week. The basic output from the computer program comes in two forms: programmed-maintenance schedule cards and programmed-maintenance data sheets. The data sheets can be issued in numerical building, route, and location number sequence as equipment lists, grouped for work assigned to a particular foreman as the foreman's equipment list, or grouped by work charged to a particular work order as the work-order list. Data sheets grouped by equipment classification are called the equipment classification list

Progress on EPRI electrical equipment qualification research

International Nuclear Information System (INIS)

Sliter, G.E.

1983-01-01

The objective of EPRI's electrical equipment qualification research program is to provide technical assistance to utilities in meeting nuclear plant safety requirements in a manner consistent with the state of the art. This paper reports progress on several research projects including: radiation effects studies, which compile data on degradation of organic materials in electrical equipment exposed to operational and accident radiation doses; the Equipment Qualification Data Bank, which is a remotely accessible computer system for disseminating qualification information on in-plant equipment, seismic data, and materials data; an aging/seismic correlation program, which is providing test data showing that, in many cases, age degradation has a negligibly small effect on the performance of electrical components under seismic excitation; a review of condition monitoring techniques, which has identified surveillance methods for measuring key performance parameters that have the potential for predicting remaining equipment life; and large-scale hydrogen burn equipment response tests, which are providing data to assess the ability of equipment to remain functional during and after hydrogen burning in postulated degraded core accidents

Surgical Skills Beyond Scientific Management.

Science.gov (United States)

Whitfield, Nicholas

2015-07-01

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

21 CFR 884.4550 - Gynecologic surgical laser.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gynecologic surgical laser. 884.4550 Section 884....4550 Gynecologic surgical laser. (a) Identification. A gynecologic surgical laser is a continuous wave carbon dioxide laser designed to destroy tissue thermally or to remove tissue by radiant light energy...

78 FR 25916 - Authorization of Radiofrequency Equipment

Science.gov (United States)

2013-05-03

...] Authorization of Radiofrequency Equipment AGENCY: Federal Communications Commission. ACTION: Proposed rule... bodies, and measurement procedures used to determine RF equipment compliance. The Commission believes... Commission is responsible for an equipment authorization program for radiofrequency (RF) devices under part 2...

Risk Factors and Predictive Model Development of Thirty-Day Post-Operative Surgical Site Infection in the Veterans Administration Surgical Population.

Science.gov (United States)

Li, Xinli; Nylander, William; Smith, Tracy; Han, Soonhee; Gunnar, William

2018-04-01

Surgical site infection (SSI) complicates approximately 2% of surgeries in the Veterans Affairs (VA) hospitals. Surgical site infections are responsible for increased morbidity, length of hospital stay, cost, and mortality. Surgical site infection can be minimized by modifying risk factors. In this study, we identified risk factors and developed accurate predictive surgical specialty-specific SSI risk prediction models for the Veterans Health Administration (VHA) surgery population. In a retrospective observation study, surgical patients who underwent surgery from October 2013 to September 2016 from 136 VA hospitals were included. The Veteran Affairs Surgical Quality Improvement Program (VASQIP) database was used for the pre-operative demographic and clinical characteristics, intra-operative characteristics, and 30-day post-operative outcomes. The study population represents 11 surgical specialties: neurosurgery, urology, podiatry, otolaryngology, general, orthopedic, plastic, thoracic, vascular, cardiac coronary artery bypass graft (CABG), and cardiac valve/other surgery. Multivariable logistic regression models were developed for the 30-day post-operative SSIs. Among 354,528 surgical procedures, 6,538 (1.8%) had SSIs within 30 days. Surgical site infection rates varied among surgical specialty (0.7%-3.0%). Surgical site infection rates were higher in emergency procedures, procedures with long operative duration, greater complexity, and higher relative value units. Other factors associated with increased SSI risk were high level of American Society of Anesthesiologists (ASA) classification (level 4 and 5), dyspnea, open wound/infection, wound classification, ascites, bleeding disorder, chemotherapy, smoking, history of severe chronic obstructive pulmonary disease (COPD), radiotherapy, steroid use for chronic conditions, and weight loss. Each surgical specialty had a distinct combination of risk factors. Accurate SSI risk-predictive surgery specialty

Diagnostic imaging and radiation therapy equipment

Energy Technology Data Exchange (ETDEWEB)

NONE

1990-05-01

This is the third edition of CSA Standard C22.2 No. 114 (now CAN/CSA-C22.2 No. 114), which is one of a series of standards issued by the Canadian Standards Association under Part II of the Canadian Electrical Code. This edition marks an important shift towards harmonization of Canadian requirements with those of the European community and the United States. Also important to this edition is the expansion of its scope to include the complete range of diagnostic imaging and radiation therapy equipment, rather than solely radiation-emitting equipment. In so doing, equipment previously addressed by CSA Standard C22.2 No. 125, Electromedical Equipment, specifically lasers for medical applications and diagnostic ultrasound units, is now dealt with in the new edition. By virtue of this expanded scope, many of the technical requirements in the electromedical equipment standard have been introduced to the new edition, thereby bringing CSA Standard C22.2 No. 114 up to date. 14 tabs., 16 figs.

Diagnostic imaging and radiation therapy equipment

International Nuclear Information System (INIS)

1990-05-01

This is the third edition of CSA Standard C22.2 No. 114 (now CAN/CSA-C22.2 No. 114), which is one of a series of standards issued by the Canadian Standards Association under Part II of the Canadian Electrical Code. This edition marks an important shift towards harmonization of Canadian requirements with those of the European community and the United States. Also important to this edition is the expansion of its scope to include the complete range of diagnostic imaging and radiation therapy equipment, rather than solely radiation-emitting equipment. In so doing, equipment previously addressed by CSA Standard C22.2 No. 125, Electromedical Equipment, specifically lasers for medical applications and diagnostic ultrasound units, is now dealt with in the new edition. By virtue of this expanded scope, many of the technical requirements in the electromedical equipment standard have been introduced to the new edition, thereby bringing CSA Standard C22.2 No. 114 up to date. 14 tabs., 16 figs

30 CFR 75.524 - Electric face equipment; electric equipment used in return air outby the last open crosscut...

Science.gov (United States)

2010-07-01

... used in return air outby the last open crosscut; maximum level of alternating or direct electric... other in return air outby the last open crosscut, shall not exceed one ampere as determined from the... Electrical Equipment-General § 75.524 Electric face equipment; electric equipment used in return air outby...

21 CFR 606.60 - Equipment.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Equipment. 606.60 Section 606.60 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS CURRENT... following frequency, include but are not limited to: Equipment Performance check Frequency Frequency of...

Surgical Management of Localized Scleroderma.

Science.gov (United States)

Lee, Jae Hyun; Lim, Soo Yeon; Lee, Jang Hyun; Ahn, Hee Chang

2017-09-01

Localized scleroderma is characterized by a thickening of the skin from excessive collagen deposits. It is not a fatal disease, but quality of life can be adversely affected due to changes in skin appearance, joint contractures, and, rarely, serious deformities of the face and extremities. We present six cases of localized scleroderma in face from our surgical practice. We reviewed six localized scleroderma cases that were initially treated with medication and then received follow-up surgery between April 2003 and February 2015. Six patients had facial lesions. These cases presented with linear dermal sclerosis on the forehead, oval subcutaneous and dermal depression in the cheek. En coup de sabre (n=4), and oval-shaped lesion of the face (n=2) were successfully treated. Surgical methods included resection with or without Z-plasty (n=3), fat graft (n=1), dermofat graft (n=1), and adipofascial free flap (n=1). Deformities of the affected parts were surgically corrected without reoccurrence. We retrospectively reviewed six cases of localized scleroderma that were successfully treated with surgery. And we propose an algorithm for selecting the best surgical approach for individual localized scleroderma cases. Although our cases were limited in number and long-term follow-up will be necessary, we suggest that surgical management should be considered as an option for treating scleroderma patients.

The Surgical Site Infection Risk Score (SSIRS: A Model to Predict the Risk of Surgical Site Infections.

Directory of Open Access Journals (Sweden)

Carl van Walraven

Full Text Available Surgical site infections (SSI are an important cause of peri-surgical morbidity with risks that vary extensively between patients and surgeries. Quantifying SSI risk would help identify candidates most likely to benefit from interventions to decrease the risk of SSI.We randomly divided all surgeries recorded in the National Surgical Quality Improvement Program from 2010 into a derivation and validation population. We used multivariate logistic regression to determine the independent association of patient and surgical covariates with the risk of any SSI (including superficial, deep, and organ space SSI within 30 days of surgery. To capture factors particular to specific surgeries, we developed a surgical risk score specific to all surgeries having a common first 3 numbers of their CPT code.Derivation (n = 181 894 and validation (n = 181 146 patients were similar for all demographics, past medical history, and surgical factors. Overall SSI risk was 3.9%. The SSI Risk Score (SSIRS found that risk increased with patient factors (smoking, increased body mass index, certain comorbidities (peripheral vascular disease, metastatic cancer, chronic steroid use, recent sepsis, and operative characteristics (surgical urgency; increased ASA class; longer operation duration; infected wounds; general anaesthesia; performance of more than one procedure; and CPT score. In the validation population, the SSIRS had good discrimination (c-statistic 0.800, 95% CI 0.795-0.805 and calibration.SSIRS can be calculated using patient and surgery information to estimate individual risk of SSI for a broad range of surgery types.

Attitudes and Perceptions of Surgical Oncology Fellows on ACGME Accreditation and the Complex General Surgical Oncology Certification.

Science.gov (United States)

Lee, David Y; Flaherty, Devin C; Lau, Briana J; Deutsch, Gary B; Kirchoff, Daniel D; Huynh, Kelly T; Lee, Ji-Hey; Faries, Mark B; Bilchik, Anton J

2015-11-01

With the first qualifying examination administered September 15, 2014, complex general surgical oncology (CGSO) is now a board-certified specialty. We aimed to assess the attitudes and perceptions of current and future surgical oncology fellows regarding the recently instituted Accreditation Council for Graduate Medical Education (ACGME) accreditation. A 29-question anonymous survey was distributed to fellows in surgical oncology fellowship programs and applicants interviewing at our fellowship program. There were 110 responses (79 fellows and 31 candidates). The response rate for the first- and second-year fellows was 66 %. Ninety-percent of the respondents were aware that completing an ACGME-accredited fellowship leads to board eligibility in CGSO. However, the majority (80 %) of the respondents stated that their decision to specialize in surgical oncology was not influenced by the ACGME accreditation. The fellows in training were concerned about the cost of the exam (90 %) and expressed anxiety in preparing for another board exam (83 %). However, the majority of the respondents believed that CGSO board certification will be helpful (79 %) in obtaining their future career goals. Interestingly, candidate fellows appeared more focused on a career in general complex surgical oncology (p = 0.004), highlighting the impact that fellowship training may have on organ-specific subspecialization. The majority of the surveyed surgical oncology fellows and candidates believe that obtaining board certification in CGSO is important and will help them pursue their career goals. However, the decision to specialize in surgical oncology does not appear to be motivated by ACGME accreditation or the new board certification.

48 CFR 870.115 - Food service equipment.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Food service equipment... DEPARTMENT SUPPLEMENTARY REGULATIONS SPECIAL PROCUREMENT CONTROLS Controls 870.115 Food service equipment. (a) All new food service equipment purchased for Dietetic Service through other than Defense General...

Diagnostic x-ray equipment and its use

International Nuclear Information System (INIS)

1993-01-01

The guide contains the requirements for the use, structure and operation of diagnostic x-ray equipment necessary to ensure the radiation safety of workers and patients. The guide is intended for the party responsible for operating the x-ray units, the staff operating, installing and maintaining x-ray examination equipment, and companies manufacturing and selling such equipment. Special requirements for mammographic and dental x-ray equipments are given in separate ST guides. (5 refs., 1 figs., 2 tabs.)

Connected Equipment Maturity Model Version 1.0

Energy Technology Data Exchange (ETDEWEB)

Butzbaugh, Joshua B. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Mayhorn, Ebony T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Sullivan, Greg [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Whalen, Scott A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2017-05-01

The Connected Equipment Maturity Model (CEMM) evaluates the high-level functionality and characteristics that enable equipment to provide the four categories of energy-related services through communication with other entities (e.g., equipment, third parties, utilities, and users). The CEMM will help the U.S. Department of Energy, industry, energy efficiency organizations, and research institutions benchmark the current state of connected equipment and identify capabilities that may be attained to reach a more advanced, future state.

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

Science.gov (United States)

Gowans, Keegan; Patel, Muneer; Lewis, Khari

2017-03-01

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

[da Vinci surgical system].

Science.gov (United States)

Watanabe, Gou; Ishikawa, Norihiro

2014-07-01

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

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

Science.gov (United States)

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

2016-04-01

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

Radioguided surgery: First experiences with surgical gamma probe

International Nuclear Information System (INIS)

Vereb, M.; Bakala, J.

2004-01-01

Full text: Thanks to the International Atomic Energy Agency and co-operation of the Nuclear Regulatory Authority of the Slovak Republic - International and Public Relations Division, sentinel lymph node detection has been introduced in one of the regional hospitals in Slovakia. Surgical Gamma Probe, the equipment needed for this has been made available. IAEA first of all helped in organizing a workshop on Scintimammography, Sentinel Lymph Node Detection and Intra-Operative Surgical Probe in Breast Cancer, in April 2002. Education of specialists - surgeons, oncologists, and pathologists and of course radiologists helped them to better understand the subject visa-vis nuclear medicine techniques. We also started the sentinel node detection following the two-days protocol. A 57 years old female with newly detected breast carcinoma in right breast, with positive mammography was investigated. Axillary lymph nodes were not palpable. Tc-99m Nanocoll, with particles size ranging 4-100 nm, was administered, 75 MBq peritumorally + 75 MBq subdermally and a dynamic lymphoscintigraphy was acquired which showed migration of the radiotracer. Static views (after 120 min.) demonstrated 4 sentinel lymph nodes in the right axilla. No lymph node was seen in the internal mammary or left axillary region. Next day before operation about 2 ml of patten blue dye was injected around the tumor and breast was compressed for about 10 min. Identification of sentinel lymph node was done with the help of surgical gamma probe and blue tinting. We found 6 nodes, first two were not really sentinel, but they were blue. A breast conservation surgery with standard axillary lymphadenectomy was performed. Pathology revealed invasive ductal carcinoma. We understand the need to establish an algorithm of examination and treatment of patients with newly diagnosed breast carcinoma. This technology requires teamwork of surgeon, nuclear medicine physician and pathologist. Regarding radiation exposure which every

Quantifying surgical access in eyebrow craniotomy with and without orbital bar removal: cadaver and surgical phantom studies.

Science.gov (United States)

Zador, Zsolt; Coope, David J; Gnanalingham, Kanna; Lawton, Michael T

2014-04-01

Eyebrow craniotomy is a recently described minimally invasive approach for tackling primarily pathology of the anterior skull base. The removal of the orbital bar may further expand the surgical corridor of this exposure, but the extent of benefit is poorly quantified. We assessed the effect of orbital bar removal with regards to surgical access in the eyebrow craniotomy using classic morphometric measurements in cadaver heads. Using surgical phantoms and neuronavigation, we also measured the 'working volume', a new parameter for characterising the volume of surgical access in these approaches. Silicon injected cadaver heads (n = 5) were used for morphometric analysis of the eyebrow craniotomy with and without orbital bar removal. Working depths and 'working areas' of surgical access were measured as defined by key anatomical landmarks. The eyebrow craniotomy with or without orbital bar removal was also simulated using surgical phantoms (n = 3, 90-120 points per trial), calibrated against a frameless neuronavigation system. Working volume was derived from reference coordinates recorded along the anatomical borders of the eyebrow craniotomy using the "α-shape algorithm" in R statistics. In cadaver heads, eyebrow craniotomy with removal of the orbital bar reduced the working depth to the ipsilateral anterior clinoid process (42 ± 2 versus 33 ± 3 mm; p < 0.05), but the working areas as defined by deep neurovascular and bony landmarks was statistically unchanged (total working areas of 418 ± 80 cm(2) versus 334 ± 48 cm(2); p = 0.4). In surgical phantom studies, however, working-volume for the simulated eyebrow craniotomies was increased with orbital bar removal (16 ± 1 cm(3) versus 21 ± 1 cm(3); p < 0.01). In laboratory studies, orbital bar removal in eyebrow craniotomy provides a modest reduction in working depth and increase in the working volume. But this must be weighed up against the added morbidity of the

Analysis of bacterial contamination on surface of general radiography equipment and CT equipment in emergency room of radiology

Energy Technology Data Exchange (ETDEWEB)

Hong, Dong Hee; KIm, Hyeong Gyun [Dept. of Radiological Science, Far East University, Eumseong (Korea, Republic of)

2016-09-15

We aim to offer basic materials about infection management through conducting bacterial contamination test about general radiography equipment and CT equipment installed in ER of three general hospitals with 100 sickbeds or more located in Gyeongsangbuk-do Province, and suggest management plan. It had been conducted from 1st December 2015 to 31st December, and objects were general radiography equipment and CT equipment of emergency room located in Gyeongsangbuk-do Province. For general radiography equipment, sources were collected from 4 places such as upper side of control box which employees use most, upper side of exposure button, whole upper side of table which is touching part of patient's skin, upper side of stand bucky's grid, and where patients put their jaws on. For CT equipment, sources were collected from 3 places such as upper side of control box which radiography room employees use most, X-ray exposure button, whole upper side of table which is touching part of patient's skin, and gantry inner. Surface contamination strain found at general radiography equipment in emergency room of radiology are Providencia stuartii(25%), Stenotrophomonas maltophilia(18%), Enterobacter cloacae(8%), Pseudomonas species(8%), Staphylococcus epidermidis(8%), Gram negative bacilli(8%), and ungrown bacteria at incubator after 48 hours of incubation (67%) which is the biggest. Most bacteria were found at upper side of stand bucky-grid and stand bucky of radiology's general radiography equipment, and most sources of CT equipment were focused at patient table, which means it is contaminated by patients who have various diseases, and patients who have strains with decreased immunity may get severe diseases. Thus infection prevention should be made through 70% alcohol disinfection at both before test and after test.

Analysis of bacterial contamination on surface of general radiography equipment and CT equipment in emergency room of radiology

International Nuclear Information System (INIS)

Hong, Dong Hee; KIm, Hyeong Gyun

2016-01-01

We aim to offer basic materials about infection management through conducting bacterial contamination test about general radiography equipment and CT equipment installed in ER of three general hospitals with 100 sickbeds or more located in Gyeongsangbuk-do Province, and suggest management plan. It had been conducted from 1st December 2015 to 31st December, and objects were general radiography equipment and CT equipment of emergency room located in Gyeongsangbuk-do Province. For general radiography equipment, sources were collected from 4 places such as upper side of control box which employees use most, upper side of exposure button, whole upper side of table which is touching part of patient's skin, upper side of stand bucky's grid, and where patients put their jaws on. For CT equipment, sources were collected from 3 places such as upper side of control box which radiography room employees use most, X-ray exposure button, whole upper side of table which is touching part of patient's skin, and gantry inner. Surface contamination strain found at general radiography equipment in emergency room of radiology are Providencia stuartii(25%), Stenotrophomonas maltophilia(18%), Enterobacter cloacae(8%), Pseudomonas species(8%), Staphylococcus epidermidis(8%), Gram negative bacilli(8%), and ungrown bacteria at incubator after 48 hours of incubation (67%) which is the biggest. Most bacteria were found at upper side of stand bucky-grid and stand bucky of radiology's general radiography equipment, and most sources of CT equipment were focused at patient table, which means it is contaminated by patients who have various diseases, and patients who have strains with decreased immunity may get severe diseases. Thus infection prevention should be made through 70% alcohol disinfection at both before test and after test

7 CFR 3015.169 - Equipment management requirements.

Science.gov (United States)

2010-01-01

... following requirements (including replacement equipment) until such actions as transfer, replacement or... transfer, replacement, or disposal of the equipment. (b) Every two years, at a minimum, a physical... 7 Agriculture 15 2010-01-01 2010-01-01 false Equipment management requirements. 3015.169 Section...

The effect of fasting on surgical performance

DEFF Research Database (Denmark)

Schefte, David Fenger; Rosenstock, Steffen Jais

2016-01-01

BACKGROUND: It is unknown whether fasting has any impact on surgical performance. This simulator-based study investigates whether fasting affects surgical performance. METHODS: Twelve healthy medical students [seven women, mean age 26.5 years (range 23-34)] with no prior experience with surgical...... simulators underwent a short course introduction to the LapSim(®) simulator. After having reached a predefined level, the participants performed five simulated salpingectomies on the LapSim(®) simulator 5-30 days after the initial introduction. The procedures took place at 9 a.m. and 2 p.m. after fasting...... in the longitudinal axis with the left hand. CONCLUSION: The simulator-based study suggests that 17 h of fasting does not deteriorate surgical performance. Further studies on the effect of fasting on surgical performance are needed....

Comparison of surgical and non-surgical orthodontic treatment approaches on occlusal and cephalometric outcomes in patients with Class II Division I malocclusions

Directory of Open Access Journals (Sweden)

Sheila Daniels

2017-07-01

Full Text Available Abstract Background This study aimed to examine end-of-treatment outcomes of severe Class II Division I malocclusion patients treated with surgical or non-surgical approaches. This study tests the hypotheses that occlusal outcomes (ABO-OGS and cephalometric outcomes differ between these groups. Methods A total of 60 patients were included: 20 of which underwent surgical correction and 40 of which did not. Cast grading of initial and final study models was performed and information was gathered from pre- to post-treatment cephalometric radiographs. The end-of-treatment ABO-OGS and cephalometric outcomes were compared to Mann-Whitney U tests and multivariable linear regression models. Results Following adjustment for multiple confounders (age, gender, complexity of case, and skeletal patterns, the final deband score (ABO-OGS was similar for both groups (23.8 for surgical group versus 22.5 for non-surgical group. Those treated surgically had a significantly larger reduction in ANB angle, 3.4° reduction versus 1.5° reduction in the non-surgical group (p = 0.002. The surgical group also showed increased maxillary incisor proclination (p = 0.001 compared to the non-surgical group. This might be attributed to retroclination of maxillary incisors during treatment selection in the non-surgical group—namely, extraction of premolars to mask the discrepancy. Conclusions Those treated surgically had a significantly larger reduction in ANB angle and increased maxillary incisor proclination compared to those treated non-surgically with no significant changes in occlusal outcomes.

Future development of IR thermovision weather satellite equipment

Science.gov (United States)

Listratov, A. V.

1974-01-01

The self radiation of the surface being viewed is used for image synthesis in IR thermovision equipment. The installation of such equipment aboard weather satellites makes it possible to obtain cloud cover pictures of the earth's surface in a complete orbit, regardless of the illumination conditions, and also provides quantitative information on the underlying surface temperature and cloud top height. Such equipment is used successfully aboard the Soviet satellites of the Meteor system, and experimentally on the American satellites of the Nimbus series. With regard to surface resolution, the present-day IR weather satellite equipment is inferior to the television equipment. This is due primarily to the comparatively low detectivity of the IR detectors used. While IR equipment has several fundamental advantages in comparison with the conventional television equipment, the problem arises of determining the possibility for future development of weather satellite IR thermovision equipment. Criteria are examined for evaluating the quality of IR.

Surgical residency: A tenant's view

African Journals Online (AJOL)

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

Access to Specialized Surgical Care

African Journals Online (AJOL)

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

[Quality of surgical continuing education in Germany].

Science.gov (United States)

Ansorg, J; Hassan, I; Fendrich, V; Polonius, M J; Rothmund, M; Langer, P

2005-03-11

One of the reasons for young doctors to leave the clinical work to go abroad or into non-clinical fields is insufficient quality of training under bad circumstances. Aim of the study was to evaluate the surgical training in Germany from the viewpoint of the residents. A questionnaire was prepared by residents and consultants and approved by the German surgical societies (Deutsche Gesellschaft fur Chirurgie und Berufsverband der Deutschen Chirurgen). It was sent to surgical residents between June 2003 and June 2004, published in "Der Chirurg BDC" and distributed among residents taking part in courses conducted by the BDC. It could be answered anonymously by email, mail or online. The questionnaire was sent back by 584 surgical residents (about 30 % of all). 58 % of the residents declared that they finished the training in the intended time (6 years). Rotation-systems as part of a structured residency program existed for 43 %. Standard surgical procedures were discussed or explained before the procedure in only 46 %. 61 % of the residents were not satisfied with the teaching assistance by their clinical teachers in the OR. Only 33 % had regular talks with the Chief about their progress in surgical training. 18 % of residents felt, that the hospital is interested in their progress in training. Indication-conferences took place in 52 % and mortality-conferences in only 20 % of programs. Regular seminars on recent issues took place in 62 %, and 61 % of residents did not get financial support to attend congresses. 36 % of residents had to use their holidays to attend congresses. Surgical training structures are not well established in about 50 % of the training hospitals from where we got answers to our survey. The training potential of daily surgical work is not used appropriately. It is therefore imperative to develop guidelines for surgical training, the use of log-books and rotation-programs.

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

Science.gov (United States)

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

2014-01-01

telemetry equipment may be useful when screening for optimal surgical candidates or informing appropriate response to mitigate potentially deleterious disorders such as acidemia.

Improving surgical weekend handover.

Science.gov (United States)

Culwick, Caroline; Devine, Chris; Coombs, Catherine

2014-01-01

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

[Surgical complications of colostomies].

Science.gov (United States)

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

2014-07-01

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

Special Equipment and/or Devices.

Science.gov (United States)

National Sanitation Foundation, Ann Arbor, MI.

This standard covers the sanitation requirements for equipment and/or devices used in the storage, preparation, or handling of foods and beverages. The National Sanitation Foundation's basic criteria for the evaluation of special equipment and/or devices has been prepared to fulfill several specific needs, its major function being to serve as a…

Electrical and control equipment in nuclear power plants. Problems when replacing aging equipment

International Nuclear Information System (INIS)

Nordling, Anna; Haakansson, Goeran

2012-01-01

Interoperability between different technical systems is more complicated when old and new technology meet, such as between analog and digital technology. New electrical and I and C equipment is selected with consideration to simplify and improve the compatibility and interoperability. The original construction of nuclear power plants with electricity and I and C equipment had more natural interfaces. Generally experienced guidance, to the management of interoperability and interfaces, feels insufficient. Skills transfer programs are identified as a major need, as more and more important personnel are retiring and important information is lost with them. Lack of appropriate skills directly affects the ability to produce accurate and complete requirements specification. Failure modes of newer electrical and I and C equipment are perceived as more complex than the older equipment. When choosing equipment, attempts are made to minimize unnecessary features, to reduce the number of potential failure modes. There is a lack of consistent understanding of the meaning of robustness in electrical technology and I and C technology, in the nuclear plant engineering departments. The overall picture is that the robustness has worsened since the facilities were built. The Swedish nuclear power plants have an internal organizational structure with separated client and support organization. This splits the nuclear organization into two distinct parts which threaten to separate the two entities focus. Engineering departments at the Swedish nuclear power plants express a need for increased expertise in the client organization (blocks). Competence requested is for example, system knowledge to facilitate and enhance the quality of the initial analysis performed in the blocks. Suppliers receive more recently larger turnkey projects, both to minimize costs but also to minimize the interfaces and co-function problems. This, however, heightens demands for knowledge transfer between

Advances in surgical treatment of chronic pancreatitis.

Science.gov (United States)

Ni, Qingqiang; Yun, Lin; Roy, Manish; Shang, Dong

2015-02-08

The incidence of chronic pancreatitis (CP) is between 2 and 200 per 100,000 persons and shows an increasing trend year by year. India has the highest incidence of CP in the world at approximately 114 to 200 per 100,000 persons. The incidence of CP in China is approximately 13 per 100,000 persons. The aim of this review is to assist surgeons in managing patients with CP in surgical treatment. We conducted a PubMed search for "chronic pancreatitis" and "surgical treatment" and reviewed relevant articles. On the basis of our review of the literature, we found that CP cannot be completely cured. The purpose of surgical therapy for CP is to relieve symptoms, especially pain; to improve the patient's quality of life; and to treat complications. Decompression (drainage), resection, neuroablation and decompression combined with resection are commonly used methods for the surgical treatment of CP. Before developing a surgical regimen, surgeons should comprehensively evaluate the patient's clinical manifestations, auxiliary examination results and medical history to develop an individualized surgical treatment regimen.

Surgical Navigation

DEFF Research Database (Denmark)

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

2017-01-01

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

X-ray equipment

International Nuclear Information System (INIS)

Redmayne, I.G.B.

1988-01-01

The patent concerns a warning and protection system for mobile x-ray equipment used for 'on site' radiography, so that workers in the vicinity of such a working unit can be alerted to its presence. The invention is a local repeater warning system which gives a preliminary warning that energisation of the tubehead is imminent, as well as a switch near the tubehead to abort or inhibit energisation. The latter switch allows personnel caught in the vicinity of the tubehead to prevent energisation. The preliminary warning may be flashing lamps or by a klaxon. The control unit for the equipment may include a monitoring circuit to detect failure of the warning light or klaxon. (U.K.)

X-ray equipment

Energy Technology Data Exchange (ETDEWEB)

Redmayne, I.G.B.

1988-01-06

The patent concerns a warning and protection system for mobile x-ray equipment used for 'on site' radiography, so that workers in the vicinity of such a working unit can be alerted to its presence. The invention is a local repeater warning system which gives a preliminary warning that energisation of the tubehead is imminent, as well as a switch near the tubehead to abort or inhibit energisation. The latter switch allows personnel caught in the vicinity of the tubehead to prevent energisation. The preliminary warning may be flashing lamps or by a klaxon. The control unit for the equipment may include a monitoring circuit to detect failure of the warning light or klaxon. (U.K.).

Equipment cost optimization

International Nuclear Information System (INIS)

Ribeiro, E.M.; Farias, M.A.; Dreyer, S.R.B.

1995-01-01

Considering the importance of the cost of material and equipment in the overall cost profile of an oil company, which in the case of Petrobras, represents approximately 23% of the total operational cost or 10% of the sales, an organization for the optimization of such costs has been established within Petrobras. Programs are developed aiming at: optimization of life-cycle cost of material and equipment; optimization of industrial processes costs through material development. This paper describes the methodology used in the management of the development programs and presents some examples of concluded and ongoing programs, which are conducted in permanent cooperation with suppliers, technical laboratories and research institutions and have been showing relevant results

An overview of pre-surgical evaluation

Directory of Open Access Journals (Sweden)

Kurupath Radhakrishnan

2014-01-01

Full Text Available The success of an epilepsy surgery program depends upon the early identification of potential surgical candidates and selecting from them, ideal candidates for surgery, who are destined to have a post-operative seizure-free outcome without any unacceptable neurological deficits. Since epilepsy surgery centers in resource-poor countries will lack the full range of state-of-the-art technologies usually available in resource-rich countries to perform pre-surgical evaluation, cost-effectively utilization of the locally available investigative facilities to select the surgical candidates becomes challenging. In the present era of rapid electronic communications and telemedicine, it has become possible for epilepsy surgery centers to pool their technological and human resources and to partner with centers nationally and internationally in implementing pre-surgical evaluation strategies.

Surgical ethics: today and tomorrow.

Science.gov (United States)

Sade, Robert M; Kavarana, Minoo N

2017-11-01

Ethical behavior has always been deeply ingrained in surgical culture, but ethical deliberation has only recently become an important component of cardiac surgical practice. In our earlier review, we covered a range of issues including several related to informed consent, conflict of interest, professional self-regulation and innovation, among many others. This update covers several topics of interest to cardiac surgeons and cardiologists, focusing on controversial issues specific to the practice of cardiothoracic surgery: informed consent, relations with hospitals and euthanasia and physician-assisted suicide. The future holds much uncertainty for cardiac surgical practice, research and culture, and we provide an update on ethical issues to serve as a platform for envisioning what is to come.

7 CFR 550.39 - Equipment replacement insurance.

Science.gov (United States)

2010-01-01

... 7 Agriculture 6 2010-01-01 2010-01-01 false Equipment replacement insurance. 550.39 Section 550.39... Agreements Equipment/property Standards § 550.39 Equipment replacement insurance. If required by the terms and conditions of the award, the Cooperator shall provide adequate insurance coverage for replacement...

47 CFR 76.1621 - Equipment compatibility offer.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Equipment compatibility offer. 76.1621 Section... MULTICHANNEL VIDEO AND CABLE TELEVISION SERVICE Notices § 76.1621 Equipment compatibility offer. Cable system... offer to supply each subscriber with special equipment that will enable the simultaneous reception of...

45 CFR 95.707 - Equipment management and disposition.

Science.gov (United States)

2010-10-01

... participation in the costs of replacement equipment shall be limited to the additional outlay. (4) If the... 45 Public Welfare 1 2010-10-01 2010-10-01 false Equipment management and disposition. 95.707... PROGRAMS) Equipment Acquired Under Public Assistance Programs § 95.707 Equipment management and disposition...

14 CFR 25.1441 - Oxygen equipment and supply.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Oxygen equipment and supply. 25.1441... Oxygen equipment and supply. (a) If certification with supplemental oxygen equipment is requested, the... oxygen available in each source of supply. (d) The oxygen flow rate and the oxygen equipment for...

47 CFR 36.126 - Circuit equipment-Category 4.

Science.gov (United States)

2010-10-01

... separating property associated with special services, circuit equipment included in Categories 4.12 (other... Equipment Excluding Wideband—Category 4.13—The cost of Circuit Equipment associated with exchange line plant... 47 Telecommunication 2 2010-10-01 2010-10-01 false Circuit equipment-Category 4. 36.126 Section 36...

49 CFR 238.230 - Safety appliances-new equipment.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Safety appliances-new equipment. 238.230 Section... I Passenger Equipment § 238.230 Safety appliances—new equipment. (a) Applicability. This section..., 2007, that is equipped with a safety appliance, required by the “manner of application” provisions in...

Surgical versus Non-surgical Management of Rotator Cuff Tears: Predictors of Treatment Allocation

OpenAIRE

Kweon, Christopher Y.; Gagnier, Joel Joseph; Robbins, Christopher; Bedi, Asheesh; Carpenter, James E.; Miller, Bruce S.

2014-01-01

Objectives: Rotator cuff tears are a common shoulder disorder resulting in significant disability to patients and strain on the health care system. While both surgical and non-surgical management are accepted treatment options, little data exist to guide the surgeon in treatment allocation. Defining variables to guide treatment allocation may be important for patient education and counseling, as well as to deliver the most efficient care plan at the time of presentation. The objective of this...

Hot conditioning equipment conceptual design report

International Nuclear Information System (INIS)

Bradshaw, F.W.

1996-01-01

This report documents the conceptual design of the Hot Conditioning System Equipment. The Hot conditioning System will consist of two separate designs: the Hot Conditioning System Equipment; and the Hot Conditioning System Annex. The Hot Conditioning System Equipment Design includes the equipment such as ovens, vacuum pumps, inert gas delivery systems, etc.necessary to condition spent nuclear fuel currently in storage in the K Basins of the Hanford Site. The Hot Conditioning System Annex consists of the facility of house the Hot Conditioning System. The Hot Conditioning System will be housed in an annex to the Canister Storage Building. The Hot Conditioning System will consist of pits in the floor which contain ovens in which the spent nuclear will be conditioned prior to interim storage

Hot conditioning equipment conceptual design report

Energy Technology Data Exchange (ETDEWEB)

Bradshaw, F.W., Westinghouse Hanford

1996-08-06

This report documents the conceptual design of the Hot Conditioning System Equipment. The Hot conditioning System will consist of two separate designs: the Hot Conditioning System Equipment; and the Hot Conditioning System Annex. The Hot Conditioning System Equipment Design includes the equipment such as ovens, vacuum pumps, inert gas delivery systems, etc.necessary to condition spent nuclear fuel currently in storage in the K Basins of the Hanford Site. The Hot Conditioning System Annex consists of the facility of house the Hot Conditioning System. The Hot Conditioning System will be housed in an annex to the Canister Storage Building. The Hot Conditioning System will consist of pits in the floor which contain ovens in which the spent nuclear will be conditioned prior to interim storage.

Surgical Site Infection Following Fixation of Acetabular Fractures.

Science.gov (United States)

Iqbal, Faizan; Younus, Sajid; Asmatullah; Zia, Osama Bin; Khan, Naveed

2017-09-01

Acetabular fractures are mainly caused by high energy trauma. Surgical fixation of these fractures requires extensive surgical exposure which increases the length of operation and blood loss as well. This may increase the risk of surgical site infection. Our aim is to evaluate the prevalence of surgical site infections and the risk factors associated with it so as to minimize its chances. A total of 261 patients who underwent acetabular fracture surgery were retrospectively reviewed. Patients were divided into 2 groups, with or without surgical site infection. Factors examined include patients' gender, age, body mass index (BMI), time between injury and surgery, operative time, estimated blood loss, number of packed red blood cell transfused, length of total intensive care unit (ICU) stay, fracture type, surgical approach, smoking status, patients' comorbids and associated injuries. Fourteen patients (5.4%) developed surgical site infection. Out of 14 infections, 4 were superficial and 10 were deep. The factors that were found to be associated with surgical site infection following acetabular fracture fixation were prolonged operation time, increased BMI, prolonged ICU stay, larger amount of packed red blood cell transfused and associated genitourinary and abdominal trauma. In our study, we conclude that measures should be undertaken to attenuate the chances of surgical site infection in this major surgery by considering the risk factors significantly associated with it.

The effects of the European Working Time Directive on surgical training: the basic surgical trainee's perspective.

LENUS (Irish Health Repository)

Kelly, B D

2012-01-31

BACKGROUND: On the 1 August 2009, the implementation of European Working Time Directive became European law and was implemented in Galway University Hospital (GUH). AIMS: The aim of the study is to ascertain the opinion of the 25 surgical SHOs in GUH on the effect of the implementation of an EWTD compliant roster had on the quality of their training. METHODS: A questionnaire was circulated to all 25 surgical SHOs. RESULTS: Twenty-two (88%) SHOs report a reduction in the quality of their training. 18 (72%) report a reduction in the development of their operative skills. The SHOs believed the EWTD Rotas would encourage Irish graduates to train abroad. CONCLUSIONS: Surgical training faces a challenge with the implementation of EWTD Rotas. Major changes need to be made to the surgical training structure to train surgeons to the highest standard and to retain Irish-trained surgeons in the Irish healthcare system.

Practical approaches to implementing facility wide equipment strengthening programs

International Nuclear Information System (INIS)

Kincaid, R.H.; Smietana, E.A.

1989-01-01

Equipment strengthening programs typically focus on components required to ensure operability of safety related equipment or to prevent the release of toxic substances. Survival of non-safety related equipment may also be crucial to ensure rapid recovery and minimize business interruption losses. Implementing a strengthening program for non-safety related equipment can be difficult due to the large amounts of equipment involved and limited budget availability. EQE has successfully implemented comprehensive equipment strengthening programs for a number of California corporations. Many of the lessons learned from these projects are applicable to DOE facilities. These include techniques for prioritizing equipment and three general methodologies for anchoring equipment. Pros and cons of each anchorage approach are presented along with typical equipment strengthening costs

Mine railway equipments management information system

Energy Technology Data Exchange (ETDEWEB)

Zhang, X.; Han, K.; Duan, T.; Liu, Z.; Lu, H. [China University of Mining and Technology, Xuzhou (China)

2007-06-15

Based on client/server and browser/server models, the management information system described realized the entire life-cycle management of mine railway equipment which included universal equipment and special equipment in the locomotive depot, track maintenance division, electrical depot and car depot. The system has other online functions such as transmitting reports, graphics management, statistics, searches, graphics wizard and web propaganda. It was applied in Pingdingshan Coal Co. Ltd.'s Railway Transport Department. 5 refs., 4 figs.

Module based training improves and sustains surgical skills

DEFF Research Database (Denmark)

Carlsen, C G; Lindorff-Larsen, K; Funch-Jensen, P

2015-01-01

PURPOSE: Traditional surgical training is challenged by factors such as patient safety issues, economic considerations and lack of exposure to surgical procedures due to short working hours. A module-based clinical training model promotes rapidly acquired and persistent surgical skills. METHODS...... hernia repair was preferable in both short and long-term compared with standard clinical training. The model will probably be applicable to other surgical training procedures....

40 CFR 63.1363 - Standards for equipment leaks.

Science.gov (United States)

2010-07-01

... the replacement equipment and the actual date of delivery of the replacement equipment. (E) The date... heavy liquid service. Information, data, and analysis used to determine that a piece of equipment or... 40 Protection of Environment 11 2010-07-01 2010-07-01 true Standards for equipment leaks. 63.1363...

41 CFR 109-50.4801 - Equipment Gift Agreement.

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Equipment Gift Agreement... 50-SPECIAL DOE DISPOSAL AUTHORITIES 50.48-Exhibits § 109-50.4801 Equipment Gift Agreement. (a) The following Equipment Gift Agreement format will be used to provide gifts of excess and/or surplus equipment...

36 CFR 1207.32 - Equipment.

Science.gov (United States)

2010-07-01

... 1207.32 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION GENERAL RULES... as follows: (1) Items of equipment with a current per-unit fair market value of less than $5,000 may...) Items of equipment with a current per unit fair market value in excess of $5,000 may be retained or sold...

Management of radiological related equipments. Creating the equipment management database and analysis of the repair and maintenance records

International Nuclear Information System (INIS)

Eguchi, Megumu; Taguchi, Keiichi; Oota, Takashi; Kajiwara, Hiroki; Ono, Kiyotune; Hagio, Kiyofumi; Uesugi, Ekizo; Kajishima, Tetuo; Ueda, Kenji

2002-01-01

In 1997, we established the committee of equipments maintenance and management in our department. We designed the database in order to classify and register all the radiological related equipments using Microsoft Access. The management of conditions and cost of each equipment has become easier, by keeping and recording the database in the equipments management ledger and by filing the history of repairs or maintenances occurred to modalities. We then accounted numbers, cost of repairs and downtimes from the data of the repair and maintenance records for four years, and we reexamined the causal analysis of failures and the contents of the regular maintenance for CT and MRI equipments that had shown the higher numbers of repairs. Consequently, we have found the improvement of registration method of the data and the more economical way to use of the cost of repair. (author)

7 CFR 3015.168 - Disposal of equipment.

Science.gov (United States)

2010-01-01

..., DEPARTMENT OF AGRICULTURE UNIFORM FEDERAL ASSISTANCE REGULATIONS Property § 3015.168 Disposal of equipment. When original or replacement equipment is no longer to be used in projects or programs currently or... 7 Agriculture 15 2010-01-01 2010-01-01 false Disposal of equipment. 3015.168 Section 3015.168...

40 CFR 63.1434 - Equipment leak provisions.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 11 2010-07-01 2010-07-01 true Equipment leak provisions. 63.1434... Standards for Hazardous Air Pollutant Emissions for Polyether Polyols Production § 63.1434 Equipment leak provisions. (a) The owner or operator of each affected source shall comply with the HON equipment leak...

Characterization equipment essential/support drawing plan

International Nuclear Information System (INIS)

WILSON, G.W.

1999-01-01

The purpose of this document is to list the Characterization equipment drawings that are classified as Essential Drawings and Support Drawings. Essential Drawings: Are those drawings identified by the facility staff as necessary to directly support the safe operation of the facility or equipment (HNF 1997a). Support Drawings: Are those drawings identified by facility staff that further describe the design details of structures, systems, or components shown on essential drawings. (HNF 1997a) The Characterization equipment drawings identified in this report are deemed essential drawings as defined in HNF-PRO-242, Engineering Drawing Requirements (HNF 1997a). These drawings will be prepared, revised, and maintained per HNF-PRO-440, Engineering Document Change Control (HNF 1997b). All other Characterization equipment drawings not identified in this document will be considered General drawings until the Characterization Equipment Drawing Evaluation Report (Wilson 1998) is updated during fiscal year 1999. Trucks 1 and 2 drawings are not included in this revision of the essential drawing list due to uncertainty about future use

Radioactive decontamination of equipment

International Nuclear Information System (INIS)

1982-03-01

After a recall of some definitions relating to decontamination techniques and of the regulation into effect, the principles to be respected to arrange rationally work zones are quoted while insisting more particularly on the types of coatings which facilitate maintenance operations and the dismantling of these installations. Then, the processes and equipments to use in decontamination units for routine or particular operations are described; the list of recommended chemical products to decontaminate the equipment is given. The influence of these treatments on the state and the duration of life of equipments is studied, and some perfectible methods are quoted. In the appendix, are given: the limits of surface contamination accepted in the centers; a standard project which defines the criteria of admissible residual contamination in wastes considered as cold wastes; some remarks on the interest that certain special ventilation and air curtain devices for the protection of operators working on apparatus generating contaminated dusts [fr

Mobile emergency (surgical hospital: Development and application in medical relief of “4.20” Lushan earthquake in Sichuan Province, China

Directory of Open Access Journals (Sweden)

Cheng Bin

2015-07-01

Full Text Available In the 21st century, natural disasters and emergencies occur frequently worldwide, which leads to the loss of hundreds of thousands of lives as well as the direct and indirect economic losses. China has a vast territory frequently struck by natural disasters. However, the reality is not optimistic. Poor organization and management during the rescue actions, the lack of large-scale, systematic medical rescue equipment were all great barriers to the outcomes. Mobile hospitals are expected to provide better health care. We were inspired by the concept of mobile hospital. Chongqing Emergency Medical Center, has set up trauma care system since 1988, in which prehospital care, intensive care, and in-hospital treatment is fully integrated. As a major advantage, such a system provided assurance of “golden hour” rescue treatment. Providing mobile intensive care and prehospital surgical service for severe trauma patients could reduce mortality significantly. Based on the civilian experiences in Chongqing Emergency Medical Center, the mobile emergency (surgical hospital was developed.

46 CFR 96.40-1 - Pilot boarding equipment.

Science.gov (United States)

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Pilot boarding equipment. 96.40-1 Section 96.40-1... CONTROL AND MISCELLANEOUS SYSTEMS AND EQUIPMENT Pilot Boarding Equipment § 96.40-1 Pilot boarding... boat or other vessel. (b) Each vessel must have suitable pilot boarding equipment available for use on...

46 CFR 195.40-1 - Pilot boarding equipment.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Pilot boarding equipment. 195.40-1 Section 195.40-1... CONTROL AND MISCELLANEOUS SYSTEMS AND EQUIPMENT Pilot Boarding Equipment § 195.40-1 Pilot boarding... boat or other vessel. (b) Each vessel must have suitable pilot boarding equipment available for use on...

Three equipment concepts for the Fusion Engineering Device

International Nuclear Information System (INIS)

Spampinato, P.T.; Masson, L.S.; Watts, K.D.; Grant, N.R.; Kuban, D.P.

1982-01-01

Maintenance equipment which is needed to remotely handle fusion device components is being conceptually developed for the Fusion Engineering Design Center. This will test the assumption that these equipment needs can be satisfied by present technology. In addition, the development of equipment conceptual designs will allow for cost estimates which have a much higher degree of certainty. Accurate equipment costs will be useful for assessments which trade off gains in availability as a function of increased investments in maintenance equipment

14 CFR 135.173 - Airborne thunderstorm detection equipment requirements.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Airborne thunderstorm detection equipment... Aircraft and Equipment § 135.173 Airborne thunderstorm detection equipment requirements. (a) No person may... the aircraft is equipped with either approved thunderstorm detection equipment or approved airborne...

Polyurethane membranes for surgical gown applications

Science.gov (United States)

Ukpabi, Pauline Ozoemena

The Occupational Safety and Health Administration (OSHA) recently issued a directive requiring all employers to supply personnel protective equipment to employees who are at risk of exposure to blood or other potentially infectious body fluids. For the healthcare worker, a wide variety of surgical gowns is available commercially but there are concerns over their barrier effectiveness and/or wearer comfort. To successfully create a barrier fabric which combines resistance to fluid penetration with comfort, a complete understanding of the relationship between membrane structure and functional properties is required. In this study, we investigated the surface properties of hydrophilicity and hydrophobicity in polyurethane membranes intended for use in surgical gowns. The polyurethane membranes were grafted with side chains of varying lengths, polyethylene glycol (PEG) being used for the hydrophilic modifications and perfluoroalkyl compounds (a monofunctional acid and a difunctional amino alcohol) for the hydrophobic modifications. The hydrophilic treatment was intended to improve the comfort properties of monolithic membranes without adversely affecting their barrier properties. The hydrophobic treatment, on the other hand, was intended to improve the fluid repellency and hence barrier properties of microporous membranes without adversely affecting their comfort properties. Reflection infrared spectroscopy showed that fluorine was successfully grafted onto the polyurethane backbone during the hydrophobic modification, but was not sensitive enough to detect PEG grafting in leached polyethylene glycol-treated polyurethanes. X-ray photoelectron spectroscopy showed that the perfluoroalkylated polyurethanes contained up to 40% fluorine on their surfaces and the PEG-treated polyurethanes showed an increase in their C-O content over the unmodified polyurethane. Scanning electron microscopy not only showed that perfluoroalkylation yielded polyurethane membranes with very

Maintenance of influenza virus infectivity on the surfaces of personal protective equipment and clothing used in healthcare settings.

Science.gov (United States)

Sakaguchi, Hiroko; Wada, Koji; Kajioka, Jitsuo; Watanabe, Mayumi; Nakano, Ryuichi; Hirose, Tatsuko; Ohta, Hiroshi; Aizawa, Yoshiharu

2010-11-01

The maintenance of infectivity of influenza viruses on the surfaces of personal protective equipment and clothing is an important factor in terms of controlling viral cross-infection in the environment and preventing contact infection. The aim of this study was to determine if laboratory-grown influenza A (H1N1) virus maintained infectivity on the surfaces of personal protective equipment and clothing used in healthcare settings. Influenza A virus (0.5 mL) was deposited on the surface of a rubber glove, an N95 particulate respirator, a surgical mask made of non-woven fabric, a gown made of Dupont Tyvek, a coated wooden desk, and stainless steel. Each sample was left for 1, 8, and 24 h, and hemagglutination (HA) and 50% tissue culture infective dose (TCID(50))/mL were measured. The HA titer of this influenza A virus did not decrease in any of the materials tested even after 24 h. The infectivity of influenza A virus measured by TCID(50) was maintained for 8 h on the surface of all materials, with the exception of the rubber glove for which virus infectivity was maintained for 24 h. Our results indicate that the replacement/renewal of personal protective equipment and clothing by healthcare professionals in cases of exposure to secretions and droplets containing viruses spread by patients is an appropriate procedure to prevent cross-infection.

14 CFR 25.1439 - Protective breathing equipment.

Science.gov (United States)

2010-01-01

... also enable the flightcrew to use radio equipment. (4) The part of the equipment protecting the eyes... Regulations: (1) The equipment must be designed to protect the appropriate crewmember from smoke, carbon... must include— (i) Masks covering the eyes, nose and mouth, or (ii) Masks covering the nose and mouth...

40 CFR 63.769 - Equipment leak standards.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 10 2010-07-01 2010-07-01 false Equipment leak standards. 63.769... § 63.769 Equipment leak standards. (a) This section applies to equipment subject to this subpart and... release to detect leaks, except under the following conditions. (i) The owner or operator has obtained...

40 CFR 63.424 - Standards: Equipment leaks.

Science.gov (United States)

2010-07-01

....424 Standards: Equipment leaks. (a) Each owner or operator of a bulk gasoline terminal or pipeline... location of all equipment in gasoline service at the facility. (c) Each detection of a liquid or vapor leak... replacement of leaking equipment shall be completed within 15 calendar days after detection of each leak...

Do psychological variables affect early surgical recovery?

Directory of Open Access Journals (Sweden)

Michael N Mavros

Full Text Available BACKGROUND: Numerous studies have examined the effect of psychological variables on surgical recovery, but no definite conclusion has been reached yet. We sought to examine whether psychological factors influence early surgical recovery. METHODS: We performed a systematic search in PubMed, Scopus and PsycINFO databases to identify studies examining the association of preoperative psychological variables or interventions with objectively measured, early surgical outcomes. RESULTS: We identified 16 eligible studies, 15 of which reported a significant association between at least one psychological variable or intervention and an early postoperative outcome. However, most studies also reported psychological factors not influencing surgical recovery and there was significant heterogeneity across the studies. Overall, trait and state anxiety, state anger, active coping, subclinical depression, and intramarital hostility appeared to complicate recovery, while dispositional optimism, religiousness, anger control, low pain expectations, and external locus of control seemed to promote healing. Psychological interventions (guided relaxation, couple support visit, and psychiatric interview also appeared to favor recovery. Psychological factors unrelated to surgical outcomes included loneliness, perceived social support, anger expression, and trait anger. CONCLUSION: Although the heterogeneity of the available evidence precludes any safe conclusions, psychological variables appear to be associated with early surgical recovery; this association could bear important implications for clinical practice. Large clinical trials and further analyses are needed to precisely evaluate the contribution of psychology in surgical recovery.

Surgical care in the isolated military hospital.

Science.gov (United States)

Lukish, J R; Gill, G G; McCoy, T R

2001-01-01

To maintain the health of service members and their families throughout the world, the Department of Defense has established several isolated military hospitals (IHs). The operational environment of IHs is such that illness and traumatic injury requiring surgical intervention is common. This study sought to examine the general and orthopedic surgical experience at an IH to determine whether surgical care could be provided in an effective and safe manner. All patients evaluated by the general and orthopedic surgeon at Guantanamo Bay Naval Hospital from October 1, 1998, to April 1, 1999, were included in this study. The following data were retrospectively reviewed: patient demographic data, diagnosis, initial and follow-up care, medical evacuation data, operative procedures, and complications. There were 336 patients who presented for surgical evaluation, resulting in 660 follow-up appointments during the study period. There were 31 medical evacuations (3 emergent). The surgical services performed 122 major operative procedures. There were 58 inpatient admissions. There was 1 death, and surgical complications occurred in 2 patients, for an overall morbidity and mortality of 1.4% and 0.7%, respectively. Our data show that an IH is capable of providing surgical care, including care for traumatic injuries, in a safe manner. This is the first study that provides objective evidence that general and orthopedic surgery at an IH can be provided within the standard of care.

Cost analysis for heavy equipment in earthfill work - An optimization of heavy equipment fleet (Case study: Jabung ring dike project)

Science.gov (United States)

Arifin, Muhammad Faizal Ardhiansyah

2017-03-01

Earth fill work with large volumes of soil deposits will involve a lot of heavy equipment with a variety of functions and with different objectives. Where each machine will have different productivity anyway. So that in this paper discusses the calculation of the cost required to do the compacted earthfill work for embankment in accordance with the volume of work, the target date for implementation, and the number of heavy equipment needs. As the cost calculations used heavy equipment rental price per hour. In the cost analysis calculations use heavy equipment here there are several factors that we included in the calculation, are: 1.)Hauling distance; 2.)Effective hour a day; 3.)Change factor of Soil Volume; 4.)Effective Speed; 5.)Equipment efficiency factor; 6.)Equipment coefficient; 7.)Cycle Time.

46 CFR 32.90-1 - Pilot boarding equipment.

Science.gov (United States)

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Pilot boarding equipment. 32.90-1 Section 32.90-1... REQUIREMENTS Pilot Boarding Equipment § 32.90-1 Pilot boarding equipment. (a) This section applies to each... must have suitable pilot boarding equipment available for use on each side of the vessel. If a vessel...

Pre-surgical register of tobacco consumption.

Science.gov (United States)

Gavilán, Eva; Moreno, Montse; Pérez, Àngels; Castellano, Yolanda; Fernández, Esteve; Martínez, Cristina

2018-03-24

Smoking cessation before surgery decreases the risk of complications. The aim of this study was to analyse the smoking register, associated variables and a short talk given to smokers in pre-surgical visits. Cross-sectional study. The pre-surgical records of 680 patients were assessed. We selected patient sociodemographic variables, surgical intervention characteristics, smoking status and consumption pattern. Logistic regression was used to study the variables association with smoking. A percentage of 97.2 of the pre-surgical records include information on tobacco consumption. Overall 20% of surgical patients are smokers. The probability of smoking is higher among men (adjusted odds ratio [aOR] 2.6, 95% confidence interval [CI] 1.7-4.0) and≤60 years (aOR 5.4, 95% CI 3.2-9.1). None of the records had information regarding a short talk given to patients to give up smoking. Smoking consumption was prevalent, but the characterisation of a smoker's profile and short talk given to patient before surgery was practically nonexistent. Ensuring that patients who smokes receives a short talk to give up smoking before surgery is necessary. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

Nuclear power equipment procurement management under EPC mode

International Nuclear Information System (INIS)

Shuai Yuezhi

2014-01-01

Nuclear power equipment procurement is one of the major constraints and management difficulties in the process of domestic nuclear power project construction for a long time. The construction of Hainan Changjiang Project can not meet the milestones due to the major equipment supply delay. Through the introduction to the organization and features of Changjiang project equipment procurement under EPC mode, and the main problems in the procurement process and its reason analysis, the purpose of this paper is to put forward ideas and suggestions of these items, i.e. selection of equipment suppliers, equipment localization, mass material design and procurement, complete system equipment supply, spare parts delivery and storage, owner process management, providing reference for follow-up projects. (author)

Liability exposure for surgical robotics instructors.

Science.gov (United States)

Lee, Yu L; Kilic, Gokhan; Phelps, John Y

2012-01-01

Surgical robotics instructors provide an essential service in improving the competency of novice gynecologic surgeons learning robotic surgery and advancing surgical skills on behalf of patients. However, despite best intentions, robotics instructors and the gynecologists who use their services expose themselves to liability. The fear of litigation in the event of a surgical complication may reduce the availability and utility of robotics instructors. A better understanding of the principles of duty of care and the physician-patient relationship, and their potential applicability in a court of law likely will help to dismantle some concerns and uncertainties about liability. This commentary is not meant to discourage current and future surgical instructors but to raise awareness of liability issues among robotics instructors and their students and to recommend certain preventive measures to curb potential liability risks. Published by Elsevier Inc.

Drawing Evaluation Report for Sampling Equipment Drawings

International Nuclear Information System (INIS)

BOGER, R.M.

1999-01-01

This document presents the results of a task to update the evaluation of River Protection Project (WP) sampling equipment drawings and updates the assigned drawings category as either essential, support, or general drawings. This report updates the drawing evaluation that was originally done per Engineering Task Plan For Truck 3 and 4 Drawing Compliance and Evaluation. The scope of this report is limited to updating the evaluation and identification of drawing category for drawings of certain tank waste sampling equipment for which the RPP Characterization Project has been assigned custody, including: vapor sampling, grab sampling, auger sampling, all core sampling equipment, and Light Duty Utility Arm (LDUA) (see LMHC contract No. 519, release 10). This report does not address drawings for other waste tank deployed equipment systems having similar assigned custody, such as, Cone Penetrometer system, or Long Length Contaminated Equipment (LLCE). The Cone Penetrometer system, which is depicted on vendor drawings, (not H- series), is not currently turned over to operations for deployment. The LLCE equipment was just recently assigned to Characterization Project and was not included in the original scope for this update and will be addressed in the evaluation update scheduled for later in fiscal year 1999, when equipment ownership is determined

Drawing evaluation report for sampling equipment drawings

International Nuclear Information System (INIS)

WILSON, G.W.

1999-01-01

This document presents the results of a task to evaluate Tank Waste Remediation System (TWRS) sampling equipment drawings and identifies drawings category as either essential, support, or general drawings. This report completes the drawing evaluation task as outlined in Engineering Task Plan For Truck 3 and 4 Drawing Compliance and Evaluation (Wilson, 1997). The scope of this report is limited to an evaluation and identification of drawing category for drawings of certain tank waste sampling equipment for which the TRWS Characterization Project has been assigned custody, including: vapor sampling, grab sampling, auger sampling, and all core sampling equipment (see LMHC Task Order 304). This report does not address drawings for other waste tank deployed equipment systems having similar assigned custody, such as, Light Duty Utility Arm (LDUA), Cone Penetrometer system, or Long Length Contaminated Equipment (LLCE). The LDUA drawings are addressed in the Characterization Equipment Essential Drawings (HNF 1998). The Cone Penetrometer system drawings which are vendor drawings (not H- series) is not currently turned over to operations for deployment. The LLCE equipment was just recently assigned to Characterization Project and were not included in the original scope for this evaluation and will be addressed in the evaluation update scheduled for fiscal year 1999

AX Tank Farm ancillary equipment study

International Nuclear Information System (INIS)

SKELLY, W.A.

1999-01-01

This report examines the feasibility of remediating ancillary equipment associated with the 241-AX Tank Farm at the Hanford Site. Ancillary equipment includes surface structures and equipment, process waste piping, ventilation components, wells, and pits, boxes, sumps, and tanks used to make waste transfers to/from the AX tanks and adjoining tank farms. Two remedial alternatives are considered: (1) excavation and removal of all ancillary equipment items, and (2) in-situ stabilization by grout filling, the 241-AX Tank Farm is being employed as a strawman in engineering studies evaluating clean and landfill closure options for Hanford single-shell tanks. This is one of several reports being prepared for use by the Hanford Tanks Initiative Project to explore potential closure options and to develop retrieval performance evaluation criteria for tank farms

29 CFR 1926.603 - Pile driving equipment.

Science.gov (United States)

2010-07-01

... 29 Labor 8 2010-07-01 2010-07-01 false Pile driving equipment. 1926.603 Section 1926.603 Labor... Operations § 1926.603 Pile driving equipment. (a) General requirements. (1) Boilers and piping systems which are a part of, or used with, pile driving equipment shall meet the applicable requirements of the...

46 CFR 71.25-25 - Hull equipment.

Science.gov (United States)

2010-10-01

... 46 Shipping 3 2010-10-01 2010-10-01 false Hull equipment. 71.25-25 Section 71.25-25 Shipping COAST... Inspection § 71.25-25 Hull equipment. (a) At each annual inspection, the inspector shall conduct the following tests and inspections of hull equipment: (1) All subdivision bulkheads shall be examined to...

Diagnostic x-ray equipment compliance and facility survey. Recommended procedures for equipment and facility testing

International Nuclear Information System (INIS)

1994-01-01

The Radiation Protection Bureau has set out guidelines for the testing of diagnostic x-ray equipment and facilities. This guide provides information for the x-ray inspector, test engineer, technologist, medical physicist and any other person responsible for verifying the regulatory compliance or safety of diagnostic x-ray equipment and facilities. Diagnostic x-radiation is an essential part of present day medical practice. The largest contributor of irradiation to the general population comes from diagnostic x-radiation. Although individual irradiations are usually small, there is a concern of possible excess cancer risk when large populations are irradiated. Unnecessary irradiations to patients from radiological procedures can be significantly reduced with little or no decrease in the value of medical diagnostic information. This can be achieved by using well designed x-ray equipment which is installed, used and maintained by trained personnel, and by the adoption of standardized procedures. In general, when patient surface dose is reduced, there is a corresponding decrease in dose to x-ray equipment operators and other health care personnel. 2 tabs., 4 figs

Diagnostic x-ray equipment compliance and facility survey. Recommended procedures for equipment and facility testing

Energy Technology Data Exchange (ETDEWEB)

NONE

1994-12-31

The Radiation Protection Bureau has set out guidelines for the testing of diagnostic x-ray equipment and facilities. This guide provides information for the x-ray inspector, test engineer, technologist, medical physicist and any other person responsible for verifying the regulatory compliance or safety of diagnostic x-ray equipment and facilities. Diagnostic x-radiation is an essential part of present day medical practice. The largest contributor of irradiation to the general population comes from diagnostic x-radiation. Although individual irradiations are usually small, there is a concern of possible excess cancer risk when large populations are irradiated. Unnecessary irradiations to patients from radiological procedures can be significantly reduced with little or no decrease in the value of medical diagnostic information. This can be achieved by using well designed x-ray equipment which is installed, used and maintained by trained personnel, and by the adoption of standardized procedures. In general, when patient surface dose is reduced, there is a corresponding decrease in dose to x-ray equipment operators and other health care personnel. 2 tabs., 4 figs.

Availability of cardiac surgical care in surgical correction of acquired heart defects in patients of older age group

Directory of Open Access Journals (Sweden)

Kubatbek S. Urmanbetov

2018-02-01

Full Text Available Objective: A study of accessibility of surgical care to elderly patients (aged 60 and above with valvular heart disease has been conducted at the BSCCS "Bakulev Scientific Center of Cardiovascular Surgery» of the Ministry of Health of the Russian Federation. Methods: A retrospective analysis of structure of hospitalizations of 1726 patients, that were hospitalized between 2009 and 2010 at the BSCCS for surgical correction of valvular heart disease was performed. Results: Our study demonstrated that age, on one hand, is not the most significant barrier in the geographical accessibility of cardiac surgical care. On the other hand, it can influence the availability in general, taking into account other factors (urban / rural areas, the presence of cardiac surgical clinics, and clinical status. Provision of cardiac surgical care for patients with heart defects at the BSCCS per 1 million population varies considerably in the context of federal districts and is 0.4 for the Siberian Federal District 30 for the Central Federal District (the highest is 42 for the Moscow Region. Conclusion: Thus, our study demonstrated accessibility of surgical care for elderly patients is the highest for the urban areas with specialized cardiac surgery centers, where patients referred from rural regions

32 CFR 34.21 - Real property and equipment.

Science.gov (United States)

2010-07-01

... original equipment as trade-in or sell it and use the proceeds to offset the costs of the replacement... request approval to use equipment as trade-in or offset for replacement equipment (see paragraph (e)(1)(i... 32 National Defense 1 2010-07-01 2010-07-01 false Real property and equipment. 34.21 Section 34.21...

Retained Surgical Foreign Bodies after Surgery

Directory of Open Access Journals (Sweden)

Valon A. Zejnullahu

2017-01-01

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

Surgical treatment of chronic pancreatitis in young patients.

Science.gov (United States)

Zhou, Feng; Gou, Shan-Miao; Xiong, Jiong-Xin; Wu, He-Shui; Wang, Chun-You; Liu, Tao

2014-10-01

The main treatment strategies for chronic pancreatitis in young patients include therapeutic endoscopic retrograde cholangio-pancreatography (ERCP) intervention and surgical intervention. Therapeutic ERCP intervention is performed much more extensively for its minimally invasive nature, but a part of patients are referred to surgery at last. Historical and follow-up data of 21 young patients with chronic pancreatitis undergoing duodenum-preserving total pancreatic head resection were analyzed to evaluate the outcomes of therapeutic ERCP intervention and surgical intervention in this study. The surgical complications of repeated therapeutic ERCP intervention and surgical intervention were 38% and 19% respectively. During the first therapeutic ERCP intervention to surgical intervention, 2 patients developed diabetes, 5 patients developed steatorrhea, and 5 patients developed pancreatic type B pain. During the follow-up of surgical intervention, 1 new case of diabetes occurred, 1 case of steatorrhea recovered, and 4 cases of pancreatic type B pain were completely relieved. In a part of young patients with chronic pancreatitis, surgical intervention was more effective than therapeutic ERCP intervention on delaying the progression of the disease and relieving the symptoms.

Innovative Surgical Management of the Synovial Chondromatosis of Temporo-Mandibular Joints: Highly Conservative Surgical Technique.

Science.gov (United States)

Ionna, Franco; Amantea, Massimiliano; Mastrangelo, Filiberto; Ballini, Andrea; Maglione, Maria Grazia; Aversa, Corrado; De Cecio, Rossella; Russo, Daniela; Marrelli, Massimo; Tatullo, Marco

2016-07-01

Synovial chondromatosis (SC) is an uncommon disease characterized by a benign nodular cartilaginous proliferation arising from the joint synovium, bursae, or tendon sheaths. Although the temporomandibular joint is rarely affected by neoplastic lesions, SC is the most common neoplastic lesion of this joint. The treatment of this disease consists in the extraoral surgery with a wide removal of the lesion; in this study, the authors described a more conservative intraoral surgical approach. Patient with SC of temporomandibular joint typically refer a limitation in the mouth opening, together with a persistent not physiological mandibular protrusion and an appearance of a neoformation located at the right preauricular region: the authors reported 1 scholar patient. After biopsy of the neoformation, confirming the synovial chondromatosis, the patient underwent thus to the surgical excision of the tumor, via authors' conservative transoral approach, to facilitate the enucleation of the neoformation. The mass fully involved the pterygo-maxillary fossa with involvement of the parotid lodge and of the right TMJ: this multifocal extension suggested for a trans-oral surgical procedure, in the light of the suspicion of a possible malignant nature of the neoplasm. Our intraoral conservative approach to surgery is aimed to reduce the presence of unaesthetic scars in preauricular and facial regions, with surgical results undoubtedly comparable to the traditional surgical techniques much more aggressive. Our technique could be a valid, alternative, and safe approach to treat this rare and complex kind of oncological disease.

Surgical Instrument

NARCIS (Netherlands)

Dankelman, J.; Horeman, T.

2009-01-01

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

Shoulder morbidity after non-surgical treatment of the neck

International Nuclear Information System (INIS)

Wouwe, Merian van; Bree, Remco de; Kuik, Dirk J.; Goede, Cees J.T. de; Verdonck-de Leeuw, Irma M.; Doornaert, Patricia; Rene Leemans, C.

2009-01-01

Background and purpose: Reports on shoulder function after non-surgical treatment are not available. In the present study shoulder morbidity after surgical and non-surgical treatment of the neck is determined and compared. Materials and methods: In 100 head and neck cancer patients 174 neck sides were treated by surgery (n = 51) or (chemo)radiation (n = 123). Abduction, anteflexion, endorotation and exorotation were assessed. Subjective measurements were performed using the Visual Analogue Scale for pain, the Shoulder Disability Questionnaire (SDQ) and stiffness reporting. Results: Predictive factors for SDQ-score > 0 (n = 54) were VAS pain score, stiffness, abduction, anteflexion, physiotherapy, low shoulder position and surgical treatment. The SDQ, stiffness and pain scores were significantly higher in the surgically treated group than in the non-surgical group (p < 0.01). Anteflexion, abduction and exorotation were less impaired in the non-surgically treated group than in the surgically treated group (p < 0.01). No differences between neck dissection and neck dissection with post-operative radiotherapy, and radiotherapy and chemoradiation were found for these movements. Conclusions: Shoulder morbidity is often present after non-surgical treatment of the neck, but to a lesser extent compared to surgical treatment. Radiotherapy adds no morbidity to neck dissection and chemotherapy does not add extra morbidity to primary radiation

33 CFR 142.24 - Use of equipment.

Science.gov (United States)

2010-07-01

... CONTINENTAL SHELF ACTIVITIES WORKPLACE SAFETY AND HEALTH Personal Protective Equipment § 142.24 Use of equipment. (a) Each holder of a lease or permit issued under the Act shall ensure that all personnel who are required by this subpart to use or wear personal protective equipment do so when within the lease area or...

Developing equipment for AGR remote visual inspection

International Nuclear Information System (INIS)

James, P.W.; Walton, P.J.

1985-01-01

The Remote Inspection Group is part of the CEGB's Generation Development and Construction Division, and has responsibility for the design, development, procurement, testing and setting to work of the equipment provided to carry out routine remote visual inspections of its AGRs. This equipment includes both the viewing devices and the necessary placement equipment. (author)

27 CFR 6.43 - Sale of equipment.

Science.gov (United States)

2010-04-01

... OF THE TREASURY LIQUORS âTIED-HOUSEâ Unlawful Inducements Furnishing Things of Value § 6.43 Sale of equipment. A transaction in which equipment is sold to a retailer by an industry member, except as provided.... Further, the negotiation by an industry member of a special price to a retailer for equipment from an...

46 CFR 28.130 - Survival craft equipment.

Science.gov (United States)

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Survival craft equipment. 28.130 Section 28.130 Shipping... INDUSTRY VESSELS Requirements for All Vessels § 28.130 Survival craft equipment. (a) General. Each item of survival craft equipment must be of good quality, effective for the purpose it is intended to serve, and...

The UK market for gaseous emissions control equipment

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-09-01

The report analyses the changes in demand for gaseous emissions control equipment in the United Kingdom over the next 5 years. It discusses the factors affecting demand such as legislation reporting of environmental performance, and economic factors. It looks at environmental expenditure by UK industry. Markets are examined, for VOC abatement systems; thermal incinerators; adsorption equipment; catalytic oxidisers; absorption equipment; biological treatments; cryogenic equipment; SO{sub x} abatement equipment; wet FGD; wet dry FGD, dry scrubbers; NOx abatement systems; selective catalytic reduction; and selective non-catalytic reduction. Profiles are given of 16 leading suppliers.

An Evaluation Method of Equipment Reliability Configuration Management

Science.gov (United States)

Wang, Wei; Feng, Weijia; Zhang, Wei; Li, Yuan

2018-01-01

At present, many equipment development companies have been aware of the great significance of reliability of the equipment development. But, due to the lack of effective management evaluation method, it is very difficult for the equipment development company to manage its own reliability work. Evaluation method of equipment reliability configuration management is to determine the reliability management capabilities of equipment development company. Reliability is not only designed, but also managed to achieve. This paper evaluates the reliability management capabilities by reliability configuration capability maturity model(RCM-CMM) evaluation method.

Lessons learned in testing of Safeguards equipment

International Nuclear Information System (INIS)

Pepper, Susan; Farnitano, Michael; Carelli, Joseph

2001-01-01

Full text: During the 1990s, the IAEA Department of Safeguards began a transition from analog to digital equipment. This included surveillance equipment, seals, NDA measurement systems, and other instruments. The transition to digital equipment was intended to facilitate compatibility between and integration of instruments, remote communication of data, improved data storage, and modernization. Many of the instruments are designed to operate on battery power during loss of facility power, and therefore, are designed to consume minimal power. In 2000, the IAEA experienced a number of failures in digital image surveillance (DIS) equipment. A study of the performance data revealed that the failures occurred in 'high risk' environments where the systems were exposed to neutrons. As a supporter of IAEA equipment development and implementation, the U.S. Support Program worked with the IAEA, the equipment designer, and the equipment manufacturer in special meetings on DIS to determine the cause of the failures. It was as a result of these meetings that single event upset (SEU) was determined to be the root cause of the failures. The meeting participants also identified a list of actions to improve the reliability of DIS systems. As a result of the DIS meetings and the identified actions, the U.S. Support Program approved a request from the IAEA and established Task E.125, 'Remote Monitoring and Unattended Digital Surveillance Systems.' This task is an umbrella task intended to provide a mechanism for response to IAEA needs related to improving the reliability of unattended, remote monitoring and DIS equipment. Subtasks approved under this task include: E.125.1, 'SDIS Software Consolidation and DCM-14 Audit' - This subtask involves the consolidation of a number of individual upgrades to the SDIS and review of the DCM-14 software. As the sponsor of the design of the DCM-14 by Dr. Neumann, the German Support Program is also a participant in this subtask; E.125.2, 'DIS

Another donation of computer equipment

CERN Multimedia

Anaïs Schaeffer

2014-01-01

On Thursday 27 February, CERN was pleased to donate computer equipment to a physics institute in the Philippines.   H.E. Leslie J. Baja and Rolf Heuer. Following donations of computer equipment to institutes in Morocco, Ghana, Bulgaria, Serbia and Egypt, CERN is to send 50 servers and 4 network switches to the National Institute of Physics at the University of the Philippines Diliman. CERN’s Director-General Rolf Heuer and the Ambassador of the Philippines to Switzerland and Lichtenstein, H.E. Leslie J. Baja, spoke of their enthusiasm for the project during an official ceremony. The equipment will be used for various high energy physics research programmes in the Philippines and for the University’s development of digital resources for science.

Local antimicrobial administration for prophylaxis of surgical site infections.

Science.gov (United States)

Huiras, Paul; Logan, Jill K; Papadopoulos, Stella; Whitney, Dana

2012-11-01

Despite a lack of consensus guidelines, local antibiotic administration for prophylaxis of surgical site infections is used during many surgical procedures. The rationale behind this practice is to provide high antibiotic concentrations at the site of surgery while minimizing systemic exposure and adverse effects. Local antibiotic administration for surgical site prophylaxis has inherent limitations in that antibiotics are applied after the incision is made, rather than the current standard for surgical site prophylaxis that recommends providing adequate antibiotic concentrations at the site before the incision. The efficacy and safety of local application of antibiotics for surgical site prophylaxis have been assessed in different types of surgery with a variety of antibiotic agents and methods of application. We identified 22 prospective, randomized, controlled trials that evaluated local application of antibiotics for surgical site prophylaxis. These trials were subsequently divided and analyzed based on the type of surgical procedure: dermatologic, orthopedic, abdominal, colorectal, and cardiothoracic. Methods of local application analyzed included irrigations, powders, ointments, pastes, beads, sponges, and fleeces. Overall, there is a significant lack of level I evidence supporting this practice for any of the surgical genres evaluated. In addition, the literature spans several decades, and changes in surgical procedures, systemic antibiotic prophylaxis, and microbial flora make conclusions difficult to determine. Based on available data, the efficacy of local antibiotic administration for the prophylaxis of surgical site infections remains uncertain, and recommendations supporting this practice for surgical site prophylaxis cannot be made. © 2012 Pharmacotherapy Publications, Inc.

Practice management education during surgical residency.

Science.gov (United States)

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

2008-12-01

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

18 CFR 367.3980 - Account 398, Miscellaneous equipment.

Science.gov (United States)

2010-04-01

... service company's operations that are not included in any other account of this system of accounts. (b... equipment. (3) Employees' recreation equipment. (4) Radios. (5) Restaurant equipment. (6) Soda fountains. (7...

Non-vascular surgical mediastinum

International Nuclear Information System (INIS)

Schiavon, S.; Trenaghi, P.; Nardini, S.; Pagan, V.

1989-01-01

A review was made of the chest X-ray features of 120 patients who underwent surgical treatment for mediastinal non-vascular pathologies over the past 12 years in the Mestre Hospital. A method of analysis is proposed which takes into account not only the differences between the immediate post-operative period and the follow-up, but also the anatomotopographic partition and the surgical practice. Normal and pathological patterns for both of the above periods are described. The ''dimness'' of the arial tracheogram is emphasized as a usefull and early sign of mediastinal recurrence

Strategy for conformity of non-standard cryogenic equipment

CERN Multimedia

CERN. Geneva

2016-01-01

CERN as an intergovernmental organization establishes its own Safety Rules as necessary for its proper functioning. In particular, the CERN General Safety Instruction for cryogenic equipment requires that cryogenic pressure equipment at CERN shall comply with the European Pressure Equipment Directive (PED). However, due to the particular features of some of the cryogenic equipment required for the accelerators, as well as the existence of international collaborations with in-kind contributions from non-EU countries, full compliance with the PED may not always be achieved. This situation is foreseen in the Safety Rules, where CERN HSE will define the Safety requirements applicable to such equipment as well as any eventual additional compensatory measure as to ensure a commensurate level of Safety for our pressure equipment. Where compliance with PED may not be achieved, CERN HSE will become the de facto Notified Body and therefore be in charge of the assessment of the conformity of the equipment to the applica...

Methodology for assessing laser-based equipment

Science.gov (United States)

Pelegrina-Bonilla, Gabriel; Hermsdorf, Jörg; Thombansen, Ulrich; Abels, Peter; Kaierle, Stefan; Neumann, Jörg

2017-10-01

Methodologies for the assessment of technology's maturity are widely used in industry and research. Probably the best known are technology readiness levels (TRLs), initially pioneered by the National Aeronautics and Space Administration (NASA). At the beginning, only descriptively defined TRLs existed, but over time, automated assessment techniques in the form of questionnaires emerged in order to determine TRLs. Originally TRLs targeted equipment for space applications, but the demands on industrial relevant equipment are partly different in terms of, for example, overall costs, product quantities, or the presence of competitors. Therefore, we present a commonly valid assessment methodology with the aim of assessing laser-based equipment for industrial use, in general. The assessment is carried out with the help of a questionnaire, which allows for a user-friendly and easy accessible way to monitor the progress from the lab-proven state to the application-ready product throughout the complete development period. The assessment result is presented in a multidimensional metric in order to reveal the current specific strengths and weaknesses of the equipment development process, which can be used to direct the remaining development process of the equipment in the right direction.

Peer-assisted teaching of basic surgical skills.

Science.gov (United States)

Preece, Ryan; Dickinson, Emily Clare; Sherif, Mohamed; Ibrahim, Yousef; Ninan, Ann Susan; Aildasani, Laxmi; Ahmed, Sartaj; Smith, Philip

2015-01-01

Basic surgical skills training is rarely emphasised in undergraduate medical curricula. However, the provision of skills tutorials requires significant commitment from time-constrained surgical faculty. We aimed to determine how a peer-assisted suturing workshop could enhance surgical skills competency among medical students and enthuse them towards a career in surgery. Senior student tutors delivered two suturing workshops to second- and third- year medical students. Suturing performance was assessed before and after teaching in a 10-min suturing exercise (variables measured included number of sutures completed, suture tension, and inter-suture distance). Following the workshop, students completed a questionnaire assessing the effect of the workshop on their suturing technique and their intention to pursue a surgical career. Thirty-five students attended. Eighty-one percent believed their medical school course provided insufficient basic surgical skills training. The mean number of sutures completed post-teaching increased significantly (p teaching, to ± 2.6 mm post-teaching. All students found the teaching environment to be relaxed, and all felt the workshop helped to improve their suturing technique and confidence; 87% found the peer-taught workshop had increased their desire to undertake a career in surgery. Peer-assisted learning suturing workshops can enhance medical students' competence with surgical skills and inspire them towards a career in surgery. With very little staff faculty contribution, it is a cheap and sustainable way to ensure ongoing undergraduate surgical skills exposure.

Detection of Equipment Faults Before Beam Loss

CERN Document Server

Galambos, J.

2016-01-01

High-power hadron accelerators have strict limits on fractional beam loss. In principle, once a high-quality beam is set up in an acceptable state, beam loss should remain steady. However, in practice, there are many trips in operational machines, owing to excessive beam loss. This paper deals with monitoring equipment health to identify precursor signals that indicate an issue with equipment that will lead to unacceptable beam loss. To this end, a variety of equipment and beam signal measurements are described. In particular, several operational examples from the Spallation Neutron Source (SNS) of deteriorating equipment functionality leading to beam loss are reported.

Utility equipment systems: promising more for less

Energy Technology Data Exchange (ETDEWEB)

1987-10-01

This paper discusses current developments in utility equipment systems, a term applied to carrier vehicles, mostly evolved from well-known forms of construction or mining equipment modified to work with a variety of different front or back end attachments. One of the equipment ranges discussed is the Normet cassette system produced by the Orion corporation of Finland, which allows a basic chassis to be converted from a personnel carrier to an ANFO carrier within minutes. LHD vehicles which are being adapted to fulfil multipurpose roles, such as carrying roof supports, chocks and other heavy mining equipment underground are also discussed. 5 figs.

Effect of postoperative pain therapy on surgical outcome

OpenAIRE

MAJERIĆ KOGLER, VIŠNJA; BANDIĆ, DANIJELA; KOGLER, JANA; BEKAVAC MIŠAK, VILKA; SAKAN, SANJA

2009-01-01

Although efficient treatment of post-surgical pain is considered to be a pre-condition for a normal course of the post-surgical period, epidemiological and clinical research show that a significant number of patients still suffer intense pain after major surgery. Intense nociceptive somatic and visceral post-surgical pain has in the last ten years been considered the most important development of endocrine and neurohumoral disorders in the immediate post-surgical period, (the vital organ f...

Experience with rotating equipment in FBTR

International Nuclear Information System (INIS)

Babu, A.; Subramanian, K.G.; Selvam, B.

2006-01-01

Fast breeder test reactor (FBTR) is a 40MWth sodium cooled PuC-UC fuelled fast breeder reactor located at Kalpakkam, Tamilnadu. FBTR has a variety of mechanical and electrical equipment comprising of single stage and multi stage water pumps, sodium pumps, compressors, Chiller units, Diesel Generator sets, vacuum pumps, ventilation fans, Turbo generator etc. The degree and extent of maintenance on these equipment are decided based on nuclear safety, station technical specification requirements, design criteria and operating philosophy. The variety and complexity of the equipment in FBTR demands various maintenance strategies (preventive, predictive, proactive etc.) for their upkeep. This paper discusses the performance of all mechanical and electrical equipment in FBTR, measures taken for their upkeep, major modifications done to prevent recurring failures, condition monitoring programme implemented, Maintenance Management and Information System developed for data acquisition and dissemination, etc. (author)

Radiation therapy sources, equipment and installations

International Nuclear Information System (INIS)

2011-03-01

The safety code for Telegamma Therapy Equipment and Installations, (AERB/SC/MED-1) and safety code for Brachytherapy Sources, Equipment and Installations, (AERB/SC/MED-3) were issued by AERB in 1986 and 1988 respectively. These codes specified mandatory requirements for radiation therapy facilities, covering the entire spectrum of operations ranging from the setting up of a facility to its ultimate decommissioning, including procedures to be followed during emergency situations. The codes also stipulated requirements of personnel and their responsibilities. With the advent of new techniques and equipment such as 3D-conformal radiation therapy, intensity modulated radiation therapy, image guided radiation therapy, treatment planning system, stereotactic radiosurgery, stereotactic radiotherapy, portal imaging, integrated brachytherapy and endovascular brachytherapy during the last two decades, AERB desires that these codes be revised and merged into a single code titled Radiation Therapy Sources, Equipment, and Installations

Contact Dermatitis to Personal Sporting Equipment in Youth.

Science.gov (United States)

Marzario, Barbara; Burrows, Dianne; Skotnicki, Sandy

2016-07-01

Contact dermatitis to personal sporting equipment in youth is poorly studied. To review the results of patch testing 6 youth to their sporting equipment in a dermatology general private practice from 2006 to 2011. A retrospective analysis of 6 youth aged 11 to 14 who were evaluated for chronic and persistent dermatitis occurring in relation to sports equipment was conducted. All patients were subjected to epicutaneous (patch) testing, which included some or all of the following: North American Contact Dermatitis Group (NACGD) series, textile series, rubber series, corticosteroid series, and raw material from the patients' own personal equipment. All cases had 1 or more positive patch test reactions to an allergen within the aforementioned series, and 3 subjects tested positive to their personal equipment in raw form. Allergic contact dermatitis, not irritant, was deemed the relevant cause of chronic dermatitis in 4 of the 6 patients due to positive reactions to epicutaneous tests and/or personal equipment. The utility of testing to patients' own sporting equipment was shown to be of additional value and should be considered when patch testing for contact allergy to sporting equipment. © The Author(s) 2015.

A Targeted E-Learning Program for Surgical Trainees to Enhance Patient Safety in Preventing Surgical Infection

Science.gov (United States)

McHugh, Seamus Mark; Corrigan, Mark; Dimitrov, Borislav; Cowman, Seamus; Tierney, Sean; Humphreys, Hilary; Hill, Arnold

2010-01-01

Introduction: Surgical site infection accounts for 20% of all health care-associated infections (HCAIs); however, a program incorporating the education of surgeons has yet to be established across the specialty. Methods: An audit of surgical practice in infection prevention was carried out in Beaumont Hospital from July to November 2009. An…

Surgical site infection rates following laparoscopic urological procedures.

Science.gov (United States)

George, Arvin K; Srinivasan, Arun K; Cho, Jane; Sadek, Mostafa A; Kavoussi, Louis R

2011-04-01

Surgical site infections have been categorized by the Centers for Medicare and Medicaid Services as "never events". The incidence of surgical site infection following laparoscopic urological surgery and its risk factors are poorly defined. We evaluated surgical site infection following urological laparoscopic surgery and identified possible factors that may influence occurrence. Patients who underwent transperitoneal laparoscopic procedures during a 4-year period by a single laparoscopic surgeon were retrospectively reviewed. Surgical site infections were identified postoperatively and defined using the Centers for Disease Control criteria. Clinical parameters, comorbidities, smoking history, preoperative urinalysis and culture results as well as operative data were analyzed. Nonparametric testing using the Mann-Whitney U test, multivariable logistic regression and Spearman's rank correlation coefficient were used for data analysis. In 556 patients undergoing urological laparoscopic procedures 14 surgical site infections (2.5%) were identified at mean postoperative day 21.5. Of the 14 surgical site infections 10 (71.4%) were located at a specimen extraction site. Operative time, procedure type and increasing body mass index were significantly associated with the occurrence of surgical site infections (p = 0.007, p = 0.019, p = 0.038, respectively), whereas history of diabetes mellitus (p = 0.071) and intraoperative transfusion (p = 0.053) were found to trend toward significance. Age, gender, positive urine culture, steroid use, procedure type and smoking history were not significantly associated with surgical site infection. Body mass index and operative time remained significant predictors of surgical site infection on multivariate logistic regression analysis. Surgical site infection is an infrequent complication following laparoscopic surgery with the majority occurring at the specimen extraction site. Infection is associated with prolonged operative time and

Oil and gas products and energy equipment

International Nuclear Information System (INIS)

1996-01-01

The planned activities of the Canadian oil and gas products and energy equipment industry for 1996-1997, were presented. The sector is made up of approximately 1500 small and medium sized enterprises. The Canadian oil field manufacturing and servicing industry holds only a small 2.5% share of the world export market, but it is recognized internationally as one of the leading suppliers of advanced petroleum equipment. Their exports include specialized equipment for extracting oil sands, gathering and treatment facilities for sour gas, underbalanced drilling technologies, equipment for wells experiencing declining production rates, top motor drives, winter drilling rigs, and horizontal drilling technologies. They also offer petroleum industry software products. Most exploration and production equipment sold abroad by Canadian firms is manufactured in Canada, but there is an increasing trend toward manufacturing in the country of operation. 2 tabs

Surgical management of Crohn's disease.

Science.gov (United States)

Lu, Kim C; Hunt, Steven R

2013-02-01

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

Current management of surgical oncologic emergencies.

Directory of Open Access Journals (Sweden)

Marianne R F Bosscher

Full Text Available For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC. In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed.A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days.In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%.In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy.

Current management of surgical oncologic emergencies.

Science.gov (United States)

Bosscher, Marianne R F; van Leeuwen, Barbara L; Hoekstra, Harald J

2015-01-01

For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC). In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed. A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days. In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%. In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy.

Medical equipment in government health facilities: missed opportunities.

Science.gov (United States)

Pardeshi, Geeta S

2005-01-01

The availability and optimal utilization of medical equipment is important for improving the quality of health services. Significant investments are made for the purchase, maintenance and repair of medical equipment. Inadequate management of these equipment will result in financial losses and deprive the public of the intended benefits. This analysis is based on the conceptual framework drawn from the WHO recommended- lifecycle of medical equipment. (1) To identify the problems in different stages of the life cycle. (2) To assess its financial implications and effect on service delivery. Analysis of secondary data from the latest Comptroller and Auditor General (CAG) Reports for the states in India. The study variables were category of equipment, financial implications and problems in the stages of life cycle. Calculation of proportions. A total of forty instances mentioning problems in the first phase of the life cycle of medical equipment were noted in 12 state reports. The equipment from the radiology department (15), equipment in the wards (5), laboratory (3) and operation theatres (4) were the ones most frequently implicated. In a majority of cases the financial implications amounted to twenty-five lakhs. The financial implications were in the form of extra expenditure, unfruitful expenditure or locking of funds. In 25 cases the equipment could not be put to use because of non-availability of trained staff and inadequate infrastructural support. Careful procurement, incoming inspection, successful installation and synchronization of qualified trained staff and infrastructural support will ensure timely onset of use of the equipment.

Social Media: Changing the Paradigm for Surgical Education.

Science.gov (United States)

Petrucci, Andrea M; Chand, Manish; Wexner, Steven D

2017-09-01

The role of social media (SoMe) in surgical education is emerging as a tool that augments and complements traditional learning. As SoMe usage has steadily increased in our personal and professional lives, it is no surprise that it has permeated into surgical education. Different SoMe sites offer distinct platforms from which knowledge can be transmitted, while catering to various learning styles. The purpose of this review is to outline the various SoMe platforms and their use in surgical education. Moreover, it will discuss their effectiveness in teaching and learning surgical knowledge and skills as well as other potential roles SoMe has to offer to improve surgical education.

Personal Protective Equipment

National Research Council Canada - National Science Library

1998-01-01

... of personal protective equipment A safety program for new employees is a necessary part of any orientation program An on-going safety program should be used to motivate employees to continue to use...

Improved patient selection by stratified surgical intervention

DEFF Research Database (Denmark)

Wang, Miao; Bünger, Cody E; Li, Haisheng

2015-01-01

BACKGROUND CONTEXT: Choosing the best surgical treatment for patients with spinal metastases remains a significant challenge for spine surgeons. There is currently no gold standard for surgical treatments. The Aarhus Spinal Metastases Algorithm (ASMA) was established to help surgeons choose...... the most appropriate surgical intervention for patients with spinal metastases. PURPOSE: The purpose of this study was to evaluate the clinical outcome of stratified surgical interventions based on the ASMA, which combines life expectancy and the anatomical classification of patients with spinal metastases...... survival times in the five surgical groups determined by the ASMA were 2.1 (TS 0-4, TC 1-7), 5.1 (TS 5-8, TC 1-7), 12.1 (TS 9-11, TC 1-7 or TS 12-15, TC 7), 26.0 (TS 12-15, TC 4-6), and 36.0 (TS 12-15, TC 1-3) months. The 30-day mortality rate was 7.5%. Postoperative neurological function was maintained...

Methodology development for availability improvement of standby equipment

International Nuclear Information System (INIS)

Shin, Sung Min; Jeon, In Seop; Kang, Hyun Gook

2014-01-01

The core damage frequency (CDF) of operating and constructing pressurized nuclear plants are ranging on the order of 10 -5 and 10 -6 per year. The target CDF of new NPP design has been set at 10 -7 . In this context, although various systems are currently studied, availability improvement of standby equipment will be more efficient than the additional application of safety systems. It is obvious in every aspect, such as management and cost efficiency. Here, soundness can affect equipment unavailability, and the soundness degrades because of aging. However, some studies did not consider aging when calculating the unavailability. Standby equipment can age because of two important factors: standby stress which accumulates over time, and test stress which accumulates with the number of tests (or operations). Both factors should be considered together when aging is considered. However, some studies only considered standby stress or test stress. There are some previous studies which considered both factors. Besides equipment soundness related to aging effect, some process like bypass during test also can affect equipment unavailability because the original function of equipment cannot be performed immediately during this process. However, there are seldom studies dealing with above factors as a whole problem. This study investigated a general approach to calculate the unavailability of standby equipment which considers aging caused by standby and test stresses and bypass process. Based on this general approach, we propose two maintenance strategies which aim to reduce standby equipment unavailability. In section 2, the general approach is presented. As one of the strategies, the changing test interval method (CIM) is introduced in section 3, and its effectiveness is also analyzed. The online monitoring method (OMM) is investigated in section 4 as another method to reduce equipment unavailability. In section 5, a combination of these two methods is analyzed. A general

Fire prevention and protection for trackless equipment

Energy Technology Data Exchange (ETDEWEB)

Burger, A.J.

1988-10-01

With the increased use of trackless diesel and electrical equipment underground, the fire danger associated with this equipment has increased. The need for adequate fire prevention and protection on all aspects of trackless mechanised mining must be taken into consideration. This paper describes briefly the causes of fires on trackless equipment and the precautions taken to reduce the risk of ignition. 1 tab.

Load Bearing Equipment for Bone and Muscle

Science.gov (United States)

Shackelford, Linda; Griffith, Bryan

2015-01-01

Resistance exercise on ISS has proven effective in maintaining bone mineral density and muscle mass. Exploration missions require exercise with similar high loads using equipment with less mass and volume and greater safety and reliability than resistance exercise equipment used on ISS (iRED, ARED, FWED). Load Bearing Equipment (LBE) uses each exercising person to create and control the load to the partner.

Open core control software for surgical robots.

Science.gov (United States)

Arata, Jumpei; Kozuka, Hiroaki; Kim, Hyung Wook; Takesue, Naoyuki; Vladimirov, B; Sakaguchi, Masamichi; Tokuda, Junichi; Hata, Nobuhiko; Chinzei, Kiyoyuki; Fujimoto, Hideo

2010-05-01

In these days, patients and doctors in operation room are surrounded by many medical devices as resulting from recent advancement of medical technology. However, these cutting-edge medical devices are working independently and not collaborating with each other, even though the collaborations between these devices such as navigation systems and medical imaging devices are becoming very important for accomplishing complex surgical tasks (such as a tumor removal procedure while checking the tumor location in neurosurgery). On the other hand, several surgical robots have been commercialized, and are becoming common. However, these surgical robots are not open for collaborations with external medical devices in these days. A cutting-edge "intelligent surgical robot" will be possible in collaborating with surgical robots, various kinds of sensors, navigation system and so on. On the other hand, most of the academic software developments for surgical robots are "home-made" in their research institutions and not open to the public. Therefore, open source control software for surgical robots can be beneficial in this field. From these perspectives, we developed Open Core Control software for surgical robots to overcome these challenges. In general, control softwares have hardware dependencies based on actuators, sensors and various kinds of internal devices. Therefore, these control softwares cannot be used on different types of robots without modifications. However, the structure of the Open Core Control software can be reused for various types of robots by abstracting hardware dependent parts. In addition, network connectivity is crucial for collaboration between advanced medical devices. The OpenIGTLink is adopted in Interface class which plays a role to communicate with external medical devices. At the same time, it is essential to maintain the stable operation within the asynchronous data transactions through network. In the Open Core Control software, several

Assessment of Surgical Skills and Competency.

Science.gov (United States)

Bhatti, Nasir I

2017-10-01

Evaluation of surgical skills and competency are important aspects of the medical education process. Measurable and reproducible methods of assessment with objective feedback are essential components of surgical training. Objective Structured Assessment of Technical Skills (OSATS) is widely used across the medical specialties and otolaryngology-specific tools have been developed and validated for sinus and mastoid surgery. Although assessment of surgical skills can be time-consuming and requires human and financial resources, new evaluation methods and emerging technology may alleviate these barriers while also improving data collection practices. Copyright © 2017 Elsevier Inc. All rights reserved.

Equipment improvements for performance enhancement

International Nuclear Information System (INIS)

Gaestel, P.; Guesnon, H.; Sauze, G.

1994-01-01

In order to enhance the reactor availability, several improvements on reactor equipment have been developed: design optimization for stator maintenance replacement in the main alternator; adjustment modification of stator coils in the main alternator for an easier maintenance; improvement of the fuel handling line (pole crane, transfer equipment, loading machine); development of a loose part trapping system in the steam generator secondary circuit. 1 tab

Low level photoneutron detection equipment

International Nuclear Information System (INIS)

Ji Changsong; Zhang Yuqin; Li Yuansui

1991-01-01

A low level photoneutron detection equipment has been developed. The photoneutrons produced by interaction of 226 Ra gamma quanta and deutron (D) target are detected with n-n discrimination detector made up of 3 He proportional counter array. The D-content information in the target can be obtained from the measured photoneutron counts. The equipment developed is mainly used for nondestructive D-content measurement of D-devices

Equipment Obsolescence Management Program

Energy Technology Data Exchange (ETDEWEB)

Redmond, J.

2014-07-01

Nuclear Power Plant (NPP) Operators are challenged with securing reliable supply channels for safety related equipment due to equipment obsolescence. Many Original Equipment Manufacturers (OEMs) have terminated production of spare parts and product life-cycle support. The average component life cycles are much shorter than the NPP design life, which means that replacement components and parts for the original NPP systems are not available for the complete design life of the NPPs. The lack or scarcity of replacement parts adversely affects plant reliability and ultimately the profitability of the affected NPPs. This problem is further compounded when NPPs pursue license renewal and approval for plant-life extension. A reliable and predictable supply of replacement co components is necessary for NPPs to remain economically competitive and meet regulatory requirements and guidelines. Electrical and I and C components, in particular, have short product life cycles and obsolescence issues must be managed pro actively and not reactively in order to mitigate the risk to the NPP to ensure reliable and economic NPP operation. (Author)

[Simulation-based robot-assisted surgical training].

Science.gov (United States)

Kolontarev, K B; Govorov, A V; Rasner, P I; Sheptunov, S A; Prilepskaya, E A; Maltsev, E G; Pushkar, D Yu

2015-12-01

Since the first use of robotic surgical system in 2000, the robot-assisted technology has gained wide popularity throughout the world. Robot-assisted surgical training is a complex issue that requires significant efforts from students and teacher. During the last two decades, simulation-based training had received active development due to wide-spread occurrence and popularization of laparoscopic and robot-assisted surgical techniques. We performed a systematic review to identify the currently available simulators for robot-assisted surgery. We searched the Medline and Pubmed, English sources of literature data, using the following key words and phrases: "robotics", "robotic surgery", "computer assisted surgery", "simulation", "computer simulation", "virtual reality", "surgical training", and "surgical education". There were identified 565 publications, which meet the key words and phrases; 19 publications were selected for the final analysis. It was established that simulation-based training is the most promising teaching tool that can be used in the training of the next generation robotic surgeons. Today the use of simulators to train surgeons is validated. Price of devices is an obvious barrier for inclusion in the program for training of robotic surgeons, but the lack of this tool will result in a sharp increase in the duration of specialists training.

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

Science.gov (United States)

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

2014-09-05

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

Use of the 3D surgical modelling technique with open-source software for mandibular fibula free flap reconstruction and its surgical guides.

Science.gov (United States)

Ganry, L; Hersant, B; Quilichini, J; Leyder, P; Meningaud, J P

2017-06-01

Tridimensional (3D) surgical modelling is a necessary step to create 3D-printed surgical tools, and expensive professional software is generally needed. Open-source software are functional, reliable, updated, may be downloaded for free and used to produce 3D models. Few surgical teams have used free solutions for mastering 3D surgical modelling for reconstructive surgery with osseous free flaps. We described an Open-source software 3D surgical modelling protocol to perform a fast and nearly free mandibular reconstruction with microvascular fibula free flap and its surgical guides, with no need for engineering support. Four successive specialised Open-source software were used to perform our 3D modelling: OsiriX ® , Meshlab ® , Netfabb ® and Blender ® . Digital Imaging and Communications in Medicine (DICOM) data on patient skull and fibula, obtained with a computerised tomography (CT) scan, were needed. The 3D modelling of the reconstructed mandible and its surgical guides were created. This new strategy may improve surgical management in Oral and Craniomaxillofacial surgery. Further clinical studies are needed to demonstrate the feasibility, reproducibility, transfer of know how and benefits of this technique. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

An Evaluation of Preparedness, Delivery and Impact of Surgical and Anesthesia Care in Madagascar: A Framework for a National Surgical Plan.

Science.gov (United States)

Bruno, Emily; White, Michelle C; Baxter, Linden S; Ravelojaona, Vaonandianina Agnès; Rakotoarison, Hasiniaina Narindria; Andriamanjato, Hery Harimanitra; Close, Kristin L; Herbert, Alison; Raykar, Nakul; Saluja, Saurabh; Shrime, Mark G

2017-05-01

The Lancet Commission on Global Surgery (LCoGS) described the lack of access to safe, affordable, timely surgical, and anesthesia care. It proposed a series of 6 indicators to measure surgery, accompanied by time-bound targets and a template for national surgical planning. To date, no sub-Saharan African country has completed and published a nationwide evaluation of its surgical system within this framework. Mercy Ships, in partnership with Harvard Medical School and the Madagascar Ministry of Health, collected data on the 6 indicators from 22 referral hospitals in 16 out of 22 regions of Madagascar. Data collection was by semi-structured interviews with ministerial, medical, laboratory, pharmacy, and administrative representatives in each region. Microsimulation modeling was used to calculate values for financial indicators. In Madagascar, 29% of the population can access a surgical facility within 2 h. Surgical workforce density is 0.78 providers per 100,000 and annual surgical volume is 135-191 procedures per 100,000 with a perioperative mortality rate of 2.5-3.3%. Patients requiring surgery have a 77.4-86.3 and 78.8-95.1% risk of incurring impoverishing and catastrophic expenditure, respectively. Of the six LCoGS indicator targets, Madagascar meets one, the reporting of perioperative mortality rate. Compared to the LCoGS targets, Madagascar has deficits in surgical access, workforce, volume, and the ability to offer financial risk protection to surgical patients. Its perioperative mortality rate, however, appears better than in comparable countries. The government is committed to improvement, and key stakeholder meetings to create a national surgical plan have begun.

Design and preliminary validation of a mobile application-based expert system to facilitate repair of medical equipment in resource-limited health settings

Directory of Open Access Journals (Sweden)

Wong AL

2018-05-01

the access to knowledge and resources in low- and middle-income countries. Further research will include prospective studies to determine the impact of an application on the availability of functional equipment in a hospital and the effect on the provision and safety of surgical care. Keywords: medical apps, global health, mHealth, repair system, pulse oximeter

Earthquake protection of essential civil and industrial equipments

International Nuclear Information System (INIS)

Bourrier, P.; Le Breton, F.; Thevenot, A.

1986-01-01

This document presents the principal reflexions concerning seismic engineering applications for equipment and the difference of the non-employment towards these structures. The notion of essential equipment is then pointed out as well as the main particularities of equipment considered as structures. Finally, this document illustrates a few pathological examples encountered after an earthquake, and presents some equipments of a nuclear power plant which to resist an increased safety seism [fr

Plutonium Immobilization Can Loading Equipment Review

International Nuclear Information System (INIS)

Kriikku, E.; Ward, C.; Stokes, M.; Randall, B.; Steed, J.; Jones, R.; Hamilton, L.

1998-05-01

This report lists the operations required to complete the Can Loading steps on the Pu Immobilization Plant Flow Sheets and evaluates the equipment options to complete each operation. This report recommends the most appropriate equipment to support Plutonium Immobilization Can Loading operations

Equipment system for advanced nuclear fuel development

International Nuclear Information System (INIS)

Kwon, Hyuk Il; Ji, C. G.; Bae, S. O.

2002-11-01

The purpose of the settlement of equipment system for nuclear Fuel Technology Development Facility(FTDF) is to build a seismic designed facility that can accommodate handling of nuclear materials including <20% enriched Uranium and produce HANARO fuel commercially, and also to establish the advanced common research equipment essential for the research on advanced fuel development. For this purpose, this research works were performed for the settlement of radiation protection system and facility special equipment for the FTDF, and the advanced common research equipment for the fuel fabrication and research. As a result, 11 kinds of radiation protection systems such as criticality detection and alarm system, 5 kinds of facility special equipment such as environmental pollution protection system and 5 kinds of common research equipment such as electron-beam welding machine were established. By the settlement of exclusive domestic facility for the research of advanced fuel, the fabrication and supply of HANARO fuel is possible and also can export KAERI-invented centrifugal dispersion fuel materials and its technology to the nations having research reactors in operation. For the future, the utilization of the facility will be expanded to universities, industries and other research institutes

Development of remote handling tools and equipment

International Nuclear Information System (INIS)

Nakahira, Masataka; Oka, Kiyoshi; Taguchi, Kou; Ito, Akira; Fukatsu, Seiichi; Oda, Yasushi; Kajiura, Soji; Yamazaki, Seiichiro; Aoyama, Kazuo.

1997-01-01

The remote handling (RH) tools and equipment development in ITER focuses mainly on the welding and cutting technique, weld inspection and double-seal door which are essential factors in the replacement of in-vessel components such as divertor and blanket. The conceptual design of these RH tools and equipment has been defined through ITER engineering design activity (EDA). Similarly, elementary R and D of the RH tools and equipment have been extensively performed to accumulate a technological data base for process and performance qualification. Based on this data, fabrications of full-scale RH tools and equipment are under progress. A prototypical bore tool for pipe welding and cutting has already been fabricated and is currently undergoing integrated performance tests. This paper describes the design outline of the RH tools and equipment related to in-vessel components maintenance, and highlights the current status of RH tools and equipment development by the Japan Home Team as an ITER R and D program. This paper also includes an outline of insulation joint and quick-pipe connector development, which has also been conducted through the ITER R and D program in order to standardize RH operations and components. (author)

Effect of Surgical Safety Checklist on Mortality of Surgical Patients in the α University Hospitals

Directory of Open Access Journals (Sweden)

R. Mohebbifar

2014-01-01

Full Text Available Background & Aims: Patient safety is one of the indicators of risk management in clinical governance system. Surgical care is one of the most sophisticated medical care in the hospitals. So it is not surprising that nearly half of the adverse events, 66% were related to surgery. Pre-flight aircraft Inspection model is starting point for designing surgical safety checklist that use for audit procedure. The aim of this study is to evaluate the effect of the use of surgical safety checklist on surgical patients mortality and complications. Materials and Methods: This is a prospective descriptive study. This study was conducted in 2012 in the North West of Iran. The population consisted of patients who had undergoing surgery in α university of medical science`s hospital which have surgical department. In this study, 1125 patients underwent surgery within 3 months were studied. Data collection tool was designed based on WHO model and Surgcical Care and Outcomes Assessment Program(SCOAP. Data analysis was performed using the SPSS-20 statistical software and logistic regression analysis was used to calculate P values for each comparison. Results: No significant differences between patients in the two periods (before and after There was. All complications rate reduced from 11 percent to 4 percent after the intervention by checklist (p<0.001. In the all hospitals mortality rate was decreased from 3.44% to 1.3% (p <0.003. Overall rate of surgical site infection and unplanned return to the operating room was reduced (p<0.001 and p<0.046. Conclusion: Many people every year due to lack of safety in hospitals, lose their lives. Despite the risks, such as leaving surgery sets in patient body and wrong surgery is due to lack of proper safety programs during surgery. By using safety checklist in all hospitals mortality rate and complications was reduced but this reduction was extremely in α3 hospital (from 5.2% to 1.48%.

The surgical care improvement project and prevention of post-operative infection, including surgical site infection.

Science.gov (United States)

Rosenberger, Laura H; Politano, Amani D; Sawyer, Robert G

2011-06-01

In response to inconsistent compliance with infection prevention measures, the Centers for Medicare & Medicaid Services collaborated with the U.S. Centers for Disease Control and Prevention on the Surgical Infection Prevention (SIP) project, introduced in 2002. Quality improvement measures were developed to standardize processes to increase compliance. In 2006, the Surgical Care Improvement Project (SCIP) developed out of the SIP project and its process measures. These initiatives, published in the Specifications Manual for National Inpatient Quality Measures, outline process and outcome measures. This continually evolving manual is intended to provide standard quality measures to unify documentation and track standards of care. Seven of the SCIP initiatives apply to the peri-operative period: Prophylactic antibiotics should be received within 1 h prior to surgical incision (1), be selected for activity against the most probable antimicrobial contaminants (2), and be discontinued within 24 h after the surgery end-time (3); (4) euglycemia should be maintained, with well-controlled morning blood glucose concentrations on the first two post-operative days, especially in cardiac surgery patients; (6) hair at the surgical site should be removed with clippers or by depilatory methods, not with a blade; (9) urinary catheters are to be removed within the first two post-operative days; and (10) normothermia should be maintained peri-operatively. There is strong evidence that implementation of protocols that standardize practices reduce the risk of surgical infection. The SCIP initiative targets complications that account for a significant portion of preventable morbidity as well as cost. One of the goals of the SCIP guidelines was a 25% reduction in the incidence of surgical site infections from implementation through 2010. Process measures are becoming routine, and as we practice more evidence-based medicine, it falls to us, the surgeons and scientists, to be active

Non-surgical therapy of Peyronie's disease.

Science.gov (United States)

Taylor, Frederick L; Levine, Laurence A

2008-01-01

The present paper provides a review of the available non-surgical treatments for Peyronie's disease (PD). A review of published literature on oral, intralesional, external energy and iontophoresis therapies for PD was performed, and the published results of available treatment options reviewed. The authors recommendations for appropriate non-surgical management of PD are provided. Although there are many published reports that show the efficacy of non-surgical therapies for PD, there is a lack of large scale, multicenter controlled clinical trials, which makes treatment recommendations difficult. Careful review of the literature does suggest that there are treatment options that make scientific sense and appear to stabilize the disease process, reduce deformity, and improve function. Offering no treatment at all will encourage our patients to pursue alternative treatments, which might do harm, and misses the opportunity to do some good. Clearly further work is necessary to develop safe and effective non-surgical treatments for PD.

Surgical treatment for ectopic atrial tachycardia.

Science.gov (United States)

Graffigna, A; Vigano, M; Pagani, F; Salerno, G

1992-08-01

Atrial tachycardia is an infrequent but potentially dangerous arrhythmia which often determines cardiac enlargement. Surgical ablation of the arrhythmia is effective and safe, provided a careful atrial mapping is performed and the surgical technique is tailored to the individual focus location. Eight patients underwent surgical ablation of ectopic atrial tachycardia between 1977 and 1990. Different techniques were adopted for each patient according to the anatomical location of the focus and possibly associated arrhythmias. Whenever possible, a closed heart procedure was chosen. In 1 patient a double focal origin was found and treated by separate procedures. In 1 patient with ostium secundum atrial septal defect and atrial flutter, surgical isolation of the right appendage and the ectopic focus was performed. In all patients ectopic atrial tachycardia was ablated with maintenance of the sinoatrial and atrioventricular nodal function as well as internodal conduction. In follow-up up to December 1991, no recurrency was recorded.

National survey of surgeons\\' attitudes to laparoscopic surgical ...

African Journals Online (AJOL)

Aim. Laparoscopic surgery forms an integral component of modern surgical practice. The perception exists that laparoscopic training in South Africa has been unplanned and under-resourced. This study set out to assess the opinions of surgeons and surgical trainees with regard to the various facets of laparoscopic surgical ...

[Diverticular disease of the large bowel - surgical treatment].

Science.gov (United States)

Levý, M; Herdegen, P; Sutoris, K; Simša, J

2013-07-01

Surgical treatment, despite the rapid development of the numerous modern miniinvasive intervention techniques, remains essential in the treatment of complicated diverticular disease. The aim of this work is to summarize indications for surgical treatment in both acute and elective patients suffering from diverticular disease of the large bowel. Review of the literature and recent findings concerning indications for surgical intervention in patients with diverticulosis of the colon. The article describes indications, types of procedures, techniques and postoperative care in patients undergoing surgical intervention for diverticular disease.

Surgical site infections

African Journals Online (AJOL)

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

Remote maintenance ''lessons learned'' on prototypical reprocessing equipment

International Nuclear Information System (INIS)

Kring, C.T.; Schrock, S.L.

1990-01-01

Hardware representative of essentially every major equipment item necessary for reprocessing breeder reactor nuclear fuel has been installed and tested for remote maintainability. This testing took place in a cold mock-up of a remotely maintained hot cell operated by the Consolidated Fuel Reprocessing Program (CFRP) within the Fuel Recycle Division at Oak Ridge National Laboratory (ORNL). The reprocessing equipment tested included a Disassembly System, a Shear System, a Dissolver System, an Automated Sampler System, removable Equipment Racks on which various chemical process equipment items were mounted, and an advanced servomanipulator (ASM). These equipment items were disassembled and reassembled remotely by using the remote handling systems that are available within the cold mock-up area. This paper summarizes the ''lessons learned'' as a result of the numerous maintenance activities associated with each of these equipment items. 4 refs., 3 figs., 1 tab

Quantifying surgical complexity with machine learning: looking beyond patient factors to improve surgical models.

Science.gov (United States)

Van Esbroeck, Alexander; Rubinfeld, Ilan; Hall, Bruce; Syed, Zeeshan

2014-11-01

To investigate the use of machine learning to empirically determine the risk of individual surgical procedures and to improve surgical models with this information. American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data from 2005 to 2009 were used to train support vector machine (SVM) classifiers to learn the relationship between textual constructs in current procedural terminology (CPT) descriptions and mortality, morbidity, Clavien 4 complications, and surgical-site infections (SSI) within 30 days of surgery. The procedural risk scores produced by the SVM classifiers were validated on data from 2010 in univariate and multivariate analyses. The procedural risk scores produced by the SVM classifiers achieved moderate-to-high levels of discrimination in univariate analyses (area under receiver operating characteristic curve: 0.871 for mortality, 0.789 for morbidity, 0.791 for SSI, 0.845 for Clavien 4 complications). Addition of these scores also substantially improved multivariate models comprising patient factors and previously proposed correlates of procedural risk (net reclassification improvement and integrated discrimination improvement: 0.54 and 0.001 for mortality, 0.46 and 0.011 for morbidity, 0.68 and 0.022 for SSI, 0.44 and 0.001 for Clavien 4 complications; P risk for individual procedures. This information can be measured in an entirely data-driven manner and substantially improves multifactorial models to predict postoperative complications. Copyright © 2014 Elsevier Inc. All rights reserved.