WorldWideScience

Sample records for surgical planning society

  1. Lesson plans in surgical training.

    Science.gov (United States)

    Lester, S E; Robson, A K R

    2007-06-01

    Lesson plans in surgery enable trainers and trainees to agree on goals that balance training needs with service commitments. Lesson plans are individualised to the trainee and encourage ownership of learning. They are based on SMART criteria and therefore have a sound educational footing. Most of the work in creating a lesson plan falls to the trainee. The total time for creation of each plan is approximately 20 min. Our use of lesson plans for surgical training has been met with favourable response from both trainer and trainees.

  2. European Planning for an Information Society

    DEFF Research Database (Denmark)

    Henten, Anders; Skouby, Knud Erik; Falch, Morten

    1996-01-01

    Article analysing the different programmes and plans for the development of information societies in Europe.......Article analysing the different programmes and plans for the development of information societies in Europe....

  3. A student surgical society – the Cape Town experience

    African Journals Online (AJOL)

    The UCT Surgical Society is a student-managed academic society that promotes ... curricular surgical lectures and clinical activities for their medical students, all with the ... accommodate all in attendance (talks regularly attract 200 - 300 attendees). ... at any institution: all that is needed is a group of motivated, hard- working ...

  4. [Is family planning beneficial for our society?].

    Science.gov (United States)

    Noudjalbaye, K

    1988-09-01

    Family planning comprises a group of activities that permit couples to decide freely the spacing and number of their children. Its other goals are to identify high risk pregnancies and treat infertility. Family planning improves the health of mothers, children, and entire families. Women understanding the benefits of family planning can space pregnancies at least 2 years apart to allow time to care for the new baby and to recuperate after the birth. Women and children in Chad and throughout Africa are the most vulnerable population groups with the greatest need for high quality nutrition, but they usually are relegated the food left over after men and other family members have eaten. Too frequent and too numerous pregnancies are likely to lead to maternal death from hemorrhage, toxemia, or septicemia. Chronic malnutrition reduces the defenses of the woman's body. Couples who plan their births for the times when the mother is best prepared avoid high risk pregnancies. Young infants whose mothers become pregnant too soon are subjected to abrupt weaning and sometimes physically separated from their mothers. The baby is at risk of infection and malnutrition because of its lack of adjustment to its new diet, and high rates of mortality are 1 result. The 2nd baby often is low birth weight and receives less milk because his malnourished, anemic, and chronically fatigued mother is unable to produce more. The infant is prey to infections, which his undernourished body is less able to fight. Traditional African societies recognized the importance of spacing and achieved it by abstinence until the child would walk. Family planning programs provide contraception, treatment and advice on sexually transmitted diseases, and alternatives to illegal abortion. Adolescents in particular should be provided with information on the consequences of too early sexual activity.

  5. Surgical accuracy of three-dimensional virtual planning

    DEFF Research Database (Denmark)

    Stokbro, Kasper; Aagaard, Esben; Torkov, Peter

    2016-01-01

    This retrospective study evaluated the precision and positional accuracy of different orthognathic procedures following virtual surgical planning in 30 patients. To date, no studies of three-dimensional virtual surgical planning have evaluated the influence of segmentation on positional accuracy ...

  6. Additive Manufacturing for Surgical Planning of Mandibular Fracture.

    Science.gov (United States)

    Brito, Nadja Maria da Silva Oliveira; Soares, Renata de Souza Coelho; Monteiro, Erik Lafitt Tavares; Martins, Sergio Charifker Ribeiro; Cavalcante, Josuel Raimundo; Grempel, Rafael Grotta; Neto, José Augusto de Oliveira

    2016-12-01

    Currently, imaging techniques such as Computed Tomography with three-dimensional reconstruction (3D) and Magnetic Resonances are being routinely used in pre-surgical planning in all fields of medicine. Nowadays, virtual three-dimensional images, commonly displayed on two-dimensional surfaces, such as the computer screen, can be used to produce rapidly prototyped models, with excellent dimensional accuracy and fine reproduction of anatomical structures, providing professionals with the ability to use the biomodel in planning and simulating medical and dental procedures (oral and maxillofacial surgery, making individualized facial implants and prostheses, measurements and previous adaptations of prefabricated fixation plates), thus contributing to considerable reductions in surgical time and consequently the duration of anesthesia, minimizing infection risks and reducing hospital costs. In this report, we describe a case of surgical planning and treatment of bilateral atrophic mandibular fracture, in which, for surgical planning, authors used Rapid Prototyping as an adjunct tool, considering the advantages already outlined.

  7. Virtual occlusion in planning orthognathic surgical procedures.

    NARCIS (Netherlands)

    Nadjmi, N.; Mollemans, W.; Daelemans, A.; Hemelen, G. Van; Schutyser, F.A.C.; Berge, S.J.

    2010-01-01

    Accurate preoperative planning is mandatory for orthognathic surgery. One of the most important aims of this planning process is obtaining good postoperative dental occlusion. Recently, 3D image-based planning systems have been introduced that enable a surgeon to define different osteotomy planes pr

  8. [Neuronavigation in the surgical planning of callosotomy].

    Science.gov (United States)

    Valencia Calderón, Carlos; Castro Cevallos, Alfredo; Calderón Valdiviezo, Ana; Escobar Dávila, Roberto; Parra Rosales, Fausto; Quispe Alcocer, Julio; Vásquez Hahn, Catalina

    2016-01-01

    To describe the usefulness of 3D computer-assisted preoperative neuronavigation for stereoscopic location of the venous sinuses, arterial branches, and corpus callosum, to extrapolate anatomical landmarks on the surgical field and make decisions before the intervention. A prospective analysis was performed on patients with refractory epilepsy who underwent neuronavigation-assisted callosotomy (BRAIN LAB Dual). A total of 10 neuronavigation-assisted callosotomies were performed in the year 2014. The ages of the patients (4 males and 6 females) were between 4 and 13 years (mean 7; SD 3.02). The most common indication for callosotomy in our sample was Lennox Gastoux (5 patients). A right parasagittal craniotomy was performed in 8 patients. An anterior two-thirds callosotomy was performed in 8 patients and anterior three-quarters in 2 patients. The mean accuracy of the neuronavigation procedure was less than 2mm. In no cases were there significant intraoperative surgical complications. Callosotomy using frameless guided neuronavigation is an accurate and safe technique in patients with epilepsy refractory to surgical resection. Copyright © 2015 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  9. Virtual occlusion in planning orthognathic surgical procedures.

    Science.gov (United States)

    Nadjmi, N; Mollemans, W; Daelemans, A; Van Hemelen, G; Schutyser, F; Bergé, S

    2010-05-01

    Accurate preoperative planning is mandatory for orthognathic surgery. One of the most important aims of this planning process is obtaining good postoperative dental occlusion. Recently, 3D image-based planning systems have been introduced that enable a surgeon to define different osteotomy planes preoperatively and to assess the result of moving different bone fragments in a 3D virtual environment, even for soft tissue simulation of the face. Although the use of these systems is becoming more accepted in orthognathic surgery, few solutions have been proposed for determining optimal occlusion in the 3D planning process. In this study, a 3D virtual occlusion tool is presented that calculates a realistic interaction between upper and lower dentitions. It enables the surgeon to obtain an optimal and physically possible occlusion easily. A validation study, including 11 patient data sets, demonstrates that the differences between manually and virtually defined occlusions are small, therefore the presented system can be used in clinical practice.

  10. Diagnosis, treatment planning, and surgical correction of obstructive sleep apnea.

    Science.gov (United States)

    Goodday, Reginald

    2009-10-01

    The aim of this report is to present the scientific rationale for considering maxillomandibular advancement as the surgical treatment of choice in selected patients with obstructive sleep apnea syndrome; review the treatment planning that will identify those patients who would benefit from this procedure; review the surgical techniques; and review the patient outcomes after maxillomandibular advancement surgery. Patients with obstructive sleep apnea syndrome who have demonstrable retropositioning of the maxilla and mandible should be informed of maxillomandibular advancement as the primary surgical treatment for obstructive sleep apnea syndrome.

  11. 3D surgical planning and navigation for CMF surgery

    Science.gov (United States)

    Chapuis, Jonas; Rudolph, Tobias; Borgesson, Blake; De Momi, Elena; Pappas, Ion P.; Hallermann, Wok; Schramm, Alexander; Caversaccio, Marco

    2004-05-01

    In this paper we describe a system for corrective and reconstructive CMF surgery that allows planning of bone segment relocations in 3D and transfer of the goal positions into an intra-operative navigation module, which provides guidance to realize the planned movement. In addition, the pre-operative planning module offers functions of mirroring and allows insertion of distraction devices. We present three clinical cases of CMF surgical procedures planned a posteriori with our application: bimaxillary realignment, involving subcondylar osteotomy of the mandible and LeFort I osteotomy, secondary orbital reconstruction and mandibular reconstruction.

  12. Needle Path Planning for Autonomous Robotic Surgical Suturing.

    Science.gov (United States)

    Jackson, Russell C; Cavuşoğlu, M Cenk

    2013-12-31

    This paper develops a path plan for suture needles used with solid tissue volumes in endoscopic surgery. The path trajectory is based on the best practices that are used by surgeons. The path attempts to minimize the interaction forces between the tissue and the needle. Using surgical guides as a basis, two different techniques for driving a suture needle are developed. The two techniques are compared in hardware experiments by robotically driving the suture needle using both of the motion plans.

  13. Virtual cystoscopy--a surgical planning and guidance tool.

    Science.gov (United States)

    Braticevici, Bogdan; Onu, Mihaela; Bengus, Florentin

    2006-03-01

    Image guided-surgery systems facilitates surgical planning phases of endoscopic procedures. In this paper, we used a software package for 3D surface model generation and vizualization of the urinary bladder, based on magnetic resonance (MR) cross sectional images of the pelvis. The patients group consisted in 6 patients diagnosed with urinary bladder tumour. They were submitted to MRI exam. Twelve consecutive cross sectional images of the pelvis were aquired (TR (repetition time) = 600 msec, TE (echo time) = 19 msec, slice thickness = 6 divided by 7 mm, FOV (field of view) = 36 cm. All these images were transferred to a personal computer running the 3DSlicer software. We obtained, for each patient, a 3D model of the pelvis including the urinary bladder. In This way, the surgical enviroment was simulated and we are able to investigate the bladder by virtual cystoscopy. The virtual endoscopy may be used as a tool in the preoperative training and in surgical planning.

  14. Enhanced segmentation and skeletonization for endovascular surgical planning

    Science.gov (United States)

    Cheng, Irene; Firouzmanesh, Amirhossein; Leleve, Arnaud; Shen, Rui; Moreau, Richard; Brizzi, Vicenzo; Pham, Minh-Tu; Redarce, Tanneguy; Lermusiaux, Patrick; Basu, Anup

    2012-02-01

    Endovascular surgery is becoming widely deployed for many critical procedures, replacing invasive medical operations with long recovery times. However, there are still many challenges in improving the efficiency and safety of its usage, and reducing surgery time; namely, regular exposure to radiation, manual navigation of surgical tools, lack of 3D visualization, and lack of intelligent planning and automatic tracking of a surgical end-effector. Thus, our goal is to develop hardware and software components of a tele-operation system to alleviate the abovementioned problems. There are three specific objectives in this project: (i) to reduce the need for a surgeon to be physically next to a patient during endovascular surgery; (ii) to overcome the difficulties encountered in manual navigation; and, (iii) to improve the speed and experience of performing such surgeries. To achieve (i) we will develop an electro-mechanical interface to accurately guide mechanically controlled surgical tools from a close distance, along with a 3D visualization interface; for (ii) we will replace the current surgical tools with an "intelligent wire" controlled by the electro-mechanical system; for (iii) we will segment 3D medical images to extract precise shapes of blood vessels, following which we will perform automatic path planning for a surgical end-effector.

  15. An interactive surgical planning tool for acetabular fractures: initial results

    Directory of Open Access Journals (Sweden)

    Marincek Borut

    2010-08-01

    Full Text Available Abstract Background Acetabular fractures still are among the most challenging fractures to treat because of complex anatomy, involved surgical access to fracture sites and the relatively low incidence of these lesions. Proper evaluation and surgical planning is necessary to achieve anatomic reduction of the articular surface and stable fixation of the pelvic ring. The goal of this study was to test the feasibility of preoperative surgical planning in acetabular fractures using a new prototype planning tool based on an interactive virtual reality-style environment. Methods 7 patients (5 male and 2 female; median age 53 y (25 to 92 y with an acetabular fracture were prospectively included. Exclusion criterions were simple wall fractures, cases with anticipated surgical dislocation of the femoral head for joint debridement and accurate fracture reduction. According to the Letournel classification 4 cases had two column fractures, 2 cases had anterior column fractures and 1 case had a T-shaped fracture including a posterior wall fracture. The workflow included following steps: (1 Formation of a patient-specific bone model from preoperative computed tomography scans, (2 interactive virtual fracture reduction with visuo-haptic feedback, (3 virtual fracture fixation using common osteosynthesis implants and (4 measurement of implant position relative to landmarks. The surgeon manually contoured osteosynthesis plates preoperatively according to the virtually defined deformation. Screenshots including all measurements for the OR were available. The tool was validated comparing the preoperative planning and postoperative results by 3D-superimposition. Results Preoperative planning was feasible in all cases. In 6 of 7 cases superimposition of preoperative planning and postoperative follow-up CT showed a good to excellent correlation. In one case part of the procedure had to be changed due to impossibility of fracture reduction from an ilioinguinal approach

  16. Current Status of Surgical Planning for Orthognathic Surgery: Traditional Methods versus 3D Surgical Planning

    Directory of Open Access Journals (Sweden)

    Jeffrey A. Hammoudeh, MD, DDS

    2015-02-01

    Conclusions: It is our opinion that virtual model surgery will displace and replace traditional model surgery as it will become cost and time effective in both the private and academic setting for practitioners providing orthognathic surgical care in cleft and noncleft patients.

  17. Managing variations from surgical care plans: challenges for coordination.

    Science.gov (United States)

    Iversen, Tobias Buschmann; Melby, Line; Landmark, Andreas Dypvik; Toussaint, Pieter

    2013-01-01

    In surgical work there is a need for 'continuous planning' among staff to handle the frequently occurring variations from the planned patient treatment. In this paper, we present how three hospital information systems have support for three common patient trajectory variations. Highlight how deviations from a plan cause different information needs and implications for design of awareness supporting computer systems. Participant observations and semi-structured interviews with stakeholders involved in peri-operative work. When trajectories progress according to plan, information needs of staff seem to be minimal, as everything is "running to plan". However, when variations occur the information need increases. In order to provide better support for variations, awareness-support systems need to inform colleagues and other stakeholders about deviations from the plan. Plans and trajectories also need to be connected by projecting estimations of incidental time of ongoing relevant events. Additionally, end-users should have the option to switch between information-sparse and information-rich computer support. Published by Elsevier Ireland Ltd.

  18. Fuzzy-logic-assisted surgical planning in adolescent idiopathic scoliosis.

    Science.gov (United States)

    Nault, Marie-Lyne; Labelle, Hubert; Aubin, Carl-Eric; Sangole, Archana; Balazinski, Marek

    2009-06-01

    Selection of appropriate curve fusion levels for surgery in adolescent idiopathic scoliosis (AIS) is a complex and difficult task and, despite numerous publications, still remains a highly controversial topic. To evaluate a fuzzy-logic-based surgical planning tool by comparing the results suggested by the software with the average outcome recommended by a panel of 5 expert spinal deformity surgeons. It is hypothesized that, given the same information, the fuzzy-logic tool will perform as favorably as the surgeons. Proof-of-concept study evaluating the use of a fuzzy-logic-assisted surgical planning tool in AIS to select the appropriate spinal curve to be instrumented. A cohort of 30 AIS surgical cases with a main thoracic curve was used. Each case included standard measurements recorded from preoperative standing postero-anterior and lateral, supine side bending, and 1-year postoperative standing radiographs. Five experienced spinal deformity surgeons evaluated each case independently and gave their preferred levels of instrumentation and fusion. The cases were then presented to the fuzzy-logic tool to determine whether the high thoracic and/or lumbar curves were to be instrumented. For each case, a percentage value was obtained indicating inclusion/exclusion of the respective curves in the surgical instrumentation procedure. Kappa statistics was used to compare the model output and the average decision of the surgeons. Kappa values of 0.71 and 0.64 were obtained, respectively, for the proximal thoracic and lumbar curves models, thus suggesting a good agreement of the fusion recommendations made by the fuzzy-logic tool and the surgeons. Given the same information, the fuzzy-logic-assisted recommendation of the curve to be instrumented compared favorably with the collective decision of the surgeons. The findings thus suggest that a fuzzy-logic approach is helpful in assisting surgeons with the preoperative selection of curve instrumentation and fusion levels in AIS.

  19. Food selection criteria for disaster response planning in urban societies.

    Science.gov (United States)

    Wien, Michelle; Sabaté, Joan

    2015-05-12

    Nutrition professionals that have menu planning and disaster management responsibilities should consider factors that have transcended from ancient to current times, in addition to recognizing societal trends that have led to our current increased vulnerability in the event of a disaster. Hence, we proceeded to develop a set of "Disaster Response Diets" (DRDs) for use in urban societies inclusive of the aforementioned considerations. A three-phase multidimensional approach was used to identify food groups suitable for creating a set of DRDs. Phase One consisted of calculating the percent daily nutrient intake and Drewnowski's naturally nutrient rich (NNR) score for an individual or mean composite for one serving of food from 11 specific food groups. In Phase Two, in addition to nutrient density, the 11 food groups were evaluated and scored based on the following DRD planning criteria: storage and handling properties, preparation ease and, cultural acceptance/individual tolerance. During Phase Three, three DRDs were developed based upon the data retrieved from Phases one and two. In Phase One, the NNR scores ranged from 2.1 for fresh fruits to 28.1 for dry cereals, a higher score indicating a higher nutrient density. During Phase Two, a maximum score of 12 was possible based on appropriateness for a disaster situation. Five plant-based food groups (dry cereals, nuts, dried fruits, grains and legumes) achieved a score ranging between 7 and 12, whereas the five fresh food groups were deemed ineligible due to sanitation and perishability concerns. During Phase Three, three DRDs (milk-inclusive, milk-free and Grab-and-Go) were developed as benchmarks for disaster response planning. Plant-based DRDs are universally acceptable and tolerated across cultures and religions. Therefore, we suggest nutrition professionals consider using a plant-based approach for creating DRDs for public health institutions and organizations.

  20. Generating patient-specific pulmonary vascular models for surgical planning

    Science.gov (United States)

    Murff, Daniel; Co-Vu, Jennifer; O'Dell, Walter G.

    2015-03-01

    Each year in the U.S., 7.4 million surgical procedures involving the major vessels are performed. Many of our patients require multiple surgeries, and many of the procedures include "surgical exploration". Procedures of this kind come with a significant amount of risk, carrying up to a 17.4% predicted mortality rate. This is especially concerning for our target population of pediatric patients with congenital abnormalities of the heart and major pulmonary vessels. This paper offers a novel approach to surgical planning which includes studying virtual and physical models of pulmonary vasculature of an individual patient before operation obtained from conventional 3D X-ray computed tomography (CT) scans of the chest. These models would provide clinicians with a non-invasive, intricately detailed representation of patient anatomy, and could reduce the need for invasive planning procedures such as exploratory surgery. Researchers involved in the AirPROM project have already demonstrated the utility of virtual and physical models in treatment planning of the airways of the chest. Clinicians have acknowledged the potential benefit from such a technology. A method for creating patient-derived physical models is demonstrated on pulmonary vasculature extracted from a CT scan with contrast of an adult human. Using a modified version of the NIH ImageJ program, a series of image processing functions are used to extract and mathematically reconstruct the vasculature tree structures of interest. An auto-generated STL file is sent to a 3D printer to create a physical model of the major pulmonary vasculature generated from 3D CT scans of patients.

  1. [Surgery and the Japan Surgical Society at the beginning of the 21st century].

    Science.gov (United States)

    Hatakeyama, K

    2001-03-01

    Numerous advances in medicine occurred during the latter half of the 20th century, and progress will accelerate in the 21st century. In particular, research in molecular biology has made significant advances, and it was reported that the human genome was almost completely deciphered in June 2000. This will contribute greatly to genetic research in malignant diseases. The development of regenerative medicine, such as cell transplantation using differentiated embryonic or mesenchymal stem cell, will have a significant effect on the field of surgery. The Japan Surgical Society must apply the new knowledge being made available to realize the concept of integrative medicine, in which surgery will play a major role. Substantial changes in postgraduate and continuing education and training of surgeons may be necessary. Other topics for discussion include risk management in the case of surgical accidents and medical ethics based on the Declaration of Helsinki.

  2. Key Tenets of Effective Surgery Leadership: Perspectives From the Society of Surgical Chairs Mentorship Sessions.

    Science.gov (United States)

    Rosengart, Todd K; Kent, K Craig; Bland, Kirby I; Britt, L D; Eberlein, Timothy J; Gewertz, Bruce Labe; Hunter, John G; Lillemoe, Keith D; Pellegrini, Carlos A; Schulick, Richard D; Stain, Steven Charles; Weigel, Ronald J

    2016-08-01

    This Special Communication summarizes the key points raised at the Society of Surgical Chairs mentorship panel sessions held at the 2014 and 2015 annual meetings of the society. Highlights of these expert panel discussions include senior chairs' insights into successfully dealing with increasingly complex academic medical organizations and horizontal department management expectations in the context of the arrival of the Millennial Generation into the work force. Three key tenets of effective surgery leadership that arose from these sessions deal with the importance of (1) collaboration and cooperativity, (2) humanized relationships and mentorship, and (3) operational efficiency. Overall, the panel consensus for the future of surgery leadership was optimistic while recognizing that the demands of chairmanship are considerable.

  3. 3D surgical planning in patients affected by lipodystrophy.

    Science.gov (United States)

    Pérez-Carrasco, J A; Acha, B; Gómez-Cia, T; Lopez-Garcia, R A; Delgado, Carlos; Serrano, C

    2015-03-01

    Lipodystrophy is a pathological condition characterized by the focal or general absence of adipose tissue. Surgeons reset the patient's surface contours using injectable materials to recreate a normal physical appearance. However, due to difficulties in preoperative planning and intraoperative assessment, about 15% of the surgical procedures involved are reinterventions to improve volume or symmetry. This increases the need for an available, efficient tool capable of providing the surgeon with a good estimation of the volumes to be injected before the intervention proper begins. This work describes a virtual reality-based application for the surgical planning of facial lipodystrophy correction (FLIC). The tool uses points selected interactively by the surgeon to compute a curve that delimits the surface area to be operated on. It then automatically computes an estimated natural reconstructed surface and the quantity of volume that needs to be implanted during the intervention. Experiments have been carried out in which the filling volumes estimated using FLIC and ZBrush software were compared with the real volumes injected by the surgeon. ICCs higher than 0.97 indicate that there were no significant differences between the respective measurements, thus validating the tool proposed in this paper.

  4. Preoperative surgical planning for intracranial meningioma resection by virtual reality

    Institute of Scientific and Technical Information of China (English)

    TANG Hai-liang; WANG Dai-jun; ZHU Hong-da; TANG Wei-jun; FENG Xiao-yuan; CHEN Xian-cheng; ZHOU Liang-fu; SUN Hua-ping; GONG Ye; MAO Ying; WU Jing-song; ZHANG Xiao-luo; XIE Qing; XIE Li-qian; ZHENG Ming-zhe

    2012-01-01

    Background The Dextroscope system by Volume Interactions (Singapore) had been applied to minimally invasive neurosurgery in many units.This system enables the neurosurgeon to interact intuitively with the three-dimensional graphics in a direct manner resembling the way one communicates with the real objects.In the paper,we explored its values in pre-operation surgical planning for intracranial meningiomas resection.Methods Brain compuled tomography (CT),magnetic resonance imaging (MRI),and magnetic resonance venography (MRV) were performed on 10 patients with parasagittal and falcine meningiomas located on central groove area; brain CT,MRI and magnetic resonance angiography (MRA) were performed on 10 patients with anterior skull base meningiomas and 10 patients with sphenoid ridge meningiomas.All these data were transferred to Dextroscope virtual reality system,and reconstructed.Then meningiomas,skull base,brain tissue,drainage vein and cerebral arteries were displayed within the system,and their anatomic relationships were evaluated.Also,the simulation operations were performed.Results For parasagittal and falcine meningiomas,the relationships of tumor with drainage vein and superior sagittal sinus were clearly displayed in the Dextroscope system.For anterior skull base and sphenoid ridge meningiomas,the relationships of tumor with bilateral internal carotid arteries,anterior cerebral arteries,middle cerebral arteries and skull base were vividly displayed within the virtual reality system.Surgical planning and simulation operation of all cases were performed as well.The real operations of all patients were conducted according to the simulation with well outcomes.Conclusions According to the virtual reality planning,neurosurgeons could get more anatomic information about meningioma and its surrounding structures,especially important vessels,and choose the best approach for tumor resection,which would lead to better prognosis for patients.

  5. Simulation based planning of surgical interventions in pediatric cardiology

    Science.gov (United States)

    Marsden, Alison L.

    2013-10-01

    Hemodynamics plays an essential role in the progression and treatment of cardiovascular disease. However, while medical imaging provides increasingly detailed anatomical information, clinicians often have limited access to hemodynamic data that may be crucial to patient risk assessment and treatment planning. Computational simulations can now provide detailed hemodynamic data to augment clinical knowledge in both adult and pediatric applications. There is a particular need for simulation tools in pediatric cardiology, due to the wide variation in anatomy and physiology in congenital heart disease patients, necessitating individualized treatment plans. Despite great strides in medical imaging, enabling extraction of flow information from magnetic resonance and ultrasound imaging, simulations offer predictive capabilities that imaging alone cannot provide. Patient specific simulations can be used for in silico testing of new surgical designs, treatment planning, device testing, and patient risk stratification. Furthermore, simulations can be performed at no direct risk to the patient. In this paper, we outline the current state of the art in methods for cardiovascular blood flow simulation and virtual surgery. We then step through pressing challenges in the field, including multiscale modeling, boundary condition selection, optimization, and uncertainty quantification. Finally, we summarize simulation results of two representative examples from pediatric cardiology: single ventricle physiology, and coronary aneurysms caused by Kawasaki disease. These examples illustrate the potential impact of computational modeling tools in the clinical setting.

  6. A soil plan of action to awaken society beyond 2015

    Science.gov (United States)

    Jones, Arwyn; Bampa, Francesca; Towers, Willie; Broll, Gabrielle; Vargas, Ronald

    2014-05-01

    suite of positive examples offered by soil enthusiasts is to provide a common platform appropriate to all parts of the world, with a common consensus on soil issues to be covered and be brought to the table of consumers. The Global Soil Partnership (GSP) is an interactive, responsive and voluntary partnership, open to governments, regional organizations, institutions and other stakeholders. One of the pillars of action aims to "Encourage investment, technical cooperation, policy, education awareness and extension in soil". In order to achieve this goal, a small regionally balanced committee was formed following the 3rd European Network on Soil Awareness conference in Aberdeen and the 2nd Global Soil Week in Berlin. This group produced a draft plan of action that will be submitted to the Intergovernmental technical Panel on Soils (ITPS) of the GSP. Some key points that we need to address are: finding new soil communicators to awake and engage the society and the political arena (e.g. actors, poets, artists, etc.); focusing on a harmonised public perception of soil and their importance for environment and society; re-introducing soil science into the school curricula as a cross-cutting discipline designing a coherent but flexible structure and ensuring a proper and logical constructive transition between each learning stage (e.g. training teachers, web-based courses/ web-based platform, etc.). REFERENCES Bouma J, Broll G, Crane TA, Dewitte O, Gardi C, Schulte RPO, Towers W (2012) Soil information in support of policy making and awareness raising. Current Opinion in Environmental Sustainability, 4, 552-558. EC (2006) (COM(2006)231 final) Communication from the Commission to the Council, the European Parliament, the European Economic and Social Committee of the Regions, Thematic Strategy for Soil Protection. (ed Commission E), Brussels, Belgium.

  7. Software components for medical image visualization and surgical planning

    Science.gov (United States)

    Starreveld, Yves P.; Gobbi, David G.; Finnis, Kirk; Peters, Terence M.

    2001-05-01

    Purpose: The development of new applications in medical image visualization and surgical planning requires the completion of many common tasks such as image reading and re-sampling, segmentation, volume rendering, and surface display. Intra-operative use requires an interface to a tracking system and image registration, and the application requires basic, easy to understand user interface components. Rapid changes in computer and end-application hardware, as well as in operating systems and network environments make it desirable to have a hardware and operating system as an independent collection of reusable software components that can be assembled rapidly to prototype new applications. Methods: Using the OpenGL based Visualization Toolkit as a base, we have developed a set of components that implement the above mentioned tasks. The components are written in both C++ and Python, but all are accessible from Python, a byte compiled scripting language. The components have been used on the Red Hat Linux, Silicon Graphics Iris, Microsoft Windows, and Apple OS X platforms. Rigorous object-oriented software design methods have been applied to ensure hardware independence and a standard application programming interface (API). There are components to acquire, display, and register images from MRI, MRA, CT, Computed Rotational Angiography (CRA), Digital Subtraction Angiography (DSA), 2D and 3D ultrasound, video and physiological recordings. Interfaces to various tracking systems for intra-operative use have also been implemented. Results: The described components have been implemented and tested. To date they have been used to create image manipulation and viewing tools, a deep brain functional atlas, a 3D ultrasound acquisition and display platform, a prototype minimally invasive robotic coronary artery bypass graft planning system, a tracked neuro-endoscope guidance system and a frame-based stereotaxy neurosurgery planning tool. The frame-based stereotaxy module has been

  8. Physiology informed virtual surgical planning: a case study with a virtual airway surgical planner and BioGears

    Science.gov (United States)

    Potter, Lucas; Arikatla, Sreekanth; Bray, Aaron; Webb, Jeff; Enquobahrie, Andinet

    2017-03-01

    Stenosis of the upper airway affects approximately 1 in 200,000 adults per year1 , and occurs in neonates as well2 . Its treatment is often dictated by institutional factors and clinicians' experience or preferences 3 . Objective and quantitative methods of evaluating treatment options hold the potential to improve care in stenosis patients. Virtual surgical planning software tools are critically important for this. The Virtual Pediatric Airway Workbench (VPAW) is a software platform designed and evaluated for upper airway stenosis treatment planning. It incorporates CFD simulation and geometric authoring with objective metrics from both that help in informed evaluation and planning. However, this planner currently lacks physiological information which could impact the surgical planning outcomes. In this work, we integrated a lumped parameter, model based human physiological engine called BioGears with VPAW. We demonstrated the use of physiology informed virtual surgical planning platform for patient-specific stenosis treatment planning. The preliminary results show that incorporating patient-specific physiology in the pretreatment plan would play important role in patient-specific surgical trainers and planners in airway surgery and other types of surgery that are significantly impacted by physiological conditions during surgery.

  9. Realistic tool-tissue interaction models for surgical simulation and planning

    NARCIS (Netherlands)

    Misra, Sarthak

    2009-01-01

    Surgical simulators present a safe and potentially effective method for surgical training, and can also be used in pre- and intra-operative surgical planning. Realistic modeling of medical interventions involving tool-tissue interactions has been considered to be a key requirement in the development

  10. The teratology society 2012-2017 strategic plan: pushing the boundaries.

    Science.gov (United States)

    Curran, Christine Perdan; Lau, Christopher; Schellpfeffer, Michael A; Stodgell, Christopher J; Carney, Edward W

    2013-01-01

    The Teratology Society held its fourth strategic planning session in Albuquerque, NM, April 10-12, 2012, and launched the 2012-2017 Strategic Plan in conjunction with the 2012 annual meeting in Baltimore, MD. Building on the energy of the successful implementation of prior strategic plans (San Diego, 2007; Nashville,TN 2002; Cincinnati, OH 1998), session participants worked to identify barriers to success as a scientific society, as well as impending challenges and opportunities to which the Society needs to respond. The following report provides an overview of the Strategic Planning process, objectives, activities, and conclusions. A total of 23 members were present at the session, and the group included representation from Council, various committees, and different member constituencies. This plan, Pushing the Boundaries, and its three strategic intents: Broaden Our Identity, Expand Our Membership, and Increase Our Influence, will drive the direction of the Teratology Society for the next five years.

  11. Planning and Restoration of Environmental Values in Nigeria Dysfunctional Societies

    Directory of Open Access Journals (Sweden)

    J. O Basorun

    2013-04-01

    Full Text Available Urban centers in Nigeria are becoming dysfunctional – a situation that threatens ourenvironmental values. This study, examines the pattern, process and problems of thesesocieties which experience rapid urban development pressure on account of highpopulation growth and decentralization of governance in the form of states and localgovernment creations. The study adopts extensive review of literature and findings revealthat Nigeria records very high level of urbanization and pollution, lacks effective culturaland physical planning policies, mismanages its urban open spaces, without adequatepersonnel to plan and organize the urban environments. Recommendations were madeon ways of restoring these environmental values through effective planning of urbancenters in Nigeria.

  12. Career satisfaction, practice patterns and burnout among surgical oncologists: report on the quality of life of members of the Society of Surgical Oncology.

    Science.gov (United States)

    Kuerer, Henry M; Eberlein, Timothy J; Pollock, Raphael E; Huschka, Mashele; Baile, Walter F; Morrow, Monica; Michelassi, Fabrizio; Singletary, S Eva; Novotny, Paul; Sloan, Jeff; Shanafelt, Tait D

    2007-11-01

    Studies show that 30-50% of medical oncologists experience burnout, but little is known about burnout among surgical oncologists. We hypothesized that wide variation in burnout and career satisfaction exist among surgical oncologists. In April 2006, members of the Society of Surgical Oncology (SSO) were sent an anonymous, cross-sectional survey evaluating demographic variables, practice characteristics, career satisfaction, burnout, and quality of life (QOL). Burnout and QOL were measured using validated instruments. Of the 1519 surgical oncologists surveyed, 549 (36%) responded. More than 50% of respondents worked more than 60 hours per week while 24% performed more than 10 surgical cases per week. Among the respondents, 72% were academic surgical oncologists and 26% spent at least 25% of their time to research. Seventy-nine percent stated that they would become a surgical oncologist again given the choice. Overall, 28% of respondents had burnout. Burnout was more common among respondents age 50 years or younger (31% vs 22%; P = .029) and women (37% vs 26%; P = .031). Factors associated with a higher risk of burnout on multivariate analysis were devoting less than 25% of time to research, had lower physical QOL, and were age 50 years or younger. Burnout was associated with lower satisfaction with career choice. Although surgical oncologists indicated a high level of career satisfaction, nearly a third experienced burnout. Factors associated with burnout in this study may inform efforts by program directors and SSO members to promote personal health and retain the best surgeons in the field of surgical oncology. Additional research is needed to inform evidenced-based interventions at both the individual and organizational level to reduce burnout.

  13. Computer-assisted surgical planning and intraoperative guidance in fetal surgery: a systematic review.

    Science.gov (United States)

    Pratt, Rosalind; Deprest, Jan; Vercauteren, Tom; Ourselin, Sebastien; David, Anna L

    2015-12-01

    Fetal surgery has become a clinical reality, with interventions for twin-to-twin transfusion syndrome (TTTS) and spina bifida demonstrated to improve outcome. Fetal imaging is evolving, with the use of 3D ultrasound and fetal MRI becoming more common in clinical practise. Medical imaging analysis is also changing, with technology being developed to assist surgeons by creating 3D virtual models that improve understanding of complex anatomy, and prove powerful tools in surgical planning and intraoperative guidance. We introduce the concept of computer-assisted surgical planning, and present the results of a systematic review of image reconstruction for fetal surgical planning that identified six articles using such technology. Indications from other specialities suggest a benefit of surgical planning and guidance to improve outcomes. There is therefore an urgent need to develop fetal-specific technology in order to improve fetal surgical outcome.

  14. Towards planning for a mobile society: mobile and residential populations and the performance of places

    NARCIS (Netherlands)

    Zandvliet, R.; Bertolini, L.; Dijst, M.

    2008-01-01

    As contemporary society is increasingly structured around highly diverse flows of people, goods, and information, mobile populations will contribute more and more to the economic, environmental and social performance of their destinations. However, planning is largely focused on residential populati

  15. Algorithm for planning a double-jaw orthognathic surgery using a computer-aided surgical simulation (CASS) protocol. Part 1: planning sequence.

    Science.gov (United States)

    Xia, J J; Gateno, J; Teichgraeber, J F; Yuan, P; Chen, K-C; Li, J; Zhang, X; Tang, Z; Alfi, D M

    2015-12-01

    The success of craniomaxillofacial (CMF) surgery depends not only on the surgical techniques, but also on an accurate surgical plan. The adoption of computer-aided surgical simulation (CASS) has created a paradigm shift in surgical planning. However, planning an orthognathic operation using CASS differs fundamentally from planning using traditional methods. With this in mind, the Surgical Planning Laboratory of Houston Methodist Research Institute has developed a CASS protocol designed specifically for orthognathic surgery. The purpose of this article is to present an algorithm using virtual tools for planning a double-jaw orthognathic operation. This paper will serve as an operation manual for surgeons wanting to incorporate CASS into their clinical practice.

  16. Functional MRI in pre-surgical planning: case study and cautionary ...

    African Journals Online (AJOL)

    Functional MRI in pre-surgical planning: case study and cautionary notes. ... Since its inception almost 20 years ago, functional magnetic resonance imaging ... Although the clinical applications of fMRI are still limited, there have recently been ...

  17. Virtual Surgical Planning for Mandibular Distraction in Infants with Robin Sequence.

    Science.gov (United States)

    Resnick, Cory M

    2017-06-01

    Mandibular distraction osteogenesis (MDO) successfully relieves obstructive sleep apnea in many infants with Robin sequence. Preoperative virtual surgical planning and fabrication of three-dimensionally printed cutting guides may lead to further improvements in the MDO technique and decrease the risk for damage to adjacent structures such as developing teeth and the inferior alveolar nerve. This report presents an algorithm for virtual surgical planning and three-dimensionally printing of cutting guides for MDO in infants with RS.

  18. Clinical feasibility and efficacy of using virtual surgical planning in bimaxillary orthognathic surgery without intermediate splint.

    Science.gov (United States)

    Li, Yunfeng; Jiang, Yangmei; Zhang, Nan; Xu, Rui; Hu, Jing; Zhu, Songsong

    2015-03-01

    Computer-aided jaw surgery has been extensively studied recently. The purpose of this study was to determine the clinical feasibility of performing bimaxillary orthognathic surgery without intermediate splint using virtual surgical planning and rapid prototyping technology. Twelve consecutive patients who underwent bimaxillary orthognathic surgery were included. The presented treatment plan here mainly consists of 6 procedures: (1) data acquisition from computed tomography (CT) of the skull and laser scanning of the dentition; (2) reconstruction and fusion of a virtual skull model with accurate dentition; (3) virtual surgery simulation including osteotomy and movement and repositioning of bony segments; (4) final surgical splint fabrication (no intermediate splint) using computer-aided design and rapid prototyping technology; (5) transfer of the virtual surgical plan to the operating room; and (6) comparison of the actual surgical outcome to the virtual surgical plan. All procedures of the treatment were successfully performed on all 12 patients. In quantification of differences between simulated and actual postoperative outcome, we found that the mean linear difference was less than 1.8 mm, and the mean angular difference was less than 2.5 degrees in all evaluated patients. Results from this study suggested that it was feasible to perform bimaxillary orthognathic surgery without intermediate splint. Virtual surgical planning and the guiding splints facilitated the diagnosis, treatment planning, accurate osteotomy, and bony segments repositioning in orthognathic surgery.

  19. Evaluation of Patient Outcome and Satisfaction after Surgical Treatment of Adolescent Idiopathic Scoliosis Using Scoliosis Research Society-30

    OpenAIRE

    Hasan Ghandehari; Maryam Ameri Mahabadi; Seyed Mani Mahdavi; Seyed Hossein Vahid Tari; Ali Shahsavaripour; Farshad Safdari

    2015-01-01

    Background: Adolescent idiopathic scoliosis (AIS) may lead to physical and mental problems. It also can adversely affect patient satisfaction and the quality of life. In this study, we assessed the outcomes and satisfaction rate after surgical treatment of AIS using scoliosis research society-30 questionnaire (SRS-30). Methods: We enrolled 135 patients with AIS undergoing corrective surgery. Patients were followed for at least 2 years. We compared pre- and post-operative x-rays in terms of Co...

  20. Evaluation of Patient Outcome and Satisfaction after Surgical Treatment of Adolescent Idiopathic Scoliosis Using Scoliosis Research Society-30

    OpenAIRE

    Hasan Ghandehari; Maryam Ameri Mahabadi; Seyed Mani Mahdavi; Seyed Hossein Vahid Tari; Ali Shahsavaripour; Farshad Safdari

    2015-01-01

    Background: Adolescent idiopathic scoliosis (AIS) may lead to physical and mental problems. It also can adversely affect patient satisfaction and the quality of life. In this study, we assessed the outcomes and satisfaction rate after surgical treatment of AIS using scoliosis research society-30 questionnaire (SRS-30). Methods: We enrolled 135 patients with AIS undergoing corrective surgery. Patients were followed for at least 2 years. We compared pre- and post-operative x-rays in terms of Co...

  1. Computer-Designed Splints for Surgical Transfer of 3D Orthognathic Planning.

    Science.gov (United States)

    Zinser, Max; Zoeller, Joachim

    2015-10-01

    Advances in computers and imaging have permitted the adoption of three-dimensional (3D) planning protocols in orthognathic surgery, which may allow a paradigm shift when the computer-assisted planning can be transferred properly. The purpose of this investigation was to introduce an innovative clinical protocol using computer-aided designed and computer-aided manufactured (CAD/CAM) surgical splints for surgical transfer of 3D orthognathic planning compared with the classic technique using arbitrary occlusal splints. The clinical protocols consisted of computed tomography (CT) or cone-beam CT (CBCT) maxillofacial imaging, bone segmentation, 3D diagnosis, computer-assisted surgical treatment planning, and CAD/CAM surgical splints (group A) and manufacture of arbitrary occlusal splints (group B) for intraoperative surgical planning transfer. The observed patients underwent bimaxillary osteotomies and, if necessary, an additional genioplasty. Both techniques were evaluated by applying 13 hard tissue parameters to compare the 3D orthognathic planning (T0) with the postoperative result (T1) using 3D cephalometry. The CAD/CAM splints showed significant better precision for the maxilla (ΔT orthognathic planning, which is more precise compared with the conventional arbitrary occlusal splints.

  2. Strategic planning ensures surgical success in cases of proliferative vitreoretinopathy.

    Science.gov (United States)

    Lakhanpal, R Ross; Hariprasad, Seenu M

    2015-02-01

    For this Practical Retina column, Dr. Ross Lakhanpal from Baltimore was asked to comment on the current state of thinking and management options for proliferative vitreoretinopathy (PVR) after retinal detachment (RD) surgery.We are all aware that PVR continues to be an important cause of recurrent RD after successful repair. This feared complication has been reported to occur in up to 8% of patients after undergoing RD repair. Despite the historic progress made in managing various vitreoretinal diseases over the past decade, most retina specialists will agree that an unmet need remains in this landscape. Fortunately, advances in various surgical technologies such as instrumentation, lighting, and visualization have improved the outcomes after PVR management.Dr. Lakhanpal discusses causes of PVR, management goals, surgical techniques, and pearls to avoid complications after managing PVR. His experience working in an urban tertiary surgical retina practice enables him to offer insights that will be highly valued by our community.

  3. SOCIETY

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    White Festival A winter Naadam as well as a fire sacrifice festival kicks off on December 23,2014,in Old Barag Banner(county)of Hulunbuir,a city of north China’s Inner Mongolia Autonomous Region.Human Rights Plan China has been working effectively toward goals set by the National Human

  4. Virtual surgical planning and 3D printing in repeat calvarial vault reconstruction for craniosynostosis: technical note.

    Science.gov (United States)

    LoPresti, Melissa; Daniels, Bradley; Buchanan, Edward P; Monson, Laura; Lam, Sandi

    2017-04-01

    Repeat surgery for restenosis after initial nonsyndromic craniosynostosis intervention is sometimes needed. Calvarial vault reconstruction through a healed surgical bed adds a level of intraoperative complexity and may benefit from preoperative and intraoperative definitions of biometric and aesthetic norms. Computer-assisted design and manufacturing using 3D imaging allows the precise formulation of operative plans in anticipation of surgical intervention. 3D printing turns virtual plans into anatomical replicas, templates, or customized implants by using a variety of materials. The authors present a technical note illustrating the use of this technology: a repeat calvarial vault reconstruction that was planned and executed using computer-assisted design and 3D printed intraoperative guides.

  5. IBMISPS (International Brain Mapping & Intraoperative Surgical Planning Symposium)

    Science.gov (United States)

    2005-12-01

    zona incerta, zi and STN subparts): mean value of current leading a benefit 13 5. Conclusions Beyond the surgical spin-offs, in terms of time...associated wet -lab (UCI Chao Cancer Center) is performing a set of experiments to obtain a consistent set of parameters that should yield more...derived from the literature. Our model predictions accord with experiments on histocultures found in the literature. Our associated wet -lab is

  6. Virtual surgical modification for planning tetralogy of Fallot repair

    Science.gov (United States)

    Plasencia, Jonathan; Babiker, Haithem; Richardson, Randy; Rhee, Edward; Willis, Brigham; Nigro, John; Cleveland, David; Frakes, David H.

    2010-01-01

    Goals for treating congenital heart defects are becoming increasingly focused on the long-term, targeting solutions that last into adulthood. Although this shift has motivated the modification of many current surgical procedures, there remains a great deal of room for improvement. We present a new methodological component for tetralogy of Fallot (TOF) repair that aims to improve long-term outcomes. The current gold standard for TOF repair involves the use of echocardiography (ECHO) for measuring the pulmonary valve (PV) diameter. This is then used, along with other factors, to formulate a Z-score that drives surgical preparation. Unfortunately this process can be inaccurate and requires a mid-operative confirmation that the pressure gradient across the PV is not excessive. Ideally, surgeons prefer not to manipulate the PV as this can lead to valve insufficiency. However, an excessive pressure gradient across the valve necessitates surgical action. We propose the use of computational fluid dynamics (CFD) to improve preparation for TOF repair. In our study, pre-operative CT data were segmented and reconstructed, and a virtual surgical operation was then performed to simulate post-operative conditions. The modified anatomy was used to drive CFD simulation. The pressure gradient across the pulmonary valve was calculated to be 9.24mmHg, which is within the normal range. This finding indicates that CFD may be a viable tool for predicting post-operative pressure gradients for TOF repair. Our proposed methodology would remove the need for mid-operative measurements that can be both unreliable and detrimental to the patient.

  7. Shared and Contested Elements in Climate Plans towards a Danish Low Carbon Society

    DEFF Research Database (Denmark)

    Jørgensen, Michael Søgaard

    and measures in a 30-40 year perspective. The presentation analyses four Danish action plans from the Danish Society of Engineers, a renewable energy NGO, an environmental NGO and a report from a governmental, independent climate change commission. The aim is to identify shared and contested elements, which...... with respect to how agriculture and food consumption should change as part of the transitions. The plans present different scenarios for the overall Danish energy system. The national commission’s plan describes a system exchanging energy with other countries through a transnational grid, while the other plans...... describe scenarios for a more independent national energy system, where wind turbine energy mainly is used or stored in Denmark. All four plans agree about a significant increase in Danish wind turbine capacity and stronger energy saving efforts in production and consumption. The plans differ with respect...

  8. Converting Scoliosis Research Society-24 to Scoliosis Research Society-22r in a Surgical-Range, Medical/Interventional Adolescent Idiopathic Scoliosis Patient Cohort.

    Science.gov (United States)

    Chen, Antonia F; Bi, Wenzhu; Singhabahu, Dilrukshika; Londino, Joanne; Hohl, Justin; Ward, Maeve; Ward, W Timothy

    2013-03-01

    Prospective questionnaire administration study. To assess the ability to translate total and domain scores from Scoliosis Research Society (SRS)-24 to SRS-22r in a surgical-range, medical/interventional adolescent idiopathic scoliosis (AIS) patient population. Conversion of SRS-24 to SRS-22r is demonstrated in an operative cohort of patients with AIS, but not in a medical/interventional patient population. We simultaneously administered SRS-24 and SRS-22r questionnaires to 75 surgical-range, medical/interventional AIS patients and compared them. We performed analysis by regression modeling to produce conversion equations from SRS-24 to SRS-22r. The total SRS-24 score for these medical/interventional AIS patients was 92.5 ± 9.45 (mean, 3.9 ± 0.39), and the total SRS-22r score was 93.5 ± 9.63 (mean, 4.3 ± 0.44). The correlation between these 2 groups was fair (R(2) = 0.77) and improved to good when mental health or recall questions were removed. The correlation was also fair for total pain domains (R(2) = 0.73). However, there was poor correlation for general self-image (R(2) = 0.6) and unacceptable for post-treatment self-image (R(2) = 0.01), general function (R(2) = 0.52), activity function (R(2) = 0.56), and satisfaction (R(2) = 0.53). Compared with a published population of operative AIS patients, R(2) values for total SRS-24 scores, pain, general self-image, activity function, and satisfaction were similar (p > .05). The R(2) values for general function and combined general and activity function were significantly different between the operative and medical/interventional cohorts. Scoliosis Research Society-24 can be converted to SRS-22r scores with fair accuracy in the surgical-range, medical/interventional AIS patient population for total score, and total pain domains. The SRS-24 translates unacceptably to the SRS-22r in self-image, function, and satisfaction domains. The SRS-24 to SRS-22r conversion equations are similar to operative AIS patients, except

  9. Stereolithography: a method for planning the surgical correction of the hypertelorism.

    Science.gov (United States)

    Hidalgo, Hector Malagon; Romo, Gabriela Wong; Estolano, Roberto Takeo Rivera

    2009-09-01

    Hypertelorism is a deformity characterized by an increase in interorbital distance. The treatment can be orbital mobilization, or if the malformation goes along with occlusal alterations, the indicated treatment is a facial bipartition with hemifacial rotation.The intention of the present study was to describe a surgical planning technique in locating the anatomic points and planes on a stereolithographic model of a patient with 0-14 fissure and its surgical application.

  10. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 5: surgical margins.

    NARCIS (Netherlands)

    Tan, P.H.; Cheng, L.; Srigley, J.R.; Griffiths, D.; Humphrey, P.A.; Kwast, T.H. van der; Montironi, R.; Wheeler, T.M.; Delahunt, B.; Egevad, L.; Epstein, J.I.; Hulsbergen- van de Kaa, C.A.

    2011-01-01

    The 2009 International Society of Urological Pathology Consensus Conference in Boston, made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to surgical margin assessment were coordinated by working group 5. Pathologists agreed

  11. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 5: surgical margins.

    NARCIS (Netherlands)

    Tan, P.H.; Cheng, L.; Srigley, J.R.; Griffiths, D.; Humphrey, P.A.; Kwast, T.H. van der; Montironi, R.; Wheeler, T.M.; Delahunt, B.; Egevad, L.; Epstein, J.I.; Hulsbergen- van de Kaa, C.A.

    2011-01-01

    The 2009 International Society of Urological Pathology Consensus Conference in Boston, made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to surgical margin assessment were coordinated by working group 5. Pathologists agreed

  12. Immediate postoperative outcome of orthognathic surgical planning, and prediction of positional changes in hard and soft tissue, independently of the extent and direction of the surgical corrections required

    DEFF Research Database (Denmark)

    Donatsky, Ole; Bjørn-Jørgensen, Jens; Hermund, Niels Ulrich;

    2011-01-01

    Our purpose was to evaluate the immediate postoperative outcome of preoperatively planned and predicted positional changes in hard and soft tissue in 100 prospectively and consecutively planned and treated patients; all had various dentofacial deformities that required single or double jaw...... orthognathic correction using the computerised, cephalometric, orthognathic, surgical planning system (TIOPS). Preoperative cephalograms were analysed and treatment plans and prediction tracings produced by computerised interactive simulation. The planned changes were transferred to models and finally...

  13. Three-dimensional virtual reality surgical planning and simulation workbench for orthognathic surgery.

    Science.gov (United States)

    Xia, J; Samman, N; Yeung, R W; Shen, S G; Wang, D; Ip, H H; Tideman, H

    2000-01-01

    A new integrated computer system, the 3-dimensional (3D) virtual reality surgical planning and simulation workbench for orthognathic surgery (VRSP), is presented. Five major functions are implemented in this system: post-processing and reconstruction of computed tomographic (CT) data, transformation of 3D unique coordinate system geometry, generation of 3D color facial soft tissue models, virtual surgical planning and simulation, and presurgical prediction of soft tissue changes. The basic mensuration functions, such as linear and spatial measurements, are also included. The surgical planning and simulation are based on 3D CT reconstructions, whereas soft tissue prediction is based on an individualized, texture-mapped, color facial soft tissue model. The surgeon "enters" the virtual operatory with virtual reality equipment, "holds" a virtual scalpel, and "operates" on a virtual patient to accomplish actual surgical planning, simulation of the surgical procedure, and prediction of soft tissue changes before surgery. As a final result, a quantitative osteotomy-simulated bone model and predicted color facial model with photorealistic quality can be visualized from any arbitrary viewing point in a personal computer system. This system can be installed in any hospital for daily use.

  14. Extended trochanteric osteotomy: planning, surgical technique, and pitfalls.

    Science.gov (United States)

    Meek, R M; Greidanus, Nelson V; Garbuz, Donald S; Masri, Bassam A; Duncan, Clive P

    2004-01-01

    The extended trochanteric osteotomy is appropriate for a number of surgical indications. It facilitates removal of well-fixed cement mantles with a loose or well-fixed stem and of extensively porous-coated or tapered cementless stems. This exposure is particularly valuable in the presence of varus remodeling of the proximal femur, permitting correction of proximal femoral deformity and reducing the risk of fracture of the greater trochanter. It is also indicated in the removal of a well-fixed cemented stem that is complicated by infection, where it is vital to extract all foreign material for successful eradication of the infection. In addition, when the osteotomy is required for femoral exposure, it enhances acetabular exposure to allow even the most complex reconstruction. Also, as the soft-tissue attachments to the bone fragment are preserved in this approach, abductor muscle tension can be adjusted.

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

    Science.gov (United States)

    Polley, John W; Figueroa, Alvaro A

    2013-05-01

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

  16. Preoperative surgical planning and simulation of complex cranial base tumors in virtual reality

    Institute of Scientific and Technical Information of China (English)

    YI Zhi-qiang; LI Liang; MO Da-peng; ZHANG Jia-yong; ZHANG Yang; BAO Sheng-de

    2008-01-01

    @@ The extremely complex anatomic relationships among bone,tumor,blood vessels and cranial nerves remains a big challenge for cranial base tumor surgery.Therefore.a good understanding of the patient specific anatomy and a preoperative planning are helpful and crocial for the neurosurgeons.Three dimensional (3-D) visualization of various imaging techniques have been widely explored to enhance the comprehension of volumetric data for surgical planning.1 We used the Destroscope Virtual Reality (VR) System (Singapore,Volume Interaction Pte Ltd,software:RadioDexterTM 1.0) to optimize preoperative plan in the complex cranial base tumors.This system uses patient-specific,coregistered,fused radiology data sets that may be viewed stereoscopically and can be manipulated in a virtual reality environment.This article describes our experience with the Destroscope VR system in preoperative surgical planning and simulation for 5 patients with complex cranial base tumors and evaluates the clinical usefulness of this system.

  17. Simulation-based planning of surgical interventions in pediatric cardiology

    Science.gov (United States)

    Marsden, Alison

    2012-11-01

    Hemodynamics plays an essential role in the progression and treatment of cardiovascular disease. This is particularly true in pediatric cardiology, due to the wide variation in anatomy observed in congenital heart disease patients. While medical imaging provides increasingly detailed anatomical information, clinicians currently have limited knowledge of important fluid mechanical parameters. Treatment decisions are therefore often made using anatomical information alone, despite the known links between fluid mechanics and disease progression. Patient-specific simulations now offer the means to provide this missing information, and, more importantly, to perform in-silico testing of new surgical designs at no risk to the patient. In this talk, we will outline the current state of the art in methods for cardiovascular blood flow simulation and virtual surgery. We will then present new methodology for coupling optimization with simulation and uncertainty quantification to customize treatments for individual patients. Finally, we will present examples in pediatric cardiology that illustrate the potential impact of these tools in the clinical setting.

  18. Algorithm for planning a double-jaw orthognathic surgery using a computer-aided surgical simulation (CASS) protocol. Part 1: planning sequence

    Science.gov (United States)

    Xia, J. J.; Gateno, J.; Teichgraeber, J. F.; Yuan, P.; Chen, K.-C.; Li, J.; Zhang, X.; Tang, Z.; Alfi, D. M.

    2015-01-01

    The success of craniomaxillofacial (CMF) surgery depends not only on the surgical techniques, but also on an accurate surgical plan. The adoption of computer-aided surgical simulation (CASS) has created a paradigm shift in surgical planning. However, planning an orthognathic operation using CASS differs fundamentally from planning using traditional methods. With this in mind, the Surgical Planning Laboratory of Houston Methodist Research Institute has developed a CASS protocol designed specifically for orthognathic surgery. The purpose of this article is to present an algorithm using virtual tools for planning a double-jaw orthognathic operation. This paper will serve as an operation manual for surgeons wanting to incorporate CASS into their clinical practice. PMID:26573562

  19. European Society of Coloproctology consensus on the surgical management of intestinal failure in adults

    DEFF Research Database (Denmark)

    Vaizey, C J; Maeda, Y; Barbosa, E;

    2016-01-01

    Intestinal failure (IF) is a debilitating condition of inadequate nutrition due to an anatomical and/or physiological deficit of the intestine. Surgical management of patients with acute and chronic IF requires expertise to deal with technical challenges and make correct decisions. Dedicated IF u...... definition of IF surgery and organization of an IF unit, strategies to prevent IF, management of acute IF, management of wound, fistula and stoma, rehabilitation, intestinal and abdominal reconstruction, criteria for referral to a specialist unit and intestinal transplantation....

  20. Multiscale modeling and surgical planning for single ventricle heart patients

    Science.gov (United States)

    Marsden, Alison

    2011-11-01

    Single ventricle heart patients are among the most challenging for pediatric cardiologists to treat, and typically undergo a palliative course of three open-heart surgeries starting immediately after birth. We will present recent tools for modeling blood flow in single ventricle heart patients using a multiscale approach that couples a 3D Navier-Stokes domain to a 0D closed loop lumped parameter network comprised of circuit elements. This coupling allows us to capture the effect of changes in local geometry, such as shunt sizes, on global circulatory dynamics, such as cardiac output. A semi-implicit numerical method is formulated to solve the coupled system in which flow and pressure information is passed between the two domains at the inlets and outlets of the model. A finite element method with outflow stabilization is applied in the 3D Navier-Stokes domain, and the LPN system of ordinary differential equations is solved numerically using a Runge-Kutta method. These tools are coupled via automated scripts to a derivative-free optimization method. Optimization is used to systematically explore surgical designs using clinically relevant cost functions for two stages of single ventricle repair. First, we will present results from optimization of the first stage Blalock Taussig Shunt. Second, we will present results from optimization of a new Y-graft design for the third stage of single ventricle repair called the Fontan surgery. The Y-graft is shown, in simulations, to successfully improve hepatic flow distribution, a known clinical problem. Preliminary clinical experience with the Y-graft will be discussed.

  1. The use of virtual surgical planning and navigation in the treatment of orbital trauma

    Directory of Open Access Journals (Sweden)

    Alan Scott Herford

    2017-02-01

    Full Text Available Virtual surgical planning (VSP has recently been introduced in craniomaxillofacial surgery with the goal of improving efficiency and precision for complex surgical operations. Among many indications, VSP can also be applied for the treatment of congenital and acquired craniofacial defects, including orbital fractures. VSP permits the surgeon to visualize the complex anatomy of craniofacial region, showing the relationship between bone and neurovascular structures. It can be used to design and print using three-dimensional (3D printing technology and customized surgical models. Additionally, intraoperative navigation may be useful as an aid in performing the surgery. Navigation is useful for both the surgical dissection as well as to confirm the placement of the implant. Navigation has been found to be especially useful for orbit and sinus surgery. The present paper reports a case describing the use of VSP and computerized navigation for the reconstruction of a large orbital floor defect with a custom implant.

  2. Managing passengers with stable respiratory disease planning air travel: British Thoracic Society recommendations.

    Science.gov (United States)

    Shrikrishna, Dinesh; Coker, Robina K

    2011-09-01

    This article summarises the key points from the 2011 British Thoracic Society (BTS) recommendations on managing passengers with respiratory disease planning air travel. The guidance aims to provide practical advice for respiratory specialists in secondary care and serves as a valuable reference for other healthcare professionals managing these patients. A greater awareness of the challenges posed by air travel will allow improved clinical assessment and practical advice to encourage patients to fly safely wherever possible.

  3. Mandible reconstruction with free fibula flaps: Outcome of a cost-effective individual planning concept compared with virtual surgical planning.

    Science.gov (United States)

    Rommel, Niklas; Kesting, Marco Rainer; Rohleder, Nils Hagen; Bauer, Florian Martin Josef; Wolff, Klaus-Dietrich; Weitz, Jochen

    2017-08-01

    The free osteomyocutaneous fibular flap has become one of the primary options for mandibular reconstruction, because of the later introduction and development of virtual surgical planning (VSP). However, VSP is associated with high additional pre-operative effort and costs. Therefore, the purpose of the study was to develop a new individual cost-effective pre-operative planning concept for free fibula mandible reconstruction and to compare it with VSP regarding clinical parameters and post-operative outcome. 31 patients undergoing mandibular reconstruction with a microvascular free fibular flap were divided into two groups and retrospectively reviewed. For the first group A (18 of 31 patients), an individual method with stererolithographic (STL) models, silicon templates and hand-made cutting guides was used (about 250 € planning costs/patient). For the second group B (13 of 31 patients), VSP including pre-fabricated cutting guides was used (about 2500 € planning costs/patient). We found no statistically significant differences with respect to intra-operative time of mandibular reconstruction, duration of hospitalisation or post-operative complications between the two groups (p ≥ 0.05). The surgical outcomes and operative efficiency of this individual and cost-effective planning concept are comparable with the much more expensive complete VSP concept. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  4. 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

  5. The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update: focus on rehabilitation and exercise and surgical coronary revascularization.

    Science.gov (United States)

    Moe, Gordon W; Ezekowitz, Justin A; O'Meara, Eileen; Howlett, Jonathan G; Fremes, Steve E; Al-Hesayen, Abdul; Heckman, George A; Ducharme, Anique; Estrella-Holder, Estrellita; Grzeslo, Adam; Harkness, Karen; Lepage, Serge; McDonald, Michael; McKelvie, Robert S; Nigam, Anil; Rajda, Miroslaw; Rao, Vivek; Swiggum, Elizabeth; Virani, Sean; Van Le, Vy; Zieroth, Shelley; Arnold, J Malcolm O; Ashton, Tom; D'Astous, Michel; Dorian, Paul; Giannetti, Nadia; Haddad, Haissam; Isaac, Debra L; Kouz, Simon; Leblanc, Marie-Hélène; Liu, Peter; Ross, Heather J; Sussex, Bruce; White, Michel

    2014-03-01

    The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update provides focused discussions on the management recommendations on 2 topics: (1) exercise and rehabilitation; and (2) surgical coronary revascularization in patients with heart failure. First, all patients with stable New York Heart Association class I-III symptoms should be considered for enrollment in a tailored exercise training program, to improve exercise tolerance and quality of life. Second, selected patients with suitable coronary anatomy should be considered for bypass graft surgery. As in previous updates, the topics were chosen in response to stakeholder feedback. The 2013 Update also includes recommendations, values and preferences, and practical tips to assist the clinicians and health care workers manage their patients with heart failure.

  6. Computer-assisted three-dimensional surgical planning and simulation: 3D virtual osteotomy.

    Science.gov (United States)

    Xia, J; Ip, H H; Samman, N; Wang, D; Kot, C S; Yeung, R W; Tideman, H

    2000-02-01

    A computer-assisted three-dimensional virtual osteotomy system for orthognathic surgery (CAVOS) is presented. The virtual reality workbench is used for surgical planning. The surgeon immerses in a virtual reality environment with stereo eyewear, holds a virtual "scalpel" (3D Mouse) and operates on a "real" patient (3D visualization) to obtain pre-surgical prediction (3D bony segment movements). Virtual surgery on a computer-generated 3D head model is simulated and can be visualized from any arbitrary viewing point in a personal computer system.

  7. Structured reporting of multiphasic CT for pancreatic cancer: potential effect on staging and surgical planning.

    Science.gov (United States)

    Brook, Olga R; Brook, Alexander; Vollmer, Charles M; Kent, Tara S; Sanchez, Norberto; Pedrosa, Ivan

    2015-02-01

    To compare structured versus nonstructured reporting of multiphasic computed tomography (CT) for staging of pancreatic cancer and the effects of both types of reporting on subjective assessment of resectability. This institutional review board-approved, HIPAA-compliant retrospective study with waiver of informed consent included all patients who were referred for presurgical multiphasic CT of the pancreas between December 2006 and April 2011 at one institution before and after implementation (April 2008) of a structured reporting template. The template was created specifically for reporting multiphasic CT results to stage pancreatic cancer in patients and contained specific information relevant to surgical and oncologic planning. Multiphasic CT reports were assessed for the presence of 12 key features required for staging and surgical planning, including location, size, enhancement, node status, and vascular involvement. Three pancreatic surgeons evaluated the reports to assess resectability, surgical planning, and ease of extracting information before and after reviewing the multiphasic CT images blinded to the patient identifiers. The Student t test and χ(2) test were used for statistical analysis. Forty-eight (40%) structured and 72 (60%) nonstructured multiphasic CT reports were reviewed. Nonstructured reports contained a mean ± standard deviation of 7.3 key features ± 2.1 (range, 1-11) and structured reports contained 10.6 ± 0.9 (range, 9-12) features (P planning was deemed easily accessible in 94%, 60%, and 98% of structured and 47%, 54%, and 32% of nonstructured reports by the three surgeons, respectively (P planning in 96%, 69%, and 98% of structured and 31%, 43%, and 25% of nonstructured reports (P planning. Surgeons were more confident regarding decisions about tumor resectability when they reviewed structured reports before review of multiphasic CT images. © RSNA, 2014.

  8. 3D printed renal cancer models derived from MRI data: application in pre-surgical planning.

    Science.gov (United States)

    Wake, Nicole; Rude, Temitope; Kang, Stella K; Stifelman, Michael D; Borin, James F; Sodickson, Daniel K; Huang, William C; Chandarana, Hersh

    2017-05-01

    To determine whether patient-specific 3D printed renal tumor models change pre-operative planning decisions made by urological surgeons in preparation for complex renal mass surgical procedures. From our ongoing IRB approved study on renal neoplasms, ten renal mass cases were retrospectively selected based on Nephrometry Score greater than 5 (range 6-10). A 3D post-contrast fat-suppressed gradient-echo T1-weighted sequence was used to generate 3D printed models. The cases were evaluated by three experienced urologic oncology surgeons in a randomized fashion using (1) imaging data on PACS alone and (2) 3D printed model in addition to the imaging data. A questionnaire regarding surgical approach and planning was administered. The presumed pre-operative approaches with and without the model were compared. Any change between the presumed approaches and the actual surgical intervention was recorded. There was a change in planned approach with the 3D printed model for all ten cases with the largest impact seen regarding decisions on transperitoneal or retroperitoneal approach and clamping, with changes seen in 30%-50% of cases. Mean parenchymal volume loss for the operated kidney was 21.4%. Volume losses >20% were associated with increased ischemia times and surgeons tended to report a different approach with the use of the 3D model compared to that with imaging alone in these cases. The 3D printed models helped increase confidence regarding the chosen operative procedure in all cases. Pre-operative physical 3D models created from MRI data may influence surgical planning for complex kidney cancer.

  9. D Modelling and Rapid Prototyping for Cardiovascular Surgical Planning - Two Case Studies

    Science.gov (United States)

    Nocerino, E.; Remondino, F.; Uccheddu, F.; Gallo, M.; Gerosa, G.

    2016-06-01

    In the last years, cardiovascular diagnosis, surgical planning and intervention have taken advantages from 3D modelling and rapid prototyping techniques. The starting data for the whole process is represented by medical imagery, in particular, but not exclusively, computed tomography (CT) or multi-slice CT (MCT) and magnetic resonance imaging (MRI). On the medical imagery, regions of interest, i.e. heart chambers, valves, aorta, coronary vessels, etc., are segmented and converted into 3D models, which can be finally converted in physical replicas through 3D printing procedure. In this work, an overview on modern approaches for automatic and semiautomatic segmentation of medical imagery for 3D surface model generation is provided. The issue of accuracy check of surface models is also addressed, together with the critical aspects of converting digital models into physical replicas through 3D printing techniques. A patient-specific 3D modelling and printing procedure (Figure 1), for surgical planning in case of complex heart diseases was developed. The procedure was applied to two case studies, for which MCT scans of the chest are available. In the article, a detailed description on the implemented patient-specific modelling procedure is provided, along with a general discussion on the potentiality and future developments of personalized 3D modelling and printing for surgical planning and surgeons practice.

  10. Predictive / Reactive Planning and Scheduling of a Surgical Suite with Emergency Patient Arrival.

    Science.gov (United States)

    Heydari, Mehdi; Soudi, Asie

    2016-01-01

    This paper surveys the problem of predictive / reactive scheduling of an integrated operating theatre with two types of demand for surgery: 1) elective or known demand; 2) emergency or uncertain demand. The stochastic arrival of emergency patients with uncertain surgery time enforces the scheduler to react to disruption and modify scheduling plan of elective patients. We focus on this predictive / reactive scheduling problem which has not been investigated in such way before. As in hospitals, at the time of occurrence a disruption in a surgical suite, the scheduler has not enough time to make the best decision; we propose a new approach based on two-stage stochastic programming model with recourse which determines the best recourse strategy in advance of any disruption occurrence. Using the proposed approach, the primary schedule is generated in such a way that it can absorb disruption with minimum effect on planned elective surgeries. For the first time in operating theatre planning, two new significant sets of performance measures comprising "robustness" and "stability" measures are considered in generation of primary schedule which will be shown to be of great importance in efficiency of surgical suite planning. Computational experiments performed on sets of generated problem based on the data obtained from a non-profit hospital. In order to demonstrate efficiency of the proposed method, computational results of the proposed approach are compared with classic approach.

  11. 2007 International Brain Mapping and Intraoperative Surgical Planning Society’s (IBMISPS) Annual World Congress

    Science.gov (United States)

    2008-02-01

    Empowered Functional Brain Imaging Cochair: Jeffrey David LEWINE Executive Director, Alexian Center for Brain Research Executive Director, Illinois...local thermal treatment improve efficacy of treatment6 Personalized targeted gene therapy Kateb B et al. Slide 9/24 Carbon Nanotubes Kateb B et al...genotype- phenotype correlations explore known severe single gene disorders in small case series. “The Child is the father of the Man.” William

  12. Evaluation of Patient Outcome and Satisfaction after Surgical Treatment of Adolescent Idiopathic Scoliosis Using Scoliosis Research Society-30.

    Science.gov (United States)

    Ghandehari, Hasan; Mahabadi, Maryam Ameri; Mahdavi, Seyed Mani; Shahsavaripour, Ali; Seyed Tari, Hossein Vahid; Safdari, Farshad

    2015-04-01

    Adolescent idiopathic scoliosis (AIS) may lead to physical and mental problems. It also can adversely affect patient satisfaction and the quality of life. In this study, we assessed the outcomes and satisfaction rate after surgical treatment of AIS using scoliosis research society-30 questionnaire (SRS-30). We enrolled 135 patients with AIS undergoing corrective surgery. Patients were followed for at least 2 years. We compared pre- and post-operative x-rays in terms of Cobb's angles and coronal balance. At the last visit, patients completed the SRS-30 questionnaire. We then assessed the correlation between radiographic measures, SRS-30 total score, and patient satisfaction. Cobb's angle and coronal balance improved significantly after surgery (Pself-image/cosmesis, mental health, and satisfaction were 27±4.3, 26±2.5, 33±5.2, 23±3.5, and 13±1.8, respectively. The total SRS-30 score was 127±13. Radiographic measures showed significant positive correlation with satisfaction and SRS-30 total scores. There was also a positive correlation between satisfaction and self-image/cosmesis domain scores. The greater the radiographic angles were corrected the higher the SRS-30 total score and patient satisfaction were. It is intuitive that the appearance and cosmesis is of most important factor associated with patient satisfaction.

  13. Highlights from the 36th European Society of Surgical Oncology Congress (ESSO 36), 14–16 September 2016, Kracow, Poland: optimising European cancer surgery

    Science.gov (United States)

    Lichosik, Danuta

    2017-01-01

    The ESSO Congress is the event for all surgeons with an interest in surgical oncology. The congress is a gathering for the surgical oncology community from all around the world to meet and gain an insight into state-of-the-art technology, latest healthcare services, and solutions within their field. The ESSO 36 congress gathered over 750 participants from 58 countries. With over 100 speakers, the scientific programme featured 18 scientific symposia including a joint symposium with the American Society of Surgical Oncology (SSO), 6 multidisciplinary sessions including joint sessions with CIRSE (Cardiovascular and Interventional Radiological Society of Europe) and JCOG (Japanese Clinical Oncology Group), 8 meet-the-expert sessions, 5 debates, 13 proffered paper sessions, and 2 video sessions. PMID:28386298

  14. Image-based mass-spring model of mitral valve closure for surgical planning

    Science.gov (United States)

    Hammer, Peter E.; Perrin, Douglas P.; del Nido, Pedro J.; Howe, Robert D.

    2008-03-01

    Surgical repair of the mitral valve is preferred in most cases over valve replacement, but replacement is often performed instead due to the technical difficulty of repair. A surgical planning system based on patient-specific medical images that allows surgeons to simulate and compare potential repair strategies could greatly improve surgical outcomes. In such a surgical simulator, the mathematical model of mechanics used to close the valve must be able to compute the closed state quickly and to handle the complex boundary conditions imposed by the chords that tether the valve leaflets. We have developed a system for generating a triangulated mesh of the valve surface from volumetric image data of the opened valve. We then compute the closed position of the mesh using a mass-spring model of dynamics. The triangulated mesh is produced by fitting an isosurface to the volumetric image data, and boundary conditions, including the valve annulus and chord endpoints, are identified in the image data using a graphical user interface. In the mass-spring model, triangle sides are treated as linear springs, and sides shared by two triangles are treated as bending springs. Chords are treated as nonlinear springs, and self-collisions are detected and resolved. Equations of motion are solved using implicit numerical integration. Accuracy was assessed by comparison of model results with an image of the same valve taken in the closed state. The model exhibited rapid valve closure and was able to reproduce important features of the closed valve.

  15. Development of a High Resolution 3D Infant Stomach Model for Surgical Planning

    Science.gov (United States)

    Chaudry, Qaiser; Raza, S. Hussain; Lee, Jeonggyu; Xu, Yan; Wulkan, Mark; Wang, May D.

    Medical surgical procedures have not changed much during the past century due to the lack of accurate low-cost workbench for testing any new improvement. The increasingly cheaper and powerful computer technologies have made computer-based surgery planning and training feasible. In our work, we have developed an accurate 3D stomach model, which aims to improve the surgical procedure that treats the infant pediatric and neonatal gastro-esophageal reflux disease (GERD). We generate the 3-D infant stomach model based on in vivo computer tomography (CT) scans of an infant. CT is a widely used clinical imaging modality that is cheap, but with low spatial resolution. To improve the model accuracy, we use the high resolution Visible Human Project (VHP) in model building. Next, we add soft muscle material properties to make the 3D model deformable. Then we use virtual reality techniques such as haptic devices to make the 3D stomach model deform upon touching force. This accurate 3D stomach model provides a workbench for testing new GERD treatment surgical procedures. It has the potential to reduce or eliminate the extensive cost associated with animal testing when improving any surgical procedure, and ultimately, to reduce the risk associated with infant GERD surgery.

  16. 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.

  17. Identifying shared and contested elements in climate plans as part of shaping transitions towards a Danish low carbon society

    DEFF Research Database (Denmark)

    Jørgensen, Michael Søgaard

    2011-01-01

    the Danish Society of Engineers, a renewable energy NGO, an environmental NGO and a national climate change commission. The aim is to identify shared and contested elements, which need to be addressed in attempts to establish alignment around transition efforts towards a fossil free Danish society...... in agriculture. The plans differ with respect to whether and how agricultural production and Danish food consumption should change as part of transitions towards a low carbon society. All four plans agree about a significant increase in Danish wind turbine capacity and stronger energy saving efforts in Danish...... production and consumption activities. The plans differ with respect to how big reduction of energy consumption it is possible to obtain and how big the future energy consumption will be. This has implications for how big wind turbine capacity the plans assume is necessary and possible to build, ranging from...

  18. Boolean Combinations of Implicit Functions for Model Clipping in Computer-Assisted Surgical Planning.

    Science.gov (United States)

    Zhan, Qiqin; Chen, Xiaojun

    2016-01-01

    This paper proposes an interactive method of model clipping for computer-assisted surgical planning. The model is separated by a data filter that is defined by the implicit function of the clipping path. Being interactive to surgeons, the clipping path that is composed of the plane widgets can be manually repositioned along the desirable presurgical path, which means that surgeons can produce any accurate shape of the clipped model. The implicit function is acquired through a recursive algorithm based on the Boolean combinations (including Boolean union and Boolean intersection) of a series of plane widgets' implicit functions. The algorithm is evaluated as highly efficient because the best time performance of the algorithm is linear, which applies to most of the cases in the computer-assisted surgical planning. Based on the above stated algorithm, a user-friendly module named SmartModelClip is developed on the basis of Slicer platform and VTK. A number of arbitrary clipping paths have been tested. Experimental results of presurgical planning for three types of Le Fort fractures and for tumor removal demonstrate the high reliability and efficiency of our recursive algorithm and robustness of the module.

  19. Role of MR imaging in surgical planning and prediction of successful surgical repair of pelvic organ prolapse

    Directory of Open Access Journals (Sweden)

    Ebtesam Moustafa Kamal

    2013-09-01

    Conclusion: Magnetic resonance imaging can accurately localize pelvic floor defects, evaluate success or failure of surgical procedures, predict the need for more extensive reconstruction, and identify complications.

  20. The accuracy of virtual surgical planning in free fibula mandibular reconstruction: comparison of planned and final results.

    Science.gov (United States)

    Roser, Steven M; Ramachandra, Srinivasa; Blair, Henry; Grist, William; Carlson, Grant W; Christensen, Andrew M; Weimer, Katherine A; Steed, Martin B

    2010-11-01

    The concept of virtual surgery uses surgical simulation rather than relying exclusively on intraoperative manual approximation of facial reconstruction. The purpose of this study was to evaluate the degree to which surgical outcomes in free fibula mandibular reconstructions planned with virtual surgery and carried out with prefabricated surgical plate templates and cutting guides correlated to the virtual surgical plan in a series of 11 patients. This retrospective study evaluated 11 consecutive patients (6 males and 5 females) with an average age of 50.73 years (range, 23-72 years) who required mandibular reconstruction for aggressive benign or malignant disease with a free fibula osseomyocutaneous flap at Emory University Hospital (Atlanta, GA) between January 1, 2009 and December 31, 2009. In each case, a high-resolution helical computed tomography (CT) scan of the maxillofacial region and mandible was obtained prior to surgery. The CT data was sent on a CD to a modeling company (Medical Modeling Inc, Golden, CO). The scans were then converted into 3-dimensional models of the maxillofacial skeleton utilizing both automatic and manual segmentation techniques in the SurgiCase CMF software (Materialise NV, Leuven, Belgium). A virtual surgery planning session was held via a Web meeting between the surgeons and the modeling company, at which the resection planes of the mandible, positioning of the plate, and fibula lengths/osteotomy angles were established. The surgery was then carried out using prefabricated cutting guides and manual bending of a reconstruction plate using a prefabricated plate template. A postoperative CT scan of each patient was obtained within the first 7 postoperative days on the same scanner. Three-dimensional computer models of the final reconstruction were obtained for comparison with the preoperative virtual plan. To make the desired comparisons, the 3-dimensional objects representing the postoperative surgical outcome were superimposed onto

  1. Improving the quality of vascular surgical discharge planning in a hub centre.

    Science.gov (United States)

    Wariyapola, C; Littlehales, E; Abayasekara, K; Fall, D; Parker, V; Hatton, G

    2016-04-01

    Introduction Discharge planning improves patient outcomes, reduces hospital stay and readmission rates, and should involve a multidisciplinary team (MDT) approach. The efficacy of MDT meetings in discharge planning was examined, as well as reasons for delayed discharge among vascular surgical inpatients. Methods Dedicated weekly MDT meetings were held on the vascular ward in Royal Derby Hospital for three months. Each patient was presented to the discharge planning meeting and an expected date of discharge was decided prospectively. Patients who were discharged after this date were considered 'delayed' and reasons for delay were explored at the next meeting. Results Overall, 193 patients were included in the study. Of these, 42 patients (22%) had a delayed discharge while 29 (15%) had an early discharge. The main reasons for delay were awaiting beds (30%), social (14%) and medical (45%). In 64%, the cause for delay was avoidable. Two-thirds (67%) of all delays were >24 hours. This totalled 115 bed days, of which 67 could have been avoided. However, 32 bed days were saved by early discharge. This equates to a net loss of 35 bed days, at a net cost of £2,936 per month or £35,235 per year. The MDT meetings also improved the quality of discharge planning; the variability between expected and actual discharge dates decreased after the first month. Conclusions Discharge planning meetings help prepare for patient discharge and are most effective with multidisciplinary input. The majority of delayed discharges from hospital are preventable. The main causes are awaiting transfers, social services input and medical reasons (eg falls). There is an obvious financial incentive to improve discharge planning. The efficiency of the MDT at discharge planning improves with time and this should therefore be continued for best results.

  2. Planned posterior assisted levitation in severe subluxated cataract: Surgical technique and clinical results

    Directory of Open Access Journals (Sweden)

    Tova Lifshitz

    2012-01-01

    Full Text Available We report the surgical technique and outcome of planned posterior assisted levitation (P-PAL in four cases of subluxated cataract. P-PAL was planned as the preferred approach in all cases. A spatula was inserted via the pars plana, the whole lens was lifted to the anterior chamber and then removed through a scleral tunnel incision. Anterior chamber intraocular lenses were implanted in all cases. All four eyes had severe subluxation of the crystalline lenses with marked phacodonesis. Two eyes had history of blunt trauma, and the other two eyes had severe pseudoexfoliation with spontaneous lens subluxation. Follow-up ranged from 1 to 2 years in three cases. The postoperative visual acuity was 20/80 or better. No intraoperative complications were observed. In conclusion, the P-PAL technique was successfully performed during cataract surgery in four eyes with severe subluxated cataracts. There were no complications over the long-term follow-up.

  3. Planned posterior assisted levitation in severe subluxated cataract: Surgical technique and clinical results

    Science.gov (United States)

    Lifshitz, Tova; Levy, Jaime; Kratz, Assaf; Belfair, Nadav; Tsumi, Erez

    2012-01-01

    We report the surgical technique and outcome of planned posterior assisted levitation (P-PAL) in four cases of subluxated cataract. P-PAL was planned as the preferred approach in all cases. A spatula was inserted via the pars plana, the whole lens was lifted to the anterior chamber and then removed through a scleral tunnel incision. Anterior chamber intraocular lenses were implanted in all cases. All four eyes had severe subluxation of the crystalline lenses with marked phacodonesis. Two eyes had history of blunt trauma, and the other two eyes had severe pseudoexfoliation with spontaneous lens subluxation. Follow-up ranged from 1 to 2 years in three cases. The postoperative visual acuity was 20/80 or better. No intraoperative complications were observed. In conclusion, the P-PAL technique was successfully performed during cataract surgery in four eyes with severe subluxated cataracts. There were no complications over the long-term follow-up. PMID:23202402

  4. Planning of surgical treatment of upper extremity in patients with cerebral palsy

    Directory of Open Access Journals (Sweden)

    V. V. Umnov

    2013-01-01

    Full Text Available The purpose - to devise the algorithm of patient examination with spastic hand to determine what the variant of surgical treatment is indicated. The variant of surgical treatment and it's results are depend on the cause of upper extremity deformation. Materials and methods. This study is based on a survey of children with cerebral palsy with lesions of the upper extremity. The main criterion for the selection of patients was the presence of the combined lesion of the upper extremity, where the cause of dysfunction hands are not only fixed contractures, but primary tonic. Was to survey 47 patients with spastic forms of cerebral palsy with the defeat of the upper limb, but the study group included only 26 of them in the ages of 7 to 18 years (average 12,1, as having the clinical picture both types of contractures. We have developed and applied a system of examinations, modeling expected outcome of selective neurotomy motor nerves of the upper limb, which allows to estimate the possible result of such treatment, and clearly differentiate tonic and fixed contracture. Results and conclusions. Based on the results of study we supposed that, using diagnostic blockade motor nerve at the period of planning surgical treatment help us to create temporary reversible model of selective neurotomy motor nerve branches and identify the type of contracture, degree of manifestation and functional perspective.

  5. Precise osteotomies for mandibular distraction in infants with Robin sequence using virtual surgical planning.

    Science.gov (United States)

    Resnick, C M

    2017-08-16

    Mandibular distraction osteogenesis (MDO) has become the first-line operation in many centers for the management of obstructive sleep apnea (OSA) in infants with (Pierre) Robin sequence (RS) not relieved by non-surgical approaches. Preoperative virtual surgical planning (VSP) may improve precision and decrease complications for this operation. This article reports a retrospective study of RS infants who underwent MDO for OSA using preoperative VSP and three-dimensionally printed cutting guides performed by one surgeon. Seventeen subjects who had MDO at a mean age of 87±96days were included. Maxillofacial computed tomography scans were obtained 15±7days prior to MDO. Osteotomy designs included linear (n=4, 23.5%), inverted-L (n=11, 64.7%), and multi-angular (n=2, 11.8%). Cutting guides were used successfully and osteotomies were created as planned in all cases. Devices were removed 67±15.6days after placement. Bone formation in the distraction gap was seen in all cases at device removal. All patients had successful airway outcomes. There were no major and four minor complications during the follow-up period of 458±267 days. In conclusion, MDO is a successful procedure for the management of OSA associated with RS in infants, and VSP facilitates its precise design and execution. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  6. [Three-dimensional visualization of CT of the neck for surgical planning].

    Science.gov (United States)

    Strauss, G; Hertel, I; Dornheim, J; Cordes, J; Burgert, O; Schulz, T; Meixensberger, J; Winkler, D; Preim, U; Dietz, A; Preim, B

    2006-10-01

    Surgical planning in ENT profits from computer assisted preoperative visualization and planning. The informative capability is to be improved by three-dimensional illustrating of the preoperative available data. The possibility of a 3-D-visualization of lymph nodes stands in the center of the interest. 16 CT data sets with a tumor-classification of T1N1 or higher were included. Altogether 720 pseudo-3-D-illustrations were provided with an average of 9.3 objects. Current algorithms were used for the segmentation and visualization and the results were divided in three classes. The average time requirement for visualization and segmenting amounted to 122 minutes, the minimum value is at 61 minutes per data set. Automatic segmenting succeeded only with structures with clear grey tone differences to the environment. In all other cases an additional manual interaction had to take place. 3-D-Visualising of CT of the neck represents a new quality in preoperative planning. A clear trend at increasing detail loyalty and information efficiency showed up in the groups of B and C. It is possible to make from these pictures a quantitative statement on surgery relevant infiltration. Likewise conceivable are the postoperative quality control or planning and process control of a postoperative radio-chemotherapy. The automatic algorithms can be estimated as reliable. Application is still far from a clinically efficient use. With the rising efficiency of the computing systems, the improved software and the imaging systems the problems mentioned are, however, solvable.

  7. Application of virtual reality techniques in preoperative surgical planning for intracranial anterior circulation aneurysms

    Directory of Open Access Journals (Sweden)

    Shou-sen WANG

    2012-05-01

    Full Text Available Objective  To investigate the value of virtual reality (VR technique in the surgical planning for anterior circulation aneurysms of Willis circle. Methods  A total of 50 patients with 57 aneurysms confirmed by CT angiography in the anterior circle of Willis were enrolled in this study. In preoperative Hunt-Hess scale, grade Ⅰ was designated in 7 patients, grade Ⅱ in 22, grade Ⅲ in 17, grade Ⅳ in 3, grade Ⅴ in 1 patient. Among the aneurysms, 16 were small (≤5mm in diameter, 28 medium (5-15mm, 10 large (15-25mm and 3 giant (≥25mm in size. The thin-slice head scanning data were achieved by 64-slice spiral CT machine. These data was then transferred into Dextroscope image workstation. The virtual imaging system generated clear and vivid virtual images. We compared the findings between simulation surgical operation and actual operation. Results  VR system make the operator felt "personally on the scene" and was able to communicate with the imaging. It could not only visually display the anatomical structures in three dimensions, but also could simulate some surgical procedures, which basically simulated the same outcome of actual operation. All the 50 patients were successfully treated by microsurgical clipping of main aneurysmal or contributory aneurysmal necks. Conclusions  The surgeons is able to be more confident, and the identification for the complex vascular abnormality is improved by planning operative procedure in virtual-reality environment. The virtual-reality system makes the actual operative procedure more concise, thus it is of positive value in surgery for intracranial aneurysm.

  8. Autism Society

    Science.gov (United States)

    ... En Español Register today for the 49th Annual Autism Society National Conference Please plan on joining us ... Today Improving the lives of all affected by autism. The Autism Society is the nation's leading grassroots ...

  9. Estimation of Carrying Angle Based on CT Images in Preoperative Surgical Planning for Cubitus Deformities

    Directory of Open Access Journals (Sweden)

    Kim,Eugene

    2009-12-01

    Full Text Available Conventionally, the carrying angle of the elbow is measured using simple two-dimensional radiography or goniometry, which has questionable reliability. This study proposes a novel method for estimating carrying angles using computed tomography that can enhance the reliability of the angle measurement. Data of CT scans from 25 elbow joints were processed to build segmented three-dimensional models. The cross-sectional centerlines of the ulna and the humerus were traced from the 3D models, and the angle between 2 vectors formed from the centerlines of the humerus and the ulna was defined as the "three-dimensional carrying angle." These angles were compared with those measured by simple radiograph. Two cases of angular deformity were underwent surgery based on this preoperative surgical planning, and the postoperative 3D carrying angles were evaluated using the proposed method. The mean value of the calculated three-dimensional carrying angle was 20.7 degrees +/-3.61, while it was 16.3 degrees +/-3.21 based on simple radiography without statistical difference. Based on the 3D carrying angle estimations, 2 surgical cases of cubitus deformities were planned by comparison with the normal contra-lateral elbow. Postoperative angle estimations confirmed that the corrected angles were nearly identical to the planned angles for both cases. The results of this study showed that the carrying angle can be accurately estimated using three-dimensional CT and that the proposed method is useful in evaluating deformities of the elbow with high reliability.

  10. Individualized Surgical Approach Planning for Petroclival Tumors Using a 3D Printer.

    Science.gov (United States)

    Muelleman, Thomas John; Peterson, Jeremy; Chowdhury, Naweed Iffat; Gorup, Jason; Camarata, Paul; Lin, James

    2016-06-01

    Objectives To determine the utility of three-dimensional (3D) printed models in individualized petroclival tumor resection planning by measuring the fidelity of printed anatomical structures and comparing tumor exposure afforded by different approaches. Design Case series and review of the literature. Setting Tertiary care center. Participants Three patients with petroclival lesions. Main Outcome Measures Subjective opinion of access by neuro-otologists and neurosurgeons as well as surface area of tumor exposure. Results Surgeons found the 3D models of each patient's skull and tumor useful for preoperative planning. Limitations of individual surgical approaches not identified through preoperative imaging were apparent after 3D models were evaluated. Significant variability in exposure was noted between models for similar or identical approaches. A notable drawback is that our printing process did not replicate mastoid air cells. Conclusions We found that 3D modeling is useful for individualized preoperative planning for approaching petroclival tumors. Our printing techniques did produce authentic replicas of the tumors in relation to bony structures.

  11. An on-line interface for integrated modeling of wildlife, climate, and society for strategic planning for the Sky Islands

    Science.gov (United States)

    Barron J. Orr; Wolfgang Grunberg; Amanda B. Cockerham; Anne Y. Thwaits; Heather S. Severson; Noah M. D. Lerman; Rachel M. Miller; Michael Haseltine; Barbara J. Morehouse; Jonathan T. Overpeck; Stephen R. Yool; Thomas W. Swetnam; Gary L. Christopherson

    2005-01-01

    The demand for strategic planning tools that account for climate and human influences on wildfire hazard is growing. In response, the University of Arizona, through an EPA STAR Grant has undertaken interdisciplinary research to characterize the human and climate dimensions of wildfire. The resulting Fire-Climate-Society (FCS-1) prototype model developed for Sky Islands...

  12. Metatarsal Reconstruction with a Fibular Osteocutaneous Flap: A Novel Approach Utilizing Virtual Surgical Planning

    Directory of Open Access Journals (Sweden)

    Hugo St. Hilaire, MD, DDS

    2014-11-01

    Full Text Available Summary: Craniofacial reconstruction remains the main application for virtual surgical planning (VSP. We present a case in which this technology was applied to reconstruct a bony defect of the first metatarsal bone from a gunshot injury. VSP was used to facilitate a 1-stage reconstruction with a fibular osteocutaneous flap. A template of the reconstructed bone was designed based on the virtual mirror-image, noninjured bone. Prefabricated cutting guides facilitated precise shaping of the vascularized bone accounting for location of perforators. Successful reconstruction of the metatarsal bone was achieved with excellent functional outcomes. We believe that VSP can be a valuable tool in reconstruction of metatarsal bones by facilitating precise intraoperative shaping and anatomic orientation of the vascularized flap and reducing flap ischemia and operative time.

  13. Update on the Surgical Trial in Lobar Intracerebral Haemorrhage (STICH II: statistical analysis plan

    Directory of Open Access Journals (Sweden)

    Gregson Barbara A

    2012-11-01

    Full Text Available Abstract Background Previous studies had suggested that the outcome for patients with spontaneous lobar intracerebral haemorrhage (ICH and no intraventricular haemorrhage (IVH might be improved with early evacuation of the haematoma. The Surgical Trial in Lobar Intracerebral Haemorrhage (STICH II set out to establish whether a policy of earlier surgical evacuation of the haematoma in selected patients with spontaneous lobar ICH would improve outcome compared to a policy of initial conservative treatment. It is an international, multi-centre, prospective randomised parallel group trial of early surgery in patients with spontaneous lobar ICH. Outcome is measured at six months via a postal questionnaire. Results Recruitment to the study began on 27 November 2006 and closed on 15 August 2012 by which time 601 patients had been recruited. The protocol was published in Trials (http://www.trialsjournal.com/content/12/1/124/. This update presents the analysis plan for the study without reference to the unblinded data. The trial data will not be unblinded until after follow-up is completed in early 2013. The main trial results will be presented in spring 2013 with the aim to publish in a peer-reviewed journal at the same time. Conclusion The data from the trial will provide evidence on the benefits and risks of early surgery in patients with lobar ICH. Trial registration ISRCTN: ISRCTN22153967

  14. The role of drug-induced sleep endoscopy in surgical planning for obstructive sleep apnea syndrome.

    Science.gov (United States)

    Aktas, Ozturk; Erdur, Omer; Cirik, Ahmet Adnan; Kayhan, Fatma Tulin

    2015-08-01

    This study investigated the role of drug-induced sleep endoscopy (DISE) in the surgical treatment planning of patients with obstructive sleep apnea syndrome (OSAS). This study was conducted using patients diagnosed with OSAS between January 2007 and March 2009, who were scheduled for surgical treatment. DISE was performed using propofol in patients considered to have upper respiratory tract obstruction as indicated by Muller's maneuver. After completing the sleep endoscopy, the patient was intubated and surgery was performed (tonsillectomy and uvulopalatopharyngoplasty). A successful operation was defined as a decrease in the respiratory disturbance index to below 5 or a decrease of ≥50 % following the operation. The study included 20 patients (4 female and 16 male) aged 19-57 years. No statistically significant correlation between modified Mallampati class and operation success or between the polysomnographic stage of disease and operation success was identified. A significantly high operation success rate was found in the group with obstruction of the upper airway according to DISE (p DISE (p DISE may be used to identify the localization of obstruction for diagnostic purposes, and it can be helpful in selecting the treatment method.

  15. Surgical Planning by 3D Printing for Primary Cardiac Schwannoma Resection.

    Science.gov (United States)

    Son, Kuk Hui; Kim, Kun-Woo; Ahn, Chi Bum; Choi, Chang Hu; Park, Kook Yang; Park, Chul Hyun; Lee, Jae-Ik; Jeon, Yang Bin

    2015-11-01

    We report herein a case of benign cardiac schwannoma in the interatrial septum. A 42-year-old woman was transferred from a clinic because of cardiomegaly as determined by chest X-ray. A transthoracic echocardiography and chest computed tomography examination revealed a huge mass in the pericardium compressing the right atrium, superior vena cava (SVC), left atrium, and superior pulmonary vein. To confirm that the tumor originated from either heart or mediastinum, cine magnetic resonance imaging was performed, but the result was not conclusive. To facilitate surgical planning, we used 3D printing. Using a printed heart model, we decided that tumor resection under cardiopulmonary bypass (CPB) through sternotomy would be technically feasible. At surgery, a huge tumor in the interatrial septum was confirmed. By incision on the atrial roof between the aorta and SVC, tumor enucleation was performed successfully under CPB. Pathology revealed benign schwannoma. The patient was discharged without complication. 3D printing of the heart and tumor was found to be helpful when deciding optimal surgical approach.

  16. PACS-based interface for 3D anatomical structure visualization and surgical planning

    Science.gov (United States)

    Koehl, Christophe; Soler, Luc; Marescaux, Jacques

    2002-05-01

    The interpretation of radiological image is routine but it remains a rather difficult task for physicians. It requires complex mental processes, that permit translation from 2D slices into 3D localization and volume determination of visible diseases. An easier and more extensive visualization and exploitation of medical images can be reached through the use of computer-based systems that provide real help from patient admission to post-operative followup. In this way, we have developed a 3D visualization interface linked to a PACS database that allows manipulation and interaction on virtual organs delineated from CT-scan or MRI. This software provides the 3D real-time surface rendering of anatomical structures, an accurate evaluation of volumes and distances and the improvement of radiological image analysis and exam annotation through a negatoscope tool. It also provides a tool for surgical planning allowing the positioning of an interactive laparoscopic instrument and the organ resection. The software system could revolutionize the field of computerized imaging technology. Indeed, it provides a handy and portable tool for pre-operative and intra-operative analysis of anatomy and pathology in various medical fields. This constitutes the first step of the future development of augmented reality and surgical simulation systems.

  17. Application of Virtual Surgical Planning with Computer Assisted Design and Manufacturing Technology to Cranio-Maxillofacial Surgery

    Directory of Open Access Journals (Sweden)

    Linping Zhao

    2012-07-01

    Full Text Available Computer aided design and manufacturing (CAD/CAM technology today is the standardin manufacturing industry. The application of the CAD/CAM technology, together withthe emerging 3D medical images based virtual surgical planning (VSP technology, tocraniomaxillofacial reconstruction has been gaining increasing attention to reconstructivesurgeons. This article illustrates the components, system and clinical management of theVSP and CAD/CAM technology including: data acquisition, virtual surgical and treatmentplanning, individual implant design and fabrication, and outcome assessment. It focusesprimarily on the technical aspects of the VSP and CAD/CAM system to improve thepredictability of the planning and outcome.

  18. Step-by-step surgical technique for mandibular reconstruction with fibular free flap: application of digital technology in virtual surgical planning.

    Science.gov (United States)

    Succo, G; Berrone, M; Battiston, B; Tos, P; Goia, F; Appendino, P; Crosetti, E

    2015-06-01

    At present, mandibular reconstruction with a fibular free flap is the gold standard for functional and esthetic rehabilitation after oncological surgery. The purpose of this study was to describe the computer-assisted mandibular reconstruction procedure adopting the customized solution Synthes ProPlan CMF. The study reports five consecutive patients with benign or malignant disease requiring mandibular reconstruction using a microvascular fibular free flap, pre-operative virtual planning, construction of cutting guides and customized laser pre-bent titanium plates. The surgical technique is discussed in a step-by-step fashion. The average post-operative hospital stay was 18 ± 3 days. Ischemia time was recorded in all five cases, with an average of 75 ± 8 min. No problems were encountered in any surgical step and there were no major complications. Excellent precision of cutting guides and a good fit of pre-bent plates were found on both the mandible and fibula. There was excellent precision in bone to bone contact and position between mandible and fibula graft. Measurement data from the pre-operative and post-operative CT scans were compared. The average difference (Δ) between programed segment lengths and CT control segment lengths was 0.098 ± 0.077 cm. Microsurgical mandibular reconstruction using a virtual surgical planning yields significantly shorter ischemia times and allows more precise osteotomies. The technology is becoming increasingly recognized for its ability to optimize surgical outcomes and minimize operating time. Considering that the extent of resection can be wider than predicted, this results in safer modeling of the fibula only after frozen sections have demonstrated the radicality of resection.

  19. Functional MRI in pre-surgical planning: Case study and cautionary notes

    Directory of Open Access Journals (Sweden)

    Bruce S Spottiswoode

    2012-09-01

    Full Text Available Background. Since its inception almost 20 years ago, functional magnetic resonance imaging (fMRI has greatly advanced our knowledge of human brain function. Although the clinical applications of fMRI are still limited, there have recently been encouraging advances for its use in pre-operative functional cortical mapping to identify potentially eloquent areas prior to neurosurgery. Objectives. We explore the potential use of this emerging technique by presenting a neurosurgical case study, as performed at the Cape Universities Brain Imaging Centre (CUBIC, Tygerberg, Cape Town. We conclude with a brief summary of the potential pitfalls of this technique, as well as cautionary guidelines based on our experience. Methods and results. A 22-year-old male patient from Tygerberg Hospital underwent the successful resection of an anaplastic astrocytoma after fMRI presurgical planning at our facility. The subject was able to leave the ward unassisted. Conclusion. If consideration is given to the many limitations of this emerging technique, fMRI can be useful in aiding the neurosurgeon in pre-operative planning of his surgical approach.

  20. Reliability of a CT reconstruction for preoperative surgical planning in the arthroscopic Latarjet procedure.

    Science.gov (United States)

    Hardy, Alexandre; Loriaut, Philippe; Granger, Benjamin; Neffati, Ahmed; Massein, Audrey; Casabianca, Laurent; Pascal-Moussellard, Hugues; Gerometta, Antoine

    2016-10-12

    The arthroscopic Latarjet procedure has provided reliable results in the treatment of anterior shoulder instability. However, this procedure remains technically challenging and is related to several complications. The morphology of the coracoid and the glenoid are inconsistent. Inadequate coracoid and glenoid preparing may lead to mismatching between their surfaces. Inadequate screws lengthening and orientation are a major concern. Too long screws can lead to suprascapular nerve injuries or hardware irritation, whereas too short screws can lead to nonunions, fibrous unions or migration of the bone block. The purpose of the study was to investigate the application of virtual surgical planning and digital technology in preoperative assessment and planning of the Latarjet procedure. Twelve patients planned for an arthroscopic Latarjet had a CT scan evaluation with multi-two-dimensional reconstruction performed before surgery. Interobserver and intraobserver reliability were evaluated. The shape of the anterior rim of the glenoid and the undersurface of the coracoid were classified. Coracoid height was measured, respectively, at 5 mm (C1) and 10 mm (C2) from the tip of the coracoid process, corresponding to the drilling zone. Measurements of the glenoid width were then taken in the axial view at 25 % (G1) and 50 % (G2) of the glenoid height with various α angles (5°, 10°, 15°, 20°, 25°, 30°) 7 mm from the anterior glenoid rim. Shapes of the undersurface of the coracoid and the anterior rim of the glenoid were noted during the surgical procedure. Post-operative measurements included the α angle. Concerning coracoid height measurements, there was an almost perfect to substantial intra- and inter-reliability, with values ranging from ICC = 0.75-0.97. For the shape of the coracoid, concordances were, respectively, perfect (ICC = 1) and almost perfect (0.87 [0.33; 1]) for the intra- and interobserver reliabilities. Concerning the glenoid, concordance was

  1. A think tank of the Italian society of colorectal surgery (SICCR) on the surgical treatment of inflammatory bowel disease using the Delphi method: Crohn's disease.

    Science.gov (United States)

    Pellino, G; Selvaggi, F; Ghezzi, G; Corona, D; Riegler, G; Delaini, G G

    2015-10-01

    The management of Crohn's disease (CD) requires extensive expertise. Many treatment options are available, and surgery still plays a crucial role. In recent years, many medical societies have provided surgeons and gastroenterologists dealing with CD with authoritative guidelines. However, a certain degree of variation can be observed in these papers, and application of guidelines in clinical practice should be improved. The Italian society of colorectal surgery (SICCR) promoted the project reported here, which consists of a think tank of Italian colorectal surgeons to address the surgical aspects of CD management. Members of the society were invited to express their opinions on several items proposed by the writing committee, based on evidence available in the literature. The results are presented, focusing on relevant points. The present paper is not an alternative to available guidelines; rather, it offers a snapshot of the attitudes of SICCR surgeons about the surgical treatment of CD. The management of CD is, by necessity, patient-tailored, and it is based on clinical data and surgeon's preference, but the committee was able to identify some points of major disagreement and suggested strategies to improve quality of available data and acceptance of guidelines.

  2. Cultural influences upon advance care planning in a family-centric society.

    Science.gov (United States)

    Tay, Keson; Yu Lee, Rachel Jia; Sim, Shin Wei; Menon, Sumytra; Kanesvaran, Ravindran; Radha Krishna, Lalit Kumar

    2017-02-08

    Advanced care plans (ACPs) are designed to convey the wishes of patients with regards to their care in the event of incapacity. There are a number of prerequisites for creation of an effective ACP. First, the patient must be aware of their condition, their prognosis, the likely trajectory of the illness, and the potential treatment options available to them. Second, patient input into ACP must be free of any coercive factors. Third, the patient must be able to remain involved in adapting their ACP as their condition evolves. Continued use of familial determination and collusion within the local healthcare system, however, has raised concerns that the basic requirements for effective ACP cannot be met. To assess the credibility of these concerns, we employed a video vignette approach depicting a family of three adult children discussing whether or not to reveal a cancer diagnosis to their mother. Semistructured interviews with 72 oncology patients and 60 of their caregivers were conducted afterwards to explore the views of the participants on the different positions taken by the children. Collusion, family-centric decision making, adulteration of information provided to patients, and circumnavigation of patient involvement appear to be context-dependent. Patients and families alike believe that patients should be told of their conditions. However, the incidence of collusion and familial determination increases with determinations of a poor prognosis, a poor anticipated response to chemotherapy, and a poor premorbid health status. Financial considerations with respect to care determinations remain secondary considerations. Our data suggest that ACPs can be effectively constructed in family-centric societies so long as healthcare professionals continue to update and educate families on the patient's situation. Collusion and familial intervention in the decision-making process are part of efforts to protect the patient from distress and are neither solely dependent on

  3. Computer-assisted three-dimensional surgical planing and simulation. 3D soft tissue planning and prediction.

    Science.gov (United States)

    Xia, J; Samman, N; Yeung, R W; Wang, D; Shen, S G; Ip, H H; Tideman, H

    2000-08-01

    The purpose of this paper is to report a new technique for three-dimensional facial soft-tissue-change prediction after simulated orthognathic surgical planning. A scheme for soft tissue deformation, "Computer-assisted three-dimensional virtual reality soft tissue planning and prediction for orthognathic surgery (CASP)", is presented. The surgical planning was based on three-dimensional reconstructed CT visualization. Soft tissue changes were predicted by two newly devised algorithms: Surface Normal-based Model Deformation Algorithm and Ray Projection-based Model Deformation Algorithm. A three-dimensional color facial texture-mapping technique was also used for generating the color photo-realistic facial model. As a final result, a predicted and simulated patient's color facial model can be visualized from arbitrary viewing points.

  4. Three dimensional model for surgical planning in resection of thoracic tumors

    Directory of Open Access Journals (Sweden)

    Min P. Kim

    2015-01-01

    Conclusion: Three-dimensional printed model provide better visualization of complex thoracic tumors, aid in counseling the patient about the surgical procedure and assisted in surgical resection of thoracic malignancy.

  5. Outcome After Pneumonectomy in 17 Dogs and 10 Cats: A Veterinary Society of Surgical Oncology Case Series.

    Science.gov (United States)

    Wavreille, Vincent; Boston, S E; Souza, C; Ham, K; Chanoit, G; Rossetti, D; Takacs, J; Milner, R

    2016-08-01

    To report the signalment, presenting clinical signs, surgical complications, histologic diagnosis, postoperative complications, and outcome of dogs and cats undergoing pneumonectomy. Retrospective case series; multicenter study. Client-owned dogs (n=17) and cats (n=10). Signalment, clinical signs, side affected, surgical data, preoperative diagnostic tests (including complete blood count, serum biochemistry, cytologic diagnosis, chest radiographs, and computed tomography), histologic diagnosis, surgical complications, adjunctive therapy, and date and cause of death were collected from records of dogs and cats that underwent pneumonectomy. Survival estimates and complication were assessed. Seventeen animals had a left-sided pneumonectomy performed (12 dogs, 5 cats) and 10 animals had a right-sided pneumonectomy (5 dogs, 5 cats). Fourteen animals were diagnosed with neoplasia (52%). The overall incidence of complications for dogs and cats were 76 and 80%, respectively, with major complications in 41 and 50%, respectively. Respiratory complications (persistent pleural effusion, oxygen dependence, persistent increased respiratory rate, or coughing) were the most frequent complications. No animals died or were euthanatized intraoperative or within the first 24 hours postoperative. One dog (6%) and 2 cats (20%) died, or were euthanatized in the first 2 weeks postoperative. Based on this case series, right and left pneumonectomy can be performed with low perioperative mortality in dogs and cats, with some animals experiencing prolonged survival. © Copyright 2016 by The American College of Veterinary Surgeons.

  6. INPRES (intraoperative presentation of surgical planning and simulation results): augmented reality for craniofacial surgery

    Science.gov (United States)

    Salb, Tobias; Brief, Jakob; Welzel, Thomas; Giesler, Bjoern; Hassfeld, Steffan; Muehling, Joachim; Dillmann, Ruediger

    2003-05-01

    In this paper we present recent developments and pre-clinical validation results of our approach for augmented reality (AR, for short) in craniofacial surgery. A commercial Sony Glasstron display is used for optical see-through overlay of surgical planning and simulation results with a patient inside the operation room (OR). For the tracking of the glasses, of the patient and of various medical instruments an NDI Polaris system is used as standard solution. A complementary inside-out navigation approach has been realized with a panoramic camera. This device is mounted on the head of the surgeon for tracking of fiducials placed on the walls of the OR. Further tasks described include the calibration of the head-mounted display (HMD), the registration of virtual objects with the real world and the detection of occlusions in the object overlay with help of two miniature CCD cameras. The evaluation of our work took place in the laboratory environment and showed promising results. Future work will concentrate on the optimization of the technical features of the prototype and on the development of a system for everyday clinical use.

  7. Three-dimensional visualization system as an aid for facial surgical planning

    Science.gov (United States)

    Barre, Sebastien; Fernandez-Maloigne, Christine; Paume, Patricia; Subrenat, Gilles

    2001-05-01

    We present an aid for facial deformities treatment. We designed a system for surgical planning and prediction of human facial aspect after maxillo-facial surgery. We study the 3D reconstruction process of the tissues involved in the simulation, starting from CT acquisitions. 3D iso-surfaces meshes of soft tissues and bone structures are built. A sparse set of still photographs is used to reconstruct a 360 degree(s) texture of the facial surface and increase its visual realism. Reconstructed objects are inserted into an object-oriented, portable and scriptable visualization software allowing the practitioner to manipulate and visualize them interactively. Several LODs (Level-Of- Details) techniques are used to ensure usability. Bone structures are separated and moved by means of cut planes matching orthognatic surgery procedures. We simulate soft tissue deformations by creating a physically-based springs model between both tissues. The new static state of the facial model is computed by minimizing the energy of the springs system to achieve equilibrium. This process is optimized by transferring informations like participation hints at vertex-level between a warped generic model and the facial mesh.

  8. A web-based federated neuroinformatics model for surgical planning and clinical research applications in epilepsy.

    Science.gov (United States)

    Cao, Xinhua; Wong, Stephen T C; Hoo, Kent Soo; Tjandra, Donny; Fu, J C; Lowenstein, Daniel H

    2004-01-01

    There is an increasing need to efficiently share diverse clinical and image data among different clinics, labs, and departments of a medical center enterprise to facilitate better quality care and more effective clinical research. In this paper, we describe a web-based, federated information model as a viable technical solution with applications in medical refractory epilepsy and other neurological disorders. We describe four such online applications developed in a federated system prototype: surgical planning, image analysis, statistical data analysis, and dynamic extraction, transforming, and loading (ETL) of data from a heterogeneous collection of data sources into an epilepsy multimedia data warehouse (EMDW). The federated information system adopts a three-tiered architecture, consisting of a user-interface layer, an application logic layer, and a data service layer. We implemented two complementary federated information technologies, i.e., XML (eXtensible Markup Language) and CORBA (Common Object Request Broker Architecture), in the prototype to enable multimedia data exchange and brain images transmission. The preliminary results show that the federated prototype system provides a uniform interface, heterogeneous information integration and efficient data sharing for users in our institution who are concerned with the care of patients with epilepsy and who pursue research in this area.

  9. A think tank of the Italian Society of Colorectal Surgery (SICCR) on the surgical treatment of inflammatory bowel disease using the Delphi method: ulcerative colitis.

    Science.gov (United States)

    Selvaggi, F; Pellino, G; Ghezzi, G; Corona, D; Riegler, G; Delaini, G G

    2015-10-01

    The majority of patients suffering from ulcerative colitis (UC) are managed successfully with medical treatment, but a relevant number of them will still need surgery at some point in their life. Medical treatments and surgical techniques have changed dramatically in recent years, and available guidelines from relevant societies are rapidly evolving, providing UC experts with updated and valid practical recommendations. However, some aspects of the management of UC patients are still debated, and the application of guidelines in clinical practice may be suboptimal. The Italian Society of Colorectal Surgery (SICCR) sponsored the think tank in order to identify critical aspects of the surgical management of UC in Italy. The present paper reports the results of a think tank of Italian colorectal surgeons concerning surgery for UC and was not developed as an alternative to authoritative guidelines currently available. Members of the SICCR voted on several items proposed by the writing committee, based on evidence from the literature. The results are presented, focusing on points to be implemented. UC management relies on evaluations that need to be individualized, but points of major disagreement reported in this paper should be considered in order to develop strategies to improve the quality of the evidence and the application of guidelines in a clinical setting.

  10. The use of Space Technology for the Benefit of Society in Context of Planning and Sustainable Development

    Science.gov (United States)

    Kuldeep, Kuldeep; Banu, Vijaya

    2016-07-01

    The introduction of the novel technology mostly leads to a number of advantages to the society. The space technology has shown such benefits in many fields including the areas of health and education, communication sectors, land and water resources management, weather forecasting and disaster management. It has vast potential for addressing a variety of societal problems of the developing countries especially in India in a effective manner. Large population which is spread over vast and remote areas of the nation, reaching out to them is a difficult task. This manuscript aims to explain the benefits originated from the application of space technology. The satellite imagery and its derived products can better be utilized for local level planning and sustainable development of a region. A case-study using Bhuvan Panchayat Portal developed by National Remote Sensing Centre, ISRO under the project "Space Based Information Support for De-Centralised Planning" towards Digital Empowerment of Society for Panchayat level Planning and Governance has been carried out, which list out the benefits that have accrued from the use of space technology for planning and development at grass root level in India. It covers, in particular, the benefits expected to be derived from the Indian Remote Sensing Satellite (IRS) Images and derived products. Certain conclusions about the benefits from space based inputs have been drawn that may be generally applicable to all developing countries. This paper also investigates the various possibilities and potentials of Remote Sensing technologies for societal applications.

  11. American Society of Clinical Oncology Strategic Plan for Increasing Racial and Ethnic Diversity in the Oncology Workforce.

    Science.gov (United States)

    Winkfield, Karen M; Flowers, Christopher R; Patel, Jyoti D; Rodriguez, Gladys; Robinson, Patricia; Agarwal, Amit; Pierce, Lori; Brawley, Otis W; Mitchell, Edith P; Head-Smith, Kimberly T; Wollins, Dana S; Hayes, Daniel F

    2017-08-01

    In December 2016, the American Society of Clinical Oncology (ASCO) Board of Directors approved the ASCO Strategic Plan to Increase Racial and Ethnic Diversity in the Oncology Workforce. Developed through a multistakeholder effort led by the ASCO Health Disparities Committee, the purpose of the plan is to guide the formal efforts of ASCO in this area over the next three years (2017 to 2020). There are three primary goals: (1) to establish a longitudinal pathway for increasing workforce diversity, (2) to enhance ASCO leadership diversity, and (3) to integrate a focus on diversity across ASCO programs and policies. Improving quality cancer care in the United States requires the recruitment of oncology professionals from diverse backgrounds. The ASCO Strategic Plan to Increase Racial and Ethnic Diversity in the Oncology Workforce is designed to enhance existing programs and create new opportunities that will move us closer to the vision of achieving an oncology workforce that reflects the demographics of the US population it serves.

  12. International Society of Urological Pathology (ISUP) Consensus Conference on Handling and Staging of Radical Prostatectomy Specimens. Working group 5: surgical margins.

    Science.gov (United States)

    Tan, Puay Hoon; Cheng, Liang; Srigley, John R; Griffiths, David; Humphrey, Peter A; van der Kwast, Theodore H; Montironi, Rodolfo; Wheeler, Thomas M; Delahunt, Brett; Egevad, Lars; Epstein, Jonathan I

    2011-01-01

    The 2009 International Society of Urological Pathology Consensus Conference in Boston, made recommendations regarding the standardization of pathology reporting of radical prostatectomy specimens. Issues relating to surgical margin assessment were coordinated by working group 5. Pathologists agreed that tumor extending close to the 'capsular' margin, yet not to it, should be reported as a negative margin, and that locations of positive margins should be indicated as either posterior, posterolateral, lateral, anterior at the prostatic apex, mid-prostate or base. Other items of consensus included specifying the extent of any positive margin as millimeters of involvement; tumor in skeletal muscle at the apical perpendicular margin section, in the absence of accompanying benign glands, to be considered organ confined; and that proximal and distal margins be uniformly referred to as bladder neck and prostatic apex, respectively. Grading of tumor at positive margins was to be left to the discretion of the reporting pathologists. There was no consensus as to how the surgical margin should be regarded when tumor is present at the inked edge of the tissue, in the absence of transected benign glands at the apical margin. Pathologists also did not achieve agreement on the reporting approach to benign prostatic glands at an inked surgical margin in which no carcinoma is present.

  13. Virtual surgical planning and 3D printing in prosthetic orbital reconstruction with percutaneous implants: a technical case report.

    Science.gov (United States)

    Huang, Yu-Hui; Seelaus, Rosemary; Zhao, Linping; Patel, Pravin K; Cohen, Mimis

    2016-01-01

    Osseointegrated titanium implants to the cranial skeleton for retention of facial prostheses have proven to be a reliable replacement for adhesive systems. However, improper placement of the implants can jeopardize prosthetic outcomes, and long-term success of an implant-retained prosthesis. Three-dimensional (3D) computer imaging, virtual planning, and 3D printing have become accepted components of the preoperative planning and design phase of treatment. Computer-aided design and computer-assisted manufacture that employ cone-beam computed tomography data offer benefits to patient treatment by contributing to greater predictability and improved treatment efficiencies with more reliable outcomes in surgical and prosthetic reconstruction. 3D printing enables transfer of the virtual surgical plan to the operating room by fabrication of surgical guides. Previous studies have shown that accuracy improves considerably with guided implantation when compared to conventional template or freehand implant placement. This clinical case report demonstrates the use of a 3D technological pathway for preoperative virtual planning through prosthesis fabrication, utilizing 3D printing, for a patient with an acquired orbital defect that was restored with an implant-retained silicone orbital prosthesis.

  14. Virtual surgical planning and 3D printing in prosthetic orbital reconstruction with percutaneous implants: a technical case report

    Directory of Open Access Journals (Sweden)

    Huang Y

    2016-10-01

    Full Text Available Yu-Hui Huang,1,2 Rosemary Seelaus,1,2 Linping Zhao,1,2 Pravin K Patel,1,2 Mimis Cohen1,2 1The Craniofacial Center, Department of Surgery, Division of Plastic & Reconstructive Surgery, University of Illinois Hospital & Health Sciences System, 2University of Illinois College of Medicine at Chicago, Chicago, IL, USA Abstract: Osseointegrated titanium implants to the cranial skeleton for retention of facial prostheses have proven to be a reliable replacement for adhesive systems. However, improper placement of the implants can jeopardize prosthetic outcomes, and long-term success of an implant-retained prosthesis. Three-dimensional (3D computer imaging, virtual planning, and 3D printing have become accepted components of the preoperative planning and design phase of treatment. Computer-aided design and computer-assisted manufacture that employ cone-beam computed tomography data offer benefits to patient treatment by contributing to greater predictability and improved treatment efficiencies with more reliable outcomes in surgical and prosthetic reconstruction. 3D printing enables transfer of the virtual surgical plan to the operating room by fabrication of surgical guides. Previous studies have shown that accuracy improves considerably with guided implantation when compared to conventional template or freehand implant placement. This clinical case report demonstrates the use of a 3D technological pathway for preoperative virtual planning through prosthesis fabrication, utilizing 3D printing, for a patient with an acquired orbital defect that was restored with an implant-retained silicone orbital prosthesis. Keywords: computer-assisted surgery, virtual surgical planning (VSP, 3D printing, orbital prosthetic reconstruction, craniofacial implants

  15. Usefulness of computed tomography in pre-surgical evaluation of maxillo-facial pathology with rapid prototyping and surgical pre-planning by virtual reality.

    Science.gov (United States)

    Toso, Francesco; Zuiani, Chiara; Vergendo, Maurizio; Salvo, Iolanda; Robiony, Massimo; Politi, Massimo; Bazzocchi, Massimo

    2005-01-01

    To validate a protocol for creating virtual models to be used in the construction of solid prototypes useful for the planning-simulation of maxillo-facial surgery, in particular for very complex anatomic and pathologic problems. To optimize communications between the radiology, engineering and surgical laboratories. We studied 16 patients with different clinical problems of the maxillo-facial district. Exams were performed with multidetector computed tomography (MDCT) and single slice computed tomography (SDCT) with axial scans and collimation of 0.5-2 mm, and reconstruction interval of 1 mm. Subsequently we performed 2D multiplanar reconstructions and 3D volume-rendering reconstructions. We exported the DICOM images to the engineering laboratory, to recognize and isolate the bony structures by software. With these data the solid prototypes were generated using stereolitography. To date, surgery has been preformed on 12 patients after simulation of the procedure on the stereolithographyc model. The solid prototypes constructed in the difficult cases were sufficiently detailed despite problems related to the artefacts generated by dental fillings an d prostheses. In the remaining cases the MPR/3D images were sufficiently detailed for surgical planning. The surgical results were excellent in all patients who underwent surgery, and the surgeons were satisfied with the improvement in quality and the reduction in time required for the procedure. MDCT enables rapid prototyping using solid replication, which was very helpful in maxillo-facial surgery, despite problems related to artifacts due to dental fillings and prosthesis within the acquisition field; solutions for this problem are work in progress. The protocol used for communication between the different laboratories was valid and reproducible.

  16. Reduced radiation exposure for face transplant surgical planning computed tomography angiography.

    Directory of Open Access Journals (Sweden)

    Kurt Schultz

    Full Text Available OBJECTIVE: To test the hypothesis that wide area detector face transplant surgical planning CT angiograms with simulated lower radiation dose and iterative reconstruction (AIDR3D are comparable in image quality to those with standard tube current and filtered back projection (FBP reconstruction. MATERIALS AND METHODS: The sinograms from 320-detector row CT angiography of four clinical candidates for face transplantation were processed utilizing standard FBP, FBP with simulated 75, 62, and 50% tube current, and AIDR3D with corresponding dose reduction. Signal-to-noise ratio (SNR and contrast-to-noise ratio (CNR were measured at muscle, fat, artery, and vein. Image quality for each reconstruction strategy was assessed by two independent readers using a 4-point scale. RESULTS: Compared to FBP, the median SNR and CNR for AIDR3D images were higher at all sites for all 4 different tube currents. The AIDR3D with simulated 50% tube current achieved comparable SNR and CNR to FBP with standard dose (median muscle SNR: 5.77 vs. 6.23; fat SNR: 6.40 vs. 5.75; artery SNR: 43.8 vs. 45.0; vein SNR: 54.9 vs. 55.7; artery CNR: 38.1 vs. 38.6; vein CNR: 49.0 vs. 48.7; all p-values >0.19. The interobserver agreement in the image quality score was good (weighted κ = 0.7. The overall score and the scores for smaller arteries were significantly lower when FBP with 50% dose reduction was used. The AIDR3D reconstruction images with 4 different simulated doses achieved a mean score ranging from 3.68 to 3.82 that were comparable to the scores from images reconstructed using FBP with original dose (3.68-3.77. CONCLUSIONS: Simulated radiation dose reduction applied to clinical CT angiography for face transplant planning suggests that AIDR3D allows for a 50% reduction in radiation dose, as compared to FBP, while preserving image quality.

  17. Using the theory of planned behaviour to model antecedents of surgical checklist use: a cross-sectional study

    OpenAIRE

    Mascherek, Anna C; Gehring, Katrin; Bezzola, Paula; David L.B. Schwappach

    2015-01-01

    Background Compliance with surgical checklist use remains an obstacle in the context of checklist implementation programs. The theory of planned behaviour was applied to analyse attitudes, perceived behaviour control, and norms as psychological antecedents of individuals’ intentions to use the checklist. Methods A cross-sectional survey study with staff (N = 866) of 10 Swiss hospitals was conducted in German and French. Group mean differences between individuals with and without managerial fu...

  18. Using the theory of planned behaviour to model antecedents of surgical checklist use: a cross-sectional study.

    OpenAIRE

    Mascherek, Anna C; Gehring, Katrin; Bezzola, Paula; David L.B. Schwappach

    2015-01-01

    BACKGROUND Compliance with surgical checklist use remains an obstacle in the context of checklist implementation programs. The theory of planned behaviour was applied to analyse attitudes, perceived behaviour control, and norms as psychological antecedents of individuals' intentions to use the checklist. METHODS A cross-sectional survey study with staff (N = 866) of 10 Swiss hospitals was conducted in German and French. Group mean differences between individuals with and without m...

  19. A plan to create a zero waste society: transforming waste into resources

    OpenAIRE

    Peljhan Korošec, Jožica

    2016-01-01

    It is only reasonable to become a zero waste society and for producers to immediately start redesigning products, and for us to make the transition in our mentality to stop buying products that we do not really need or products that we could, in fact, borrow. In the interim (transitional period), until all our products are sustainable ones, waste incinerators (thermal treatment that utilises energy recovery) will still be unavoidable. However, this does not mean that new ones will need to be ...

  20. Assessment of the role of a student-led surgical interest group in surgical education.

    Science.gov (United States)

    Li, Ran; Buxey, Kenneth; Ashrafi, Akbar; Drummond, Katharine J

    2013-01-01

    We describe the development of a medical student surgical interest group, its initial evaluation, and future plans. The Surgical Students Society of Melbourne was formed in August 2008 by a group of senior medical students from the University of Melbourne. The Surgical Students Society of Melbourne seeks to provide additional surgical teaching and professional development for students interested in a career in surgery. It also aims to provide junior doctors with leadership and teaching opportunities to meet the requirements of the Royal Australasian College of Surgeons for application to the Surgical Education and Training program. Its program also addresses contemporary workforce issues, such as women in surgery and rural surgery. The society runs a weekly teaching program during the semester and procedural and careers workshops throughout the year. A survey of students attending the teaching program was conducted by means of written and online questionnaires. The results suggest that the society has been successful in augmenting surgical education and providing opportunities to improve procedural skills, but also highlighted areas of the program that may be improved, including aspects of surgical professional development and role modeling. The Surgical Students Society initiative was generally very well received by students and shows great potential as a means for augmenting surgical education at the medical student level. Copyright © 2012 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. [Planning, realization and evaluation of post-marketing surveillance studies. Recommendations of the Society for Phytotherapy].

    Science.gov (United States)

    Kraft, K; Loew, D; Schneider, B; Kemper, F H

    1997-08-01

    Post-marketing-surveillance studies with herbal drugs usually are prospective prescription-epidemiological studies, which should allow statements on quality, efficacy and safety. Until now neither laws nor concrete normative guidelines for the methodology and the evaluation of post-marketing-surveillance studies are existing which could be used for pharmacovigilance. In the present paper guidelines for planning, realisation and evaluation are presented which should allow studies of high quality. The essential components required for the investigational plan are focussed. Also recommendations on the obligatory, optional and special components of the study protocols are made. Additionally statistical methods which allow the evaluation of the therapeutic efficacy are presented.

  2. Virtual surgical planning for orthognathic surgery using digital data transfer and an intraoral fiducial marker: the charlotte method.

    Science.gov (United States)

    Bobek, Sam; Farrell, Brian; Choi, Chris; Farrell, Bart; Weimer, Katie; Tucker, Myron

    2015-06-01

    We describe an alternative workup protocol for virtual surgical planning of orthognathic surgery using an intraoral fiducial marker, clinical photography, and the digital transfer of occlusal data. We also discuss our initial experience using this protocol in a series of patients. A retrospective cohort study was performed of consecutive patients who had undergone combined maxillary and mandibular osteotomies for the correction of dentofacial deformities at 1 center. These patients underwent treatment planning using the modified virtual surgical planning protocol described in the present report. The primary outcome evaluated was the accuracy of the method, which was determined through superimposition of the surgical plan to the postoperative cone-beam computed tomography (CBCT) scan. The secondary outcomes included the accuracy of the natural head position readings and the adequacy of the CBCT scanned stone models for the fabrication of occlusal splints. The population included 25 patients. The root mean standard deviation (RMSD) from the preoperative plan to the postoperative scan at the maxillary cephalometric points was 1.2, 1.4, and 2.1 mm in the axial, sagittal, and coronal planes, respectively. The RMSD of the superimposed plan to the postoperative scan at the 3 mandibular cephalometric points was 1.2, 0.8, and 0.7 mm in the axial, sagittal, and coronal planes, respectively. The average variance from the axial, sagittal, and coronal planes for the natural head position was 0.05, 2.22, and 0.69 mm, respectively. All splints fabricated from the CBCT occlusal data fit the stone models and were used intraoperatively. In the subset of patients whose models were both digitally transferred and laser scanned, the superimposition of the laser scan data to the CBCT scanned data was found to have a maximum variation of 0.2 mm at the occlusal level. The use of an intraoral fiducial marker changed the workflow for the data collection needed for virtual surgical

  3. Application of computer-assisted three-dimensional quantitative assessment and a surgical planning tool for living donor liver transplantation

    Institute of Scientific and Technical Information of China (English)

    WEI Lin; ZHU Zhi-jun; L(U) Yi; JIANG Wen-tao; GAO Wei; ZENG Zhi-gui; SHEN Zhong-yang

    2013-01-01

    Background Precise evaluation of the live donor's liver is the most important factor for the donor's safety and the recipient's prognosis in living donor liver transplantation (LDLT).Our study assessed the clinical value of computer-assisted three-dimensional quantitative assessment and a surgical planning tool for donor evaluation in LDLT.Methods Computer-assisted three-dimensional (3D) quantitative assessment was used to prospectively provide quantitative assessment of the graft volume for 123 consecutive donors of LDLT and its accuracy and efficiency were compared with that of the standard manual-traced method.A case of reduced monosegmental LDLT was also assessed and a surgical planning tool displayed the precise surgical plan to avoid large-for-size syndrome.Results There was no statistically significant difference between the detected graft volumes with computer-assisted 3D quantitative assessment and manual-traced approaches ((856.76±162.18) cm3 vs.(870.64±172.54) cm3,P=0.796).Estimated volumes by either method had good correlation with the actual graft weight (r-manual-traced method:0.921,r-3D quantitative assessment method:0.896,both P <0.001).However,the computer-assisted 3D quantitative assessment approach was significantly more efficient taking half the time of the manual-traced method ((16.91±1.375) minutes vs.(39.27±2.102) minutes,P <0.01) to estimate graft volume.We performed the reduced monosegmental LDLT,a pediatric case,with the surgical planning tool (188 g graft in the operation,which was estimated at 208 cm3 pre-operation).The recipient recovered without large-for-size syndrome.Conclusions Computer-assisted 3D quantitative assessment provided precise evaluation of the graft volume.It also assisted surgeons with a better understanding of the hepatic 3D anatomy and was useful for the individual surgical planning tool.

  4. A retrospective analysis of 20-year data of the surgical management of ulcerative colitis patients in Taiwan: a study of Taiwan Society of Inflammatory Bowel Disease

    Science.gov (United States)

    Lin, Chun-Chi; Wei, Shu-Chen; Lin, Been-Ren; Tsai, Wen-Sy; Chen, Jinn-Shiun; Hsu, Tzu-Chi; Lin, Wei-Chen; Huang, Tien-Yu; Chao, Te-Hsin; Lin, Hung-Hsin; Wong, Jau-Min

    2016-01-01

    Background/Aims With the recent progress in medical treatment, surgery still plays a necessary and important role in treating ulcerative colitis (UC) patients. In this study, we analyzed the surgical results and outcomes of UC in Taiwan in the recent 20 years, via a multi-center study through the collaboration of Taiwan Society of IBD. Methods A retrospective analysis of surgery data of UC patients from January 1, 1995, through December 31, 2014, in 6 Taiwan major medical centers was conducted. The patients' demographic data, indications for surgery, and outcome details were recorded and analyzed. Results The data of 87 UC patients who received surgical treatment were recorded. The median post-operative follow-up duration was 51.1 months and ranged from 0.4 to 300 months. The mean age at UC diagnosis was 45.3±16.0 years and that at operation was 48.5±15.2 years. The 3 leading indications for surgical intervention were uncontrolled bleeding (16.1%), perforation (13.8%), and intractability (12.6%). In total, 27.6% of surgeries were performed in an emergency setting. Total or subtotal colectomy with rectal preservation (41.4%) was the most common operation. There were 6 mortalities, all due to sepsis. Emergency operation and low pre-operative albumin level were significantly associated with poor survival (P=0.013 and 0.034, respectively). Conclusions In the past 20 years, there was no significant change in the indications for surgery in UC patients. Emergency surgeries and low pre-operative albumin level were associated with poor survival. Therefore, an optimal timing of elective surgery for people with poorly controlled UC is paramount. PMID:27433147

  5. Housing as a part of identity in the consumerist society and an assesment in the frame of urban planning

    Directory of Open Access Journals (Sweden)

    Ebru Firidin Özgür

    2012-12-01

    Full Text Available Private sector investments are the leading factor of housing production today while public agents become a part of the housing market, instead of controlling it. A new consumerist segment in the society has emerged in Turkey after the transition to free market economy, in line with the global tendencies. Luxury housing became an instrument for investment as well as a sign of social status of the inhabitants. Housing production, which is a human right, without public control leads to problems in the field of urban planning. On the one hand, there is a shortage of affordable housing production, on the other development of gated communities surround periphery of the cities. Not only gated communities but also housing development projects in inner cities became the commodities of free market, which constitutes a contradiction with the nature of the planning. The aim of this article is to discuss the gated communities, which epitomize commodified housing production in the frame of consumer society, referring to Istanbul.

  6. A systematic investigation of the invariance of resting-state network patterns: is resting-state fMRI ready for pre-surgical planning?

    OpenAIRE

    Kathrin eKollndorfer; Fischmeister, Florian Ph. S.; Gregor eKasprian; Daniela ePrayer; Veronika eSchöpf

    2013-01-01

    Objectives: Measurements of resting-state networks (RSN) have been used to investigate a wide range of diseases, such as dementia or epilepsy. This raises the question whether this method could also serve as a pre-surgical planning tool. Generating reliable functional connectivity patterns is of crucial importance, particularly for pre-surgical planning, as these patterns may directly affect the outcome.Methods: This study investigated the reproducibility of four commonly used resting-state c...

  7. Use of three-dimensional, CAD/CAM-assisted, virtual surgical simulation and planning in the pediatric craniofacial population.

    Science.gov (United States)

    Gray, Rachel; Gougoutas, Alexander; Nguyen, Vinh; Taylor, Jesse; Bastidas, Nicholas

    2017-06-01

    Virtual Surgical Planning (VSP) and computer-aided design/computer-aided manufacturing (CAD/CAM) have recently helped improve efficiency and accuracy in many different craniofacial surgeries. Research has mainly focused on the use in the adult population with the exception of the use for mandibular distractions and cranial vault remodeling in the pediatric population. This study aims to elucidate the role of VSP and CAD/CAM in complex pediatric craniofacial cases by exploring its use in the correction of midface hypoplasia, orbital dystopia, mandibular reconstruction, and posterior cranial vault expansion. A retrospective analysis of thirteen patients who underwent 3d, CAD/CAM- assisted preoperative surgical planning between 2012 and 2016 was performed. All CAD/CAM assisted surgical planning was done in conjunction with a third party vendor (either 3D Systems or Materialise). Cutting and positioning guides as well as models were produced based on the virtual plan. Surgeries included free fibula mandible reconstruction (n = 4), lefort I osteotomy and distraction (n = 2), lefort II osteotomy with monobloc distraction (n = 1), expansion of the posterior vault for correction of chiari malformation (n = 3), and secondary orbital and midface reconstruction for facial trauma (n = 3). The patient's age, diagnosis, previous surgeries, length of operating time, complications, and post-surgery satisfaction were determined. In all cases we found presurgical planning was helpful to improve accuracy and significantly decrease intra-operative time. In cases where distraction was used, the planned and actual vectors were found to be accurate with excellent clinical outcomes. There were no complications except for one patient who experienced a wound infection post-operatively which did not alter the ultimate reconstruction. All patients experienced high satisfaction with their outcomes and excellent subjective aesthetic results were achieved. Preoperative planning using

  8. Review Pages: Planning for Livable and Safe Cities: Socio-economic Changes in Advanced Societies

    Directory of Open Access Journals (Sweden)

    Gennaro Angiello

    2016-12-01

    Full Text Available Starting from the relationship between urban planning and mobility management, TeMA has gradually expanded the view of the covered topics, always remaining in the groove of rigorous scientific in-depth analysis. During the last two years a particular attention has been paid on the Smart Cities theme and on the different meanings that come with it. The last section of the journal is formed by the Review Pages. They have different aims: to inform on the problems, trends and evolutionary processes; to investigate on the paths by highlighting the advanced relationships among apparently distant disciplinary fields; to explore the interaction’s areas, experiences and potential applications; to underline interactions, disciplinary developments but also, if present, defeats and setbacks. Inside the journal the Review Pages have the task of stimulating as much as possible the circulation of ideas and the discovery of new points of view. For this reason the section is founded on a series of basic’s references, required for the identification of new and more advanced interactions. These references are the research, the planning acts, the actions and the applications, analysed and investigated both for their ability to give a systematic response to questions concerning the urban and territorial planning, and for their attention to aspects such as the environmental sustainability and the innovation in the practices. For this purpose the Review Pages are formed by five sections (Web Resources; Books; Laws; Urban Practices; News and Events, each of which examines a specific aspect of the broader information storage of interest for TeMA.

  9. The role of linguists in planning and making dictionaries in modern information society

    DEFF Research Database (Denmark)

    Bergenholtz, Henning

    2013-01-01

    There is an ongoing discussion on the status of lexicography: Is lexicography a linguistic sub discipline? Or is it a discipline of its own? Or should lexicography be a special part of information science? But the topic of this paper deals with another question: Who is a lexicographer, and which...... lexicographer making the concept for a planned dictionary, 3. lexicographer making the concrete dictionary articles or parts of them. For (2) a linguist is of course not the natural choice. For (3) we need linguists for certain kind of dictionaries and certain data types in general languages....... It has data only from the data field “meaning”. The second monofunctional dictionary is a text production dictionary for help to find another word instead of the one you do not want to use, in other words a synonym dictionary. Such a dictionary can be used for reception too, but it is not its genuine...

  10. The role of linguists in planning and making dictionaries in modern information society

    DEFF Research Database (Denmark)

    Bergenholtz, Henning

    2013-01-01

    function. The third dictionary is a text production dictionary with most of the data you find in the traditional polyfunctional dictionaries. There is at least one big difference: It is a proscriptive dictionary not only describing or forbidding, but making recommendations in cases of variation. The fourth...... dictionary is a text production dictionary with spelling and inflectional data - but in addition a meaning item in cases of homonymy. The fifth dictionary is a text production dictionary called “Tell me the word I am looking for”. Here you can search for words with a certain meaning or use a Boolean search...... lexicographer making the concept for a planned dictionary, 3. lexicographer making the concrete dictionary articles or parts of them. For (2) a linguist is of course not the natural choice. For (3) we need linguists for certain kind of dictionaries and certain data types in general languages...

  11. Science-society collaboration for robust adaptation planning in water management - The Maipo River Basin in Chile

    Science.gov (United States)

    Ocampo Melgar, Anahí; Vicuña, Sebastián; Gironás, Jorge

    2015-04-01

    The Metropolitan Region (M.R.) in Chile is populated by over 6 million people and supplied by the Maipo River and its large number of irrigation channels. Potential environmental alterations caused by global change will extremely affect managers and users of water resources in this semi-arid basin. These hydro-climatological impacts combined with demographic and economic changes will be particularly complex in the city of Santiago, due to the diverse, counterpoised and equally important existing activities and demands. These challenges and complexities request the implementation of flexible plans and actions to adapt policies, institutions, infrastructure and behaviors to a new future with climate change. Due to the inherent uncertainties in the future, a recent research project entitled MAPA (Maipo Adaptation Plan for its initials in Spanish) has formed a collaborative science-society platform to generate insights into the vulnerabilities, challenges and possible mitigation measures that would be necessary to deal with the potential changes in the M.R. This large stakeholder platform conformed by around 30 public, private and civil society organizations, both at the local and regional level and guided by a Robust Decision Making Framework (RDMF) has identified vulnerabilities, future scenarios, performance indicators and mitigation measures for the Maipo River basin. The RDMF used in this project is the XLRM framework (Lempert et al. 2006) that incorporates policy levers (L), exogenous uncertainties (X), measures of performance standards (M) and relationships (R) in an interlinked process. Both stakeholders' expertise and computational capabilities have been used to create hydrological models for the urban, rural and highland sectors supported also by the Water Evaluation and Planning system software (WEAP). The identification of uncertainties and land use transition trends was used to develop future development scenarios to explore possible water management

  12. A virtual reality interface for pre-planning of surgical operations based on a customized model of the patient

    Science.gov (United States)

    Witkowski, Marcin; Lenar, Janusz; Sitnik, Robert; Verdonschot, Nico

    2012-03-01

    We present a human-computer interface that enables the operator to plan a surgical procedure on the musculoskeletal (MS) model of the patient's lower limbs, send the modified model to the bio-mechanical analysis module, and export the scenario parameters to the surgical navigation system. The interface provides the operator with tools for: importing customized MS model of the patient, cutting bones and manipulating/removal of bony fragments, repositioning muscle insertion points, muscle removal and placing implants. After planning the operator exports the modified MS model for bio-mechanical analysis of the functional outcome. If the simulation result is satisfactory the exported scenario data may be directly used during the actual surgery. The advantages of the developed interface are the possibility of installing it in various hardware configurations and coherent operation regardless of the devices used. The hardware configurations proposed to be used with the interface are: (a) a standard computer keyboard and mouse, and a 2-D display, (b) a touch screen as a single device for both input and output, or (c) a 3-D display and a haptic device for natural manipulation of 3-D objects. The interface may be utilized in two main fields. Experienced surgeons may use it to simulate their intervention plans and prepare input data for a surgical navigation system while student or novice surgeons can use it for simulating results of their hypothetical procedure. The interface has been developed in the TLEMsafe project (www.tlemsafe.eu) funded by the European Commission FP7 program.

  13. Medical and surgical interventions to improve outcomes in obese women planning for pregnancy.

    Science.gov (United States)

    Sharma, Anu; Bahadursingh, Sarasvati; Ramsewak, Samuel; Teelucksingh, Surujpal

    2015-05-01

    Obesity is a known risk factor for infertility in women. The exact mechanism through which obesity is linked to infertility is still not fully understood. Hyperleptinaemia, hyperinsulinaemia and resultant hyperandrogenism are all thought to play a role. Various medical and surgical interventions have been attempted to improve fertility rates in obese women. Encouraging evidence for pharmacotherapy, bariatric surgery and assisted reproduction are yet to be seen. In this chapter, we review the hormonal changes in obesity and the evidence behind medical and surgical interventions to improve fertility in obese women.

  14. Surgical and prosthodontic consequences of inadequate treatment planning for fixed implant-supported prosthesis in the edentulous mandible.

    Science.gov (United States)

    Bidra, Avinash S

    2010-10-01

    Treatment planning for mandibular fixed implant-supported prostheses requires close communication between surgeons and restorative dentists. Improper implant positioning can result in significant difficulty for patient comfort and fabrication of a functional prosthesis. This case report describes the consequences of placing implants with no preoperative planning with regard to the implant position based on the final restorative plan. A 46-year-old male had all of his remaining maxillary and mandibular teeth extracted, and had 5 implants placed immediately in the interforaminal region of the mandible with the intent of providing a fixed prosthesis. Six weeks later, the patient was referred for prosthodontic care. The patient had no prostheses at that time and was in severe pain due to impingement of the lower lip by one of the implants. The implants were deemed to be in unfavorable positions and angulations. Thereafter, the case was treatment-planned systematically, requiring 2 additional surgical procedures---removal of one of the implants and alveoloplasty of posterior mandible for creation of space for prosthetic components. The remaining 4 implants with unfavorable angulations posed a prosthodontic challenge for fabrication of a prosthesis. The situation was eventually managed by fabrication of a screw-retained metal-resin fixed prosthesis over the remaining 4 implants. Although the situation was managed successfully, it resulted in increased time and treatment expenses, additional appointments, and elaborative steps for correction. Prosthodontics-driven treatment planning concepts and guidelines for prevention of such situations are described in this article. Published by Elsevier Inc.

  15. Postoperative perceived health status in adolescent following idiopathic scoliosis surgical treatment: results using the adapted French version of Scoliosis Research Society Outcomes questionnaire (SRS-22).

    Science.gov (United States)

    Chaib, Y; Bachy, M; Zakine, S; Mary, P; Khouri, N; Vialle, R

    2013-06-01

    Assessing functional outcome from patient-based outcomes questionnaires are essential to the evaluation of adolescent idiopathic scoliosis surgical treatment At the minimum follow-up of 2 years, 45 operated on adolescent idiopathic scoliosis patients were mailed the French version of the Scoliosis Research Society Outcome Instrument (SRS-22) questionnaires containing items on pain, activities of daily living, and satisfaction. Mean values of the SRS-22 domains were 3,66 for the Pain domain, 3,85 for the Self-perceived image domain, 4,32 for the Function domain, 3,52 for the Mental health domain and 4,12 for the Global satisfaction with management domain. Mean value of the global SRS-22 score was 3,88. We showed no differences in functional SRS-22 health status in patients according to the type of curve (Lenke classification). We showed statistically significant correlations between the gain of Cobb angle and Patients self-image and function domain scores. There was a statistically significant correlation between preoperative Cobb angle and patient satisfaction with management. Even if Function and Self-image scores in our patients are close to control group values, indicating good short to mid-term outcome of surgical treatment, scores for pain and mental health status were significantly lower in patients than controls. Long-term follow-up studies conducted by multiple surgeons over successive generations are mandatory to assess clinical significance of these differences. Level IV. Retrospective study. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  16. Using the theory of planned behaviour to model antecedents of surgical checklist use: a cross-sectional study.

    Science.gov (United States)

    Mascherek, Anna C; Gehring, Katrin; Bezzola, Paula; Schwappach, David L B

    2015-10-07

    Compliance with surgical checklist use remains an obstacle in the context of checklist implementation programs. The theory of planned behaviour was applied to analyse attitudes, perceived behaviour control, and norms as psychological antecedents of individuals' intentions to use the checklist. A cross-sectional survey study with staff (N = 866) of 10 Swiss hospitals was conducted in German and French. Group mean differences between individuals with and without managerial function were computed. Structural equation modelling and confirmatory factor analysis was applied to investigate the structural relation between attitudes, perceived behaviour control, norms, and intentions. Significant mean differences in favour of individuals with managerial function emerged for norms, perceived behavioural control, and intentions, but not for attitudes. Attitudes and perceived behavioural control had a significant direct effect on intentions whereas norms had not. Individuals with managerial function exhibit stronger perceived behavioural control, stronger norms, and stronger intentions. This could be applied in facilitating checklist implementation. The structural model of the theory of planned behaviour remains stable across groups, indicating a valid model to describe antecedents of intentions in the context of surgical checklist implementation.

  17. Computer-assisted three-dimensional surgical planning: 3D virtual articulator: technical note.

    Science.gov (United States)

    Ghanai, S; Marmulla, R; Wiechnik, J; Mühling, J; Kotrikova, B

    2010-01-01

    This study presents a computer-assisted planning system for dysgnathia treatment. It describes the process of information gathering using a virtual articulator and how the splints are constructed for orthognathic surgery. The deviation of the virtually planned splints is shown in six cases on the basis of conventionally planned cases. In all cases the plaster models were prepared and scanned using a 3D laser scanner. Successive lateral and posterior-anterior cephalometric images were used for reconstruction before surgery. By identifying specific points on the X-rays and marking them on the virtual models, it was possible to enhance the 2D images to create a realistic 3D environment and to perform virtual repositioning of the jaw. A hexapod was used to transfer the virtual planning to the real splints. Preliminary results showed that conventional repositioning could be replicated using the virtual articulator.

  18. 3D-visualization by MRI for surgical planning of Wilms tumors; 3-D-Visualisierung in der MRT zur Operationsplanung von Wilms-Tumoren

    Energy Technology Data Exchange (ETDEWEB)

    Schenk, J.P.; Wunsch, R.; Jourdan, C.; Troeger, J. [Universitaetsklinik Heidelberg (Germany). Abteilung Paediatrische Radiologie; Waag, K.-L.; Guenther, P. [Universitaetsklinik Heidelberg (Germany). Abteilung Kinderchirurgie; Graf, N. [Universitaetsklinik Homburg (Germany). Abteilung Paediatrische Haematologie und Onkologie; Behnisch, W. [Universitaetsklinik Heidelberg (Germany). Abteilung Paediatrische Haematologie und Onkologie

    2004-10-01

    Purpose: To improve surgical planning of kidney tumors in childhood (Wilms tumor, mesoblastic nephroma) after radiologic verification of the presumptive diagnosis with interactive colored 3D-animation in MRI. Materials and Methods: In 7 children (1 boy, 6 girls) with a mean age of 3 years (1 month to 11 years), the MRI database (DICOM) was processed with a raycasting-based 3D-volume-rendering software (VG Studio Max 1.1/Volume Graphics). The abdominal MRI-sequences (coronal STIR, coronal T1 TSE, transverse T1/T2 TSE, sagittal T2 TSE, transverse and coronal T1 TSE post contrast) were obtained with a 0.5T unit in 4-6 mm slices. Additionally, phase-contrast-MR-angiography was applied to delineate the large abdominal and retroperitoneal vessels. A notebook was used to demonstrate the 3D-visualization for surgical planning before surgery and during the surgical procedure. Results: In all 7 cases, the surgical approach was influenced by interactive 3D-animation and the information found useful for surgical planning. Above all, the 3D-visualization demonstrates the mass effect of the Wilms tumor and its anatomical relationship to the renal hilum and to the rest of the kidney as well as the topographic relationship of the tumor to the critical vessels. One rupture of the tumor capsule occurred as a surgical complication. For the surgeon, the transformation of the anatomical situation from MRI to the surgical situs has become much easier. Conclusion: For surgical planning of Wilms tumors, the 3D-visualization with 3D-animation of the situs helps to transfer important information from the pediatric radiologist to the pediatric surgeon and optimizes the surgical preparation. A reduction of complications is to be expected. (orig.)

  19. [Demography and society. An analysis of the goals of the State Development Plan (Sinaloa) 1987-1992].

    Science.gov (United States)

    Aguayo Hernandez, J R

    1991-01-01

    The State Development Plan for Sinaloa, Mexico, for 1987-1992 contains 7 important goals in its section on Demography and Society that have met with considerable success. Data from the 1990 general population census and projections by the state population council are the basis for an evaluation of progress. To contribute to lowering the fertility rate, the State Population Council for Sinaloa (CONEPOSIN), in coordination with the educational and health sectors, has developed family planning activities for all levels of care throughout the state. The emphasis is on population education, and a program to evaluate IEC programs has been underway since 1987. The crude birth rate declined from 51.9/1000 in 1970 to 39.8 in 1980 and 28.6 in 1990. In the area of regulating population growth and bringing it into balance with economic and social development, the 1st step was consideration of a population policy in the 1987-1992 state development plan. During the past 4 years, the gross state product increased by 2.9% annually, while population increased at 1.8% annually. Economic projections indicate improvement with the culmination of some major infrastructural projects. But demographic growth reduces the speed of economic and social improvement. The goal of reducing population concentration in the municipio of Culiacan will be furthered by a continuing decline in the natural increase rate and a gradual improvement in social development. The population of the municipio for the year 2000 is projected at slightly over 718,000 and the growth rate at about 1.8%. Even if the growth goal is achieved there will still be strong demand for employment because of the young age structure. The 4th plan goal is generating development strategies that will contribute to rationalizing population distribution in the state. The proportion of the population living in localities of over 15,000 increased from 33% in 1970 to 42% in 1980 and around 50% in 1990. 90% of the urban population and 45

  20. The Danish government's climate plan. Towards a society without greenhouse gases; Regeringens klimaplan. Pae vej mod et samfund uden drivhusgasser

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-08-15

    The Danish government's goal is to reduce greenhouse gas emissions with 40% by the year 2020, compared to 1990 levels. A major step towards reaching that goal was accomplished in March 2012, with the political agreement on energy policy. The remaining reductions to achieve the goal will come primarily from the transportation, agriculture and construction sectors, and from waste management. In order to reach the government's goal, we must eliminate the equivalent of approximately four million tonnes of CO{sub 2} emissions by 2020. Reaching the goal in 2020 also depends on factors such as the economy as we progress toward 2020, as well as on EU climate policy. The government will continue to work proactively to ensure that ambitious climate and energy policies are pursued by the EU. The EU policies will contribute significantly in order to achieve the national objectives. The government will engage in a dialogue with parliament, business society and civil society to discuss what kind of national policy initiatives to be decided on to reduce greenhouse gas emissions. The government will introduce a climate change bill during the upcoming session of parliament. The purpose of this upcoming bill is to ensure progress and transparency in the climate policy development. The bill will include requirements for an annual climate policy progress report to show whether Denmark is on track to meet the goal of a 40% reduction in greenhouse gases by 2020. As part of its work on the climate policy plan, an inter-ministerial working group has developed a catalogue of about 80 possible climate policy initiatives to address climate change. These policy proposals, along with the proposed legislation, will be the government's main instruments in the coming years in order to continuously monitor and adjust its climate policy. (Author)

  1. Repositioning template for mandibular reconstruction with fibular free flaps: an alternative technique to pre-plating and virtual surgical planning.

    Science.gov (United States)

    Berrone, M; Crosetti, E; Succo, G

    2014-08-01

    Oral malignancies involving the mandibular bone require a complex reconstructive plan. Mandibular reconstruction with a fibular free flap is currently considered the best choice for functional and aesthetic rehabilitation after oncological surgery. This flap can be modelled with multiple osteotomies and can provide bone, muscle and skin for composite reconstruction. One of the most delicate aspects of mandibular reconstruction is the technique of bone modelling; the risk of prolonging the period of ischaemia and not restoring the correct maxillomandibular and occlusal relationships can ultimately lead to a higher rate of complications as well as poor aesthetic and functional results. Recently, there has been rising interest in virtual surgical planning and computer-assisted mandibular reconstruction in pre-operative planning; however, this is not always possible because of the costs involved and the set-up time for the entire procedure. In this paper, we present a simple and inexpensive technique for fibular free flap modelling and repositioning after segmental resection of the mandible; the technique entails the pre-operative preparation of a resin repositioning template on a stereolithographic model. This technique has been successfully applied in four cases: two cases underwent resection involving only the mandibular body, one case involving the mandibular body and symphysis and one case in which a ramus to ramus resection was performed. In this preliminary report, we show that the resin repositioning template is an easy, safe and useful tool for mandibular reconstruction with a fibular free flap.

  2. Computational fluid dynamics as surgical planning tool: a pilot study on middle turbinate resection.

    Science.gov (United States)

    Zhao, Kai; Malhotra, Prashant; Rosen, David; Dalton, Pamela; Pribitkin, Edmund A

    2014-11-01

    Controversies exist regarding the resection or preservation of the middle turbinate (MT) during functional endoscopic sinus surgery. Any MT resection will perturb nasal airflow and may affect the mucociliary dynamics of the osteomeatal complex. Neither rhinometry nor computed tomography (CT) can adequately quantify nasal airflow pattern changes following surgery. This study explores the feasibility of assessing changes in nasal airflow dynamics following partial MT resection using computational fluid dynamics (CFD) techniques. We retrospectively converted the pre- and postoperative CT scans of a patient who underwent isolated partial MT concha bullosa resection into anatomically accurate three-dimensional numerical nasal models. Pre- and postsurgery nasal airflow simulations showed that the partial MT resection resulted in a shift of regional airflow towards the area of MT removal with a resultant decreased airflow velocity, decreased wall shear stress and increased local air pressure. However, the resection did not strongly affect the overall nasal airflow patterns, flow distributions in other areas of the nose, nor the odorant uptake rate to the olfactory cleft mucosa. Moreover, CFD predicted the patient's failure to perceive an improvement in his unilateral nasal obstruction following surgery. Accordingly, CFD techniques can be used to predict changes in nasal airflow dynamics following partial MT resection. However, the functional implications of this analysis await further clinical studies. Nevertheless, such techniques may potentially provide a quantitative evaluation of surgical effectiveness and may prove useful in preoperatively modeling the effects of surgical interventions.

  3. Factors associated with surgical site infection after lower extremity bypass in the Society for Vascular Surgery (SVS) Vascular Quality Initiative (VQI).

    Science.gov (United States)

    Kalish, Jeffrey A; Farber, Alik; Homa, Karen; Trinidad, Magdiel; Beck, Adam; Davies, Mark G; Kraiss, Larry W; Cronenwett, Jack L

    2014-11-01

    Surgical site infection (SSI) is a major source of morbidity after infrainguinal lower extremity bypass (LEB). This study examines processes of care associated with in-hospital SSI after LEB and identifies factors that could potentially be modified to improve outcomes. The Society for Vascular Surgery (SVS) Vascular Quality Initiative (VQI) registry (2003 to 2012) was queried to identify in-hospital SSI after 7908 consecutive LEB procedures performed by 365 surgeons at 91 academic and community hospitals in 45 states. Variables associated with SSI were identified using multivariable logistic regression and hierarchical clustering. Expected and observed SSI rates were calculated for each hospital. The overall in-hospital SSI rate after LEB was 4.8%. Univariate analysis showed that obesity, dialysis, tissue loss, preoperative ankle-brachial index 2 units of packed red blood cells, procedure time >220 minutes, and estimated blood loss >100 mL were associated with higher SSI rates, whereas chlorhexidine (compared with iodine) skin preparation was protective. Multivariable analysis showed independent predictors of SSI included ankle-brachial index 2 units (OR, 3.30; 95% CI, 2.17-5.02; P 220 minutes (OR, 2.11; 95% CI, 1.05-4.23; P < .04). Chlorhexidine was protective against SSI (OR, 0.53; 95% CI, 0.35-0.79; P = .002). Stratified analyses based on the presence of tissue loss yielded similar results. Across VQI hospitals, observed SSI rates ranged from 0% to 30%, whereas expected SSI rates adjusted by the four independent predictors ranged from 0% to 7.2%. In-hospital SSI after LEB varies substantially across VQI hospitals. Three modifiable processes of care (transfusion rate, procedure time, and type of skin preparation) were identified and may be used by hospitals to reduce SSI rates. This study demonstrates the value of the SVS VQI detailed shared clinical registry to identify improvement opportunities directly pertinent to providers that are not available in

  4. Managing patients with stable respiratory disease planning air travel: a primary care summary of the British Thoracic Society recommendations.

    Science.gov (United States)

    Josephs, Lynn K; Coker, Robina K; Thomas, Mike

    2013-06-01

    Air travel poses medical challenges to passengers with respiratory disease, principally because of exposure to a hypobaric environment. In 2002 the British Thoracic Society published recommendations for adults and children with respiratory disease planning air travel, with a web update in 2004. New full recommendations and a summary were published in 2011, containing key recommendations for the assessment of high-risk patients and identification of those likely to require in-flight supplemental oxygen. This paper highlights the aspects of particular relevance to primary care practitioners with the following key points: (1) At cabin altitudes of 8000 feet (the usual upper limit of in-flight cabin pressure, equivalent to 0.75 atmospheres) the partial pressure of oxygen falls to the equivalent of breathing 15.1% oxygen at sea level. Arterial oxygen tension falls in all passengers; in patients with respiratory disease, altitude may worsen preexisting hypoxaemia. (2) Altitude exposure also influences the volume of any air in cavities, where pressure x volume remain constant (Boyle's law), so that a pneumothorax or closed lung bulla will expand and may cause respiratory distress. Similarly, barotrauma may affect the middle ear or sinuses if these cavities fail to equilibrate. (3) Patients with respiratory disease require clinical assessment and advice before air travel to: (a) optimise usual care; (b) consider contraindications to travel and possible need for in-flight oxygen; (c) consider the need for secondary care referral for further assessment; (d) discuss the risk of venous thromboembolism; and (e) discuss forward planning for the journey.

  5. Planning the Surgical Correction of Spinal Deformities: Toward the Identification of the Biomechanical Principles by Means of Numerical Simulation

    Science.gov (United States)

    Galbusera, Fabio; Bassani, Tito; La Barbera, Luigi; Ottardi, Claudia; Schlager, Benedikt; Brayda-Bruno, Marco; Villa, Tomaso; Wilke, Hans-Joachim

    2015-01-01

    In decades of technical developments after the first surgical corrections of spinal deformities, the set of devices, techniques, and tools available to the surgeons has widened dramatically. Nevertheless, the rate of complications due to mechanical failure of the fixation or the instrumentation remains rather high. Indeed, basic and clinical research about the principles of deformity correction and the optimal surgical strategies (i.e., the choice of the fusion length, the most appropriate instrumentation, and the degree of tolerable correction) did not progress as much as the implantable devices and the surgical techniques. In this work, a software approach for the biomechanical simulation of the correction of patient-specific spinal deformities aimed to the identification of its biomechanical principles is presented. The method is based on three-dimensional reconstructions of the spinal anatomy obtained from biplanar radiographic images. A user-friendly graphical user interface allows for the planning of the desired deformity correction and to simulate the implantation of pedicle screws. Robust meshing of the instrumented spine is provided by using consolidated computational geometry and meshing libraries. Based on a finite element simulation, the program is able to predict the loads and stresses acting in the instrumentation as well as those in the biological tissues. A simple test case (reduction of a low-grade spondylolisthesis at L3–L4) was simulated as a proof of concept, and showed plausible results. Despite the numerous limitations of this approach which will be addressed in future implementations, the preliminary outcome is promising and encourages a wide effort toward its refinement. PMID:26579518

  6. Surgical planning for resection of an ameloblastoma and reconstruction of the mandible using a selective laser sintering 3D biomodel.

    Science.gov (United States)

    Sannomiya, Eduardo Kazuo; Silva, Jorge Vicente L; Brito, Antonio Albuquerque; Saez, Daniel Martinez; Angelieri, Fernanda; Dalben, Gisele da Silva

    2008-07-01

    Ameloblastoma is a benign locally aggressive infiltrative odontogenic lesion. It is characterized by slow growth and painless swelling. The treatment for ameloblastoma varies from curettage to en bloc resection, and the reported recurrence rates after treatment are high; the safety margin of resection is important to avoid recurrence. Advances in technology brought about great benefits in dentistry; a new generation of computed tomography scanners and 3-dimensional images enhance the surgical planning and management of maxillofacial tumors. The development of new prototyping systems provides accurate 3D biomodels on which surgery can be simulated, especially in cases of ameloblastoma, in which the safety margin is important for treatment success. A case of mandibular follicular ameloblastoma is reported where a 3D biomodel was used before and during surgery.

  7. Preserving the socket dimensions with bone grafting in single sites: an esthetic surgical approach when planning delayed implant placement.

    Science.gov (United States)

    Irinakis, Tassos; Tabesh, Moe

    2007-01-01

    Recent advancements in barrier membranes, bone grafting substitutes, and surgical techniques have led to a predictable arsenal of treatment methods for clinicians who practice implant dentistry. The contemporary clinician is supplied with proven knowledge, substantiated materials, and instrument inventory that allows implant placement in cases that used to be reserved for the specialist in the past because of their complexity. Nowadays, postextraction alveolar ridge maintenance can be a predictable procedure and can certainly aid the clinician in preventing ridge collapse, thereby allowing for implant placement in a position that satisfies esthetics and function. Extraction socket maintenance for future implant therapy does not rule out immediate implant placement but rather provides an additional option when treatment planning implant patients. This article will focus on the concept of extraction socket preservation using regenerative materials. It will describe a technique suggested by the authors to resist bone resorption and soft tissue shrinkage following tooth extraction.

  8. Integrated surgical emergency training plan in the internship: A step toward improving the quality of training and emergency center management.

    Science.gov (United States)

    Akhlaghi, Mohammad Reza; Vafamehr, Vajiheh; Dadgostarnia, Mohammad; Dehghani, Alireza

    2013-01-01

    In this study, by using a problem-oriented approach in the needs assessment, identifying the defects and deficiencies in emergency health training centers has been determined as the basis for the requirements. The main objective of the study was the implementation of surgical emergencies integration of the five surgical groups (general surgery, urology, orthopedics, neurosurgery, and ENT) to meet the needs and determining its efficacy. THIS INTERVENTIONAL STUDY WAS CONDUCTED IN THREE PHASES: (1) Phase I (design and planning): Needs assessment, recognition of implementation barriers and providing the objectives and training program for integrated emergencies. (2) Phase II (implementation): Justification of the main stakeholders of the project, preparation of students' duties in the emergency department, preparation of on-duty plans, supervising the implementation of the program, and reviewing the plan in parallel with the implementation based on the problems. (3) Phase III (evaluation): Reviewing the evidences based on the amount of efficiency of the plan and justification for its continuation. In the first and the second phase, the data were collected through holding focus group meetings and interviews. In the third phase, the opened-reply and closed-reply researcher-made questionnaires were used. The questionnaire face and content validity were confirmed by experts and the reliability was assessed by calculating the Cronbach's alpha. ACCORDING TO THE VIEWS OF THE INTERNS, ASSISTANTS, TEACHERS, AND EMERGENCY PERSONNEL, THE POSITIVE FEATURES OF THE PLAN INCLUDED THE FOLLOWING: Increasing the patients' satisfaction, reducing the patients' stay in the Emergency Department, increasing the speed of handling the patients, balancing the workloads of the interns, direct training of interns by young teachers of emergency medicine, giving the direct responsibility of the patient to the intern, practical and operational training of emergency issues, increasing the teamwork

  9. 3D planning in orthognathic surgery: CAD/CAM surgical splints and prediction of the soft and hard tissues results - our experience in 16 cases.

    Science.gov (United States)

    Aboul-Hosn Centenero, Samir; Hernández-Alfaro, Federico

    2012-02-01

    The aim of this article is to determine the advantages of 3D planning in predicting postoperative results and manufacturing surgical splints using CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) technology in orthognathic surgery when the software program Simplant OMS 10.1 (Materialise(®), Leuven, Belgium) was used for the purpose of this study which was carried out on 16 patients. A conventional preoperative treatment plan was devised for each patient following our Centre's standard protocol, and surgical splints were manufactured. These splints were used as study controls. The preoperative treatment plans devised were then transferred to a 3D-virtual environment on a personal computer (PC). Surgery was simulated, the prediction of results on soft and hard tissue produced, and surgical splints manufactured using CAD/CAM technology. In the operating room, both types of surgical splints were compared and the degree of similitude in results obtained in three planes was calculated. The maxillary osteotomy line was taken as the point of reference. The level of concordance was used to compare the surgical splints. Three months after surgery a second set of 3D images were obtained and used to obtain linear and angular measurements on screen. Using the Intraclass Correlation Coefficient these postoperative measurements were compared with the measurements obtained when predicting postoperative results. Results showed that a high degree of correlation in 15 of the 16 cases. A high coefficient of correlation was obtained in the majority of predictions of results in hard tissue, although less precise results were obtained in measurements in soft tissue in the labial area. The study shows that the software program used in the study is reliable for 3D planning and for the manufacture of surgical splints using CAD/CAM technology. Nevertheless, further progress in the development of technologies for the acquisition of 3D images, new versions of software programs

  10. The clinical utility of QSM: disease diagnosis, medical management, and surgical planning.

    Science.gov (United States)

    Eskreis-Winkler, Sarah; Zhang, Yan; Zhang, Jingwei; Liu, Zhe; Dimov, Alexey; Gupta, Ajay; Wang, Yi

    2017-04-01

    Quantitative susceptibility mapping (QSM) is an MR technique that depicts and quantifies magnetic susceptibility sources. Mapping iron, the dominant susceptibility source in the brain, has many important clinical applications. Herein, we review QSM applications in the diagnosis, medical management, and surgical treatment of disease. To assist in early disease diagnosis, QSM can identify elevated iron levels in the motor cortex of amyotrophic lateral sclerosis patients, in the substantia nigra of Parkinson's disease (PD) patients, in the globus pallidus, putamen, and caudate of Huntington's disease patients, and in the basal ganglia of Wilson's disease patients. Additionally, QSM can distinguish between hemorrhage and calcification, which could prove useful in tumor subclassification, and can measure microbleeds in traumatic brain injury patients. In guiding medical management, QSM can be used to monitor iron chelation therapy in PD patients, to monitor smoldering inflammation of multiple sclerosis (MS) lesions after the blood-brain barrier (BBB) seals, to monitor active inflammation of MS lesions before the BBB seals without using gadolinium, and to monitor hematoma volume in intracerebral hemorrhage. QSM can also guide neurosurgical treatment. Neurosurgeons require accurate depiction of the subthalamic nucleus, a tiny deep gray matter nucleus, prior to inserting deep brain stimulation electrodes into the brains of PD patients. QSM is arguably the best imaging tool for depiction of the subthalamic nucleus. Finally, we discuss future directions, including bone QSM, cardiac QSM, and using QSM to map cerebral metabolic rate of oxygen. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  11. Perianal fistulas in Crohn's disease: MRI diagnosis and surgical planning: MRI in fistulazing perianal Crohn's disease.

    Science.gov (United States)

    Szurowska, Edyta; Wypych, Joanna; Izycka-Swieszewska, Ewa

    2007-11-01

    Crohn's disease is a chronic, transmural inflammatory process of the gastrointestinal tract. It often affects the colon with the perianal area. The most common intestinal manifestations include external and/or internal fistulas and abscesses. Assessment of the activity of perianal fistulas in the course of Crohn's disease seems to be an important factor influencing therapeutic approach. Fistula's activity is evaluated by such methods as magnetic resonance imaging, anal ultrasound and examination under anaesthesia. Usefulness of imaging methods in the diagnosis of fistulas still remains to be defined.MRI is used to present a wide spectrum of perianal fistulazing Crohn's disease. Additionally, it is an important instrument revealing location, extent and severity of inflammation. It is also very helpful to detect clinically silent sepsis related to small, local inflammation. The most common method used in MR imaging to assess topography of a fistula's track, is Parks' classification.Clinical indications to MRI may include follow-up studies of a diagnosed disease, classification of fistulas' subtypes in the course of Crohn's disease, determination of the extent of fistulas' tracts and spread of an inflammatory process what can guide surgical procedures.

  12. Application of a new laser Doppler imaging system in planning and monitoring of surgical flaps

    Science.gov (United States)

    Schlosser, Stefan; Wirth, Raphael; Plock, Jan A.; Serov, Alexandre; Banic, Andrej; Erni, Dominique

    2010-05-01

    There is a demand for technologies able to assess the perfusion of surgical flaps quantitatively and reliably to avoid ischemic complications. The aim of this study is to test a new high-speed high-definition laser Doppler imaging (LDI) system (FluxEXPLORER, Microvascular Imaging, Lausanne, Switzerland) in terms of preoperative mapping of the vascular supply (perforator vessels) and postoperative flow monitoring. The FluxEXPLORER performs perfusion mapping of an area 9×9 cm with a resolution of 256×256 pixels within 6 s in high-definition imaging mode. The sensitivity and predictability to localize perforators is expressed by the coincidence of preoperatively assessed LDI high flow spots with intraoperatively verified perforators in nine patients. 18 free flaps are monitored before, during, and after total ischemia. 63% of all verified perforators correspond to a high flow spot, and 38% of all high flow spots correspond to a verified perforator (positive predictive value). All perfused flaps reveal a value of above 221 perfusion units (PUs), and all values obtained in the ischemic flaps are beneath 187 PU. In summary, we conclude that the present LDI system can serve as a reliable, fast, and easy-to-handle tool to detect ischemia in free flaps, whereas perforator vessels cannot be detected appropriately.

  13. Surgical Navigation

    DEFF Research Database (Denmark)

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

    2017-01-01

    were identified in the field of traumatology. Treatment of complex orbital fractures was considerably improved by the use of SN compared with traditionally treated control groups. Conclusions: SN seems to be a very promising addition to the surgical toolkit. Planning details of the surgical procedure...... in a 3-dimensional virtual environment and execution with real-time guidance can significantly improve precision. Among factors to be considered are the financial investments necessary and the learning curve....

  14. College and University Planning -- 1969. Selected Papers from Society for College and University Planning Annual Conference. (4th, Houston, Texas, August 17-20, 1969.)

    Science.gov (United States)

    Mayer, Frederick W., Ed.; Schmult, Carl V., Jr., Ed.

    Six major conference papers cover selected planning activities for eight institutions of higher education. Discussed are academic planning for the University of Houston; circulation, parking, and landscape planning for the University of California at Irvine; planning office organization and staffing at Harvard and Ohio State Universities; building…

  15. The medical exploration toolkit: an efficient support for visual computing in surgical planning and training.

    Science.gov (United States)

    Mühler, Konrad; Tietjen, Christian; Ritter, Felix; Preim, Bernhard

    2010-01-01

    Application development is often guided by the usage of software libraries and toolkits. For medical applications, the toolkits currently available focus on image analysis and volume rendering. Advance interactive visualizations and user interface issues are not adequately supported. Hence, we present a toolkit for application development in the field of medical intervention planning, training, and presentation--the MEDICALEXPLORATIONTOOLKIT (METK). The METK is based on the rapid prototyping platform MeVisLab and offers a large variety of facilities for an easy and efficient application development process. We present dedicated techniques for advanced medical visualizations, exploration, standardized documentation, adn interface widgets for common tasks. These include, e.g., advanced animation facilities, viewpoint selection, several illustrative rendering techniques, and new techniques for object selection in 3D surface models. No extended programming skills are needed for application building, since a graphical programming approach can be used. the toolkit is freely available and well documented to facilitate the use and extension of the toolkit.

  16. Cine computed tomography angiography evaluation of blood flow for full face transplant surgical planning.

    Science.gov (United States)

    Sisk, Geoffroy C; Kumamaru, Kanako K; Schultz, Kurt; Bueno, Ericka M; Diaz-Siso, J Rodrigo; George, Elizabeth; Redjaee, Marta M; Mitsouras, Dimitrios; Steigner, Michael L; Pomahac, Bohdan; Rybicki, Frank J

    2012-01-01

    Screening for full face transplantation candidates includes computed tomographic vascular mapping of the external carotid distribution for potential arterial and venous anastomoses. The purpose of this study is to illustrate the benefits and drawbacks of cine computed tomographic imaging for preoperative vascular mapping compared with best arterial and venous phase static images. Two image data sets were retrospectively created and compared for diagnostic findings. The first set of images was the clinical cine computed tomographic acquisition including all phases. The second set of images was composed of the best arterial and best venous phases extracted from the cine loop and determined by the quality of contrast enhancement. For each patient, the benefits and drawbacks of the cine loop were documented in consensus by a plastic surgeon and a radiologist. Cine loop analysis identified retrograde arterial filling not illustrated on the static images alone. Cine assessment identified most of the major vessels necessary for surgery, whereas the static images depicted small vessels more clearly, particularly in the crowded vessel takeoffs. Cine computed tomographic images provide data on direction of blood flow, which is important for preoperative planning. Combination of cine computed tomographic and the best static images will allow comprehensive vascular assessment necessary for future successful full face transplantation.

  17. Soft tissue models: easy and inexpensive flexible 3D printing as a help in surgical planning of cardiovascular disorders

    Science.gov (United States)

    Starosolski, Zbigniew; Ezon, David S.; Krishnamurthy, Rajesh; Dodd, Nicholas; Heinle, Jeffrey; Mckenzie, Dean E.; Annapragada, Ananth

    2017-03-01

    We developed a technology that allows a simple desktop 3D printer with dual extruder to fabricate 3D flexible models of Major AortoPulmonary Collateral Arteries. The study was designed to assess whether the flexible 3D printed models could help during surgical planning phase. Simple FDM 3D printers are inexpensive, versatile in use and easy to maintain, but complications arise when the designed model is complex and has tubular structures with small diameter less than 2mm. The advantages of FDM printers are cost and simplicity of use. We use precisely selected materials to overcome the obstacles listed above. Dual extruder allows to use two different materials while printing, which is especially important in the case of fragile structures like pulmonary vessels and its supporting structures. The latter should not be removed by hand to avoid a truncation of the model. We utilize the water soluble PVA as a supporting structure and Poro-Lay filament for flexible model of AortoPulmonary collateral arteries. Poro-Lay filament is different as compared to all the other flexible ones like polymer-based. Poro-Lay is rigid while printing and this allows printing of structures small in diameter. It achieves flexibility after washing out of printed model with water. It becomes soft in touch and gelatinous. Using both PVA and Poro-Lay gives a huge advantage allowing to wash out the supporting structures and achieve flexibility in one washing operation, saving time and avoiding human error with cleaning the model. We evaluated 6 models for MAPCAS surgical planning study. This approach is also cost-effective - an average cost of materials for print is less than $15; models are printed in facility without any delays. Flexibility of 3D printed models approximate soft tissues properly, mimicking Aortopulmonary collateral arteries. Second utilization models has educational value for both residents and patients' family. Simplification of 3D flexible process could help in other models

  18. New approach for virtual surgical planning and mandibular reconstruction using a fibula free flap.

    Science.gov (United States)

    Mottini, Matthias; Seyed Jafari, S M; Shafighi, Maziar; Schaller, Benoît

    2016-08-01

    Maxillofacial reconstruction poses a major challenge to surgeons because of the associated anatomical complexity, the sensitivity of the involved systems and the need to maintain a pleasing facial appearance. Here, we present a detailed description of a new method for extensive mandibular reconstruction using open-source virtual design software and a desktop 3D printer. A surgeon segmented preoperative computed tomography angiography scans with the Amira program to create a digital model of the mandible, skull and fibula. These datasets were imported into Blender, an open-source computer-aided design software package, where arrangement of the fibula segments into aligned sections was performed. Then, a desktop 3D printer was used to produce a reconstructed mandible. After fixation of a plate onto the reconstructed mandible, cutting guides were digitally designed using Blender. Following this, the surgeon performed mandible resection using the fixed cutting guides, which were 3D-printed using biocompatible plastic (Med 610/Stratasys Inc.) and fixed to the prebent reconstructed mandible at a predetermined position. After cutting the fibula with the help of the cutting guides and aligning the fibular segments into mandibular space, the surgeon fixed the segments to the reconstruction plate. Postoperatively, multislice computed tomography scans were taken for control purposes. Our method for mandibular reconstruction offers the following benefits: shorter operation planning time, increased accuracy during osteotomy through the use of a special fibula cutting guide and low costs. In brief, this method is an easy, precise and highly flexible technique for mandibular reconstruction with a fibula flap.

  19. The Efficacy and Utilisation of Preoperative Magnetic Resonance Imaging in Robot-assisted Radical Prostatectomy: Does it Change the Surgical Dissection Plan? A Preliminary Report

    Directory of Open Access Journals (Sweden)

    Hasan Hüseyin Tavukçu

    2015-06-01

    Full Text Available Purpose: We investigated the effect of prostate magnetic resonance imaging (MRI on the dissection plan of the neurovascular bundle and the oncological results of our patients who underwent robotic radical prostatectomy operation. Materials and Methods: We prospectively evaluated 30 consecutive patients, 15 of whom had prostate MRI before the operation, and 15 of whom did not. With the findings of MRI, the dissection plan was changed as intrafascial, interfascial, and extrafascial technique in the MRI group. Two groups were compared in terms of age, prostate-specific antigen (PSA, and Gleason scores (GSs. Surgical margin status was also checked with the final pathology. Results: There was no significant difference between the two groups in terms of age, PSA, biopsy GS, and final pathological GS. MRI changed the initial surgical plan to a nerve-sparing technique in 7 of the 15 patients. Only one patient in the MRI group had a positive surgical margin on bladder neck. MRI was confirmed as the primary tumour localisation in the final pathology in 93.3% of patients. Conclusion: Preoperative prostate MRI influenced the decision to carry out a nerve-sparing technique in 46% of the patients in our study; however, the change to a nerve-sparing technique did not seem to compromise the surgical margin positivity.

  20. Application of 3D Printing in the Surgical Planning of Trimalleolar Fracture and Doctor-Patient Communication

    Directory of Open Access Journals (Sweden)

    Long Yang

    2016-01-01

    Full Text Available To evaluate the effect of 3D printing in treating trimalleolar fractures and its roles in physician-patient communication, thirty patients with trimalleolar fractures were randomly divided into the 3D printing assisted-design operation group (Group A and the no-3D printing assisted-design group (Group B. In Group A, 3D printing was used by the surgeons to produce a prototype of the actual fracture to guide the surgical treatment. All patients underwent open reduction and internal fixation. A questionnaire was designed for doctors and patients to verify the verisimilitude and effectiveness of the 3D-printed prototype. Meanwhile, the operation time and the intraoperative blood loss were compared between the two groups. The fracture prototypes were accurately printed, and the average overall score of the verisimilitude and effectiveness of the 3D-printed prototypes was relatively high. Both the operation time and the intraoperative blood loss in Group A were less than those in Group B (P<0.05. Patient satisfaction using the 3D-printed prototype and the communication score were 9.3±0.6 points. A 3D-printed prototype can faithfully reflect the anatomy of the fracture site; it can effectively help the doctors plan the operation and represent an effective tool for physician-patient communication.

  1. Surgical Versus Orthodontic Correction for Class II Patients: Age and Severity in Treatment Planning and Treatment Outcome

    Science.gov (United States)

    Camilla Tulloch, J. F.; Lenz, Brent E.; Phillips, Ceib

    2013-01-01

    Treatment options for Class II malocclusion include orthognathic surgery. Treatment choices are particularly difficult for young patients because of the uncertainty regarding future growth. Surgical treatment has generally been considered necessary for older patients with more severe Class II problems. The treatment records of more than 500 patients with Class II malocclusion were reviewed. Patients were grouped according to their initial treatment plan (surgery or orthodontics) and treatment outcome (overjet [OJ] reduced to function analyses using data from the patient’s pretreatment cephalogram were used to determine whether age, in combination with malocclusion severity, could predict the choice of treatment, and whether a simple set of pretreatment variables could predict the success or failure of OJ reduction. The derived equations were tested in a similar group of growing Class II children. Although the data showed clinicians use patient’s age in determining treatment choice, age did not seem to be associated with treatment outcome. The majority of the variability that determined the success or failure of OJ reduction was not explained by patient’s age or malocclusion severity. These findings suggest other factors, including psychosocial variables, need to be explored if we are to gain a better understanding of why treatments succeed or fail. PMID:10860060

  2. Application of 3D Printing in the Surgical Planning of Trimalleolar Fracture and Doctor-Patient Communication.

    Science.gov (United States)

    Yang, Long; Shang, Xian-Wen; Fan, Jian-Nan; He, Zhi-Xu; Wang, Jian-Ji; Liu, Miao; Zhuang, Yong; Ye, Chuan

    2016-01-01

    To evaluate the effect of 3D printing in treating trimalleolar fractures and its roles in physician-patient communication, thirty patients with trimalleolar fractures were randomly divided into the 3D printing assisted-design operation group (Group A) and the no-3D printing assisted-design group (Group B). In Group A, 3D printing was used by the surgeons to produce a prototype of the actual fracture to guide the surgical treatment. All patients underwent open reduction and internal fixation. A questionnaire was designed for doctors and patients to verify the verisimilitude and effectiveness of the 3D-printed prototype. Meanwhile, the operation time and the intraoperative blood loss were compared between the two groups. The fracture prototypes were accurately printed, and the average overall score of the verisimilitude and effectiveness of the 3D-printed prototypes was relatively high. Both the operation time and the intraoperative blood loss in Group A were less than those in Group B (P < 0.05). Patient satisfaction using the 3D-printed prototype and the communication score were 9.3 ± 0.6 points. A 3D-printed prototype can faithfully reflect the anatomy of the fracture site; it can effectively help the doctors plan the operation and represent an effective tool for physician-patient communication.

  3. 3D virtual planning in orthognathic surgery and CAD/CAM surgical splints generation in one patient with craniofacial microsomia: a case report

    Directory of Open Access Journals (Sweden)

    Francisco Vale

    2016-02-01

    Full Text Available Objective: In this case report, the feasibility and precision of tridimensional (3D virtual planning in one patient with craniofacial microsomia is tested using Nemoceph 3D-OS software (Software Nemotec SL, Madrid, Spain to predict postoperative outcomes on hard tissue and produce CAD/CAM (Computer Aided Design/Computer Aided Manufacturing surgical splints. Methods: The clinical protocol consists of 3D data acquisition of the craniofacial complex by cone-beam computed tomography (CBCT and surface scanning of the plaster dental casts. The ''virtual patient'' created underwent virtual surgery and a simulation of postoperative results on hard tissues. Surgical splints were manufactured using CAD/CAM technology in order to transfer the virtual surgical plan to the operating room. Intraoperatively, both CAD/CAM and conventional surgical splints are comparable. A second set of 3D images was obtained after surgery to acquire linear measurements and compare them with measurements obtained when predicting postoperative results virtually. Results: It was found a high similarity between both types of surgical splints with equal fitting on the dental arches. The linear measurements presented some discrepancies between the actual surgical outcomes and the predicted results from the 3D virtual simulation, but caution must be taken in the analysis of these results due to several variables. Conclusions: The reported case confirms the clinical feasibility of the described computer-assisted orthognathic surgical protocol. Further progress in the development of technologies for 3D image acquisition and improvements on software programs to simulate postoperative changes on soft tissue are required.

  4. Status of cardiac surgical intensive care medicine in Germany during 2013: a report on behalf of the German Society for Thoracic and Cardiovascular Surgery.

    Science.gov (United States)

    Markewitz, Andreas; Trummer, Georg; Pilarczyk, Kevin; Beckmann, Andreas

    2014-10-01

    This report summarizes the results of a voluntary survey designed to assess the current situation of cardiac surgical intensive care medicine in Germany in 2013. standardized questionnaire concerning detailed information about structural characteristics of cardiac surgical intensive care units (ICUs) was sent to all German departments performing cardiac surgery. Participation quota resp. response rate was 100%. Compared with previous surveys since 1998, the total number of available intensive care capacities for patients after cardiac surgery increased to 1,404 beds, whereas the proportion of cardiac surgical ICUs decreased to 59% with a simultaneous increase of interdisciplinary ICUs. The proportion of cardiac surgeons acting as director of an ICU declined to 36%. The physicians' teams were predominantly interdisciplinary (74%). More than half of the directors were board-certified intensivists (54%), with a peak of 81% in ICUs run by cardiac surgeons. Human resources development in the ICU showed divergent trends with an increase of physicians and a decrease of nurses. Half of all ICUs (50%) and two-thirds of cardiac surgical ICUs (65%) offer an accredited training program for intensive care medicine. The results of this survey corroborate that intensive care medicine represents a substantial and important part of cardiac surgery. However, efforts are necessary to keep this attitude alive for the future. Georg Thieme Verlag KG Stuttgart · New York.

  5. Corrective Osteotomy for Malunited Diaphyseal Forearm Fractures Using Preoperative 3-Dimensional Planning and Patient-Specific Surgical Guides and Implants.

    Science.gov (United States)

    Byrne, Ann-Maria; Impelmans, Bianca; Bertrand, Veronique; Van Haver, Annemieke; Verstreken, Frederik

    2017-07-11

    Three-dimensional planning based on computed tomography images of the malunited and the mirrored contralateral forearm allows preoperative simulations of corrective osteotomies, the fabrication of patient-specific osteotomy guides, and custom-made 3-dimensional printed titanium plates. This study aims to assess the precision and clinical outcome of this technique. This was a prospective pilot study with 5 consecutive patients. The mean age at initial injury was 11 years (range, 4-16 years), and the mean interval from the time of injury to the time of corrective surgery was 32 months (range, 7-107 months). Patient-specific osteotomy guides and custom-made plates were used for multiplanar corrective osteotomies of both forearm bones at the distal level in 1 patient and at the middle-third level in 4 patients. Patients were assessed before and after surgery after a mean follow-up of 42 months (range, 29-51 months). The mean planned angular corrections of the ulna and radius before surgery were 9.9° and 10.0°, respectively. The mean postoperative corrections obtained were 10.1° and 10.8° with corresponding mean errors in correction of 1.8° (range, 0.3°-5.2°) for the ulna and 1.4° (range, 0.2°-3.3°) for the radius. Forearm supination improved significantly from 47° (range, 25°-75°) before surgery to 89° (range, 85°-90°) at final review. Forearm pronation improved from 68° (range, 45°-84°) to 87° (range, 82°-90°). In addition, there was a statistically significant improvement in pain and grip strength. This study demonstrates that 3-dimensional planned patient-specific guides and implants allow the surgeon to perform precise corrective osteotomies of complex multiplanar forearm deformities with satisfactory preliminary results. Therapeutic V. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  6. Usage of fMRI for pre-surgical planning in brain tumor and vascular lesion patients: Task and statistical threshold effects on language lateralization

    Directory of Open Access Journals (Sweden)

    Tanvi N. Nadkarni

    2015-01-01

    Conclusion: Our results suggest that the type of task and the applied statistical threshold influence LI and that the threshold effects on LI may be task-specific. Thus identifying critical functional regions and computing LIs should be conducted on an individual subject basis, using a continuum of threshold values with different tasks to provide the most accurate information for surgical planning to minimize post-operative language deficits.

  7. Perioperative management of antiplatelet therapy in patients with coronary stents undergoing cardiac and non-cardiac surgery: a consensus document from Italian cardiological, surgical and anaesthesiological societies.

    Science.gov (United States)

    Rossini, Roberta; Musumeci, Giuseppe; Visconti, Luigi Oltrona; Bramucci, Ezio; Castiglioni, Battistina; De Servi, Stefano; Lettieri, Corrado; Lettino, Maddalena; Piccaluga, Emanuela; Savonitto, Stefano; Trabattoni, Daniela; Capodanno, Davide; Buffoli, Francesca; Parolari, Alessandro; Dionigi, Gianlorenzo; Boni, Luigi; Biglioli, Federico; Valdatta, Luigi; Droghetti, Andrea; Bozzani, Antonio; Setacci, Carlo; Ravelli, Paolo; Crescini, Claudio; Staurenghi, Giovanni; Scarone, Pietro; Francetti, Luca; D'Angelo, Fabio; Gadda, Franco; Comel, Andrea; Salvi, Luca; Lorini, Luca; Antonelli, Massimo; Bovenzi, Francesco; Cremonesi, Alberto; Angiolillo, Dominick J; Guagliumi, Giulio

    2014-05-01

    Optimal perioperative antiplatelet therapy in patients with coronary stents undergoing surgery still remains poorly defined and a matter of debate among cardiologists, surgeons and anaesthesiologists. Surgery represents one of the most common reasons for premature antiplatelet therapy discontinuation, which is associated with a significant increase in mortality and major adverse cardiac events, in particular stent thrombosis. Clinical practice guidelines provide little support with regard to managing antiplatelet therapy in the perioperative phase in the case of patients with non-deferrable surgical interventions and/or high haemorrhagic risk. Moreover, a standard definition of ischaemic and haemorrhagic risk has never been determined. Finally, recommendations shared by cardiologists, surgeons and anaesthesiologists are lacking. The present consensus document provides practical recommendations on the perioperative management of antiplatelet therapy in patients with coronary stents undergoing surgery. Cardiologists, surgeons and anaesthesiologists have contributed equally to its creation. On the basis of clinical and angiographic data, the individual thrombotic risk has been defined. All surgical interventions have been classified according to their inherent haemorrhagic risk. A consensus on the optimal antiplatelet regimen in the perioperative phase has been reached on the basis of the ischaemic and haemorrhagic risk. Aspirin should be continued perioperatively in the majority of surgical operations, whereas dual antiplatelet therapy should not be withdrawn for surgery in the case of low bleeding risk. In selected patients at high risk for both bleeding and ischaemic events, when oral antiplatelet therapy withdrawal is required, perioperative treatment with short-acting intravenous glycoprotein IIb/IIIa inhibitors (tirofiban or eptifibatide) should be taken into consideration.

  8. [Consensus statement of the National AIDS Plan Secretariat, Spanish Society of Emergency Medicine and AIDS Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology on Emergency and Human Immunodeficiency Virus Infection].

    Science.gov (United States)

    2013-01-01

    Supporting non-HIV specialist professionals in the treatment of patients with urgent diseases resulting from HIV infection. These recommendations have been agreed by an expert panel from the National AIDS Plan Secretariat, the Spanish Society of Emergency Medicine, and the AIDS Study Group. A review has been made of the safety and efficacy results of clinical trials and cohort studies published in biomedical journals (PubMed and Embase) or presented at conferences. The strength of each recommendation (A, B, C) and the level of supporting evidence (I, II, III) are based on a modification of the criteria of the Infectious Diseases Society of America. The data to be collected from the emergency medical history in order to recognize the patient at risk of HIV infection were specified. It stressed the basic knowledge of ART principles and its importance in terms of decline in morbidity and mortality of HIV+ patients and referring to the HIV specialist for follow-up, where appropriate, including drug interactions. Management of different emergency situations that may occur in patients with HIV infection is also mentioned. The non-HIV specialist professional, will find the necessary tools to approach HIV patients with an emergency disease. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  9. Surgical innovation as sui generis surgical research.

    Science.gov (United States)

    Lotz, Mianna

    2013-12-01

    Successful innovative 'leaps' in surgical technique have the potential to contribute exponentially to surgical advancement, and thereby to improved health outcomes for patients. Such innovative leaps often occur relatively spontaneously, without substantial forethought, planning, or preparation. This feature of surgical innovation raises special challenges for ensuring sufficient evaluation and regulatory oversight of new interventions that have not been the subject of controlled investigatory exploration and review. It is this feature in particular that makes early-stage surgical innovation especially resistant to classification as 'research', with all of the attendant methodological and ethical obligations--of planning, regulation, monitoring, reporting, and publication--associated with such a classification. This paper proposes conceptual and ethical grounds for a restricted definition according to which innovation in surgical technique is classified as a form of sui generis surgical 'research', where the explicit goal of adopting such a definition is to bring about needed improvements in knowledge transfer and thereby benefit current and future patients.

  10. Gender Planning and Vocational Education, and Technical Training in Palestine: An Initial Framework. Gender and Society Working Paper #4.

    Science.gov (United States)

    Nahleh, Lamis Abu

    Gender planning and vocational education and technical training (VETT) in Palestine were examined through the following: review of available literature and policy-oriented reports, discussions with educators in the field, and roundtable discussion in which representatives of the Palestinian Ministry of Education and Ministry of Labor and experts…

  11. Landscape architecture between politics and science : an integrative perspective on landscape planning and design in the network society

    NARCIS (Netherlands)

    Jonge, de J.M.

    2009-01-01

    This thesis examines the typical nature of design thinking, which is compared and contrasted with scientific and political thinking. A theretical framework is formulated and applied to landscape planning and design. During the 20th century the established operational orientation in landscape

  12. Foraminal deposition of calcium pyrophosphate dihydrate crystals in the thoracic spine: possible relationship with disc herniation and implications for surgical planning. Report of two cases.

    Science.gov (United States)

    Paolini, Sergio; Ciappetta, Pasquale; Guiducci, Antonio; Principi, Massimo; Missori, Paolo; Delfini, Roberto

    2005-01-01

    The authors report two cases of nodular calcium pyrophosphate dihydrate (CPPD) crystal deposition close to the thoracic neural foramen, which caused chronic radiculopathy. Preoperatively, the lesions were interpreted as calcified disc herniations. Both patients underwent surgery in which an extended transfacet pedicle-sparing approach was used. Incision of the posterior longitudinal ligament released soft degenerated material. In both cases, histological examination showed abundant degenerative debris along with CPPD crystals. Spinal CPPD deposition is a comparatively rare disease that almost invariably involves the posterior aspect of the spinal canal, typically the ligamentum flavum. The exceptional foraminal location of the lesions reported here, combined with the surgical findings, indicated that the CPPD crystals were deposited on a laterally herniated disc fragment. A distinctive feature in both cases was the soft consistency of the resected tissue. The consistency of the disc material and the location of the lesion in the axial plane (that is, median compared with lateral) are key factors in determining the optimal surgical approach to thoracic disc herniations. In describing consistency, terms such as "calcified" and "hard" have been used interchangeably in the literature. In the cases reported here, what appeared on computerized tomography and magnetic resonance imaging studies to be densely calcified lesions were shown intraoperatively to be soft herniations. The authors' experience underscores that not all densely calcified herniated discs are hard. Although detection of this discrepancy would have left surgical planning for the lateral disc herniations unchanged, it could have altered planning for centrally or centrolaterally located disc herniations.

  13. Surgical planning and microvascular reconstruction of the mandible with a fibular flap using computer-aided design, rapid prototype modelling, and precontoured titanium reconstruction plates: a prospective study.

    Science.gov (United States)

    Sieira Gil, R; Roig, A Marí; Obispo, C Arranz; Morla, A; Pagès, C Martí; Perez, J Llopis

    2015-01-01

    The standard of mandibular reconstruction has increased since the introduction of computer-assisted design (CAD) and rapid prototype modelling (RPM) for surgical planning. Between 2008 and 2013, a prospective pilot study of 20 patients was planned to compare the outcomes of patients treated by mandibular reconstruction who had CAD and RPM-guided operations using a precontoured titanium plate, with the outcomes of patients treated conventionally. We recorded the time taken for reconstruction, total operating time, and whether this type of planning could improve the results of mandibular reconstruction. We found significant differences in the incidence of dental malocclusion (p=0.03) and exposure of the titanium plate (p=0.009). The mean operating time for reconstruction in the preoperative planning group was 135 (37)min compared with 176 (58)min in the conventional group (p=0.04). Preoperative planning using CAD and RPM can increase the accuracy of microvascular mandibular reconstruction and reduce the operating time for reconstruction. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Medical oncology future plan of the Spanish Society of Medical Oncology: challenges and future needs of the Spanish oncologists.

    Science.gov (United States)

    Rivera, F; Andres, R; Felip, E; Garcia-Campelo, R; Lianes, P; Llombart, A; Piera, J M; Puente, J; Rodriguez, C A; Vera, R; Virizuela, J A; Martin, M; Garrido, P

    2017-04-01

    The SEOM Future Plan is aimed at identifying the main challenges, trends and needs of the medical oncology speciality over the next years, including potential oncologist workforce shortages, and proposing recommendations to overcome them. The estimations of the required medical oncologists workforce are based on an updated Medical Oncologist Register in Spain, Medical Oncology Departments activity data, dedication times and projected cancer incidence. Challenges, needs and future recommendations were drawn from an opinion survey and an advisory board. A shortage of 211 FTE medical oncologist specialists has been established. To maintain an optimal ratio of 158 new cases/FTE, medical oncology workforce should reach 1881 FTE by 2035. Main recommendations to face the growing demand and complexity of oncology services include a yearly growth of 2.5% of medical oncologist's workforce until 2035, and development and application of more accurate quality indicators for cancer care and health outcomes measure.

  15. The Impact of Social and Cultural Difference in Relation to Job Loss and Financial Planning: Reflections on the Risk Society

    Directory of Open Access Journals (Sweden)

    David Abbott

    2006-01-01

    Full Text Available This paper is based on data collected as part of a research study which looks at how different social and cultural groups frame, and respond to, the risk of income and/or job loss. Writers like LASH, DOUGLAS and LUPTON have placed an emphasis on the importance of group membership and social categories in structuring response to different types of risk preferring to talk about "risk cultures" rather than "risk society". However, the writers acknowledge that there is little empirical research which explores this. As the first stage of our research, focus groups in two parts of the UK explored the relationship between risk and social difference with an emphasis on the risk of job or income loss. The groups were comprised of lesbian, gay and bisexual people; people from Black and Minority Ethnic backgrounds; Disabled people; and, people who actively practice a religion. Participants did not see strong links between their sexuality, race, or religion and their perceptions of, or responses to, risk. Income, and attitudinal factors were cited as being more important. Disabled people however were much more likely to make connections between being disabled and a range of barriers to responding to risky situations. URN: urn:nbn:de:0114-fqs0601160

  16. A novel combination of printed 3-dimensional anatomic templates and computer-assisted surgical simulation for virtual preoperative planning in Charcot foot reconstruction.

    Science.gov (United States)

    Giovinco, Nicholas A; Dunn, S Patrick; Dowling, Leslie; Smith, Clifford; Trowell, Larry; Ruch, John A; Armstrong, David G

    2012-01-01

    Charcot foot syndrome (Charcot neuroarthropathy affecting the foot), particularly in its latter stages, may pose a significant technical challenge to the surgeon. Because of the lack of anatomic consistency, preoperative planning with virtual and physical models of the foot could improve the chances of achieving a predictable intraoperative result. In this report, we describe the use of a novel, inexpensive, 3-dimensional template printing technique that can provide, with just a normal printer, multiple "copies" of the foot to be repaired. Although we depict this method as it pertains to repair of the Charcot foot, it could also be used to plan and practice, or revise, 3-dimensional surgical manipulations of other complex foot deformities.

  17. Reproductive planning in times of Zika: getting pregnant or delaying plans? The opinion of the Brazilian Society of Assisted Reproduction Committee - a basis for a bioethical discussion.

    Science.gov (United States)

    Carvalho, Bruno R de; Taitson, Paulo F; Brandão, Karina S A G; Ferriani, Rui Alberto; Nakagawa, Hitomi M; Silva, Adelino A; Lopes, Joaquim R C

    2016-08-01

    Although the causality between Zika virus, microcephaly, and other central nervous system disorders has been taken for granted by the scientific community, many uncertainties remain. The gap of knowledge at the moment is large enough to remove part of the confidence physicians have on the advice given to patients - and infertile women in particular - on their reproductive plans. Pretreatment serologic screening is a possible strategy to offer more confidence for individuals choosing to bear children regardless of the Zika virus, but the tests currently available do not seem to be sufficiently adequate. Until now, there is no formal recommendation to avoid pregnancy solely because of the Zika virus outbreak, and the choice of becoming pregnant has been regarded as a personal decision to be made by each woman and her family.

  18. 老龄社会生育政策新内涵%New Connotation of Family Planning Policy in Aging Society

    Institute of Scientific and Technical Information of China (English)

    胡乃军; 于淼

    2013-01-01

    在老龄社会,生育政策必须与国家人力资源发展规划相匹配。本文运用人口数据建立老龄化的时间表,代入计划生育政策变量,建立预测和分析模型,观察其对人口总量和人口结构的影响,论证了二胎间隔生育政策的必要性。继而运用典型案例分析方法进一步证明二胎间隔生育政策的可行性,由此推论生育政策内涵从“节制生育”到“调节人口结构和控制总量”的新内涵转变及其实现路径。%In aging society, family planning policy must be matched to the national human resource development planning. To demonstrate the necessity of the two-child policy, this paper first uses population data to form an aging timetable and establish the forecasting and analytical model to observe the impact of family planning policy on total population and population structure. Then the paper further demonstrates the feasibility of two-child policy by a case study. Based on the above analysis, one can draw a conclusion that the connotation of family planning policy should be changed from“birth control”to“adjusting population structure and controlling the total population”. Finally, the ways of implementation are discussed.

  19. Support and Dissemination of Teacher-Authored Lesson Plans: a Digital Library for Earth System Education (DLESE) and Geological Society of America (GSA) Collaboration

    Science.gov (United States)

    Devaul, H.; Pandya, R. E.; McLelland, C. V.

    2003-12-01

    The Digital Library for Earth System Education (www.dlese.org) and the Geological Society of America (www.geosociety.org) are working together to publish and disseminate teacher-authored Earth science lesson plans. DLESE is a community-based effort involving teachers, students, and scientists working together to create a library of educational resources and services to support Earth system science education. DLESE offers free access to electronic resources including lesson plans, maps, images, data sets, visualizations, and assessment activities. A number of thematic collections have recently been accessioned, which has substantially increased library holdings. Working in concert with GSA, a non-profit organization dedicated to the advancement of the geosciences, small-scale resource creators such as classroom teachers without access to a web server can also share educational resources of their own design. Following a two-step process, lesson plans are submitted to the GSA website, reviewed and posted to the K-12 resource area: http://www.geosociety.org/educate/resources.htm. These resources are also submitted to the DLESE Community Collection using a simple cataloging tool. In this way resources are available to other teachers via the GSA website as well as via the DLESE collection. GSA provides a template for lesson plan developers which assists in providing the necessary information to help users find and understand the intent of the activity when searching in DLESE. This initial effort can serve as a prototype for important services allowing individual community members to contribute their work to DLESE with little technical overhead.

  20. The application of the theory of planned behavior to help-seeking intention in a Chinese society.

    Science.gov (United States)

    Mak, Hio Wa; Davis, J Mark

    2014-09-01

    This study tested the efficacy of Ajzen's theory of planned behavior (TPB) in explaining intention to seek mental health services and compared the traditional TPB model with a TPB partial mediation model. It also aimed to understand factors related to intention to seek mental health services in Macao to inform local policies. The present study consisted of two phases: (a) a pilot study to develop belief-based measures used in the main study, and (b) a cross-sectional study to investigate the application of TPB in understanding help-seeking intention. In the main study, 337 Macao residents (age range 18-65) participated in a survey conducted in the community. The TPB partial mediation model was better than the traditional TPB model in explaining help-seeking intention in Macao. The model also suggested that attitude, subjective norm, and perceived behavioral control were all significant predictors of help-seeking intention. However, symptom severity, prior help-seeking, and gender did not significantly directly predict help-seeking intention. Preference for the TPB partial mediation model may be culturally relevant. The implications of the findings are discussed in relation to the salient beliefs about help-seeking. Limitations and recommendations for future research are provided.

  1. A systematic investigation of the invariance of resting-state network patterns: is resting-state fMRI ready for pre-surgical planning?

    Science.gov (United States)

    Kollndorfer, K; Fischmeister, F Ph S; Kasprian, G; Prayer, D; Schöpf, V

    2013-01-01

    Measurements of resting-state networks (RSNs) have been used to investigate a wide range of diseases, such as dementia or epilepsy. This raises the question whether this method could also serve as a pre-surgical planning tool. Generating reliable functional connectivity patterns is of crucial importance, particularly for pre-surgical planning, as these patterns may directly affect the outcome. This study investigated the reproducibility of four commonly used resting-state conditions: fixation of a black crosshair on a white screen; fixation of the center of a black screen; eyes-closed and fixation of the words "Entspann dich!" (Engl., "relax"). Ten healthy, right-handed male subjects (mean age, 25 years; SD 2) participated in the experiment. The spatial overlap for different RSNs across the four conditions was calculated. The spatial overlap across all four conditions was calculated for each seed region on a single subject and at the group level. Activation maps at the single-subject and group levels were highly stable, especially for the reading network (RNW). The lowest consistency measures were found for the visual network (VIN). At the single-subject level spatial overlap values ranged from 0.31 (VIN) to 0.45 (RNW). These findings suggest that RSN measurements are a reliable tool to assess language-related networks in clinical settings. Generally, resting-state conditions showed comparable activation patterns, therefore no specific conditions appears to be preferable.

  2. The utility of 3D printing for surgical planning and patient-specific implant design for complex spinal pathologies: case report.

    Science.gov (United States)

    Mobbs, Ralph J; Coughlan, Marc; Thompson, Robert; Sutterlin, Chester E; Phan, Kevin

    2017-04-01

    OBJECTIVE There has been a recent renewed interest in the use and potential applications of 3D printing in the assistance of surgical planning and the development of personalized prostheses. There have been few reports on the use of 3D printing for implants designed to be used in complex spinal surgery. METHODS The authors report 2 cases in which 3D printing was used for surgical planning as a preoperative mold, and for a custom-designed titanium prosthesis: one patient with a C-1/C-2 chordoma who underwent tumor resection and vertebral reconstruction, and another patient with a custom-designed titanium anterior fusion cage for an unusual congenital spinal deformity. RESULTS In both presented cases, the custom-designed and custom-built implants were easily slotted into position, which facilitated the surgery and shortened the procedure time, avoiding further complex reconstruction such as harvesting rib or fibular grafts and fashioning these grafts intraoperatively to fit the defect. Radiological follow-up for both cases demonstrated successful fusion at 9 and 12 months, respectively. CONCLUSIONS These cases demonstrate the feasibility of the use of 3D modeling and printing to develop personalized prostheses and can ease the difficulty of complex spinal surgery. Possible future directions of research include the combination of 3D-printed implants and biologics, as well as the development of bioceramic composites and custom implants for load-bearing purposes.

  3. 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. ...

  4. Planning geological underground repositories - Communicating with society; Sachplan geologische Tiefenlager - Forschungsprojekt 'Kommunikation mit der Gesellschaft': Wissenschaftlicher Schlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Schenkel, W. [synergo, Mobilitaet-Politik-Raum, Zuerich (Switzerland); Gallego Carrera, D.; Renn, O.; Dreyer, M. [Dialogik gemeinnuetzige GmbH, Kommunikations- und Kooperationsforschung, Stuttgart (Germany)

    2009-06-15

    The project 'Planning geological underground repositories: Communicating with society', financed by the Swiss Federal Office for Energy, aimed at identifying basic principles for an appropriate information and communication strategy in the process of finding an underground site to store radioactive wastes. The topic concerns an issue increasingly discussed in modern societies: How to improve the dialogue between science, infrastructure operators, public authorities, groups in civil society and the population to answer complex problems? Against this background, in the project the following questions were taken into account: (i) How can the dialogue between science, politics, economy, and the (non-)organised public be arranged appropriately? Which principles are to be considered in organising this process? How can distrust within the population be reduced and confidence in authorities and scientific expertise be increased? (ii) How can society be integrated in the process of decision-making so that this process is perceived as comprehensible, acceptable and legitimate? To answer these questions, an analysis method based on scientific theory and methodology was developed, which compares national participation and communication processes in finding underground storage sites in selected countries. Case studies have been carried out in Germany, Sweden, Belgium, and Switzerland. By using specific criteria to evaluate communication processes, the strong points as well as the drawbacks of the country-specific concepts of information, communication and participation have been analysed in a comparing dimension. By taking into account the outcomes, prototypical scenarios have been deduced that can serve as a basis for compiling a reference catalogue of measures, which is meant to support the Swiss communication strategy in the finding of an appropriate site for a nuclear waste repository. Following conclusions can be drawn from the international comparison: (i) Open

  5. Hazard responses in the pre-industrial era: vulnerability and resilience of traditional societies to volcanic disasters and the implications for present-day disaster planning

    Science.gov (United States)

    Sangster, Heather

    2014-05-01

    A major research frontier in the study of natural hazard research involves unravelling the ways in which societies have reacted historically to disasters, and how such responses influence current policies of disaster reduction. For societies it is common to classify responses to natural hazards into: pre-industrial (folk); industrial; and post-industrial (comprehensive) responses. Pre-industrial societies are characterised by: a pre-dominantly rural location; an agricultural economic focus; artisan handicrafts rather than industrial production, parochialism, with people rarely travelling outside their local area and being little affected by external events and a feudal or semi-feudal social structure. In the past, hazard assessment focused on the physical processes that produced extreme and potentially damaging occurrences, however from the middle of the twenty-first century research into natural hazards has been cast within a framework defined by the polarities (or opposites) of vulnerability and resilience, subject to a blend of unique environmental, social, economic and cultural forces in hazardous areas, that either increase or decrease the impact of extreme events on a given society. In the past decade research of this type has been facilitated by a 'revolution' of source materials across a range of languages and in a variety of electronic formats (e.g. official archives; major contemporary and near-contemporary publications - often available as reprints; national and international newspapers of record; newsreel-films; and, photographs) and in the introduction of more reliable translation software (e.g. Systrans) that provides far more scope to the researcher in the study of natural hazards than was the case even a few years ago. Knowledge of hazard responses in the pre-industrial era is, not only important in its own right because it reveals indigenous strategies of coping, but also informs present-day disaster planners about how people have reacted to past

  6. Reliability Of A Surgeon-Reported Morbidity And Mortality Database: A Comparison Of Short-Term Morbidity Between The Scoliosis Research Society And National Surgical Quality Improvement Program Databases

    Science.gov (United States)

    Martin, Christopher T.; Pugely, Andrew J.; Gao, Yubo; Skovrlj, Branko; Lee, Nathan J.; Cho, Samuel K.; Mendoza-Lattes, Sergio

    2016-01-01

    Background There exists a lack of comparison between large national healthcare databases reporting surgical morbidity and mortality. Prior authors have expressed concern that the Scoliosis Research Society (SRS) membership may have underreported complications in spinal surgery. Thus, the purpose of the present study was to compare the incidence of morbidity between the SRS and National Surgical Quality Improvement Program (NSQIP) databases. Methods We reviewed patients enrolled between 2012 and 2013, with a total of 96,875 patients identified in the SRS dataset and 15,909 in the combined adult and pediatric NSQIP dataset. Patients were matched based on diagnostic category,and a univariate analysis was used to compare reported complication rates in the categories of perioperative infection, neurologic injury, and mortality. The SRS database only requires detailed demographic data reporting on patients that have had a complication event. We compared the demographics and comorbidities of this subgroup, and used this as a surrogate to assess the potential magnitude of confounders. Results Small differences existed between the SRS and NSQIP databases in terms of mortality (0.1% v. 0.2%), infection (1.2% v. 2%), and neurologic injury (0.8% v. 0.1%) (p<0.001 for each comparison). Infection rates were consistently lower across multiple diagnostic sub-categories in the SRS database, whereas neurologic injury rates were consistently lower in the NSQIP database. These differences reached statistical significance across several diagnostic subcategories, but the clinical magnitude of the differences was small. Amongst the patients with a complication, modest differences in comorbidities existed between the two cohorts. Conclusion Overall, the incidence of short-term morbidity and mortality was similar between the two databases. There were modest differences in comorbidities, which may explain the small differences observed in morbidity. Concerns regarding possible under

  7. Flapless surgery and immediately loaded implants: a retrospective comparison between implantation with and without computer-assisted planned surgical stent.

    Science.gov (United States)

    Danza, Matteo; Carinci, Francesco

    2010-01-01

    Computer planned flapless surgery and immediate loading are the most recent topics in implantology. One new computer-planned implant system uses a three-dimensional parallelometer able to transfer the implant position from the virtual project to the master model. The aim of this study was to verify if the new medical device gives an advantage in term of implant failures and/or crestal bone remodeling. A retrospective study was planned to analyze a series of 193 immediately loaded fixtures inserted by means of flapless surgery. From those sixty six implants were inserted with computer planning whereas 127 were inserted "free-hand". Several variables related to patient, anatomy, implant, surgery and prosthesis were investigated. To detect the clinical outcome implant' failure and peri-implant bone resorption were considered. Kaplan-Meier algorithm and Cox regression were then performed to detect those variables statistically associated with the clinical outcome. Implant length and diameter ranged from 10 to 16 mm and from 3.75 to 6.0 mm, respectively. Implants were inserted to replace 46 incisors, 30 cuspids, 75 premolars and 42 molars. The mean follow-up period was 15 months. Seven implants were lost (survival rate 96.4%) but no studied variable has a statistical impact on failures. On the contrary, implants inserted in sites with completed bone healing, wide diameter fixtures and implants inserted in totally edentulous jaw had a significantly lower crestal bone resorption. The other variables (age, gender, upper/lower jaws, tooth site, implant' type and length, number of prosthetic units antagonist condition) did not have impact on crestal remodeling. Computer-planned and cast model transferred implantology is a reliable technology that provides a slightly higher clinical outcome than "free hand" technique at least in healed sites, wider implants and totally edentulous jaws.

  8. Magnetic resonance imaging depiction of tight iliotibial band in melorheostosis associated with severe external rotation deformity, limb shortening and patellar dislocation in planning surgical correction

    Energy Technology Data Exchange (ETDEWEB)

    Osgood, Greg M.; Lee, Francis Young-In [Department of Orthopaedic Surgery, College of Physicians and Surgeons of Columbia University, New York, NY (United States); Parisien, May V. [Department of Pathology, College of Physicians and Surgeons of Columbia University, New York, NY (United States); Ruzal-Shapiro, Carrie [Department of Radiology, Babies and Children' s Hospital of New York, NY (United States)

    2002-01-01

    We present the case of a 14-year-old male with melorhesotosis and severe iliotibial band tightness which was associated with femoral shortening, severe external rotational deformity of the femur, genu valgum and patellar dislocation in the right lower extremity. Skeletal survey revealed irregular radiodense streaks involving the pelvis, femoral head, femoral shaft, distal femoral epiphysis, talus and middle phalangeal bones of the foot. Magnetic resonance (MR) imaging showed thickening of the iliotibial band in addition to low MR signal changes in the bone. Intraoperatively fibrosis in the subcutaneous layer and a thickened iliotibial band were found. MR images were very useful in understanding the soft tissue pathoanatomy in melorheostosis and planning surgical correction. (orig.)

  9. Three-dimensional virtual operations can facilitate complicated surgical planning for the treatment of patients with jaw deformities associated with facial asymmetry:a case report

    Institute of Scientific and Technical Information of China (English)

    Shingo Hara; Masaharu Mitsugi; Takahiro Kanno; Akihiko Nomachi; Takehiko Wajima; Yukihiro Tatemoto

    2013-01-01

    This article describes a case we experienced in which good postsurgical facial profiles were obtained for a patient with jaw deformities associated with facial asymmetry, by implementing surgical planning with SimPlant OMS. Using this method, we conducted LF1 osteotomy, intraoral vertical ramus osteotomy (IVRO), sagittal split ramus osteotomy (SSRO), mandibular constriction and mandibular border genioplasty. Not only did we obtain a class I occlusal relationship, but the complicated surgery also improved the asymmetry of the frontal view, as well as of the profile view, of the patient. The virtual operation using three-dimensional computed tomography (3D-CT) could be especially useful for the treatment of patients with jaw deformities associated with facial asymmetry.

  10. Repositioning template for mandibular reconstruction with fibular free flap: an alternative technique to pre-plating and virtual surgical planning

    OpenAIRE

    Berrone, M.; Crosetti, E.; Succo, G

    2014-01-01

    SUMMARY Oral malignancies involving the mandibular bone require a complex reconstructive plan. Mandibular reconstruction with a fibular free flap is currently considered the best choice for functional and aesthetic rehabilitation after oncological surgery. This flap can be modelled with multiple osteotomies and can provide bone, muscle and skin for composite reconstruction. One of the most delicate aspects of mandibular reconstruction is the technique of bone modelling; the risk of prolonging...

  11. Cerebral Angiography for Multimodal Surgical Planning in Epilepsy Surgery: Description of a New Three-Dimensional Technique and Literature Review.

    Science.gov (United States)

    Cardinale, Francesco; Pero, Guglielmo; Quilici, Luca; Piano, Mariangela; Colombo, Paola; Moscato, Alessio; Castana, Laura; Casaceli, Giuseppe; Fuschillo, Dalila; Gennari, Luciana; Cenzato, Marco; Lo Russo, Giorgio; Cossu, Massimo

    2015-08-01

    Cerebrovascular imaging is critical for safe and accurate planning of Stereo-ElectroEncephaloGraphy (SEEG) electrode trajectory. We developed a new technique for Cone Beam Computed Tomography (CBCT) Three-Dimensional Digital Subtraction Angiography (3D DSA). The workflow core is the acquisition of computed tomography datasets without (bone mask) and with selective injection of contrast medium in the main brain-feeding arteries, followed by dataset registration and subtraction. The images were acquired with the O-armTM 1000 System (Medtronic). Images were postprocessed with FSL software package. We retrospectively analyzed 191 3D DSA procedures and qualitatively analyzed the quality of each 3D DSA dataset. The quality of 3D DSA was good in 150 procedures, sufficient in 37, and poor in 4. 3D rendering of the vascular tree was helpful for both SEEG implantation and resective surgery planning. Angiography complications occurred in only one procedure that was aborted due to a major allergic reaction to contrast medium. No other complications directly related to 3D DSA occurred. Minor intracerebral hemorrhage occurred in 2/191 patients after SEEG implantation, with no permanent sequelae. CBCT 3D DSA is a safe diagnostic procedure for SEEG electrode trajectory planning and for 3D reconstructions of the vascular tree in multimodal scenes for resections. The high fidelity and geometric accuracy contribute to the safety of electrode implantation. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. New Frontiers in Surgical Innovation.

    Science.gov (United States)

    Jackson, Ryan S; Schmalbach, Cecelia E

    2017-08-01

    It is an exciting time for head and neck surgical innovation with numerous advances in the perioperative planning and intraoperative management of patients with cancer, trauma patients, and individuals with congenital defects. The broad and rapidly changing realm of head and neck surgical innovation precludes a comprehensive summary. This article highlights some of the most important innovations from surgical planning with sentinel node biopsy and three-dimensional, stereolithic modeling to intraoperative innovations, such as transoral robotic surgery and intraoperative navigation. Future surgical innovations, such as intraoperative optical imaging of surgical margins, are also highlighted. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Cross case analysis of institutions and adaptive capacity in The Netherlands: Do institutions for spatial planning, water and nature management in The Netherlands enhance the capacity of society to adapt to climate change?

    NARCIS (Netherlands)

    Meijerink, S.; Bergsma, E.; Gupta, J.; Jong, P.; Klostermann, J.E.M.; Termeer, C.J.A.M.

    2010-01-01

    In this working document we aim to answer the following question: Do institutions for spatial planning, water and nature management in the Netherlands enhance the capacity of society to adapt to climate change? To answer this question we have first reviewed the literature on adaptive governance and

  14. The Bristol Hip View: Its Role in the Diagnosis and Surgical Planning and Occult Fracture Diagnosis for Proximal Femoral Fractures

    Directory of Open Access Journals (Sweden)

    J. Harding

    2013-01-01

    Full Text Available Aim. To evaluate whether a modified radiographic view of the femoral neck improves the diagnosis of occult proximal femoral. Materials and Methods. Prospective study of patients presenting with clinically suspected proximal femoral fractures or who underwent traditional plain radiographic views and the Bristol hip view (a 30-degree angled projection. Six blinded independent observers assessed the images for presence of a fracture, anatomical level, and displacement. Results. 166 consecutive patients presenting with the clinical diagnosis of a proximal femoral fracture, of which 61 sustained a fracture. Six of these were deemed occult due to negative plain and had proven fractures on subsequent cross-sectional imaging. The Bristol hip view demonstrated five of these six fractures. It performed better than the traditional lateral hip view to identify the injury. The Bristol hip view predicted correctly the fracture type and displacement in all cases and missed only one of the occult fractures. Conclusion. The Bristol hip view is more sensitive and clearer than a lateral projection for patients. It adds useful diagnostic information and performs better than the traditional views in occult fractures. Its use may prevent the need for further cross sectional imaging and subsequent surgical delay.

  15. 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

  16. Surgical Assisting

    Science.gov (United States)

    ... Insert and remove Foley urinary bladder catheter Place pneumatic tourniquet Confirm procedure with surgeon Drape patient within ... Technology and Surgical Assisting (NBSTSA) offers the CertifiedSurgical First Assistant (CSFA) credential, and the National Surgical Assistant ...

  17. Planetary Society

    Science.gov (United States)

    Murdin, P.

    2000-11-01

    Carl Sagan, Bruce Murray and Louis Friedman founded the non-profit Planetary Society in 1979 to advance the exploration of the solar system and to continue the search for extraterrestrial life. The Society has its headquarters in Pasadena, California, but is international in scope, with 100 000 members worldwide, making it the largest space interest group in the world. The Society funds a var...

  18. The accuracy of three-dimensional prediction planning for the surgical correction of facial deformities using Maxilim.

    Science.gov (United States)

    Shafi, M I; Ayoub, A; Ju, X; Khambay, B

    2013-07-01

    The motivation for orthognathic surgery is to improve facial appearance and quality of life. This study aimed to validate a three-dimensional (3D) orthognathic planning programme (Maxilim) for predicting soft tissue changes following Le Fort I advancements. Cone beam computed tomography (CBCT) scans were taken before surgery (T(1)) and at 6-12 months after surgery (T(2)) for 13 patients. For each patient the 3D hard tissue changes between T(1) and T(2) were determined by CBCT superimposition on the cranial vault. Using Maxilim, each patient's skeletal movements were used to generate a 3D soft tissue prediction. The actual soft tissue mesh at T(2) was compared to the predicted mesh. The face was divided into areas: nose, right and left nares, right and left paranasal regions, upper and lower lip, and chin. The absolute distance between meshes for each region was calculated. A one-sample t-test showed the distances between the meshes for all of the areas were within 3 mm (P3D soft tissue predictions for Le Fort I advancements were clinically satisfactory in the regions assessed, but associated with marked errors around the region of the upper lip.

  19. Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Process, format, and clinimetric testing plan.

    Science.gov (United States)

    Goetz, Christopher G; Fahn, Stanley; Martinez-Martin, Pablo; Poewe, Werner; Sampaio, Cristina; Stebbins, Glenn T; Stern, Matthew B; Tilley, Barbara C; Dodel, Richard; Dubois, Bruno; Holloway, Robert; Jankovic, Joseph; Kulisevsky, Jaime; Lang, Anthony E; Lees, Andrew; Leurgans, Sue; LeWitt, Peter A; Nyenhuis, David; Olanow, C Warren; Rascol, Olivier; Schrag, Anette; Teresi, Jeanne A; Van Hilten, Jacobus J; LaPelle, Nancy

    2007-01-01

    This article presents the revision process, major innovations, and clinimetric testing program for the Movement Disorder Society (MDS)-sponsored revision of the Unified Parkinson's Disease Rating Scale (UPDRS), known as the MDS-UPDRS. The UPDRS is the most widely used scale for the clinical study of Parkinson's disease (PD). The MDS previously organized a critique of the UPDRS, which cited many strengths, but recommended revision of the scale to accommodate new advances and to resolve problematic areas. An MDS-UPDRS committee prepared the revision using the recommendations of the published critique of the scale. Subcommittees developed new material that was reviewed by the entire committee. A 1-day face-to-face committee meeting was organized to resolve areas of debate and to arrive at a working draft ready for clinimetric testing. The MDS-UPDRS retains the UPDRS structure of four parts with a total summed score, but the parts have been modified to provide a section that integrates nonmotor elements of PD: I, Nonmotor Experiences of Daily Living; II, Motor Experiences of Daily Living; III, Motor Examination; and IV, Motor Complications. All items have five response options with uniform anchors of 0 = normal, 1 = slight, 2 = mild, 3 = moderate, and 4 = severe. Several questions in Part I and all of Part II are written as a patient/caregiver questionnaire, so that the total rater time should remain approximately 30 minutes. Detailed instructions for testing and data acquisition accompany the MDS-UPDRS in order to increase uniform usage. Multiple language editions are planned. A three-part clinimetric program will provide testing of reliability, validity, and responsiveness to interventions. Although the MDS-UPDRS will not be published until it has successfully passed clinimetric testing, explanation of the process, key changes, and clinimetric programs allow clinicians and researchers to understand and participate in the revision process.

  20. Immediate locally advanced breast cancer and chest wall reconstruction: surgical planning and reconstruction strategies with extended V-Y latissimus dorsi myocutaneous flap.

    Science.gov (United States)

    Munhoz, Alexandre Mendonça; Montag, Eduardo; Arruda, Eduardo; Okada, Alberto; Brasil, José Augusto; Gemperli, Rolf; Filassi, José Roberto; Ferreira, Marcus Castro

    2011-06-01

    Surgical resection in locally advanced breast cancer produces large defects that may not be suitable for primary closure. Immediate reconstruction is controversial and presents a complicated scenario for breast surgeons and plastic surgeons. In this study, a different design was planned for the latissimus dorsi musculocutaneous flap with primary closure in V-Y for the correction of major lesions in the anterior chest wall. Twenty-five patients underwent immediate locally advanced breast cancer reconstruction with a V-Y latissimus dorsi musculocutaneous flap. This flap was raised from adjacent tissue located on the lateral and posterior thoracic region and presented a triangular shape whose base was the lateral aspect of the mastectomy wound. The technique was indicated in patients with large thoracic wounds. Mean follow-up time was 16 months. Closure was obtained in the donor and recipient sites without the use of skin grafts or other more major procedures. Complications occurred in nine patients (36 percent), including dorsal wound dehiscence in five patients and seroma in three. All cases except one were treated by a conservative approach with a good result. No total flap loss was reported. All patients achieved a satisfactory thoracic reconstruction and adequate wound care. The V-Y latissimus dorsi musculocutaneous flap is a reliable technique for immediate locally advanced breast cancer reconstruction. The technique is advantageous because the V-Y design allows primary closure of the chest wound and donor defect. Success depends on patient selection, coordinated planning with the breast cancer surgeon, and careful intraoperative management.

  1. Resultados de un plan de gestión de listas de espera quirúrgica de prótesis articulares Results of a management plan for surgical waiting lists for hip and knee replacements

    Directory of Open Access Journals (Sweden)

    Josep Martí-Valls

    2006-06-01

    Full Text Available Se describe un plan de gestión de las listas de espera quirúrgicas de prótesis articulares de cadera y rodilla y sus resultados a los 3 años. El plan de gestión se basó en la unificación de la información y programación, depuración periódica, guía clínica, gestión de la demanda, priorización por necesidad e incremento de la oferta. Durante el primer año se consiguió aflorar la lista de espera real, con un 23% más de pacientes de los contabilizados hasta entonces. A los 3 años, se depuró la lista en un 16% de los pacientes, se disminuyó la estancia media de estos procedimientos en 4 días, se evaluó el 59,5% de los pacientes con un instrumento de priorización y se incrementó la actividad de artroplastias en un 16%. Se redujo en un 14,7% los pacientes en espera de prótesis articulares y el tiempo de resolución de estos procedimientos disminuyó en 3 meses para las artroplastias de rodilla y en un mes para las de cadera.This study describes the implementation of a management plan for surgical joint replacement waiting lists and its results after 3 years. The plan was based on the following: unification of information and scheduling, periodic review, clinical guidelines, management of demand, prioritization according to need, and increasing the services provided. During the first year, the plan succeeded in revealing the real waiting list, with 23% more patients than previously included. Three years later, 16% of the patients had not turned up for surgery after being scheduled; the mean length of hospital stay for joint replacements had been reduced by 4 days; 59.5% of the patients joining the list had been assessed with a prioritization instrument, and the number of joint replacements had increased by 16% with a reduction of 14.7% in patients waiting for joint replacements. The resolution time for these procedures had also deceased by 3 months for knee arthroplasty and by 1 month for hip arthroplasty.

  2. Role of Surgical Services in Profitability of Hospitals in California: An Analysis of Office of Statewide Health Planning and Development Annual Financial Data.

    Science.gov (United States)

    Moazzez, Ashkan; de Virgilio, Christian

    2016-10-01

    With constant changes in health-care laws and payment methods, profitability, and financial sustainability of hospitals are of utmost importance. The purpose of this study is to determine the relationship between surgical services and hospital profitability. The Office of Statewide Health Planning and Development annual financial databases for the years 2009 to 2011 were used for this study. The hospitals' characteristics and income statement elements were extracted for statistical analysis using bivariate and multivariate linear regression. A total of 989 financial records of 339 hospitals were included. On bivariate analysis, the number of inpatient and ambulatory operating rooms (ORs), the number of cases done both as inpatient and outpatient in each OR, and the average minutes used in inpatient ORs were significantly related with the net income of the hospital. On multivariate regression analysis, when controlling for hospitals' payer mix and the study year, only the number of inpatient cases done in the inpatient ORs (β = 832, P = 0.037), and the number of ambulatory ORs (β = 1,485, 466, P = 0.001) were significantly related with the net income of the hospital. These findings suggest that hospitals can maximize their profitability by diverting and allocating outpatient surgeries to ambulatory ORs, to allow for more inpatient surgeries.

  3. Surgical scar revision: An overview

    Directory of Open Access Journals (Sweden)

    Shilpa Garg

    2014-01-01

    Full Text Available Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods.

  4. Network Society

    DEFF Research Database (Denmark)

    Clausen, Lars; Tække, Jesper

    2017-01-01

    the five strands of theory on the network society. Each theoretical position has its specific implications for acting toward strategic goals. In its entirety, the five perspectives give a thorough understanding of the conditions for successful strategic communication in the 21st century....

  5. Rehabilitation of a dentate mandible requiring a full arch rehabilitation. Immediate loading of a fixed complete denture on 8 implants placed with a bone-supported surgical computer-planned guide: a case report.

    Science.gov (United States)

    Amorfini, Leonardo; Storelli, Stefano; Romeo, Eugenio

    2011-03-01

    The use of technologies that merge computerized tomography X-ray imaging and 3-dimensional (3D) planning software allow the surgeon to digitally elaborate on the computer the position, length, and diameter of every implant to be placed. Following this approach, the placement is guided in a 3D digital model, and the implants are placed in the final position avoiding eventual anatomic structures. In this case report, the patient's remaining mandibular teeth were extracted, and the patient received 8 implants with the help of a computer surgical guide. The case was planned using SimPlant and a bone-supported guide. Because of the high precision of the planning, it was possible to realize a provisional rehabilitation before the actual surgery. The planning allows placement of parallel implants to optimize the prosthetic procedure and outcome. An immediate provisional implant was fixed with a flow composite on the temporary abutments and then refined in the dental laboratory. The patient received the provisional rehabilitation the same day of the surgery. After 6 weeks of healing, the final impression was taken and the prosthesis was finalized with a computer-aided design/computer-aided manufacturing titanium full-arch screwed framework with composite veneering. A 6-month follow-up showed good integration of the prostheses and success of all 8 implants. The use of surgical computer-guided planning changes the surgeon's approach: whereas before the use of conventional guides permitted a certain degree of offset from what was planned, the use of computer guides allows the implant to be inserted in a far more precise way. It is obvious that careful planning is the key factor to avoid implant misplacement.

  6. Cryptozoology Society

    Science.gov (United States)

    Richman, Barbara T.

    Reports of Loch Ness monsters, Bigfoot, and the Yeti spring u p from time to time, sparking scientific controversy about the veracity of these observations. Now an organization has been established to help cull, analyze, and disseminate information on the alleged creatures. The International Society of Cryptozoology, formed at a January meeting at the U.S. National Museum of Natural History of the Smithsonian Institution, will serve as the focal point for the investigation, analysis, publication, and discussion of animals of unexpected form or size or of unexpected occurrences in time or space.

  7. Uso da rede neural artificial no planejamento cirúrgico da correção do estrabismo Neural network approach for planning surgical correction of strabismus

    Directory of Open Access Journals (Sweden)

    Murilo Barreto Souza

    2004-06-01

    Full Text Available OBJETIVO: Desenvolver uma rede neural artificial para planejar a estratégia cirúrgica em pacientes portadores de estrabismo sensorial, com desvio horizontal. MÉTODOS: Foi realizado estudo retrospectivo envolvendo 95 pacientes portadores de estrabismo sensorial, atendidos no Ambulatório de Motilidade Ocular Extrínseca do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Foi construída uma rede neural artificial utilizando-se o Java Neural Network 1.1. Foram utilizados 68 pacientes para treinamento e validação da rede e 27 para testar o seu funcionamento. RESULTADOS: Dos 68 pacientes utilizados no treinamento da rede, 37 apresentavam exotropia e 31 esotropia. O método utilizado para treinamento da rede foi o "backpropagation". A taxa de aprendizado utilizada foi de 0,6, e a taxa de tolerância de erro 0,05. Dos 27 pacientes utilizados para avaliação da eficácia da rede, 18 apresentavam exotropia, e 9 esotropia. A eficácia da rede foi avaliada pela média da diferença entre os resultados fornecidos pela rede, e as indicações originais. Nos pacientes com exotropia o erro médio foi de 0,4 mm (±0,4, para o retrocesso do músculo reto lateral, e de 0,3 mm (±0,3, para a ressecção do músculo reto medial. Nas esotropias, o erro médio foi de 0,2 mm (±0,2, para o retrocesso do músculo reto medial e de 0,5 mm (±0,3, para ressecção do músculo reto lateral. CONCLUSÃO: A rede neural artificial, por sua característica de simular o sistema nervoso central biológico, e sua capacidade de realizar tarefas cognitivas, é opção viável para auxiliar no planejamento cirúrgico da cor-reção do estrabismo.PURPOSE: To develop a neural network model for planning of the surgical strategy of patients with sensorial strabismus. METHODS: In this retrospective study, medical records of 95 patients with sensorial strabismus were reviewed. All patients were seen at the Strabismus Sector of the Hospital das Cl

  8. Languages in Contemporary Anglophone Caribbean Societies

    Science.gov (United States)

    Davids, Melva P.

    2013-01-01

    The paper Languages in Contemporary Anglophone Caribbean Societies examines how language is treated in Jamaica and other Anglophone Caribbean societies and the effects of a haphazard approach to language planning on the social dynamics of the society as well as the individual. It briefly explores how Language is handled in Francophone or…

  9. Operating theatre quality and prevention of surgical site infections.

    Science.gov (United States)

    Spagnolo, A M; Ottria, G; Amicizia, D; Perdelli, F; Cristina, M L

    2013-09-01

    Surgical site infections (SSI) account for 14% to 17% of all hospital-acquired infections and 38% of nosocomial infections in surgical patients. SSI remain a substantial cause of morbidity and death, possibly because of the larger numbers of elderly surgical patients or those with a variety of chronic and immunocompromising conditions, and emergence of antibiotic-resistant microorganisms. Factors causing surgical site infection are multifarious. Several studies have identified the main patient-related (endogenous risk factors) and procedure-related (external risk factors) factors that influence the risk of SSI. The rate of surgical wound infections is strongly influenced by operating theatre quality, too. A safe and salubrious operating theatre is an environment in which all sources of pollution and any micro-environmental alterations are kept strictly under control. This can be achieved only through careful planning, maintenance and periodic checks, as well as proper ongoing training for staff Many international scientific societies have produced guidelines regarding the environmental features of operating theatres (positive pressure, exchanges of filtered air per hour, air-conditioning systems with HEPA filters, etc.) and issued recommendations on healthcare-associated infection, including SSI, concerning surveillance methods, intervention to actively prevent SSI and approaches to monitoring the implementation of such strategies. Therefore, the prevention of SSI requires a multidisciplinary approach and the commitment of all concerned, including that of those who are responsible for the design, layout and functioning of operating theatres.

  10. PERSEPSI MASYARAKAT ADAT TERHADAP IMPLEMENTASI RENCANA TATA RUANG WILAYAH (RTRW DI NUSA CENINGAN, KLUNGKUNG, BALI (The Indigenous Society Perception towards The Reghional Spatial Planning Implementation In Nusa Ceningan, Klungkung, Bali

    Directory of Open Access Journals (Sweden)

    IGM. Konsukartha

    2015-01-01

    implicated the spatial pattern conversion management and natural resources exploitation that damage the indigeneous society, including the physical, socio-economic and socio-culture aspects. Nusa Ceningan constitutes Nusa Penida developing areas in this research is purposively chosen with the spatial planning dichotomies concideration. The conflict of the spatial users consists of the elite government, elite economic (nongovernment and elite society (indigenous are caused by the both dichotomies interest of the indigenous society and government idea’s on spatial planning respectively. The indigenous society are seen as the object (subordinate as opposed to the government because its authority are always become a subject (dominant of spatial planning, so that the indigenous society interest are negated and finally be marginalized. The research method applies the combination of both qualitative and qualitative approaches with triangulation principle. The qualitative and qualitative data were both collected by survey method, depth interview, focused group discussion and document over view. Data were analyzed quantitatively by single frequency table to find out the fenomena, expression and dominant variable are explored through qualitative data and be analyzed by qualitative description. The spatial pattern conversion and natural resources management have influences the physical structure of traditional space conversion and socioculture shifting among the parhangan, palemahan and pawongan components.

  11. In-office fabrication of dental implant surgical guides using desktop stereolithographic printing and implant treatment planning software: A clinical report.

    Science.gov (United States)

    Whitley, Daniel; Eidson, R Scott; Rudek, Ivan; Bencharit, Sompop

    2017-09-01

    Guided surgery is accepted as the most accurate way to place an implant and predictably relate the implant to its definitive prosthesis, although few clinicians use it. However, recent developments in high-quality desktop 3-dimensional stereolithographic printers have led to the in-office fabrication of stereolithographic surgical guides at reduced cost. This clinical report demonstrates a protocol for using a cost-effective, in-office rapid prototyping technique to fabricate a surgical guide for dental implant placement. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  12. Computer-Assisted Orthognathic Surgery for Patients with Cleft Lip/Palate: From Traditional Planning to Three-Dimensional Surgical Simulation.

    Directory of Open Access Journals (Sweden)

    Daniel Lonic

    Full Text Available Although conventional two-dimensional (2D methods for orthognathic surgery planning are still popular, the use of three-dimensional (3D simulation is steadily increasing. In facial asymmetry cases such as in cleft lip/palate patients, the additional information can dramatically improve planning accuracy and outcome. The purpose of this study is to investigate which parameters are changed most frequently in transferring a traditional 2D plan to 3D simulation, and what planning parameters can be better adjusted by this method.This prospective study enrolled 30 consecutive patients with cleft lip and/or cleft palate (mean age 18.6±2.9 years, range 15 to 32 years. All patients received two-jaw single-splint orthognathic surgery. 2D orthodontic surgery plans were transferred into a 3D setting. Severe bony collisions in the ramus area after 2D plan transfer were noted. The position of the maxillo-mandibular complex was evaluated and eventually adjusted. Position changes of roll, midline, pitch, yaw, genioplasty and their frequency within the patient group were recorded as an alternation of the initial 2D plan. Patients were divided in groups of no change from the original 2D plan and changes in one, two, three and four of the aforementioned parameters as well as subgroups of unilateral, bilateral cleft lip/palate and isolated cleft palate cases. Postoperative OQLQ scores were obtained for 20 patients who finished orthodontic treatment.83.3% of 2D plans were modified, mostly concerning yaw (63.3% and midline (36.7% adjustments. Yaw adjustments had the highest mean values in total and in all subgroups. Severe bony collisions as a result of 2D planning were seen in 46.7% of patients. Possible asymmetry was regularly foreseen and corrected in the 3D simulation.Based on our findings, 3D simulation renders important information for accurate planning in complex cleft lip/palate cases involving facial asymmetry that is regularly missed in conventional 2D

  13. The Efficacy and Utilisation of Preoperative Magnetic Resonance Imaging in Robot-assisted Radical Prostatectomy: Does it Change the Surgical Dissection Plan? A Preliminary Report

    OpenAIRE

    Hasan Hüseyin Tavukçu; Ömer Aytaç; Cem Balcı; Haluk Kulaksızoğıu; Fatih Atuğ

    2015-01-01

    Purpose: We investigated the effect of prostate magnetic resonance imaging (MRI) on the dissection plan of the neurovascular bundle and the oncological results of our patients who underwent robotic radical prostatectomy operation. Materials and Methods: We prospectively evaluated 30 consecutive patients, 15 of whom had prostate MRI before the operation, and 15 of whom did not. With the findings of MRI, the dissection plan was changed as intrafascial, interfascial, and extrafascial techniqu...

  14. The Ambivalences of Civil Society

    Directory of Open Access Journals (Sweden)

    Henrik Kaare Nielsen

    2008-07-01

    Full Text Available This article discusses the conceptual heterogeneity in the field of ‘civil society’ in the light of a distinction between positions that reflect civil society as a democratic-emancipatory category and positions that consider civil society from the perspective of the state: as an instrumental resource for the technocratic planning of the competitive nation state.The article discusses the implications and perspectives in these two different strategic scenarios for conceptualizing civil society. The argument is made that civil society in relation to democratic citizenship should basically rather be understood as a concept for specific, communicative principles for institutionalizing societal relations and organizing public experience than as an overall concept for third sector organizations.

  15. Accuracy of implant placement based on pre-surgical planning of three-dimensional cone-beam images: a pilot study.

    NARCIS (Netherlands)

    Assche, N. Van; Steenberghe, D van; Guerrero, M.E.; Hirsch, E.; Schutyser, F.A.C.; Quirynen, M.; Jacobs, R.

    2007-01-01

    AIM: To evaluate the precision of transfer of a computer-based three-dimensional (3D) planning, using re-formatted cone-beam images, for oral implant placement in partially edentulous jaws. MATERIAL AND METHODS: Four formalin-fixed cadaver jaws were imaged in a 3D Accuitomo FPD cone-beam computed to

  16. New Groups Study Science's Effect on Society

    Science.gov (United States)

    O'Sullivan, Dermot A.

    1973-01-01

    Describes the chief aims of the Council for Science and Society in London and the International Institute for Applied Systems Analysis in Vienna. Indicates that both groups are planning to function as a multinational interdisciplinary organization. (CC)

  17. Use of 3D-computed tomography angiography for planning the surgical removal of pineal region meningiomas using Poppen's approach: a report of ten cases and a literature review

    Directory of Open Access Journals (Sweden)

    Li Ye

    2011-06-01

    Full Text Available Abstract Background There are several treatment approaches for pineal region meningiomas, such as Poppen's approach, Krause's approach and combinations of the two approaches. We present our experience with the use of 3D-computed tomography angiography for planning the surgical removal of pineal region meningiomas using a suboccipital transtentorial approach (Poppen's approach and evaluate the role of Poppen's approach. Methods During the period from January 2005 to June 2010, ten patients presented to us with pineal region meningioma. MRI was routinely used to define the tumor size, position, and its relevant complications while 3D-CTA was applied to define the blood supply of the tumor and the venous complex (VC shift before operations. Most of the meningiomas had developed at both sides of the tentorial plane and extended laterally with typical characteristics of a pineal region tumor. Results All tumors were completely removed surgically without any injury to the VC. Postoperative intracranial infection occurred in one case who recovered after antibiotics were given. Postoperative intraventricular hemorrhage and pneumocephalus were found in one case, but fully recovered after conservative treatment. In the nine cases of concurrent hydrocephalus, this was gradually relieved in eight patients and the single case that became aggravated was successfully treated with ventriculoperitoneal shunt. Moreover, the follow-up MRI examinations did not indicate any recurrence of the meningiomas. Conclusion We found that the use of Poppen's approach is strongly supported for the successful removal of pineal region meningiomas without serious complications.

  18. Quantitative comparisons on hand motor functional areas determined by resting state and task BOLD fMRI and anatomical MRI for pre-surgical planning of patients with brain tumors.

    Science.gov (United States)

    Hou, Bob L; Bhatia, Sanjay; Carpenter, Jeffrey S

    2016-01-01

    For pre-surgical planning we present quantitative comparison of the location of the hand motor functional area determined by right hand finger tapping BOLD fMRI, resting state BOLD fMRI, and anatomically using high resolution T1 weighted images. Data were obtained on 10 healthy subjects and 25 patients with left sided brain tumors. Our results show that there are important differences in the locations (i.e., > 20 mm) of the determined hand motor voxels by these three MR imaging methods. This can have significant effect on the pre-surgical planning of these patients depending on the modality used. In 13 of the 25 cases (i.e., 52%) the distances between the task-determined and the rs-fMRI determined hand areas were more than 20 mm; in 13 of 25 cases (i.e., 52%) the distances between the task-determined and anatomically determined hand areas were > 20 mm; and in 16 of 25 cases (i.e., 64%) the distances between the rs-fMRI determined and anatomically determined hand areas were more than 20 mm. In just three cases, the distances determined by all three modalities were within 20 mm of each other. The differences in the location or fingerprint of the hand motor areas, as determined by these three MR methods result from the different underlying mechanisms of these three modalities and possibly the effects of tumors on these modalities.

  19. Quantitative comparisons on hand motor functional areas determined by resting state and task BOLD fMRI and anatomical MRI for pre-surgical planning of patients with brain tumors

    Directory of Open Access Journals (Sweden)

    Bob L. Hou

    2016-01-01

    Full Text Available For pre-surgical planning we present quantitative comparison of the location of the hand motor functional area determined by right hand finger tapping BOLD fMRI, resting state BOLD fMRI, and anatomically using high resolution T1 weighted images. Data were obtained on 10 healthy subjects and 25 patients with left sided brain tumors. Our results show that there are important differences in the locations (i.e., >20 mm of the determined hand motor voxels by these three MR imaging methods. This can have significant effect on the pre-surgical planning of these patients depending on the modality used. In 13 of the 25 cases (i.e., 52% the distances between the task-determined and the rs-fMRI determined hand areas were more than 20 mm; in 13 of 25 cases (i.e., 52% the distances between the task-determined and anatomically determined hand areas were >20 mm; and in 16 of 25 cases (i.e., 64% the distances between the rs-fMRI determined and anatomically determined hand areas were more than 20 mm. In just three cases, the distances determined by all three modalities were within 20 mm of each other. The differences in the location or fingerprint of the hand motor areas, as determined by these three MR methods result from the different underlying mechanisms of these three modalities and possibly the effects of tumors on these modalities.

  20. Citizenship in civil society?

    NARCIS (Netherlands)

    Ossewaarde, Marinus R.R.

    2007-01-01

    This article seeks to provide a conceptual framework to complement and guide the empirical analysis of civil society. The core argument is that civil society must be understood, not as a category of (post)industrialized society, but as one of individualized society. Civil society is characterized by

  1. Are Teachers Teaching for a Knowledge Society?

    Science.gov (United States)

    Sahlberg, Pasi; Boce, Elona

    2010-01-01

    Many countries whose economies are in transition have initiated ambitious education reforms intended to modernize their education systems to better respond to the needs of new social and economic realities. Albania is a good example of a society that is emerging from a closed planned socialist system and moving fast to an open society and…

  2. Implant treatment planning considerations.

    Science.gov (United States)

    Kao, Richard T

    2008-04-01

    As dental implants become a more accepted treatment modality, there is a need for all parties involved with implant dentistry to be familiar with various treatment planning issues. Though the success can be highly rewarding, failure to forecast treatment planning issues can result in an increase of surgical needs, surgical cost, and even case failure. In this issue, the focus is on implant treatment planning considerations.

  3. Posterior fossa meningioma (surgical experiences)

    African Journals Online (AJOL)

    Wael M. Moussa

    2012-08-27

    Aug 27, 2012 ... Morbidity included decreased level of consciousness, cranial nerve palsy and wound infection. ..... (10 cases), trigeminal nerve compression (6 cases), facial nerve .... and magnetic resonance imaging for surgical planning for menin- ... anatomy scanning in the operation of intracranial parasagittal.

  4. Globalization and State–Society Relations in Africa

    African Journals Online (AJOL)

    sulaiman.adebowale

    2008-10-20

    Oct 20, 2008 ... shifting the balance of power between state and society in favor of society. The findings ..... The peace plans proposed by various mediators in efforts to settle ...... Perspective, New York: Colombia University Press. Centre for ...

  5. Society of Reproductive Surgeons

    Science.gov (United States)

    ... affiliated society to the American Society for Reproductive Medicine . Below are links to publications authored by ASRM and its affiliated societies. Latest Additions: Diagnostic Testing for Male Factor Infertility Robotic surgery The Intrauterine Device (IUD): A Long-acting ...

  6. SURGICAL ORTHODONTICS: LITERATURE REVIEW AND CASE REPORT

    OpenAIRE

    2013-01-01

    Orthognathic surgery is a surgical procedure largely practiced throughout the world for the correction of various maxillofacial deformities. The procedure for correcting a particular deformity will be done after proper evaluation, which includes cephalometric, dental model analysis and photographs. The patient undergoes pre-surgical orthodontic correction for dental compensation, after which surgery is planned. During the last few decades, the profession has witnessed ...

  7. The assessment and management of older cancer patients : A SIOG surgical task force survey on surgeons' attitudes

    NARCIS (Netherlands)

    Ghignone, F; van Leeuwen, B. L.; Montroni, I; Huisman, M G; Somasundar, P; Cheung, K L; Audisio, R A; Ugolini, G

    Aim: The Surgical Task Force at SIOG (International Society of Geriatric Oncology) designed this survey to explore the surgical oncologists' approach toward elderly cancer patients. Methods: A web-based survey was sent to all members of ESSO (European Society of Surgical Oncology) and SSO (Society

  8. Otimização do planejamento hierárquico da produção em usinas cooperadas do setor sucroenergético Optimization of the hierarchical production planning of a cooperative society of sugarcane milling companies

    Directory of Open Access Journals (Sweden)

    Rafael Piatti Oiticica de Paiva

    2012-01-01

    Full Text Available Neste trabalho apresenta-se um modelo de otimização para o planejamento agregado da produção em usinas cooperadas do setor sucroenergético. Esta modelagem considera a relação hierárquica existente entre o planejamento anual da cooperativa e o planejamento tático de safra das usinas cooperadas. No nível de decisão da cooperativa, o modelo indica a meta de produção de cada usina e define a política de estocagem e de atendimento da demanda. No nível de decisão de uma usina cooperada, o modelo possibilita definir a quantidade de cana-de-açúcar colhida, a quantidade transportada por prestador de serviço, a seleção dos processos de produção de açúcar, álcool, melaço e energia elétrica. Para resolver os modelos de programação linear e programação inteira mista envolvidos, utilizou-se uma linguagem de modelagem algébrica e um software de última geração de programação matemática. Resultados computacionais obtidos em estudo de caso são apresentados como forma de ilustrar e validar a aplicação.The main concern of this work is related to the presentation of an aggregate production planning model of a cooperative society of sugar and alcohol milling companies. This mathematical model is based on a hierarchical approach between the annual planning problem of the cooperative and the tactical planning horizon of the sugarcane mills. At the cooperative level, the main questions are related to the allocation of production goals to each mill and the management of inventory and dynamic demands. At the milling companies' level, a process selection model aims at helping the decision makers to determine the following: quantity of sugarcane crushed; selection of sugarcane suppliers; selection of sugarcane transport system; and selection of industrial processes used in sugar, alcohol, molasses and energy production. In order to solve the linear and mixed integer mathematical models involved, a modeling language with an

  9. Moral Choices in Contemporary Society: Source Book.

    Science.gov (United States)

    Hellman, Mary, Ed.

    One of several supplementary materials for a newspaper course on moral choices in contemporary society, this sourcebook contains program ideas and resources to help civic leaders and educators plan programs based on the course topics. There are four sections. The first section explains how the topics can be used in planning programs, identifies…

  10. Nutrition support in surgical oncology.

    Science.gov (United States)

    Huhmann, Maureen B; August, David A

    2009-01-01

    This review article, the second in a series of articles to examine the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Guidelines for the Use of Parenteral and Enteral Nutrition in Adult and Pediatric Patients, evaluates the evidence related to the use of nutrition support in surgical oncology patients. Cancer patients develop complex nutrition issues. Nutrition support may be indicated in malnourished cancer patients undergoing surgery, depending on individual patient characteristics. As with the first article in this series, this article provides background concerning nutrition issues in cancer patients, as well as discusses the role of nutrition support in the care of surgical cancer patients. The goal of this review is to enrich the discussion contained in the clinical guidelines as they relate to recommendations made for surgical patients, cite the primary literature more completely, and suggest updates to the guideline statements in light of subsequently published studies.

  11. Circular Traj ectory Planning for A 7 DOF Surgical Robot%基于四元数的手术机器人圆弧轨迹规划

    Institute of Scientific and Technical Information of China (English)

    乔正; 栾楠; 张诗雷

    2014-01-01

    为提高七自由度手术机器人末端执行器空间圆弧作业任务的位姿轨迹精度,系统提出采用四元数代替原有的齐次坐标矩阵描述末端执行器的位置和姿态,并采用梯形速度规划生成平滑连续的位姿轨迹,实现等夹角姿态均匀渐变。以在研究的颅颌面七自由度冗余手术机器人为原型,通过三次B样条曲线对反解后的关节轨迹进行插值处理,生成各关节速度、加速度连续平滑的轨迹规划曲线。仿真结果表明,算法符合手术机器人的插补精度和连续性要求,具有实际推广价值。%To improve the arc traj ectory preci-sion of 7 DOF robot end effector passing the non collinear three points,this paper uses quater-nion to describe the position and posture of the end effector instead of the original homogeneous coor-dinate matrix,generates smooth continuous pose traj ectory by using trapezoidal velocity and realizes posture change gradually and linearly.Take the in research 7 DOF cranio maxillofacial surgical robot as the prototype,three B spine curve inter-polation was carried out on the inverse solution of joint trajectory,and generate continuous smooth velocity and acceleration curve of each joint.Simu-lation results showed that the proposed circular arc traj ectory algorithm conforms to the requirements of the interpolation precision and continuity of the robot,and can be applied to practical situation.

  12. Abortion in a just society.

    Science.gov (United States)

    Hunt, M E

    1993-01-01

    A female Catholic theologian imagines a just society that does not judge women who decide to undergo an abortion. The Church, practitioners, and the courts must trust that women do make person-enhancing choices about the quality of life. In the last 15 years most progress in securing a woman's right to abortion has been limited to white, well-educated, and middle or upper middle class women. A just society would consider reproductive options a human right. Abortion providers are examples of a move to a just society; they are committed to women's well-being. There are some facts that make one pessimistic about achieving abortion in a just society. The US Supreme Court plans to review important decisions establishing abortion as a civil right. Further, some men insist on suing women who want to make their own reproductive decisions--an anti-choice tactic to wear away women's right to reproductive choice. Bombings of abortion clinics and harassment campaigns by anti-choice groups are common. These behaviors strain pro-choice proponents emotionally, psychically, and spiritually. Their tactics often lead to theologians practicing self-censorship because they fear backlash. Abortion providers also do this. Further, the reaction to AIDS is that sex is bad. Anti-abortion groups use AIDS to further their campaigns, claiming that AIDS is a punishment for sex. Strategies working towards abortion in a just society should be education and persuasion of policymakers and citizens about women's right to choose, since they are the ones most affected by abortion. Moreover, only women can secure their rights to abortion. In a just society, every health maintenance organization, insurance company, and group practice would consider abortion a normal service. A just society provides for the survival needs of the most marginalized.

  13. LA ADAPTACIÓN DE LAS SOCIEDADES COOPERATIVAS AL NUEVO PLAN GENERAL CONTABLE: ANÁLISIS DE LAS PRINCIPALES IMPLICACIONES ECONÓMICAS Y FINANCIERAS/THE ADJUSTMENT OF THE COOPERATIVE SOCIETIES TO THE NEW GENERAL ACCOUNTING PLAN: ANALYSIS OF THE PRINCIPAL ECONOMIC AND FINANCIAL IMPLICATIONS

    Directory of Open Access Journals (Sweden)

    Javier ITURRIOZ DEL CAMPO

    2008-01-01

    Full Text Available La aprobación de la Ley 16/2007, de reforma y adaptación de la legislación mercantil en materia contable en España, así como del Plan General de Contabilidad, y del Plan General de Contabilidad para Pequeñas y Medianas Empresas, han permitido la incorporación de los nuevos criterios contables recogidos en la Normas Internacionales de Información Financiera (NIIF para dar respuesta al objetivo marcado desde la Unión Europa de favorecer la comparación de los estados contables elaborados en los distintos estados miembros, para contribuir así a incrementar la transparencia de los mercados en un entorno económico cada vez más global e internacional. No obstante, en el caso de las sociedades cooperativas, todavía está pendiente de publicación la correspondiente norma sectorial. Por ello, a lo largo de este trabajo se pretende analizar las implicaciones que tienen en las sociedades cooperativas tanto las novedades contables ya publicadas como los aspectos que deben ser fijados en la citada regulación sectorial atendiendo a sus características especiales. /The Law 16/2007, of reform and adjustment of the mercantile legislation about accounting in Spain, as well as of the General Plan of Accounting, and of the General Plan of Accounting for Small and Medium Companies, they have allowed the incorporation of the new accounting criteria gathered in International Financial Reporting Standards (IFRS to give response to the aim marked from the European Union of favouring the comparison of the accounting forms elaborated in the different member states, to help to increase this way the transparency of the markets in an economic environment increasingly globally and internationally. Nevertheless, in case of the cooperative societies, the sectorial normative has not been published. This work centres on the analysis of the implications that have in the cooperative societies so much the accounting innovations already published as the aspects that

  14. Role of Computational Modelling in Planning and Executing Interventional Procedures for Congenital Heart Disease.

    Science.gov (United States)

    Slesnick, Timothy C

    2017-09-01

    Increasingly, computational modelling and numerical simulations are used to help plan complex surgical and interventional cardiovascular procedures in children and young adults with congenital heart disease. From its origins more than 30 years ago, surgical planning with analysis of flow hemodynamics and energy loss/efficiency has helped design and implement many modifications to existing techniques. On the basis of patient-specific medical imaging, surgical planning allows accurate model production that can then be manipulated in a virtual surgical environment, with the proposed solutions finally tested with advanced computational fluid dynamics to evaluate the results. Applications include a broad range of congenital heart disease, including patients with single-ventricle anatomy undergoing staged palliation, those with arch obstruction, with double outlet right ventricle, or with tetralogy of Fallot. In the present work, we focus on clinical applications of this exciting field. We describe the framework for these techniques, including brief descriptions of the engineering principles applied and the interaction between "benchtop" data with medical decision-making. We highlight some early insights learned from pioneers over the past few decades, including refinements in Fontan baffle geometries and configurations. Finally, we offer a glimpse into exciting advances that are presently being explored, including use of modelling for transcatheter interventions. In this era of personalized medicine, computational modelling and surgical planning allows patient-specific tailoring of interventions to optimize clinical outcomes. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  15. Analysis of edentulous maxillae using computed tomography and panoramic radiography in the surgical planning of dental implants; Analise da maxila edentula por meio da tomografia computadorizada e radiografia panoramica no planejamento cirurgico de implantes dentarios

    Energy Technology Data Exchange (ETDEWEB)

    Sahuinco, Humberto Lazaro Choquepuma; Souza, Ricardo Pires de [Complexo Hospitalar Heliopolis (HOSPHEL), Sao Paulo, SP (Brazil). Curso de pos-graduacao em Ciencias da Saude]. E-mail: humbertchs@hotmail.com

    2006-04-15

    Objective: to determine agreement of three observers on analysis of linear measurements of edentulous maxillae using computed tomography and panoramic radiography in the surgical planning of dental implants. Material and Method: the samples of 17 patients were analyzed with computed tomography and panoramic radiography. Linear measurements obtained from both methods were made at the following anatomical points: left tuberosity, left canine pillar, incisive foramen, right canine pillar and right tuberosity. Kendall's W test was applied to assess the level of agreement. Results: measured W-values from the samples of the anatomical points mentioned above, analyzed with panoramic radiography and computed tomography, were: 0.75 and 0.901; 0.916 and 0.956; 0.843 and 0.964; 0.963 and 0.931; 0.95 and 0.89 respectively. Statistical analysis showed that there was no statistically significant difference. Conclusion: agreement occurred in the measurements of variables.That means that if the three observers were to select an implant to be placed in each of the anatomical regions studied, there would be a good chance whey would choose the same type. (author)

  16. American Headache Society

    Science.gov (United States)

    ... Applications are now being accepted for the 2017 International headache Society scheduled for January 20 - 22, 2017 at the ... READ MORE Sep 7 18th Congress of the International Headache Society Vancouver, BC Canada , Vancouver Convention Centre READ MORE ...

  17. Society for Vascular Medicine

    Science.gov (United States)

    ... Certification with this new online course from the Society for Vascular Medicine. Learn more. Looking for a ... jobs are listed right now. Copyright © 2016 The Society for Vascular Medicine. All Rights Reserved.

  18. American Society of Nephrology

    Science.gov (United States)

    ... stay safe! – @ASNKidney on Twitter ASN News Feed Society Events Interact With ASN rss Facebook Twitter YouTube ... Podcast ASN Communities Share ASN User Login © American Society of Nephrology top Text Size + - Translate Sitemap Terms ...

  19. Society for Ambulatory Anesthesia

    Science.gov (United States)

    ... We Represent Ambulatory and Office-Based Anesthesia The Society for Ambulatory Anesthesia provides educational opportunities, encourages research ... 6620 | E-mail: info@sambahq.org Copyright | 2016 Society for Ambulatory Anesthesia Home | Search | Terms | Privacy Policy | ...

  20. Ehlers-Danlos Society

    Science.gov (United States)

    ... Scientific Board Staff Volunteer Leaders The Ehlers-Danlos Society Center for EDS Research & Clinical Care Our History ... Message Boards Patient Resource Library The Ehlers-Danlos Society Center for EDS Research & Clinical Care Loose Connections ...

  1. American Society of Echocardiography

    Science.gov (United States)

    American Society of Echocardiography Join Ase Member Portal Log In Membership Member Portal Log In Join ASE Renew Benefits Rates FASE – Fellow of the American Society of Echocardiography Member Referral Program FAQs Initiatives Advocacy ...

  2. International Transplant Nurses Society

    Science.gov (United States)

    ... The Mission of ITNS The International Transplant Nurses Society is committed to the promotion of excellence in ... 20-1589538 Copyright © 2006 - 2014 International Transplant Nurses Society (ITNS). No materials, including graphics, may be reused, ...

  3. American Urogynecologic Society

    Science.gov (United States)

    ... Patient Site » PFD Registry » Contact Us American Urogynecologic Society 1100 Wayne Avenue, Suite 670 Silver Spring, MD ... Us | Privacy Policy | HONcode Accredited © 2016 American Urogynecologic Society. All rights reserved.

  4. Scoliosis Research Society

    Science.gov (United States)

    Scoliosis Research Society Close Menu Member Login Become a Member Home Find a Specialist | Calendar Contact | Donate ... a Member Find a Specialist Calendar Contact Donate Scoliosis Research Society Dedicated to the optimal care of ...

  5. Reclaiming Society Publishing

    Directory of Open Access Journals (Sweden)

    Philip E. Steinberg

    2015-07-01

    Full Text Available Learned societies have become aligned with commercial publishers, who have increasingly taken over the latter’s function as independent providers of scholarly information. Using the example of geographical societies, the advantages and disadvantages of this trend are examined. It is argued that in an era of digital publication, learned societies can offer leadership with a new model of open access that can guarantee high quality scholarly material whose publication costs are supported by society membership dues.

  6. 浅析“家庭-学校-社会”三位一体的大学生职业生涯规划指导模式的构建%A Brief Analysis on the Construction of the "Family-Uni-versity-Society" Three-in-one Career Planning Guidance Mode for University Students

    Institute of Scientific and Technical Information of China (English)

    钟卓良

    2015-01-01

    大学生的职业生涯规划是一项复杂而艰辛的系统工程,家庭、学校、社会等多方面的因素都对大学生的职业规划产生深远影响。目前,高校的职业生涯规划指导体系主要建立在课程体系上,缺乏家庭与社会方面的体系建设。构建“家庭—学校—社会”三位一体的大学生职业生涯规划指导模式,让家庭、学校、社会以一种互动的方式帮助大学生开展职业规划,更有利于发挥职业生涯规划对大学生成长成才的巨大作用。%The career planning of university students is a compli-cated and arduous systematic project, influenced by the family, university and the society from multiple dimensions. The current university career planning guidance system is mainly built on curriculum system, lacking the system construction on family and society aspects. The "family-university-society" three-in-one career planning guidance mode for university students is a way to help university students implement career planning by an inter-active style cooperated by the family, the university and the soci-ety, and it is more beneficial to play the crucial role of career planning in university students' growth and success.

  7. Arthroscopic Posterior Subtalar Arthrodesis: Surgical Technique

    Science.gov (United States)

    Vilá y Rico, Jesús; Ojeda Thies, Cristina; Parra Sanchez, Guillermo

    2016-01-01

    Surgical fusion of the subtalar joint is a procedure indicated to alleviate pain of subtalar origin, such as in post-traumatic osteoarthritis, adult-acquired flatfoot deformity, and other disorders. Open subtalar arthrodesis has been performed with predictable results, but concerns exist regarding injury to proprioception and local vascularity due to wide surgical dissection. Minimally invasive techniques try to improve results by avoiding these issues but have a reputation for being technically demanding. We describe the surgical technique for arthroscopic subtalar arthrodesis, which has proved to be a safe and reliable technique in our experience, with consistent improvements in American Orthopaedic Foot & Ankle Society scores. PMID:27073783

  8. Arthroscopic Posterior Subtalar Arthrodesis: Surgical Technique.

    Science.gov (United States)

    Vilá Y Rico, Jesús; Ojeda Thies, Cristina; Parra Sanchez, Guillermo

    2016-02-01

    Surgical fusion of the subtalar joint is a procedure indicated to alleviate pain of subtalar origin, such as in post-traumatic osteoarthritis, adult-acquired flatfoot deformity, and other disorders. Open subtalar arthrodesis has been performed with predictable results, but concerns exist regarding injury to proprioception and local vascularity due to wide surgical dissection. Minimally invasive techniques try to improve results by avoiding these issues but have a reputation for being technically demanding. We describe the surgical technique for arthroscopic subtalar arthrodesis, which has proved to be a safe and reliable technique in our experience, with consistent improvements in American Orthopaedic Foot & Ankle Society scores.

  9. Indian Vacuum Society: The Indian Vacuum Society

    Science.gov (United States)

    Saha, T. K.

    2008-03-01

    The Indian Vacuum Society (IVS) was established in 1970. It has over 800 members including many from Industry and R & D Institutions spread throughout India. The society has an active chapter at Kolkata. The society was formed with the main aim to promote, encourage and develop the growth of Vacuum Science, Techniques and Applications in India. In order to achieve this aim it has conducted a number of short term courses at graduate and technician levels on vacuum science and technology on topics ranging from low vacuum to ultrahigh vacuum So far it has conducted 39 such courses at different parts of the country and imparted training to more than 1200 persons in the field. Some of these courses were in-plant training courses conducted on the premises of the establishment and designed to take care of the special needs of the establishment. IVS also regularly conducts national and international seminars and symposia on vacuum science and technology with special emphasis on some theme related to applications of vacuum. A large number of delegates from all over India take part in the deliberations of such seminars and symposia and present their work. IVS also arranges technical visits to different industries and research institutes. The society also helped in the UNESCO sponsored post-graduate level courses in vacuum science, technology and applications conducted by Mumbai University. The society has also designed a certificate and diploma course for graduate level students studying vacuum science and technology and has submitted a syllabus to the academic council of the University of Mumbai for their approval, we hope that some colleges affiliated to the university will start this course from the coming academic year. IVS extended its support in standardizing many of the vacuum instruments and played a vital role in helping to set up a Regional Testing Centre along with BARC. As part of the development of vacuum education, the society arranges the participation of

  10. LIBRARY ROLES IN CHANGING SOCIETY

    Directory of Open Access Journals (Sweden)

    Laura Juchnevič

    2014-08-01

    roles changing from library as the repository to the library as the place and information to the customer anywhere and anytime. Library itself can take and fulfill several roles simultaneously, while responding to various needs of society’s members. Research limitations/implications – libraries are analyzed as a social institution in the dynamic environment. Practical implications – it allows to analyze society influence on libraries activities and plan libraries roles changing. Originality/Value – based on first try to research libraries roles in Lithuania systematically. Keywords: library, libraries roles, digital native, digital immigrants. Research type: literature review.

  11. World Federation of Vascular Societies: presidential address

    DEFF Research Database (Denmark)

    Sillesen, Henrik Hegaard

    2010-01-01

    The presidential address describes briefly the history of the World Federation for Vascular Societies (WFVS) and its objectives. Vascular Surgery today includes interventional procedures (open surgical and endovascular) in addition to risk factor reduction and medical treatment. It is equally imp...... throughout the world. In addition, for introduction of new treatments, training issues and dissemination of science a global organisation like the WFVS is needed.......The presidential address describes briefly the history of the World Federation for Vascular Societies (WFVS) and its objectives. Vascular Surgery today includes interventional procedures (open surgical and endovascular) in addition to risk factor reduction and medical treatment. It is equally....... Similar, in order to be able to train with relevant case mix and numbers, and in order always to have both complex open and endovascular skills on call 24 hours per day, 365 days a year, centralisation into larger units is necessary. The WFVS is important simply looking at the huge demographic differences...

  12. Participation in a post-socialist society

    DEFF Research Database (Denmark)

    Eskemose Andersen, Jørgen

    2004-01-01

    Urban development and urban planning in a society like the Mozambican under transformation from a centrally planned society to a market oriented democracy. The transition from a one party state to a multiparty state involving participation of the population is a lengthy process with many obstacles....... The housing issue and the land issue are dealt with as crucial determinants in an attempt to facilitate the urban poor with affordable housing options. The urban environmental issue with a degraded urban environment facilitated with rudimentary infrastructure is dealt with and experiences from an ongoing...... urban environmental project are highlighted....

  13. Do Robotic Surgical Systems Improve Profit Margins? A Cross-Sectional Analysis of California Hospitals.

    Science.gov (United States)

    Shih, Ya-Chen Tina; Shen, Chan; Hu, Jim C

    2017-09-01

    The aim of this study was to examine the association between ownership of robotic surgical systems and hospital profit margins. This study used hospital annual utilization data, annual financial data, and discharge data for year 2011 from the California Office of Statewide Health Planning and Development. We first performed bivariate analysis to compare mean profit margin by hospital and market characteristics and to examine whether these characteristics differed between hospitals that had one or more robotic surgical systems in 2011 and those that did not. We applied the t test and the F test to compare mean profit margin between two groups and among three or more groups, respectively. We then conducted multilevel logistic regression to determine the association between ownership of robotic surgical systems and having a positive profit margin after controlling for other hospital and market characteristics and accounting for possible correlation among hospitals located within the same market. The study sample included 167 California hospitals with valid financial information. Hospitals with robotic surgical systems tended to report more favorable profit margins. However, multilevel logistic regression showed that this relationship (an association, not causality) became only marginally significant (odds ratio [OR] = 6.2; P = 0.053) after controlling for other hospital characteristics, such as ownership type, teaching status, bed size, and surgical volumes, and market characteristics, such as total number of robotic surgical systems owned by other hospitals in the same market area. As robotic surgical systems become widely disseminated, hospital decision makers should carefully evaluate the financial and clinical implications before making a capital investment in this technology. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  14. Diagnostic accuracy of the A-test and cutoff points for assessing outcomes and planning acute and post-acute rehabilitation of patients surgically treated for hip fractures and osteoarthritis

    Directory of Open Access Journals (Sweden)

    Vukomanović Aleksandra

    2016-01-01

    Full Text Available Background/Aim. The A-test is used in daily clinical practice for monitoring functional recovery of orthopedic patients during early rehabilitation. The aim of this study was to determine the accuracy of A-test and cutoff point at which the test can separate patients with and without functional disability at the end of early rehabilitation. Also, it was important to determine whether A-test has that discriminative ability (and at which cutoff points in the first days of early rehabilitation in order to have time to plan post acute rehabilitation. Methods. This measurement-focused study was conducted in the Orthopedic Ward during early inpatient rehabilitation (1st−5th day after the operation of 60 patients with hip osteoarthritis (HO that underwent arthroplasty and 60 surgically treated patients with hip fracture (HF. For measurements we used the A-test and the University of Iowa Level of Assistance Scale (ILAS as the gold standard. For statistical analysis we used the receiver operating characteristic (ROC curve and the area under the curve (AUC with 95% confidence interval for the results of A-test from the first to the fifth day of rehabilitation, sensitivity, specificity, the rate of false positive and false negative errors, positive and negative predictive value, ratio of positive and negative likelihood ratio, accuracy, point to the ROC curve closest to 0.1 and Youden index for all the cutoff points. Results. The AUC was 0.825 (0.744−0.905 for the first day of rehabilitation, 0.922 (0.872−0.972 for the second day of rehabilitation, 0.980 (0.959−1.000 for the third day of rehabilitation, 0.989 (0.973−1.004 for the fourth day, and 0.999 (0.996−1.001 for the fifth day of rehabilitation. The optimal cutoff for the results of A-test was: 7/8 for the first day, 29/30 for the fourth day, and 34/35 for the fifth day of rehabilitation. On the second and the third day A-test had two cutoff points, the lower point safely separated the

  15. 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.

  16. Surgical travellers: tapestry to Bayeux.

    Science.gov (United States)

    Hedley-Whyte, John; Milamed, Debra R

    2014-09-01

    The planning for surgery in war was revisited in 1937 when Ian Fraser was elected a member of the Surgical Travellers. At their 1938 Surgical Travellers meeting in Vienna, Ian and Eleanor Fraser were evicted from their hotel room by the Nazis. The 1939 meeting in Belfast discussed the organization of surgery and the conduct of Emergency Medical Service Hospitals in the United Kingdom; the vast majority were to be under civilian government and military control. From 1943 lengthy and informative organizational meetings were held at least monthly under the chairmanship of Sir Alexander Hood, KBE, Head of the RAMC. Surgical Consultants, now Major Generals, Brigadiers or Full Colonels in the British and U.S. Armies stationed in the UK, prepared for the invasion of Europe. The allocation of medical, surgical, nursing and auxiliary responsibilities was delineated. Liaison with the RAF and US Army Air Force was close as it was with the proposed leaders, Ulstermen Brooke and Montgomery. Montgomery chose Arthur Porritt as Surgeon in Chief to Supreme Headquarters Allied Expeditionary Force (SHAEF), and Eisenhower, General Albert W. Kenner. Just after D-Day, Porritt met Ian Fraser, who had waded in on Arromanches Beach. The triage and evacuation plans for Allied casualties had been controversial, particularly as regards Landing Ship Tanks (LSTs). The dispute with the Hood-selected surgeons on one side, against medical and surgical deployment of LSTs, and Admiral Ernest King and Winston Churchill on the other, favouring LST use for surgery and evacuation. King and Churchill were correct but total Allied air superiority allowed wide use of many of the Allies' Dakotas; 10,000 DC-3s were eventually in service. Supported by forty Allied combat planes to each Luftwaffe, the dispute about Landing Ship Tank use in about a fortnight became moot. The multifaceted role of the Princess Royal in the Emergency Medical Services of the United Kingdom and her close liaison with the Consultant

  17. Civil Society and Governance

    DEFF Research Database (Denmark)

    Hulgård, Lars

    An illustration of how important the relationship is between civil society anbd governance. A short historic journey with four snapshots of times and situations that have provided interesting evidence about the connection between civil society and governance. My goal for the short historic journey...... is to make clear and hopefully even verify that providing knowledge about the impact of civil society and citizens’ participation on governance is one of the most urgent research tasks in the current period of time....

  18. Civil Society and Governance

    DEFF Research Database (Denmark)

    Hulgård, Lars

    An illustration of how important the relationship is between civil society anbd governance. A short historic journey with four snapshots of times and situations that have provided interesting evidence about the connection between civil society and governance. My goal for the short historic journey...... is to make clear and hopefully even verify that providing knowledge about the impact of civil society and citizens’ participation on governance is one of the most urgent research tasks in the current period of time....

  19. Technology Planning: Thinking Strategically for Planning.

    Science.gov (United States)

    Westbrook, Kathleen C.

    1993-01-01

    Sound educational planning is essential in an era faced with declining resources, increasing accountability demands, and reluctance to fund higher taxation requests. Planners are seriously challenged by shift from an industrial to a paperless, technological society. This article compares long-range and strategic planning approaches, describes…

  20. Fieldwork in Transforming Societies

    DEFF Research Database (Denmark)

    Clark, Ed; Michailova, Snejina

    The contributors to this text discuss the personal and professional challenges of conducting fieldwork in the difficult, sometimes threatening contexts of the transforming societies of post-socialist Europe and China.......The contributors to this text discuss the personal and professional challenges of conducting fieldwork in the difficult, sometimes threatening contexts of the transforming societies of post-socialist Europe and China....

  1. The Tranquebarian Society

    DEFF Research Database (Denmark)

    Jensen, Niklas Thode

    2015-01-01

    of this development was the establishment of the Tranquebarian Society, the third learned society east of the Cape of Good Hope. The article examines the unique assemblage of scientific networks, people, instruments, institutions, and ideas of local and global origin that converged in Tranquebar, and it investigates...

  2. The Tranquebarian Society

    DEFF Research Database (Denmark)

    Jensen, Niklas Thode

    2015-01-01

    of this development was the establishment of the Tranquebarian Society, the third learned society east of the Cape of Good Hope. The article examines the unique assemblage of scientific networks, people, instruments, institutions, and ideas of local and global origin that converged in Tranquebar, and it investigates...

  3. American Society of Neuroradiology

    Science.gov (United States)

    ASNR American Society of Neuroradiology Forgot username or password ? .: International Day Of Radiology :. Tues, Nov 8 is International Day of Radiology. ... you celebrate, #neurorad? #IDoR2016 Once again, the European Society of Radiology has created a wonderful ... Tues, Nov ...

  4. Transformation of Neolithic Societies

    DEFF Research Database (Denmark)

    Iversen, Rune

    and prepared the way for the appearance of Bronze Age societies. The great era of megalithic architecture came to an end as the production and exchange of gold, copper and bronze objects became the driving force in the development of Copper and Bronze Age societies. This development also had a great influence...

  5. Refractions of Civil Society

    DEFF Research Database (Denmark)

    Kuzmanovic, Daniella

    The thesis investigates various perceptions of civil society among civic activists in Turkey, and how these perceptions are produced and shaped. The thesis is an anthropological contribution to studies of civil society in general, as well as to studies on political culture in Turkey....

  6. Surgical infection in art.

    Science.gov (United States)

    Meakins, J L

    1996-12-01

    The earliest images of medicine and surgery in Western art are from the late Middle Ages. Although often attractive, at that time they were illustrative and mirrored the text on how to diagnose or treat a specific condition. These drawings in medieval manuscripts represent management of abscesses, perianal infection and fistulas, amputation, and wound dressings. With the Renaissance, art in all its forms flourished, and surgeons were represented at work draining carbuncles, infected bursae, and mastoiditis; managing ulcers, scrofula, and skin infections; and performing amputations. Specific diagnosis can be made, such as streptococcal infection in the discarded leg of the miraculous transplantation performed by Saints Cosmas and Damian and in the works of Rembrandt van Rijn and Frederic Bazille. Evocations of cytokine activity are evident in works by Albrecht Dürer, Edvard Munch, and James Tissot. The iconography of society's view of a surgeon is apparent and often not complimentary. The surgeon's art is a visual art. Astute observation leads to early diagnosis and better results in surgical infection and the septic state. Learning to see what we look at enhances our appreciation of the world around us but, quite specifically, makes us better clinicians.

  7. Looking ahead: the SSAT strategic plan for the next decade.

    Science.gov (United States)

    Rattner, David W; Mahvi, David M; Hunter, John G

    2011-07-01

    The Society for Surgery of the Alimentary Tract's (SSAT) mission is to advance the science and practice of surgery in the treatment of digestive disease. An essential core value of the SSAT is multidisciplinary collaboration with both its sister societies in the Digestive Disease Week (DDW) Council and other surgical societies in Gastrointestinal Surgery. In order to achieve the society's goals, the strategic plan rests on the society's values of interdisciplinary collaboration, scholarship, education, and discovery. The strategic plan also creates a meritocracy system to foster the development of future leaders for both the SSAT and the broader house of surgery. In the short term, this plan will: Re-organize committee structure and reporting responsibilities; Clarify committee goals and deliverables; Facilitate member participation in the committees and governance of the society; Enhance member services by utilizing enhanced communication strategies; Accelerate efforts to meet the Maintenance of Certification needs of the membership; Re-focus the SSAT's energy on Quality and Outcome Assessment of GI surgery; Clarify and standardize the methodology for allocating funds for new projects. Over the course of the next few years, the SSAT will: Develop a financial model that increases revenue to support the expanded tasks the society intends to undertake; Play an active role in developing the evolving training paradigms for gastrointestinal surgeons through the continuum from residency, fellowship, and early mentored practice; Continue to support development of surgeon scientists through Career Development Award; Enhance relationship with the SSAT Foundation; Continue to improve the experience of members attending DDW; Develop surgeons interested in public policy to be leaders at a national level. The strategic plan is ambitious, and the current leadership realizes that all the tasks and objectives cannot be accomplished in 1 year. There is much to do in order to keep

  8. The Society for Scandinavian Art

    DEFF Research Database (Denmark)

    Grand, Karina Lykke

    2016-01-01

    The Society for Nordic Art & the Scandinavian Society [Selskabet for Nordisk Kunst & Skandinavisk Selskab]......The Society for Nordic Art & the Scandinavian Society [Selskabet for Nordisk Kunst & Skandinavisk Selskab]...

  9. Hernia Surgical Mesh Implants

    Science.gov (United States)

    ... Prosthetics Hernia Surgical Mesh Implants Hernia Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine) ...

  10. Urogynecologic Surgical Mesh Implants

    Science.gov (United States)

    ... Prosthetics Urogynecologic Surgical Mesh Implants Urogynecologic Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine). ...

  11. 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 / ...

  12. Optimizing surgical f

    Directory of Open Access Journals (Sweden)

    Sabry Mohamed Amin

    2016-07-01

    Conclusions: In our study both dexmedetomidine and esmolol were effective in reducing MABP, and lowering the heart rate providing dry surgical field and ensured good surgical condition during cochlear implant surgery in pediatric patients.

  13. 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 ...

  14. Surgical skin-marking techniques.

    Science.gov (United States)

    Granick, M S; Heckler, F R; Jones, E W

    1987-04-01

    Surgical skin-marking inks and dyes are in everyday use for designing and planning incisions in plastic and reconstructive surgery. We have traced the historical development of surgical skin-marking techniques from ancient times to the present. The biochemical characteristics of the commonly used marking agents are discussed. A three-part experiment utilizing a pig model was carried out to test the tissue inflammatory response to the various dyes and inks when used intradermally as tattoos, the persistence of such tattoos, and the ease of skin erasure for each of eight stains. Methylene blue and gentian violet are recommended as the best all-purpose marking agents. The use of proprietary inks is discouraged.

  15. Information society studies

    CERN Document Server

    Duff, Alistair S

    2013-01-01

    We are often told that we are ""living in an information society"" or that we are ""information workers."" But what exactly do these claims mean, and how might they be verified? In this important methodological study, Alistair S. Duff cuts through the rhetoric to get to the bottom of the ""information society thesis."" Wide-ranging in coverage, this study will be of interest to scholars in information science, communication and media studies and social theory. It is a key text for the newly-unified specialism of information society studies, and an indispensable guide to the future of this disc

  16. Fairness in society

    CERN Document Server

    Flomenbom, Ophir

    2011-01-01

    Models that explain the economical and political realities of nowadays societies should help all the world's citizens. Yet, the last four years showed that the current models are missing. Here we develop a dynamical society-deciders model showing that the long lasting economical stress can be solved when increasing fairness in nations. fairness is computed for each nation using indicators from economy and politics. Rather than austerity versus spending, the dynamical model suggests that solving crises in western societies is possible with regulations that reduce the stability of the deciders, while shifting wealth in the direction of the people. This shall increase the dynamics among socio-economic classes, further increasing fairness.

  17. Climate and Ancient Societies

    DEFF Research Database (Denmark)

    Climate, and human responses to it, have a strongly interconnected relationship. This when climate change occurs, the result of either natural or human causes, societies should react and adapt to these. But do they? If so, what is the nature of that change, and are the responses positive...... or negative for the long-term survival of social groups? In this volume, scholars from diverse disciplines including archaeology, geology and climate sciences explore scientific and material evidence for climate changes in the past, their causes, their effects on ancient societies and how those societies...

  18. Changing anthropology, changing society.

    Science.gov (United States)

    Varughese, Heather

    2009-12-01

    Fifty years after the founding of the field of medical anthropology, the Society for Medical Anthropology of the American Anthropological Association held its first independent meeting on September 24-27, 2009, at Yale University.

  19. Valie EXPORT Society Rooseumis

    Index Scriptorium Estoniae

    2002-01-01

    Malmös Rooseumi Kaasaegse Kunsti Keskuses näitus "Baltic Babel". Projekt koosneb Läänemeremaade linnades tegutsevate innovatiivsete gruppide aktsioonidest. Kuraator Charles Esche. Esinejatest (Eestist Valie Export Society: Kadi Estland, Killu Sukmit)

  20. Valie EXPORT Society. Overlok

    Index Scriptorium Estoniae

    2001-01-01

    Valie EXPORT Society asutasid 23. okt. 1999. a. Frankfurdis Kadi Estland, Killu Sukmit ja Mari Laanemets, kui olid külastanud austria naiskunstniku Valie Exporti näitust. Rühmituse aktsioonide kirjeldus

  1. American Society of Nephrology

    Science.gov (United States)

    ... Week Abstracts In The Loop Request Missing Publication Advertising Opportunities Advocacy and public policy Legislative Action Center ... News Feed Society Events Interact With ASN rss Facebook Twitter YouTube Flickr LinkedIn Podcast ASN Communities Share ...

  2. National Multiple Sclerosis Society

    Science.gov (United States)

    ... Join the Community Stay Informed Corporate Support National Multiple Sclerosis Society Meet the Challenge to end MS Give ... in MS Research November 2, 2016 View All Multiple Sclerosis News & Press View All Clinical Trial Alerts Every ...

  3. American Geriatrics Society

    Science.gov (United States)

    ... Travel Award for Research Symposium on Pharmacotherapy and Older Adults with CVD November 10th, 2016 Need Help Understanding MACRA? Check Out this Free Toolkit ... © 2016 The American Geriatrics Society. All rights reserved. Privacy Policy . Copyright & Permissions . Disclaimer .

  4. Valie EXPORT Society Rooseumis

    Index Scriptorium Estoniae

    2002-01-01

    Malmös Rooseumi Kaasaegse Kunsti Keskuses näitus "Baltic Babel". Projekt koosneb Läänemeremaade linnades tegutsevate innovatiivsete gruppide aktsioonidest. Kuraator Charles Esche. Esinejatest (Eestist Valie Export Society: Kadi Estland, Killu Sukmit)

  5. Valie EXPORT Society. Overlok

    Index Scriptorium Estoniae

    2001-01-01

    Valie EXPORT Society asutasid 23. okt. 1999. a. Frankfurdis Kadi Estland, Killu Sukmit ja Mari Laanemets, kui olid külastanud austria naiskunstniku Valie Exporti näitust. Rühmituse aktsioonide kirjeldus

  6. Society of Thoracic Surgeons

    Science.gov (United States)

    ... Care for You How to Use Apps and Social Media for Your Practice Why Participation in the STS ... STS_CTsurgery Surgeons Residents & Students Allied ... Hotel Discount for STS Members Copyright © 2016 The Society ...

  7. National Multiple Sclerosis Society

    Science.gov (United States)

    ... an experience grounded in camaraderie and marked by passion, inspiration, determination and pure enjoyment. Register Now You ... Pinterest MS Connection About the Society Vision Careers Leadership Cultural Values Financials News Press Room MS Prevalence ...

  8. Changing Anthropology, Changing Society

    Science.gov (United States)

    Varughese, Heather

    2009-01-01

    Fifty years after the founding of the field of medical anthropology, the Society for Medical Anthropology of the American Anthropological Association held its first independent meeting on September 24-27, 2009, at Yale University. PMID:20027281

  9. The Tranquebarian Society

    DEFF Research Database (Denmark)

    Jensen, Niklas Thode

    2015-01-01

    of this development was the establishment of the Tranquebarian Society, the third learned society east of the Cape of Good Hope. The article examines the unique assemblage of scientific networks, people, instruments, institutions, and ideas of local and global origin that converged in Tranquebar, and it investigates...... the fusion of local problems and radical ideas of enlightenment, education, and improvement that united government, mission, and merchants in Tranquebar in the quest for ‘useful knowledge’....

  10. Transnationalising Civil Society?

    DEFF Research Database (Denmark)

    Jørgensen, Martin Bak

    The paper takes a transnational perspective on developing an analytical framework for understanding how transnationalism interacts with civil society and how immigrant organisations use transnational strategies to challenge the pre-given positions of immigrants within given integration- and citiz......The paper takes a transnational perspective on developing an analytical framework for understanding how transnationalism interacts with civil society and how immigrant organisations use transnational strategies to challenge the pre-given positions of immigrants within given integration...

  11. Family in contemporary society

    OpenAIRE

    Rabije Murati

    2016-01-01

    The family is part of social change and, as such changes and transform into steps with modern trends of society. Family function in a given society is structured according to the overall changes that occur in all areas of social life, not neglecting family life. The contemporary conditions impose requirements that must be met to move forward with the times that follow. In particular, should highlight the social changes that are related to the growth and advancement of the educational and prof...

  12. Urban Settlements in Post-modern Society: Analysis from An Eco-landscape Planning Perspective%基于生态景观规划的后现代社会城市住区研究

    Institute of Scientific and Technical Information of China (English)

    马娜; 孙攀; 杨文忠; 张珊珊; 康洪梅; 方波

    2015-01-01

    在综述和分析原始社会、 农业社会、 工业社会和现代社会人类居住环境发展变化的基础上, 结合景观生态学、 田园城市理论和可持续发展思想, 提出了后现代社会城市住区的进化论社区模式和后进化论时期的轮歇模式, 详细介绍了进化论社区模式中动植物生态群落、 建筑形式和社区人文三位一体的结构功能特征, 阐释了三者相互融合的关系. 通过分析后进化论时期的轮歇模式, 探讨城市住区的发展趋势和方向.%To understand the development trend of urban settlements , settlement patterns and their physical envi-ronment changes in primitive society, agricultural society, industrial society and modern society were reviewed. Based on garden city theory, the theory of landscape ecology and sustainable development, possible settlement pat-terns in post-modern society were derived from the history of settlement development.The configuration and func-tion of postmodern urban settlement , in which a trinity of biological community , building pattern and human cul-ture, was introduced, and their syncretic relationships were reasonably established.

  13. Rehabilitation of a dentate mandible requiring a full arch rehabilitation. Immediate loading of a fixed complete denture on 8 implants placed with a bone-supported surgical computer-planned guide: a case report

    National Research Council Canada - National Science Library

    Amorfini, Leonardo; Storelli, Stefano; Romeo, Eugenio

    2011-01-01

    .... The case was planned using SimPlant and a bone-supported guide. Because of the high precision of the planning, it was possible to realize a provisional rehabilitation before the actual surgery...

  14. [Gender equality activity in the Bioimaging Society].

    Science.gov (United States)

    Suzaki, Etsuko

    2013-09-01

    Gender equality activity in the Bioimaging Society was initiated in 2005 when it joined the Japan Inter-Society Liaison Association Committee for Promoting Equal Participation of Men and Women in Science and Engineering (EPMEWSE). The Gender Equality Committee of the Bioimaging Society is acting on this issue by following the policy of the EPMEWSE, and has also been planning and conducting lectures at annual meetings of the society to gain the understanding, consents, and cooperation of the members of the society to become conscious of gender equality. Women's participation in the society has been promoted through the activities of the Gender Equality Committee, and the number of women officers in the society has since increased from two women out of 40 members in 2005 to five out of 44 in 2013. The activities of the Gender Equality Committee of the Japanese Association of Anatomists (JAA) have just started. There are more than 400 women belonging to the JAA. When these women members join together and collaborate, women's participation in the JAA will increase.

  15. Surgical Lasers In Gynecology

    Science.gov (United States)

    Schellhas, Helmut F.; Barnes, Alfonso E.

    1982-12-01

    Multipurpose surgical CO2 lasers marketed in the USA have been developed to be applicable to a variety of surgical procedures in many surgical fields. They are all suited for endoscopic surgical procedures and can be fitted to all standard surgical microscopes. They all can adjust the focal length of the laser beam to the different standard focal lengths of the surgical microscope which for instance in laryngoscopy is 400 mm and in colposcopy 300 mm. One laser instrument can even change the spot size in a given focal distance which is very advantageous for some microsurgical procedures (Merrimack Laboratories 820). All multipurpose surgical CO2 laser systems provide a multi-articulated surgical arm for free-hand surgery. The surgical arms are cumbersome to use but they are adapted to the surgeons needs with ingenuity. The practicality of the multi-articulated surgical arms depends mostly on the distance of the handpiece from the surgical console which now is also overbridged by the laser tube in most surgical laser system. The spot size of the beam is variable in most handpieces by interchangeable lenses which modify the focal distance of the beam and the power density. Another common feature in all systems is a coaxial He-Ne pilot light which provides a red spot which unfortunately becomes invisible in a bleeding surgical field. Most surgical laser systems have a spacial mode of TEM 00 which is essential for incisional surgery. The continuous mode of beam delivery is used for incisional surgery and also for most endoscopic procedures.

  16. Society of Gynecologic Surgeons

    Science.gov (United States)

    Search Member Login Home About Mission Strategic Plan Leadership Bylaws History Past Presidents Past TeLinde Lectures Past Distinguished Surgeon ... Search Member Login Home About Mission Strategic Plan Leadership Bylaws History Past Presidents Past TeLinde Lectures Past Distinguished Surgeon ...

  17. Science and Society: The Third Dimension of the Atlantic Alliance.

    Science.gov (United States)

    Sudarskis, Michel

    1983-01-01

    Discusses North Atlantic Treaty Organization (NATO) activities related to science and society. NATO Scientific Exchanges Programme; pilot studies (pollution control, natural resources, health and technological risks, quality of life, and planning); and cultural exchanges are among the areas considered. (JN)

  18. ORIGINAL ARTICLE CASE REPORT Functional MRI in pre-surgical ...

    African Journals Online (AJOL)

    CASE REPORT. Functional magnetic resonance imaging (fMRI) is an MRI technique ... most promising direct clinical application is in pre-surgical planning, where fMRI is ... robust and established, although it is interesting to note that recent.

  19. Consumption in the Information Society

    Science.gov (United States)

    Zherebin, V. M.; Ermakova, N. A.; Makhrova, O. N.

    2010-01-01

    The current state of the economy in the developed countries make it possible to characterize them using concepts and terms such as the postindustrial society, the new economy, the service economy, the creative economy, the posteconomic society, the information society, the knowledge society, and the consumer society. Among these terms and…

  20. Consumption in the Information Society

    Science.gov (United States)

    Zherebin, V. M.; Ermakova, N. A.; Makhrova, O. N.

    2010-01-01

    The current state of the economy in the developed countries make it possible to characterize them using concepts and terms such as the postindustrial society, the new economy, the service economy, the creative economy, the posteconomic society, the information society, the knowledge society, and the consumer society. Among these terms and…

  1. Three-dimensional Echocardiography in Congenital Heart Disease: An Expert Consensus Document from the European Association of Cardiovascular Imaging and the American Society of Echocardiography.

    Science.gov (United States)

    Simpson, John; Lopez, Leo; Acar, Philippe; Friedberg, Mark K; Khoo, Nee S; Ko, H Helen; Marek, Jan; Marx, Gerald; McGhie, Jackie S; Meijboom, Folkert; Roberson, David; Van den Bosch, Annemien; Miller, Owen; Shirali, Girish

    2017-01-01

    Three-dimensional echocardiography (3DE) has become important in the management of patients with congenital heart disease (CHD), particularly with pre-surgical planning, guidance of catheter intervention, and functional assessment of the heart. 3DE is increasingly used in children because of good acoustic windows and the non-invasive nature of the technique. The aim of this paper is to provide a review of the optimal application of 3DE in CHD including technical considerations, image orientation, application to different lesions, procedural guidance, and functional assessment. Copyright © 2016 European Society of Cardiology. Published by Elsevier Inc. All rights reserved.

  2. New land, new town, new health care system: primary care based health care planning in a modern, industrialized society; a case-study evaluating the health care demonstration project in the new Dutch town of Almere.

    NARCIS (Netherlands)

    Sixma, H.J.M.

    1997-01-01

    Het NIVEL evalueerde het Experiment Almeerse Gezondheidszorg (EAG). Dit experiment was bedoeld om de gezondheidszorg efficiënter en goedkoper te maken door middel van een strikte planning waarin voorrang werd gegeven aan de eerstelijns gezondheidszorg. Begin jaren zeventig wilde de overheid de

  3. Control tower to surgical theater

    Directory of Open Access Journals (Sweden)

    Buccioli Matteo

    2016-09-01

    Full Text Available The main social priority is to reduce public debt and to streamline national health service (NHS costs. Consequently, health managers need to acquire operating methods within their managerial structures so that all available resources are better planned in terms of effectiveness and efficiency, without compromising patient safety. In order to identify the information categories needed to know the whole surgical process is necessary to divide these in two main categories, supply and demand. Demand Information Group (DIG contains the information that identify patients and its needs in terms of care. Instead Supply Information Group (SIG contains information about hospital resources in order to cover the supply. The surgical process analyzed in terms such as industrial production process has the goal of produce the “health product for the patient” and its central part is performed in the operating room by a surgical team. This does not mean that the precedent and subsequent phases of the operating room have minor importance, in fact to obtain a high quality “health product” and reduce to a minimum the clinical risks related to the patient it is necessary that each phase of the process is carried out in the right way. The implementation of a Control Tower Approach allows for the management of productive process, able to guide hospital managers to identify the best strategies and to improve the risk management of patient safety in response to the guidelines of the World Health Organization.

  4. 77 FR 26768 - Food and Drug Administration/International Society for Pharmaceutical Engineering Cosponsorship...

    Science.gov (United States)

    2012-05-07

    ... cosponsorship with the International Society for Pharmaceutical Engineering (ISPE), is planning a multiday... HUMAN SERVICES Food and Drug Administration Food and Drug Administration/International Society for Pharmaceutical Engineering Cosponsorship Educational Workshop: Redefining the `C' in CGMP: Creating,...

  5. Science and Society Colloquium

    CERN Multimedia

    Randi, J

    1991-01-01

    Mr. Randi will give an update of his lecture to the American Physical Society on the occasion of his award of the 1989 Forum Prize. The citation said: "for his unique defense of Science and the scientific method in many disciplines, including physics, against pseudoscience, frauds and charlatans. His use of scientific techniques has contributed to refuting suspicious and fraudulent claims of paranormal results. He has contributed significantly to public understanding of important issues where science and society interact". He is a professional magician and author of many books. He worked with John Maddox, the Editor of Nature to investigate the claims of "water with memory".

  6. Producing Civil Society

    DEFF Research Database (Denmark)

    Feldt, Liv Egholm; Hein Jessen, Mathias

    Since the beginning of the 1990’s, civil society has attracted both scholarly and political interest as the ‘third sphere’ outside the state and the market not only a normatively privileged site of communication and ‘the public sphere’, but also as a resource for democratization processes...... of the century. 2, the laws and strategies of implementing regarding the regulation of civil societal institutions (folkeoplysningsloven) since the 1970’s this paper shows how civil society in 20th century Denmark was produced both conceptually and practically and how this entailed a specific vision and version...

  7. Internet plan and planning

    Directory of Open Access Journals (Sweden)

    Kahriman Emina

    2008-01-01

    Full Text Available Paper discuss specific features of internet plan as well as planning as management process in general in the contemporary environment. No need to stress out that marketing plan and marketing planning is core activity in approaching to market. At the same time, there are a lot specific c request in preparing marketing plan comparing to business planning due to marketing plan is an essential part. The importance of internet plan and planning rely on specific features of the internet network but as a part of general corporate as well as marketing strategy.

  8. Virtual planning in orthognathic surgery

    DEFF Research Database (Denmark)

    Stokbro, K.; Aagaard, E.; Torkov, P.

    2014-01-01

    and accuracy of three-dimensional (3D) virtual surgical planning of orthognathic procedures compared with the actual surgical outcome following orthognathic surgery reported in clinical trials. A systematic search of the current literature was conducted to identify clinical trials with a sample size of more...

  9. 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.

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

    Science.gov (United States)

    Gandedkar, Narayan H; Chng, Chai Kiat; Yeow, Vincent Kok Leng

    2016-01-01

    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.

  11. Virtual planning in orthognathic surgery.

    Science.gov (United States)

    Stokbro, K; Aagaard, E; Torkov, P; Bell, R B; Thygesen, T

    2014-08-01

    Numerous publications regarding virtual surgical planning protocols have been published, most reporting only one or two case reports to emphasize the hands-on planning. None have systematically reviewed the data published from clinical trials. This systematic review analyzes the precision and accuracy of three-dimensional (3D) virtual surgical planning of orthognathic procedures compared with the actual surgical outcome following orthognathic surgery reported in clinical trials. A systematic search of the current literature was conducted to identify clinical trials with a sample size of more than five patients, comparing the virtual surgical plan with the actual surgical outcome. Search terms revealed a total of 428 titles, out of which only seven articles were included, with a combined sample size of 149 patients. Data were presented in three different ways: intra-class correlation coefficient, 3D surface area with a difference planning appears to be an accurate and reproducible method for orthognathic treatment planning. A more uniform presentation of the data is necessary to allow the performance of a meta-analysis. Currently, the software system most often used for 3D virtual planning in clinical trials is SimPlant (Materialise). More independent clinical trials are needed to further validate the precision of virtual planning.

  12. American Society of Transplantation

    Science.gov (United States)

    ... we are Strategic Plan Annual Report Board of Directors Board Meeting Summaries Committees Staff Bylaws and Policies Bylaws Statement on Ethics 501(c)(3) and Financial Information Conflict of Interest Education Disclaimer Privacy Policy ...

  13. Application of 3D-printing technology in surgical planning for renal tumor: a preliminary report%3D打印技术在肾肿瘤手术规划中的应用研究初探

    Institute of Scientific and Technical Information of China (English)

    葛宏伟; 张弋; 李宁忱; 于澄钒; 果宏锋; 柳金顺; 那彦群

    2014-01-01

    efficacy of using three-dimensional (3D) printing technique on surgical planning and its function in enhancing the physician-patient rapport before surgery.Methods From June 2013 to January 2014,10 patients with T1 renal tumors,who were received laparoscopic partial nephrectomy,were selected in study.Left renal tumor was found in 3 cases and right renal tumor was found in 7 cases.The location of tumor included upper part of kidney in 5 cases,lower part of kidney in 3 cases and renal hilum in 2 cases,4 cases were diagnosed as T1a stage and 6 cases were diagnosed as T1b stage.64-slice enhanced CT scan was performed preoperatively.Data of DICOM format was sent for post processing.The final data was then output to 3 d printer for generating kidney models using thermoplastic plastics.After generating the model,different colors were put on the model,including pink in kidney,yellow in pelvis and ureter,red in renal artery and blue in renal vein.Plotted questionnaires were designed for medical professionals and patients,respectively.4 urological experts make the scores by this questionnaire in order to evaluate the efficacy and fidelity of the model.2 surgeons evaluated the efficacy of model after operation by comparing the actual tumor size with that measured on the models.Meanwhile,the model was used for conversation before operation.The questionnaires were also used for evaluating the effectiveness of conversion.Results 10 kidney models fabricated successfully with 3D-printing.The tumor size,position,renal vascular and collecting system could be clearly presented.Being evaluated by 4 experts and 2 performing urologists,and the mean scores was 7.8 ± 0.7.Intraoperative correlation was advocated by the performing urologists.The mean evaluation score was 7.5.The bias between real diameter of renal carcinoma and that of 3 d model was 3.4± 1.3 mm.Patients and family members preferred the demonstration of the disease and the procedure with a visual and tactile " diseased organ

  14. [Surgical research in Germany. Organization, quality and international competitiveness].

    Science.gov (United States)

    Menger, M D; Laschke, M W

    2012-04-01

    Surgical research in Germany is performed within surgical clinics by individual working groups or in surgical research divisions. Additionally, a few independent institutes and departments of surgical research have been established at medical faculties. The number of these institutions, however, is too small. To increase productivity in surgical research, structural changes are necessary, including additional establishment of further institutes and professorships. The quality of clinical research in surgery in Germany is critically discussed. International comparison shows that Germany has a low ranking with respect to the number of clinical studies published in leading surgical journals. However, there has been some improvement in the quality of clinical studies performed in surgical departments during the last 15 years. The establishment of the study center of the German Society of Surgery shows that excellent clinical studies with adequate numbers of patients can also be performed in Germany and can be published in leading journals. Accordingly, there is need to distribute the structures and the competence necessary to perform clinical studies in a standardized manner to all surgical departments involved in clinical research. The experimental surgical research in Germany is not adequately visible, although over the last 10 years the most relevant publications from institutions for surgical research have been placed in journals with a mean impact factor of 8. This may be due to the fact that 85% of these top publications are published in non-surgical journals. The aim for the future must therefore be to increase the impact factor and, thus, the attractiveness of surgical journals. This may be achieved by publishing the highest quality results from experimental surgical research not in non-surgical but in surgical journals.

  15. Empowering the society through companies CSR agenda

    Directory of Open Access Journals (Sweden)

    Sulaiman Noor Adwa

    2017-01-01

    Full Text Available Topic of socioeconomic issue is one of the most widely discussed globally as it gives effects to occupation, education, income, wealth, and place of residence of individuals. These social challenges should be addressed and resolved because to enhance individuals’ contribution to economic and social life of their society and reduce social tensions and conflicts that negatively affects country’s economic development. For this reason, in the Eleventh Malaysia Plan (2016-2020, the Malaysian Government stresses on the importance of participation of companies in empowering society to improve socioeconomic that could support equitable society. The empowerment programs aim to improve the education, quality of life and wellbeing of individuals and groups in society through reducing wealth gap, racial imbalance and promoting employment equity. One way to initiate greater involvement of the companies in socioeconomic development of the society is through CSR agenda. Specifically, the CSR agenda through empowerment activities (such as trainings programs, educational sponsorship mentorship program and learning and development programs is believed to have a positive implication on society by way of improving wealth, education and skills of the individuals. Hence, this paper aims to develop measurement of empowerment in companies CSR agenda.

  16. Manual of Surgical Instruments

    Directory of Open Access Journals (Sweden)

    Olga Lidia Sánchez Sarría

    2014-10-01

    Full Text Available Surgical instruments are the group of tools used in surgical procedures. They are very expensive and sophisticated. Consequently, a standardized and meticulous care is essential; they should go through the decontamination, cleaning and sterilization process. These instruments are designed in order to provide surgeons with tools that help them to perform a basic surgical procedure; there are multiple variations and the design depends on their function. This paper aims at showing all surgical instruments that can be used in an operating room during surgery and are not generally included in the medical literature.

  17. Science, technology and society

    CERN Document Server

    Giacomelli, G

    2005-01-01

    We shall discuss some aspects of science and technology, their increasing role in the society, the fast advances in modern science, the apparent decrease of interest of the young generation in basic sciences, the importance of proper science popularization for better public education and awareness in scientific fields.

  18. Air pollution and society

    OpenAIRE

    Brimblecombe P.

    2010-01-01

    Air pollution is as much a product of our society as it is one of chemistry and meteorology. Social variables such as gender, age, health status and poverty are often linked with our exposure to air pollutants. Pollution can also affect our behaviour, while regulations to improve the environment can often challenge of freedom.

  19. Connecting Science with Society

    DEFF Research Database (Denmark)

    awareness of the important questions of our society reflected in scientific research and of the answers produced by these research activities. The CRIS2010 conference, entitled “Bringing Science to Society”, therefore seeks to highlight the role of Current Research Information Systems for communicating...

  20. Teaching Global Society.

    Science.gov (United States)

    Peet, Richard

    2002-01-01

    Describes the course, "Global Society," for first-year International Studies students at a Massachusetts liberal arts college. The course, which takes a historical approach, informs students about the nature, history, and present characteristics of the global system, taking theoretical, historical, and critical approaches that stress the…

  1. Exploratory of society

    Science.gov (United States)

    Cederman, L.-E.; Conte, R.; Helbing, D.; Nowak, A.; Schweitzer, F.; Vespignani, A.

    2012-11-01

    A huge flow of quantitative social, demographic and behavioral data is becoming available that traces the activities and interactions of individuals, social patterns, transportation infrastructures and travel fluxes. This has caused, together with innovative computational techniques and methods for modeling social actions in hybrid (natural and artificial) societies, a qualitative change in the ways we model socio-technical systems. For the first time, society can be studied in a comprehensive fashion that addresses social and behavioral complexity. In other words we are in the position to envision the development of large data and computational cyber infrastructure defining an exploratory of society that provides quantitative anticipatory, explanatory and scenario analysis capabilities ranging from emerging infectious disease to conflict and crime surges. The goal of the exploratory of society is to provide the basic infrastructure embedding the framework of tools and knowledge needed for the design of forecast/anticipatory/crisis management approaches to socio technical systems, supporting future decision making procedures by accelerating the scientific cycle that goes from data generation to predictions.

  2. Education for Jobless Society

    Science.gov (United States)

    Sidorkin, Alexander M.

    2017-01-01

    The advent of societies with low employment rates will present a challenge to education. Education must move away from the discourse of skills and towards the discourse of meaning and motivation. The paper considers three kinds of non-waged optional labor that may form the basis of the future economy: prosumption, volunteering, and self-design.…

  3. Education for Jobless Society

    Science.gov (United States)

    Sidorkin, Alexander M.

    2017-01-01

    The advent of societies with low employment rates will present a challenge to education. Education must move away from the discourse of skills and towards the discourse of meaning and motivation. The paper considers three kinds of non-waged optional labor that may form the basis of the future economy: prosumption, volunteering, and self-design.…

  4. Libraries in Society

    DEFF Research Database (Denmark)

    Kristiansson, Michael; Skouvig, Laura

    by Michel Foucault on discourse and power to the introduction of open shelves. Furthermore, the paper discusses current challenges facing the modern public library in coping with openness issues that follow from changes in society and advances in technology. These influences and developments are not least...

  5. Man--Society--Technology.

    Science.gov (United States)

    Taxis, Linda A., Ed.

    The 32nd annual American Industrial Arts Association (AIAA) Convention was held in Louisville in 1970. Topics for the AIAA general session addresses were: (1) "Industrial Arts--The Blender Between Social Form and Technical Function," (2) "Technology and Society: Present and Future Challenges," (3) "A Student-Oriented Industrial Arts," (4) "Man:…

  6. MARX EMBRYOLOGY OF SOCIETY

    NARCIS (Netherlands)

    WOUTERS, A

    1993-01-01

    This article presents a new interpretation of Marx's dialectical method. Marx conceived dialectics as a method for constructing a model of society. The way this model is developed is analogous to the way organisms develop according to the German embryologist Karl Ernst von Baer, and, indeed, Marx's

  7. National Down Syndrome Society

    Science.gov (United States)

    ... DONATE HERE The ABLE Act is Now the Law of the Land! LEARN HOW TO PASS ABLE IN YOUR STATE! NDSS Your Way Join Our Independent Fundraising Program! The mission of the National Down Syndrome Society is to be the national advocate for the ...

  8. Surgical checklists: the human factor.

    LENUS (Irish Health Repository)

    O Connor, Paul

    2013-05-14

    BACKGROUND: Surgical checklists has been shown to improve patient safety and teamwork in the operating theatre. However, despite the known benefits of the use of checklists in surgery, in some cases the practical implementation has been found to be less than universal. A questionnaire methodology was used to quantitatively evaluate the attitudes of theatre staff towards a modified version of the World Health Organisation (WHO) surgical checklist with relation to: beliefs about levels of compliance and support, impact on patient safety and teamwork, and barriers to the use of the checklist. METHODS: Using the theory of planned behaviour as a framework, 14 semi-structured interviews were conducted with theatre personnel regarding their attitudes towards, and levels of compliance with, a checklist. Based upon the interviews, a 27-item questionnaire was developed and distribute to all theatre personnel in an Irish hospital. RESULTS: Responses were obtained from 107 theatre staff (42.6% response rate). Particularly for nurses, the overall attitudes towards the effect of the checklist on safety and teamworking were positive. However, there was a lack of rigour with which the checklist was being applied. Nurses were significantly more sensitive to the barriers to the use of the checklist than anaesthetists or surgeons. Moreover, anaesthetists were not as positively disposed to the surgical checklist as surgeons and nurse. This finding was attributed to the tendency for the checklist to be completed during a period of high workload for the anaesthetists, resulting in a lack of engagement with the process. CONCLUSION: In order to improve the rigour with which the surgical checklist is applied, there is a need for: the involvement of all members of the theatre team in the checklist process, demonstrated support for the checklist from senior personnel, on-going education and training, and barriers to the implementation of the checklist to be addressed.

  9. Digital Denmark: From Information Society to Network Society

    DEFF Research Database (Denmark)

    Henten, Anders; Falch, Morten

    2000-01-01

    The Danish Government recently issued a new policy report, Digital Denmark, on the "conversion to a network society", as a successor to its Information Society 2000 report (1994). This is part of a new round of information society policy vision statements that are, or will be forthcoming from...... for the next phase of information society development. (C) 2000 Elsevier Science Ltd. All rights reserved....

  10. [Croatian guidelines for perioperative enteral nutrition of surgical patients].

    Science.gov (United States)

    Zelić, Marko; Bender, Darija Vranesić; Kelecić, Dina Ljubas; Zupan, Zeljko; Cicvarić, Tedi; Maldini, Branka; Durut, Iva; Rahelić, Velimir; Skegro, Mate; Majerović, Mate; Perko, Zdravko; Sustić, Alan; Madzar, Tomislav; Kovacić, Borna; Kekez, Tihomir; Krznarić, Zeljko

    2014-01-01

    Nutritional status of patients significantly affects the outcome of surgical treatment, whether it's about being obese or malnutrition with loss of muscle mass. Inadequate nutritional support in the perioperative period compromises surgical procedures even in patients who are adequately nourished. In this paper, particular attention was paid to malnourished patients, and their incidence in population hospitalized in surgical wards can be high up to 30%. Special emphasis was paid to the appropriateness of preoperative fasting and to the acceptance of new knowledge in this area of treatment. The aim of this working group was to make guidelines for perioperative nutritional support with different modalities of enteral nutrition. The development of these guidelines was attended by representatives of Croatian Medical Association: Croatian Society for Digestive Surgery, Croatian Society for Clinical Nutrition, Croatian Society of Surgery, Croatian Society for Endoscopic Surgery, Croatian Trauma Society and the Croatian Society of Anesthesiology and Intensive Care. The guidelines are designed as a set of questions that arise daily in clinical practice when preparing patients for surgery and after the surgical treatment, which relate to the assessment of nutritional status, perioperative nutritional support, duration of preoperative fasting period and the selection of food intake route. Assessment of nutritional status and the use of different modes of enteral nutrition should enter into standard protocols of diagnosis and treatment in the Croatian hospitals.

  11. Principles and Applications of Surgical Oncology in Exotic Animals.

    Science.gov (United States)

    Steffey, Michele A

    2017-01-01

    The diagnosis and treatment of cancer in exotic species is a rapidly evolving area of veterinary medicine. In general, surgical excision remains pivotal in cancer treatment, although optimal outcomes are achieved when a coherent and thorough diagnostic and therapeutic plan is created prior to surgery. While surgical cure is not always achieveable, multimodal treatment plans can offer a variety of options, and palliative procedures may be used to improve quality of life. Treatment goals, whether curative intent or palliative intent, should be identified before surgery, and practitioners should endeavor to adhere to surgical principles in order to attain the best outcomes.

  12. Surgical ethics and the challenge of surgical innovation.

    Science.gov (United States)

    Angelos, Peter

    2014-12-01

    Surgical ethics as a specific discipline is relatively new to many. Surgical ethics focuses on the ethical issues that are particularly important to the care of surgical patients. Informed consent for surgical procedures, the level of responsibility that surgeons feel for their patients' outcomes, and the management of surgical innovation are specific issues that are important in surgical ethics and are different from other areas of medicine. The future of surgical progress is dependent on surgical innovation, yet the nature of surgical innovation raises specific concerns that challenge the professionalism of surgeons. These concerns will be considered in the following pages.

  13. The open society and its enemies

    CERN Document Server

    Popper, Karl Raimund

    2003-01-01

    Written in political exile during the Second World War and first published in 1945, Karl Popper's The Open Society and Its Enemies is one of the most influential books of the twentieth century. Hailed by Bertrand Russell as a 'vigorous and profound defence of democracy', its now legendary attack on the philosophies of Plato, Hegel and Marx exposed the dangers inherent in centrally planned political systems. Popper's highly accessible style, his erudite and lucid explanations of the thought of great philosophers and the recent resurgence of totalitarian regimes around the world are just three of the reasons for the enduring popularity of The Open Society and Its Enemies, and for why it demands to be read both today and in years to come. This is the second of two volumes of The Open Society and Its Enemies.

  14. Empowering the society through companies CSR agenda

    OpenAIRE

    Sulaiman Noor Adwa; Muhamad Rusnah

    2017-01-01

    Topic of socioeconomic issue is one of the most widely discussed globally as it gives effects to occupation, education, income, wealth, and place of residence of individuals. These social challenges should be addressed and resolved because to enhance individuals’ contribution to economic and social life of their society and reduce social tensions and conflicts that negatively affects country’s economic development. For this reason, in the Eleventh Malaysia Plan (2016-2020), the Malaysian Gove...

  15. Perioperative management of anticoagulant users scheduled for glaucoma surgery: a survey among the Brazilian Glaucoma Society members

    Directory of Open Access Journals (Sweden)

    Marcos Balbino

    2013-12-01

    Full Text Available PURPOSE: To investigate and describe, among the members of the Brazilian Glaucoma Society (BGS, the practices regarding the perioperative management of anticoagulants (warfarin and aspirin use in patients scheduled for glaucoma surgery. METHODS: The active members of the Brazilian Glaucoma Society answered a questionnaire evaluating different aspects of their current perioperative management of glaucomatous patients taking warfarin or aspirin. RESULTS: A total of 52 participants returned a complete questionnaire. Warfarin or aspirin was routinely interrupted prior to glaucoma surgery by 82.7% of the respondents. The majority of the surgeons who discontinued these medications reported doing so 7 days prior to surgery and resumed their use the day after the procedure. Almost half of our interviewees reported hemorrhagic complications that could be related to anticoagulant therapy. A large number of the surgeons (86.5% preferred a particular surgical technique for anticoagulated patients; however, most of them (88.5% do not change the anesthetic planning in such patients. Finally, the majority of the participants (90.4% refer their anticoagulated patients to a preoperative appointment with a cardiologist or a general practitioner before the surgery. CONCLUSIONS: The majority of Brazilian Glaucoma Society members participating in this study interrupt either warfarin or aspirin prior to glaucoma surgery. Although there is scant information available in the literature to offer definitive guidance, most participants from the Brazilian Glaucoma Society seem to share the same opinion when it comes to perioperative management of anticoagulant users.

  16. 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

  17. 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...

  18. Stereolithography in oral implantology: a comparison of surgical guides.

    Science.gov (United States)

    Sammartino, Gilberto; Della Valle, Antonio; Marenzi, Gaetano; Gerbino, Salvatore; Martorelli, Massimo; di Lauro, Alessandro Espedito; di Lauro, Francesco

    2004-06-01

    This article presents the use of stereolithography in oral implantology. Stereolithography is a new technology that can produce physical models by selectively solidifying an ultraviolet-sensitive liquid resin using a laser beam, reproducing the true maxillary and mandibular anatomic dimensions. With these models, it is possible to fabricate surgical guides that can place the implants in vivo in the same places and same directions as those in the planned computer simulation. A 70-year-old woman, in good health, with severe mandibular bone atrophy was rehabilitated with an over-denture supported by 2 Branemark implants. Two different surgical planning methods were considered: 1) the construction of a surgical guide evaluating clinical aspects, and 2) the surgical guide produced by stereolithographic study. The accuracy of surgical planning can reduce the problems related to bone density and dimensions. Furthermore, the stereolithographic study assured the clinicians of a superior location of fixtures in bone. Surgical planning based on stereolithographic technique is a safe procedure and has many advantages. This technologic advance has biologic and therapeutic benefits because it simplifies anatomic surgical management for improved implant placement.

  19. Branding Cities, Changing Societies

    DEFF Research Database (Denmark)

    Ooi, Can-Seng

    Societal changes are seldom discussed in the literature on city branding. The time element is important because it highlights the fluctuating reality of society. The city brand message freezes the place but in fact, the city branding exercise is a continuous process. Society emerges too. City...... brands are supposed to accentuate the uniqueness of the city, be built from the bottom-up and reflect the city's identity. This paper highlights three paradoxes, pointing out that city branding processes can also make cities more alike, bring about societal changes and forge new city identities. A city...... branding campaign does not just present the city, it may change the city. The relationships between the branding exercise and the city are intertwined in the evolution of the place....

  20. l'Internet Society

    CERN Multimedia

    CERN

    1997-01-01

    Conference of Vinton "Vint" Gray Cerf in the Intercontinental Hostel. Vinton Gray Cerf (born June 23, 1943) is an American computer scientist who is commonly referred to as one of the "founding fathers of the Internet" for his key technical and managerial role, together with Bob Kahn, in the creation of the Internet and the TCP/IP protocols which it uses. He was also a co-founder (in 1992) of the Internet Society (ISOC) which is intended to both promote the views of ordinary users of the Internet, and also serve as an umbrella body for the technical groups developing the Internet (such as the Internet Engineering Task Force). He served as the first president of the Internet Society from 1992-1995.

  1. Connecting Science with Society

    DEFF Research Database (Denmark)

    awareness of the important questions of our society reflected in scientific research and of the answers produced by these research activities. The CRIS2010 conference, entitled “Bringing Science to Society”, therefore seeks to highlight the role of Current Research Information Systems for communicating......CRIS2010, the 10th conference in the bi-annual series organized by euroCRIS, focuses on the connecting role of Current Research Information Systems (CRIS). Aalborg, Denmark where CRIS2010 is held, is located near the intersection of the Northern Sea and Kattegat, a place were not only the waters...... of two seas are exchanged, but also goods and culture. In a similar way, Current Research Information Systems are at the intersection between (publicly funded) research and society. They do not only connect actors, activities and results within the research domain but also play a crucial role in raising...

  2. Civil society sphericules

    DEFF Research Database (Denmark)

    Tufte, Thomas

    2014-01-01

    This article explores the communicative practice of a Tanzanian NGO, Femina. Based on a tripartite model of engagement (Madianou, 2012) integrating speech, action and understanding, and drawing on fieldwork on the communication practices of Femina, I critically assess the forms of civic engagement...... movement and a media initiative. In the context of the growing literature on social networking sites and their affordances, dynamics and structures, the case of Femina illustrates how a civil society sphericule emerges within the dynamic co-evolution of new and old media platforms. The study is furthermore...... an example of the difficult shift in civil society practice, from service provision to an agenda of public service monitoring, social accountability and community engagement....

  3. Vertical orbital dystopia--surgical correction.

    Science.gov (United States)

    Edgerton, M T; Jane, J A

    1981-02-01

    The surgical correction of vertical malpositions of the human eye has been made relatively safe and reliable by recent surgical techniques. The authors define this condition as vertical orbital dystopia and review the etiology of this deformity in 38 recent consecutive cases that were surgically treated at the Craniofacial Anomalies Center of The University of Virginia. Some new and useful tests are described that are of value to the plastic surgeon in analysis of the facial deformity and in planning the appropriate surgical procedure to correct the vertical dystopia of one or both eyes. Several cases are illustrated that describe the principal surgical methods of moving the eye up or down without loss of vision. The vertical eye shifts in this series have been in the range of 2 to 3 mm to over 22 mm. No loss of vision was produced by these corrections. The most common difficulties and complications of orbital dystopia corrections are described. The implications of this type of surgery in terms of visual physiology are suggested. The authors conclude that surgical correction of vertical orbital dystopias is possible, safe, and rewarding to the patients. However, they advise that the correction is best performed in young children and by a specially trained team of plastic surgeons, neurosurgeons, and ophthalmologists.

  4. Primary cutaneous mucormycosis: guide to surgical management.

    Science.gov (United States)

    Losee, Joseph E; Selber, Jesse; Vega, Stephen; Hall, Caroline; Scott, Glynis; Serletti, Joseph M

    2002-10-01

    Mucormycosis is the most acute, fulminate, and fatal of all fungal infections in humans. It presents most frequently in immunocompromised patients, but can occur in healthy patients in the presence of often-insignificant trauma. Surgical management of primary cutaneous mucormycosis is almost always required. Case reports of surgical treatment for primary cutaneous mucormycosis are reported in the literature; however, the extent of debridement required for cure is unclear and no uniform plan of treatment has been suggested. To date, no clinical guidelines exist to assist the clinician in the surgical management of this disease. This article reviews the literature, reports on two clinical cases, and submits clinical guidelines designed to assist the clinician in the surgical management of primary cutaneous mucormycosis. Because of the infrequent and potentially fatal nature of the diagnosis, a high index of suspicion and a low threshold for wound biopsy must be maintained. Wound cultures are grossly inadequate and should not be relied on for a false sense of security. It is recommended that, for the early diagnosis of cutaneous mucormycosis, chemotherapy and surgical debridement of grossly necrotic tissue be performed at the earliest possible time. The debrided wound is monitored for the resolution of surrounding erythema and induration before definitive reconstruction. In the case of delayed diagnosis and/or advanced or rapidly progressive disease, surgical debridement of all involved tissue, in addition to chemotherapy, is warranted.

  5. 基于城镇化背景下老龄化社会的环境设计与规划%Based on environmental design and planning of urban background of an aging society

    Institute of Scientific and Technical Information of China (English)

    路遥

    2016-01-01

    进入老年后,人的生活结构发生了重大转折,在生理、心理和社会等方面都发生着巨大的变化,影响了老人对环境的感知、判断、理解。老年人具有比其他年龄人群更多的闲暇时光,从而有了足够的时间与他们所在的住所及其环境发生更多的接触,住宅区由此而暴露出各种新的问题,如老年服务设施缺口较大,老年人的休闲场所少且选址不妥、环境不佳等问题正引起全社会的密切关注。这些变化和需求对住宅小区条件、环境等方面提出了新的课题。%After entering the elderly,people living structure has undergone a major turning point,in terms of physiological,psychological and social are undergoing tremendous changes that affect their perception of the environment,judgment and understanding.The elderly more than other age groups of leisure,thus more exposure have enough time with their homes and their environment where a variety of new special issue thus exposed residential areas,such as the elderly service facilities gap larger,older and less leisure venues and the location is wrong,the poor and other environmental problems are caused by the close attention of the whole society.These changes and the demand for residential quarters respect the conditions,environment,urban society and put forward new issues.

  6. An initial radiation safety needs assessment of Costa Rica: the South Texas Chapter of the Health Physics Society's strategic planning appraisal for participation in the "Radiation Safety Without Borders" initiative.

    Science.gov (United States)

    Emery, Robert J; Felknor, S A

    2002-05-01

    In response to the Health Physics Society's recent 'radiation safety without borders" initiative, the South Texas Chapter of the Health Physics Society selected Costa Rica as its partner country of choice. To develop an understanding of the radiation safety needs of this country, the fall 2001 University of Texas Health Science Center at Houston School of Public Health Environmental Radiation and Radioactivity class was tasked with the assignment of assessing the possible radiation safety needs and concerns for this country. The assignment culminated in a class presentation to the membership of the South Texas Chapter during its annual fall meeting. Using library and web based resources, tile students reviewed a number of public health and radiation-related topics. Life expectancies were found to be equivalent to the United States, even though significant differences in per capita health expenditures were noted. Costa Rica exhibited lower population mortality rates from major causes such as cardiovascular diseases, neoplasms, and external sources. Maternal and infant mortality rates were found to be much higher in Costa Rica than in the United States. Naturally occurring radiation sources such as uranium deposits were not identified as apparent major radiation issues of concern, although ultraviolet radiation exposures are consistently high. Several recent events in the country and the region involving patient overexposures suggest that concerns are likely focused on ensuring the proper use and maintenance of healing arts radiation equipment. The lack of available information on radioactive waste disposal suggests that waste handling also may be an issue warranting attention. The exercise proved to be very educational for the students, and the information gathered will serve to focus the Chapter's efforts when technical exchanges are initiated. The importance of linking this initiative to other existing programs within the country is also discussed.

  7. Evolvement of Classification Society

    Institute of Scientific and Technical Information of China (English)

    Xu Hua

    2011-01-01

    As an independent industry, the emergence of the classification society was perhaps the demand of beneficial interests between shipowners, cargo owners and insurers at the earliest time. Today, as an indispensable link of the international maritime industry, class role has changed fundamentally. Start off from the demand of the insurersSeaborne trade, transport and insurance industries began to emerge successively in the 17th century. The massive risk and benefit brought by seaborne transport provided a difficult problem to insurers.

  8. Society and Social Power

    Directory of Open Access Journals (Sweden)

    Janani Harish

    2014-10-01

    Full Text Available Society is the source of immense power. Over the past few centuries humanity has record­ed phenomenal growth in its collective capacity for accomplishment, as reflected in the 12-fold growth in global per capita income since 1800. The remarkable achievements in living standards, longevity, science, technology, industry, education, democracy, human rights, peace and global governance are the result of the exponential development of the capacity of society to harness human energies and convert them into social power for productive purposes. Today, humanity possesses the power and capabilities needed to fully meet the multi-dimensional challenges confronting global society. The source of this energy is people. Human energy is transformed into social power by the increasing reach, frequency and complexity of human relationships. Society is a complex living network of organized relationships between people. Its power issues from channelizing our collective energies in productive ways by means of organizing principles such as coordination, systems, specialization of function, hierarchy of authority, and integration. This immense social power remains largely underutilized. Social science needs to evolve a comprehensive, trans-disciplinary understanding of the roots of social power and the process by which it is generated, distributed and applied. This knowledge is the essential foundation for formulating effective social policies capable of eradicating forever persistent poverty, unemployment and social inequality. This article is based on a series of lectures delivered by the author in the WAAS-WUC course on “Toward a Trans-disciplinary Science of Society” at Dubrovnik on September 1-3, 2014. It traces the development of social power in different fields to show that human and social capital are inexhaustible in potential. The more we harness them, the more they grow. Unleashing, directing, channeling and converting human potential into social

  9. Behaviorism and Society

    OpenAIRE

    Krapfl, Jon E.

    2016-01-01

    A probable list of causes for the limited acceptance of behaviorism in our society is identified. This is followed by a summary review of the proposed solutions identified in other papers in this special issue of The Behavior Analyst, most of which relate to either better marketing of either the behavior analytic process or the results achieved as a consequence. One paper proposes a more broad conception of behavior analysis. This paper endorses the solutions identified in previous papers and...

  10. European Physical Society awards

    CERN Multimedia

    2004-01-01

    The winners of the 2004 Accelerator Prizes, awarded by the European Physical Society's Interdivisional Group on Accelerators (EPS-IGA), have been announced. Vladmir Shiltsev (Fermilab) and Igor Meshkov (JINR, Joint Institute of Nuclear Research, Dubna) will be presented with their awards during the 9th European Particle Accelerator Conference, EPAC'04, on 8 July 2004 in Lucerne. Both physicists will also give a talk about their work. More details on: http://epac.web.cern.ch/

  11. Evolution, museums and society.

    Science.gov (United States)

    MacFadden, Bruce J

    2008-11-01

    Visitors to natural history museums have an incomplete understanding of evolution. Although they are relatively knowledgeable about fossils and geological time, they have a poor understanding of natural selection. Museums in the 21st century can effectively increase public understanding of evolution through interactive displays, novel content (e.g. genomics), engaging videos and cyberexhibits that communicate to a broad spectrum of society, both within the exhibit halls as well as outside the museum.

  12. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings – Guideline of the German Society for Hospital Hygiene (DGKH

    Directory of Open Access Journals (Sweden)

    Külpmann, Rüdiger

    2016-02-01

    Full Text Available Since the publication of the first “Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems in hospitals” ( in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section “Ventilation and air conditioning technology” attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care.

  13. Sound & The Society

    DEFF Research Database (Denmark)

    Schulze, Holger

    2014-01-01

    How are those sounds you hear right now socially constructed and evaluated, how are they architecturally conceptualized and how dependant on urban planning, industrial developments and political decisions are they really? How is your ability to hear intertwined with social interactions and their ......How are those sounds you hear right now socially constructed and evaluated, how are they architecturally conceptualized and how dependant on urban planning, industrial developments and political decisions are they really? How is your ability to hear intertwined with social interactions...

  14. Modeling of tool-tissue interactions for computer-based surgical simulation: a literature review

    NARCIS (Netherlands)

    Misra, Sarthak; Ramesh, K.T.; Okamura, Allison M.

    2008-01-01

    Surgical simulators present a safe and potentially effective method for surgical training, and can also be used in robot-assisted surgery for pre- and intra-operative planning. Accurate modeling of the interaction between surgical instruments and organs has been recognized as a key requirement in th

  15. The New Rural Society.

    Science.gov (United States)

    Goldmark, Peter C.

    The population explosion and the trend to urban-suburban living means that 80% of the nation's population lives on less than 10% of the land. A long-term solution to this problem calls for a total change in our population distribution as well as our life style--and the key to this plan lies in new applications for existing communication…

  16. 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.

  17. Computer-Assisted Technique for Surgical Tooth Extraction.

    Science.gov (United States)

    Hamza, Hosamuddin

    2016-01-01

    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.

  18. 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.

  19. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings - Guideline of the German Society for Hospital Hygiene (DGKH).

    Science.gov (United States)

    Külpmann, Rüdiger; Christiansen, Bärbel; Kramer, Axel; Lüderitz, Peter; Pitten, Frank-Albert; Wille, Frank; Zastrow, Klaus-Dieter; Lemm, Friederike; Sommer, Regina; Halabi, Milo

    2016-01-01

    Since the publication of the first "Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems) in hospitals" (http://www.krankenhaushygiene.de/informationen/fachinformationen/leitlinien/12) in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section "Ventilation and air conditioning technology" attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care.

  20. Hygiene guideline for the planning, installation, and operation of ventilation and air-conditioning systems in health-care settings – Guideline of the German Society for Hospital Hygiene (DGKH)

    Science.gov (United States)

    Külpmann, Rüdiger; Christiansen, Bärbel; Kramer, Axel; Lüderitz, Peter; Pitten, Frank-Albert; Wille, Frank; Zastrow, Klaus-Dieter; Lemm, Friederike; Sommer, Regina; Halabi, Milo

    2016-01-01

    Since the publication of the first “Hospital Hygiene Guideline for the implementation and operation of air conditioning systems (HVAC systems) in hospitals” (http://www.krankenhaushygiene.de/informationen/fachinformationen/leitlinien/12) in 2002, it was necessary due to the increase in knowledge, new regulations, improved air-conditioning systems and advanced test methods to revise the guideline. Based on the description of the basic features of ventilation concepts, its hygienic test and the usage-based requirements for ventilation, the DGKH section “Ventilation and air conditioning technology” attempts to provide answers for the major air quality issues in the planning, design and the hygienically safe operation of HVAC systems in rooms of health care. PMID:26958457

  1. Multiscale Surgical Telerobots

    Energy Technology Data Exchange (ETDEWEB)

    Miles, R R; Seward, K P; Benett, W J; Tendick, F; Bentley, L; Stephan, P L

    2002-01-23

    A project was undertaken to improve robotic surgical tools for telerobotic minimally invasive surgery. The major objectives were to reduce the size of the tools to permit new surgical procedures in confined spaces such as the heart and to improve control of surgical tools by locating positional sensors and actuators at the end effector rather than external to the patient as is currently the state of the technology. A new compact end-effector with wrist-like flexibility was designed. Positional sensors based on MEMS microfabrication techniques were designed.

  2. End-of-life care policy: An integrated care plan for the dying: A Joint Position Statement of the Indian Society of Critical Care Medicine (ISCCM) and the Indian Association of Palliative Care (IAPC).

    Science.gov (United States)

    Myatra, Sheila Nainan; Salins, Naveen; Iyer, Shivakumar; Macaden, Stanley C; Divatia, Jigeeshu V; Muckaden, Maryann; Kulkarni, Priyadarshini; Simha, Srinagesh; Mani, Raj Kumar

    2014-09-01

    The purpose was to develop an end-of-life care (EOLC) policy for patients who are dying with an advanced life limiting illness and to develop practical procedural guidelines for limiting inappropriate therapeutic medical interventions and improve the quality of care of the dying within an ethical framework and through a professional and family/patient consensus process. The Indian Society of Critical Care Medicine (ISCCM) published its first guidelines on EOLC in 2005 [1] which was later revised in 2012.[2] Since these publications, there has been an exponential increase in empirical information and discussion on the subject. The literature reviewed observational studies, surveys, randomized controlled studies, as well as guidelines and recommendations, for education and quality improvement published across the world. The search terms were: EOLC; do not resuscitate directives; withdrawal and withholding; intensive care; terminal care; medical futility; ethical issues; palliative care; EOLC in India; cultural variations. Indian Association of Palliative Care (IAPC) also recently published its consensus position statement on EOLC policy for the dying.[3]. An expert committee of members of the ISCCM and IAPC was formed to make a joint EOLC policy for the dying patients. Proposals from the chair were discussed, debated, and recommendations were formulated through a consensus process. The members extensively reviewed national and international established ethical principles and current procedural practices. This joint EOLC policy has incorporated the sociocultural, ethical, and legal perspectives, while taking into account the needs and situation unique to India.

  3. Publication planning 101.

    Science.gov (United States)

    Sismondo, Sergio; Nicholson, Scott Howard

    2009-01-01

    Publication planning is the sub-industry to the pharmaceutical industry that does the organizational and practical work of shaping pharmaceutical companies' data and turning it into medical journal articles. Its main purpose is to create and communicate scientific information to support the marketing of products. This report is based mostly on information presented at the 2007 annual meeting of the International Society of Medical Planning Professionals, including a workshop entitled "Publication Planning 101/201", attended by one of us. We provide some analysis of the role of publication planning in medical publishing, and its implications for the structuring of medical knowledge.

  4. Participation in physical planning

    Directory of Open Access Journals (Sweden)

    Zlata Ploštajner

    2003-01-01

    Full Text Available Physical planning is also a political activity. Therefore participation is a necessary form of democratic actions undertaken by individuals and groups that strive for democratisation of civil society and strengthening of democratic social values. Public participation of citizens, legal subjects, interest groups and others in physical planning is essential even from the aspect of ensuring success and efficiency of planning documents, if the idea is to devise a plan, which the people would be ready and capable of implementing. Thus the role of the physical planner is changing from technical expert to mediator or anchor-person, who nevertheless has to operate within a normative framework.

  5. Afghanistan, state and society

    DEFF Research Database (Denmark)

    Kværnø, Ole

    In June 2007, the RAND Corporation and the Royal Danish Defence College hosted a conference titled “Afghanistan: State and Society, Great Power Politics, and the Way Ahead”. The two-day event, held in Copenhagen, was attended by more than 100 politicians, scholars, academics, and representative...... of both governmental and nongovernmental institutions from more than 20 states. Its theme was to discuss the problems that Afghanistan faces in the wake of the U.S.-led attack on al Qaeda training camps and the Taliban government; examine the challenges confronting the NATO International Security......-encompassing, long-term strategic approach....

  6. Disciplining Global Society

    Directory of Open Access Journals (Sweden)

    Tony Evans

    2007-06-01

    Full Text Available One of the puzzles of the current era is the divide between optimists and pessimists on the question of human rights. The prominence of human rights on the international political agenda sustains the optimist’s hopes for the future, while pessimists point to continued and widespread reports of civil, political, economic, social and cultural violations. This article looks at the tensions and apparent contradictions between these two approaches. Following a discussion on the construction of global human rights discourse(s, the article concludes that the pretensions of law act to mask the socioeconomic normative framework that acts to discipline global society.

  7. Disciplining Global Society

    Directory of Open Access Journals (Sweden)

    Tony Evans

    2007-12-01

    Full Text Available One of the puzzles of the current era is the divide between optimists and pessimists on the question of human rights. The prominence of human rights on the international political agenda sustains the optimist’s hopes for the future, while pessimists point to continued and widespread reports of civil, political, economic, social and cultural violations. This article looks at the tensions and apparent contradictions between these two approaches. Following a discussion on the construction of global human rights discourse(s, the article concludes that the pretensions of law act to mask the socioeconomic normative framework that acts to discipline global society.

  8. Advanced information society (9)

    Science.gov (United States)

    Kamata, Hiroki

    This article discusses the U.S. and European national strategies and policies for information society. Coping with the declining competitiveness in high-tech products and Japanese technological advantages both have been trying hard to strengthen technology base and to deregulate the telecommunications services markets. The U.S. approach in 1980's, unlike its liberalist principle, has been characterized by technological protectlonism and defense-oriented policies. European Communities' approach has been more comprehensive and systematic, investing heavily telecommunication infrastructure, deregulating domestic market, and promoting cooperation of member countries. However, both of these approaches have, so far, been unable to achieve a considerable success.

  9. Libraries in Society

    DEFF Research Database (Denmark)

    Kristiansson, Michael; Skouvig, Laura

    understood in a library setting. Historically, openness in form of the open shelves played a crucial role in developing the modern public library. The paper examines this openness-centred library policy as adopted by Danish public libraries in the beginning of the 20th century by applying the theories...... by Michel Foucault on discourse and power to the introduction of open shelves. Furthermore, the paper discusses current challenges facing the modern public library in coping with openness issues that follow from changes in society and advances in technology. These influences and developments are not least...

  10. Popular Music and Society

    DEFF Research Database (Denmark)

    2007-01-01

    or the Russkii Rok-Klub v Amerike (Russian Rock Club of America).   This special edition of Popular Music and Society aims to present research on contemporary popular music (broadly defined) in the former Soviet republics and their diasporas.  A central issue will be how the musical landscape has changed since...... the collapse of the Soviet Union: What present trends can be observed?  How has the Soviet context influenced the popular music of today?  How is music performed and consumed?  How has the interrelationship between cultural industry and performers developed?  How are nationalist sensibilities affecting popular...

  11. 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.

    2016-01-01

    Context A detailed understanding of renal surgical anatomy is necessary to optimize preoperative planning and operative technique and provide a basis for improved outcomes. Objective 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). Evidence acquisition A literature review was conducted. Evidence synthesis 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. Conclusions 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. Patient summary In this report

  12. Sound & The Society

    DEFF Research Database (Denmark)

    Schulze, Holger

    2014-01-01

    How are those sounds you hear right now socially constructed and evaluated, how are they architecturally conceptualized and how dependant on urban planning, industrial developments and political decisions are they really? How is your ability to hear intertwined with social interactions and their ...... and their professional design? And how is listening and sounding a deeply social activity – constructing our way of living together in cities as well as in apartment houses? A radio feature with Nina Backmann, Jochen Bonz, Stefan Krebs, Esther Schelander & Holger Schulze......How are those sounds you hear right now socially constructed and evaluated, how are they architecturally conceptualized and how dependant on urban planning, industrial developments and political decisions are they really? How is your ability to hear intertwined with social interactions...

  13. Family in contemporary society

    Directory of Open Access Journals (Sweden)

    Rabije Murati

    2016-01-01

    Full Text Available The family is part of social change and, as such changes and transform into steps with modern trends of society. Family function in a given society is structured according to the overall changes that occur in all areas of social life, not neglecting family life. The contemporary conditions impose requirements that must be met to move forward with the times that follow. In particular, should highlight the social changes that are related to the growth and advancement of the educational and professional standards, which will increase the overall impact on the family and its function. If you're looking for full responsibility of parents in the upbringing of children then it is necessary to see the conditions in which the family lives. For normal education and the rights of children with special meaning the number of members in the (quantity family. The tendency to a higher standard of economic life, a small number of children in the family and it is more than obvious that fewer family members or less have greater opportunity for parents to pay more attention to their children. One of the main roles of family, no matter where they are located in the city, village, developed or developing countries, by all means participate, intermediates and transfers the moral, social and other values in modern life.

  14. Guide to Surgical Specialists

    Science.gov (United States)

    ... have expertise in the following areas of responsibility: neonatal surgery (specialized knowledge in the surgical repair of ... and non-operative management of certain types of pain. Common conditions managed by neurologic surgeons include disorders ...

  15. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  16. Ambulatory Surgical Measures - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  17. Ambulatory Surgical Measures - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  18. Surgical site infections

    African Journals Online (AJOL)

    and mortality as well as significant financial implications. Worldwide it has ... common nosocomial infection amongst surgical patients with up to 38% .... antibiotics as soon as the sensitivity results are available. ... Breast surgery. Staph Aureus/ ...

  19. The surgical treatment of acromegaly.

    Science.gov (United States)

    Buchfelder, Michael; Schlaffer, Sven-Martin

    2017-02-01

    Surgical extraction of as much tumour mass as possible is considered the first step of treatment in acromegaly in many centers. In this article the potential benefits, disadvantages and limitations of operative acromegaly treatment are reviewed. Pertinent literature was selected to provide a review covering current indications, techniques and results of operations for acromegaly. The rapid reduction of tumour volume is an asset of surgery. To date, in almost all patients, minimally invasive, transsphenoidal microscopic or endoscopic approaches are employed. Whether a curative approach is feasible or a debulking procedure is planned, can be anticipated on the basis of preoperative magnetic resonance imaging. The radicality of adenoma resection essentially depends on localization, size and invasive character of the tumour. The normalization rates of growth hormone and IGF-1 secretion, respectively, depend on tumour-related factors such as size, extension, the presence or absence of invasion and the magnitude of IGF-1 and growth hormone oversecretion. However, also surgeon-related factors such as experience and patient load of the centers have been shown to strongly affect surgical results and the rate of complications. As compared to most medical treatments, surgery is relatively cheap since the costs occur only once and not repeatedly. There are several new technical gadgets which aid in the surgical procedure: navigation and variants of intraoperative imaging. For the mentioned reasons, current algorithms of acromegaly management suggest an initial operation, unless the patients are unfit for surgery, refuse an operation or only an unsatisfactory resection is anticipated. A few suggestions are made when a re-operation could be considered.

  20. SURGICAL ORTHODONTICS: LITERATURE REVIEW AND CASE REPORT

    Directory of Open Access Journals (Sweden)

    Piyush HEDA

    2013-03-01

    Full Text Available Orthognathic surgery is a surgical procedure largely practiced throughout the world for the correction of various maxillofacial deformities. The procedure for correcting a particular deformity will be done after proper evaluation, which includes cephalometric, dental model analysis and photographs. The patient undergoes pre-surgical orthodontic correction for dental compensation, after which surgery is planned. During the last few decades, the profession has witnessed intense interest for the treatment of facial deformities, being widely practiced throughout the world. Orthognathic surgery has become an acceptable treatment plan for patients with various maxillofacial deformities, giving pleasing results. The present study reports the successful treatment method of Class II division 1 malocclusion through orthognathic surgery.

  1. Thoracic surgery associations, societies, and clubs: which organizations are right for you?

    Science.gov (United States)

    Schieman, Colin; Grondin, Sean C; Gelfand, Gary A J

    2011-08-01

    Determining which organizations to join can be challenging given the wide selection of associations, societies, and clubs available to practicing thoracic surgeons. This article briefly reviews 7 important North American thoracic surgery organizations (the American Association for Thoracic Surgery, the Canadian Association of Thoracic Surgeons, the General Thoracic Surgical Club, the Society of Thoracic Surgeons, the Southern Thoracic Surgical Association, the Western Thoracic Surgical Association, and Women in Thoracic Surgery). The authors also review the criteria that may assist in deciding which organizations best meet a surgeon's career goals and personal expectations. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Communicating Science to Society

    Science.gov (United States)

    Illingworth, Samuel; Muller, Jennifer; Leather, Kimberley; Morgan, William; O'Meara, Simon; Topping, David; Booth, Alastair; Llyod, Gary; Young, Dominique; Bannan, Thomas; Simpson, Emma; Percival, Carl; Allen, Grant; Clark, Elaine; Muller, Catherine; Graves, Rosemarie

    2014-05-01

    "Nothing in science has any value to society if it is not communicated." So goes the 1952 quote from Anne Roe, the noted twentieth century American psychologist and writer. She went on to say that "scientists are beginning to learn their social obligations", and now over 60 years later there is certainly evidence to support her assertions. As scientists, by communicating our research to the general public we not only better inform the tax payer where their money is being spent, but are also able to help put into context the topical environmental challenges and issues that society faces, as well as inspiring a whole new generation of future scientists. This process of communication is very much a two-way street; by presenting our work to people outside of our usual spheres of contemporaries, we expose ourselves to alternative thoughts and insights that can inspire us, as scientists, to take another look at our research from angles that we had never before considered. This work presents the results and experiences from a number of public engagement and outreach activities across the UK, in which geoscientists engaged and interacted with members of the general public. These include the design and implementation of Raspberry Pi based outreach activities for several hundred high school students; the process of running a successful podcast (http://thebarometer.podbean.com); hosting and participating in science events for thousands of members of the general public (e.g. http://www.manchestersciencefestival.com and http://sse.royalsociety.org/2013); and creating a citizen science activity that involved primary school children from across the UK. In communicating their research it is imperative that scientists interact with their audience in an effective and engaging manner, whether in an international conference, a classroom, or indeed down the pub. This work also presents a discussion of how these skills can be developed at an early stage in the careers of a research

  3. Radiologic Evaluation of Small Lepidic Adenocarcinomas to Guide Decision Making in Surgical Resection.

    Science.gov (United States)

    Wilshire, Candice L; Louie, Brian E; Manning, Kristin A; Horton, Matthew P; Castiglioni, Massimo; Gorden, Jed A; Aye, Ralph W; Farivar, Alexander S; Vallières, Eric

    2015-09-01

    The International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification of pulmonary adenocarcinomas identifies indolent lesions associated with low recurrence, superior survival, and the potential for sublobar resection. The distinction, however, is determined on the pathologic evaluation, limiting preoperative surgical planning. We sought to determine whether preoperative computed tomography (CT) characteristics could guide decisions about the extent of the pulmonary resection. We reviewed the preoperative CT scans for 136 patients identified to have adenocarcinomas with lepidic features on the final pathologic evaluation. The solid component on CT was substituted for the invasive component, and patients were radiologically classified as adenocarcinoma in situ, 3 cm or less with no solid component; minimally invasive adenocarcinoma, 3 cm or less with a solid component of 5 mm or less; or invasive adenocarcinoma, exceeding 3 cm or solid component exceeding 5 mm, or both. Analysis of variance, t test, χ(2) test, and Kaplan-Meier methods were used for analysis. The radiologic classification identified 35 adenocarcinomas in situ (26%) and 12 minimally invasive (9%) and 89 invasive adenocarcinoma (65%) lesions. At a 32-month median follow-up, patient outcomes associated with the radiologic classification were similar to the pathologic-based classification: the radiologic classification identified 14 of 16 patients with recurrent disease and all 6 who died of lung cancer. In addition, patients with radiologic adenocarcinoma in situ and minimally invasive adenocarcinoma who underwent sublobar resections had no recurrence and 100% disease-free and overall survival at 5 years. The radiologic classification of patients with lepidic adenocarcinomas is associated with similar oncologic and survival outcomes compared with the pathologic classification and may guide decision making in the approach to surgical resection

  4. 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.

  5. Nuclear Research and Society

    Energy Technology Data Exchange (ETDEWEB)

    Eggermont, G

    2000-07-01

    In 1998, SCK-CEN took the initiative to include social sciences and humanities into its research programme. Within this context, four projects were defined, respectively on sustainability and nuclear development; transgenerational ethics related to the disposal of long-lived radioactive waste; legal aspects and liability; emergency communication and risk perception. Two reflection groups were established, on expert culture and ethical choices respectively, in order to deepen insight while creating exchange of disciplinary approaches of the committed SCK-CEN researchers and social scientists. Within the context of SCK-CEN's social sciences and humanities programme, collaborations with various universities were initiated, teams consisting of young doctorate and post-doctorate researchers and university promotors with experience in interaction processes of technology with society were established and steering committees with actors and external experts were set up for each project. The objectives and main achievements in the four projects are summarised.

  6. Advanced information society(5)

    Science.gov (United States)

    Tanizawa, Ippei

    Based on the advancement of information network technology information communication forms informationalized society giving significant impact on business activities and life style in it. The information network has been backed up technologically by development of computer technology and has got great contribution by enhanced computer technology and communication equipments. Information is transferred by digital and analog methods. Technical development which has brought out multifunctioned modems of communication equipments in analog mode, and construction of advanced information communication network which has come out by joint work of computer and communication under digital technique, are described. The trend in institutional matter and standardization of electrical communication is also described showing some examples of value-added network (VAN).

  7. Science, Technology and Society

    Science.gov (United States)

    Bridgstock, Martin; Burch, David; Forge, John; Laurent, John; Lowe, Ian

    1998-03-01

    This book provides a comprehensive introduction to the human, social and economic aspects of science and technology. It examines a broad range of issues from a variety of perspectives, using examples and experiences from around the world. The authors present complex issues, including the responsibilities of scientists, ethical dilemmas and controversies, the Industrial Revolution, economic issues, public policy, and science and technology in developing countries. The book ends with a thoughtful and provocative look toward the future. It features extensive guides to further reading, as well as a useful section on information searching skills. This book will provoke, engage, inform and stimulate thoughtful discussion about culture, society and science. Broad and interdisciplinary, it will be of considerable value to both students and teachers.

  8. Behaviorism and Society.

    Science.gov (United States)

    Krapfl, Jon E

    2016-05-01

    A probable list of causes for the limited acceptance of behaviorism in our society is identified. This is followed by a summary review of the proposed solutions identified in other papers in this special issue of The Behavior Analyst, most of which relate to either better marketing of either the behavior analytic process or the results achieved as a consequence. One paper proposes a more broad conception of behavior analysis. This paper endorses the solutions identified in previous papers and then goes on to propose an even more broad conception of behavior analysis and makes the point that behavior analysis is unlikely to flourish unless behavior analysts understand a good deal more about the cultural and other contextual features of the environments in which they work.

  9. War and society

    Directory of Open Access Journals (Sweden)

    Upeniece V.

    2016-01-01

    Full Text Available A discussion of effects of war on society is desirable as it can stimulate nations and their politicians to refrain in their international and non-international relations from the threat or use of force against the territorial integrity or political independence of the state. The prohibition of the use of force is a valid norm of customary international law and is fixed in the Charter of the United Nations. Any specific use of force can be lawful only if it is based on exceptions of this rule (action of self-defence under the Article 51 or action under specific authorization by the Security Council under Chapter VII. However the main issue is how to ensure that the other states respect this principle of non-use of force.

  10. [Changing surgical therapy because of clinical studies?].

    Science.gov (United States)

    Schwenk, W; Haase, O; Müller, J M

    2002-04-01

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

  11. Preventing surgical site infection. Where now?

    LENUS (Irish Health Repository)

    Humphreys, H

    2009-12-01

    Surgical site infection (SSI) is increasingly recognised as a measure of the quality of patient care by surgeons, infection control practitioners, health planners and the public. There is increasing pressure to compare SSI rates between surgeons, institutions and countries. For this to be meaningful, data must be standardised and must include post-discharge surveillance (PDS) as many superficial SSIs do not present to the original institution. Further work is required to determine the best method of conducting PDS. In 2008 two important documents on SSI were published from the Society for Healthcare Epidemiology of America\\/The Infectious Disease Society of America and the National Institute for Health and Clincal Excellence, UK. Both emphasise key aspects during the preoperative, operative and postoperative phases of patient care. In addition to effective interventions known to be important for some time, e.g. not shaving the surgical site until the day of the procedure, there is increasing emphasis on physiological parameters, e.g. blood glucose concentrations, oxygen tensions and body temperature. Laparoscopic procedures are increasingly associated with reduced SSI rates, and the screening and decontamination of meticillin-resistant Staphylococcus aureus carriers is effective for certain surgical procedures but has to be balanced by cost and the risk of mupirocin resistance. Finally, there is a need to convert theory into practice by the rigorous application of SSI healthcare bundles. Recent studies suggest that, with a multidisciplinary approach, simple measures can be effective in reducing SSI rates.

  12. Indicators of Information Society Measurement :

    Directory of Open Access Journals (Sweden)

    Hind Elwy

    2006-09-01

    Full Text Available The indicator of information society describe the infrastructure of information and communication technology ; as well as it’s use and it’s production in different estate of society. The importance economic and social of tic is crescent in modern society. and the presentation of tendency inform above the situation of information society . in this article we want to describe the indicator of tic in Algeria according to librarian’s vision in Mentouri university

  13. Planned Cardiac Reexploration in the Intensive Care Unit Is a Safe Procedure

    Science.gov (United States)

    LaPar, Damien J.; Isbell, James M.; Mulloy, Daniel P.; Stone, Matthew L.; Kern, John A.; Ailawadi, Gorav; Kron, Irving L.

    2015-01-01

    Background Cardiac surgical reexploration is necessary in approximately 5% of all patients. However, the impact of routine, planned reexploration performed in the intensive care unit (ICU) remains poorly defined. This study evaluated postoperative outcomes after cardiac reexplorations to determine the safety and efficacy of a planned approach in the ICU. Methods All patients undergoing ICU cardiac reexplorations (2000 to 2011) at a single institution were stratified according to a routine, planned ICU approach to reexploration (planned) versus unplanned ICU or operating room reexploration. Patient risk and outcomes were compared by univariate and multivariate analyses. Results 8,151 total patients underwent cardiac operations, including 267 (3.2%) reexplorations (planned ICU = 75% and unplanned ICU = 18%). Among planned ICU reexplorations, 38% of patients had an identifiable surgical bleeding source, and 60% underwent reexploration less than 12 hours after the index procedure. Unplanned ICU reexplorations had a higher Society of Thoracic Surgeons (STS) predicted mortality (5% vs 3%, p < 0.001) and incurred higher observed mortality (37% vs 6%, p < 0.001) and morbidity. Sternal wound infections were rare and were similar between groups (p = 0.81). Furthermore, upon STS mortality risk adjustment, unplanned ICU reexplorations were associated with significantly increased odds of mortality (OR = 26.6 [7.1, 99.7], p < 0.001) compared with planned ICU reexplorations. Conclusions Planned reexploration in the ICU is a safe procedure with acceptable mortality and morbidity and low infection rates. Unplanned reexplorations, however, increase postoperative risk and are associated with high mortality and morbidity. These data argue for coordinated, routine approaches to planned ICU reexploration to avoid delay in treatment for postoperative hemorrhage. PMID:25173720

  14. Computer aided planning of orthopaedic surgeries: the definition of generic planning steps for bone removal procedures.

    Science.gov (United States)

    Putzer, David; Moctezuma, Jose Luis; Nogler, Michael

    2017-09-18

    An increasing number of orthopaedic surgeons are using computer aided planning tools for bone removal applications. The aim of the study was to consolidate a set of generic functions to be used for a 3D computer assisted planning or simulation. A limited subset of 30 surgical procedures was analyzed and verified in 243 surgical procedures of a surgical atlas. Fourteen generic functions to be used in 3D computer assisted planning and simulations were extracted. Our results showed that the average procedure comprises 14 ± 10 (SD) steps with ten different generic planning steps and four generic bone removal steps. In conclusion, the study shows that with a limited number of 14 planning functions it is possible to perform 243 surgical procedures out of Campbell's Operative Orthopedics atlas. The results may be used as a basis for versatile generic intraoperative planning software.

  15. 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...

  16. Towards a Low Energy Society from me

    DEFF Research Database (Denmark)

    Nørgaard, Jørgen; Christensen, Bente Lis

    The book is based on energy planning research at Technical University of Denmark. With 1980 as a base year, two possible scenarios for future development in Denmark are analysed and described with respect to technology used and life style practised. In a high-energy society the country's energy...... consumption is almost doubled by 2030, and in a low-energy society energy consumption in 2030 can be less than one third of that in the base year. In this updated version a chapter is added dealing with what actually happened over the first 20 years of the scenario period, in which energy consumption stayed...... constant in between the two scenarios. It is analysed what went right with energy savings and what didn't over these passed years. The book is illustrated with drawings and graphs by Claus Deleuran....

  17. CERN & Society launches donation portal

    CERN Document Server

    Cian O'Luanaigh

    2014-01-01

    The CERN & Society programme brings together projects in the areas of education and outreach, innovation and knowledge exchange, and culture and arts, that spread the CERN spirit of scientific curiosity for the inspiration and benefit of society. Today, CERN & Society is launching its "giving" website – a portal to allow donors to contribute to various projects and forge new relationships with CERN.   "The CERN & Society initiative in its embryonic form began almost three years ago, with the feeling that the laboratory could play a bigger role for the benefit of society," says Matteo Castoldi, Head of the CERN Development Office, who, with his team, is seeking supporters and ambassadors for the CERN & Society initiative. "The concept is not completely new – in some sense it is embedded in CERN’s DNA, as the laboratory helps society by creating knowledge and new technologies – but we would like to d...

  18. ANALYSIS OF GOVERNANCE AND CIVIL SOCIETY SUBJECTS IN TRAKYA REGION

    OpenAIRE

    Şerife Kuzgun

    2015-01-01

    Governance and civil society subjects, which acquired more importance in new ordinary settlement and which takes participation as mutual point, are mentioned in this study. The group which is taken as base in scope of evaluation is “Governance and Civil Society Commission” which is one of 16 specialization commission created by Trakya Development Agency in scope of 2014-2023 Region Plans. The commission’s working progress and used methods were analyzed step by step in this study. The members ...

  19. Surgical bleeding in microgravity

    Science.gov (United States)

    Campbell, M. R.; Billica, R. D.; Johnston, S. L. 3rd

    1993-01-01

    A surgical procedure performed during space flight would occur in a unique microgravity environment. Several experiments performed during weightlessness in parabolic flight were reviewed to ascertain the behavior of surgical bleeding in microgravity. Simulations of bleeding using dyed fluid and citrated bovine blood, as well as actual arterial and venous bleeding in rabbits, were examined. The high surface tension property of blood promotes the formation of large fluid domes, which have a tendency to adhere to the wound. The use of sponges and suction will be adequate to prevent cabin atmosphere contamination with all bleeding, with the exception of temporary arterial droplet streams. The control of the bleeding with standard surgical techniques should not be difficult.

  20. Surgical management of presbyopia

    Directory of Open Access Journals (Sweden)

    Torricelli AA

    2012-09-01

    Full Text Available André AM Torricelli, Jackson B Junior, Marcony R Santhiago, Samir J BecharaDivision of Ophthalmology, University of São Paulo Medical School, São Paulo, BrazilAbstract: Presbyopia, the gradual loss of accommodation that becomes clinically significant during the fifth decade of life, is a physiologic inevitability. Different technologies are being pursued to achieve surgical correction of this disability; however, a number of limitations have prevented widespread acceptance of surgical presbyopia correction, such as optical and visual distortion, induced corneal ectasia, haze, anisometropy with monovision, regression of effect, decline in uncorrected distance vision, and the inherent risks with invasive techniques, limiting the development of an ideal solution. The correction of the presbyopia and the restoration of accommodation are considered the final frontier of refractive surgery. The purpose of this paper is to provide an update about current procedures available for presbyopia correction, their advantages, and disadvantages.Keywords: presbyopia, surgical correction, treatment

  1. Development of a Cognitive Robotic System for Simple Surgical Tasks

    Directory of Open Access Journals (Sweden)

    Riccardo Muradore

    2015-04-01

    Full Text Available The introduction of robotic surgery within the operating rooms has significantly improved the quality of many surgical procedures. Recently, the research on medical robotic systems focused on increasing the level of autonomy in order to give them the possibility to carry out simple surgical actions autonomously. This paper reports on the development of technologies for introducing automation within the surgical workflow. The results have been obtained during the ongoing FP7 European funded project Intelligent Surgical Robotics (I-SUR. The main goal of the project is to demonstrate that autonomous robotic surgical systems can carry out simple surgical tasks effectively and without major intervention by surgeons. To fulfil this goal, we have developed innovative solutions (both in terms of technologies and algorithms for the following aspects: fabrication of soft organ models starting from CT images, surgical planning and execution of movement of robot arms in contact with a deformable environment, designing a surgical interface minimizing the cognitive load of the surgeon supervising the actions, intra-operative sensing and reasoning to detect normal transitions and unexpected events. All these technologies have been integrated using a component-based software architecture to control a novel robot designed to perform the surgical actions under study. In this work we provide an overview of our system and report on preliminary results of the automatic execution of needle insertion for the cryoablation of kidney tumours.

  2. Development of a Cognitive Robotic System for Simple Surgical Tasks

    Directory of Open Access Journals (Sweden)

    Riccardo Muradore

    2015-04-01

    Full Text Available The introduction of robotic surgery within the operating rooms has significantly improved the quality of many surgical procedures. Recently, the research on medical robotic systems focused on increasing the level of autonomy in order to give them the possibility to carry out simple surgical actions autonomously. This paper reports on the development of technologies for introducing automation within the surgical workflow. The results have been obtained during the ongoing FP7 European funded project Intelligent Surgical Robotics (I-SUR. The main goal of the project is to demonstrate that autonomous robotic surgical systems can carry out simple surgical tasks effectively and without major intervention by surgeons. To fulfil this goal, we have developed innovative solutions (both in terms of technologies and algorithms for the following aspects: fabrication of soft organ models starting from CT images, surgical planning and execution of movement of robot arms in contact with a deformable environment, designing a surgical interface minimizing the cognitive load of the surgeon supervising the actions, intra-operative sensing and reasoning to detect normal transitions and unexpected events. All these technologies have been integrated using a component-based software architecture to control a novel robot designed to perform the surgical actions under study. In this work we provide an overview of our system and report on preliminary results of the automatic execution of needle insertion for the cryoablation of kidney tumours.

  3. Some Observations on Veterinary Undergraduate Training in Surgical Techniques.

    Science.gov (United States)

    Whittick, William G.

    1978-01-01

    The undergraduate surgery course of the Faculty of Veterinary Medicine and Animal Science, Universiti Pertanian Malaysia, is described with focus on its experential method of teaching surgical techniques. Also discussed are the benefits of veterinary school cooperation with a large city Society for the Prevention of Cruelty to Animals (SPCA). (JMD)

  4. Unusual synechia at hysterosalpingography: intrauterine fallopian tube after surgical abortion.

    Science.gov (United States)

    Ceccaldi, Pierre-François; Nguyen, Thuy; Mandelbrot, Laurent

    2011-05-01

    We report a patient who had uterine perforation with incarceration of the fallopian tube after surgical abortion. The diagnosis was made during hysteroscopy, realized after hysterosalpingography, and treated by laparoscopy. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Surgical crown lengthening: a periodontal and restorative interdisciplinary approach.

    Science.gov (United States)

    Parwani, Simran R; Parwani, Rajkumar N

    2014-01-01

    Surgical crown lengthening helps to provide an adequate retention form for proper tooth preparation, thus enabling dentists to create esthetically pleasing and healthy restorations. Long-term stability requires accurate diagnosis and development of a comprehensive treatment plan in each case. This sequence of events stresses the importance of communication between the restorative dentist and the periodontist. This article presents 2 cases that involve surgical crown lengthening (including mucoperiosteal flap and ostectomy) for the restoration of teeth.

  6. Hypermedia Applications for Army Installation Master Planning

    Science.gov (United States)

    1993-01-01

    node E, "pizza 8 1. Habermas . Communication and the Evolution of Society (Beacon Press, 1979). 9 J. Forester. 10 1. Friend and A. Hickling, Planning...Planning Under Pressure (Pergamon, 1987). Gillenson. M.L., Database (Wiley, 1985). Habermas , J., Communication and the Evolution of Society (Beacon Press

  7. Beijing Society of Women’s Theory

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    THE Beijing Society of Women’s Theory was founded in 1985 during an unusual time in China. Economic reform was happening gradually throughout China. The new economic order broke the one-sided pattern of a planned economy which had existed in the country for many years. The trend of this economic reform affected everybody—especially women—to varying degrees. It forced enterprises to break the mindset of maintaining a large pot of rice in favor of economic efficiency, so that the

  8. Novel Uses of Video to Accelerate the Surgical Learning Curve.

    Science.gov (United States)

    Ibrahim, Andrew M; Varban, Oliver A; Dimick, Justin B

    2016-04-01

    Surgeons are under enormous pressure to continually improve and learn new surgical skills. Novel uses of surgical video in the preoperative, intraoperative, and postoperative setting are emerging to accelerate the learning curve of surgical skill and minimize harm to patients. In the preoperative setting, social media outlets provide a valuable platform for surgeons to collaborate and plan for difficult operative cases. Live streaming of video has allowed for intraoperative telementoring. Finally, postoperative use of video has provided structure for peer coaching to evaluate and improve surgical skill. Applying these approaches into practice is becoming easier as most of our surgical platforms (e.g., laparoscopic, and endoscopy) now have video recording technology built in and video editing software has become more user friendly. Future applications of video technology are being developed, including possible integration into accreditation and board certification.

  9. The obesity paradox in surgical patients : From preoperative assessment to long term outcome

    NARCIS (Netherlands)

    W. Galal (Wael)

    2016-01-01

    markdownabstractIn the Netherlands, 16 million inhabitants undergo about 1 million surgical procedures annually. The percentage of serious adverse advents is a burden to society and stresses the need for adequate preoperative assessment in order to select and optimize surgical patients. The clinical

  10. Surgical management of pelvic organ prolapse and uterine descent in the Netherlands

    NARCIS (Netherlands)

    Detollenaere, R.J.; Boon, J. den; Kluivers, K.B.; Vierhout, M.E.; Eijndhoven, H.W. van

    2013-01-01

    INTRODUCTION AND HYPOTHESIS: To evaluate current practice in the surgical treatment of uterine descent among members of the Dutch Urogynecological Society and to analyze possible trends in the surgical treatment of pelvic organ prolapse in the Netherlands during the last decade. METHODS: A

  11. Acupuncture in modern society.

    Science.gov (United States)

    Vanderploeg, Kristin; Yi, Xiaobin

    2009-03-01

    For at least 2,500 years, acupuncture has been an integral part of traditional Chinese medicine. However, recently as more people in western countries are diagnosed with chronic disease poorly treated with modern medical therapies, many are turning to acupuncture and other forms of alternative medical treatments. Based on the theory of harmonious flowing qi being the basis of good health, acupuncture focuses on restoring qi by manipulation of the complementary and opposing elements of yin and yang. However, in the modern medical community we struggle to with the concept of qi, given a lack of anatomic and histological evidence supporting its existence. However, with the surge in public interest in acupuncture, the scientific community begun heavy investigation of acupuncture's efficacy, as well as the physiologic basis behind it. Thus far, evidence supports the use of acupuncture in post-operative nausea and vomiting, postoperative dental pain, chronic pain conditions such as lower back pain, and possibly also such psychologic conditions as addiction. It is possible that by affecting afferent nerve signaling, acupuncture may influence the release of endogenous opioids to promote pain relief. This effect may be augmented by release of ACTH and cortisol, as well as through down-regulation of signaling through pain fibers. When treating patients who may utilize alternative forms of medicine, it is important that medical practitioners be educated in regards to the basic fundamental beliefs behind acupuncture, as well as the scientific evidence supporting its use and revealing its efficacy. The purpose of this review is to give western trained physicians exposure to history, basic knowledge and its clinical applications of acupuncture to accommodate accelerating interests in acupuncture in modern society.

  12. Doctor’s identity in modern Western society

    OpenAIRE

    Kim, Ock-Joo

    2005-01-01

    Two centuries ago doctors perceived themselves quite differently as they do today Doctor’s identity in modern Western society shaped from the modernization of medicine starting in the nineteenth century Modern medicine as practiced today was established from 1800 to the World War I In the eighteenth century three medical groups (physicians surgeons and apothecaries) struggled to elevate their position and to organize their education Surgery and surgical education in hospitals developed greatl...

  13. [Optimizing surgical hand disinfection].

    Science.gov (United States)

    Kampf, G; Kramer, A; Rotter, M; Widmer, A

    2006-08-01

    For more than 110 years hands of surgeons have been treated before a surgical procedure in order to reduce the bacterial density. The kind and duration of treatment, however, has changed significantly over time. Recent scientific evidence suggests a few changes with the aim to optimize both the efficacy and the dermal tolerance. Aim of this article is the presentation and discussion of new insights in surgical hand disinfection. A hand wash should be performed before the first disinfection of a day, ideally at least 10 min before the beginning of the disinfection as it has been shown that a 1 min hand wash significantly increases skin hydration for up to 10 min. The application time may be as short as 1.5 min depending on the type of hand rub. Hands and forearms should be kept wet with the hand rub for the recommended application time in any case. A specific rub-in procedure according to EN 12791 has been found to be suitable in order to avoid untreated skin areas. The alcohol-based hand rub should have a proven excellent dermal tolerance in order to ensure appropriate compliance. Considering these elements in clinical practice can have a significant impact to optimize the high quality of surgical hand disinfection for prevention of surgical site infections.

  14. [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.

  15. Augmented reality in surgical procedures

    Science.gov (United States)

    Samset, E.; Schmalstieg, D.; Vander Sloten, J.; Freudenthal, A.; Declerck, J.; Casciaro, S.; Rideng, Ø.; Gersak, B.

    2008-02-01

    Minimally invasive therapy (MIT) is one of the most important trends in modern medicine. It includes a wide range of therapies in videoscopic surgery and interventional radiology and is performed through small incisions. It reduces hospital stay-time by allowing faster recovery and offers substantially improved cost-effectiveness for the hospital and the society. However, the introduction of MIT has also led to new problems. The manipulation of structures within the body through small incisions reduces dexterity and tactile feedback. It requires a different approach than conventional surgical procedures, since eye-hand co-ordination is not based on direct vision, but more predominantly on image guidance via endoscopes or radiological imaging modalities. ARIS*ER is a multidisciplinary consortium developing a new generation of decision support tools for MIT by augmenting visual and sensorial feedback. We will present tools based on novel concepts in visualization, robotics and haptics providing tailored solutions for a range of clinical applications. Examples from radio-frequency ablation of liver-tumors, laparoscopic liver surgery and minimally invasive cardiac surgery will be presented. Demonstrators were developed with the aim to provide a seamless workflow for the clinical user conducting image-guided therapy.

  16. Paperless or vanishing society

    Science.gov (United States)

    Turner Luke, Joy

    2002-06-01

    In the 1940s color photography became available and within a few years, extremely popular. As people switched from black and white photographs made with the old metallic silver process to the new color films, pictures taken to record their lives and families began a slow disappearing act. The various color processes, coupled with the substrates they were printed on, affected their longevity, but many color photographs taken from the late 1950s through the 1970s, and even into the 1980s, faded not only when exposed to the light, but also when stored in the dark. Henry Wilhelm's excellent book 'The Permanence and Care of Color Photographs' documents this history in detail. Today we are making another transition in the storage of pictures and information. There are questions about the longevity of different types of digital storage, and also of the images printed by various types of inkjet printers, or by laser printers using colored toners. Very expensive and very beautiful works of art produced on Iris printers are appearing in art exhibitions. Some of these are referred to as Giclee prints and are offered on excellent papers. Artists are told the prints will last a lifetime; and if by change they don't it is only necessary to make another print. Henry Wilhelm has begun to test and rate these images for lightfastness; however, his test method was developed for examining longevity in colored photographs. It is of interest to find out how these prints will hold up in the tests required for fine art materials. Thus far companies producing digital inks and printers have not invested the time and money necessary to develop an American Society for Testing and Materials (ASTM) standard method for evaluating the lightfastness of digital prints. However, it is possible to use ASTM D 5383, Standard Practice for Visual Determination of the Lightfastness of Art Materials by Art Technologists, to pinpoint colors that will fade in a short time, even though the test is not as

  17. Design, Implementation and Testing of Master Slave Robotic Surgical System

    OpenAIRE

    Syed Amjad Ali; Amir Mahmood Soomro; Arbab Nighat Khizer

    2015-01-01

    The autonomous manipulation of the medical robotics is needed to draw up a complete surgical plan in development. The autonomy of the robot comes from the fact that once the plan is drawn up off-line, it is the servo loops, and only these, that control the actions of the robot online, based on instantaneous control signals and measurements provided by the vision or force sensors. Using only these autonomous techniques in medical and surgical robotics remain relatively limited for two main rea...

  18. Society for Assisted Reproductive Technology

    Science.gov (United States)

    The Society for Assisted Reproductive Technology PATIENTS Patient Information What Is SART? Risks of IVF Third Party Reproduction A Patient's Guide to Assisted Reproductive Technology Frequently Asked ...

  19. American Society of Nuclear Cardiology

    Science.gov (United States)

    ... much more! class="box-li"> Journal of Nuclear Cardiology Official publication of the American Society of Nuclear Cardiology Clinical Guidelines Procedures, Appropriate Use Criteria, Information Statements ...

  20. Privacy and the Connected Society

    DEFF Research Database (Denmark)

    Sørensen, Lene Tolstrup; Khajuria, Samant; Skouby, Knud Erik

    the society. Enabling the vision of the connected society, researchers point in the direction of security and privacy as areas to challenge the vision. By use of the Internet of Things reference model as well as the vision of the connected society, this paper identifies privacy of the individual with respect...... to three selected areas: Shopping, connected cars and online gaming. The paper concludes that privacy is a complexity within the connected society vision and that thee is a need for more privacy use cases to shed light on the challenge....

  1. Fundamental Ethical Issues in Unnecessary Surgical Procedures.

    Science.gov (United States)

    Tayade, Motilal Chandu; Dalvi, Shashank D

    2016-04-01

    In clinical practice performing any surgical procedure is inconsistent because all surgical procedures carry definitely some degree of risk. Worldwide every year millions of patients go under knife, but many of them are enduring great pain and shelling out thousands and dollars for surgeries they don't really need. This review work was planned with an intention to focus attention towards it with reporting cited evidences of unnecessary surgical operations and discuss ethical issues concern with it. In present review the references search included standard citations Google scholar, MEDLINE and PUBMED. We also used Google search engine for screening various news concern with highlighting this topic in community and online media. For articles we go through more than 60 articles from worldwide and 12 news media views from Google search in last one year. We used following quotes for their search-unnecessary surgeries, second opinion, ethical issues in unnecessary surgeries. Geographical variations were also kept in view. Our intension was highlighting ethical issues concern with unnecessary surgical operations. Henceforth we excluded such work that does not concern with ethical issues. Unnecessary surgery is that which is medically unjustifiable when the risks and costs are more than the likely therapeutic benefits or relief to the patient based on the patient's lifestyle requirements. To avoid or minimize such interventions basic seeding of ethics in curriculum and strict laws will definitely helpful in clinical practice. In conclusion, our aim was to highlight this major issue and underline need of competency based medical bioethics education in Indian scenario.

  2. November 2014 Arizona thoracic society notes

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2014-11-01

    Full Text Available No abstract available. Article truncated after 150 words. The November 2014 Arizona Thoracic Society meeting was held on Wednesday, November 19, 2014 at the Scottsdale Shea Hospital beginning at 6:30 PM. This was a dinner meeting with case presentations. There were about 30 in attendance representing the pulmonary, critical care, sleep, pathology and radiology communities. Jud Tillinghast was nominated as the Arizona Thoracic Society physician of the year. Three cases were presented: 1. George Parides presented a case of a 70-year-old woman with a 3 areas of ground glass picked up incidentally on CT scan. She had some wheezing. A needle biopsy revealed adenocarcinoma. The biopsy and radiologic pattern were consistent with adenocarcinoma in situ or minimally invasive adenocarcinoma. Discussion centered around treatment. Most felt that if the areas could be removed that surgical resection was indicated (1. 2. Lewis Wesselius presented a 60-year-old man with Marfan's syndrome and a history of an aortic valve replacement on chronic ...

  3. Huntington's Disease Society of America

    Science.gov (United States)

    ... The Scope of HD Who Is At Risk Genetic Testing & Family Planning Juvenile HD An End to HD? ... Find Help Living with HD Living with HD Genetic Testing & Family Planning / Prenatal Testing Juvenile Onset HD Nutrition ...

  4. Violence in society

    Directory of Open Access Journals (Sweden)

    António Pedro de Andrade Dores

    2014-07-01

    Full Text Available The recent interest in the sociology of violence has arisen at the same time that western societies are being urged to consider the profound social crisis provoked by global financial turmoil. Social changes demand the evo- lution of sociological practices. The analysis herein proposed, based on the studies of M. Wieviorka, La Violence (2005, and of R. Collins, Violence: A Micro-sociological Theory (2008, concludes that violence is subject to sociological treatments cen- tered on the aggressors, on the struggles for power and on male gender. There is a lack of connection between prac- tical proposals for violence prevention and the sociol- ogy of violence. It is accepted that violence as a subject of study has the potential, as well as the theoretical and social centrality, to promote the debate necessary to bring social theory up to date. This process is more likely to oc- cur in periods of social transformation, when sociology is open to considering subjects that are still taboo in its study of violence, such as the female gender and the state. The rise of the sociology of violence confronts us with a dilemma. We can either collaborate with the construc- tion of a sub discipline that reproduces the limitations and taboos of current social theory, or we can use the fact that violence has become a “hot topic” as an opportunity to open sociology to themes that are taboo in social the- ory (such as the vital and harmonious character of the biological aspects of social mechanisms or the normative aspects of social settings. ResumenEl interés reciente en la sociología de la violencia ha surgido al mismo tiempo que las sociedades occidenta- les están requiriendo considerar la profunda crisis social provocada por la agitación financiera global. Los cambios sociales demandan la evolución de las prácticas socioló- gicas. El análisis aquí expuesto, basado en los estudios de M. Wieviorka, La Violence (2005, and of R. Collins

  5. PLANNING CAREERS IN PUBLIC INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    CÎRNU DORU

    2015-03-01

    Full Text Available Planning careers, in any organization, but especially in the public ones, is a process of great importance. Today, in modern society, there is virtually no person who does not need a public service provided by trained staff, helpful, kind and involved. By judiciously prepared career plans, public organizations develop their employees. As a result, the administrative career planning is currently one issue that do not admit any delay.

  6. Digitally Designed Surgical Guides for Placing Extraoral Implants in the Mastoid Area

    NARCIS (Netherlands)

    van der Meer, W. Joerd; Vissink, Arjan; Raghoebar, Gerry M.; Visser, Anita

    2012-01-01

    Purpose: When planning implant therapy, knowledge of the bone volume in the implant area is needed to plan and place implants in the most appropriate locations from the prosthetic and surgical perspectives. Commercial software for digital planning of implants in the craniofacial region is not yet av

  7. Digitally Designed Surgical Guides for Placing Extraoral Implants in the Mastoid Area

    NARCIS (Netherlands)

    van der Meer, W. Joerd; Vissink, Arjan; Raghoebar, Gerry M.; Visser, Anita

    2012-01-01

    Purpose: When planning implant therapy, knowledge of the bone volume in the implant area is needed to plan and place implants in the most appropriate locations from the prosthetic and surgical perspectives. Commercial software for digital planning of implants in the craniofacial region is not yet av

  8. Planned inguinal herniorrhaphy but no hernia sac?

    DEFF Research Database (Denmark)

    Jensen, P; Bay-Nielsen, M; Kehlet, H

    2004-01-01

    Planned inguinal herniorrhaphy may present a clinical dilemma when no hernia is found. No large-scale data are available on the incidence of this problem, and, therefore, no recommendations exist for choice of surgical intervention.......Planned inguinal herniorrhaphy may present a clinical dilemma when no hernia is found. No large-scale data are available on the incidence of this problem, and, therefore, no recommendations exist for choice of surgical intervention....

  9. Public Libraries in postindustrial societies

    DEFF Research Database (Denmark)

    Elbeshausen, Hans

    2015-01-01

    The article’s focus is on how public libraries are affected by structural changes in the wake of the transition to the knowledge society. Their attempts to match the knowledge society are illustrated by processes of sensemaking and sensegiving made in public libraries in Canada, the UK and Denmark....

  10. Colleges Enter the Information Society.

    Science.gov (United States)

    Current Issues in Higher Education, 1983

    1983-01-01

    The implications for higher education of the U.S. transformation from an industrial to an information society are discussed in six papers. Russell Edgerton provides an overview in "Entering the Information Society: An Introduction." In "The Computer: An Enabling Instrument," Louis Robinson considers the current era of the personalization of the…

  11. Chinese Women Lawyers Society Established

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    ON November 12, 1993, the Chinese Women Lawyers Society was established in Beijing. The more than 10,000 women lawyers in the country were excited to have their own organization. Xu Weihua, secretary-general of the society and a lawyer working in the All-China Women’s Federation, said: "The society’s establishment will promote the participation of

  12. Education in the Information Society

    Directory of Open Access Journals (Sweden)

    Octavia-Luciana Porumbeanu

    2007-01-01

    Full Text Available This article approaches the fundamental role which education has in the information society. The continuous evolution of information and communication technologies requires that all citizens have the necessary skills have to use these technologies and to access information for efficient individual functioning in the information society. In this context, the information literacy programmes have a growing importance.

  13. Emerging Artificial Societies Through Learning

    NARCIS (Netherlands)

    Gilbert, N.; Besten, M.; Bontovics, A.; Craenen, B.G.W.; Divina, F.; Eiben, A.E.; Griffioen, R.; Hévízi, G.; Lõrincz, A.; Paechter, B.; Schuster, S.; Schut, M.C.; Tzolov, C.; Vogt, P.; Yang, L.

    2006-01-01

    The NewTies project is implementing a simulation in which societies of agents are expected to develop autonomously as a result of individual, population and social learning. These societies are expected to be able to solve environmental challenges by acting collectively. The challenges are intended

  14. The governance of cooperative societies

    Directory of Open Access Journals (Sweden)

    Yaiza Juanes Sobradillo

    2005-12-01

    Full Text Available The present work aims to expose the appropriate legislation for cooperative societies to which Article 129 of the Spanish Constitution refers, deepen the analysis of the organs of management and control based on the Spanish and Basque Laws on Cooperatives and the Statute for the European Cooperative Societies.

  15. Making the Good Society Work

    Science.gov (United States)

    Field, John

    2010-01-01

    Everyone is talking about civil society. Perhaps it's the election, and the shock of seeing more voters at the polling booths than anyone had expected. Now David Cameron's idea of a "big society" is being translated into some early policy measures. Does today's debate have anything to do with adult learning? The author believes that the…

  16. Social Science and Civil Society

    OpenAIRE

    Hogg, Eddy

    2015-01-01

    This article gives an overview of key social science approaches to civil society. It addresses in turn civil society organizations, volunteering, and philanthropy. For each, it looks at how they are defined, their scope, how social science approaches the study of them, and how social policy has sought to encourage or coordinate them.

  17. 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. Spatial planning

    OpenAIRE

    Dimitrov, Nikola; Koteski, Cane

    2016-01-01

    The professional book ,, Space planning "processed chapters on: space, concept and definition of space, space as a system, spatial economics, economic essence of space, space planning, social determinants of spatial planning, spatial planning as a process, factors development and elements in spatial planning, methodology, components and content of spatial planning stages and types of preparation of spatial planning, spatial planning and industrialization, industrialization, urbanization and s...

  19. Spatial planning

    OpenAIRE

    Dimitrov, Nikola; Koteski, Cane

    2016-01-01

    The professional book ,, Space planning "processed chapters on: space, concept and definition of space, space as a system, spatial economics, economic essence of space, space planning, social determinants of spatial planning, spatial planning as a process, factors development and elements in spatial planning, methodology, components and content of spatial planning stages and types of preparation of spatial planning, spatial planning and industrialization, industrialization, urbanization and s...

  20. Rhinoplasty: surface aesthetics and surgical techniques.

    Science.gov (United States)

    Çakir, Bariş; Doğan, Teoman; Öreroğlu, Ali Riza; Daniel, Rollin K

    2013-03-01

    Surface aesthetics of the attractive nose are created by certain lines, shadows, and highlights, with specific proportions and breakpoints. Our evaluation of the nasal surface aesthetics is achieved using the concept of geometric polygons as aesthetic subunits, both to define the existing deformity and the aesthetic goals. Surgical techniques have been developed and modified to achieve the desired surface appearance, and those are detailed in this article. The principles of geometric polygons allow the surgeon to analyze the deformities of the nose, to define an operative plan to achieve specific goals, and to select the appropriate operative technique. These aesthetic concepts and surgical techniques were used in 257 consecutive rhinoplasties performed in the past 3 years by the principal author (B.Ç.).

  1. Vitiligo- A surgical approach

    Directory of Open Access Journals (Sweden)

    Deepti Ghia

    2012-01-01

    Full Text Available Aims and objective- To describe the spectrum of surgical modalities for stable vitiligo patients Methods- Patients having stable vitiligo since past 2 years with no improvement with medical line of treatment were enrolled for surgery after informed consent. Depending upon the size and location of vitiligo patch different modalities were performed. Suction blister, mini-punch grafting, split thickness skin grafting, trypsinised melanocyte-keratinocyte transfer and non-trypsinised melanocyte- keratinocyte transfer (Jodhpur technique and follicular grafting technique have been described photographically which have been performed at a tertiary care hospital. Conclusion- Vitiligo is often difficult to treat, stable patches resistant to medical line of management do respond to surgical treatment; however it is very important to choose the modality of surgery according location of the patch, size of the lesion and available resources.

  2. Spacecraft surgical scrub system

    Science.gov (United States)

    Abbate, M.

    1980-01-01

    Ease of handling and control in zero gravity and minimizing the quantity of water required were prime considerations. The program tasks include the selection of biocidal agent from among the variety used for surgical scrub, formulation of a dispensing system, test, and delivery of flight dispensers. The choice of an iodophore was based on effectiveness on single applications, general familiarity among surgeons, and previous qualification for space use. The delivery system was a choice between the squeeze foamer system and impregnated polyurethane foam pads. The impregnated foam pad was recommended because it is a simpler system since the squeeze foamer requires some applicator to effectively clean the skin surfaces, whereas the form pad is the applicator and agent combined. Testing demonstrated that both systems are effective for use as surgical scrubs.

  3. What is the Knowledge Society?

    Directory of Open Access Journals (Sweden)

    Marin Dinu

    2008-02-01

    Full Text Available This study sets out to establish conceptual delimitations, more concordant to the theoretical acquisitions with regard to the knowledge society. The author considers it opportune to situate in the center of the definition of the concept of knowledge society the problem of prevalence in the typology of resources. Thus, the knowledge society appears as a form of organization in which scientific knowledge predominates, be that informatics as well. The concordances of essence are discovered through the discerning of the functional relationship knowledge society – global society. In the spectrum of meanings specific to this highway of post-postmodernist configuration of the world, the priorities of the project of the second modernity – the paradigmatic matrix of globalization – are approached. In fact, the study argues in favor of refocusing globalization on the humane, on its distinctive values which substantiate and lend sense to the evolutions of the world. Postreferentiality is the rational expression of humanity coming back to itself.

  4. Innovation in prediction planning for anterior open bite correction.

    Science.gov (United States)

    Almuzian, Mohammed; Almukhtar, Anas; O'Neil, Michael; Benington, Philip; Al Anezi, Thamer; Ayoub, Ashraf

    2015-05-01

    This study applies recent advances in 3D virtual imaging for application in the prediction planning of dentofacial deformities. Stereo-photogrammetry has been used to create virtual and physical models, which are creatively combined in planning the surgical correction of anterior open bite. The application of these novel methods is demonstrated through the surgical correction of a case.

  5. Surgical Splint Design Influences Transverse Expansion in Segmental Maxillary Osteotomies

    DEFF Research Database (Denmark)

    Stokbro, Kasper; Aagaard, Esben; Torkov, Peter

    2017-01-01

    splint designs on achieving the planned transverse expansion in bimaxillary surgery with segmental maxillary procedures. Materials and Methods: Forty-two participants were included in a retrospective observational study. All participants had completed virtually planned bimaxillary surgery with 3-piece....... To test measurement reliability, all measurements were performed twice by the same observer. The primary predictor variable was the planned expansion according to the virtual surgical plan. The primary covariate with influence on the obtained expansion was the surgical splint design. Other covariates...... of interest included patient age, patient gender, and surgeon. Descriptive and bivariate statistics were performed using Student t tests and linear regression analysis. Results: Measurements showed high reliability, with an intraclass correlation coefficient of 0.99 and Bland-Altman plots without systematic...

  6. Gossypiboma—Retained Surgical Sponge

    Directory of Open Access Journals (Sweden)

    Hung-Shun Sun

    2007-11-01

    Full Text Available Intra-abdominal retained surgical sponge is an uncommon surgical error. Herein, we report a 92-year-old woman who was brought to the emergency room for acute urinary retention. She had a history of vaginal hysterectomy for uterine prolapse 18 years previously, performed at our hospital. Retained surgical sponge in the pelvic cavity was suspected by abdominal computed tomography. The surgical gauze was removed by laparotomy excision and the final diagnosis was gossypiboma.

  7. Hepatic surgical anatomy.

    Science.gov (United States)

    Skandalakis, John E; Skandalakis, Lee J; Skandalakis, Panajiotis N; Mirilas, Petros

    2004-04-01

    The liver, the largest organ in the body, has been misunderstood at nearly all levels of organization, and there is a tendency to ignore details that do not fit the preconception. A complete presentation of the surgical anatomy of the liver includes the study of hepatic surfaces, margins, and fissures; the various classifications of lobes and segments; and the vasculature and lymphatics. A brief overview of the intrahepatic biliary tract is also presented.

  8. Louis Pasteur surgical revolution.

    Science.gov (United States)

    Toledo-Pereyra, Luis H

    2009-01-01

    Louis Pasteur (1822-1895) is considered the most notable medical scientist of his time and perhaps one of the most distinguished of all times in the history of medicine. From Dole in France to Paris, from a student of crystals to "living ferments," and from chemistry to biology and medicine, Pasteur changed the world for the benefit of humanity. The genius of Pasteur dealt with the most pressing issues of his time, basing the germ theory on the effects that microorganisms had on fermentation and putrefaction of organic matter, which gave birth to the science of bacteriology. Many other difficult problems in medicine and biology were tackled by Pasteur, culminating in the spectacular results seen with the treatment of rabies. Surgery was no exception to the scientific conquests of Pasteur. The transformation of the surgical world arose from the antiseptic concepts of Lister that were based on the germ theory of the disease, which had been derived from the germ theory of fermentation and putrefaction discovered by Pasteur. The acceptance of these principles represented the surgical revolution brought on by the science of Pasteur, a revolution that is now accepted in our daily care of surgical patients.

  9. Guideline implementation: Surgical attire.

    Science.gov (United States)

    Cowperthwaite, Liz; Holm, Rebecca L

    2015-02-01

    Surgical attire helps protect patients from microorganisms that may be shed from the hair and skin of perioperative personnel. The updated AORN "Guideline for surgical attire" provides guidance on scrub attire, shoes, head coverings, and masks worn in the semirestricted and restricted areas of the perioperative setting, as well as how to handle personal items (eg, jewelry, backpacks, cell phones) that may be taken into the perioperative suite. This article focuses on key points of the guideline to help perioperative personnel adhere to facility policies and regulatory requirements for attire. The key points address the potential benefits of wearing scrub attire made of antimicrobial fabric, covering the arms when in the restricted area of the surgical suite, removing or confining jewelry when wearing scrub attire, disinfecting personal items that will be taken into the perioperative suite, and sending reusable attire to a health care-accredited laundry facility after use. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  10. Society of American Gastrointestinal and Endoscopic Surgeons

    Science.gov (United States)

    ... privileges for flexible gastrointestinal endoscopy. Privileging in flexible gastrointestinal endoscopy should be based on demonstration of competency in these techniques. Surgical Simulation: The Value of Individualization Surgical simulation ...

  11. Planejamento pré-operatório e técnica cirúrgica da osteotomia supracondiliana varizante de adição do fêmur para correção do geno valgo e fixação com implante de ângulo fixo Pre-operative planning and surgical technique of the open wedge supracondylar osteotomy for correction of valgus knee and fixation with a fixed-angle implant

    Directory of Open Access Journals (Sweden)

    Cleber Antonio Jansen Paccola

    2010-01-01

    Full Text Available É apresentado o planejamento pré-operatório passo a passo da osteotomia de abertura supracondiliana do fêmur para a correção precisa do eixo de carga do membro inferior usando um implante de ângulo fixo (placa lâmina AO 95º. Também é apresentada a técnica cirúrgica e a utilização de enxerto ósseo do próprio local para o preenchimento da falha.The pre-operative planning is presented in a step by step fashion and the surgical technique of the lateral open wedge supracondylar femoral osteotomy for correction of the valgus knee using a fixed angle implant (95º AO angled blade plate. A surgical method for filling in the defect using an autologous bone graft is also presented.

  12. 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. Debridement for surgical wounds.

    Science.gov (United States)

    Dryburgh, Nancy; Smith, Fiona; Donaldson, Jayne; Mitchell, Melloney

    2008-07-16

    Surgical wounds that become infected are often debrided because clinicians believe that removal of this necrotic or infected tissue will expedite wound healing. There are numerous methods available but no consensus on which one is most effective for surgical wounds. The aim of this review is to determine the effect of different methods of debridement on the rate of debridement and healing of surgical wounds. We developed a search strategy to search the following electronic databases: Wounds Group Specialised Trials Register (searched 3/3/08) , Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2008, issue 1), MEDLINE (1950 to February Week 3 2008 ), EMBASE (1980 to 2008 Week 09) and CINHAL (1982 to February Week 4 2008). We checked the citations within obtained studies to identify additional papers and also relevant conference proceedings. We contacted manufactures of wound debridement agents to ascertain the existence of published, unpublished and ongoing trials. Our search was not limited by language or publication status. We included relevant randomised controlled trials (RCT) with outcomes including at least one of the following: time to complete debridement, or time to complete healing. Two authors independently reviewed the abstracts and titles obtained from the search, two extracted data independently using a standardised extraction sheet, and two independently assessed methodological quality. One author was involved in all stages of the data collection and extraction process, thus ensuring continuity. Five RCTs were eligible for inclusion; all compared treatments for infected surgical wounds and reported time required to achieve a clean wound bed (complete debridement). One trial compared an enzymatic agent (Streptokinase/streptodornase) with saline-soaked dressings and reported the time to complete debridement. Four of the trials compared the effectiveness of dextranomer beads or paste with other products (different comparator

  14. Biomicroscopia ultra-sônica (UBM no planejamento cirúrgico e acompanhamento pós-operatório de melanomas malignos de íris e corpo ciliar Ultrasound biomicroscopy (UBM in the surgical planning and postoperative follow-up of iris and ciliary body melanomas

    Directory of Open Access Journals (Sweden)

    Zélia Maria da Silva Corrêa

    2003-08-01

    for histopathologic study. Patients were followed-up for a minimum of 6 months when a new ultrasound biomi croscopy examination was performed. RESULTS: In this group of 5 patients, 3 were females and 2, males, age range from 32 to 64 years. All tumors were unilateral. Four patients presented an iridociliary tumor and one presented a lesion limited to the iris. In all cases ultrasound biomicroscopy was very helpful to determine surgical planning ensuring free surgical margins. Postoperative ultrasound biomicroscopy revealed no signs of tumor recurrence in all cases; 2 patients presented vitreous in the surgical wound, one with limited vitreous traction but no retinal detachment was detected. CONCLUSIONS: Ultrasound biomicroscopy seems to be a reliable ancilliary method to diagnose iris and iridociliary tumors, plan surgical treatment and postoperative follow-up.

  15. Role of Scientific Societies in International Collaboration

    Science.gov (United States)

    Fucugauchi, J. U.

    2007-12-01

    Geophysical research increasingly requires global multidisciplinary approaches. Understanding how deeply interrelated are Earth components and processes, population growth, increased needs of mineral and energy resources, global impact of human activities, and view of our planet as an interconnected system emphasizes the need of international cooperation. International research collaboration has an immense potential and is needed for further development of Earth science research and education. The Union Session is planned to provide a forum for analysis and discussion of the status of research and education of geosciences in developing countries, international collaboration programs and new initiatives for promoting and strengthening scientific cooperation. A theme of particular relevance in the analyses and discussions is the role of scientific societies in international collaboration. Societies organize meetings, publish journals and books and promote cooperation through academic exchange activities. They may further assist communities in developing countries in providing and facilitating access to scientific literature, attendance to international meetings, short and long-term stays and student and young researcher mobility. What else can be done? This is a complex subject and scientific societies may not be seen independently from the many factors involved in research and education. Developing countries present additional challenges resulting from limited economic resources and social and political problems, while urgently requiring improved educational and research programs. Needed are in-depth analyses of infrastructure and human resources, and identification of major problems and needs. What are the major limitations and needs in research and postgraduate education in developing countries? What and how should international collaboration do? What are the roles of individuals, academic institutions, funding agencies, scientific societies? Here we attempt to

  16. 双血管融合技术在硬脑膜动静瘘诊断和手术计划中的应用%Application of dual vessel fusion technique in the diagnosis of dural arteriovenous fistula and surgical planning

    Institute of Scientific and Technical Information of China (English)

    盛柳青; 李俊; 李国栋; 李欢欢; 陈刚; 向伟楚; 王强; 甘志强; 马廉亭

    2015-01-01

    Objective To investigate the application values of dual vessel fusion technique in the diagnosis of dural arteriovenous fistula (DAVF) and surgical planning.Methods Ten patients with DAVF underwent selective cerebral angiography using plate digital subtraction angiography (DSA).The lesion vessels performed three-dimensional angiography.The "double volume reconstruction" technique was used to perform two-vessel three-dimensional image fusion at the three-dimensional workstation.The angioarchitecture of DAVF was investigated.Results Ten patients obtained satisfactory "dual vessel fusion" with a good spatial coherence.On the dual vessel fusion images,the blood flow from different feeding arteries flowed together into the same fistula and draining vein (presented as a fusion of red and white blood flow) and the location and shape of the fistula cold be identified clearly.It could be used to guide the choice of treatment strategy,design surgery and surgical intervention plan.Conclusions Based on the "dual vessel fusion" of fiat panel DSA three-dimensional vascular data,it can obtain accurate vascular fusion,more clearly reveal fistulas,feeding arteries,draining veins and other angioarchitecture information of DAVF,and ultimately be beneficial to the development of surgical planning.%目的 探讨双血管融合技术在硬脑膜动静瘘(dural arteriovenous fistula,DAVF)诊断和手术计划中的应用价值,指导术中准确找到瘘口.方法 在10例DAVF病例采用平板DSA行选择性全脑血管造影,病变血管行三维血管成像.在三维工作站采用“双容积重建”技术进行两支血管三维像的融合,研究DAVF的血管构筑.结果 在10例均获得满意的“双血管融合”,具有很好的空间一致性.在双血管融合图像上可以清晰看到来自不同供血动脉的血流汇流到同一瘘口和引流静脉(表现为红白相间的血流融合),可以清晰判断瘘口的部位和形态,指导选择治疗策略、设计外

  17. Report: hospitals need more sophisticated planning efforts.

    Science.gov (United States)

    Anderson, H J

    1990-09-20

    Sophisticated planning efforts are increasing among hospitals. However, hospital planners and marketers still have far to go before they can match their counterparts in industry. This is according to a report on hospital planning recently released by the Society for Healthcare Planning and Marketing of the American Hospital Association, Chicago.

  18. Surgical crown lengthening for function and esthetics.

    Science.gov (United States)

    Allen, E P

    1993-04-01

    Clinical crown lengthening is a useful procedure to provide tooth length for proper restoration of a tooth without compromising the periodontium or the retentive qualities of the restoration. It is also useful for enhancing maxillary anterior esthetics. Crown lengthening may be as simple as a limited removal of soft tissue or as complex as orthodontic extrusion followed by flap with osseous surgery on a tooth requiring endodontic therapy. Total treatment could thus involve endodontic, orthodontic, periodontic, and restorative procedures. Careful evaluation, case selection, treatment planning, and surgical treatment following the principles outlined in this article can achieve results that meet the functional and esthetic challenges of current dental practice.

  19. Novel Surgical Approaches to the Orbit.

    Science.gov (United States)

    Campbell, Ashley A; Grob, Seanna R; Yoon, Michael K

    2015-01-01

    Determining safe surgical access to the orbit can be difficult given the complex anatomy and delicacy of the orbital structures. When considering biopsy or removal of an orbital tumor or repair of orbital fractures, careful planning is required to determine the ideal approach. Traditionally, this has at times necessitated invasive procedures with large incisions and extensive bone removal. The purpose of this review was to present newly techniques and devices in orbital surgery that have been reported over the past decade, with aims to provide better exposure and/or minimally invasive approaches and to improve morbidity and/or mortality.

  20. Education in an Information Society

    Science.gov (United States)

    Moore, John W.

    1999-04-01

    Last month's editorial pointed out that higher education may well change significantly as a result of the tremendous impact that information technologies are having on society. It quoted a white paper (1) by Russell Edgerton, Director of the Education Program of the Pew Charitable Trusts. Edgerton argued that higher education is currently failing to meet three challenges: to provide higher quality education; to reduce costs; and to regain its former stature as an important player in shaping public policy. Edgerton recommended that the Pew Trusts should encourage colleges and universities to set more ambitious goals for undergraduate education, to enter the public arena and play a major role in the reform of K-12 education, and to develop an academic profession interested in working toward these goals. Four new aims for undergraduate education were identified: "encouraging institutions to take learning seriously, encouraging faculty to take pedagogy seriously, demonstrating that technology can be used to reduce costs as well as to enhance learning, and developing new incentives for continuous quality improvement." One wonders why institutions of higher education should need to be encouraged toward goals that seem obviously congruent with their mission and self interest, but today's colleges and universities seem more likely to respond to outside offers of funding than to develop their own plans of action. As members of the faculty of such institutions, it behooves us to consider what some of those outside influences are likely to be and what effects they are likely to have on us, on our institutions, and on our students. Higher education is seen as a growth market by Michael Dolence and Donald Norris (2). In 1995 they projected that in five years there would be an increase of 20 million full-time equivalent enrollments in the U.S. and more than 100 million world wide. However, this growth was not projected to be traditional, on-campus students. Most was expected to

  1. Analysis of surgical intervention populations using generic surgical process models.

    Science.gov (United States)

    Neumuth, Thomas; Jannin, Pierre; Schlomberg, Juliane; Meixensberger, Jürgen; Wiedemann, Peter; Burgert, Oliver

    2011-01-01

    According to differences in patient characteristics, surgical performance, or used surgical technological resources, surgical interventions have high variability. No methods for the generation and comparison of statistical 'mean' surgical procedures are available. The convenience of these models is to provide increased evidence for clinical, technical, and administrative decision-making. Based on several measurements of patient individual surgical treatments, we present a method of how to calculate a statistical 'mean' intervention model, called generic Surgical Process Model (gSPM), from a number of interventions. In a proof-of-concept study, we show how statistical 'mean' procedure courses can be computed and how differences between several of these models can be quantified. Patient individual surgical treatments of 102 cataract interventions from eye surgery were allocated to an ambulatory or inpatient sample, and the gSPMs for each of the samples were computed. Both treatment strategies are exemplary compared for the interventional phase Capsulorhexis. Statistical differences between the gSPMs of ambulatory and inpatient procedures of performance times for surgical activities and activity sequences were identified. Furthermore, the work flow that corresponds to the general recommended clinical treatment was recovered out of the individual Surgical Process Models. The computation of gSPMs is a new approach in medical engineering and medical informatics. It supports increased evidence, e.g. for the application of alternative surgical strategies, investments for surgical technology, optimization protocols, or surgical education. Furthermore, this may be applicable in more technical research fields, as well, such as the development of surgical workflow management systems for the operating room of the future.

  2. Promoting astronomy for the development of society in Nepal

    Science.gov (United States)

    Bhattarai, Suresh; Neupane, Sudeep

    2011-06-01

    Astronomy as one of the oldest sciences has influenced and spurred steady development of society and culture. Inherent superstitious beliefs and their related rituals that have been hampering the progress and prosperity of nations have been dispelled and reduced considerably through the promotion of astronomical activities at all levels of the society. For disseminating basic knowledge and logic of astronomical facts that were deemed important for the development of our society, various programmes have been conducted through mass media. Many talk programmes, seminars and star parties were organised in different places. Our experiences when planning and executing such programmes are summarised and illustrated. The effectiveness of our programmes with the participation of general public is discussed in detail. Positive results of our activities that have contributed towards creation of substantial awareness of astronomy for the development of our society in Nepal are explained.

  3. Giant cell tumor of bone and tenosynovial tissue : surgical outcome

    NARCIS (Netherlands)

    Heijden, Lizz van der

    2014-01-01

    Giant cell tumor of bone (GCTB) is an intermediate, locally aggressive but rarely metastasizing tumor. Radiologically, GCTB shows typical lytic lesions. MR imaging is required to evaluate extent of GCTB for surgical planning. Preferred treatment for GCTB is extended curettage with local adjuvants, w

  4. Reconstrucción de la articulación temporomandibular postraumática con prótesis a medida: Planificación quirúrgica virtual Post-traumatic reconstruction with custom prosthesis of the temporomandibular joint: Computerized surgical planning

    Directory of Open Access Journals (Sweden)

    Aitor García Sánchez

    2011-06-01

    Full Text Available Introducción: Las nuevas técnicas de planificación quirúrgica virtual, como la tecnología CAD/CAM, así como los avances en biomateriales, permiten abordar casos cada vez más complejos de reconstrucción de la articulación temporomandibular. La planificación y la fabricación de dispositivos aloplásticos a medida permiten una adaptación excelente a las estructuras anatómicas. Las deformidades dentofaciales coexisten en muchas ocasiones con la afección articular. Con estos métodos de planificación es posible asociar procedimientos de cirugía ortognática, a la vez que reconstruimos la articulación temporomandibular en un solo tiempo quirúrgico. Material y métodos: En este artículo presentamos nuestra experiencia en la planificación virtual y posterior cirugía de 3 casos de anquilosis articular bilateral (6 articulaciones, con simulación de osteotomías, movimientos maxilomandibulares y diseño de prótesis totales aloplásticas a medida de la articulación temporomandibular. Conclusiones: El abordaje integral de la biomecánica articular, la relación intermaxilar y la oclusión dental es imprescindible para obtener resultados predecibles y satisfactorios. La planificación virtual y la utilización de dispositivos aloplásticos a medida permiten la reconstrucción total articular de una forma precisa y segura.Introduction: New virtual surgery planning techniques like CAD/CAM and advances in biomaterials have made it possible to undertake increasingly complex cases of temporomandibular joint reconstruction. The planning and preparation of custom alloplastic devices makes it possible to accurately accommodate anatomic structures. Dental and facial deformities often coexist with articular pathology. Using computerized planning methods, orthognathic surgery procedures can be combined with temporomandibular joint reconstruction in a single procedure. Material and methods: The authors' experience with computerized planning and

  5. [125 years' of the Serbian Medical Society].

    Science.gov (United States)

    Sulović, V; Pavlović, B

    1998-01-01

    , 1872 it was decided to start the publication of a professional journal "Srpski arhiv za celokupno lekarstvo" (Serbian Archives of General Medicine). The journal has still been edited. On suggestion of the Serbian Medical Society the Law of Health Care was promulgated in 1881. It was translated into German and French languages and sent to about 400 addresses in different European countries with the request for their opinion and suggestion. The reply of the Vienna Medical Society was as follows: "... While the Austrians carry out some stupid regulations of health care, at the same time a small Balkan country, Serbia promulgated a Law according to which no one, including the King, the Government or a political party dare not use a cent intended for health service, treatment of the sick people and payment of physicians...". On the occasion of the centenary of the First Serbian insurrection and coronation ceremonies of the King Petar I Karadjordjević, and under the King's patronage, the First Congress of Serbian physicians and naturalists was organized from 5 to 7 September 1904. There were 433 participants of whom more than 100 foreign participants. A Serbian professor of infectious diseases at the University School of Medicine in Vienna, Dr. Jovan Cokor, presented a paper with results of his studies of tuberculosis according to which tuberculosis could be transmitted from a sick cow to man; in this way he complemented the results and explanations of Dr. Robert Koch who discovered Mycobacterium tuberculosis. In 1907 the Serbian Medical Society organized in Belgrade the First meeting of Yugoslav surgeons. At that time, the foundation of a University school of medicine was planned. The Serbian Red Cross Organization was initiated by the Serbian Medical Society in 1876. On February 2, 1891 a procedure was brought for the establishment of the Medical Chamber. Its activity began in 1901. During the First and Second world wars the activity of the Serbian Medical Society was di

  6. Systematic review of the application of quality improvement methodologies from the manufacturing industry to surgical healthcare.

    Science.gov (United States)

    Nicolay, C R; Purkayastha, S; Greenhalgh, A; Benn, J; Chaturvedi, S; Phillips, N; Darzi, A

    2012-03-01

    The demand for the highest-quality patient care coupled with pressure on funding has led to the increasing use of quality improvement (QI) methodologies from the manufacturing industry. The aim of this systematic review was to identify and evaluate the application and effectiveness of these QI methodologies to the field of surgery. MEDLINE, the Cochrane Database, Allied and Complementary Medicine Database, British Nursing Index, Cumulative Index to Nursing and Allied Health Literature, Embase, Health Business(™) Elite, the Health Management Information Consortium and PsycINFO(®) were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Empirical studies were included that implemented a described QI methodology to surgical care and analysed a named outcome statistically. Some 34 of 1595 articles identified met the inclusion criteria after consensus from two independent investigators. Nine studies described continuous quality improvement (CQI), five Six Sigma, five total quality management (TQM), five plan-do-study-act (PDSA) or plan-do-check-act (PDCA) cycles, five statistical process control (SPC) or statistical quality control (SQC), four Lean and one Lean Six Sigma; 20 of the studies were undertaken in the USA. The most common aims were to reduce complications or improve outcomes (11), to reduce infection (7), and to reduce theatre delays (7). There was one randomized controlled trial. QI methodologies from industry can have significant effects on improving surgical care, from reducing infection rates to increasing operating room efficiency. The evidence is generally of suboptimal quality, and rigorous randomized multicentre studies are needed to bring evidence-based management into the same league as evidence-based medicine. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  7. [Dentist in an information society].

    Science.gov (United States)

    van Cuilenburg, J J

    1990-02-01

    Many commentators say that at present we are living in an information society, a society in which the main sources of national income are communication and information. This article aims at the question how the dentist's practice will be influenced by the information society. The dentist's role in the information society is described as an information broker between the dental science and the public, the patients. In that role the dentist is confronted with two developments, i.e. 'information overload' and 'rising expectations as to the possibilities of medical help'. The article concludes with a plea for 'good health education'. Against the background of the developments at the side of the public 'good health education' is not to be understood as 'more health information' for the public, but as 'more quality in health information'.

  8. American Society of Clinical Oncology

    Science.gov (United States)

    ... of Interest Mobile App Privacy Policy Privacy Policy Social Media Policy Sponsor Policy Terms of Use American Society of Clinical Oncology ASCO Annual Meeting Register and Reserve Your Hotel June 2-6, 2017 | Chicago, Illinois Hotel Reservation & ...

  9. School in the knowledge society

    DEFF Research Database (Denmark)

    Sørensen, Birgitte Holm; Levinsen, Karin

    2011-01-01

      Implementation of ICT in Danish and Nordic schools gradually moves from an industrial towards an emerging knowledge society school paradigm. Simultaneously it, digital literacy and the school's physical and social organization are constantly negotiated. In schools that proactively meet...

  10. Documentation in an information society

    OpenAIRE

    Bawden, D.

    2004-01-01

    The contributions of the theories and practices of “documentation”, located with the library/information disciplines, to the development of information society are real, but limited. The scope for further input is considerable.

  11. American Society for Dermatologic Surgery

    Science.gov (United States)

    ... work in your practice Promote your practice with marketing tools from the ASDS Branding Campaign. Free and ... new clinical research projects through its Cutting Edge Research Grant program. Learn ... methods. Copyright © 1971–2016. American Society for Dermatologic Surgery ( ...

  12. Science in Society in Europe

    DEFF Research Database (Denmark)

    Mejlgaard, Niels; Bloch, Carter Walter

    2012-01-01

    This paper introduces a special section of Science and Public Policy on science in society in Europe. Based on extensive data collected for the Monitoring Policy and Research Activities on Science in Society in Europe (MASIS) project, contributions to this special section explore pertinent issues...... related to the location, role and responsibility of science across EU member states and associated countries. By developing analytical typologies and classifying countries, the collection of papers provides a novel and detailed picture of Europe. It reveals considerable variation regarding...... the interactions of science and society at the national level, and it offers a platform for international learning. The identification of patterns and trends concerning the place of science in society may also feed into emerging European discussions about ‘responsible research and innovation’....

  13. Phoenix Society for Burn Survivors

    Science.gov (United States)

    ... Medical Professionals Phoenix Society is the leader in connecting the burn recovery community and creating resources for survivors. Since 1977, we have partnered with survivors, families, health care professionals, burn centers, and the fire ...

  14. The Engineering Societies & Continuing Education.

    Science.gov (United States)

    Professional Engineer, 1979

    1979-01-01

    Gives a description of what the major engineering societies (ASCE, ASME, AICHE, and IEEE) are doing in the area of continuing education. The description includes the short courses, their costs, duration, type and scope of the content. (GA)

  15. The Engineering Societies & Continuing Education.

    Science.gov (United States)

    Professional Engineer, 1979

    1979-01-01

    Gives a description of what the major engineering societies (ASCE, ASME, AICHE, and IEEE) are doing in the area of continuing education. The description includes the short courses, their costs, duration, type and scope of the content. (GA)

  16. [Duane vertical surgical treatment].

    Science.gov (United States)

    Merino, M L; Gómez de Liaño, P; Merino, P; Franco, G

    2014-04-01

    We report 3 cases with a vertical incomitance in upgaze, narrowing of palpebral fissure, and pseudo-overaction of both inferior oblique muscles. Surgery consisted of an elevation of both lateral rectus muscles with an asymmetrical weakening. A satisfactory result was achieved in 2 cases, whereas a Lambda syndrome appeared in the other case. The surgical technique of upper-insertion with a recession of both lateral rectus muscles improved vertical incomitance in 2 of the 3 patients; however, a residual deviation remains in the majority of cases. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  17. Diverticulitis: selective surgical management.

    Science.gov (United States)

    Rugtiv, G M

    1975-08-01

    The surgical treatment of complications of diverticulitis remains most challenging. A review of twenty years' experience with one hundred fifteen cases is presented with one proved anastomotic leak and no deaths. Interval primary resection with anastomosis for chronic recurrent disease including colovesical fistula and mesocolic abscess was proved sate with low morbidity. The three-stage procedure for perforated diverticulitis with spreading peritonitis or pericolic abscess was associated with a high rate of complications and morbidity. An aggressive approach with resection without anastomosis in two stages is indicated.

  18. Orthodontic-orthognathic interventions in orthognathic surgical cases: “Paper surgery” and “model surgery” concepts in surgical orthodontics

    Science.gov (United States)

    Gandedkar, Narayan H.; Chng, Chai Kiat; Yeow, Vincent Kok Leng

    2016-01-01

    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. PMID:27630506

  19. Surgical training in your hands: organising a skills course.

    Science.gov (United States)

    Burnand, Henry; Mutimer, Jon

    2012-12-01

    The advent of simulated surgical skills courses has brought dynamic changes to the traditional approach to acquiring practical skills in surgery. Teaching is a core part of the surgical profession, and any trainee can be involved in the organisation of skills training courses. This paper outlines the importance of organising surgical skills courses for trainees, and provides a practical guide on how to do so within busy clinical environments. The paper examines how to plan a course, how to design the programme, and provides tips on faculty staff requirements, venue, finance and participants, with additional suggestions for assessment and evaluation. We recommend the organisation of skills courses to any trainee. By following key ground rules, the surgical trainee can enable the acquisition of advanced learning opportunities and the ability to demonstrate valuable organisational skills. © Blackwell Publishing Ltd 2012.

  20. Finnish Society of Soil Sciences

    Science.gov (United States)

    Rankinen, Katri; Hänninen, Pekka; Soinne, Helena; Leppälammi-Kujansuu, Jaana; Salo, Tapio; Pennanen, Taina

    2017-04-01

    In 1998 the organization of the International Union of Soil Sciences (IUSS) was renewed to better support national activities. That was also the new start in the operation of the Finnish Society of Soil Sciences, which became affiliated to the IUSS. The society was originally established in 1971 but it remained relatively inactive. Currently, there are around 200 members in the Finnish Society of Soil Sciences. The members of the executive board cover different fields of soil science from geology to microbiology. Mission statement of the society is to promote the soil sciences and their application in Finland, to act as a forum for creation of better links between soil scientists, interested end users and the public, and to promote distribution and appreciation of general and Finnish research findings in soil science. Every second year the society organizes a national two-day long conference. In 2017 the theme 'circular economy' collected all together 57 presentations. The members of the incoming student division carried responsibility in practical co-ordination committee, acting also as session chairs. In the intervening years the society organizes a weekend excursion to neighboring areas. Lately we have explored the use of biochar in landscaping of Stockholm.

  1. Planning Lessons

    Institute of Scientific and Technical Information of China (English)

    Linda Jensen

    2007-01-01

    @@ Jensen's "Lesson Planning"article serves aS a guide fOr novice teachers who need to create formalized lesson plans.The article covers why,when,and how teachers plan lessons,as well aS basic lesson plan principles and a lesson plan template.

  2. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline.

    Science.gov (United States)

    Runowicz, Carolyn D; Leach, Corinne R; Henry, N Lynn; Henry, Karen S; Mackey, Heather T; Cowens-Alvarado, Rebecca L; Cannady, Rachel S; Pratt-Chapman, Mandi L; Edge, Stephen B; Jacobs, Linda A; Hurria, Arti; Marks, Lawrence B; LaMonte, Samuel J; Warner, Ellen; Lyman, Gary H; Ganz, Patricia A

    2016-02-20

    The purpose of the American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline is to provide recommendations to assist primary care and other clinicians in the care of female adult survivors of breast cancer. A systematic review of the literature was conducted using PubMed through April 2015. A multidisciplinary expert workgroup with expertise in primary care, gynecology, surgical oncology, medical oncology, radiation oncology, and nursing was formed and tasked with drafting the Breast Cancer Survivorship Care Guideline. A total of 1,073 articles met inclusion criteria; and, after full text review, 237 were included as the evidence base. Patients should undergo regular surveillance for breast cancer recurrence, including evaluation with a cancer-related history and physical examination, and should be screened for new primary breast cancer. Data do not support performing routine laboratory tests or imaging tests in asymptomatic patients to evaluate for breast cancer recurrence. Primary care clinicians should counsel patients about the importance of maintaining a healthy lifestyle, monitor for post-treatment symptoms that can adversely affect quality of life, and monitor for adherence to endocrine therapy. Recommendations provided in this guideline are based on current evidence in the literature and expert consensus opinion. Most of the evidence is not sufficient to warrant a strong evidence-based recommendation. Recommendations on surveillance for breast cancer recurrence, screening for second primary cancers, assessment and management of physical and psychosocial long-term and late effects of breast cancer and its treatment, health promotion, and care coordination/practice implications are made.This guideline was developed through a collaboration between the American Cancer Society and the American Society of Clinical Oncology and has been published jointly by invitation and consent in both CA: A Cancer Journal for

  3. Surgical patients travel longer distances than non-surgical patients to receive care at a rural hospital in Mozambique.

    Science.gov (United States)

    Faierman, Michelle L; Anderson, Jamie E; Assane, Americo; Bendix, Peter; Vaz, Fernando; Rose, John A; Funzamo, Carlos; Bickler, Stephen W; Noormahomed, Emilia V

    2015-01-01

    Surgical care is increasingly recognised as an important component of global health delivery. However, there are still major gaps in knowledge related to access to surgical care in low-income countries. In this study, we compare distances travelled by surgical patients with patients seeking other medical services at a first-level hospital in rural Mozambique. Data were collected on all inpatients at Hospital Rural de Chókwè in rural Mozambique between 20 June 2012 and 3 August 2012. Euclidean distances travelled by surgical versus non-surgical patients using coordinates of each patient's city of residence were compared. Data were analysed using ArcGIS 10 and STATA. In total, 500 patients were included. Almost one-half (47.6%) lived in the city where the hospital is based. By hospital ward, the majority (62.0%) of maternity patients came from within the hospital's city compared with only 35.2% of surgical patients. The average distance travelled was longest for surgical patients (42 km) compared with an average of 17 km for patients on all other wards. Patients seeking surgical care at this first-level hospital travel farther than patients seeking other services. While other patients may have access to at community clinics, surgical patients depend more heavily on the services available at first-level hospitals. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Minimally invasive surgical technique for tethered surgical drains

    Directory of Open Access Journals (Sweden)

    Shane R Hess

    2017-01-01

    Full Text Available A feared complication of temporary surgical drain placement is from the technical error of accidentally suturing the surgical drain into the wound. Postoperative discovery of a tethered drain can frequently necessitate return to the operating room if it cannot be successfully removed with nonoperative techniques. Formal wound exploration increases anesthesia and infection risk as well as cost and is best avoided if possible. We present a minimally invasive surgical technique that can avoid the morbidity associated with a full surgical wound exploration to remove a tethered drain when other nonoperative techniques fail.

  5. Interactive Environmental Planning

    DEFF Research Database (Denmark)

    Freudendal-Pedersen, Malene; Hartmann-Petersen, Katrine; Kjærulff, Aslak Aamot

    2017-01-01

    This article presents a research project on mobility management in Danish municipalities aimed at creating more sustainable mobilities. The project, called Formula M (2011–2014), worked within sciences, public and private sectors, and civil society. Often contemporary projects in both planning...... the planners involved in the project on their ‘why’ and ‘for what’. Based on a theoretical understanding of relational and collaborative planning the article contributes to an understanding of which approaches and methods can be used to facilitate the relationships and dialogues between many actors...

  6. Language Planning: Corpus Planning.

    Science.gov (United States)

    Baldauf, Richard B., Jr.

    1989-01-01

    Focuses on the historical and sociolinguistic studies that illuminate corpus planning processes. These processes are broken down and discussed under two categories: those related to the establishment of norms, referred to as codification, and those related to the extension of the linguistic functions of language, referred to as elaboration. (60…

  7. Optimizing Surgical Margins in Breast Conservation

    Directory of Open Access Journals (Sweden)

    Preya Ananthakrishnan

    2012-01-01

    Full Text Available Adequate surgical margins in breast-conserving surgery for breast cancer have traditionally been viewed as a predictor of local recurrence rates. There is still no consensus on what constitutes an adequate surgical margin, however it is clear that there is a trade-off between widely clear margins and acceptable cosmesis. Preoperative approaches to plan extent of resection with appropriate margins (in the setting of surgery first as well as after neoadjuvant chemotherapy, include mammography, US, and MRI. Improvements have been made in preoperative lesion localization strategies for surgery, as well as intraoperative specimen assessment, in order to ensure complete removal of imaging findings and facilitate margin clearance. Intraoperative strategies to accurately assess tumor and cavity margins include cavity shave techniques, as well as novel technologies for margin probes. Ablative techniques, including radiofrequency ablation as well as intraoperative radiation, may be used to extend tumor-free margins without resecting additional tissue. Oncoplastic techniques allow for wider resections while maintaining cosmesis and have acceptable local recurrence rates, however often involve surgery on the contralateral breast. As systemic therapy for breast cancer continues to improve, it is unclear what the importance of surgical margins on local control rates will be in the future.

  8. Transoral endoscopic-assisted styloidectomy: How should Eagle syndrome be managed surgically?

    Science.gov (United States)

    Al Weteid, A S; Miloro, M

    2015-09-01

    Eagle syndrome, or calcification of the stylohyoid ligament, is a rare condition that may present a clinical diagnostic dilemma for those unfamiliar with its existence and its typical presenting signs and symptoms. Management of this disease process may involve either non-surgical or surgical treatment options. When surgery is indicated, the choice of a specific surgical modality is highly variable and is generally dependent upon individual surgeon preference and experience, since the location of the styloid process is consistent between patients, and the required surgical access is also similar depending upon the specific surgical plan. This paper reports a case of Eagle syndrome managed with a transoral endoscopic-assisted approach, explores the advantages and disadvantages of each surgical approach, and reviews the literature regarding surgical management options for Eagle syndrome.

  9. The contribution of the Estonian Soil Sciences Society to the science, society and education

    Science.gov (United States)

    Rossner, Helis; Reintam, Endla; Astover, Alar; Shanskiy, Merrit

    2015-04-01

    Predecessor of todays Estonian Soil Science Society was Estonian Branch of All-Union Soil Society of Soil Scientist which acted from 1957 to 1991. In 1957-1964 Estonian Branch was leaded by prof. Osvald Hallik and in 1964-1991 by prof. Loit Reintam. After re-independence of Estonia in 1991 the society acted in informal way and was leaded by prof. L. Reintam. Non-profit organization "Estonian Soil Science Society" was officially (re)established in 10.23.2009. Estonian Soil Science Society (ESSS) is aimed to: • coordinate collaboration between institutions and individuals intrested of soil science, conservation and sustainable use of soils; • promoting soil science education and research, raising awareness of publicity on topics relating to soils in Estonia; • cooperation between local and foreign unions and associations. In recent years the ESSS had managed to reunite the number of soil scientist from different research institutions of Estonia and of related institutions. Also, the ESSS had provided numerous of materials based on later scientific findings. One of most important activity leaded by ESSS is the organizing Soil Day in Estonia with relevant seminar, where the speakers are sharing latest information with target group (researchers, teachers, policy makers, farmers, students etc.). In a frames of Soil Day the Soil of the Year is selected for Estonia. In 2015, the soil of the year is Leptosol. For current, International Year of the Soil ESSS had planned numerous activities to introduce the importance of soils to wider audience. In current presentation we would like to share the soil science researchers experience through- out the decades of soil science research in Estonia, show our latest findings and designed activities for the International Year of SOIL.

  10. SOCIETY

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    This group of photos were specially chosen from the works of two young photographers, Yan Xinfa and Zhai Dongfeng. Both love children, particularly children living in villages and small towns. They prefer to JnterwJne children closely with scenery in the countryside. They snap children fishing in rivers, climbing trees to catch birds, running with their dogs in the wind, gathering sugar cane and playing hide-and-seek in maize fields. Rural children seem to enjoy nature much more than urban children.

  11. SOCIETY

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Training for More Students Twelve vocational high schools will be built in the Pearl River Delta over the next few years to train up to 100,000 studentsfrom less-developed areas of south China’s Guangdong Province, to meet the soaring demand for skilled workers in the region, a local education official said on September 1.The delta region has long faced a shortage of labor, and skilled workers are now in particularly high demand as the region seeks to switch focus from labor-intensive manufacturing to value-added industries.

  12. SOCIETY

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Congress for Disabled The Fifth National Congress of the China Disabled Persons Federation (CDPF) was held in Beijing on November 11-13. A totalof 630 delegates representing China’s 83 million disabled people heard and discussed a work report by the CDPF before adopting amendments to the federation’s constitution.Deng Pufang, Chairman of the CDPF,said that the federation would enhance con-struction of its local branches. By the end oflast year, 90 percent of its branches in urbanareas and 40 percent in rural regions hadbeen established.The federation employs more than 94,000 full-time staff and more than 400,000 volun-teers in urban communities and villages.

  13. Astronomical Society of the Pacific IYA Programs

    Science.gov (United States)

    Manning, James G.

    2009-05-01

    The Astronomical Society of the Pacific is presently engaged in a series of initiatives for the International Year of Astronomy (IYA) with the aim of using public awareness and interest to create sustainable education programs and products for the longer term. The presenter will describe progress in its four signature IYA efforts: IYA Discovery Guides for the amateur astronomy community and others providing outreach activities and materials, keyed to NASA's monthly IYA calendar of themes and featured objects, supported by NASA and the NSF; adaptation of these materials to expand astronomy education capacity in the informal education community working in museums and science and nature centers, supported by NASA; the Galileo Teacher Training Program of planned pilot workshops for the professional development of K-12 classroom teachers, to develop a workshop model focusing on the process of science and the adaptation of tools and resources for the classroom; and the development of a Cosmic Clearinghouse web page associated with the IAU Portal to the Universe to provide links to a wide variety of education resources. The presenter will also relate progress in other IYA efforts, including supporting Interstellar Studios’ 400 Years of the Telescope PBS documentary film and its accompanying planetarium program and educational initiatives, promoting other IYA products and services to its networks and others, and plans for the Society's 121st annual meeting in September that will focus on IYA and the Year of Science_and especially on building on the momentum of these efforts to forge a future path for science and science education, nationally and globally.

  14. Evolving society and mental health

    Directory of Open Access Journals (Sweden)

    Dipesh Bhagabati

    2016-07-01

    Full Text Available Numerous issues related to culture, occupation, gender, caste, and health, to name a few, have faced harshness of society from time immemorial. Reasons are debatable, ranging from somewhat understandable to completely unacceptable. There is no doubt that society is dynamic and it has changed its view on many of the issues with passing time. Mental health is one such issue which society has neglected for quite a long time. Even today, mental health and mentally ill people face stigma and discrimination in their family, society, and at their workplace. People do not feel comfortable talking about mental health, even if they know that there cannot be any health without a healthy mind. But, as Albert Einstein has said “learn from yesterday, live for today, and hope for tomorrow”, everything is not lost. The mentally ill patients who were once abandoned and left on their own have now started to get humane care and attention. This article discusses this very pertinent topic of changing society and mental health.

  15. Mohs Surgical Reconstruction Educational Activity: a resident education tool

    Science.gov (United States)

    Croley, Julie A; Malone, C Helen; Goodwin, Brandon P; Phillips, Linda G; Cole, Eric L; Wagner, Richard F

    2017-01-01

    Background Surgical reconstructive planning following Mohs surgery can be a difficult subject for dermatology residents to master. Prior research demonstrates that active learning is preferred and more effective compared to passive learning models and that dermatology residents desire greater complexity and volume in surgical training. We present a novel, active, problem-based learning tool for the education of Mohs reconstruction with the goal of improving residents’ ability to plan surgical reconstructions. Materials and methods The Mohs Surgical Reconstruction Educational Activity is an active, problem-based learning activity in which residents designed repairs for planned Mohs defects prior to surgery on an iPad application or on a printed photograph. The attending Mohs surgeon reviewed the reconstructive designs, provided feedback, guided discussion, and facilitated insight into additional issues requiring further review. Residents performed or observed the Mohs and reconstructive surgical procedures for respective repairs. Surveys were administered to participants before and after participating in the Mohs Surgical Reconstruction Educational Activity to assess the educational value of the activity. Survey responses were recorded on a 5-point Likert scale. Results Mean participant-reported confidence in flap and graft knowledge, flap and graft planning, and flap and graft performance increased 1.50–2.50 Likert scale points upon completion of the Mohs surgery rotation by residents participating in the educational activity. The observed trend was larger in the dermatology resident subset, with increases of 2.00–3.50 Likert scale points reported for these questions. Mean participant-reported likelihoods of performing flaps and grafts in the future increased 0.25–0.50 Likert scale points among all residents participating in the educational activity and 0.50–1.00 Likert scale points in the dermatology resident subset. All residents participating in the

  16. Mohs Surgical Reconstruction Educational Activity: a resident education tool.

    Science.gov (United States)

    Croley, Julie A; Malone, C Helen; Goodwin, Brandon P; Phillips, Linda G; Cole, Eric L; Wagner, Richard F

    2017-01-01

    Surgical reconstructive planning following Mohs surgery can be a difficult subject for dermatology residents to master. Prior research demonstrates that active learning is preferred and more effective compared to passive learning models and that dermatology residents desire greater complexity and volume in surgical training. We present a novel, active, problem-based learning tool for the education of Mohs reconstruction with the goal of improving residents' ability to plan surgical reconstructions. The Mohs Surgical Reconstruction Educational Activity is an active, problem-based learning activity in which residents designed repairs for planned Mohs defects prior to surgery on an iPad application or on a printed photograph. The attending Mohs surgeon reviewed the reconstructive designs, provided feedback, guided discussion, and facilitated insight into additional issues requiring further review. Residents performed or observed the Mohs and reconstructive surgical procedures for respective repairs. Surveys were administered to participants before and after participating in the Mohs Surgical Reconstruction Educational Activity to assess the educational value of the activity. Survey responses were recorded on a 5-point Likert scale. Mean participant-reported confidence in flap and graft knowledge, flap and graft planning, and flap and graft performance increased 1.50-2.50 Likert scale points upon completion of the Mohs surgery rotation by residents participating in the educational activity. The observed trend was larger in the dermatology resident subset, with increases of 2.00-3.50 Likert scale points reported for these questions. Mean participant-reported likelihoods of performing flaps and grafts in the future increased 0.25-0.50 Likert scale points among all residents participating in the educational activity and 0.50-1.00 Likert scale points in the dermatology resident subset. All residents participating in the educational activity somewhat or completely agreed

  17. Trust and Estate Planning

    DEFF Research Database (Denmark)

    Harrington, Brooke

    2012-01-01

    , these professionals keep a significant portion of the world’s private wealth beyond the reach of the state. Trust and estate planning thus contributes to creating and maintaining socioeconomic inequality on a global scale. The significance of the profession has grown as wealth itself has become more fungible......, spurring innovation in legal, organizational, and financial strategies, and thwarting a myriad of laws and policies designed to limit enduring inequality in modern, democratic societies....

  18. Three-dimensional echocardiography in congenital heart disease: an expert consensus document from the European Association of Cardiovascular Imaging and the American Society of Echocardiography.

    Science.gov (United States)

    Simpson, John; Lopez, Leo; Acar, Philippe; Friedberg, Mark; Khoo, Nee; Ko, Helen; Marek, Jan; Marx, Gerald; McGhie, Jackie; Meijboom, Folkert; Roberson, David; Van den Bosch, Annemien; Miller, Owen; Shirali, Girish

    2016-10-01

    Three-dimensional echocardiography (3DE) has become important in the management of patients with congenital heart disease (CHD), particularly with pre-surgical planning, guidance of catheter intervention, and functional assessment of the heart. 3DE is increasingly used in children because of good acoustic windows and the non-invasive nature of the technique. The aim of this paper is to provide a review of the optimal application of 3DE in CHD including technical considerations, image orientation, application to different lesions, procedural guidance, and functional assessment. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  19. Tophi - surgical treatment.

    Science.gov (United States)

    Słowińska, Iwona; Słowiński, Radosław; Rutkowska-Sak, Lidia

    2016-01-01

    Gout is an inflammatory joint disease associated with deposition of monosodium urate crystals in the bones forming the joints, in periarticular tissues and in other organs. The disease is one of the most frequent causes of disability. This paper presents the case of a 57-year-old male patient treated for generalised gout. A "clinical mask" suggesting another disease was the cause of making the correct diagnosis only six years after the occurrence of the first manifestations. The patient, with high values of inflammatory markers, severe pain and advanced joint destruction, was given an aggressive anti-inflammatory treatment. The unsatisfactory effect of the conservative treatment forced the authors to perform surgical resection of the gouty nodules in the hands. After several operations the function of the hand joints operated on, appearance of the hands and the quality of the patient's life improved significantly.

  20. Tophi – surgical treatment

    Science.gov (United States)

    Słowińska, Iwona; Słowiński, Radosław

    2016-01-01

    Gout is an inflammatory joint disease associated with deposition of monosodium urate crystals in the bones forming the joints, in periarticular tissues and in other organs. The disease is one of the most frequent causes of disability. This paper presents the case of a 57-year-old male patient treated for generalised gout. A “clinical mask” suggesting another disease was the cause of making the correct diagnosis only six years after the occurrence of the first manifestations. The patient, with high values of inflammatory markers, severe pain and advanced joint destruction, was given an aggressive anti-inflammatory treatment. The unsatisfactory effect of the conservative treatment forced the authors to perform surgical resection of the gouty nodules in the hands. After several operations the function of the hand joints operated on, appearance of the hands and the quality of the patient’s life improved significantly. PMID:27994273