Search results for: surgery planning and control

Authors: Adie, Julius Undiukeye

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This research investigated the practice of academic leadership succession planning in Nigerian higher education institutions, drawing on the lived experiences of the academic staff of the case study institutions. It is multi-case study research that adopts a qualitative research method. Ten participants (mainly academic staff) were used as the study sample. The study was guided by four research questions. Semi-structured interviews and archival information from official documents formed the sources of data. The data collected was analyzed using the Constant Comparative Technique (CCT) to generate empirical insights and facts on the subject of this paper. The following findings emerged from the data analysis: firstly, there was no formalized leadership succession plan in place in the institutions that were sampled for this study; secondly, despite the absence of a formal succession plan, the data indicates that academics believe that succession planning is very significant for institutional survival; thirdly, existing practices of succession planning in the sampled institutions, takes the forms of job seniority ranking, political process and executive fiat, ad-hoc arrangement, and external hiring; and finally, data revealed that there are some barriers to the practice of succession planning, such as traditional higher education institutions’ characteristics (e.g. external talent search, shared governance, diversity, and equality in leadership appointment) and the lack of interest in leadership positions. Based on the research findings, some far-reaching recommendations were made, including the urgent need for the ‘formalization’ of leadership succession planning by the higher education institutions concerned, through the design of an official policy framework.

Keywords: academic leadership, succession, planning, higher education

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Authors: Ching-Yuan Chen, Lung-Kwang Pan

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Objective: Back pain is a major health problem costing billions of health budgets annually in Taiwan. Thousands of back pain surgeries are performed annually with up to 40% of patients complaining of back pain at time of post-surgery causing failed back surgery syndrome (FBSS), although diagnosis in these patients may be complex. The aim of study is to assess the feasibility of using bone SPECT-CT imaging to localize the active lesions causing persistent, recurrent or new backache after spine surgery. Materials and Methods: Bone SPECT-CT imaging was performed after the intravenous injection of 20 mCi of 99mTc-MDP for all the patients with diagnosis of FBSS. Patients were evaluated using status of subjectively pain relief, functional improvement and degree of satisfaction by reviewing the medical records and questionnaires in a 2 more years’ follow-up. Results: We enrolled a total of 16 patients were surveyed in our hospital from Jan. 2015 to Dec. 2016. Four people on SPEC/CT imaging ensured significant lesions were undergone a revised surgery (surgical treatment group). The mean visual analogue scale (VAS) decreased 5.3 points and mean Oswestry disability index (ODI) improved 38 points in the surgical group. The remaining 12 on SPECT/CT imaging were diagnosed as no significant lesions then received drug treatment (medical treatment group). The mean VAS only decreased 2 .1 point and mean ODI improved 12.6 points in the medical treatment group. In the posttherapeutic evaluation, the pain of the surgical treatment group showed a satisfactory improvement. In the medical treatment group, 10 of the 12 were also satisfied with the symptom relief while the other 2 did not improve significantly. Conclusions: Findings on SPECT-CT imaging appears to be easily explained the patients' pain. We recommended that SPECT/CT imaging was a feasible and useful clinical tool to improve diagnostic confidence or specificity when evaluating patients with FBSS.

Keywords: failed back surgery syndrome, oswestry disability index, SPECT-CT imaging, 99mTc-MDP, visual analogue scale

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Authors: Z. Bouchama, N. Essounbouli, A. Hamzaoui, M. N. Harmas

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A new robust finite time synergetic controller is presented based on recently developed synergetic control methodology and a terminal attractor technique. A Fast Terminal Synergetic Control (FTSC) is proposed for controlling DC-DC buck converter. Unlike Synergetic Control (SC) and sliding mode control, the proposed control scheme has the characteristics of finite time convergence and chattering free phenomena. Simulation of stabilization and reference tracking for buck converter systems illustrates the approach effectiveness while stability is assured in the Lyapunov sense and converse Lyapunov results involving scalar differential inequalities are given for finite-time stability.

Keywords: dc-dc buck converter, synergetic control, finite time convergence, terminal synergetic control, fast terminal synergetic control, Lyapunov

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Authors: Majid Etaati, Hamid Majedi

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Relational planning approach proposed by Patsy Healey goes beyond the physical proximity and emphasizes social proximity. This approach stresses the importance of nodes and flows between nodes. Current plans in European cities have incrementally incorporated this approach, but urban plans in Iran have still stayed very detailed and rigid. In response to the weak evaluation results of the comprehensive planning approach in Qazvin, the local authorities applied the City Development Strategy (CDS) to cope with new urban challenges. The paper begins with an explanation of relational planning and suggests that Healey gives urban planners about spatial strategies and then it surveys relational factors in CDS of Qazvin. This study analyzes the extent which CDS of Qazvin have highlighted nodes, flows, and dynamics. In the end, the study concludes that there is a relational understanding of urban dynamics in the plan, but it is weak.

Keywords: relational, dynamics, city development strategy, urban planning, Qazvin

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Authors: Chaimongkol Limpianchob

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This work addresses the problem of production planning that arises in the production of aromatic coconuts from Samudsakhorn province in Thailand. The planning involves the forwarding of aromatic coconuts from the harvest areas to the factory, which is classified into two groups; self-owned areas and contracted areas, the decisions of aromatic coconuts flow in the plant, and addressing a question of which warehouse will be in use. The problem is formulated as a mixed-integer linear programming model within supply chain management framework. The objective function seeks to minimize the total cost including the harvesting, labor and inventory costs. Constraints on the system include the production activities in the company and demand requirements. Numerical results are presented to demonstrate the feasibility of coconuts supply chain model compared with base case.

Keywords: aromatic coconut, supply chain management, production planning, mixed-integer linear programming

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Authors: Chitresh Kumar, Santanu Gupta

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The research work intends to understand the process of initiation, planning and development of capital-intensive urban area level infrastructure development in East Asian Cities (specific to Indian Cities). With the onset of emphasis on sustainable urban transport, self-financed urban local bodies, it has become of utmost important to identify infrastructure and projects on a priority basis, which provide optimal utility to the urban area. Through identification of Spatial, Demographic and Socio-Economic and Political Instability Parameters and their trends for the past 60 years at the urban area and state level, the paper attempts to identify the most suitable time period when initiation of the project would become economically and demographically viable for the city.

Keywords: urban planning, regional planning, mass transit, infrastructure development, spatial planning

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Authors: Sheren H. Salah

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The inverted pendulum is a highly nonlinear and open-loop unstable system. An inverted pendulum (IP) is a pendulum which has its mass above its pivot point. It is often implemented with the pivot point mounted on a cart that can move horizontally and may be called a cart and pole. The characteristics of the inverted pendulum make identification and control more challenging. This paper presents the simulation study of several control strategies for an inverted pendulum system. The goal is to determine which control strategy delivers better performance with respect to pendulum’s angle. The inverted pendulum represents a challenging control problem, which continually moves toward an uncontrolled state. For controlling the inverted pendulum. The simulation study that sliding mode control (SMC) control produced better response compared to Genetic Algorithm Control (GAs) and proportional-integral-derivative(PID) control.

Keywords: Inverted Pendulum (IP) Proportional-Integral-Derivative (PID), Genetic Algorithm Control (GAs), Sliding Mode Control (SMC)

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Authors: Mekroud Amel

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Introduction The rate of use by the elderly of emergency departments, operating rooms and intensive care units has increased worldwide. Emergency surgery is a context where evaluation is often insufficient, with incomplete information gathering. The aim of this work is to shed light on the frequent use of emergency surgeries by the elderly and their characteristics, as well as on the lack of geriatric assessment scores in the emergency room. Material : Prospective, observational and descriptive, monocentric study. Patients aged 65 and over, admitted for emergency surgery in the operating room, were counted. Emergency operating room including visceral surgery, urology, traumatology and neurosurgery. Parameters studied: Patient characteristics, degree of autonomy, type of surgical pathology, operative management times, preoperative evaluation, postoperative outcome Results : 192 patients were identified over 12 months, from 09.01.2017 to 08.31.2018 Age from 65 to 101 years, 79.81 years +/- 8.38. With predominance of the age group between [65-75 years] 41.1% Female predominance, Sexratio = 0.81 Elderly subjects with total motor autonomy are in the majority at 57.8% Subjects without pathological ATCD represent 12.5% of cases Those who are on only one type of medication or without any treatment are at 36.9% Discussion : The emergency operative care of the elderly patient for a surgical or traumatological pathology is characterized by many specificities linked first to the emergency context, where the evaluation is often insufficient, besides the fact that the elderly patient has particularities requiring reception in centers with experience in the care of this category of patient, or, failing that, a center which uses the minimum of geriatric evaluation scores which are simplified for the emergency departments. In our hospital, we have not yet made this evaluation routine in the emergency room and this delay in the introduction of these scores can be directly attributed to the covid 19 pandemic. Besides the standard preoperative assessment, only 43.2% of patients were assessed in the preoperative period by an anesthesiologist. Traumatological emergencies come first 68.2% followed by visceral emergencies 19.2% (including proctological, urological emergencies), neurosurgical emergencies 7.8% and finally peripheral emergency surgery all acts combined 4.7%. Hospital stay at 9.6 +/- 16.8 days, average operability time of 4.5 +/- 3 days. Death rate at 7.29% Conclusion This work has demonstrated the major impact of emergency surgery, which remains curable for the most part, on the elderly patient despite total motor and cognitive autonomy preoperatively. The improvement of the preoperative evaluation, the reduction of the operating time and enhanced recovery after surgery, with personalized protocols, are the only guarantee for the resumption of preoperative autonomy in these patients.

Keywords: emergency surgery, elderly patients, preoperative geriatric scores, curable emergency surgical pathologies

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Authors: Zhao Jiashen, Serene Goh, Jerry Goo, Anthony Li, Lim Woan Wui, Paul Drakeford, Chen Qing Yan

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Introduction: Emergency laparotomy (EL) is one of the most common surgeries done in Singapore to treat acute abdominal pathologies. A significant proportion of these surgeries are performed in the geriatric population (65 years and older), who tend to have the highest postoperative morbidity, mortality, and highest utilization of intensive care resources. Frailty, the state of vulnerability to adverse outcomes from an accumulation of physiological deficits, has been shown to be associated with poorer outcomes after surgery and remains a strong driver of healthcare utilization and costs. To date, there is little understanding of the impact it has on emergency laparotomy outcomes. The objective of this study is to examine the impact of frailty on postoperative morbidity, mortality, and length of stay after EL. Methods: A retrospective study was conducted in two tertiary centres in Singapore, Tan Tock Seng Hospital and Khoo Teck Puat Hospital the period from January to December 2019. Patients aged 65 years and above who underwent emergency laparotomy for intestinal obstruction, perforated viscus, bowel ischaemia, adhesiolysis, gastrointestinal bleed, or another suspected acute abdomen were included. Laparotomies performed for trauma, cholecystectomy, appendectomy, vascular surgery, and non-GI surgery were excluded. The Clinical Frailty Score (CFS) developed by the Canadian Study of Health and Aging (CSHA) was used. A score of 1 to 4 was defined as non-frail and 5 to 7 as frail. We compared the clinical outcomes of elderly patients in the frail and non-frail groups. Results: There were 233 elderly patients who underwent EL during the study period. Up to 26.2% of patients were frail. Patients who were frail (CFS 5-9) tend to be older, 79 ± 7 vs 79 ± 5 years of age, p <0.01. Gender distribution was equal in both groups. Indication for emergency laparotomies, time from diagnosis to surgery, and presence of consultant surgeons and anaesthetists in the operating theatre were comparable (p>0.05). Patients in the frail group were more likely to receive postoperative geriatric assessment than in the non-frail group, 49.2% vs. 27.9% (p<0.01). The postoperative complications were comparable (p>0.05). The length of stay in the critical care unit was longer for the frail patients, 2 (IQR 1-6.5) versus 1 (IQR 0-4) days, p<0.01. Frailty was found to be an independent predictor of 90-day mortality but not age, OR 2.9 (1.1-7.4), p=0.03. Conclusion: Up to one-fourth of the elderly who underwent EL were frail. Patients who were frail were associated with a longer length of stay in the critical care unit and a 90-day mortality rate of more than three times that of their non-frail counterparts. PPOSSUM was a better predictor of 90-day mortality in the non-frail group than in the frail group. As frailty scoring was a significant predictor of 90-day mortality, its integration into acute surgical units to facilitate shared decision-making and discharge planning should be considered.

Keywords: frailty elderly, emergency, laparotomy

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Authors: Michael Dimmer, Holger Flederer

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The basis of realizing a construction project is a technically flawless concept which satisfies conditions regarding environment and costs, as well as static-constructional terms. The presented software system actively supports civil engineers during the setup of optimal designs, by giving advice regarding durability, life-cycle costs, sustainability and much more. A major part of the surrounding conditions of a design process is gathered and assimilated by experienced engineers subconsciously. It is a question about eligible building techniques and their practicability by considering emerging costs. Planning engineers have acquired many of this experience during their professional life and use them for their daily work. Occasionally, the planning engineer should disassociate himself from his experience to be open for new and better solutions which meet the functional demands, as well. The developed expert system gives planning engineers recommendations for preferred design options of new constructions as well as for existing bridge constructions. It is possible to analyze construction elements and techniques regarding sustainability and life-cycle costs. This way the software provides recommendations for future constructions. Furthermore, there is an option to design existing road bridges especially for heavy duty transport. This implies a route planning tool to get quick and reliable information as to whether the bridge support structures of a transport route have been measured sufficiently for a certain heavy duty transport. The use of this expert system in bridge planning companies and building authorities will save costs massively for new and existent bridge constructions. This is achieved by consequently considering parameters like life-cycle costs and sustainability for its planning recommendations.

Keywords: expert system, planning process, road bridges, software system

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Authors: Ligia Florio, João Mauricio Castaldelli-Maia

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Background: Food addiction (FA) emerged in the 1990s as a possible contributor to the increasing prevalence of obesity and overweight, in conjunction with changing food environments and mental health conditions. However, FA is not yet listed as one of the disorders in the DSM-5 and/or the ICD-11. Although there are controversies and debates in the literature about the classification and construct of FA, the most common approach to access it is the use of a research tool - the Yale Food Addiction Scale (YFAS) - which approximates the concept of FA to the concept diagnosis of dependence on psychoactive substances. There is a need to explore the dimensional phenotypes accessed by YFAS in different population groups for a better understanding and scientific support of FA diagnoses. Methods: The primary objective of this project was to investigate the construct validity of the FA concept by mYFAS 2.0 in individuals who underwent bariatric surgery (n = 100) at the Hospital Estadual Mário Covas since 2011. Statistical analyzes were conducted using the STATA software. In this sense, structural or factor validity was the type of construct validity investigated using exploratory factor analysis (EFA) and item response theory (IRT) techniques. Results: EFA showed that the one-dimensional model was the most parsimonious. The IRT showed that all criteria contributed to the latent structure, presenting discrimination values greater than 0.5, with most presenting values greater than 2. Conclusion: This study reinforces a FA dimension in patients who underwent bariatric surgery. Within this dimension, we identified the most severe and discriminating criteria for the diagnosis of FA.

Keywords: obesity, food addiction, bariatric surgery, regain

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Authors: Jhuang Jin-Jhong, Hsieh Wei-Fan

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Climate change causes natural disasters persistently. Therefore, nowadays environmental planning objective tends to the issues of respecting nature and coexisting with nature. As a result, the natural environment analysis, e.g., the analysis of topography, soil, hydrology, climate, vegetation, is highly emphasized. On the other hand, Feng Shui has been a criterion of site selection for residence in Eastern since the ancient times and has had farther influence on site selection for castles and even for temples and tombs. The primary criterion of site selection is judging the quality of Long: mountain range, Sha: nearby mountains, Shui: hydrology, Xue: foundation, Xiang: aspect, which are similar to the environmental variables of mountain range, topography, hydrology and aspect. For the reason, a lot researchers attempt to probe into the connection between the criterion of Feng Shui and environmental planning factors. Most researches only discussed with the composition and theory of space of Feng Shui, but there is no research which explained Feng Shui through the environmental field. Consequently, this study reviewed the theory of Feng Shui through the environmental planning viewpoint and assembled essential composition factors of Feng Shui. The results of this study point. From literature review and comparison of theoretical meanings, we find that the ideal principles for planning the Feng Shui environment can also be used for environmental planning. Therefore, this article uses 12 ideal environmental features used in Feng Shui to contrast the natural aspects of the environment and make comparisons with previous research and classifies the environmental factors into climate, topography, hydrology, vegetation, and soil.

Keywords: the composition of Feng Shui, environmental planning, site selection, main components of the Feng Shui environment

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Authors: R. Chakib, A. Essadki, M. Cherkaoui

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This paper proposes the study of a robust control of the doubly fed induction generator (DFIG) used in a wind energy production. The proposed control is based on the linear active disturbance rejection control (ADRC) and it is applied to the control currents rotor of the DFIG, the DC bus voltage and active and reactive power exchanged between the DFIG and the network. The system under study and the proposed control are simulated using MATLAB/SIMULINK.

Keywords: doubly fed induction generator (DFIG), active disturbance rejection control (ADRC), vector control, MPPT, extended state observer, back-to-back converter, wind turbine

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Authors: Cinzia Colapinto, Davide La Torre

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Goal Programming (GP) and its variants were applied to marketing and specific marketing issues, such as media scheduling problems in the last decades. The concept of satisfaction functions has been widely utilized in the GP model to explicitly integrate the Decision-Maker’s preferences. These preferences can be guided by the available information regarding the decision-making situation. A GP model with satisfaction functions for media planning decisions is proposed and then illustrated through a case study related to a marketing/media campaign in the Italian market.

Keywords: goal programming, satisfaction functions, media planning, tourism management

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Authors: Anel Hasić, Naser Prljača

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In the domain of autonomous or piloted flights, the accurate control of quadrotor trajectories is of paramount significance for large numbers of tasks. These adaptable aerial platforms find applications that span from high-precision aerial photography and surveillance to demanding search and rescue missions. Among the fundamental challenges confronting quadrotor operation is the demand for accurate following of desired flight paths. To address this control challenge, among others, two celebrated well-established control strategies have emerged as noteworthy contenders: Model Predictive Control (MPC) and Proportional-Integral-Derivative (PID) control. In this work, we focus on the extensive examination of MPC and PID control techniques by using comprehensive simulation studies in MATLAB/Simulink. Intensive simulation results demonstrate the performance of the studied control algorithms.

Keywords: MATLAB, MPC, PID, quadcopter, simulink

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Authors: Javier Fernandez De Canete, Alvaro Fernandez-Quintero

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Nowadays, adaptive control schemes are being used when model based control schemes are applied in presence of uncertainty and model mismatches. Artificial neural networks have been employed both in modelling and control of non-linear dynamic systems with unknown dynamics. In fact, these are powerful tools to solve this control problem when only input-output operational data are available. A neural network controller under SIMULINK together with the ARDUINO hardware platform has been used to perform real-time speed control of a computer case fan. Comparison of performance with a PID controller has also been presented in order to show the efficacy of neural control under different command signals tracking and also when disturbance signals are present in the speed control loops.

Keywords: neural networks, ARDUINO platform, SIMULINK, adaptive speed control

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Authors: Chee Young Kim, Tae Hyun Kim, Anbok Lee, Hyun-Ah Kim, Woosung Lim, Ku Sang Kim, Jinsun Lee, Yoo Seok Kim, Beom Seok Ko

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Background: CollatampTM is Gentamicin-containing collagen sponge well known for its hemostatic effect, commonly utilized in surgeries. We inserted CollatempTM wrapped by SurgicelTM (oxidized cellulose polymer) to fill up the defect after breast conserving surgery. The purpose of this study is to verify the furthermore cosmetic value of CollatampTM in breast conserving surgery conducted in breast cancer patients. Methods: 17 patients were enrolled in this study, underwent breast conserving surgery with CollatampTM wrapped by SurgicelTM insertion, in Inje University Busan Paik Hospital from October 2015 to September 2016. Patient satisfaction, cosmetic outcome, results at 6 months from operation was analyzed to verify the effectiveness and usefulness of CollatampTM for cosmetics. Patient satisfaction was investigated through interviews on a scale of good, fair, poor, and the cosmetic outcome was investigated through physical examination by a surgeon who did not participate in the operations. Results: Among 17 patients, nine of them gave ‘good’ for patient satisfaction, eight gave ‘fair’ and none of them ‘poor’. Also, cosmetic outcome came out with 11 ‘good’s, six ‘fair’s, no ‘poor’. In ‘good’ patient satisfaction group, the mean value of resection to breast volume ratio was 16%, compared to 24% of ‘fair’ group. The mean value of actual resection volume was 100.6cm3, 102.7cm3 each. In ‘good’ cosmetic outcome group, the mean value of resection to breast volume ratio was 18%, compared to 23% of ‘fair’ group. The mean value of actual resection volume was 99.2cm3, 105.9cm3 respectively. According to these results, patient satisfaction and cosmetic outcome after surgeries were more reliable on the resection to breast volume ratio, rather than the actual resection volume. There were eight cases of postoperative complications, consisting of a lymphedema, a seroma, and six patients had mild pain. Conclusions: Cosmetic effect of CollatampTM in breast conserving surgery was more reliable on the resection to breast volume ratio, rather than the actual resection volume. In this short term survey, patients were tend to be satisfied with the cosmetics, all giving either good or fair scores. However, long term outcomes should be further assessed.

Keywords: breast cancer, breast conserving surgery, collatamp, cosmetics

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Authors: Catherine Bernard, Paul Ransom

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Recent events have prompted emergency planners to re-evaluate their emergency response to major incidents and mass casualties. At the Royal Sussex County Hospital, we have adopted a tiered system comprised of three levels, anticipating an increasing P1, P2 or P3 load. This will aid planning in the golden period between Major Incident ‘Standby,’ and ‘Declared’. Each tier offers step-by-step instructions on appropriate patient movement within and out of the department, as well as suggestions for overflow areas and additional staffing levels. This system can be adapted to individual hospitals and provides concise instructions to be followed in a potentially overwhelming situation.

Keywords: disaster planning, emergency preparedness, major incident planning, mass casualty event

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Authors: Han Song, Tingting Wei, Dong Chen

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The combination of capital and rural areas in China has shown its great significance in promoting urban-rural integration and new-style urbanization, enhancing regional capacity for sustainable rural development and optimizing human settlement environment. The purpose of this study is to find capital operation mechanism in rural area and rural planning guidance in China. Based on case studies in Chinese rural areas, two types of capital operation mechanism in rural areas are summed up: intervention in the field of agriculture promoting the upgrading and innovation of agricultural industry chain, intervention in rural life and leisure areas updating rural connotation and form. In the light of experiences in Japan and Taiwan, it is proposed that government's norms and guidance, rural investment intensity and rural self-organization are three important factors for capital to drive rural development. It is also found that the unique land tenure and rural governance tradition are two important factors effecting the combination of capital and rural regions in China, which requires full attention in rational policy-making and rural planning. It comes to a conclusion as four directions of the overall reform of the rural planning: targeting at enhancing the viability of rural and sustainable capacity, encouraging differences in investment incentives and planning policies, providing land usage in the rural areas with planning support and reforming the village system. Directional guidance is also made for different types of capital investments, suggesting that capital should be rooted in agriculture and rural land to benefit farmers and update human settlements.

Keywords: capital, rural areas, rural planning, rural governance

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Authors: Hadi Gholizadeh, Ali Tajdin

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To have effective production planning, it is necessary to control the quality of processes. This paper aims at improving the performance of the disposable essentials process using statistical quality control and goal programming in a vague environment. That is expressed uncertainty because there is always a measurement error in the real world. Therefore, in this study, the conditions are examined in a vague environment that is a distance-based environment. The disposable essentials process in Kach Company was studied. Statistical control tools were used to characterize the existing process for four factor responses including the average of disposable glasses’ weights, heights, crater diameters, and volumes. Goal programming was then utilized to find the combination of optimal factors setting in a vague environment which is measured to apply uncertainty of the initial information when some of the parameters of the models are vague; also, the fuzzy regression model is used to predict the responses of the four described factors. Optimization results show that the process capability index values for disposable glasses’ average of weights, heights, crater diameters and volumes were improved. Such increasing the quality of the products and reducing the waste, which will reduce the cost of the finished product, and ultimately will bring customer satisfaction, and this satisfaction, will mean increased sales.

Keywords: goal programming, quality control, vague environment, disposable glasses’ optimization, fuzzy regression

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Authors: Hamidreza Hoshyarmanesh, Sanju Lama, Garnette R. Sutherland

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In tele-operative robotic surgery, an ideal haptic device should be equipped with an intuitive and smooth end-effector to cover the surgeon’s hand/wrist degrees of freedom (DOF) and translate the hand joint motions to the end-effector of the remote manipulator with low effort and high level of comfort. This research introduces the design and development of a microsurgery-specific end-effector, a gimbal mechanism possessing 4 passive and 1 active DOFs, equipped with a bipolar forceps and haptic feedback. The robust gimbal structure is comprised of three light-weight links/joint, pitch, yaw, and roll, each consisting of low-friction support and a 2-channel accurate optical position sensor. The third link, which provides the tool roll, was specifically designed to grip the tool prongs and accommodate a low mass geared actuator together with a miniaturized capstan-rope mechanism. The actuator is able to generate delicate torques, using a threaded cylindrical capstan, to emulate the sense of pinch/coagulation during conventional microsurgery. While the tool left prong is fixed to the rolling link, the right prong bears a miniaturized drum sector with a large diameter to expand the force scale and resolution. The drum transmits the actuator output torque to the right prong and generates haptic force feedback at the tool level. The tool is also equipped with a hall-effect sensor and magnet bar installed vis-à-vis on the inner side of the two prongs to measure the tooltip distance and provide an analogue signal to the control system. We believe that such a haptic end-effector could significantly increase the accuracy of telerobotic surgery and help avoid high forces that are known to cause bleeding/injury.

Keywords: end-effector, force generation, haptic interface, robotic surgery, surgical tool, tele-operation

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Authors: Hennie Boeije, Renate Verkaik, Joke Korevaar

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In Dutch national policy, it is promoted that the elderly remain living at home longer. They are less often admitted to a nursing home or only later in life. While living at home, it is important that they experience a good quality of life. Care providers in primary care support this. In this study, it was investigated what quality of life means for the elderly and which characteristics care should have that supports living at home longer with quality of life. To explore this topic, a qualitative methodology was used. Four focus groups were conducted: two with elderly people who live at home and their family caregivers, one with district nurses employed in-home care services and one with elderly care physicians working in primary care. Next to this individual interviews were employed with general practitioners (GPs). In total 32 participants took part in the study. The data were thematically analysed with MaxQDA software for qualitative analysis and reported. Quality of life is a multi-faceted term for elderly. The essence of their description is that they can still undertake activities that matter to them. Good physical health, mental well-being and social connections enable them to do this. Own control over their life is important for some. They are of opinion that how they experience life and manage old age is related to their resilience and coping. Key terms in the definitions of quality of life by GPs are also physical and mental health and social contacts. These are the three pillars. Next, to this elderly care, physicians mention security and safety and district nurses add control over their own life and meaningful daily activities. They agree that with frail elderly people, the balance is delicate and a change in one of the three pillars can cause it to collapse like a house of cards. When discussing what support is needed, professionals agree on access to care with a low threshold, prevention, and life course planning. When care is provided in a timely manner, a worsening of the situation can be prevented. They agree that hospital care often is not needed since most of the problems with the elderly have to do with care and security rather than with a cure per se. GPs can consult elderly care physicians to lower their workload and to bring in specific knowledge. District nurses often signal changes in the situation of the elderly. According to them, the elderly predominantly need someone to watch over them and provide them with a feeling of security. Life course planning and advance care planning can contribute to uniform treatment in line with older adults’ wishes. In conclusion, all stakeholders, including elderly persons, agree on what entails quality of life and the quality of care that is needed to support that. A future challenge is to shape conditions for the right skill mix of professionals, cooperation between the professions and breaking down differences in financing and supply. For the elderly, the challenge is preparing for aging.

Keywords: elderly living at home, quality of life, quality of care, professional cooperation, life course planning, advance care planning

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Authors: Alexander Winkler, Jozef Suchý

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This paper investigates simple implicit force control algorithms realizable with industrial robots. A lot of approaches already published are difficult to implement in commercial robot controllers, because the access to the robot joint torques is necessary or the complete dynamic model of the manipulator is used. In the past we already deal with explicit force control of a position controlled robot. Well known schemes of implicit force control are stiffness control, damping control and impedance control. Using such algorithms the contact force cannot be set directly. It is further the result of controller impedance, environment impedance and the commanded robot motion/position. The relationships of these properties are worked out in this paper in detail for the chosen implicit approaches. They have been adapted to be implementable on a position controlled robot. The behaviors of stiffness control and damping control are verified by practical experiments. For this purpose a suitable test bed was configured. Using the full mechanical impedance within the controller structure will not be practical in the case when the robot is in physical contact with the environment. This fact will be verified by simulation.

Keywords: robot force control, stiffness control, damping control, impedance control, stability

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Authors: Pavol Tanuska, Pavel Vazan, Michal Kebisek, Dominika Jurovata

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The paper gives the results of the project that was oriented on the usage of knowledge discoveries from production systems for needs of the hierarchical process control. One of the main project goals was the proposal of knowledge discovery model for process control. Specifics data mining methods and techniques was used for defined problems of the process control. The gained knowledge was used on the real production system, thus, the proposed solution has been verified. The paper documents how it is possible to apply new discovery knowledge to be used in the real hierarchical process control. There are specified the opportunities for application of the proposed knowledge discovery model for hierarchical process control.

Keywords: hierarchical process control, knowledge discovery from databases, neural network, process control

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Authors: John Yahng, Hansraj Riteesh Bookun

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Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.

Keywords: carotid, complication, discharge, surgery

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Authors: Zhen Wu, David Lupien St-Pierre, Georges Abdul-Nour

Abstract:

In decision making under strict uncertainty, decision makers have to choose a decision without any information about the states of nature. The classic criteria of Laplace, Wald, Savage, Hurwicz and Starr are introduced and compared in a case study of sewer network planning. Furthermore, results from different criteria are discussed and analyzed. Moreover, this paper discusses the idea that decision making under strict uncertainty (DMUSU) can be viewed as a two-player game and thus be solved by a solution concept in game theory: Nash equilibrium.

Keywords: decision criteria, decision making, sewer network planning, decision making, strict uncertainty

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Authors: Mehdi Modabberifar, Sanaz Jabary, Mojtaba Ghodsi

Abstract:

Stiffness sensing is an important issue in medical diagnostic, robotics surgery, safe handling, and safe grasping of objects in production lines. Detecting and obtaining the characteristics in dwelling lumps embedded in a soft tissue and safe removing and handling of detected lumps is needed in surgery. Also in industry, grasping and handling an object without damaging in a place where it is not possible to access a human operator is very important. In this paper, a method for object handling is presented. It is based on the use of an intelligent gripper to detect the object stiffness and then setting a programmable force for grasping the object to move it. The main components of this system includes sensors (sensors for measuring force and displacement), electrical (electrical and electronic circuits, tactile data processing and force control system), mechanical (gripper mechanism and driving system for the gripper) and the display unit. The system uses a rotary potentiometer for measuring gripper displacement. A microcontroller using the feedback received by the load cell, mounted on the finger of the gripper, calculates the amount of stiffness, and then commands the gripper motor to apply a certain force on the object. Results of Experiments on some samples with different stiffness show that the gripper works successfully. The gripper can be used in haptic interfaces or robotic systems used for object handling.

Keywords: gripper, haptic, stiffness, robotic

Procedia PDF Downloads 352

Authors: Elahe Memari, Ahmad Aslizadeh, Ahmad Memari

Abstract:

Today strategic planning is counted as the most important duties of senior directors in each organization. Strategic planning allows the organizations to implement compiled strategies and reach higher competitive benefits than their competitors. The present research work tries to prepare and rank the strategies form effective factors on strategic planning in fulfillment of the State Road Management and Transportation Organization in order to indicate the role of organizational factors in efficiency of the process to organization managers. Connection between six main factors in fulfillment of State Road Management and Transportation Organization were studied here, including Improvement of Strategic Thinking in senior managers, improvement of the organization business process, rationalization of resources allocation in different parts of the organization, coordination and conformity of strategic plan with organization needs, adjustment of organization activities with environmental changes, reinforcement of organizational culture. All said factors approved by implemented tests and then ranked using fuzzy multivariate decision-making technique.

Keywords: Fuzzy TOPSIS, improvement of organization business process, multivariate decision-making, strategic planning

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Authors: Mohammad Talei, Neda Ranjbar Nosheri, Reza Kazemi Gorzadini

Abstract:

Today municipalities are searching for the new tools for increasing the public participation in different levels of urban planning. This approach of urban planning involves the community in planning process using participatory approaches instead of the long traditional top-down planning methods. These tools can be used to obtain the particular problems of urban furniture form the residents’ point of view. One of the tools that is designed with this goal is public participation GIS (PPGIS) that enables citizen to record and following up their feeling and spatial knowledge regarding main problems of the city, specifically urban furniture, in the form of maps. However, despite the good intentions of PPGIS, its practical implementation in developing countries faces many problems including the lack of basic supporting infrastructure and services and unavailability of sophisticated public participatory models. In this research we develop a PPGIS using of Web 2 to collect voluntary geodataand to perform spatial analysis based on Spatial OnLine Analytical Processing (SOLAP) and Spatial Data Mining (SDM). These tools provide urban planners with proper informationregarding the type, spatial distribution and the clusters of reported problems. This system is implemented in a case study area in Tehran, Iran and the challenges to make it applicable and its potential for real urban planning have been evaluated. It helps decision makers to better understand, plan and allocate scarce resources for providing most requested urban furniture.

Keywords: PPGIS, spatial information, urbanizing futures, urban planning

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Authors: Daniel Scherman, Daniel Madani, Shanu Gambhir, Marcus Ling Zhixing, Yingda Li

Abstract:

Objective: This study aims to identify clinical factors that may predict failed endoscopic lumbar spine surgery to guide surgeons with patient selection during the initial learning curve. Methods: This is an Australasian prospective analysis of the first 105 patients to undergo lumbar endoscopic spine decompression by 3 surgeons. Modified MacNab outcomes, Oswestry Disability Index (ODI) and Visual Analogue Score (VAS) scores were utilized to evaluate clinical outcomes at 6 months postoperatively. Descriptive statistics and Anova t-tests were performed to measure statistically significant (p<0.05) associations between variables using GraphPad Prism v10. Results: Patients undergoing endoscopic lumbar surgery via an interlaminar or transforaminal approach have overall good/excellent modified MacNab outcomes and a significant reduction in post-operative VAS and ODI scores. Regardless of the anatomical location of disc herniations, good/excellent modified MacNab outcomes and significant reductions in VAS and ODI were reported post-operatively; however, not in patients with calcified disc herniations. Patients with central and foraminal stenosis overall reported poor/fair modified MacNab outcomes. However, there were significant reductions in VAS and ODI scores post-operatively. Patients with subarticular stenosis or an associated spondylolisthesis reported good/excellent modified MacNab outcomes and significant reductions in VAS and ODI scores post-operatively. Patients with disc herniation and concurrent degenerative stenosis had generally poor/fair modified MacNab outcomes. Conclusion: The outcomes of endoscopic spine surgery are encouraging, with a low complication and reoperation rate. However, patients with calcified disc herniations, central canal stenosis or a disc herniation with concurrent degenerative stenosis present challenges during the initial learning curve and may benefit from traditional open or other minimally invasive techniques.

Keywords: complications, lumbar disc herniation, lumbar endoscopic spine surgery, predictors of failed endoscopic spine surgery

Procedia PDF Downloads 144