Associations between intraoperative factors and surgeons' self-assessed operative satisfaction.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadBackground: Little is known concerning what may influence surgeon satisfaction with a surgical procedure and its associations with intraoperative factors. The objective was to explore the relationships between surgeons' self-assessed satisfaction with performed radical prostatectomies and intraoperative factors such as technical difficulties and intraoperative complications as reported by the surgeon subsequent to the operation. Methods: We utilized prospectively collected data from the controlled LAPPRO trial where 4003 patients with prostate cancer underwent open (ORP) or robot-assisted laparoscopic (RALP) radical prostatectomy. Patients were included from fourteen centers in Sweden during 2008-2011. Surgeon satisfaction was assessed by questionnaires at the end of each operation. Intraoperative factors included time for the surgical procedure as well as difficulties and complications in various steps of the operation. To model surgeon satisfaction, a mixed effect logistic regression was used. Results were presented as odds ratios (OR) with 95% confidence intervals (CI). Results: The surgeons were satisfied in 2905 (81%) and dissatisfied in 702 (19%) of the surgical procedures. Surgeon satisfaction was not statistically associated with type of surgical technique (ORP vs. RALP) (OR 1.36, CI 0.76; 2.43). Intraoperative factors such as technical difficulties or complications, for example, suturing of the anastomosis was negatively associated with surgeon satisfaction (OR 0.24, CI 0.19; 0.30). Conclusions: Our data indicate that technical difficulties and/or intraoperative complications were associated with a surgeon's level of satisfaction with an operation. Keywords: Intraoperative factors; Prostate cancer; Self-assessment; Surgeon; Surgical performance; Surgical satisfaction.Swedish Cancer Society Swedish Research Council Region Vastra Gotaland, Sahlgrenska University Hospital (ALF) Mrs. Mary von Sydow Foundation Anna and Edvin Berger Foundatio

Aluminide Diffusion Coatings for Ni Based Superalloys. Coating and Oxide Microstructure

This thesis reports on investigations of high temperature oxidation resistant aluminide diffusion coatings for Ni based superalloys. Such coatings basically consist of a .BETA.-NiAl layer at the surface of the .gamma.-Ni/.gamma.\u27-Ni3Al based substrate alloy. The presence of .BETA.-NiAl increases the Al activity at the surface, so that, upon high temperature oxidation, a protective .alfa.-Al2O3 scale can form. However, during service, both the substrate and the .BETA.-NiAl coating degrade, due to outward Ni diffusion from the substrate and the consumption of Al by the oxide scale. Moreover, as the oxide scale grows, several different processes may reduce the adherence of the oxide scale to the metal. This results in spallation of the scale, after which catastrophic oxidation may follow. The aim of this study was to describe the development of the coating and oxide microstructures upon high temperature oxidation and to correlate them to the protective properties of the coating. It was also attempted to clarify which mechanisms that play a dominant role in the determination of the total useful life of a particular coating. Special focus was also placed on the mechanisms by which the addition of Pt improves the coatings resistance to high temperature oxidation. For this purpose, one Pt-free (PWA73) and three Pt modified (RT22, SS82A and MDC150L) coatings, applied to the same single crystalline Ni based superalloy (CMSX-4), were studied. The materials were oxidised isothermally at 1,050 \ubaC for times ranging from 20 to 20,000 h, and subsequently investigated by gravimetry, scanning electron microscopy (SEM), transmission electron microscopy (TEM) and X-ray diffraction (XRD). It was found that the presence of Pt in the materials did not have any significant effect on the microstructural development on the coatings. However, Pt decreased the oxide scale growth rate by the suppression of deleterious spinel phases. Besides the presence of Pt, also a low surface roughness of the coating prior to oxidation promoted a slower oxide scale growth. It was shown that a high oxide growth rate itself promotes the formation of Kirkendall voids at the coating/oxide interface, which cause scale spallation during cooling to room temperature. These factors were found to be more important for the oxidation resistance than the degradation of the coating microstructure. For example, it was observed that the transformation of .BETA.-NiAl to the less Al rich phase .gamma.\u27-Ni3Al was not directly correlated with the onset of oxide spallation

Expanding in situ TEM instrumentation with MEMS technology

Nanofactory Instruments is a spin off company from Chalmers University of Technology which offers instrumentation for nano-scale electrical and mechanical characterization correlated with real time imaging in situ in transmission electron microscopes (TEM).As a core component in the company’s product portfolio, proprietary MEMS sensors for quantitative force measurements on the nano-Newton and micro-Newton scales were developed. As a result of the introduction of MEMS technology into the products, added value was created and the company has now established a leading position in the market