4,476 research outputs found

    Engineering the Hardware/Software Interface for Robotic Platforms - A Comparison of Applied Model Checking with Prolog and Alloy

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    Robotic platforms serve different use cases ranging from experiments for prototyping assistive applications up to embedded systems for realizing cyber-physical systems in various domains. We are using 1:10 scale miniature vehicles as a robotic platform to conduct research in the domain of self-driving cars and collaborative vehicle fleets. Thus, experiments with different sensors like e.g.~ultra-sonic, infrared, and rotary encoders need to be prepared and realized using our vehicle platform. For each setup, we need to configure the hardware/software interface board to handle all sensors and actors. Therefore, we need to find a specific configuration setting for each pin of the interface board that can handle our current hardware setup but which is also flexible enough to support further sensors or actors for future use cases. In this paper, we show how to model the domain of the configuration space for a hardware/software interface board to enable model checking for solving the tasks of finding any, all, and the best possible pin configuration. We present results from a formal experiment applying the declarative languages Alloy and Prolog to guide the process of engineering the hardware/software interface for robotic platforms on the example of a configuration complexity up to ten pins resulting in a configuration space greater than 14.5 million possibilities. Our results show that our domain model in Alloy performs better compared to Prolog to find feasible solutions for larger configurations with an average time of 0.58s. To find the best solution, our model for Prolog performs better taking only 1.38s for the largest desired configuration; however, this important use case is currently not covered by the existing tools for the hardware used as an example in this article.Comment: Presented at DSLRob 2013 (arXiv:cs/1312.5952

    Sacroiliac Joint Fusion – Impact of a New Image-Guidance Protocol on Safety and Complications

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    INTRODUCTION Low back pain is a common affliction impacting patients worldwide. The burden of low back pain on modern society in terms of direct costs associated with diagnosis and treatment, as well as indirect costs such as time missed from work for both patients and caregivers, is estimated to be as high as $100 billion annually in the United States alone.1,2 Up to 2-3% of physician visits are thought to be related to chronic low back pain.1,3 While the traditional focus of healthcare providers has been on lumbosacral pathology, sacroiliac joint dysfunction is an underappreciated and underdiagnosed cause of low back pain. Previous studies3-8 have suggested that 15-30% of chronic low back pain is due to pathology located in the sacroiliac joint. Historically, recognition of this pathology was difficult, limited by lack of standardized diagnostic criteria and disease-specific outcome measures. Traditional treatment focused on conservative therapy, such as physical therapy with focus on core and pelvic stability, orthoses, pain and anti-inflammatory medication, weight loss, intra- or peri-articular injections, and radiofrequency ablation.4,5,9-12 Early surgical intervention came in the form of morbid open approaches often utilizing iliac crest autografting. More recently, minimally invasive techniques for sacroiliac fusion have been developed that allow for significant sparing of muscle dissection, shorter operating room times and blood loss, reduced length of stay, and fewer complications.13-17 Such techniques are often performed with fluoroscopic guidance. However, three-dimensional sacral anatomy can be challenging to conceptualize on fluoroscopic imaging and several centers are now beginning to perform the procedure utilizing image-guidance with intraoperative CT data. This is particularly helpful in patients with transitional lumbosacral anatomy or those undergoing revision procedures. Complications such as pseudarthrosis and neural injuries, while rare, are often associated with need for revision surgery and poorer outcome.18,19 The transition to CT-based image-guidance aims to reduce such complications. The purpose of this study is to review our series of minimally invasive sacroiliac fusion with a focus on safety and complications, and to review differences in these parameters between patients undergoing fluoroscopic technique versus CT-based image-guidance

    Retrospective Chart Review Assessing Factors that Contribute to Network Leakage in Postoperative Pancreatic Cancer Patients

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    Introduction: Standard of care for resectable pancreatic cancer includes surgery, chemotherapy, with consideration of radiotherapy. Thomas Jefferson University Hospital (TJUH) is a large volume institution for pancreatectomy. Rate of subsequent in-network adjuvant treatment are far less which may impact outcomes. We will elucidate variables that influence coordinated patient care. Objective: To evaluate variables that correlate with follow up and adjuvant treatment of pancreatic cancer patients at TJUH. Methods: Retrospective medical chart reviews will be performed with data from patients with pancreatic cancer who have undergone resection at TJUH from April 2017 to March 2018. Patient demographics, clinical, and pathologic information will be obtained and a multivariable logistic regression done to identify variables associated with follow up and reception of adjuvant treatment. Results: We hypothesize that distance from TJUH will be the strongest predictor of follow up and adjuvant treatment at TJUH. Discussion: The findings will help us to characterize the quality of follow up and adjuvant treatment at TJUH. Identification of significant variables will help select patients that may benefit most from additional efforts to coordinate follow up. This may benefit patient outcomes as adjuvant treatment at high volume, academic centers have been associated with overall survival outcomes (Mandelson, ASCO 2016, abstract #191). Future projects based on our findings will evaluate the impact of current TJUH efforts such as the in-house inpatient medical and radiation oncology consultation through patient interviews and surveys. The ultimate goal of our work is to optimize current efforts while identifying gaps for innovation to maximize coordinating care

    Motivating Acceptance of Information and Communication Technologies in Rural Agribusiness: It’s Not the Money!

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    The study investigates the key motivational driver(s) for the acceptance of a digital procurement (e-purjee) system by sugarcane growers in rural Bangladesh. The e-purjee system is a simple SMS-based purchase order system that replaces a paper-based procurement order system. Treating the acceptance of the e-purjee system as the sugarcane growers‟ decision problem, and applying a multi-criteria decision making (Zionts & Wallenius, 1976) approach to that problem, the study identifies the trade-offs growers appear to make between non-monetary and monetary decision criteria. The study draws on interviews with local growers to reveal their preferences and their reasoning. The findings indicate that non-monetary incentives, namely procedural fairness and uncertainty reduction, are more important than the positive monetary benefits. Interview responses also suggest that the non-monetary benefits affect small scale growers more than the large scale growers. Based on these findings, we draw several practical and theoretical recommendations about the structuring of incentive systems for rural technology based development projects, and about decision modeling for a relatively untrained informant group

    “Facebook Distress”: A Model to Investigate Discontinuation of Social Networking Site Use

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    The study proposes a model to investigate discontinuation of social networking site use based on gratification and distress factors. The model of two contrasting beliefs is founded on Social Exchange Theory (Homans, 1958). The study reviews past research of user motivations to participate in social networking sites, and identifies gratification factors of using the sites, however, uses methods from thematic analysis (Aronson, 1994; Barun & Clarke, 2006) to identify the factors that cause use-based distress. Drawing on the recognition of these two contrasting beliefs and two forms of affective reactions, the article argues that users make cost-benefit assessments leading to post-adoption decisions on whether to continue or discontinue social networking site use. The article concludes with several theoretical and practical contributions

    Complication Rates in Resident Cataract Surgery After Elective Operating Room Shutdown During the COVID-19 Pandemic

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    Purpose: To assess the types of cataract surgeries being performed at one large eye institute from before and after the COVID-19 induced shutdown of elective surgeries in Spring 2020. Methods: This is a retrospective chart review study of operative reports from resident performed cataract surgeries from January 1st, 2020 through July 31st, 2020. Cataract surgeries were categorized into Pre-COVID (Jan – Mar 2020) if they occurred prior to operating room (OR) shutdown on March 18th, 2020 and Post COVID for all cases which occurred after the shutdown orders were lifted (May – July 2020). A resident survey was also used to gather data regarding resident case numbers and resident concern performing cataract upon re-opening of the operating room for elective surgeries. Results: A total of 480 cases (n=306 Pre-COVID and n=174 Post-COVID) were analyzed. Our study shows a higher frequency of complex cataract surgeries being boarded after the COVID-19 pandemic induced shutdown of elective surgeries in Michigan (P\u3c0.0001). However, the incidence rate of complications in resident performed cataract surgeries was not significantly higher immediately following the government induced shutdown. Complications analyzed included anterior rent or capsulorrhexis, wound burn, placement of iris dilator, posterior capsular rupture, anterior vitrectomy, and capsular ring tension. Survey results showed that phacoemulsification was the step of cataract surgery which residents were most concerned about when returning to the OR after their hiatus from operating. Conclusion: Significantly more complex cataract surgeries were performed immediately after opening of the OR, however, there was no significant increase in resident complications in performing cataract surgery

    Hyponatremia as a leading sign of hypopituitarism

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    We report the case of a 67-year-old man admitted to our hospital in an obtunded state. We found that a severe hyponatremia (115 mEq/L) was the cause of patient's status. In turn, hyponatremia was due to hypopituitarism (nonfunctioning macroadenoma). Mild to moderate hyponatremia had been previously detected in this patient, but it was overlooked. Correction of hyponatremia and treatment replacement therapy for central hypothyroidism and hypocortisolism restored a satisfactory clinical condition before discharge. The clinical onset of hypopituitarism is often characterized by mild nonspecific symptoms especially in older people, and it is often overlooked. Hypoglycemia can be another clue to undiagnosed hypopituitarism, and in the reported case, suspicious episodes of hypoglycemia occurred in the months preceding admission. Furthermore, several physicians consider hyponatremia as a normal consequence of aging. Although hyponatremia is a common electrolyte disorder in the elderly, physicians should not forget that it could be the leading manifestation of hypopituitarism. Hypopituitarism may be easily diagnosed, but clinical suspicion is needed. Because of the excess mortality associated with hypopituitarism, hormone assays should be included in the initial diagnostic work-up of hyponatremia. Keywords: Electrolyte balance, Hyponatremia, Hypopituitarism, Adrenal insufficiency, Elderl

    A Telehealth Clinical Workflow for Academic Radiation Oncology Programs During the COVID19 Pandemic

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    COVID19 has resulted in drastic measures to decrease exposure risks within healthcare systems, with cancer patients at increased risk of infection and death (Liang. Lancet Oncol. 2020). Telehealth is the delivery of medical care via interactive audio and/or video telecommunication services. Telehealth was previously used sparingly within the department of radiation oncology but has suddenly become the preferred method of contact. In order to maintain quality of care, patient satisfaction, resident learning, and reimbursement, a robust telehealth clinical workflow is critical. Our department engaged various stakeholder to quickly develop a clinical workflow

    Hybrid Laparoscopic and Endoscopic Management of Gastric Band Erosion Resulting in Bowel Obstruction

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    While laparoscopic gastric banding is not as prevalent, the management of patients with a history of gastric banding remains a concern. Gastric bands have been noted to erode and can migrate through the bowel leading to a variety of issues. We were able to successfully manage this almost completely endoscopically without the need for a bowel enterotomy for retrieval. This allowed for enhanced patient recovery and avoided the morbidity associated with bowel enterotomy which is commonly done in these settings

    Spinal Cord Stimulation in the 21st Century — Reviewing Innovation in Neuromodulation

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    INTRODUCTION Low back pain (LBP) is a pervasive problem impacting health systems across the world. In the United States, chronic LBP impacts up to 40% of Americans and results in excessive financial strain on the healthcare budget, estimated at up to $100 billion annually.1 Furthermore, treatment results are often disappointing, with the traditional pathway of conservative measures, narcotic pain medication, and surgical decompression and/or fusion leading to both patient and provider frustration, complications, and diminished patient productivity and quality of life. This has naturally led to questions from policymakers regarding the utility of healthcare dollars spent on back pain. In this milieu, a variety of neuromodulation techniques have found a niche in the management of this patient population, with indications commonly quoted including failed back surgery syndrome (FBSS), chronic neuropathic pain, and complex regional pain syndrome (CRPS), among others.1,2 From its inception on the basis of Melzak and Wall’s gate theory³, to its first human trial in the 1960s,⁴ and to the modern era, spinal cord stimulation has undergone a series of innovations that have expanded indications and improved patient outcomes. The goal of this study is to summarize the most important clinical trials involving both traditional SCS and newer stimulation paradigms to provide an overview of the current state of affairs of this rapidly-growing field
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