Determination of the transection margin during colorectal resection with hyperspectral imaging (HSI)

Abstract Purpose: This study evaluated the use of hyperspectral imaging for the determination of the resection margin during colorectal resections instead of clinical macroscopic assessment. Methods: The used hyperspectral camera is able to record light spectra from 500 to 1000 nm and provides information about physiologic parameters of the recorded tissue area intraoperatively (e.g., tissue oxygenation and perfusion). We performed an open-label, single-arm, and non-randomized intervention clinical trial to compare clinical assessment and hyperspectral measurement to define the resection margin in 24 patients before and after separation of the marginal artery over 15 min; HSI was performed each minute to assess the parameters mentioned above. Results: The false color images calculated from the hyperspectral data visualized the margin of perfusion in 20 out of 24 patients precisely. In the other four patients, the perfusion difference could be displayed with additional evaluation software. In all cases, there was a deviation between the transection line planed by the surgeon and the border line visualized by HSI (median 1 mm; range - 13 to 13 mm). Tissue perfusion dropped up to 12% within the first 10 mm distal to the border line. Therefore, the resection area was corrected proximally in five cases due to HSI record. The biggest drop in perfusion took place in less than 2 min after devascularization. Conclusion: Determination of the resection margin by HSI provides the surgeon with an objective decision aid for assessment of the best possible perfusion and ideal anastomotic area in colorectal surgery.:Inhaltsverzeichnis Inhaltsverzeichnis................................................................. I 1 Einführung............................................................................. 1 1.1 Anastomoseninsuffizienz...................................................1 1.2 Methodik Hyperspectral Imaging (HSI)............................. 3 1.3 Einsatzbereiche der Hyperspektral-Kamera..................... 5 1.4 Chirurgische Technik........................................................ 6 1.5 Studienplanung................................................................. 7 1.6 Vergleich der HSI-Technik mit weiteren Messmethoden...8 2 Publikation...............................................................................11 3 Zusammenfassung der Arbeit............................................... 21 4 Literaturverzeichnis............................................................... 26 5 Anhang.................................................................................... 30 Darstellung des eigenen Beitrags.........................................34 Eigenständigkeitserklärung...................................................35 Lebenslauf.............................................................................. 36 Danksagung........................................................................... 3

Testverfahren zur Einschätzung des Befallsrisikos komposthaltiger Pflanzsubstrate durch Trauermücken (Sciaridae)

Growing media for organic farming are increasingly attacked by fungus gnats (Sciaridae) because of their increased microbial activity. Within this study a new method was developed to assess the level of infestation of growing media by the fungus gnat Bradysia difformis (Frey, 1948). The method is based on a comparison of any growing media with two standard substrates. The test method provides the ability to classify growing media in infestation risk classes (low, medium, high) and to test suitable additives, pesticides and bio-control organisms on the fungus gnat infestation

Learning objectives for Department of the Navy entry-level budget analysts (Series GS-560)

This thesis identifies learning objectives which Department of the Navy (DoN) entry-level budget analysts should learn during their first year on the job in order to perform effectively and efficiently. It provides various demographics of budget analysts, including job requirements and locations of assignments. A discussion of the Department of Defense financial management environment focuses on current and future trends which are or will be impacting budget analysts. In addition, training courses and programs that are currently available to DoN entry-level budget analysts are examined. The primary conclusion of this research was that these is a dire need for quality training of DoN entry-level budget analysts. Recommendations are offered on how the learning objectives identified by this study can be utilized to assist in the development of quality training courses, materials and programs.http://archive.org/details/learningobjectiv00holfLieutenant, United States NavyApproved for public release; distribution is unlimited

Structured health care for subjects with diabetic foot ulcers results in a reduction of major amputation rates

OBJECTIVE: We tested the effects of structured health care for the diabetic foot in one region in Germany aiming to reduce the number of major amputations. RESEARCH DESIGN AND METHODS: In a prospective study we investigated patients with diabetic foot in a structured system of outpatient, in-patient and rehabilitative treatment. Subjects were recruited between January 1(st), 2000 and December 31, 2007. All participants underwent a two-year follow-up. The modified University of Texas Wound Classification System (UT) was the basis for documentation and data analysis. We evaluated numbers of major amputations, rates of ulcer healing and mortality. In order to compare the effect of the structured health care program with usual care in patients with diabetic foot we evaluated the same parameters at another regional hospital without interdisciplinary care of diabetic foot (controls). RESULTS: 684 patients with diabetic foot and 508 controls were investigated. At discharge from hospital 28.3% (structured health care program, SHC) vs. 23.0% (controls) of all ulcers had healed completely. 51.5% (SHC) vs. 49.8% (controls) were in UT grade 1. Major amputations were performed in 32 subjects of the structured health care program group (4.7%) vs. 110 (21.7%) in controls (p<0.0001). Mortality during hospitalization was 2.5% (SHC) vs. 9.4% in controls (p<0.001). CONCLUSIONS: With the structured health care program we achieved a significant reduction of major amputation rates by more than 75% as compared to standard care

5. Folge (30.05.2021): Studierendenwerk Thüringen –EinBlick in die Mensen und Cafeterien

In der fünften Folge »Campusgespräch« geht es um Mensen und Cafeterien. Wie entsteht eigentlich ein Mensa-Gericht? Was hat sich im Studierendenwerk in Sachen Nachhaltigkeit geändert? Und was hat das eigentlich alles mit studentischer Gesundheit zu tun? In einem spannenden Gespräch mit Antje Hermsdorf vom Studierendenwerk Thüringen erfahren Sie mehr über Mensen, gesunde Ernährung und zukünftige Projekte

Corporate Real Estate Management Practices in Sweden

Purpose – The authors want to give an actual overview of the CREM in Sweden and investigate how certain issues, such as business alignment and strategy of CREM are handled in Sweden.Importance – Scant published research in the academic field of corporate real estate management is covering the Swedish market, hence this paper tries to close this gap. Design/methodology/approach – The paper examines current literature on the topic of CREM and analyses market data gained by a survey and interviews to illustrate the status of CREM in Sweden to dayLimitation – The participation rate in the survey prevents the authors from drawing conclusions significant for the whole market, a wider ranged survey including unlisted companies would certainly help enhancing this research and identify more patterns in the marketKeywords – Corporate Real Estate Management, strategy, business alignment, performance, benchmarking, flexibility, outsourcing, Swede

Corporate Real Estate Management Practices in Sweden

Purpose – The authors want to give an actual overview of the CREM in Sweden and investigate how certain issues, such as business alignment and strategy of CREM are handled in Sweden.Importance – Scant published research in the academic field of corporate real estate management is covering the Swedish market, hence this paper tries to close this gap. Design/methodology/approach – The paper examines current literature on the topic of CREM and analyses market data gained by a survey and interviews to illustrate the status of CREM in Sweden to dayLimitation – The participation rate in the survey prevents the authors from drawing conclusions significant for the whole market, a wider ranged survey including unlisted companies would certainly help enhancing this research and identify more patterns in the marketKeywords – Corporate Real Estate Management, strategy, business alignment, performance, benchmarking, flexibility, outsourcing, Swede