DIAMS revisited: Taming the variety of knowledge in fault diagnosis expert systems

The DIAMS program, initiated in 1986, led to the development of a prototype expert system, DIAMS-1 dedicated to the Telecom 1 Attitude and Orbit Control System, and to a near-operational system, DIAMS-2, covering a whole satellite (the Telecom 2 platform and its interfaces with the payload), which was installed in the Satellite Control Center in 1993. The refinement of the knowledge representation and reasoning is now being studied, focusing on the introduction of appropriate handling of incompleteness, uncertainty and time, and keeping in mind operational constraints. For the latest generation of the tool, DIAMS-3, a new architecture has been proposed, that enables the cooperative exploitation of various models and knowledge representations. On the same baseline, new solutions enabling higher integration of diagnostic systems in the operational environment and cooperation with other knowledge intensive systems such as data analysis, planning or procedure management tools have been introduced

Construction of a Baculovirus-Silkworm Multigene Expression System and Its Application on Producing Virus-Like Particles

A new baculovirus-silkworm multigene expression system named Bombyx mori MultiBac is developed and described here, by which multiple expression cassettes can be introduced into the Bombyx mori nuclear polyhedrosis virus (BmNPV) genome efficiently. The system consists of three donor vectors (pCTdual, pRADM and pUCDMIG) and an invasive diaminopimelate (DAP) auxotrophic recipient E. coli containing BmNPV-Bacmid (BmBacmid) with a homologous recombination region, an attTn7 site and a loxp site. Two genes carried by pCTdual are firstly inserted into BmBacmid by homologous recombination, while the other eight genes in pRADM and pUCDMIG are introduced into BmBacmid through Tn7 transposition and cre-loxp recombination. Then the invasive and DAP auxotrophic E. coli carrying recombinant BmBacmid is directly injected into silkworm for expressing heterologous genes in larvae or pupae. Three structural genes of rotavirus and three fluorescent genes have been simultaneously expressed in silkworm larvae using our new system, resulting in the formation of virus-like particles (VLPs) of rotavirus and the color change of larvae. The VLPs were purified from hemolymph by ultracentrifugation using CsCl gradients, with a yield of 12.7 µg per larva. For the great capacity of foreign genes and the low cost of feeding silkworm, this high efficient BmMultiBac expression system provides a suitable platform to produce VLPs or protein complexes

Fluorescent nanodiamond tracking reveals intraneuronal transport abnormalities induced by brain disease-related genetic risk factors

[[sponsorship]]原子與分子科學研究所[[note]]出版中(submitted);[SCI];有審查制度;具代表性[[note]]http://gateway.isiknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=Drexel&SrcApp=hagerty_opac&KeyRecord=1748-3387&DestApp=JCR&RQ=IF_CAT_BOXPLO

Patients' Perception of Technology: an Update of Patients' Understanding of Robotics and Navigation in Total Joint Arthroplasty

Background. Given the increasing use of RN in orthopaedics, our aim is to evaluate TJA patients' understanding of RN technology. Methods. A survey based cross sectional study was conducted in one joint replacement clinic from January-March 2021. Questions pertaining to demographic information, robotics and navigation prevalence, autonomy, benefits, drawbacks, costs, and patient experiences and attitudes were asked. Results. Ninety-seven completed questionnaires were included in our results. 70.1% of patients knew that some orthopaedic surgeons use robotics and navigation systems in surgery. 71.1% had not undergone or did not know a first degree relative who had undergone an orthopaedic surgery performed with RN assistance. 86.6% of patients thought that >10% of operations were performed using a RN system. 58.7%, 49.4% and 49.4% of the patients believed that RN makes surgeries more accurate, easier, and quicker, respectively. 73.2% believed that robotic surgery would increase the price of their surgery. 46.3% answered that RN costs > $ 100,000. 55.7% of the patients responded that they would be willing to pay extra for a RN assisted surgery. 39.2% of patients were unsure of whether they would like to have RN surgery. Conclusions. Patients' understanding of robotic and navigation in arthroplasty seems to be limited and inconsistent. With increased direct-to-consumer marketing of these technologies, it is critical for physicians and healthcare systems to promote balanced and complete information

Time-Driven Activity-Based Costing in Preoperative Tasks for Total Hip and Knee Arthroplasty

Substantial work in the preoperative phase of total hip arthroplasty (THA) and total knee arthroplasty (TKA) is unaccounted for in current Relative Value Scale Update Committee methodology. A Time-Driven Activity-Based Costing (TDABC) analysis allows for an accurate assessment of the preoperative costs associated with total joint replacement surgery. The mean time that clinical staff members spent on preoperative tasks per patient was multiplied by the hourly salary. Clinical staff members included orthopedic surgeons, nurse practitioners or physician assistants, nurses, medical assistants, and surgical coordinators. Mean time spent on preoperative tasks was obtained from the most recent literature. Salaries were obtained from the nationwide database provided by Glassdoor Inc. Total time spent among clinical staff involved in preoperative tasks for each arthroplasty patient was 8.45 hours (2.96-13.94). Total TDABC was calculated to be $348.17 (132.46-562.64). Accounting for preoperative tasks, the TDABC for TKA/THA increases from$13321.5 to $13669.67. Preoperative tasks are composed of 2.6$544,189,710 of preoperative TKA/THA work was completed. Surgeons, providers, and ancillary staff involved in THA/TKA spend a cumulative preoperative work time of approximately 8.5 hours per patient, which equates to $348.17 that is currently unaccounted for in Relative Value Scale Update Committee methodology

A Discussion on The Utility of Discharge Location Prediction Models for Total Joint Arthroplasty Surgery

Objective. Total Joint Arthroplasty (TJA) remains one of the highest frequency elective surgical procedures. Medicare is expected to spend close to $ 50 Billion on TJAs by 2030. Predicting discharge location could allow for cost mitigation and the ability to set appropriate expectations for patients preoperatively. Our aim is to determine the validity of one predictive model. We hypothesize that this tool will demonstrate comparable predictive value as in the pilot study.Methods. We conducted a cross-sectional study of unilateral, primary, total joint replacements from January 2020 through February 2021. Nine variables were input into a predictive model at https://dukeriskcalculators.shinyapps.io/Dispo/and percent likelihood of discharge to SNF/rehabilitation facility was recorded and analyzed. Receiver operating characteristics curve (ROC) analysis was utilized to evaluate the model's predictive capability.Results. Our cohort consisted of 264 patients. 9.1% of patients were discharged to an SNF/rehabilitation facility. ROC analysis demonstrated an area under the curve (AUC) of 0.72 indicating good predictive value. The mean percent likelihood of discharge to SNF/rehab was 31% +/- 9% (mean +/- 95% confidence interval) for patients whose final discharge location was an acute rehabilitation facility; The mean percent likelihood of discharge to SNF/rehab was 15% +/- 2% for patients who were discharged home.Conclusions. The predictive model analyzed uses nine easily accessible variables and demonstrates good predictive capability. Discharge to acute rehabilitation is a costly and often unnecessary intervention. Predictive models can reduce discharge to these facilities, reduce healthcare costs, and improve patient outcomes

Survivorship and Outcomes of Femoral Neck Preserving Stems in Primary Total Hip Arthroplasty

Short-stem femoral implants (SSFIs) promote the preservation of bone in the femoral neck, reduce soft tissue disruption, and facilitate minimally invasive surgical techniques. The purpose of this study was to report the revision rate, complication rate, patient satisfaction, patient-reported outcomes, and radiographic outcomes of patients who underwent total hip arthroplasty (THA) with the Alteon Neck Preserving Femoral Stem (ANPS). A prospectively maintained database was reviewed which analyzed 92 THAs between the years 2016 and 2018. Patient-reported outcomes, patient satisfaction, complication rates, and radiographic outcomes were assessed at 2-5 years postoperatively. The final cohort consisted of 63 hips. Five patients (7.9%) underwent revision surgery and 2 (3.2%) had other complications not requiring revision. Survivorship when considering only the femoral component was 93.7% at an average of 41.4 months of follow-up. The average postoperative Oxford Hip Score (41.5 ± 8.3) and Harris Hip Score (77.9 ± 16.6) demonstrated significant improvement among our nonrevised patients, respectively (P < .001). Radiographs demonstrated spot welding in 56% of arthroplasties most commonly in Gruen Zones 2, 3, and 13 and that femur radiolucencies were visualized in 58% predominantly along the distal aspect of the stem. Radiographic femoral component subsidence was present in 9.7% of patients. The ANPS may be less reliable than previously reported. Our cohort’s revision rate was unacceptably high with 6.3% requiring revision surgery for femoral component loosening in less than 5 years. Surgeons should consider the challenges and prohibitive failure rate associated with SSFIs before routine usage in THA