11 research outputs found
Precision connector assembly automation
Thesis (Ph.D.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 1999.Includes bibliographical references (p. 209-214).Telecommunication systems, network servers, mainframes, and high-performance computers contain several printed circuit boards (PCBs) that are mounted in card-cage assemblies. Level-3 connectors, often called board-to-board connectors, transmit signals between the primary backplane PCB and the daughter card PCBs. These connectors are customized for each PCB by configuring modules along the length of the connector. Hence, the connector's assembly system must flexibly accommodate the connector configurations. Prior to this research, the assembly of daughter card connectors was a manual process. This thesis presents the conceptual design of an assembly cell, and thoroughly presents the selected concept, a flexible assembly system. In the flexible assembly system, the connector is fixtured on a pallet and transferred to assembly stations on a conveyor. The pallet must be precisely located at each station, to minimize the relative errors between the new component and the connector on the pallet. Kinematic couplings deterministically locate one rigid body with respect to another. Therefore, a pallet system was developed that uses split-groove kinematic couplings between the pallets and machines. Experiments demonstrated that the split-groove kinematic pallet was approximately O1X more repeatable than conventional pallet location methods. The design is evident in the fabrication and operation of the first automated machines for the connector assembly system. In automated machinery, kinematically coupled bodies are often subjected to ranges of disturbance forces. This thesis presents new methods for analyzing the static equilibrium, errors due to contact deformation, and contact stresses that result from disturbance forces. In addition, the manufacturing errors within individual pallets and machines combine to cause system-wide, variability in pallet location. Two methods are presented for estimating the system-wide variability in the position and orientation of the pallets.by Robert Ryan Vallance.Ph.D
Design and prototype fabrication of a manipulator for semiconductor test equipment
Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 1996.by Robert Ryan Vallance.M.S
Processes for Nanomachining Using Carbon Nanotubes
Novel methods and devices for nanomachining a desired pattern on a surface of a conductive workpiece are disclosed. In one aspect, the method comprises using an electron beam emitted from one or more nanotubes to evaporate nanoscale quantities of material from the workpiece surface. The surface of the workpiece to be machined may be excited to a threshold energy to reduce the amount of power required to be emitted by the nanotube. In another aspect, a device is described for nanomachining a desired pattern on a surface of a conductive workpiece, comprising a vessel capable of sustaining a vacuum, a leveling support, a nanopositioning stage, and a laser for heating the workpiece. A nanotool is provided comprising at least one nanotube supported on an electrically conductive base, adapted to emit an electron beam for evaporating material from an electrically conductive workpiece
Linear Actuator Using Shape Memory Wire with Controller
A linear actuator is provided, comprising a housing defining an interior channel, a stop extending from the housing and displaceable relative to the housing, and at least one wire formed of a shape-memory alloy, the wire being attached at a first end to the stop and at a second end to the housing. When heated to a predetermined temperature, the wire applies a pulling force to the stop to cause the stop to slide in a first direction into the housing interior channel. A spring located in the housing interior channel applies a biasing force to the stop in a second direction counter to the first direction when the wire cools, thereby returning the stop to the unactuated position. A wire heater is provided, which may be an electrical source for resistive heating of the wire. Multiple actuators of the present invention may be configured in parallel to increase the force generated by the wires. In yet another embodiment the actuators of the invention may be arranged in a serial configuration for controlling a rotary or carousel dispenser
System and Device for Characterizing Shape Memory Alloy Wires
Instruments and methods for measuring a property of a shape memory alloy are provided. The instrument includes a base plate, a non-contact movable mass, a force gauge, an actuator, a biasing spring, a heater for heating the shape memory alloy, and a non-contact displacement detector. The biasing spring and the shape memory alloy are disposed whereby a force applied thereby is applied substantially through a center of stiffness of the movable mass. The displacement detector measures a displacement of the movable mass in a colinear direction with a direction of movement of the movable mass and with a direction of the force applied by the biasing spring and the shape memory alloy. The linear motion stage comprises a housing and at least one guide bar, and wherein a calculated axial expansion of the guide bar is substantially equal to a calculated axial expansion of the base plate
The revised Approved Instructional Resources score:An improved quality evaluation tool for online educational resources
BACKGROUND: Free Open-Access Medical education (FOAM) use among residents continues to rise. However, it often lacks quality assurance processes and residents receive little guidance on quality assessment. The Academic Life in Emergency Medicine Approved Instructional Resources tool (AAT) was created for FOAM appraisal by and for expert educators and has demonstrated validity in this context. It has yet to be evaluated in other populations.OBJECTIVES: We assessed the AAT's usability in a diverse population of practicing emergency medicine (EM) physicians, residents, and medical students; solicited feedback; and developed a revised tool.METHODS: As part of the Medical Education Translational Resources: Impact and Quality (METRIQ) study, we recruited medical students, EM residents, and EM attendings to evaluate five FOAM posts with the AAT and provide quantitative and qualitative feedback via an online survey. Two independent analysts performed a qualitative thematic analysis with discrepancies resolved through discussion and negotiated consensus. This analysis informed development of an initial revised AAT, which was then further refined after pilot testing among the author group. The final tool was reassessed for reliability.RESULTS: Of 330 recruited international participants, 309 completed all ratings. The Best Evidence in Emergency Medicine (BEEM) score was the component most frequently reported as difficult to use. Several themes emerged from the qualitative analysis: for ease of use-understandable, logically structured, concise, and aligned with educational value. Limitations include deviation from questionnaire best practices, validity concerns, and challenges assessing evidence-based medicine. Themes supporting its use include evaluative utility and usability. The author group pilot tested the initial revised AAT, revealing a total score average measure intraclass correlation coefficient (ICC) of moderate reliability (ICC = 0.68, 95% confidence interval [CI] = 0 to 0.962). The final AAT's average measure ICC was 0.88 (95% CI = 0.77 to 0.95).CONCLUSIONS: We developed the final revised AAT from usability feedback. The new score has significantly increased usability, but will need to be reassessed for reliability in a broad population.</p
The Social Media Index as an Indicator of Quality for Emergency Medicine Blogs: A METRIQ Study
Study objective: Online educational resources such as blogs are increasingly used for education by emergency medicine clinicians. The Social Media Index was developed to quantify their relative impact. The Medical Education Translational Resources: Indicators of Quality (METRIQ) study was conducted in part to determine the association between the Social Media Index score and quality as measured by gestalt and previously derived quality instruments. Methods: Ten blogs were randomly selected from a list of emergency medicine and critical care Web sites. The 2 most recent clinically oriented blog posts published on these blogs were evaluated with gestalt, the Academic Life in Emergency Medicine Approved Instructional Resources (ALiEM AIR) score, and the METRIQ-8 score. Volunteer raters (including medical students, emergency medicine residents, and emergency medicine attending physicians) were identified with a multimodal recruitment methodology. The Social Media Index was calculated in February 2016, November 2016, April 2017, and December 2017. Pearson's correlations were calculated between the Social Media Index and the average rater gestalt, ALiEM AIR score, and METRIQ-8 score. Results: A total of 309 of 330 raters completed all ratings (93.6%). The Social Media Index correlated moderately to strongly with the mean rater gestalt ratings (range 0.69 to 0.76) and moderately with the mean rater ALiEM AIR score (range 0.55 to 0.61) and METRIQ-8 score (range 0.53 to 0.57) during the month of the blog post's selection and for 2 years after. Conclusion: The Social Media Index's correlation with multiple quality evaluation instruments over time supports the hypothesis that it is associated with overall Web site quality. It can play a role in guiding individuals to high-quality resources that can be reviewed with critical appraisal techniques
Global Survey of Outcomes of Neurocritical Care Patients: Analysis of the PRINCE Study Part 2
BACKGROUND: Neurocritical care is devoted to the care of critically ill patients with acute neurological or neurosurgical emergencies. There is limited information regarding epidemiological data, disease characteristics, variability of clinical care, and in-hospital mortality of neurocritically ill patients worldwide. We addressed these issues in the Point PRevalence In Neurocritical CarE (PRINCE) study, a prospective, cross-sectional, observational study. METHODS: We recruited patients from various intensive care units (ICUs) admitted on a pre-specified date, and the investigators recorded specific clinical care activities they performed on the subjects during their first 7 days of admission or discharge (whichever came first) from their ICUs and at hospital discharge. In this manuscript, we analyzed the final data set of the study that included patient admission characteristics, disease type and severity, ICU resources, ICU and hospital length of stay, and in-hospital mortality. We present descriptive statistics to summarize data from the case report form. We tested differences between geographically grouped data using parametric and nonparametric testing as appropriate. We used a multivariable logistic regression model to evaluate factors associated with in-hospital mortality. RESULTS: We analyzed data from 1545 patients admitted to 147 participating sites from 31 countries of which most were from North America (69%, N = 1063). Globally, there was variability in patient characteristics, admission diagnosis, ICU treatment team and resource allocation, and in-hospital mortality. Seventy-three percent of the participating centers were academic, and the most common admitting diagnosis was subarachnoid hemorrhage (13%). The majority of patients were male (59%), a half of whom had at least two comorbidities, and median Glasgow Coma Scale (GCS) of 13. Factors associated with in-hospital mortality included age (OR 1.03; 95% CI, 1.02 to 1.04); lower GCS (OR 1.20; 95% CI, 1.14 to 1.16 for every point reduction in GCS); pupillary reactivity (OR 1.8; 95% CI, 1.09 to 3.23 for bilateral unreactive pupils); admission source (emergency room versus direct admission [OR 2.2; 95% CI, 1.3 to 3.75]; admission from a general ward versus direct admission [OR 5.85; 95% CI, 2.75 to 12.45; and admission from another ICU versus direct admission [OR 3.34; 95% CI, 1.27 to 8.8]); and the absence of a dedicated neurocritical care unit (NCCU) (OR 1.7; 95% CI, 1.04 to 2.47). CONCLUSION: PRINCE is the first study to evaluate care patterns of neurocritical patients worldwide. The data suggest that there is a wide variability in clinical care resources and patient characteristics. Neurological severity of illness and the absence of a dedicated NCCU are independent predictors of in-patient mortality.status: publishe
A Bayesian reanalysis of the Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial
Background
Timing of initiation of kidney-replacement therapy (KRT) in critically ill patients remains controversial. The Standard versus Accelerated Initiation of Renal-Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial compared two strategies of KRT initiation (accelerated versus standard) in critically ill patients with acute kidney injury and found neutral results for 90-day all-cause mortality. Probabilistic exploration of the trial endpoints may enable greater understanding of the trial findings. We aimed to perform a reanalysis using a Bayesian framework.
Methods
We performed a secondary analysis of all 2927 patients randomized in multi-national STARRT-AKI trial, performed at 168 centers in 15 countries. The primary endpoint, 90-day all-cause mortality, was evaluated using hierarchical Bayesian logistic regression. A spectrum of priors includes optimistic, neutral, and pessimistic priors, along with priors informed from earlier clinical trials. Secondary endpoints (KRT-free days and hospital-free days) were assessed using zero–one inflated beta regression.
Results
The posterior probability of benefit comparing an accelerated versus a standard KRT initiation strategy for the primary endpoint suggested no important difference, regardless of the prior used (absolute difference of 0.13% [95% credible interval [CrI] − 3.30%; 3.40%], − 0.39% [95% CrI − 3.46%; 3.00%], and 0.64% [95% CrI − 2.53%; 3.88%] for neutral, optimistic, and pessimistic priors, respectively). There was a very low probability that the effect size was equal or larger than a consensus-defined minimal clinically important difference. Patients allocated to the accelerated strategy had a lower number of KRT-free days (median absolute difference of − 3.55 days [95% CrI − 6.38; − 0.48]), with a probability that the accelerated strategy was associated with more KRT-free days of 0.008. Hospital-free days were similar between strategies, with the accelerated strategy having a median absolute difference of 0.48 more hospital-free days (95% CrI − 1.87; 2.72) compared with the standard strategy and the probability that the accelerated strategy had more hospital-free days was 0.66.
Conclusions
In a Bayesian reanalysis of the STARRT-AKI trial, we found very low probability that an accelerated strategy has clinically important benefits compared with the standard strategy. Patients receiving the accelerated strategy probably have fewer days alive and KRT-free. These findings do not support the adoption of an accelerated strategy of KRT initiation
Initiation of continuous renal replacement therapy versus intermittent hemodialysis in critically ill patients with severe acute kidney injury: a secondary analysis of STARRT-AKI trial
Background: There is controversy regarding the optimal renal-replacement therapy (RRT) modality for critically ill patients with acute kidney injury (AKI). Methods: We conducted a secondary analysis of the STandard versus Accelerated Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial to compare outcomes among patients who initiated RRT with either continuous renal replacement therapy (CRRT) or intermittent hemodialysis (IHD). We generated a propensity score for the likelihood of receiving CRRT and used inverse probability of treatment with overlap-weighting to address baseline inter-group differences. The primary outcome was a composite of death or RRT dependence at 90-days after randomization. Results: We identified 1590 trial participants who initially received CRRT and 606 who initially received IHD. The composite outcome of death or RRT dependence at 90-days occurred in 823 (51.8%) patients who commenced CRRT and 329 (54.3%) patients who commenced IHD (unadjusted odds ratio (OR) 0.90; 95% confidence interval (CI) 0.75-1.09). After balancing baseline characteristics with overlap weighting, initial receipt of CRRT was associated with a lower risk of death or RRT dependence at 90-days compared with initial receipt of IHD (OR 0.81; 95% CI 0.66-0.99). This association was predominantly driven by a lower risk of RRT dependence at 90-days (OR 0.61; 95% CI 0.39-0.94). Conclusions: In critically ill patients with severe AKI, initiation of CRRT, as compared to IHD, was associated with a significant reduction in the composite outcome of death or RRT dependence at 90-days