scholarly journals Routine intraoperative cholangiography during cholecystectomy is a cost-effective approach when analysing the cost of iatrogenic bile duct injuries

HPB ◽  
2017 ◽  
Vol 19 (10) ◽  
pp. 881-888 ◽  
Author(s):  
Jenny M.L. Rystedt ◽  
Bobby Tingstedt ◽  
Fredrik Montgomery ◽  
Agneta K. Montgomery
Keyword(s):  
Bile Duct ◽  
Cost Effective ◽  
Intraoperative Cholangiography ◽  
Bile Duct Injuries ◽  
Cost Effective Approach ◽  
The Cost

scholarly journals Is there a Role for Preoperative Infusion or Intraoperative Cholangiography?

HPB Surgery ◽  
1997 ◽  
Vol 10 (5) ◽  
pp. 342-345
Author(s):  
W. Y. Lau ◽  
Arthur K. C. Li
Keyword(s):  
Bile Duct ◽  
Operative Time ◽  
Intraoperative Cholangiography ◽  
Laboratory Findings ◽  
Cbd Stones ◽  
Bile Duct Injuries ◽  
Increased Risk ◽  
History Of ◽  
Biliary Anomaly ◽  
The Cost

Background: There has been a resurgence of interest in recent years in preoperative infusion cholangiography (PIC). The role of routine PIC compared to routine intraoperative cholangiography (IOC) has not been clearly defined.Study design: In our department between 1985 and 1991, 1,042 of 1,576 consecutive patients with biliary calculous disease had elective cholecystectomy: 694 patients were prospectively scheduled for PIC, and 348 patients were randomly allocated to IOC. The patients in the PIC and IOC groups were similar with regard to age, history of biliopancreatic complications, and laboratory findings. The cost of PIC in Sweden is nearly five times greater than the cost of IOC.Results: Satisfactory opacification of the biliary system was obtained in 90.1 and 96.8 percent of patients who underwent PIC and IOC, respectively. Preoperative infusion cholangiography required support by IOC in 19.5 percent of patients. There were no statistically significant differences between the PIC and IOC groups with regard to the incidence (7 percent in both groups) of or positive predictive value (68 and 80 percent, respectively) for bile duct stones, rate of retained stones (6 and 20 percent, respectively), intraoperative (5.6 and 6.3 percent, respectively) or postoperative (13.3 and 15.9 percent, respectively) morbidity, or incidence of bile duct anomalies (0.9 and 0.3 percent, respectively). Median operative time was longer in .patients with (95 minutes) compared to those without (75 minutes) IOC (p<0.001). More postoperative complications occurred after bile duct exploration (26 of 75 patients) compared to cholecystectomy alone (114 of 917 patients, p<0.001). The 30-day mortality was zero. Minor bile duct injuries occurred in two patients (0.2 percent) at cholecystectomy, (one with and one without bile duct exploration). In no patient was the cholangiographic finding of a biliary anomaly crucial for the safe execution of cholecystectomy.Conclusions: In our study, PIC and IOC were comparable, but routine use of either method did not promote the safety of cholecystectomy and thus their routine use is not warranted. The shorter operative time and preoperative identification of common bile duct (CBD) stones provided by PIC might favor this examination when applied selectively in patients with increased risk of having CBD stones. However, this potential advantage is offset by the need for PIC to be supported by IOC in approximately 20 percent of patients. Also, the cost of PIC is greater than the cost of IOC.

An Innovative Cost-Effective Approach for Characterization of Removable Prosthesis - Case Series

2021 ◽  
Author(s):  
Tushar
Keyword(s):  
Case Series ◽  
Cost Effective ◽  
Functional Rehabilitation ◽  
Denture Base ◽  
Cost Effective Approach ◽  
Removable Denture ◽  
Removable Prosthesis ◽  
Cost Effective Alternative ◽  
The Aesthetic ◽  
The Cost

Esthetics plays a crucial role in rehabilitation of removable dentures to achieve a pleasant smile. Denture esthetics is the effect produced, which improves the beauty and attractiveness of a person. With the advances of implants and ceramics, the conventional removable denture needs to be updated. denture characterization is a must in avoiding denture look and giving natural look. Giving the prosthesis as close as possible to the natural apparatus before the tooth loss is the key to a successful prosthetic, esthetic and functional rehabilitation. As a prosthodontist dealing in fulfilling the aesthetic challenges an economical alternative to high-end costly procedures is a must considering the Indian scenario, keeping in mind the biocompatibility and longevity of the treatment. As per literature light cure, gum staining is one of the techniques for masking denture base color and imparting natural color to mucosa but considering the cost involved many patients requiring aesthetic enhancement of prosthesis avoid going for such treatment thereby compromising their aesthetic. the present case series describe an innovative cost-effective alternative to the previously describe technique for masking the denture base color by using composite mixed with stains to replicate the natural apparatus.

scholarly journals Protection of computers from side electromagnetic radiation during monitor images formation

2021 ◽  
Vol 4 (4) ◽  
pp. 377-385
Author(s):  
Volodymyr M. Lucenko ◽  
Dmytro O. Progonov
Keyword(s):  
Electromagnetic Radiation ◽  
Ad Hoc ◽  
Low Cost ◽  
Cost Effective ◽  
Switching Speed ◽  
Cost Effective Approach ◽  
Alternative Approach ◽  
Confidential Data ◽  
The Cost ◽  
Communication Lines

Reliable protection of confidential data processed in critical information infrastructure elements of public institutions and private organizations is topical task today. Of particular interest are methods to prevent the leakage of confidential data by localizing informative (dangerous) signals that both carry an informative component, and have a signal level higher than predefined threshold. The increase in signal energy from personal computers is caused by increasing of its transistors switching speed. Modern passive shielding methods for secured computers, similar to the well-known program TEMPEST, require either costly and large shielding units or technological simplification by using of low-cost fragmentary shielding of computer’s individual elements. Therefore, localization of side electromagnetic radiation produced by personal computer is needed. The paper presents a cost-effective approach to reducing the level of computer’s electromagnetic radiation by passive method. The radiation are localized and measured by its estimation on personal computer’s elements, namely unshielded communication lines between video processor and a monitor, fragments of electric tracks on motherboards, etc. During experiments authors used ad-hoc miniature electric (ball antenna) and magnetic (Hall sensor) antennas connected to selective voltmeters. This approach significantly reduces the cost of equipment and measurements as well as requirements to analytics’ qualification for improving computer’s protection. Also, the alternative approach for computer protection is proposed. The approach is based on image content protection by distorting the image on the monitor instead of reducing electromagnetic radiation caused by signals from the monitor. The protection includes image scrambling using Arnold transform that randomly “shuffle” the lines in each frame.

scholarly journals Novel Method for Laparoscopic Common Bile Duct Exploration Performed Using a Disposable Bronchoscope (Ambu® aScope TM)

2017 ◽  
Vol 2 (2) ◽  
pp. 49-51
Author(s):  
Yousif Mahmood Aawsaj ◽  
Ibrahim K Ibrahim ◽  
Andrew Gilliam
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Case Series ◽  
Cost Effective ◽  
Common Bile Duct Exploration ◽  
Capital Outlay ◽  
Case Surgery ◽  
Laparoscopic Cbd Exploration ◽  
The Cost ◽  
Cbd Exploration

Laparoscopic common bile duct (CBD) exploration can be performed following choledocotomy or via the trancystic approach. Laparoscopic CBD exploration is limited in some benign upper gastrointestinal units due to the cost of sterilization of the re-usable choledochoscope. We have recently published a case series confirming the safety and efficacy of the 5mm re-usable bronchoscope for CBD exploration. This case series evaluates a single-use bronchochoscope (Ambu aScopeTM) for laparoscopic CBD exploration. Data were collected from electronic records of the patients from January 2015 until December 2016; all the cases had confirmation of CBD stones. Twenty-one patients had CBD exploration using the disposable bronchochoscope. There were 7 male and 14 female (median age 42). 8 procedures were performed as emergencies and 13 were performed electively. All the cases were done laparoscopically apart from one planned as an open procedure due to previous extensive open surgery. Twenty cases had their CBD cleared using disposable bronchoscope and one needed subsequent special test follow up. Choledocotomy was performed in 15 and Tran’s cystic approach was performed in 6. No T-tube was used in the laparoscopic cases. 2 cases were performed as day case surgery. Median postoperative hospital stay was 2.5 days. In conclusion, the disposable bronchoscope is safe and effective for use in CBD exploration with results comparable to our previously published case series. It has guaranteed sterility and is cost effective compared to the re-usable bronchoscope especially when initial capital outlay, sterile processing and maintenance costs are considered.

Cost Comparison of Fan-Out WLP vs. Embedded Die

2011 ◽  
Vol 2011 (DPC) ◽  
pp. 001003-001018
Author(s):  
Alan Palesko ◽  
Jan Vardaman
Keyword(s):  
Cost Model ◽  
Form Factors ◽  
Cost Effective ◽  
Cost Comparison ◽  
Package Design ◽  
Supply Chain Logistics ◽  
Cost Effective Approach ◽  
Large Production ◽  
The Cost ◽  
Cost Differences

Fabricating the package after the die is placed can result in smaller form factors, increased performance, and improved supply chain logistics for OEMs. There are many different approaches for this packaging technique, but two of the most prominent are Fan-Out WLP and Embedded Die. Fan-Out WLP leverages existing semiconductor technology for a cost effective approach to achieve relatively tight package design rules. The Embedded Die strategy leverages existing PCB lamination technology for cost-reduction through scale: fabricating many small packages on large production panels. We will examine the cost differences and similarities between Fan-Out WLP and Embedded Die strategies by developing a comprehensive cost model for each technology. We will then analyze the manufacturing costs (labor, material, depreciation, yield loss, and tooling) and yield impacts across a variety of designs to demonstrate the cost differences and similarities in each packaging technology.

scholarly journals Use of Targeted Amplicon Sequencing in Peanut to Generate Allele Information on Allotetraploid Sub-Genomes

Genes ◽  
2020 ◽  
Vol 11 (10) ◽  
pp. 1220
Author(s):  
Roshan Kulkarni ◽  
Ratan Chopra ◽  
Jennifer Chagoya ◽  
Charles E. Simpson ◽  
Michael R. Baring ◽  
...  
Keyword(s):  
Cost Effective ◽  
Amplicon Sequencing ◽  
Routine Practice ◽  
Specific Information ◽  
Illumina Hiseq ◽  
Breeding Programs ◽  
Polymorphic Snps ◽  
Cost Effective Approach ◽  
A Genome ◽  
The Cost

The use of molecular markers in plant breeding has become a routine practice, but the cost per accession can be a hindrance to the routine use of Quantitative Trait Loci (QTL) identification in breeding programs. In this study, we demonstrate the use of targeted re-sequencing as a proof of concept of a cost-effective approach to retrieve highly informative allele information, as well as develop a bioinformatics strategy to capture the genome-specific information of a polyploid species. SNPs were identified from alignment of raw transcriptome reads (2 × 50 bp) to a synthetic tetraploid genome using BWA followed by a GATK pipeline. Regions containing high polymorphic SNPs in both A genome and B genomes were selected as targets for the resequencing study. Targets were amplified using multiplex PCR followed by sequencing on an Illumina HiSeq. Eighty-one percent of the SNP calls in diploids and 68% of the SNP calls in tetraploids were confirmed. These results were also confirmed by KASP validation. Based on this study, we find that targeted resequencing technologies have potential for obtaining maximum allele information in allopolyploids at reduced cost.

A cost effective approach to stormwater management? source control and distributed storage

1997 ◽  
Vol 36 (8-9) ◽  
pp. 307-311 ◽  
Author(s):  
R. Y. G. Andoh ◽  
C. Declerck
Keyword(s):  
Large Scale ◽  
Traditional Approach ◽  
Distributed Storage ◽  
Cost Effective ◽  
Source Control ◽  
Slowing Down ◽  
Surface Areas ◽  
Cost Effective Approach ◽  
Receiving Waters ◽  
The Cost

Rapid urbanisation and its consequent increase in impermeable surface areas and changes in land use has generally resulted in problems of flooding and heavy pollution of urban streams and other receiving waters. This has often been coupled with ground water depletion and a threat to water resources. The first part of this paper presents an alternative drainage philosophy and strategy which mimics nature's way by slowing down (attenuating) the movement of urban runoff. This approach results in cost-effective, affordable and sustainable drainage schemes. The alternative strategy can be described as one of prevention rather than cure by effecting controls closer to source rather than the traditional approach which results in the transfer of problems downstream, resulting in its cumulation and the need for large scale, centralised control. The second part describes a research project which has been launched in order to quantify the cost and operational benefits of source control and distributed storage. Details of the methodology of the modelling and simulation processes which are being followed to achieve this target are presented.

Intraoperative Cholangiography and Repair of Bile Duct Injuries

2013 ◽  
Vol 217 (2) ◽  
pp. 374-375
Author(s):  
Daniel Zamora-Valdés ◽  
Ismael Domínguez ◽  
Miguel A. Mercado
Keyword(s):  
Bile Duct ◽  
Intraoperative Cholangiography ◽  
Bile Duct Injuries

scholarly journals Assessing Effectiveness and Costs in Robot-Mediated Lower Limbs Rehabilitation: A Meta-Analysis and State of the Art

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Giorgio Carpino ◽  
Alessandra Pezzola ◽  
Michele Urbano ◽  
Eugenio Guglielmelli
Keyword(s):  
Meta Analysis ◽  
Cost Effective ◽  
Conventional Approach ◽  
Lower Limbs ◽  
Secondary Outcome ◽  
Robotic Rehabilitation ◽  
Wearable Robots ◽  
Cost Effective Approach ◽  
Significant Difference ◽  
The Cost

Robots were introduced in rehabilitation in the 90s to meet different needs, that is, reducing the physical effort of therapists. This work consists of a meta-analysis of robot-mediated lower limbs rehabilitation for stroke-affected patients; it aims at evaluating the effectiveness of the robotic approach through the use of wearable robots or operational machines with respect to the conventional approach (i.e., manual rehabilitation therapy). The primary assessed outcome is the patient’s ability to recover walking independence, whereas the secondary outcome is the average walking speed. The therapy acceptability and the treatment costs are also assessed. The assessment shows that the robot-mediated therapy is more effective than the conventional one in reaching the primary outcome. As for the secondary outcome, there is no significant difference between the robotic (wearable robots or operational machines) and the conventional approach. Rehabilitation using wearable robots has a greater acceptability than the conventional one. This does not apply to operational machines. The cost of robotic treatment with wearable robots ranges from double to triple the cost of the conventional approach. On the contrary, rehabilitation using operational machines costs the same as the conventional treatment. Robotic rehabilitation based on operational machines is the most cost-effective approach.

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