Technical Accuracy in Descriptions and Recommendations for CIED Security

Heart Rhythm ◽  
2021 ◽  
Author(s):  
G. Stuart Mendenhall
Keyword(s):  
Technical Accuracy

Semiology of the Pain Syndrome - Identifying the Ideal Methods of Locoregional Anesthesia Based on Their Rationale and Features

2017 ◽  
Vol 68 (10) ◽  
pp. 2373-2377
Author(s):  
Mihaela Monica Scutariu ◽  
Vlad Danila ◽  
Corina Ciupilan ◽  
Oana Elena Ciurcanu
Keyword(s):  
Maxillofacial Surgery ◽  
Essential Element ◽  
Pain Syndrome ◽  
Oral And Maxillofacial Surgery ◽  
Structuring Element ◽  
Technical Accuracy ◽  
Locoregional Anesthesia ◽  
Special Approach ◽  
The Individual ◽  
High Degree

Anesthesia and the degree of control over the perception of pain depends on the personality of the individual, the socio-economic conditions, potential previous painful experiences and, last but not least, on fatigue and fear of the dentist. The perception of pain in patients is closely connected to their mental state. Pain is defined as a sensation of discomfort, with wide variations, both in quality and intensity, for different people in seemingly identical conditions; an unpleasant sensitive and emotional phenomena connected to the threat of a wound or caused in the tissues or described in the terms of this disease. The essential element of any type of anesthesia is analgesia, an effect which in some cases cannot be achived, due to the patient�s particularities or the physician�s lack of experience in anesthesia. Locoregional anesthesia (LRA) represents the blocking of the nociceptive sensitive and sympathetic autonomic afferents as well as that of motor efferents at the level of peripheral nerves� axons, by means of local anesthetic. To achieve the set purpose, we carried out a study on a representative human sample comprised of 10.123 patients treated in the Oral and Maxillofacial Surgery Clinic (Ambulatory) from the County Clinic Emergency Hospital St. Spiridon Iasi, between 01.01.2015-31.12.2016. The reason for the exclusion of certain categories of patients in the reseach was: the patients with a special conditions background require individual pre-anesthesia schemes, personalised for the nature of the pre-existing general condition, which must be further approved by the attending specialist physician : cardiologist, internist, diabetologist; children under 18 years old, with a high degree of anxiety; a high precentage of elderly patients, over 60 years old, possess a combination of general issues, thus requiring a special approach. The thoroughness lying at the core of the anesthetic practice, most especially the safegurading of a technical accuracy in the performance of anesthesia [12,], instead of improvisations, the lack of anatomical and stomatological training in general and the resulting inefficiency as such, is the underlying in-depth structuring element of this paper.

scholarly journals Digital Diabetes Management: A Literature Review of Smart Insulin Pens

2021 ◽  
pp. 193229682098386 ◽  
Author(s):  
Lutz Heinemann ◽  
Oliver Schnell ◽  
Bernhard Gehr ◽  
Nanette C. Schloot ◽  
Sven W. Görgens ◽  
...  
Keyword(s):  
Patient Preference ◽  
Diabetes Management ◽  
Electronic Device ◽  
Digital Health ◽  
Memory Function ◽  
Near Field ◽  
Self Management ◽  
Published Data ◽  
Technical Accuracy ◽  
Insulin Pens

Digital health management is increasingly pivotal in the care of patients with diabetes. The aim of this review was to evaluate the clinical benefits of using smart insulin pens with connectivity for diabetes management. The search was performed using PubMed and PubMed Central on May 15, 2019, to identify publications investigating the use of insulin pens. Studies evaluating insulin pens with connectivity via Bluetooth/Near Field Communication, with an associated electronic device enabling connectivity, or with a memory function were included in the review. Nine studies were identified in the search. Overall, these studies lacked data on smart insulin pens with a connectivity function, with eight of the available studies investigating only pens with a memory function. The studies focused primarily on assessing patient preference, usability, and technical accuracy. The number of studies assessing clinical outcomes was small ( n = 3). However, the majority of studies ( n = 8) reported that patients preferred smart insulin pens because they increased confidence with regard to diabetes self-management. These results suggest a lack of published data regarding smart insulin pens with connectivity for the management of diabetes. However, the available published data on usability and patient preference suggest that the use of smart insulin pens holds promise for improving and simplifying diabetes self-management.

Evaluation of Aortic Zone 2 Proximal Landing Accuracy During Thoracic Endovascular Aortic Repair Following Carotid-Subclavian Revascularization

2021 ◽  
Vol 55 (4) ◽  
pp. 355-360
Author(s):  
Sally H. J. Choi ◽  
Gary K. Yang ◽  
Keith Baxter ◽  
Joel Gagnon
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Retrospective Review ◽  
Average Distance ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Aortic Repair ◽  
Technical Accuracy ◽  
Corrective Procedures

Background: Adequate seal for thoracic endovascular aortic repair (TEVAR) commonly requires landing in zone 2, but can prove to be challenging due to the tortuous and angulated anatomy of the region. Objectives: Our objective was to determine the proximal landing accuracy of zone 2-targeted TEVARs following carotid-subclavian revascularization (CSR) and its impact on clinical outcomes. Methods: Retrospective review of patients that underwent CSR for zone 2 endograft delivery at a tertiary institute between January 2008 and March 2018 was conducted. Technical outcomes were assessed by examining the incidence of intraoperative corrective maneuvers, 1a endoleaks and reinterventions. Distance to target and incidence of LSA stump filling were examined as radiographic markers of landing accuracy. Results: Zone 2-targeted TEVAR with CSR was performed in 53 patients for treatment of dissections (49%), aneurysms (30%) or trauma (21%). Nine (17%) cases required intraoperative corrective procedures: 5 (9%) proximal cuffs due to type 1a endoleak and 4 (8%) left common carotid artery (LCCA) stenting due to inadvertent coverage. Cases performed using higher resolution hybrid fluoroscopy machine compared to mobile C-arm were associated with increased proximal cuff use (OR 8.8; 95% CI 1.2-62.4). Average distance between the proximal edge of the covered graft to LCCA was 8 ± 1 mm and larger distances were not associated with higher rates of 1a endoleak. Twenty-eight (53%) cases of antegrade LSA stump filling were noted on follow-up imaging, but were not associated with higher rates of reinterventions (OR 0.8, 95% CI [0.2-4.6]). Three (6%) patients had a stroke within 30 days and 4 (8%) patients expired within 1 month. Intraoperative corrective maneuvers, post-operative 1a endoleak and reinterventions were not associated with higher rates of stroke or mortality. Conclusion: Using current endografts and imaging modalities, zone 2-targeted TEVARs have suboptimal technical accuracy.

Approximate Analytical Model for Hertzian Elliptical Wheel/Rail or Wheel/Crossing Contact Problems

2008 ◽  
Vol 130 (4) ◽  
Author(s):  
F. D. Fischer ◽  
M. Wiest
Keyword(s):  
Contact Pressure ◽  
Contact Problems ◽  
Hertzian Contact ◽  
Contact Theory ◽  
Technical Accuracy ◽  
Elliptical Contact ◽  
Current Approximation ◽  
Analytical Expressions ◽  
Maximum Contact ◽  
Hertzian Contact Theory

The Hertzian contact theory is approximated according to a concept by Tanaka (2001, “A New Calculation Method of Hertz Elliptical Contact Pressure,” ASME J. Tribol., 123, pp. 887–889) yielding simple analytical expressions for the elliptical semi-axes, the maximum contact pressure, the mutual approach and the contact spring constant. Several configurations are compared using the exact Hertz theory and the current approximation. The results agree within technical accuracy.

scholarly journals Laboratory validation and field usability assessment of a point-of-care test for serum bilirubin levels in neonates in a tropical setting

2018 ◽  
Vol 3 ◽  
pp. 110
Author(s):  
Laurence Thielemans ◽  
Ahmar Hashmi ◽  
Dah Dah Priscilla ◽  
Moo Kho Paw ◽  
Tekel Pimolsorntong ◽  
...  
Keyword(s):  
Focus Group ◽  
Direct Observation ◽  
Serum Bilirubin ◽  
Point Of Care ◽  
Research Unit ◽  
Focus Group Discussions ◽  
Error Message ◽  
Group Discussions ◽  
Resource Setting ◽  
Technical Accuracy

Background: Screening and monitoring serum bilirubin (SBR) in neonates is crucial to prevent neonatal hyperbilirubinemia (NH)-associated morbidity and mortality worldwide. A lack of resources is often a barrier for measuring SBR in developing countries. Reliable, cost-effective, easy to use point-of-care (POC) SBR tests are needed. This study aimed to evaluate the technical accuracy and usability of the Bilistick System (BS), a new bilirubin POC test, in a tropical setting. Methods: This was a mixed-methods study, including laboratory validation of the BS, direct observation of technical procedures as performed by the midwives and midwives’ assessment of the device’s easiness of use through focus group discussions (FGD) and a self-administered questionnaire. The study was conducted in a field clinic of the Shoklo Malaria Research Unit along the Thailand-Myanmar border between January and December 2017. Results: A total of 173 samples were tested at a median age of 4 days. BS generated an error message—providing no SBR readout—in 48.6% of the tests performed. For the tests that yielded a result, the correlation coefficient (95% CI) between BS and routine laboratory bilirubinometer SBR was 0.87 (0.77-0.93). The accuracy decreased with increasing haematocrit and at higher humidity (≥75%). Direct observation of the operators using the device and analysis of the focus group discussions and questionnaires indicated that the BS was considered easy to use and required limited training. Conclusions: This evaluation showed that the BS, in its current formulation, does not provide reliable results for measuring SBR in a tropical, low-resource setting  but has acceptable usability features.

scholarly journals Laboratory validation and field usability assessment of a point-of-care test for serum bilirubin levels in neonates in a tropical setting

2018 ◽  
Vol 3 ◽  
pp. 110 ◽  
Author(s):  
Laurence Thielemans ◽  
Ahmar Hashmi ◽  
Dah Dah Priscilla ◽  
Moo Kho Paw ◽  
Tekel Pimolsorntong ◽  
...  
Keyword(s):  
Focus Group ◽  
Direct Observation ◽  
Serum Bilirubin ◽  
Point Of Care ◽  
Research Unit ◽  
Focus Group Discussions ◽  
Error Message ◽  
Group Discussions ◽  
Resource Setting ◽  
Technical Accuracy

Background: Screening and monitoring serum bilirubin (SBR) in neonates is crucial to prevent neonatal hyperbilirubinemia (NH)-associated morbidity and mortality worldwide. A lack of resources is often a barrier for measuring SBR in developing countries. Reliable, cost-effective, easy to use point-of-care (POC) SBR tests are needed. This study aimed to evaluate the technical accuracy and usability of the Bilistick System (BS), a new bilirubin POC test, in a tropical setting. Methods: This was a mixed-methods study, including laboratory validation of the BS, direct observation of technical procedures as performed by the midwives and midwives’ assessment of the device’s easiness of use through focus group discussions (FGD) and a self-administered questionnaire. The study was conducted in a field clinic of the Shoklo Malaria Research Unit along the Thailand-Myanmar border between January and December 2017. Results: A total of 173 samples were tested at a median age of 4 days. BS generated an error message—providing no SBR readout—in 48.6% of the tests performed. For the tests that yielded a result, the correlation coefficient (95% CI) between BS and routine laboratory bilirubinometer SBR was 0.87 (0.77-0.93). The accuracy decreased with increasing haematocrit and at higher humidity (≥75%). Direct observation of the operators using the device and analysis of the focus group discussions and questionnaires indicated that the BS was considered easy to use and required limited training. Conclusions: This evaluation showed that the BS, in its current formulation, does not provide reliable results for measuring SBR in a tropical, low-resource setting  but has acceptable usability features.

scholarly journals When Compliance Checks are Just the Start of the Journey: an Aviation Case

2019 ◽  
Vol 273 ◽  
pp. 01009
Author(s):  
Mart De Vré ◽  
Delia A. Richardson
Keyword(s):  
Service Provider ◽  
System Performance ◽  
Language Barriers ◽  
Substantial Improvement ◽  
Insurance Companies ◽  
Sufficient Condition ◽  
Structured Interviews ◽  
Optimum System ◽  
Technical Accuracy ◽  
Compliant Material

Compliance with standards is assessed through internal and external audits, the findings of which are viewed as imperfections to be quickly repaired. A zero-findings mentality underlies companies that want to excel before the eyes of the authorities, customers, insurance companies and competitors. However, scholars and professionals over the last decades agree that compliance is a necessary but not sufficient condition for optimum system performance. The current study was initiated by a Ground Service Provider that in 2017 underwent an IATA Safety Audit for Ground Operations and revealed several findings, especially in the documentation, such as missing parts, non-compliant material and lack of detail. Their goal was to pass the next audit without any findings within the documented procedures of six operational departments. To assess the audit documentation criteria, the researchers visited the operational departments, analysed 186 procedures, and conducted six semi-structured interviews with managers/supervisors and nine interviews with operational personnel. The analysis showed that all documents were properly controlled, but four departments had duplicated generic guidance material from 6% to 83% of the text checked. The interviewees claimed that understandability was not optimum due to language barriers and the non-tailoring of the content to their needs, leading to some staff disregarding manuals and consulting their supervisor instead. Other remarks included the long length of the documents, lack of knowledge of how to access online material, ignorance of the existence of documentation access points, and low technical accuracy. Overall, the results suggested room for improvement. Most importantly, through this research, the specific Ground Service Provider gained a better understanding behind non-compliance and had the opportunity to improve the quality and communication of its procedures. This study showed that even when compliance is the target, substantial improvement moves beyond box-ticking and engages employees in the revelation and mitigation of system imperfections.

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