scholarly journals DyNeuMo Mk-1: A Fully-Implantable, Motion-Adaptive Neurostimulator with Configurable Response Algorithms

2020 ◽  
Author(s):  
Mayela Zamora ◽  
Robert Toth ◽  
Jon Ottaway ◽  
Tom Gillbe ◽  
Sean Martin ◽  
...  
Keyword(s):  
High Reliability ◽  
Free Fall ◽  
Consumer Electronics ◽  
Stimulation Parameter ◽  
Device Development ◽  
Ensure Patient Safety ◽  
Management Techniques ◽  
Novel Algorithms ◽  
Circadian Patterns ◽  
Improve Patient

AbstractThere is growing interest in using adaptive neuro-modulation to provide a more personalized therapy experience that might improve patient outcomes. This paper describes the design of the ‘DyNeuMo Mk-1’, a fully-implantable, motion-adaptive research stimulator that titrates stimulation based on the patient’s movement state (e.g. posture, activity, shock, free-fall). The design leverages off-the-shelf consumer technology that provides inertial sensing with low-power, high reliability and modest cost. We used a three-axis accelerometer and its embedded digital motion processor to enable real-time stimulation adaption based on configurable motion parameters. The algorithm configurability and expanded stimulation parameter space allows for a number of applications to be explored in both central and peripheral applications. The implantable system was designed, prototyped and verified using ISO 13485 design controls, including ISO 14971 risk management techniques to ensure patient safety, while enabling novel algorithms. With the design controls in place, first-in-human research trials are now being prepared to explore the utility of automated motion-adaptive algorithms. The design highlights how consumer electronics technology can be leveraged for efficient and reliable medical device development. The implantable system automatically provides activity- and posture-based responsive stimulation which can be configured by the clinician to optimize therapy. Intended applications include adaptive stimulation for movement disorders, synchronizing stimulation with circadian patterns, and reacting to transient inertial events such as shocks for urinary incontinence.

scholarly journals Opinion of the junior doctors on the existing morale, support and autonomy at their workplace and the factors positively influencing them

2021 ◽  
Vol 12 (1) ◽  
pp. 30-35
Author(s):  
Khandakar Rezwanur Rahman ◽  
Nabila Tabassum ◽  
Md Abid Hossain Mollah
Keyword(s):  
Teaching Hospitals ◽  
Easy Access ◽  
Junior Doctors ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Ensure Patient Safety ◽  
Everyday Work ◽  
Tertiary Hospitals ◽  
Improve Patient

Background: Junior doctors form the majority of the workforce in patient care. Their job is perilous, highly critical, tedious and exhausting and it is imperative that they stay motivated while at work. Improving the morale of physicians has the potential to increase efficiency, ensure patient safety and improve patient outcomes. We aimed to identify the existing status and explore the factors affecting junior doctors’ morale, their sense of feeling supported and their levels of autonomy in 2 large teaching hospitals in Bangladesh. Methods: This cross-sectional observational study was done across 2 large tertiary hospitals- Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders(BIRDEM) General Hospital and Dhaka Shishu Hospital, over 4 months period from September- December 2020. The study was carried out on 120 junior doctors by an online questionnaire, distributed through emails and Facebook messenger, asking junior doctors to rate their morale, sense of feeling supported and autonomy and rank the top factors that positively affected them. Results: Data were finally collected from 117 junior doctors after 3 incomplete data were discarded. Most of the junior doctors felt ‘neither good nor bad’ in the domains of existing ‘morale’ (44.4%), ‘feeling supported’ (46.5%) and ‘autonomy’ (48.7%). Additionally, ‘good’ morale was seen in 39.3%, while around 34% rated their support system as ‘good’ and around 24% reported a ‘good’ autonomy. The most important factor positively affecting morale was recognition and reward for good performance (70.1%), factor influencing support was an easy access to senior clinicians (70.4%) and that defining autonomy was constant senior supervision of the everyday work (61.1%). Conclusion: The study aims to identify the existing level of morale, support and autonomy of the junior doctors at their workplace and explore the factors positively affecting them. It is concluded from this study that the junior doctors rated their existing morale, support and autonomy as ‘average’. According to the opinions of the doctors, this study also concludes that, to improve their morale, there is a need to recognize and reward their good work and provide positive feedback. Doctors identified an easy access to senior clinicians with a problem was the primary factor influencing support. Finally, junior doctors wanted constant senior supervision of their everyday work in the wards to improve output. BIRDEM Med J 2022; 12(1): 30-35

Surgical Site Infections in Aesthetic Surgery

2019 ◽  
Vol 39 (10) ◽  
pp. 1118-1138 ◽  
Author(s):  
Christodoulos Kaoutzanis ◽  
Nishant Ganesh Kumar ◽  
Julian Winocour ◽  
Keith Hood ◽  
K Kye Higdon
Keyword(s):  
Postoperative Complications ◽  
Surgical Site Infections ◽  
Aesthetic Surgery ◽  
Prevention Measures ◽  
Timely Manner ◽  
Ensure Patient Safety ◽  
The Right ◽  
Improve Patient ◽  
Prompt Diagnosis

AbstractSurgical site infections represent one of the most common postoperative complications in patients undergoing aesthetic surgery. As with other postoperative complications, the incidence of these infections may be influenced by many factors and varies depending on the specific operation performed. Understanding the risk factors for infection development is critical because careful patient selection and appropriate perioperative counseling will set the right expectations and can ultimately improve patient outcomes and satisfaction. Various perioperative prevention measures may also be employed to minimize the incidence of these infections. Once the infection occurs, prompt diagnosis will allow management of the infection and any associated complications in a timely manner to ensure patient safety, optimize the postoperative course, and avoid long-term sequelae.

Low-cost high-reliability 830nm single mode lasers for consumer electronics and CtP applications

2011 ◽  
Author(s):  
J. Boucart ◽  
E. Zibik ◽  
S. Renz ◽  
B. Sverdlov ◽  
M. Kearley ◽  
...  
Keyword(s):  
High Reliability ◽  
Low Cost ◽  
Single Mode ◽  
Consumer Electronics

Application of Acoustic Technique for Surveillance and Anomaly Detection in LMFBRs

2008 ◽  
Author(s):  
V. Prakash ◽  
M. Anandaraj ◽  
M. Thirumalai ◽  
P. Kalyanasundaram ◽  
G. Vaidyanathan
Keyword(s):  
Detection System ◽  
High Reliability ◽  
Reactor Core ◽  
Performance Testing ◽  
Free Fall ◽  
Operating Conditions ◽  
Fast Breeder Reactor ◽  
Steam Generators ◽  
Acoustic Technique ◽  
Drop Time

Acoustic techniques find wide application in Liquid Metal Fast Breeder Reactors (LMFBRs) for ensuring its high reliability, safety and plant availability. Various surveillance methods based on acoustic technique can be employed in these reactors to detect deviations from normal operating conditions. This could be used for the measurement of drop time of Diverse Safety Rods (DSRs) in the core, detection of in-sodium water leaks in Steam Generators, cavitation detection in sodium pumps and reactor core components. An active R&D program is being pursued in these areas at Indira Gandhi Centre for Atomic Research. Acoustic measurement technique has been used to determine the drop time of Diverse Safety Rods in sodium. 3 nos of Diverse Safety Rods (DSRs) are provided in Prototype Fast Breeder Reactor (PFBR) for its safe shut down in case of a SCRAM. An online drop time measurement system using acoustic technique is planned to detect the proper insertion of DSRs into their corresponding Subassemblies. Experiments were conducted during the performance testing of DSRs in sodium using accelerometer instrumented wave-guide system and free fall time and braking time of DSR have been measured. For detection of in-sodium water leaks in Steam Generators, acoustic method serves as a supplementary monitoring technique with an intermediate sensitivity and instantaneous response. To develop an acoustic leak detection system for Steam Generators of Prototype Fast Breeder Reactor, preliminary studies on the behavior of micro leak and its propagation has been carried out in Sodium Water Reaction Test Rig, injecting steam into sodium. Acoustic technique was employed to characterize the onset of leak. Cavitation in LMFBRs can occur in fuel subassemblies, pressure drop devices, pumps etc. It is important to minimize cavitation to reduce the risk of damage from erosion. Acoustic technique was extensively used in qualifying Prototype Fast Breeder Reactor components against cavitation phenomenon. This paper discusses the various experiments carried out towards the development of the acoustic surveillance methods for FBRs, instrumentation involved, results obtained from experiments and brief details of the future programme.

Pb-free v/s Tin-Lead Reliability Comparison for Telecom/High Reliability Applications

2010 ◽  
Vol 2010 (1) ◽  
pp. 000284-000293
Author(s):  
Ganesh Iyer ◽  
Gnyaneshwar Ramakrishna ◽  
Lavanya Gopalakrishnan ◽  
Kuo-Chuan Liu
Keyword(s):  
Service Providers ◽  
High Reliability ◽  
Consumer Electronics ◽  
Circuit Board ◽  
Evaluation Methodology ◽  
Mechanical Shock ◽  
Printed Circuit Board Assembly ◽  
Component Level ◽  
Cross Sectional ◽  
Free Solder

With the European Union's (EU's) RoHS directives coming into force in July 2006 for consumer electronics products, the transition to lead-free (Pb-free) solder has occurred at a rapid pace. This push has driven many OEM suppliers/manufacturers to adopt Pb-free solder and End of Life many of their conventional Tin-Lead (Sn-Pb) components. This has forced telecom or high reliability applications to adopt Pb-free solder compositions with many reliability anomalies unanswered. While there have been many studies published on long term reliability of Pb-free solder joints at the component level, there have been few studies focused on the time zero reliability of the joints at the printed circuit board assembly (PCBA) level. The goal of this study is to help the OEM suppliers and their customers (like service providers) to come up with a common PCBA test methodology that will help identify and weed out early, marginal manufacturing and design defects that would crop up due to transition to the Pb-free solder. A normalized reliability data comparison and impact of the test on Pb-free and Tin-Lead solder alloys using test vehicles is presented in this study. The sequential PCBA level evaluation methodology involves a series of tests that include Thermal Aging, Mechanical Shock, Vibration, Functional test over elevated temperature and Destructive Analysis (Dye & Pry and Cross-sectional analysis) . The solder joint reliability comparisons for different components are presented against this methodology using different PCBA constructions (test vehicles).

Optimizing X-Ray Inspection for Advanced Packaging Applications

2020 ◽  
Vol 2020 (1) ◽  
pp. 000165-000168
Author(s):  
Brennan Peterson ◽  
Michael Kwan ◽  
Fred Duewer ◽  
Andrew Reid ◽  
Rhiannon Brooks
Keyword(s):  
Signal To Noise Ratio ◽  
High Reliability ◽  
Important Change ◽  
Device Integration ◽  
Advanced Packaging ◽  
High Bandwidth ◽  
Failure Point ◽  
And Performance ◽  
Novel Algorithms ◽  
The Individual

ABSTRACT Over the coming decade, advanced packaging will become increasingly critical to performance, cost, and density improvements in advanced electronics. There is both an industry push: cost and performance advances in transistor scaling are increasingly difficult. And there is an industry pull: customization for each market can be done far more quickly by assembling a series of parts in a package, rather than by design and integration into a single device. This isnt a new idea: Gordon Moore said the same in the 60’s. But after decades of increased device level integration, it is an important change. Figure 1 shows an example (future) device: there are large bumps, hybrid bonds--for extreme bandwidth and low latency connection to cache memory, TSV based DRAM, and multiple CPU to CPU interconnects. Each of these is a failure point. Figure 1: The wide variety of interconnects on future advanced packages Figure 2: the triangle of misery as applied to standard and Advanced xray imaging (AXI) Manufacturing will necessarily advance in the packaging arena: pin density and package size will both increase to support the high bandwidth and device integration demands. The downside of multiple device integration is a higher set of requirements on the reliability of both the individual devices and the fully assembled system. This is an opportunity to take advantage of new strategies and technologies in package inspection. The sampling challenges for both control and inspection for high reliability require systems that can run at 100% coverage and millions of units per year. An overview of reliability sampling challenges as it relates to the end of line inspection, as well as sampling for both defect type and incidence is critical to understanding how and what to measure to maximize yield. There are fundamental tradeoffs between speed, resolution, and signal to noise ratio that inform a systematic engineering understanding of inspection. Optimizing that trade-off specifically for semiconductor inspection leads to dedicated tools with extremely high resolution, speed, and low dose. In parallel with the speed requirements, sensitivity, and noise immunity can be improved with an understanding of the systematic sources of noise. These can be mitigated and even eliminated with novel algorithms for both image enhancement and defect location.

Failure Analysis With the Scanning Electron Microscope

1972 ◽  
Vol 30 ◽  
pp. 482-483
Author(s):  
John R. Devaney
Keyword(s):  
Electron Microscope ◽  
Scanning Electron Microscope ◽  
Integrated Circuits ◽  
Failure Analysis ◽  
High Reliability ◽  
Military Applications ◽  
Small Structure ◽  
Useful Life ◽  
Insight Into ◽  
Scanning Electron

Occasionally in history, an event may occur which has a profound influence on a technology. Such an event occurred when the scanning electron microscope became commercially available to industry in the mid 60's. Semiconductors were being increasingly used in high-reliability space and military applications both because of their small volume but, also, because of their inherent reliability. However, they did fail, both early in life and sometimes in middle or old age. Why they failed and how to prevent failure or prolong “useful life” was a worry which resulted in a blossoming of sophisticated failure analysis laboratories across the country. By 1966, the ability to build small structure integrated circuits was forging well ahead of techniques available to dissect and analyze these same failures. The arrival of the scanning electron microscope gave these analysts a new insight into failure mechanisms.

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