Sleep position, patient comfort, and technical performance with two established procedures for home sleep testing

Purpose In patients with a high pre-test probability of suffering from obstructive sleep apnea (OSA), (cardio)-respiratory polygraphy (RP; level 3) is commonly used for home sleep testing (HST); however, testing based on peripheral arterial tonometry (PAT) is increasingly recognized as an alternative method. The aim of the study was to compare sleep position, patients’ comfort, and technical failure rates of HST with RP and PAT in patients with suspected OSA. Methods Sleep position, patients’ comfort, and technical failure rates of RP and PAT were compared in 56 patients receiving two nights of HST with either RP or PAT in a randomized fashion. Results Time in supine position with PAT was significantly lower (173.7±88 min) compared to RP (181.7±103.7 min; p < 0.001), although the absolute mean difference was not clinically significant. Patients reported to sleep better, feeling less disturbed when falling asleep, losing less sensors, and fewer nightly awakenings with PAT, but experienced more pain at the side of the finger probe. Forty-five out of 56 patients (80%) rated PAT as being the superior sleep test and 49 out of 56 (88%) would prefer PAT for further investigations (p<0.001). PAT testing was associated with less technical failures. Conclusion The results demonstrate that HST with PAT leads to less time in supine sleep positioning, which may be clinically relevant in selected patients. Moreover, PAT is associated with less technical failures and is perceived with less discomfort during testing and a reduced number of nocturnal awakenings in patient self-reports.

Diagnosing the state of marine diesel engines by probabilistic fault recognition method

Diagnostics of marine diesel engines, during the navigation of the vessel, allows you to prevent the development of an accident, perform maintenance in a timely manner, eliminate the possibility of technical failures. The wear of parts is one of the main reasons for putting a diesel engine into repair. Timely detection of the occurrence of wear according to the indications of standard monitoring devices, allows you to prevent the negative consequences of wear, perform repairs in a timely manner, eliminate the possibility of an unplanned exit of the marine diesel engine from operation. If there is a need to operate a marine diesel engine in conditions different from those established by the manufacturer, diagnostics allows you to predict the temporary operational characteristics

Retrospective analysis of failures of ambulatory elastomeric pumps containing 5-FU in a hospital pharmacy unit

Introduction Ambulatory chemotherapy is an important and major advance in clinical oncology practice since it allows the administration of chemotherapy in the comfort of the patient's home without the assistance of a health professional by means of an elastomeric pump. However, these pumps are not without risks and can be the cause of incidents due to technical failures. Our objective is to study the technical failures of elastomeric pumps in the Cytotoxic Preparation Unit and in the patient's home, to evaluate the possible impact of these failures on the patient and on the staff and to propose measures to reduce them. Materials and methods This is a retrospective study conducted at the pharmacy of the National Institute of Oncology in Rabat. It gathered all the specific reports on elastomeric pumps issued during the period (January 2017–May 2021) by the cytotoxic preparation unit to the materiovigilance cell via a notification form. Results 205 cases of elastomeric pump materialovigilance were identified during the study period. The main technical failures were: chemotherapy product leakage (44%), flow rate anomalies (30%) and injection difficulties (20%). Following these incidents, certain actions were undertaken such as alerts sent to the supplier and letters sent to the competent health authorities. Conclusion Despite the failures that may have occurred, elastomeric pumps have revolutionized home chemotherapy delivery. They are considered reliable, consistent, easy to use and handle, and are well accepted in the population.

Commanding Police Operations Using a Mobile Distribution Point of ICT Infrastructure

Currently, public safety is threatened by emergencies related to broadly understood terrorism, natural disasters and technical failures or related to mass events, public gatherings and state or religious ceremonies and other situations causing risks that may lead to losing control over the course of events. It makes the police take specific actions as part of organised police activities, primarily police operations. The condition for the efficiency and effectiveness of the command in the police is to develop new, alternative, innovative technical solutions. The Mobile Distribution Point of ICT Infrastructure serves as an example in this respect. It will be an autonomous node that integrates technologically advanced ICT services, such as voice, data and image transmission, GPS positioning, for the needs of mobile command posts and the provision of ICT infrastructure in a specific area. Currently, the Polish police do not have a similar device, which reduces effective operation in emergencies.

525 Minimally Invasive Surgical Treatment of Benign Prostatic Hyperplasia: A Systematic Review

Introduction Minimally invasive surgical treatments (MISTs) of benign prostatic hyperplasia (BPH) have evolved to offer men daycase care with preservation of urinary continence and sexual function. This systematic review evaluates trends in minimally invasive BPH surgery over the last decade Method Systematic review (PRISMA) of Embase/MEDLINE databases (2010-2020). MISTs included Rezum, Urolift, Prostatic Artery Embolisation (PAE), Temporary Implantable Nitinol Device (TIND), Intraprostatic Injection, Transurethral Microwave Therapy (TUMT) and Transurethral Needle Ablation (TUNA). Primary outcome: urinary functional change (International Prostate Symptom Score (IPSS)/maximum flow (Qmax)). Secondary outcomes: sexual functional change (International Index of Erectile Function-5 (IIEF-5)), technical failures and complications. Results 74 studies were included (total: 8,917 patients). Primary: all interventions offered improvement in IPSS and Qmax (intervention (no. studies): range IPSS change, range Qmax change, range months follow-up; Rezum (4): -46.7% to -62.7%, +17.6% to + 55.6%, 6-48; Urolift (11): -35.2% to -64.2%, +16.7% to + 89.6%, 1-60; PAE (36): -36.8% to -85.2%, +17.4% to + 155.2%, 3-38; TIND (2): -36.8% to -59.6%, +32.9% to + 95.9%, 12-36; Intraprostatic Injection (14): -24.3% to -62%, +8.7% to + 98.4%, 3-24; TUMT (4): -56.1% to -58.7%, +12.9% to + 60.2%, 6-60; TUNA (3): -17.6% to -63.2%, +3.9% to + 39%, 1-120). Secondary: 33 studies of all interventions bar TIND and TUMT reported IIEF-5 change; sexual function was largely preserved. Technical failures and Clavien-Dindo ≥3 complications were rare. Conclusions MISTs for BPH are efficacious and safe. Randomised comparisons with long-term urinary and sexual follow-up are needed to guide choice; until then, patients should be carefully counselled based on individual priorities and circumstances.

Bayesian network model to distinguish between intentional attacks and accidental technical failures: a case study of floodgates

Water management infrastructures such as floodgates are critical and increasingly operated by Industrial Control Systems (ICS). These systems are becoming more connected to the internet, either directly or through the corporate networks. This makes them vulnerable to cyber-attacks. Abnormal behaviour in floodgates operated by ICS could be caused by both (intentional) attacks and (accidental) technical failures. When operators notice abnormal behaviour, they should be able to distinguish between those two causes to take appropriate measures, because for example replacing a sensor in case of intentional incorrect sensor measurements would be ineffective and would not block corresponding the attack vector. In the previous work, we developed the attack-failure distinguisher framework for constructing Bayesian Network (BN) models to enable operators to distinguish between those two causes, including the knowledge elicitation method to construct the directed acyclic graph and conditional probability tables of BN models. As a full case study of the attack-failure distinguisher framework, this paper presents a BN model constructed to distinguish between attacks and technical failures for the problem of incorrect sensor measurements in floodgates, addressing the problem of floodgate operators. We utilised experts who associate themselves with the safety and/or security community to construct the BN model and validate the qualitative part of constructed BN model. The constructed BN model is usable in water management infrastructures to distinguish between intentional attacks and accidental technical failures in case of incorrect sensor measurements. This could help to decide on appropriate response strategies and avoid further complications in case of incorrect sensor measurements.

Strategic Management Technical Skills, Interpersonal Skills and Conceptual Skills of Officers in Manning KRI

To achieve increased professionalism, the officers were disturbed by several shipwrecks that occurred. During the period 2013-2016, there have been 32 KRI accidents, the data can show an increasing trend of KRI accidents. In the maritime world, several ship accidents occur due to, among others, natural conditions, technical failures, shipping lane conditions, ship-related factors, human error, and cargo-related factors. This research uses a qualitative research approach with a case study method. From the research results, the ship which weighs 1,900 tons, has dimensions of 90.70 meters x 11.12 meters x 3.4 meters, is powered by 2 diesel engines, which can propel the ship up to a speed of 18 knots and can carry cargo up to 600 tons. happened when the ship finished docking. The habit factor of the ships above, anchoring like that, of course, has a reason, the Commander should in the learning process find out to enrich knowledge through experience to find the truth of the habit because one day it becomes one of the keys to work effectiveness and benefits in taking an action. If he learns from experience, leakage can be avoided. The results of the research show that expertise and responsibility are two of the pillars of professionalism, which are relevant to the case study of the shipwreck that the researcher lifted. The results of the ship accident case study, identified that to prevent accidents, officers must have technical, interpersonal, and conceptual skills. These three factors constitute a totality. This means that all three are interrelated and all KRI officers need some mix of all three. If one of them is not perfect or does not exist, it will have implications for shipping safety.

Digital transformation of major scientific meetings induced by the COVID-19 pandemic: insights from the ESC 2020 annual congress

As a consequence of the COVID-19 pandemic, the European Society of Cardiology (ESC) was forced to pivot the scientific programme of the ESC Congress 2021 into a totally new format for online consumption, The Digital Experience. A variety of new suppliers were involved, including experts in TV studio, cloud infrastructure, online platforms, video management, and online analytics. An information technology platform able to support hundreds of thousands simultaneous connections was built and cloud computing technologies were put in place to help scale up and down the resources needed for the high number of users at peak times. The video management system was characterized by multiple layers of security and redundancy and offered the same fluidity, albeit at a different resolution, to all user independently of the performance of their internet connection. The event, free for all users, was an undisputed success, both from a scientific/educational as well as from a digital technology perspective. The number of registrations increased by almost four-fold when compared with the 2019 record-breaking edition in Paris, with a greater proportion of younger and female participants as well as of participants from low- and middle-income countries. No major technical failures were encountered. For the first time in history, attendees from all around the globe had the same real-time access to the world’s most popular cardiovascular conference.

Double tunnel technique reduces technical failure during POEM in cases with severe submucosal fibrosis

Background and study aims Submucosal fibrosis (SMF) is one of the major reasons for technical failure during per-oral endoscopic myotomy (POEM). In this study, we aimed to evaluate the impact of double tunnel technique (DT-POEM) on the technical success of POEM in cases with severe SMF. Patients and methods Data from patients with achalasia in whom SMF was encountered during POEM from Jan 2013 to Jan 2020 at our center were retrospectively evaluated. The technical success and adverse events (AEs) were analyzed and compared between cases with SMF who underwent POEM via single tunnel versus DT-POEM technique. Results A total of 1,150 patients underwent POEM during the study period. There were 14 technical failures (1.2 %). SMF and severe SMF was found in 104 (9 %) and 21 (1.8 %) patients, respectively. The majority of patients (17, 80.9 %) with severe SMF had type I achalasia. Overall, technical failures occurred in 14 cases (1.2 %) and severe SMF resulted in the majority of the technical failures (10, 71.4 %). DT-POEM was utilized in 11 cases (52.4 %) with severe SMF. The median procedure time with DT-POEM was 150 minutes (85–210). There were no major AEs and DT-POEM was technically successful in all the patients. The technical success of POEM in cases with SMF improved after the adoption of the double tunnel technique (98.4 % vs 68.3 %, P = 0.0001). Conclusions Severe SMF is the most common reason for technical failure during POEM. DT-POEM improves the technical success rates of POEM in patients with severe SMF.

Civil Aviation Occurrences in Slovakia and their Evaluation Using Statistical Methods

The nature of a civil aviation occurrence may be defined in three different categories while considering its severity. General categories include civil aviation accidents, serious incidents and incidents. The present article analyses the civil aviation occurrences in Slovakia which happened in the period from 2000 to 2019. In this period, there was a significant increase in the number of civil aviation occurrences, and incidents, in particular, represented the highest percentage. A Pareto analysis was applied to identify the key incident categories (wildlife strike, technical failures of the aviation technology and unauthorised penetration of airspace). A multiple regression analysis and the Poisson regression were used to create two models of correlations between the number of civil aviation occurrences and the selected input variables. Both models are statistically significant, and, based on the AIC (Akaike Information Criterion), the Poisson regression model appeared to be of higher quality. The model showed, for example, that an increase in variables (the number of commercial aircrafts aged over 14 years and the number of total aircraft movements) resulted in a slight increase in the expected number of civil aviation occurrences.