Effect of C-Arm Year Model on Radiation Scatter

2015 ◽  
Vol 9 (1) ◽  
Author(s):  
Omar Bakr ◽  
Saam Morshed ◽  
Meir Marmor
Keyword(s):  
Real Time ◽  
Operating Room ◽  
Trauma Surgery ◽  
Image Intensifier ◽  
Operating Rooms ◽  
Phantom Limb ◽  
Orthopaedic Trauma ◽  
Total Radiation ◽  
Set Up ◽  
Radiation Scatter

Since the 1980’s C-arm fluoroscopy has been an integral part of orthopaedic trauma surgery. The advancement in C-arm technology has resulted in different generations of C-arms co-existing in the operating rooms. The purpose of this study was to compare the radiation scatter patterns of different generation C-arms. Three generation of C-arms were tested: GE OEC 9800 Plus (1999/2000), Siemens Arcadis Orbic 3D (2004), Philips BV Pulsera 2.3 (2008). Radiation scatter was measured using six real-time dosimetry badges set up on either side of the surgical table (Mizuho OSI, flat-top). Distance of C-arm was normalized at 20 in. and 10 in. from Image Intensifier. Each device was set to the automatic brightness control (ABC) setting. A phantom limb was irradiated for 120 s and radiation scatter was summed for both AP and lateral positions. At their typical operating room settings there was a reduction in radiation scatter using the newer generation C-arms. Results for total radiation, normalized to Philips, are as follows: Philips 1 (100%), GE 2.4 (240%), and Siemens 1.4 (140%). Newer generation C-arms can be expected to generate lower radiation scatter. Special care should be taken to attempt a lower dose setting, especially when utilizing older generation C-arms to minimize radiation scatter to practitioner.

scholarly journals Development and Implementation of the Portable Operating Room Tracker App With Vital Signs Streaming Infrastructure: Operational Feasibility Study (Preprint)

2019 ◽  
Author(s):  
Matthias Görges ◽  
Nicholas C West ◽  
Christian L Petersen ◽  
J Mark Ansermino
Keyword(s):  
Real Time ◽  
Operating Room ◽  
Information Exchange ◽  
Vital Signs ◽  
Operating Rooms ◽  
Mobile App ◽  
Data Availability ◽  
Major Barrier ◽  
Team Members ◽  
Feasibility Testing

BACKGROUND In the perioperative environment, a multidisciplinary clinical team continually observes and evaluates patient information. However, data availability may be restricted to certain locations, cognitive workload may be high, and team communication may be constrained by availability and priorities. We developed the remote Portable Operating Room Tracker app (the telePORT app) to improve information exchange and communication between anesthesia team members. The telePORT app combines a real-time feed of waveforms and vital signs from the operating rooms with messaging, help request, and reminder features. OBJECTIVE The aim of this paper is to describe the development of the app and the back-end infrastructure required to extract monitoring data, facilitate data exchange and ensure privacy and safety, which includes results from clinical feasibility testing. METHODS telePORT’s client user interface was developed using user-centered design principles and workflow observations. The server architecture involves network-based data extraction and data processing. Baseline user workload was assessed using step counters and communication logs. Clinical feasibility testing analyzed device usage over 11 months. RESULTS telePORT was more commonly used for help requests (approximately 4.5/day) than messaging between team members (approximately 1/day). Passive operating room monitoring was frequently utilized (34% of screen visits). Intermittent loss of wireless connectivity was a major barrier to adoption (decline of 0.3%/day). CONCLUSIONS The underlying server infrastructure was repurposed for real-time streaming of vital signs and their collection for research and quality improvement. Day-to-day activities of the anesthesia team can be supported by a mobile app that integrates real-time data from all operating rooms.

scholarly journals A Supine Achilles Tendon Repair Decreases Total Operating Room and Anesthesia Time Without Sacrificing Outcomes

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0001 ◽  
Author(s):  
David Beck ◽  
Steven Raikin ◽  
David Pedowitz ◽  
Benjamin Zmistowski
Keyword(s):  
Achilles Tendon ◽  
Operating Room ◽  
Prone Position ◽  
Supine Position ◽  
Tendon Repair ◽  
Operating Rooms ◽  
Set Up ◽  
Anesthesia Time ◽  
Room Time ◽  
Operating Room Time

Category: Ankle, Sports, Trauma Introduction/Purpose: Achilles tendon repairs have traditionally been performed using a prone position. Prone positioning gives the surgeon easy visualization of the tendon, but may not offer the safest position for anesthesia and requires more peri-operative positioning time. We propose that the use of a supine position for primary Achilles tendon repairs offers similar surgical times, while saving non-surgical operating room time during positioning and anesthesia set-up. Methods: A retrospective review of primary Achilles tendon repairs done at our institution’s surgical sites between March of 2010 and July of 2015 was performed. Using the institutional database, 145 procedures were identified. Chart review demonstrated that 82 were performed open-supine (OS), 31 were performed open-prone(OP), and 32 were performed percutaneous-prone(PP). Surgical, non-surgical, and total operating room times were compared between the three groups. Results: Average surgical times were 32.8, 49, and 32.3 minutes for the OS, OP, and PP procedures, respectively. Total operating rooms times were 59.1, 88.9, and 76.7; while non-surgical times spent in the operating rooms were 26.3, 39.9, and 44.4 minutes for these groups, respectively. Achilles tendons repaired either OP or PP resulted in an additional 13.6 and 18.1 (average 15.9) minutes of operating room time. There was not an increase in complications with the supine procedure compared to the prone procedures. Conclusion: Primary Achilles tendon repairs can be performed effectively using an open technique in a supine position, saving non-surgical operating room time without increasing complications. The supine position may also offer a safer method of providing anesthesia to these patients by allowing the anesthesiologist a more accessible airway and decreasing the risks involved with placing an intubated patient into a prone position.

scholarly journals Development and Implementation of the Portable Operating Room Tracker App With Vital Signs Streaming Infrastructure: Operational Feasibility Study

10.2196/13559 ◽  
2019 ◽  
Vol 2 (2) ◽  
pp. e13559
Author(s):  
Matthias Görges ◽  
Nicholas C West ◽  
Christian L Petersen ◽  
J Mark Ansermino
Keyword(s):  
Real Time ◽  
Operating Room ◽  
Information Exchange ◽  
Vital Signs ◽  
Operating Rooms ◽  
Mobile App ◽  
Data Availability ◽  
Major Barrier ◽  
Team Members ◽  
Feasibility Testing

Background In the perioperative environment, a multidisciplinary clinical team continually observes and evaluates patient information. However, data availability may be restricted to certain locations, cognitive workload may be high, and team communication may be constrained by availability and priorities. We developed the remote Portable Operating Room Tracker app (the telePORT app) to improve information exchange and communication between anesthesia team members. The telePORT app combines a real-time feed of waveforms and vital signs from the operating rooms with messaging, help request, and reminder features. Objective The aim of this paper is to describe the development of the app and the back-end infrastructure required to extract monitoring data, facilitate data exchange and ensure privacy and safety, which includes results from clinical feasibility testing. Methods telePORT’s client user interface was developed using user-centered design principles and workflow observations. The server architecture involves network-based data extraction and data processing. Baseline user workload was assessed using step counters and communication logs. Clinical feasibility testing analyzed device usage over 11 months. Results telePORT was more commonly used for help requests (approximately 4.5/day) than messaging between team members (approximately 1/day). Passive operating room monitoring was frequently utilized (34% of screen visits). Intermittent loss of wireless connectivity was a major barrier to adoption (decline of 0.3%/day). Conclusions The underlying server infrastructure was repurposed for real-time streaming of vital signs and their collection for research and quality improvement. Day-to-day activities of the anesthesia team can be supported by a mobile app that integrates real-time data from all operating rooms.

DEVELOPMENT OF MULTIPLEX REAL-TIME PCR ASSAY FOR SIX PATHOGENS: RAPID TOOL FOR DIAGNOSIS OF BACTERIAL MENINGITIS

2019 ◽  
pp. 60-66
Author(s):  
Viet Quynh Tram Ngo ◽  
Thi Ti Na Nguyen ◽  
Hoang Bach Nguyen ◽  
Thi Tuyet Ngoc Tran ◽  
Thi Nam Lien Nguyen ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Real Time ◽  
Real Time Pcr ◽  
Diagnostic Methods ◽  
Type B ◽  
E Coli ◽  
Pcr Assays ◽  
Set Up ◽  
Etiological Agents ◽  
Suis Serotype

Introduction: Bacterial meningitis is an acute central nervous infection with high mortality or permanent neurological sequelae if remained undiagnosed. However, traditional diagnostic methods for bacterial meningitis pose challenge in prompt and precise identification of causative agents. Aims: The present study will therefore aim to set up in-house PCR assays for diagnosis of six pathogens causing the disease including H. influenzae type b, S. pneumoniae, N. meningitidis, S. suis serotype 2, E. coli and S. aureus. Methods: inhouse PCR assays for detecting six above-mentioned bacteria were optimized after specific pairs of primers and probes collected from the reliable literature resources and then were performed for cerebrospinal fluid (CSF) samples from patients with suspected meningitis in Hue Hospitals. Results: The set of four PCR assays was developed including a multiplex real-time PCR for S. suis serotype 2, H. influenzae type b and N. meningitides; three monoplex real-time PCRs for E. coli, S. aureus and S. pneumoniae. Application of the in-house PCRs for 116 CSF samples, the results indicated that 48 (39.7%) cases were positive with S. suis serotype 2; one case was positive with H. influenzae type b; 4 cases were positive with E. coli; pneumococcal meningitis were 19 (16.4%) cases, meningitis with S. aureus and N. meningitidis were not observed in any CSF samples in this study. Conclusion: our in-house real-time PCR assays are rapid, sensitive and specific tools for routine diagnosis to detect six mentioned above meningitis etiological agents. Key words: Bacterial meningitis, etiological agents, multiplex real-time PCR

scholarly journals Implementation of a deep learning model for automated classification of Aedes aegypti (Linnaeus) and Aedes albopictus (Skuse) in real time

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Song-Quan Ong ◽  
Hamdan Ahmad ◽  
Gomesh Nair ◽  
Pradeep Isawasan ◽  
Abdul Hafiz Ab Majid
Keyword(s):  
Deep Learning ◽  
Aedes Aegypti ◽  
Real Time ◽  
Aedes Albopictus ◽  
Automated Classification ◽  
Expert Performance ◽  
Deep Convolutional Neural Networks ◽  
Significant Difference ◽  
Set Up

AbstractClassification of Aedes aegypti (Linnaeus) and Aedes albopictus (Skuse) by humans remains challenging. We proposed a highly accessible method to develop a deep learning (DL) model and implement the model for mosquito image classification by using hardware that could regulate the development process. In particular, we constructed a dataset with 4120 images of Aedes mosquitoes that were older than 12 days old and had common morphological features that disappeared, and we illustrated how to set up supervised deep convolutional neural networks (DCNNs) with hyperparameter adjustment. The model application was first conducted by deploying the model externally in real time on three different generations of mosquitoes, and the accuracy was compared with human expert performance. Our results showed that both the learning rate and epochs significantly affected the accuracy, and the best-performing hyperparameters achieved an accuracy of more than 98% at classifying mosquitoes, which showed no significant difference from human-level performance. We demonstrated the feasibility of the method to construct a model with the DCNN when deployed externally on mosquitoes in real time.

scholarly journals Operational Research to Assess the Real-Time Impact of COVID-19 on TB and HIV Services: The Experience and Response from Health Facilities in Harare, Zimbabwe

2021 ◽  
Vol 6 (2) ◽  
pp. 94
Author(s):  
Pruthu Thekkur ◽  
Kudakwashe C. Takarinda ◽  
Collins Timire ◽  
Charles Sandy ◽  
Tsitsi Apollo ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Treatment Outcomes ◽  
Real Time ◽  
Treatment Success ◽  
Health Facilities ◽  
Case Detection ◽  
Monthly Data ◽  
Hiv Services ◽  
Tb Treatment ◽  
Set Up

When COVID-19 was declared a pandemic, there was concern that TB and HIV services in Zimbabwe would be severely affected. We set up real-time monthly surveillance of TB and HIV activities in 10 health facilities in Harare to capture trends in TB case detection, TB treatment outcomes and HIV testing and use these data to facilitate corrective action. Aggregate data were collected monthly during the COVID-19 period (March 2020–February 2021) using EpiCollect5 and compared with monthly data extracted for the pre-COVID-19 period (March 2019–February 2020). Monthly reports were sent to program directors. During the COVID-19 period, there was a decrease in persons with presumptive pulmonary TB (40.6%), in patients registered for TB treatment (33.7%) and in individuals tested for HIV (62.8%). The HIV testing decline improved in the second 6 months of the COVID-19 period. However, TB case finding deteriorated further, associated with expiry of diagnostic reagents. During the COVID-19 period, TB treatment success decreased from 80.9 to 69.3%, and referral of HIV-positive persons to antiretroviral therapy decreased from 95.7 to 91.7%. Declining trends in TB and HIV case detection and TB treatment outcomes were not fully redressed despite real-time monthly surveillance. More support is needed to transform this useful information into action.

scholarly journals Design Opportunities to Reduce Waste in Operating Rooms

2021 ◽  
Vol 13 (4) ◽  
pp. 2207
Author(s):  
Charlotte Harding ◽  
Joren Van Loon ◽  
Ingrid Moons ◽  
Gunter De Win ◽  
Els Du Bois
Keyword(s):  
Operating Room ◽  
Circular Economy ◽  
Operating Rooms ◽  
Medical Waste ◽  
Waste Reduction ◽  
Infrastructure Management ◽  
Expert Interviews ◽  
Hospital Waste ◽  
Observation Results ◽  
Taking Care

While taking care of the population’s health, hospitals generate mountains of waste, which in turn causes a hazard to the environment of the population. The operating room is responsible for a disproportionately big amount of hospital waste. This research aims to investigate waste creation in the operating room in order to identify design opportunities to support waste reduction according to the circular economy. Eight observations and five expert interviews were conducted in a large sized hospital. The hospital’s waste infrastructure, management, and sterilization department were mapped out. Findings are that washable towels and operation instruments are reused; paper, cardboard, and specific fabric are being recycled; and (non-)hazardous medical waste is being incinerated. Observation results and literature findings are largely comparable, stating that covering sheets of the operation bed, sterile clothing, sterile packaging, and department-specific products are as well the most used and discarded. The research also identified two waste hotspots: the logistical packaging (tertiary, secondary, and primary) of products and incorrect sorting between hazardous and non-hazardous medical waste. Design opportunities include optimization of recycling and increased use of reusables. Reuse is the preferred method, more specifically by exploring the possibilities of reuse of textiles, consumables, and packaging.

scholarly journals Real time surveillance of COVID-19 space and time clusters during the summer 2020 in Spain

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nicolás Rosillo ◽  
Javier Del-Águila-Mejía ◽  
Ayelén Rojas-Benedicto ◽  
María Guerrero-Vadillo ◽  
Marina Peñuelas ◽  
...  
Keyword(s):  
Real Time ◽  
Scan Statistic ◽  
Cluster Aggregation ◽  
Space And Time ◽  
Spatial Trends ◽  
Community Transmission ◽  
Low Incidence ◽  
Set Up ◽  
And Control ◽  
Time Scan

Abstract Background On June 21st de-escalation measures and state-of-alarm ended in Spain after the COVID-19 first wave. New surveillance and control strategy was set up to detect emerging outbreaks. Aim To detect and describe the evolution of COVID-19 clusters and cases during the 2020 summer in Spain. Methods A near-real time surveillance system to detect active clusters of COVID-19 was developed based on Kulldorf’s prospective space-time scan statistic (STSS) to detect daily emerging active clusters. Results Analyses were performed daily during the summer 2020 (June 21st – August 31st) in Spain, showing an increase of active clusters and municipalities affected. Spread happened in the study period from a few, low-cases, regional-located clusters in June to a nationwide distribution of bigger clusters encompassing a higher average number of municipalities and total cases by end-August. Conclusion STSS-based surveillance of COVID-19 can be of utility in a low-incidence scenario to help tackle emerging outbreaks that could potentially drive a widespread transmission. If that happens, spatial trends and disease distribution can be followed with this method. Finally, cluster aggregation in space and time, as observed in our results, could suggest the occurrence of community transmission.

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