scholarly journals Development of a High-Fidelity, 3D Printed Otoplasty Surgical Simulator

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Chelsey Wallace, M.S. ◽  
Zahra Nourmohammadi, Ph.D. ◽  
David A. Zopf, M.D., M.S.
Keyword(s):  
Surgical Simulation ◽  
Low Cost ◽  
Cost Effective ◽  
Occurrence Rate ◽  
Surgical Simulator ◽  
Risk Environment ◽  
Surgical Simulators ◽  
Protruding Ears ◽  
Surgical Trainees ◽  
Ear Cartilage

Background and Hypothesis: Protruding ears, also known as prominauris, are prevalent worldwide at an occurrence rate of about 5%. Children with prominauris report lower self-esteem and experience increased teasing and social isolation at school. From a functional standpoint, protruding ears can make wearing prescription glasses difficult. This increased stress and anxiety and impaired functionality lead children and families to seek treatment. One of the most effective treatments for protruding ears is otoplasty. This procedure involves an incision in the back of the ear and the placement of non-resorbable sutures to reform the ear. Alternatively, the procedure can be performed using an incisionless technique. As this is an elective procedure done commonly in children, adequate education of medical trainees is critical to ensure the proper level of skill is attained and patient satisfaction is maximized. Currently, teaching otoplasty is done with cadavers and supervised procedures with an attending. Surgical simulators are employed in the instruction of a variety of surgical procedures and allow residents to practice in a zero-risk environment. In addition, 3D printing has facilitated the development of surgical simulators allowing for a more cost-effective, consistent, and anatomically correct simulator. We developed an ear model made from silicone for trainees to practice traditional and incisionless otoplasty. Project Methods: The otoplasty surgical simulator was developed by isolating an ear from a computed-tomography scan in the Materialise software to create a 3D model. This model was then altered to create a negative mold. The mold was printed using fusion deposition printing with 1.75 MM polylactic acid filament. After printing, the mold was filled with Dragon Skin Silicone Shore 20 to simulate ear cartilage. The model was then coated in a layer of Dragon Skin Silicone Shore 10 to simulate a layer of skin. Conclusion and Potential Impact: This otoplasty simulator will next be validated by expert surgeons and then used in a surgical simulation workshop for surgical trainees. Because of the low-cost of the surgical simulator and the ease of manufacturing, this simulator can also be used to train surgeons abroad where access to surgical training may not be readily available. 

Development of a Cost-Effective Surgical Headlight Using Consumer Light Emitting Diode Lighting and 3D Printing

2021 ◽  
pp. 155335062199776
Author(s):  
Deven K. Gupta ◽  
Lily Chen ◽  
Andrew E. Heidari ◽  
Steven Chau ◽  
Brandyn Dunn ◽  
...  
Keyword(s):  
Light Emitting Diode ◽  
Low Cost ◽  
Cost Effective ◽  
Technical Solution ◽  
Light Emitting ◽  
Exit Survey ◽  
Surgical Residents ◽  
Surgical Trainees ◽  
Time Required ◽  
Simulation Task

Need. Battery-powered Light Emitting Diode (LED) surgical headlights are necessary for improved intraoperative illumination but may be costly. Technical Solution. The objective of this study was to develop a low-cost surgical headlight using a consumer-grade LED headlight and 3D-printed mount. Proof of Concept. Eighteen surgical residents performed simulation exercises that mimicked suturing in the oral cavity using both a custom prototype headlight and a commercial surgical headlight. The time required to complete the task with each headlight was recorded along with an exit survey. A second device was created based on the critiques of the first device and was tested by ten additional surgical trainees. Surgical residents completed the simulation task in 27 ± 8.6 seconds and 21 ± 5.6 seconds with the commercially available headlight and first prototype, respectively. In the second experiment, the simulation task was completed in 23 ± 11.1 and 23 ± 12.2 seconds with the commercially available headlight and second device, respectively. Survey results showed an overall positive consensus, with critiques about headband security, suggestions for smaller LED chassis, and a more robust mounting bracket. Some preferred the prototype headlight due to the wider field of illumination compared to the commercially available unit (ie, beam spread/beam angle). Next Steps. Future adjustments are required to optimize the location of the headlight and the battery to modify the weight distribution of the device. Conclusion. These findings demonstrate that our prototype models are viable alternatives to conventional surgical headlights and warrant continued optimization for broader adoption by surgeons and trainees for whom higher-cost alternatives are not an option.

scholarly journals New Age Teaching: Beyond Didactics

2006 ◽  
Vol 6 ◽  
pp. 2370-2380 ◽  
Author(s):  
Peter D. Vlaovic ◽  
Elspeth M. McDougall
Keyword(s):  
Operating Room ◽  
Surgical Simulation ◽  
Public Awareness ◽  
Skills Training ◽  
Surgical Skills ◽  
Surgical Simulators ◽  
Surgical Trainees ◽  
Surgical Skills Training ◽  
Increasing Demand

Widespread acceptance of laparoscopic urology techniques has posed many challenges to training urology residents and allowing postgraduate urologists to acquire often difficult new surgical skills. Several factors in surgical training programs are limiting the ability to train residents in the operating room, including limited-hours work weeks, increasing demand for operating room productivity, and general public awareness of medical errors. As such, surgical simulation may provide an opportunity to enhance residency experience and training, and optimize post-graduate acquisition of new skills and maintenance of competency. This review article explains and defines the various levels of validity as it pertains to surgical simulators. The most recently and comprehensively validity tested simulators are outlined and summarized. The potential role of surgical simulation in the formative and summative assessment of surgical trainees, as well as, the certification and recertification process of postgraduate surgeons will be delineated. Surgical simulation will be an important adjunct to the traditional methods of surgical skills training and will allow surgeons to maintain their proficiency in the technically challenging aspects of minimally invasive urologic surgery.

Multicenter Advanced Pediatric Otolaryngology Fellowship Prep Surgical Simulation Course with 3D Printed High-Fidelity Models

2020 ◽  
Vol 162 (5) ◽  
pp. 658-665
Author(s):  
Brian Chang ◽  
Allison Powell ◽  
Susan Ellsperman ◽  
Daniel Wehrmann ◽  
April Landry ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Course Design ◽  
Surgical Simulation ◽  
High Fidelity ◽  
Risk Environment ◽  
Contract Research Organization ◽  
Surgical Simulators ◽  
Pediatric Otolaryngology ◽  
Cleft Lip Palate ◽  
3D Printed

Objective To assess the effect of 3-dimensional (3D)–printed surgical simulators used in an advanced pediatric otolaryngology fellowship preparatory course on trainee education. Study Design Quasi-experimental pre/postsurvey. Setting Multicenter collaborative course conducted at a contract research organization prior to a national conference. Subjects and Methods A 5-station, 7-simulator prep course was piloted for 9 pediatric otolaryngology fellows and 17 otolaryngology senior residents, with simulators for airway graft carving, microtia ear framework carving, and cleft lip/palate repair. Prior to the course, trainees were provided educational materials electronically along with presurveys rating confidence, expertise, and attitude around surgical simulators. In October 2018, surgeons engaged in simulation stations with direction from 2 attending faculty per station, then completed postsurveys for each simulator. Results Statistically significant increases ( P < .05) in self-reported confidence (average, 53%; range, 18%-80%) and expertise (average, 68%; range, 9%-95%) were seen across all simulators, corresponding to medium to large effect sizes as measured by Cohen’s d statistic (0.41-1.71). Positive attitudes around 3D printing in surgical education also demonstrated statistically significant increases (average, 10%; range, 8%-13%). Trainees commented positively on gaining such broad exposure, although consistently indicated a preference for more practice time during the course. Conclusion We demonstrate the benefit of high-fidelity, 3D-printed simulators in exposing trainees to advanced procedures, allowing them hands-on practice in a zero-risk environment. In the future, we hope to refine this course design, develop standardized tools to assess their educational value, and explore opportunities for integration into use in milestone assessment and accreditation.

ASSESSMENT OF THE PLATELET COUNT IN THE PREGNANT WOMEN IN IGIMS, PATNA, BIHAR

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Tanwi Singh ◽  
Anshuman Sinha
Keyword(s):  
Platelet Count ◽  
Pregnant Women ◽  
Screening Test ◽  
Low Cost ◽  
Medical Science ◽  
Cost Effective ◽  
Platelet Indices ◽  
Increased Risk ◽  
Low Platelet Count ◽  
Severity Of The Disease

The major risk associated with low platelet count in pregnancy is the increased risk of bleeding during the childbirth or post that. There is an increased blood supply to the uterus during pregnancy and the surgical procedure requires cutting of major blood vessels. Women with thrombocytopenia are at increased risk of losing excessive blood. The risk is more in case of caesarean delivery as compared to vaginal delivery. Hence based on above findings the present study was planned for Assessment of the Platelet Count in the Pregnant Women in IGIMS, Patna, Bihar. The present study was planned in Department of Pathology, Indira Gandhi Institute of Medical Science, Patna, Bihar, India. The present study was planned from duration of January 2019 to June 2019. In the present study 200 pregnant females samples received for the platelet estimation were enrolled in the present study. Clinically platelet indices can be a useful screening test for early identification of preeclampsia and eclampsia. Also platelet indices can assess the prognosis of this disease in pregnant women and can be used as an effective prognostic marker because it correlates with severity of the disease. Platelet count is a simple, low cost, and rapid routine screening test. Hence the data generated from the present study concludes that platelet count can be used as a simple and cost effective tool to monitor the progression of preeclampsia, thereby preventing complications to develop during the gestational period. Keywords: Platelet Count, Pregnant Women, IGIMS, Patna, Bihar, etc.

Janus – A New Approach to Air Combat Pilot Training

2019 ◽  
Vol 2019 (4) ◽  
pp. 7-22
Author(s):  
Georges Bridel ◽  
Zdobyslaw Goraj ◽  
Lukasz Kiszkowiak ◽  
Jean-Georges Brévot ◽  
Jean-Pierre Devaux ◽  
...  
Keyword(s):  
Low Cost ◽  
Cost Effective ◽  
High Energy ◽  
Training System ◽  
Embedded Sensors ◽  
Pilot Training ◽  
New Approach ◽  
Combat Aircraft ◽  
Air Combat ◽  
The Cost

Abstract Advanced jet training still relies on old concepts and solutions that are no longer efficient when considering the current and forthcoming changes in air combat. The cost of those old solutions to develop and maintain combat pilot skills are important, adding even more constraints to the training limitations. The requirement of having a trainer aircraft able to perform also light combat aircraft operational mission is adding unnecessary complexity and cost without any real operational advantages to air combat mission training. Thanks to emerging technologies, the JANUS project will study the feasibility of a brand-new concept of agile manoeuvrable training aircraft and an integrated training system, able to provide a live, virtual and constructive environment. The JANUS concept is based on a lightweight, low-cost, high energy aircraft associated to a ground based Integrated Training System providing simulated and emulated signals, simulated and real opponents, combined with real-time feedback on pilot’s physiological characteristics: traditionally embedded sensors are replaced with emulated signals, simulated opponents are proposed to the pilot, enabling out of sight engagement. JANUS is also providing new cost effective and more realistic solutions for “Red air aircraft” missions, organised in so-called “Aggressor Squadrons”.

Motivating Compliance: Firm Response to Mandatory Disclosure Policies

2018 ◽  
Vol 32 (2) ◽  
pp. 103-119
Author(s):  
Colleen M. Boland ◽  
Chris E. Hogan ◽  
Marilyn F. Johnson
Keyword(s):  
Conflict Of Interest ◽  
Low Cost ◽  
Cost Effective ◽  
Data Availability ◽  
Policy Adoption ◽  
Future Research ◽  
Regulated Firms ◽  
Firm Response ◽  
Disclosure Rules ◽  
The Impact

SYNOPSIS Mandatory existence disclosure rules require an organization to disclose a policy's existence, but not its content. We examine policy adoption frequencies in the year immediately after the IRS required mandatory existence disclosure by nonprofits of various governance policies. We also examine adoption frequencies in the year of the subsequent change from mandatory existence disclosure to a disclose-and-explain regime that required supplemental disclosures about the content and implementation of conflict of interest policies. Our results suggest that in areas where there is unclear regulatory authority, mandatory existence disclosure is an effective and low cost regulatory device for encouraging the adoption of policies desired by regulators, provided those policies are cost-effective for regulated firms to implement. In addition, we find that disclose-and-explain regulatory regimes provide stronger incentives for policy adoption than do mandatory existence disclosure regimes and also discourage “check the box” behavior. Future research should examine the impact of mandatory existence disclosure rules in the year that the regulation is implemented. Data Availability: Data are available from sources cited in the text.

Azo (Hydrazone) pigments: general principles

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Robert Christie
Keyword(s):  
High Performance ◽  
Metal Salt ◽  
Low Cost ◽  
Cost Effective ◽  
Precipitation Process ◽  
Ambient Temperatures ◽  
Technical Performance ◽  
Chemical Structures ◽  
General Chemical ◽  
Physical Form

Abstract This paper presents an overview of the general chemical principles underlying the structures, synthesis and technical performance of azo pigments, the dominant chemical class of industrial organic pigments in the yellow, orange, and red shade areas, both numerically and in terms of tonnage manufactured. A description of the most significant historical features in this group of pigments is provided, starting from the discovery of the chemistry on which azo colorants are based by Griess in the mid-nineteenth century, through the commercial introduction of the most important classical azo pigments in the early twentieth century, including products known as the Hansa Yellows, β-naphthol reds, including metal salt pigments, and the diarylide yellows and oranges, to the development in the 1950s and 1960s of two classes of azo pigments that exhibit high performance, disazo condensation pigments and benzimidazolone-based azo pigments. A feature that complicates the description of the chemical structures of azo pigments is that they exist in the solid state as the ketohydrazone rather than the hydroxyazo form, in which they have been traditionally been illustrated. Numerous structural studies conducted over the years on an extensive range of azo pigments have demonstrated this feature. In this text, they are referred to throughout as azo (hydrazone) pigments. Since a common synthetic procedure is used in the manufacture of virtually all azo (hydrazone) pigments, this is discussed in some detail, including practical aspects. The procedure brings together two organic components as the fundamental starting materials, a diazo component and a coupling component. An important reason for the dominance of azo (hydrazone) pigments is that they are highly cost-effective. The syntheses generally involve low cost, commodity organic starting materials and are carried out in water as the reaction solvent, which offers obvious economic and environmental advantages. The versatility of the approach means that an immense number of products may be prepared, so that they have been adapted structurally to meet the requirements of many applications. On an industrial scale, the processes are straightforward, making use of simple, multi-purpose chemical plant. Azo pigments may be produced in virtually quantitative yields and the processes are carried out at or below ambient temperatures, thus presenting low energy requirements. Finally, provided that careful control of the reaction conditions is maintained, azo pigments may be prepared directly by an aqueous precipitation process that can optimise physical form, with control of particle size distribution, crystalline structure, and surface character. The applications of azo pigments are outlined, with more detail reserved for subsequent papers on individual products.

scholarly journals Chemical Modification of Combusted Coal Gangue for U(VI) Adsorption: Towards a Waste Control by Waste Strategy

2021 ◽  
Vol 13 (15) ◽  
pp. 8421
Author(s):  
Yuan Gao ◽  
Jiandong Huang ◽  
Meng Li ◽  
Zhongran Dai ◽  
Rongli Jiang ◽  
...  
Keyword(s):  
Structural Analysis ◽  
High Efficiency ◽  
Low Cost ◽  
Chemical Activation ◽  
Cost Effective ◽  
Coal Gangue ◽  
Order Kinetic ◽  
Practical Applications ◽  
Detailed Structural Analysis ◽  
Alkaline Conditions

Uranium mining waste causes serious radiation-related health and environmental problems. This has encouraged efforts toward U(VI) removal with low cost and high efficiency. Typical uranium adsorbents, such as polymers, geopolymers, zeolites, and MOFs, and their associated high costs limit their practical applications. In this regard, this work found that the natural combusted coal gangue (CCG) could be a potential precursor of cheap sorbents to eliminate U(VI). The removal efficiency was modulated by chemical activation under acid and alkaline conditions, obtaining HCG (CCG activated with HCl) and KCG (CCG activated with KOH), respectively. The detailed structural analysis uncovered that those natural mineral substances, including quartz and kaolinite, were the main components in CCG and HCG. One of the key findings was that kalsilite formed in KCG under a mild synthetic condition can conspicuous enhance the affinity towards U(VI). The best equilibrium adsorption capacity with KCG was observed to be 140 mg/g under pH 6 within 120 min, following a pseudo-second-order kinetic model. To understand the improved adsorption performance, an adsorption mechanism was proposed by evaluating the pH of uranyl solutions, adsorbent dosage, as well as contact time. Combining with the structural analysis, this revealed that the uranyl adsorption process was mainly governed by chemisorption. This study gave rise to a utilization approach for CCG to obtain cost-effective adsorbents and paved a novel way towards eliminating uranium by a waste control by waste strategy.

scholarly journals Platforms for Production of Protein-Based Vaccines: From Classical to Next-Generation Strategies

Biomolecules ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1072
Author(s):  
Raquel Cid ◽  
Jorge Bolívar
Keyword(s):  
Infectious Diseases ◽  
Mammalian Cells ◽  
Vaccine Development ◽  
Low Cost ◽  
Cost Effective ◽  
Insect Larvae ◽  
Subunit Vaccines ◽  
Effective Strategies ◽  
Alternative Systems ◽  
Inactivated Vaccines

To date, vaccination has become one of the most effective strategies to control and reduce infectious diseases, preventing millions of deaths worldwide. The earliest vaccines were developed as live-attenuated or inactivated pathogens, and, although they still represent the most extended human vaccine types, they also face some issues, such as the potential to revert to a pathogenic form of live-attenuated formulations or the weaker immune response associated with inactivated vaccines. Advances in genetic engineering have enabled improvements in vaccine design and strategies, such as recombinant subunit vaccines, have emerged, expanding the number of diseases that can be prevented. Moreover, antigen display systems such as VLPs or those designed by nanotechnology have improved the efficacy of subunit vaccines. Platforms for the production of recombinant vaccines have also evolved from the first hosts, Escherichia coli and Saccharomyces cerevisiae, to insect or mammalian cells. Traditional bacterial and yeast systems have been improved by engineering and new systems based on plants or insect larvae have emerged as alternative, low-cost platforms. Vaccine development is still time-consuming and costly, and alternative systems that can offer cost-effective and faster processes are demanding to address infectious diseases that still do not have a treatment and to face possible future pandemics.

scholarly journals Design Considerations and Selection of Cost-Effective Switched Reluctance Drive for Radiator Cooling Fans

Electronics ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 917
Author(s):  
Ickjin Son ◽  
Grace Firsta Lukman ◽  
Mazahir Hussain Shah ◽  
Kwang-Il Jeong ◽  
Jin-Woo Ahn
Keyword(s):  
Low Cost ◽  
Cost Effective ◽  
Magnetic Characteristics ◽  
Switched Reluctance Motors ◽  
Switched Reluctance ◽  
Design Considerations ◽  
Cooling Fan ◽  
Cooling Fans ◽  
Power Switches ◽  
Selection Of

Switched reluctance motors (SRMs) are simple in structure, easy to manufacture, magnet-less, brushless, and highly robust compared to other AC motors which makes them a good option for applications that operate in harsh environment. However, the motor has non-linear magnetic characteristics, and it comes with various pole-phase combinations and circuit topologies that causes many difficulties in deciding on which type to choose. In this paper, the viability of SRM as a low-cost, rugged machine for vehicle radiator cooling fan is considered. First, necessary design considerations are presented, then three commonly use types of SRM are analyzed: A 3-phase 6/4, 3-phase 12/8, and a 4-phase 8/6 to find their static and dynamic characteristics so the most suitable type can be selected. Simulation results show that the 8/6 SRM produces the highest efficiency with less phase current which reduces the converter burden. However, with asymmetric half bridge converter, eight power switches are required for 8/6 SRM and thus put a burden on the overall drive cost. As a solution, the Miller converter with only six switches for four phase SRM. To verify the proposed idea, the 8/6 SRM was manufactured and tested. The results show that Miller converter can be used for the proposed SRM with slightly reduced efficiency at 80.4%.

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