Preliminary clinical trial in percutaneous nephrolithotomy using a real-time navigation system for percutaneous kidney access

Background: Precise needle puncture of renal calyces is a challenging and essential step for successful percutaneous nephrolithotomy. This work tests and evaluates, through a clinical trial, a real-time navigation system to plan and guide percutaneous kidney puncture. Methods: A novel system, entitled i3DPuncture, was developed to aid surgeons in establishing the desired puncture site and the best virtual puncture trajectory, by gathering and processing data from a tracked needle with optical passive markers. In order to navigate and superimpose the needle to a preoperative volume, the patient, 3D image data and tracker system were previously registered intraoperatively using seven points that were strategically chosen based on rigid bone structures and nearby kidney area. In addition, relevant anatomical structures for surgical navigation were automatically segmented using a multi-organ segmentation algorithm that clusters volumes based on statistical properties and minimum description length criterion. For each cluster, a rendering transfer function enhanced the visualization of different organs and surrounding tissues. Results: One puncture attempt was sufficient to achieve a successful kidney puncture. The puncture took 265 seconds, and 32 seconds were necessary to plan the puncture trajectory. The virtual puncture path was followed correctively until the needle tip reached the desired kidney calyceal. Conclusions: This new solution provided spatial information regarding the needle inside the body and the possibility to visualize surrounding organs. It may offer a promising and innovative solution for percutaneous punctures.

A Travel Optimization System for Academic Environments

Carpooling initiated in America in the 1970s due to the oil crisis. However, over the past years, carpooling has increased significantly across the world. Some countries have created a High Occupancy Vehicle (HOV) lane to encourage commuters not to travel alone. In additional, carpool websites has been developed to facilitate the connection between the commuters, making it possible to create a compatible match in a faster and efficient manner. This project focuses on carpooling, especially in an academic environment since younger people are more likely to choose carpool. Initially, an intense research was made to examine carpool studies that occurred all over the world, following with a research of higher education institutes that use carpooling as a transportation mode. Most websites created carpools by targeting people from a specific country. These commuters have different origins and destinations making it more complicated to create compatible matches. The objective of this project is to develop a system helping teachers and students from an academic environment to create carpool matches. This objective makes it easier to create carpools because these students and teachers have the same destination. During the research, it was essential to explore, as many as possible, existing carpool websites that are available across the world. After this analysis, several sketches were made to develop the layout and structure of the web application that’s being implemented throughout the project. Once the layout was established, the development of the web application was initiated. This project had its ups and downs but it accomplished all the necessary requirements. This project can be accessed on the link: http://ipcacarpool.somee.com. Once the website was up and running, a web-based survey was developed to study the reasons that motivate people to consider carpooling as an alternative to driving alone. To develop this survey was used a tool called Survey Planet. This survey contained 408 respondents, which 391 are students and 17 are teachers. This study concludes that a majority of the respondents don’t carpool, however they will consider carpooling if there was a dedicated parking space. A majority of the respondents that carpool initiated less than a year ago, indicating that this mean of transportation is recent.

IMI: ELES COMEM TUDO E NÃO DEIXAM NADA

O IMI é aliás, em si mesmo, um imposto profundamente injusto. A sua aplicação constitui, em muitos casos, uma situação de Abuso do Direito, art. 334º do Código Civil. A sua concretização implica uma violação do fim económico e social da própria Justiça no Direito. O sistema fiscal não objectiva apenas as necessidades financeiras do Estado e doutras entidades públicas, mas também, e sobretudo uma repartição justa dos rendimentos e da riqueza: art. 103º da Constituição. É claro que, para isso, tem que existir também um controlo rigoroso e honesto da gestão e da distribuição constitucional dos dinheiros públicos. § IMI is indeed in itself a profoundly unfair tax. Its use is in many cases a right Abuse situation art. 334 of the Civil Code. Its implementation involves a violation of economic and social justice at the end of its law. The tax system does not seek only the financial needs of the state and of other public authorities, but also and especially a fair distribution of income and wealth: art. 103 of the Constitution. Of course, for this, it must also be a rigorous and honest control of the constitutional management and distribution of public funds.

A-scan ultrasound system for real-time puncture safety assessment during percutaneous nephrolithotomy

Background: Kidney stone is a major universal health problem, affecting 10% of the population worldwide. Percutaneous nephrolithotomy is a first-line and established procedure for disintegration and removal of renal stones. Its surgical success depends on the precise needle puncture of renal calyces, which remains the most challenging task for surgeons. This work describes and tests a new ultrasound based system to alert the surgeon when undesirable anatomical structures are in between the puncture path defined through a tracked needle. Methods: Two circular ultrasound transducers were built with a single 3.3-MHz piezoelectric ceramic PZT SN8, 25.4 mm of radius and resin-epoxy matching and backing layers. One matching layer was designed with a concave curvature to work as an acoustic lens with long focusing. The A-scan signals were filtered and processed to automatically detect reflected echoes. Results: The transducers were mapped in water tank and tested in a study involving 45 phantoms. Each phantom mimics different needle insertion trajectories with a percutaneous path length between 80 and 150 mm. Results showed that the beam cross-sectional area oscillates around the ceramics radius and it was possible to automatically detect echo signals in phantoms with length higher than 80 mm. Conclusions: This new solution may alert the surgeon about anatomical tissues changes during needle insertion, which may decrease the need of X-Ray radiation exposure and ultrasound image evaluation during percutaneous puncture.

IDEA MANAGEMENT SYSTEM - AN ESSENTIAL COMPONENT IN THE CONTINUOUS IMPROVEMENT OF QUALITY AND INNOVATION

It is known the power of ideas is tremendous. But there are employees in many companies who have good ideas but not put them into practice. On the other hand, there are many others who have good ideas and are encouraged to contribute their ideas for innovation in the company. This study attempts to identify factors that contribute to success in managing ideas and consequent business innovation. The method used was the case study applied to two companies. During the investigation, factors considered essential for the success of an idea management program were identified, of which we highlight, among others, evidences the results, involvement of the top management, establishment of goals and objectives; recognition; dissemination of good results. Companies with these implemented systems, capture the best ideas from their collaborators and apply them internally. This study intends to contribute to business innovation in enterprises through creation and idea management, mainly through collecting the best ideas of their own employees. The results of this study can be used to help improving deployed suggestions systems, as well as, all managers who wish to implement suggestions systems/ideas management systems.