742 resultados para Portland and Oxford Central Railroad Company.
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[Michigan Alumnus caption: "A Football Adjunct. Special trains line up on Ann Arbor Railroad sidings near Stadium"]
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Cover title.
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Mode of access: Internet.
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Mode of access: Internet.
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Mode of access: Internet.
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Mode of access: Internet.
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Description based on: 13th (1876).
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Mode of access: Internet.
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Cover title (on mounted label): Observations on the overland communication with India.
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Guest editors' introduction
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There is a great deal of literature about the initial stages of innovative design. This is the process whereby a completely new product is conceived, invented and developed. In industry, however, the continuing success of a company is more often achieved by improving or developing existing designs to maintain their marketability. Unfortunately, this process of design by evolution is less well documented. This thesis reports the way in which this process was improved for the sponsoring company. The improvements were achieved by implementing a new form of computer aided design (C.A.D.) system. The advent of this system enabled the company to both shorten the design and development time and also to review the principles underlying the existing design procedures. C.A.D. was a new venture for the company and care had to be taken to ensure that the new procedures were compatible with the existing design office environment. In particular, they had to be acceptable to the design office staff. The C.A.D. system produced guides the designer from the draft specification to the first prototype layout. The computer presents the consequences of the designer's decisions clearly and fully, often by producing charts and sketches. The C.A.D. system and the necessary peripheral facilities were implemented, monitored and maintained. The system structure was left sufficiently flexible for maintenance to be undertaken quickly and effectively. The problems encountered during implementation are well documented in this thesis.
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Introduction: We have adapted the existing , optometry diabetic retinopathy screening pathway and software , so that it can be used for wet AMD fast track referral. Purpose: To compare the conventional, optometry wet AMD fast track referral service using FAX transmission, with a teleophthalmology service using colour fundus photography transmitted to a central retinal grading centre. Method: 40 optometry practices involved in diabetic retinopathy screening were enrolled and had modified computer software installed. Referrals were made by conventional fast track FAX to the macular clinic, and patients were photographed by the optometrist and images transmitted to a central grading centre Results of the two pathways were compared in terms of 1)speed of diagnosis and 2)sensitivity and specificity of diagnosis of wet AMD. Results: Over a ten month period, 62 consecutive patients were referred. The mean time for conventional pathway was 20.8 days (range 3-34),and for new teleophthalmology pathway was 6.9 days (range 1-13). Sensitivity of technician grading of images was 96%, Specificity 53%, and consultant ophthalmologist was sensitivity 96%, specificiity 87%. The technician showed a learning effect with specificity increasing from 30.7% for first 31 patient cohort, to 70.6% for the second cohort. One patient had images that could not be graded. Conclusion: Rapid referral of wet AMD cases by optometrists using modified diabetic retinopathy screening software, allows fast and accurate diagnosis, and may reduce unnecessary referrals. Retinal grading technicians can be trained to grade wet AMD images.