A novel detection method for determining a surgeon's fatigue and hand tremor

The thesis presents new methodology and algorithms that can be used to analyse and measure the hand tremor and fatigue of surgeons while performing surgery. This will assist them in deriving useful information about their fatigue levels, and make them aware of the changes in their tool point accuracies. This thesis proposes that muscular changes of surgeons, which occur through a day of operating, can be monitored using Electromyography (EMG) signals. The multi-channel EMG signals are measured at different muscles in the upper arm of surgeons. The dependence of EMG signals has been examined to test the hypothesis that EMG signals are coupled with and dependent on each other. The results demonstrated that EMG signals collected from different channels while mimicking an operating posture are independent. Consequently, single channel fatigue analysis has been performed. In measuring hand tremor, a new method for determining the maximum tremor amplitude using Principal Component Analysis (PCA) and a new technique to detrend acceleration signals using Empirical Mode Decomposition algorithm were introduced. This tremor determination method is more representative for surgeons and it is suggested as an alternative fatigue measure. This was combined with the complexity analysis method, and applied to surgically captured data to determine if operating has an effect on a surgeon’s fatigue and tremor levels. It was found that surgical tremor and fatigue are developed throughout a day of operating and that this could be determined based solely on their initial values. Finally, several Nonlinear AutoRegressive with eXogenous inputs (NARX) neural networks were evaluated. The results suggest that it is possible to monitor surgeon tremor variations during surgery from their EMG fatigue measurements.

Fibre Bragg grating sensors for distributive tactile sensing

Distributive tactile sensing is a method of tactile sensing in which a small number of sensors monitors the behaviour of a flexible substrate which is in contact with the object being sensed. This paper describes the first use of fibre Bragg grating sensors in such a system. Two systems are presented: the first is a one-dimensional metal strip with an array of four sensors, which is capable of detecting the magnitude and position of a contacting load. This system is favourably compared experimentally with a similar system using resistive strain gauges. The second system is a two-dimensional steel plate with nine sensors which is able to distinguish the position and shape of a contacting load, or the positions of two loads simultaneously. This system is compared with a similar system using 16 infrared displacement sensors. Each system uses neural networks to process the sensor data to give information concerning the type of contact. Issues and limitations of the systems are discussed, along with proposed solutions to some of the difficulties.

Determination of muscle fatigue in clinical practices using dynamically embedded signals

This paper explores a new method of analysing muscle fatigue within the muscles predominantly used during microsurgery. The captured electromyographic (EMG) data retrieved from these muscles are analysed for any defining patterns relating to muscle fatigue. The analysis consists of dynamically embedding the EMG signals from a single muscle channel into an embedded matrix. The muscle fatigue is determined by defining its entropy characterized by the singular values of the dynamically embedded (DE) matrix. The paper compares this new method with the traditional method of using mean frequency shifts in the EMG signal's power spectral density. Linear regressions are fitted to the results from both methods, and the coefficients of variation of both their slope and point of intercept are determined. It is shown that the complexity method is slightly more robust in that the coefficient of variation for the DE method has lower variability than the conventional method of mean frequency analysis.

Distributive tactile sensing using fibre Bragg grating sensors

Two distributive tactile sensing systems are presented, based on fibre Bragg grating sensors. The first is a onedimensional metal strip with an array of 4 sensors, which is capable of detecting the magnitude and position of a contacting load. This system is compared experimentally with a similar system using resistive strain gauges. The second is a two-dimensional steel plate with 9 sensors which is able to distinguish the position and shape of a contacting load. This system is compared with a similar system using 16 infrared displacement sensors. Each system uses neural networks to process the sensor data to give information concerning the type of contact.

Real options in multinational decision-making:managerial awareness and risk implications

This paper addresses the theme of real options decision-making in multinational corporations (MNCs) and stresses the role of real options attention and managerial learning in company performance. Using a sample of 278 large MNCs with categorised degrees of managerial real options awareness, we examine the risk implications of switching options in multinational operations, and explore the extent to which the real options logic can be classified as “best practice” in decision-making and risk management. Our results reveal that MNCs which have high managerial awareness about their real options are able to reduce their downside risk through multinationality, organisational slack and other firm characteristics. This finding does not apply fully to MNCs without evidence of such an awareness. Also, although real options awareness does not systematically guarantee lower downside risk from operations, supplementary results indicate that MNCs with evidence of significant investment in the acquisition of real options knowledge tend to outperform competitors that are unaware of their real options. This suggests that if real options are explored and exploited appropriately, real options decision-making can result into superior performance for MNCs in the long-term.

Competitive edge through operations management

A view has emerged within manufacturing and service organizations that the operations management function can hold the key to achieving competitive edge. This has recently been emphasized by the demands for greater variety and higher quality which must be set against a background of increasing cost of resources. As nations' trade barriers are progressively lowered and removed, so producers of goods and service products are becoming more exposed to competition that may come from virtually anywhere around the world. To simply survive in this climate many organizations have found it necessary to improve their manufacturing or service delivery systems. To become real ''winners'' some have adopted a strategic approach to operations and completely reviewed and restructured their approach to production system design and operations planning and control. The articles in this issue of the International journal of Operations & Production Management have been selected to illustrate current thinking and practice in relation to this situation. They are all based on papers presented to the Sixth International Conference of the Operations Management Association-UK which was held at Aston University in June 1991. The theme of the conference was "Achieving Competitive Edge" and authors from 15 countries around the world contributed to more than 80 presented papers. Within this special issue five topic areas are addressed with two articles relating to each. The topics are: strategic management of operations; managing change; production system design; production control; and service operations. Under strategic management of operations De Toni, Filippini and Forza propose a conceptual model which considers the performance of an operating system as a source of competitive advantage through the ''operation value chain'' of design, purchasing, production and distribution. Their model is set within the context of the tendency towards globalization. New's article is somewhat in contrast to the more fashionable literature on operations strategy. It challenges the validity of the current idea of ''world-class manufacturing'' and, instead, urges a reconsideration of the view that strategic ''trade-offs'' are necessary to achieve a competitive edge. The importance of managing change has for some time been recognized within the field of organization studies but its relevance in operations management is now being realized. Berger considers the use of "organization design", ''sociotechnical systems'' and change strategies and contrasts these with the more recent idea of the ''dialogue perspective''. A tentative model is suggested to improve the analysis of different strategies in a situation specific context. Neely and Wilson look at an essential prerequisite if change is to be effected in an efficient way, namely product goal congruence. Using a case study as its basis, their article suggests a method of measuring goal congruence as a means of identifying the extent to which key performance criteria relating to quality, time, cost and flexibility are understood within an organization. The two articles on production systems design represent important contributions to the debate on flexible production organization and autonomous group working. Rosander uses the results from cases to test the applicability of ''flow groups'' as the optimal way of organizing batch production. Schuring also examines cases to determine the reasons behind the adoption of ''autonomous work groups'' in The Netherlands and Sweden. Both these contributions help to provide a greater understanding of the production philosophies which have emerged as alternatives to more conventional systems -------for intermittent and continuous production. The production control articles are both concerned with the concepts of ''push'' and ''pull'' which are the two broad approaches to material planning and control. Hirakawa, Hoshino and Katayama have developed a hybrid model, suitable for multistage manufacturing processes, which combines the benefits of both systems. They discuss the theoretical arguments in support of the system and illustrate its performance with numerical studies. Slack and Correa's concern is with the flexibility characteristics of push and pull material planning and control systems. They use the case of two plants using the different systems to compare their performance within a number of predefined flexibility types. The two final contributions on service operations are complementary. The article by Voss really relates to manufacturing but examines the application of service industry concepts within the UK manufacturing sector. His studies in a number of companies support the idea of the ''service factory'' and offer a new perspective for manufacturing. Harvey's contribution by contrast, is concerned with the application of operations management principles in the delivery of professional services. Using the case of social-service provision in Canada, it demonstrates how concepts such as ''just-in-time'' can be used to improve service performance. The ten articles in this special issue of the journal address a wide range of issues and situations. Their common aspect is that, together, they demonstrate the extent to which competitiveness can be improved via the application of operations management concepts and techniques.

A cable actuated flexible digit with tactile feedback for use in clinical applications

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Fibre Bragg grating sensors for distributive tactile sensing

Distributive tactile sensing is a method of tactile sensing in which a small number of sensors monitors the behaviour of a flexible substrate which is in contact with the object being sensed. This paper describes the first use of fibre Bragg grating sensors in such a system. Two systems are presented: the first is a one-dimensional metal strip with an array of four sensors, which is capable of detecting the magnitude and position of a contacting load. This system is favourably compared experimentally with a similar system using resistive strain gauges. The second system is a two-dimensional steel plate with nine sensors which is able to distinguish the position and shape of a contacting load, or the positions of two loads simultaneously. This system is compared with a similar system using 16 infrared displacement sensors. Each system uses neural networks to process the sensor data to give information concerning the type of contact. Issues and limitations of the systems are discussed, along with proposed solutions to some of the difficulties. © 2007 IOP Publishing Ltd.

Visual performance of a new bi-aspheric, segmented, asymmetric multifocal IOL

PURPOSE: To assess the visual performance and subjective experience of eyes implanted with a new bi-aspheric, segmented, multifocal intraocular lens: the Mplus X (Topcon Europe Medical, Capelle aan den IJssel, Netherlands). METHODS: Seventeen patients (mean age: 64.0 ± 12.8 years) had binocular implantation (34 eyes) with the Mplus X. Three months after the implantation, assessment was made of: manifest refraction; uncorrected and corrected distance visual acuity; uncorrected and distance corrected near visual acuity; defocus curves in photopic conditions; contrast sensitivity; halometry as an objective measure of glare; and patient satisfaction with unaided near vision using the Near Acuity Visual Questionnaire. RESULTS: Mean residual manifest refraction was -0.13 ± 0.51 diopters (D). Twenty-five eyes (74%) were within a mean spherical equivalent of ±0.50 D. Mean uncorrected distance visual acuity was +0.10 ± 0.12 logMAR monocularly and 0.02 ± 0.09 logMAR binocularly. Thirty-two eyes (94%) could read 0.3 or better without any reading correction and all patients could read 0.3 or better with a reading correction. Mean monocular uncorrected near visual acuity was 0.18 ± 0.16 logMAR, improving to 0.15 ± 0.15 logMAR with distance correction. Mean binocular uncorrected near visual acuity was 0.11 ± 0.11 logMAR, improving to 0.09 ± 0.12 logMAR with distance correction. Mean binocular contrast sensitivity was 1.75 ± 0.14 log units at 3 cycles per degree, 1.88 ± 0.20 log units at 6 cycles per degree, 1.66 ± 0.19 log units at 12 cycles per degree, and 1.11 ± 0.20 log units at 18 cycles per degree. Mean binocular and monocular halometry showed a glare profile of less than 1° of debilitating light scatter. Mean Near Acuity Visual Questionnaire Rasch score (0 = no difficulty, 100 = extreme difficulty) for satisfaction for near vision was 20.43 ± 14.64 log-odd units. CONCLUSIONS: The Mplus X provides a good visual outcome at distance and near with minimal dysphotopsia. Patients were very satisfied with their uncorrected near vision. © SLACK Incorporated.

Distributive tactile sensing using fibre Bragg grating sensors for biomedical applications

Artificial tactile sensing systems using the distributive tactile sensing technique and fibre Bragg grating sensors are presented. A one-dimensional arrangement, with possible applications in an endoscope, is compared with a similar arrangement using conventional electronic sensors. A two-dimensional sensing surface is described, with potential applications in human balance and gait analysis, capable of detecting simultaneously the position and shape of an object placed upon it. It is believed that this work represents the first use of fibre Bragg grating sensors in a distributive sensing regime.

Distributive tactile sensing using fibre bragg grating sensors

Two distributive tactile sensing systems are presented, based on fibre Bragg grating sensors. The first is a one-dimensional metal strip with an array of 4 sensors, which is capable of detecting the magnitude and position of a contacting load. This system is compared experimentally with a similar system using resistive strain gauges. The second is a two-dimensional steel plate with 9 sensors which is able to distinguish the position and shape of a contacting load. This system is compared with a similar system using 16 infrared displacement sensors. Each system uses neural networks to process the sensor data to give information concerning the type of contact.

Variation in the length of an undergraduate degree:participation and outcomes

Recent policy in England has advocated the introduction of fast-track degrees to provide an alternative, shorter route to a bachelor's degree. It has been argued that this will widen participation in higher education and increase labour market flexibility by providing an option in which undergraduates spend one fewer years out of the labour market. Critics have suggested that the outcomes from this new undergraduate option will be worse than those for students following the standard length of undergraduate degree (which is three years for most subjects studied at universities in England). This criticism is based on a belief that students on the shorter degrees will be encouraged to 'cram', having less opportunity for reflection that will foster a deep understanding. These arguments are evaluated using data which compare students following two and three year degrees in the same subjects at the same university. © 2012 Copyright Society for Research into Higher Education.

Implementing innovation management in project based firms:a perspective from project management

Project-based firms currently follow an organizational structure whereby all projects are dealt with using a functionalist perspective which is integrated with projects so as to support a project-based structure. Project-based firms are increasingly moving towards the realization that innovation management is an integral part of any organizational strategy and the same is true for project-based firms. Moreover, the current body of knowledge regarding project-based firms does not incorporate any findings regarding the integration or use of innovation management in project management. As a result, it becomes important to research organizations to see how innovation management is applied in organizations and what the perspective is regarding innovation in organizations. Secondly, the question of whether slack resources can contribute to higher levels of innovation must also be researched. It has been a longstanding viewpoint that a lack of resources or limited resources results in higher levels of innovation. This study analyzes these two main viewpoints using qualitative analysis of 12 firms. The findings add to the current literature on innovation in organizations and project based firms while expanding the knowledge on innovation.

The effect of supporting a surgeon's wrist on their hand tremor

Background. Operative tremor can greatly influence the outcome of certain, precise, microsurgical operations. Reducing a surgeons tremor may not only improve the operative results but decrease the operative time. Previous studies have only measured uni or bi directional tremor and therefore have been unable to calculate both the overall tremor amplitude and the tremor reduction by resting the wrists. Materials and methods. We measured the tremor of 21 neurologically normal volunteers while performing a micromanipulation task, with and without wrist support. Measurements were acquired in three dimensions using three accelerometers attached to the hand, allowing an overall tremor amplitude to be calculated. Results. Resting the wrist on a gelled surface decreases an individuals tremor by a factor of 2.67 (P = 0). Conclusions. Supporting the wrists significantly decreases the amplitude of the tremor. Surgeons should consider using wrist supports when performing parts of operations which necessitate a high degree of accuracy. © 2010 Wiley-Liss, Inc.