No surgical innovation without evaluation: the IDEAL recommendations

Surgery and other invasive therapies are complex interventions, the assessment of which is challenged by factors that depend on operator, team, and setting, such as learning curves, quality variations, and perception of equipoise. We propose recommendations for the assessment of surgery based on a five-stage description of the surgical development process. We also encourage the widespread use of prospective databases and registries. Reports of new techniques should be registered as a professional duty, anonymously if necessary when outcomes are adverse. Case series studies should be replaced by prospective development studies for early technical modifications and by prospective research databases for later pre-trial evaluation. Protocols for these studies should be registered publicly. Statistical process control techniques can be useful in both early and late assessment. Randomised trials should be used whenever possible to investigate efficacy, but adequate pre-trial data are essential to allow power calculations, clarify the definition and indications of the intervention, and develop quality measures. Difficulties in doing randomised clinical trials should be addressed by measures to evaluate learning curves and alleviate equipoise problems. Alternative prospective designs, such as interrupted time series studies, should be used when randomised trials are not feasible. Established procedures should be monitored with prospective databases to analyse outcome variations and to identify late and rare events. Achievement of improved design, conduct, and reporting of surgical research will need concerted action by editors, funders of health care and research, regulatory bodies, and professional societies.

Thermographie zur Temperaturmessung beim Laser-Sintern – ein Beitrag zur Qualitätssicherung?

Beim Laser-Sintern wird das Pulverbett durch Heizstrahler vorgeheizt, um an der Pulveroberfläche eine Temperatur knapp unterhalb des Materialschmelzpunktes zu erzielen. Dabei soll die Temperaturverteilung auf der Oberfläche möglichst homogen sein, um gleiche Bauteileigenschaften im gesamten Bauraum zu erzielen und den Bauteilverzug gering zu halten. Erfahrungen zeigen jedoch sehr inhomogene Temperaturverteilungen, weshalb oftmals die Integration von neuen oder optimierten Prozessüberwachungssystemen in die Anlagen gefordert wird. Ein potentiell einsetzbares System sind Thermographiekameras, welche die flächige Aufnahme von Oberflächentemperaturen und somit Aussagen über die Temperaturen an der Pulverbettoberfläche erlauben. Dadurch lassen sich kalte Bereiche auf der Oberfläche identifizieren und bei der Prozessvorbereitung berücksichtigen. Gleichzeitig ermöglicht die Thermografie eine Beobachtung der Temperaturen beim Lasereingriff und somit das Ableiten von Zusammenhängen zwischen Prozessparametern und Schmelzetemperaturen. Im Rahmen der durchgeführten Untersuchungen wurde ein IR-Kamerasystem erfolgreich als Festeinbau in eine Laser-Sinteranlage integriert und Lösungen für die hierbei auftretenden Probleme erarbeitet. Anschließend wurden Untersuchungen zur Temperaturverteilung auf der Pulverbettoberfläche sowie zu den Einflussfaktoren auf deren Homogenität durchgeführt. In weiteren Untersuchungen wurden die Schmelzetemperaturen in Abhängigkeit verschiedener Prozessparameter ermittelt. Auf Basis dieser Messergebnisse wurden Aussagen über erforderliche Optimierungen getroffen und die Nutzbarkeit der Thermografie beim Laser-Sintern zur Prozessüberwachung, -regelung sowie zur Anlagenwartung als erster Zwischenstand der Untersuchungen bewertet.

NEW TOOLS FOR MONITORING GAMMA CAMERA UNIFORMITY

Detector uniformity is a fundamental performance characteristic of all modern gamma camera systems, and ensuring a stable, uniform detector response is critical for maintaining clinical images that are free of artifact. For these reasons, the assessment of detector uniformity is one of the most common activities associated with a successful clinical quality assurance program in gamma camera imaging. The evaluation of this parameter, however, is often unclear because it is highly dependent upon acquisition conditions, reviewer expertise, and the application of somewhat arbitrary limits that do not characterize the spatial location of the non-uniformities. Furthermore, as the goal of any robust quality control program is the determination of significant deviations from standard or baseline conditions, clinicians and vendors often neglect the temporal nature of detector degradation (1). This thesis describes the development and testing of new methods for monitoring detector uniformity. These techniques provide more quantitative, sensitive, and specific feedback to the reviewer so that he or she may be better equipped to identify performance degradation prior to its manifestation in clinical images. The methods exploit the temporal nature of detector degradation and spatially segment distinct regions-of-non-uniformity using multi-resolution decomposition. These techniques were tested on synthetic phantom data using different degradation functions, as well as on experimentally acquired time series floods with induced, progressively worsening defects present within the field-of-view. The sensitivity of conventional, global figures-of-merit for detecting changes in uniformity was evaluated and compared to these new image-space techniques. The image-space algorithms provide a reproducible means of detecting regions-of-non-uniformity prior to any single flood image’s having a NEMA uniformity value in excess of 5%. The sensitivity of these image-space algorithms was found to depend on the size and magnitude of the non-uniformities, as well as on the nature of the cause of the non-uniform region. A trend analysis of the conventional figures-of-merit demonstrated their sensitivity to shifts in detector uniformity. The image-space algorithms are computationally efficient. Therefore, the image-space algorithms should be used concomitantly with the trending of the global figures-of-merit in order to provide the reviewer with a richer assessment of gamma camera detector uniformity characteristics.

Volunteering in sport clubs

Volunteers are the most important resource for non-profit sport clubs seeking to bolster their viability (e.g. sporting programs). Although many people do voluntary work in sport clubs, stable voluntary engagement can no longer be granted. This difficulty is confirmed by existing research across various European countries. From a club management point of view, a detailed understanding of how to attract volunteers and retain them in the long term is becoming a high priority. The purpose of this study is (1) to analyse the influence of individual characteristics and corresponding organisational conditions on volunteering in sports clubs as well as (2) to examine the decision-making processes in relation to implement effective strategies for recruiting volunteers. For the first perspective a multi-level framework for the investigation of the factors of voluntary engagement in sports clubs is developed. The individual and context factors are estimated in different multi-level models based on a sample of n = 1,434 sport club members from 36 sport clubs in Switzerland. Results indicate that volunteering is not just an outcome of individual characteristics such as lower workloads, higher income, children belonging to the sport club, longer club memberships, or a strong commitment to the club. It is also influenced by club-specific structural conditions; volunteering is more probable in rural sports clubs whereas growth-oriented goals in clubs have a destabilising effect. Concerning decision-making processes an in-depth analysis of recruitment practices for volunteers was conducted in nine selected sport clubs (case study design) based on the garbage can model. Results show that the decision-making processes are generally characterised by a reactive approach in which dominant actors try to handle personnel problems of recruitment in the administration and sport domains through routine formal committee work and informal networks. In addition, it proved possible to develop a typology that deliver an overview of different decision-making practices in terms of the specific interplay of the relevant components of process control (top-down vs. bottom-up) and problem processing (situational vs. systematic). Based on the findings some recommendations for volunteer management in sport clubs are worked out.

How do sport clubs recruit volunteers? Analyzing and developing a typology of decision-making processes on recruiting volunteers in sport clubs.

Effective strategies for recruiting volunteers who are prepared to make a long-term commitment to formal positions are essential for the survival of voluntary sport clubs. This article examines the decision-making processes in relation to these efforts. Under the assumption of bounded rationality, the garbage can model is used to grasp these decision-making processes theoretically and access them empirically. Based on case study framework an in-depth analysis of recruitment practices was conducted in nine selected sport clubs. Results showed that the decision-making processes are generally characterized by a reactive approach in which dominant actors try to handle personnel problems of recruitment in the administration and sport domains through routine formal committee work and informal networks. In addition, it proved possible to develop a typology that deliver an overview of different decision-making practices in terms of the specific interplay of the relevant components of process control (top-down vs. bottom-up) and problem processing (situational vs. systematic).

ERP Software Selection Processes: A Case Study in the Metal Transformation Sector

When a firm decides to implement ERP softwares, the resulting consequences can pervade all levels, includ- ing organization, process, control and available information. Therefore, the first decision to be made is which ERP solution must be adopted from a wide range of offers and vendors. To this end, this paper describes a methodology based on multi-criteria factors that directly affects the process to help managers make this de- cision. This methodology has been applied to a medium-size company in the Spanish metal transformation sector which is interested in updating its IT capabilities in order to obtain greater control of and better infor- mation about business, thus achieving a competitive advantage. The paper proposes a decision matrix which takes into account all critical factors in ERP selection.

Improving Speech Interaction in Vehicles Using Context-Aware Information through A SCXML Framework

Speech Technologies can provide important benefits for the development of more usable and safe in-vehicle human-machine interactive systems (HMIs). However mainly due robustness issues, the use of spoken interaction can entail important distractions to the driver. In this challenging scenario, while speech technologies are evolving, further research is necessary to explore how they can be complemented with both other modalities (multimodality) and information from the increasing number of available sensors (context-awareness). The perceived quality of speech technologies can significantly be increased by implementing such policies, which simply try to make the best use of all the available resources; and the in vehicle scenario is an excellent test-bed for this kind of initiatives. In this contribution we propose an event-based HMI design framework which combines context modelling and multimodal interaction using a W3C XML language known as SCXML. SCXML provides a general process control mechanism that is being considered by W3C to improve both voice interaction (VoiceXML) and multimodal interaction (MMI). In our approach we try to anticipate and extend these initiatives presenting a flexible SCXML-based approach for the design of a wide range of multimodal context-aware HMI in-vehicle interfaces. The proposed framework for HMI design and specification has been implemented in an automotive OSGi service platform, and it is being used and tested in the Spanish research project MARTA for the development of several in-vehicle interactive applications.

Criterios de calidad del servicio prestado en el ámbito de la línea de atraque de las terminales portuarias de contenedores

Esta Tesis Doctoral evalúa empíricamente la calidad del servicio en la línea de atraque de las terminales portuarias de contenedores. La metodología propuesta utiliza indicadores de calidad y se basa en el concepto de la segmentación de servicio. Para ello se desarrolla la teoría del Control Estadístico de Procesos (CEP) y se utilizan los gráficos de control para clasificar el servicio en las terminales de contenedores. El propósito de la Tesis es proporcionar una metodología basada en el Control Estadístico de Procesos (CEP) para evaluar la calidad del servicio y detectar las escalas de un servicio regular de línea que se encuentran fuera de control. Por tanto, la metodología se puede utilizar para detectar eventos que son indicativos de cambio real del proceso en la línea de atraque. Esta detección puede ser compleja pues las características de los procesos en terminales de contenedores son variables. La metodología proporciona mediante los gráficos de control criterios estadísticamente objetivos de cambio. Cuando el cambio es detectado y considerado bueno sus causas deben ser identificadas y posiblemente convertirse en la nueva forma de trabajar, cuando el cambio es negativo, entonces sus causas deberían ser identificadas y eliminadas. La Tesis Doctoral está organizado de la siguiente manera: La primera parte es la introducción, e incluye los capítulos 1 al 4, la segunda parte presenta el Estado del Arte (capítulo 5) y algunos de los estudios que han inspirado esta investigación, la tercera parte se centra en la metodología utilizada (capítulo 6) y su aplicación sobre un caso de estudio (capítulo 7). Finalmente, en la cuarta parte se presentan las conclusiones y se proponen algunas de las nuevas líneas de investigación que quedan abiertas (capítulo 8). This Thesis empirically evaluates the quality of service in the berthing face of container terminals. The methodology proposed is focused on quality of service indicators and is based on the concept of service segmentation. The Statistical Process Control (SPC) theory and the control charts are used to classify container terminal service. The aim of this Thesis is to provide a methodology based on Statistical Process Control that can evaluate the quality of service and also can detect scales of shipping liner service that are out of control. Therefore, the methodology can be used to detect events that are indicative of real change in the berthing process of container vessels. The methodology proposed allows simple detection of events that are indicative of actual process change in container terminals. This detection is complex because the characteristics of the processes are variable in the container terminals; the control chart provides statistically objective criteria of change. When change is detected and considered good its cause should be identified and possibly become the new way of working, where the change is bad then its cause should be identified and eliminated. This Thesis is organized as follows: The first part is the introduction (includes Chapters 1 to 4), the second part presents the State of the Art (Chapter 5) and some of the studies that have inspired this research. The third part focuses on the methodology used (Chapter 6) and its application to a case study (Chapter 7). Finally, Part 4 presents the conclusions and suggests future research (Chapter 8).

Desenvolvimento de um controlador preditivo estocástico para processos da indústria química.

O sucesso de estratégias de controle preditivo baseado em modelo (MPC, na sigla em inglês) tanto em ambiente industrial quanto acadêmico tem sido marcante. No entanto, ainda há diversas questões em aberto na área, especialmente quando a hipótese simplificadora de modelo perfeito é abandonada. A consideração explícita de incertezas levou a importantes progressos na área de controle robusto, mas esta ainda apresenta alguns problemas: a alta demanda computacional e o excesso de conservadorismo são questões que podem ter prejudicado a aplicação de estratégias de controle robusto na prática. A abordagem de controle preditivo estocástico (SMPC, na sigla em inglês) busca a redução do conservadorismo através da incorporação de informação estatística dos ruídos. Como processos na indústria química sempre estão sujeito a distúrbios, seja devido a diferenças entre planta e modelo ou a distúrbios não medidos, está técnica surge como uma interessante alternativa para o futuro. O principal objetivo desta tese é o desenvolvimento de algoritmos de SMPC que levem em conta algumas das especificidades de tais processos, as quais não foram adequadamente tratadas na literatura até o presente. A contribuição mais importante é a inclusão de ação integral no controlador através de uma descrição do modelo em termos de velocidade. Além disso, restrições obrigatórias (hard) nas entradas associadas a limites físicos ou de segurança e restrições probabilísticas nos estados normalmente advindas de especificações de produtos também são consideradas na formulação. Duas abordagens foram seguidas neste trabalho, a primeira é mais direta enquanto a segunda fornece garantias de estabilidade em malha fechada, contudo aumenta o conservadorismo. Outro ponto interessante desenvolvido nesta tese é o controle por zonas de sistemas sujeitos a distúrbios. Essa forma de controle é comum na indústria devido à falta de graus de liberdade, sendo a abordagem proposta a primeira contribuição da literatura a unir controle por zonas e SMPC. Diversas simulações de todos os controladores propostos e comparações com modelos da literatura são exibidas para demonstrar o potencial de aplicação das técnicas desenvolvidas.

1992 census of manufactures.

Mode of access: Internet.

1987 census of manufactures.

Mode of access: Internet.

A cross-assembler/simulator for a microprocessor-based industrial controller /

Vita: p. 65.

A graphically-programmed, microprocessor-based industrial controller /

Vita.

Semiconductor measurement technology:

Title varies slightly.

Proceedings of the U.S. Nuclear Regulatory Commission Tenth Water Reactor Safety Research Information Meeting, held at National Bureau of Standards, Gaithersburg, Maryland, October 12-15, 1982 /

Includes papers describing research sponsored by the Office of Nuclear Regulatory Research, NRC.