C-Port Flex-A-assisted automated anastomosis for high-flow extracranial-intracranial bypass surgery in patients with symptomatic carotid artery occlusion: a feasibility study. Clinical article

OBJECT: Preliminary experience with the C-Port Flex-A Anastomosis System (Cardica, Inc.) to enable rapid automated anastomosis has been reported in coronary artery bypass surgery. The goal of the current study was to define the feasibility and safety of this method for high-flow extracranial-intracranial (EC-IC) bypass surgery in a clinical series. METHODS: In a prospective study design, patients with symptomatic carotid artery (CA) occlusion were selected for C-Port-assisted high-flow EC-IC bypass surgery if they met the following criteria: 1) transient or moderate permanent symptoms of focal ischemia; 2) CA occlusion; 3) hemodynamic instability; and 4) had provided informed consent. Bypasses were done using a radial artery graft that was proximally anastomosed to the superficial temporal artery trunk, the cervical external, or common CA. All distal cerebral anastomoses were performed on M2 branches using the C-Port Flex-A system. RESULTS: Within 6 months, 10 patients were enrolled in the study. The distal automated anastomosis could be accomplished in all patients; the median temporary occlusion time was 16.6+/-3.4 minutes. Intraoperative digital subtraction angiography (DSA) confirmed good bypass function in 9 patients, and in 1 the anastomosis was classified as fair. There was 1 major perioperative complication that consisted of the creation of a pseudoaneurysm due to a hardware problem. In all but 1 case the bypass was shown to be patent on DSA after 7 days; furthermore, in 1 patient a late occlusion developed due to vasospasm after a sylvian hemorrhage. One-week follow-up DSA revealed transient asymptomatic extracranial spasm of the donor artery and the radial artery graft in 1 case. Two patients developed a limited zone of infarction on CT scanning during the follow-up course. CONCLUSIONS: In patients with symptomatic CA occlusion, C-Port Flex-A-assisted high-flow EC-IC bypass surgery is a technically feasible procedure. The system needs further modification to achieve a faster and safer anastomosis to enable a conclusive comparison with standard and laser-assisted methods for high-flow bypass surgery.

Semi-Automated Creation of Converged iTV Services: From Macromedia Director Simulations to Services Ready for Broadcast

While sound and video may capture viewers' attention, interaction can captivate them. This has not been available prior to the advent of Digital Television. In fact, what lies at the heart of the Digital Television revolution is this new type of interactive content, offered in the form of interactive Television (iTV) services. On top of that, the new world of converged networks has created a demand for a new type of converged services on a range of mobile terminals (Tablet PCs, PDAs and mobile phones). This paper aims at presenting a new approach to service creation that allows for the semi-automatic translation of simulations and rapid prototypes created in the accessible desktop multimedia authoring package Macromedia Director into services ready for broadcast. This is achieved by a series of tools that de-skill and speed-up the process of creating digital TV user interfaces (UI) and applications for mobile terminals. The benefits of rapid prototyping are essential for the production of these new types of services, and are therefore discussed in the first section of this paper. In the following sections, an overview of the operation of content, service, creation and management sub-systems is presented, which illustrates why these tools compose an important and integral part of a system responsible of creating, delivering and managing converged broadcast and telecommunications services. The next section examines a number of metadata languages candidates for describing the iTV services user interface and the schema language adopted in this project. A detailed description of the operation of the two tools is provided to offer an insight of how they can be used to de-skill and speed-up the process of creating digital TV user interfaces and applications for mobile terminals. Finally, representative broadcast oriented and telecommunication oriented converged service components are also introduced, demonstrating how these tools have been used to generate different types of services.

Reliability of evaluations for the choice of system solutions at the example of automated order-picking systems for bagged goods

There is a steadily increasing pressure on cost-savings and productivity growth in sectors of order-picking such that the wish for rationalization by automation is rising. Special problems are faced trying to automatize handling operations of order-picking articles packed in bags. The mechanical properties of the objects and their hard-to-predict shape and position represent obstacles and are complicating handling operations. A systematic approach in system design is required. This article deals with the properties of such products under aspects of difficulties arising in automated handling and points out a useful system development methodology.

Book review of “Germany in Transit: Nation and Migration, 1955-2005”. 588 pages, University of California Press, 2007, by Deniz Göktürk, David Gramling and Anton Kaes (eds.)

Though migration is an age-old feature of human activity, driven by various circumstances, its current place in the midst of global dynamics and the phenomenon of globalization is becoming increasingly critical. International immigration and its regulation have been largely shaped by the policies in the receiving countries, often determining preferences for nationality cohorts and work skills to satisfy their labor and human capital requirements. When immigration has been necessitated by political strife, host countries have displayed immense magnanimity as well. However, the growing realization of resource limitations and the strange quirks of cultural pluralism are in turn creating waves of dissonance. Literature and the media are now replete with an in depth look into the immigration debate in various nations of the world in trying to seek new directions and satisfactory solutions.

Automated load securing system for cargo vans

The use of lashing means, for example load securing straps or nets, is often time-consuming, especially for courier, express and parcel-services (CEP) using a lot stops. The following article describes the development of an automated load securing system with a three-dimensional-preformed net. Mainly two components interact in this system. On the one hand, an anti-skid system is integrated, which uses the advantages of a low-friction surface for loading and the anti-slip properties of an adhesive coating for the transport. On the other hand, a flexibly adaptive net consisting of high-performance synthetic fibers and integrated shorteners lash different sized transport units. Especially, the automatic lashing should increase the acceptance of the drivers for the new load securing system.

Meta-model for calculating the mean energy demand of automated storage and retrieval systems

Energy efficiency has become an important research topic in intralogistics. Especially in this field the focus is placed on automated storage and retrieval systems (AS/RS) utilizing stacker cranes as these systems are widespread and consume a significant portion of the total energy demand of intralogistical systems. Numerical simulation models were developed to calculate the energy demand rather precisely for discrete single and dual command cycles. Unfortunately these simulation models are not suitable to perform fast calculations to determine a mean energy demand value of a complete storage aisle. For this purpose analytical approaches would be more convenient but until now analytical approaches only deliver results for certain configurations. In particular, for commonly used stacker cranes equipped with an intermediate circuit connection within their drive configuration there is no analytical approach available to calculate the mean energy demand. This article should address this research gap and present a calculation approach which enables planners to quickly calculate the energy demand of these systems.

Importance of vegetation, topography and flow paths for water transit times of base flow in alpine headwater catchments

The mean transit time (MTT) of water in a catchment gives information about storage, flow paths, sources of water and thus also about retention and release of solutes in a catchment. To our knowledge there are only a few catchment studies on the influence of vegetation cover changes on base flow MTTs. The main changes in vegetation cover in the Swiss Alps are massive shrub encroachment and forest expansion into formerly open habitats. Four small and relatively steep headwater catchments in the Swiss Alps (Ursern Valley) were investigated to relate different vegetation cover to water transit times. Time series of water stable isotopes were used to calculate MTTs. The high temporal variation of the stable isotope signals in precipitation was strongly dampened in stream base flow samples. MTTs of the four catchments were 70 to 102 weeks. The strong dampening of the stable isotope input signal as well as stream water geochemistry points to deeper flow paths and mixing of waters of different ages at the catchments' outlets. MTTs were neither related to topographic indices nor vegetation cover. The major part of the quickly infiltrating precipitation likely percolates through fractured and partially karstified deeper rock zones, which increases the control of bedrock flow paths on MTT. Snow accumulation and the timing of its melt play an important role for stable isotope dynamics during spring and early summer. We conclude that, in mountainous headwater catchments with relatively shallow soil layers, the hydrogeological and geochemical patterns (i.e. geochemistry, porosity and hydraulic conductivity of rocks) and snow dynamics influence storage, mixing and release of water in a stronger way than vegetation cover or topography do.