Design and optimization of turbo-expanders for organic rankine cycles

In a world focused on the need to produce energy for a growing population, while reducing atmospheric emissions of carbon dioxide, organic Rankine cycles represent a solution to fulfil this goal. This study focuses on the design and optimization of axial-flow turbines for organic Rankine cycles. From the turbine designer point of view, most of this fluids exhibit some peculiar characteristics, such as small enthalpy drop, low speed of sound, large expansion ratio. A computational model for the prediction of axial-flow turbine performance is developed and validated against experimental data. The model allows to calculate turbine performance within a range of accuracy of ±3%. The design procedure is coupled with an optimization process, performed using a genetic algorithm where the turbine total-to-static efficiency represents the objective function. The computational model is integrated in a wider analysis of thermodynamic cycle units, by providing the turbine optimal design. First, the calculation routine is applied in the context of the Draugen offshore platform, where three heat recovery systems are compared. The turbine performance is investigated for three competing bottoming cycles: organic Rankine cycle (operating cyclopentane), steam Rankine cycle and air bottoming cycle. Findings indicate the air turbine as the most efficient solution (total-to-static efficiency = 0.89), while the cyclopentane turbine results as the most flexible and compact technology (2.45 ton/MW and 0.63 m3/MW). Furthermore, the study shows that, for organic and steam Rankine cycles, the optimal design configurations for the expanders do not coincide with those of the thermodynamic cycles. This suggests the possibility to obtain a more accurate analysis by including the computational model in the simulations of the thermodynamic cycles. Afterwards, the performance analysis is carried out by comparing three organic fluids: cyclopentane, MDM and R245fa. Results suggest MDM as the most effective fluid from the turbine performance viewpoint (total-to-total efficiency = 0.89). On the other hand, cyclopentane guarantees a greater net power output of the organic Rankine cycle (P = 5.35 MW), while R245fa represents the most compact solution (1.63 ton/MW and 0.20 m3/MW). Finally, the influence of the composition of an isopentane/isobutane mixture on both the thermodynamic cycle performance and the expander isentropic efficiency is investigated. Findings show how the mixture composition affects the turbine efficiency and so the cycle performance. Moreover, the analysis demonstrates that the use of binary mixtures leads to an enhancement of the thermodynamic cycle performance.

Design of nanoparticle systems with antimicrobial properties

Infektiöse Komplikationen im Zusammenhang mit Implantaten stellen einen Großteil aller Krankenhausinfektionen dar und treiben die Gesundheitskosten signifikant in die Höhe. Die bakterielle Kolonisation von Implantatoberflächen zieht schwerwiegende medizinische Konsequenzen nach sich, die unter Umständen tödlich verlaufen können. Trotz umfassender Forschungsaktivitäten auf dem Gebiet der antibakteriellen Oberflächenbeschichtungen ist das Spektrum an wirksamen Substanzen aufgrund der Anpassungsfähigkeit und Ausbildung von Resistenzen verschiedener Mikroorganismen eingeschränkt. Die Erforschung und Entwicklung neuer antibakterieller Materialien ist daher von fundamentaler Bedeutung.rnIn der vorliegenden Arbeit wurden auf der Basis von Polymernanopartikeln und anorganischen/polymeren Verbundmaterialien verschiedene Systeme als Alternative zu bestehenden antibakteriellen Oberflächenbeschichtungen entwickelt. Polymerpartikel finden Anwendung in vielen verschiedenen Bereichen, da sowohl Größe als auch Zusammensetzung und Morphologie vielseitig gestaltet werden können. Mit Hilfe der Miniemulsionstechnik lassen sich u. A. funktionelle Polymernanopartikel im Größenbereich von 50-500 nm herstellen. Diese wurde im ersten System angewendet, um PEGylierte Poly(styrol)nanopartikel zu synthetisieren, deren anti-adhesives Potential in Bezug auf P. aeruginosa evaluiert wurde. Im zweiten System wurden sog. kontakt-aktive kolloide Dispersionen entwickelt, welche bakteriostatische Eigenschaften gegenüber S. aureus zeigten. In Analogie zum ersten System, wurden Poly(styrol)nanopartikel in Copolymerisation in Miniemulsion mit quaternären Ammoniumgruppen funktionalisiert. Als Costabilisator diente das zuvor quaternisierte, oberflächenaktive Monomer (2-Dimethylamino)ethylmethacrylat (qDMAEMA). Die Optimierung der antibakteriellen Eigenschaften wurde im nachfolgenden System realisiert. Hierbei wurde das oberflächenaktive Monomer qDMAEMA zu einem oberflächenaktiven Polyelektrolyt polymerisiert, welcher unter Anwendung von kombinierter Miniemulsions- und Lösemittelverdampfungstechnik, in entsprechende Polyelektrolytnanopartikel umgesetzt wurde. Infolge seiner oberflächenaktiven Eigenschaften, ließen sich aus dem Polyelektrolyt stabile Partikeldispersionen ohne Zusatz weiterer Tenside ausbilden. Die selektive Toxizität der Polyelektrolytnanopartikel gegenüber S. aureus im Unterschied zu Körperzellen, untermauert ihr vielversprechendes Potential als bakterizides, kontakt-aktives Reagenz. rnAufgrund ihrer antibakteriellen Eigenschaften wurden ZnO Nanopartikel ausgewählt und in verschiedene Freisetzungssysteme integriert. Hochdefinierte eckige ZnO Nanokristalle mit einem mittleren Durchmesser von 23 nm wurden durch thermische Zersetzung des Precursormaterials synthetisiert. Durch die nachfolgende Einkapselung in Poly(L-laktid) Latexpartikel wurden neue, antibakterielle und UV-responsive Hybridnanopartikel entwickelt. Durch die photokatalytische Aktivierung von ZnO mittels UV-Strahlung wurde der Abbau der ZnO/PLLA Hybridnanopartikel signifikant von mehreren Monaten auf mehrere Wochen verkürzt. Die Photoaktivierung von ZnO eröffnet somit die Möglichkeit einer gesteuerten Freisetzung von ZnO. Im nachfolgenden System wurden dünne Verbundfilme aus Poly(N-isopropylacrylamid)-Hydrogelschichten mit eingebetteten ZnO Nanopartikeln hergestellt, die als bakterizide Oberflächenbeschichtungen gegen E. coli zum Einsatz kamen. Mit minimalem Gehalt an ZnO zeigten die Filme eine vergleichbare antibakterielle Aktivität zu Silber-basierten Beschichtungen. Hierbei lässt sich der Gehalt an ZnO relativ einfach über die Filmdicke einstellen. Weiterhin erwiesen sich die Filme mit bakteriziden Konzentrationen an ZnO als nichtzytotoxisch gegenüber Körperzellen. Zusammenfassend wurden mehrere vielversprechende antibakterielle Prototypen entwickelt, die als potentielle Implantatbeschichtungen auf die jeweilige Anwendung weiterhin zugeschnitten und optimiert werden können.

Einflüsse von Folienqualität und Blister-Design auf die Funktionalität von Blisterverpackungen

Ziel dieser Arbeit ist die Untersuchung der Einflüsse von Blister-Design und Folienqualität auf die Funktionalität von Blisterverpackungen. Hierzu werden analytische Methoden mittels Interferometrie, IR-Spektroskopie, Betarückstreuverfahren, Wirbelstromverfahren und Impedanzspektroskopie entwickelt, die zur quantitativen Bestimmung von Heißsiegellacken und Laminatbeschichtungen von Aluminium-Blisterfolien geeignet sind. Ein Vergleich der Methoden zeigt, dass sich das Betarückstreuverfahren, die Interferometrie und IR-Messungen für die Heißsiegellackbestimmung, die Interferometrie und das Wirbelstromverfahren für die Bestimmung von Kunststofflaminaten eignen.rnIm zweiten Abschnitt der Arbeit werden Einflüsse des Heißsiegellack-Flächengewichtes von Deckfolien auf die Qualität von Blisterverpackungen untersucht. Mit Zunahme des Flächengewichtes zeigt sich eine Erhöhung der Siegelnahtfestigkeit aber auch der Wasserdampfdurchlässigkeit von Blistern. Die untersuchten Heißsiegellacke zeigen Permeationskoeffizienten vergleichbar mit Polyvinylchlorid. In Untersuchungen zur Siegelprozessvalidität zeigt das Heißsiegellack-Flächengewicht nur geringfügige Auswirkungen auf diese. rnIm dritten Abschnitt der Arbeit werden Einflüsse des Blister-Designs auf die Benutzerfreundlichkeit von Blisterverpackungen durch eine Handlingstudie untersucht. Variationen der Öffnungskräfte von Durchdrück-Blistern wirken sich deutlich auf die Bewertungen der Blister durch die Probanden aus. Während die meisten Probanden alle getesteten Durchdrück-Blister innerhalb der Testdauer von 4 Minuten öffnen können (>84%), treten beim Peel-Blister und Peel-off-push-through-Blister deutlich mehr Handlingprobleme auf. Die Handlingprobleme korrelieren mit dem Alter, der Lebenssituation, der gesundheitlichen Verfassung und der Sehfähigkeit der Probanden. rn

Safety by design: production of engineering surface modified nanomaterials

This PhD thesis focused on nanomaterial (NM) engineering for occupational health and safety, in the frame of the EU project “Safe Nano Worker Exposure Scenarios (SANOWORK)”. Following a safety by design approach, surface engineering (surface coating, purification process, colloidal force control, wet milling, film coating deposition and granulation) were proposed as risk remediation strategies (RRS) to decrease toxicity and emission potential of NMs within real processing lines. In the first case investigated, the PlasmaChem ZrO2 manufacturing, the colloidal force control applied to the washing of synthesis rector, allowed to reduce ZrO2 contamination in wastewater, performing an efficient recycling procedure of ZrO2 recovered. Furthermore, ZrO2 NM was investigated in the ceramic process owned by CNR-ISTEC and GEA-Niro; the spray drying and freeze drying techniques were employed decreasing NM emissivity, but maintaining a reactive surface in dried NM. Considering the handling operation of nanofibers (NFs) obtained through Elmarco electrospinning procedure, the film coating deposition was applied on polyamide non-woven to avoid free fiber release. For TiO2 NF the wet milling was applied to reduce and homogenize the aspect ratio, leading to a significant mitigation of fiber toxicity. In the Colorobbia spray coating line, Ag and TiO2 nanosols, employed to transfer respectively antibacterial or depolluting properties to different substrates, were investigated. Ag was subjected to surface coating and purification, decreasing NM toxicity. TiO2 was modified by surface coating, spray drying and blending with colloidal SiO2, improving its technological performance. In the extrusion of polymeric matrix charged with carbon nanotube (CNTs) owned by Leitat, the CNTs used as filler were granulated by spray drying and freeze spray drying techniques, allowing to reduce their exposure potential. Engineered NMs tested by biologists were further investigated in relevant biological conditions, to improve the knowledge of structure/toxicity mechanisms and obtain new insights for the design of safest NMs.

Arte e design in Italia dalla metà degli anni Sessanta alle ultime tendenze

Il lavoro di ricerca è rivolto ad indagare l’emersione di schemi di variazione comuni all’arte e al design, limitatamente al contesto italiano e in un arco di tempo che va dalla metà degli anni Sessanta del secolo scorso a oggi. L’analisi vuole rintracciare, mediante l’applicazione della metodologia fenomenologica, un sentire condiviso tra le due discipline e, nel pieno rispetto dei relativi linguaggi e con nessuna volontà di sudditanza degli uni rispetto agli altri, individuare i rapporti di corrispondenza omologica capaci di mettere in luce lo spirito del tempo che le ha generate. La ricerca si pone l’obiettivo di estendere gli studi sul contemporaneo attraverso un’impostazione che intende applicare gli strumenti metodologici della critica d’arte all’evoluzione stilistica delle tendenze del design italiano. Non si è voluto redigere una “storia” del design italiano ma, considerata anche l’ampiezza dell’argomento, si è necessariamente proceduto a delimitare il territorio di applicazione scegliendo di prendere in considerazione il solo settore del design dell’arredo. Si è dunque optato per una visione globale delle vicende del design del prodotto, tesa ad indagare gli snodi principali, concentrando pertanto l’analisi su alcuni protagonisti della cultura del progetto, ossia su quelle figure risultate dominanti nel proprio tempo perché capaci con il loro lavoro di dare un contribuito determinante alla comprensione delle fasi evolutive del design italiano. Gli strumenti utili a condurre l’analisi provengono principalmente dalla metodologia binaria individuata dallo storico dell’arte Heinrich Wölfflin e dagli studi di Renato Barilli, il cui impianto culturologico ha fornito un indispensabile contributo al processo di sistematizzazione dei meccanismi di variazione interni alle arti; sia quelli di tipo orizzontale, di convergenza reciproca con gli altri saperi, che di tipo verticale, in rapporto cioè con le scoperte scientifiche e tecnologiche della coeva cultura materiale.

Design and Control of Robotic Hands

The application of dexterous robotic hands out of research laboratories has been limited by the intrinsic complexity that these devices present. This is directly reflected as an economically unreasonable cost and a low overall reliability. Within the research reported in this thesis it is shown how the problem of complexity in the design of robotic hands can be tackled, taking advantage of modern technologies (i.e. rapid prototyping), leading to innovative concepts for the design of the mechanical structure, the actuation and sensory systems. The solutions adopted drastically reduce the prototyping and production costs and increase the reliability, reducing the number of parts required and averaging their single reliability factors. In order to get guidelines for the design process, the problem of robotic grasp and manipulation by a dual arm/hand system has been reviewed. In this way, the requirements that should be fulfilled at hardware level to guarantee successful execution of the task has been highlighted. The contribution of this research from the manipulation planning side focuses on the redundancy resolution that arise in the execution of the task in a dexterous arm/hand system. In literature the problem of coordination of arm and hand during manipulation of an object has been widely analyzed in theory but often experimentally demonstrated in simplified robotic setup. Our aim is to cover the lack in the study of this topic and experimentally evaluate it in a complex system as a anthropomorphic arm hand system.

Design methods and geometric modelling of scaffolds for bone tissue engineering

Every year, thousand of surgical treatments are performed in order to fix up or completely substitute, where possible, organs or tissues affected by degenerative diseases. Patients with these kind of illnesses stay long times waiting for a donor that could replace, in a short time, the damaged organ or the tissue. The lack of biological alternates, related to conventional surgical treatments as autografts, allografts, e xenografts, led the researchers belonging to different areas to collaborate to find out innovative solutions. This research brought to a new discipline able to merge molecular biology, biomaterial, engineering, biomechanics and, recently, design and architecture knowledges. This discipline is named Tissue Engineering (TE) and it represents a step forward towards the substitutive or regenerative medicine. One of the major challenge of the TE is to design and develop, using a biomimetic approach, an artificial 3D anatomy scaffold, suitable for cells adhesion that are able to proliferate and differentiate themselves as consequence of the biological and biophysical stimulus offered by the specific tissue to be replaced. Nowadays, powerful instruments allow to perform analysis day by day more accurateand defined on patients that need more precise diagnosis and treatments.Starting from patient specific information provided by TC (Computed Tomography) microCT and MRI(Magnetic Resonance Imaging), an image-based approach can be performed in order to reconstruct the site to be replaced. With the aid of the recent Additive Manufacturing techniques that allow to print tridimensional objects with sub millimetric precision, it is now possible to practice an almost complete control of the parametrical characteristics of the scaffold: this is the way to achieve a correct cellular regeneration. In this work, we focalize the attention on a branch of TE known as Bone TE, whose the bone is main subject. Bone TE combines osteoconductive and morphological aspects of the scaffold, whose main properties are pore diameter, structure porosity and interconnectivity. The realization of the ideal values of these parameters represents the main goal of this work: here we'll a create simple and interactive biomimetic design process based on 3D CAD modeling and generative algorithmsthat provide a way to control the main properties and to create a structure morphologically similar to the cancellous bone. Two different typologies of scaffold will be compared: the first is based on Triply Periodic MinimalSurface (T.P.M.S.) whose basic crystalline geometries are nowadays used for Bone TE scaffolding; the second is based on using Voronoi's diagrams and they are more often used in the design of decorations and jewellery for their capacity to decompose and tasselate a volumetric space using an heterogeneous spatial distribution (often frequent in nature). In this work, we will show how to manipulate the main properties (pore diameter, structure porosity and interconnectivity) of the design TE oriented scaffolding using the implementation of generative algorithms: "bringing back the nature to the nature".

Dynamic distance analysis : new geometric data structures and algorithms for the real-time calculation of tolerance violating regions in the digital mockup process

In vielen Industriezweigen, zum Beispiel in der Automobilindustrie, werden Digitale Versuchsmodelle (Digital MockUps) eingesetzt, um die Konstruktion und die Funktion eines Produkts am virtuellen Prototypen zu überprüfen. Ein Anwendungsfall ist dabei die Überprüfung von Sicherheitsabständen einzelner Bauteile, die sogenannte Abstandsanalyse. Ingenieure ermitteln dabei für bestimmte Bauteile, ob diese in ihrer Ruhelage sowie während einer Bewegung einen vorgegeben Sicherheitsabstand zu den umgebenden Bauteilen einhalten. Unterschreiten Bauteile den Sicherheitsabstand, so muss deren Form oder Lage verändert werden. Dazu ist es wichtig, die Bereiche der Bauteile, welche den Sicherhabstand verletzen, genau zu kennen. rnrnIn dieser Arbeit präsentieren wir eine Lösung zur Echtzeitberechnung aller den Sicherheitsabstand unterschreitenden Bereiche zwischen zwei geometrischen Objekten. Die Objekte sind dabei jeweils als Menge von Primitiven (z.B. Dreiecken) gegeben. Für jeden Zeitpunkt, in dem eine Transformation auf eines der Objekte angewendet wird, berechnen wir die Menge aller den Sicherheitsabstand unterschreitenden Primitive und bezeichnen diese als die Menge aller toleranzverletzenden Primitive. Wir präsentieren in dieser Arbeit eine ganzheitliche Lösung, welche sich in die folgenden drei großen Themengebiete unterteilen lässt.rnrnIm ersten Teil dieser Arbeit untersuchen wir Algorithmen, die für zwei Dreiecke überprüfen, ob diese toleranzverletzend sind. Hierfür präsentieren wir verschiedene Ansätze für Dreiecks-Dreiecks Toleranztests und zeigen, dass spezielle Toleranztests deutlich performanter sind als bisher verwendete Abstandsberechnungen. Im Fokus unserer Arbeit steht dabei die Entwicklung eines neuartigen Toleranztests, welcher im Dualraum arbeitet. In all unseren Benchmarks zur Berechnung aller toleranzverletzenden Primitive beweist sich unser Ansatz im dualen Raum immer als der Performanteste.rnrnDer zweite Teil dieser Arbeit befasst sich mit Datenstrukturen und Algorithmen zur Echtzeitberechnung aller toleranzverletzenden Primitive zwischen zwei geometrischen Objekten. Wir entwickeln eine kombinierte Datenstruktur, die sich aus einer flachen hierarchischen Datenstruktur und mehreren Uniform Grids zusammensetzt. Um effiziente Laufzeiten zu gewährleisten ist es vor allem wichtig, den geforderten Sicherheitsabstand sinnvoll im Design der Datenstrukturen und der Anfragealgorithmen zu beachten. Wir präsentieren hierzu Lösungen, die die Menge der zu testenden Paare von Primitiven schnell bestimmen. Darüber hinaus entwickeln wir Strategien, wie Primitive als toleranzverletzend erkannt werden können, ohne einen aufwändigen Primitiv-Primitiv Toleranztest zu berechnen. In unseren Benchmarks zeigen wir, dass wir mit unseren Lösungen in der Lage sind, in Echtzeit alle toleranzverletzenden Primitive zwischen zwei komplexen geometrischen Objekten, bestehend aus jeweils vielen hunderttausend Primitiven, zu berechnen. rnrnIm dritten Teil präsentieren wir eine neuartige, speicheroptimierte Datenstruktur zur Verwaltung der Zellinhalte der zuvor verwendeten Uniform Grids. Wir bezeichnen diese Datenstruktur als Shrubs. Bisherige Ansätze zur Speicheroptimierung von Uniform Grids beziehen sich vor allem auf Hashing Methoden. Diese reduzieren aber nicht den Speicherverbrauch der Zellinhalte. In unserem Anwendungsfall haben benachbarte Zellen oft ähnliche Inhalte. Unser Ansatz ist in der Lage, den Speicherbedarf der Zellinhalte eines Uniform Grids, basierend auf den redundanten Zellinhalten, verlustlos auf ein fünftel der bisherigen Größe zu komprimieren und zur Laufzeit zu dekomprimieren.rnrnAbschießend zeigen wir, wie unsere Lösung zur Berechnung aller toleranzverletzenden Primitive Anwendung in der Praxis finden kann. Neben der reinen Abstandsanalyse zeigen wir Anwendungen für verschiedene Problemstellungen der Pfadplanung.

Automatic Design of Boolean Networks for Modelling Differentiation Trees

Real living cell is a complex system governed by many process which are not yet fully understood: the process of cell differentiation is one of these. In this thesis work we make use of a cell differentiation model to develop gene regulatory networks (Boolean networks) with desired differentiation dynamics. To accomplish this task we have introduced techniques of automatic design and we have performed experiments using various differentiation trees. The results obtained have shown that the developed algorithms, except the Random algorithm, are able to generate Boolean networks with interesting differentiation dynamics. Moreover, we have presented some possible future applications and developments of the cell differentiation model in robotics and in medical research. Understanding the mechanisms involved in biological cells can gives us the possibility to explain some not yet understood dangerous disease, i.e the cancer. Le cellula è un sistema complesso governato da molti processi ancora non pienamente compresi: il differenziamento cellulare è uno di questi. In questa tesi utilizziamo un modello di differenziamento cellulare per sviluppare reti di regolazione genica (reti Booleane) con dinamiche di differenziamento desiderate. Per svolgere questo compito abbiamo introdotto tecniche di progettazione automatica e abbiamo eseguito esperimenti utilizzando vari alberi di differenziamento. I risultati ottenuti hanno mostrato che gli algoritmi sviluppati, eccetto l'algoritmo Random, sono in grado di poter generare reti Booleane con dinamiche di differenziamento interessanti. Inoltre, abbiamo presentato alcune possibili applicazioni e sviluppi futuri del modello di differenziamento in robotica e nella ricerca medica. Capire i meccanismi alla base del funzionamento cellulare può fornirci la possibilità di spiegare patologie ancora oggi non comprese, come il cancro.

Progettazione e sviluppo di un framework per la realizzazione di process-aware Web applications.

Il potenziale che il Web ha raggiunto in termini di accessibilità, gestione e flessibilità, ha spinto i più svariati settori ad approcciarsi ad esso e ad adottarlo all’interno delle proprie organizzazioni. É stato quindi necessario applicare alle tradizionali applicazioni web, nuove soluzioni al fine di integrare gli elementi di workflow management con il modello dei dati di navigazione e di presentazione. In questo lavoro di tesi, si affrontano gli aspetti legati ai processi di business, con riferimento alla progettazione e allo sviluppo di applicazioni Web. Verranno introdotti standard di modellazione come UML e BPMN per poi descrivere soluzioni e casi di studio esistenti. Nella seconda parte dell'elaborato invece, verranno presentate le tecnologie utilizzate per il design e lo sviluppo di un framework, a supporto delle process-aware Web applications.

Reduction of inappropriate medications among older nursing-home residents: a nurse-led, pre/post-design, intervention study

Background: Medication-related problems are common in the growing population of older adults and inappropriate prescribing is a preventable risk factor. Explicit criteria such as the Beers criteria provide a valid instrument for describing the rate of inappropriate medication (IM) prescriptions among older adults. Objective: To reduce IM prescriptions based on explicit Beers criteria using a nurse-led intervention in a nursing-home (NH) setting. Study Design: The pre/post-design included IM assessment at study start (pre-intervention), a 4-month intervention period, IM assessment after the intervention period (post-intervention) and a further IM assessment at 1-year follow-up. Setting: 204-bed inpatient NH in Bern, Switzerland. Participants: NH residents aged ≥60 years. Intervention: The intervention included four key intervention elements: (i) adaptation of Beers criteria to the Swiss setting; (ii) IM identification; (iii) IM discontinuation; and (iv) staff training. Main Outcome Measure: IM prescription at study start, after the 4-month intervention period and at 1-year follow-up. Results: The mean±SD resident age was 80.3±8.8 years. Residents were prescribed a mean±SD 7.8±4.0 medications. The prescription rate of IMs decreased from 14.5% pre-intervention to 2.8% post-intervention (relative risk [RR] = 0.2; 95% CI 0.06, 0.5). The risk of IM prescription increased nonstatistically significantly in the 1-year follow-up period compared with post-intervention (RR = 1.6; 95% CI 0.5, 6.1). Conclusions: This intervention to reduce IM prescriptions based on explicit Beers criteria was feasible, easy to implement in an NH setting, and resulted in a substantial decrease in IMs. These results underscore the importance of involving nursing staff in the medication prescription process in a long-term care setting.

Randomization in clinical trials in orthodontics: its significance in research design and methods to achieve it

Randomization is a key step in reducing selection bias during the treatment allocation phase in randomized clinical trials. The process of randomization follows specific steps, which include generation of the randomization list, allocation concealment, and implementation of randomization. The phenomenon in the dental and orthodontic literature of characterizing treatment allocation as random is frequent; however, often the randomization procedures followed are not appropriate. Randomization methods assign, at random, treatment to the trial arms without foreknowledge of allocation by either the participants or the investigators thus reducing selection bias. Randomization entails generation of random allocation, allocation concealment, and the actual methodology of implementing treatment allocation randomly and unpredictably. Most popular randomization methods include some form of restricted and/or stratified randomization. This article introduces the reasons, which make randomization an integral part of solid clinical trial methodology, and presents the main randomization schemes applicable to clinical trials in orthodontics.

Minimization of Intra-Operative Shaping of Orthopaedic Fixation Plates: A Population-Based Design

In this paper we present a new population-based method for the design of bone fixation plates. Standard pre-contoured plates are designed based on the mean shape of a certain population. We propose a computational process to design implants while reducing the amount of required intra-operative shaping, thus reducing the mechanical stresses applied to the plate. A bending and torsion model was used to measure and minimize the necessary intra-operative deformation. The method was applied and validated on a population of 200 femurs that was further augmented with a statistical shape model. The obtained results showed substantial reduction in the bending and torsion needed to shape the new design into any bone in the population when compared to the standard mean-based plates.

A navigation system for percutaneous needle interventions based on PET/CT images: design, workflow and error analysis of soft tissue and bone punctures

Percutaneous needle intervention based on PET/CT images is effective, but exposes the patient to unnecessary radiation due to the increased number of CT scans required. Computer assisted intervention can reduce the number of scans, but requires handling, matching and visualization of two different datasets. While one dataset is used for target definition according to metabolism, the other is used for instrument guidance according to anatomical structures. No navigation systems capable of handling such data and performing PET/CT image-based procedures while following clinically approved protocols for oncologic percutaneous interventions are available. The need for such systems is emphasized in scenarios where the target can be located in different types of tissue such as bone and soft tissue. These two tissues require different clinical protocols for puncturing and may therefore give rise to different problems during the navigated intervention. Studies comparing the performance of navigated needle interventions targeting lesions located in these two types of tissue are not often found in the literature. Hence, this paper presents an optical navigation system for percutaneous needle interventions based on PET/CT images. The system provides viewers for guiding the physician to the target with real-time visualization of PET/CT datasets, and is able to handle targets located in both bone and soft tissue. The navigation system and the required clinical workflow were designed taking into consideration clinical protocols and requirements, and the system is thus operable by a single person, even during transition to the sterile phase. Both the system and the workflow were evaluated in an initial set of experiments simulating 41 lesions (23 located in bone tissue and 18 in soft tissue) in swine cadavers. We also measured and decomposed the overall system error into distinct error sources, which allowed for the identification of particularities involved in the process as well as highlighting the differences between bone and soft tissue punctures. An overall average error of 4.23 mm and 3.07 mm for bone and soft tissue punctures, respectively, demonstrated the feasibility of using this system for such interventions. The proposed system workflow was shown to be effective in separating the preparation from the sterile phase, as well as in keeping the system manageable by a single operator. Among the distinct sources of error, the user error based on the system accuracy (defined as the distance from the planned target to the actual needle tip) appeared to be the most significant. Bone punctures showed higher user error, whereas soft tissue punctures showed higher tissue deformation error.