591 resultados para Drawbar traction
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"September 1989."
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Mode of access: Internet.
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PurposeTo develop and validate a classification system for focal vitreomacular traction (VMT) with and without macular hole based on spectral domain optical coherence tomography (SD-OCT), intended to aid in decision-making and prognostication.MethodsA panel of retinal specialists convened to develop this system. A literature review followed by discussion on a wide range of cases formed the basis for the proposed classification. Key features on OCT were identified and analysed for their utility in clinical practice. A final classification was devised based on two sequential, independent validation exercises to improve interobserver variability.ResultsThis classification tool pertains to idiopathic focal VMT assessed by a horizontal line scan using SD-OCT. The system uses width (W), interface features (I), foveal shape (S), retinal pigment epithelial changes (P), elevation of vitreous attachment (E), and inner and outer retinal changes (R) to give the acronym WISPERR. Each category is scored hierarchically. Results from the second independent validation exercise indicated a high level of agreement between graders: intraclass correlation ranged from 0.84 to 0.99 for continuous variables and Fleiss' kappa values ranged from 0.76 to 0.95 for categorical variables.ConclusionsWe present an OCT-based classification system for focal VMT that allows anatomical detail to be scrutinised and scored qualitatively and quantitatively using a simple, pragmatic algorithm, which may be of value in clinical practice as well as in future research studies.
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La Formule SAE (Society of Automotive Engineers) est une compétition étudiante consistant en la conception et la fabrication d’une voiture de course monoplace. De nombreux événements sont organisés à chaque année au cours desquels plusieurs universités rivalisent entre elles lors d’épreuves dynamiques et statiques. Celles-ci comprennent l’évaluation de la conception, l’évaluation des coûts de fabrication, l’accélération de la voiture, etc. Avec plus de 500 universités participantes et des événements annuels sur tous les continents, il s’agit de la plus importante compétition d’ingénierie étudiante au monde. L’équipe ULaval Racing a participé pendant plus de 20 ans aux compétitions annuelles réservées aux voitures à combustion. Afin de s’adapter à l’électrification des transports et aux nouvelles compétitions destinées aux voitures électriques, l’équipe a conçu et fabriqué une chaîne de traction électrique haute performance destinée à leur voiture 2015. L’approche traditionnelle employée pour concevoir une motorisation électrique consiste à imposer les performances désirées. Ces critères comprennent l’inclinaison maximale que la voiture doit pouvoir gravir, l’autonomie désirée ainsi qu’un profil de vitesse en fonction du temps, ou tout simplement un cycle routier. Cette approche n’est malheureusement pas appropriée pour la conception d’une traction électrique pour une voiture de type Formule SAE. Ce véhicule n’étant pas destiné à la conduite urbaine ou à la conduite sur autoroute, les cycles routiers existants ne sont pas représentatifs des conditions d’opération du bolide à concevoir. Ainsi, la réalisation de ce projet a nécessité l’identification du cycle d’opération routier sur lequel le véhicule doit opérer. Il sert de point de départ à la conception de la chaîne de traction composée des moteurs, de la batterie ainsi que des onduleurs de tension. L’utilisation d’une méthode de dimensionnement du système basée sur un algorithme d’optimisation génétique, suivie d’une optimisation locale couplée à une analyse par éléments-finis a permis l’obtention d’une solution optimale pour les circuits de type Formule SAE. La chaîne de traction conçue a été fabriquée et intégrée dans un prototype de voiture de l’équipe ULaval Racing lors de la saison 2015 afin de participer à diverses compétitions de voitures électriques.
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Aim: To investigate the qualitative aspects in patient selection and the quantitative impact of disease burden in real world treatment of vitreomacular traction (VMT) and implementation of the National Institute for Health and Care Excellence (NICE) guidance (TA297). Methods: A monocentric, retrospective review of consecutive patients undergoing optical coherence tomography (OCT) imaging over a 3 month period. Patients with VMT in at least one eye were identified for further data collection on laterality, visual acuity, symptoms, presence of epiretinal membrane, macular hole and treatment selection. Results: A total of 3472 patients underwent OCT imaging with a total of 6878 eyes scanned. Out of 87 patients, 74 patients had unilateral VMT (38 right, 36 left) and 13 patients had bilateral VMT. Eighteen patients with unilateral VMT satisfied NICE criteria of severe sight problems in the affected eye. Eight were managed for a coexisting pathology, one refused treatment, one patient did not attend, two closed spontaneously, and one received ocriplasmin prior to the study start date. Only two patients with unilateral VMT received ocriplasmin and three underwent vitrectomy. Those failing to meet NICE criteria for unilateral VMT were predominantly asymptomatic (n=49) or had coexisting ERM (n=5) or both (n=2). Conclusion: Ocriplasmin provides an alternative treatment for patients with symptomatic VMT. Our data shows that the majority of patients with VMT do not meet NICE TA297 primarily due to lack of symptoms. Those meeting NICE criteria, but not treated, tended to have coexisting macular pathology. Variation in patient selection due to subjective factors not outlined in NICE guidance suggests that real world outcomes of ocriplasmin therapy should be interpreted with caution.
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The concept of star rating council facilities has progressively gained traction in Australia following the work of Dean Taylor at Marochy Shire Council in Queensland in 2006 – 2007 and more recently by the Victorian STEP asset management program. The following paper provides a brief discussion on the use and merits of star rating within community asset management. We suggest that the current adoption of the star rating system to manage community investment in services is lacking in consistency. It is suggested that the major failing is a lack of clear understanding in the purpose being served by the systems. The discussion goes on to make some recommendations on how the concept of a star system could be further enhanced to serve the needs of our communities better.
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Six Sigma provides a framework for quality improvement and business excellence. Introduced in the 1980s in manufacturing, the concept of Six Sigma has gained popularity in service organizations. After initial success in healthcare and banking, Six Sigma has gradually gained traction in other types of service industries, including hotels and lodging. Starwood Hotels and Resorts was the first hospitality giant to embrace Six Sigma. In 2001, Starwood adopted the method to develop innovative, customer-focused solutions and to transfer these solutions throughout the global organization. To analyze Starwood's use of Six Sigma, the authors collected data from articles, interviews, presentations and speeches published in magazines, newspapers and Web sites. This provided details to corroborate information, and they also made inferences from these sources. Financial metrics can explain the success of Six Sigma in any organization. There was no shortage of examples of Starwood's success resulting from Six Sigma project metrics uncovered during the research.