Robotic fundoplication: from theoretic advantages to real problems.
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Stereotactic radiosurgery is a minimally invasive procedure that uses a focused beam of radiation as an ablative instrument to destroy brain tumors. To deposit a high dose of radiation in a tumor, while reducing the dose to healthy tissue, a large number of beams are crossfired at the tumor from multiple directions. The treatment planning problem (also called the inverse dosimetry problem) is to compute a set of beams that produces the desired dose distribution. So far its investigation has focused on the generation of isocenter-based treatments in which the beam axes intersect at a common point, the isocenter. However this restriction limits the applicability of the treatments to tumors which have simple shapes. This paper describes CARABEAMER, a new treatment planner for a radiosurgical system in which the radiation source can be arbitrarily positioned and oriented by a six-degree-of-freedom manipulator. This planner uses randomized techniques to guess a promising initial set of beams. It then applies space partitioning and linear programming techniques to compute the energy to be delivered along each beam. Finally, it exploits the results of the linear program to iteratively adapt and improve the beam set. Experimental results obtained with CARABEAMER on both patient and synthetic cases are presented and discussed. These results demonstrate that a radiosurgical system with general kinematics can deliver treatments in which the region receiving a high dose closely matches the shape of the tumor, even in complicated cases. They also suggest new research directions which are discussed at the end of the paper.
Technological advances in the automation of parallel synthesis are following the model set by the semiconductor industry: miniaturization, increasing speed, lower costs. Recent work includes preparation of high-density reaction blocks, development of ink-jet dispensing to polypropylene sheets and synthesis inside customized microchips.
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A database consisting of 35291 milking records from 83 cows was built over a period of 10 months with the objectives of studying the effect of teat cup attachment failures and milking interval regularity on milk production with an automated milking system (AMS). The database collected records of lactation number, days in milk (DIM), milk production, interval between milkings (for both the entire udder and individual quarters in case of a teat cup attachment failure) and average and peak milk flows for each milking. The weekly coefficient of variation (CV) of milking intervals was used as a measure of milking regularity. DIM, milking intervals, and CV of milking intervals were divided into four categories coinciding with the four quartiles of their respective distributions. The data were analysed by analysis of variance with cow as a random effect and lactation number, DIM, the occurrence of a milking failure, and the intervals between milkings or the weekly CV of milking intervals as fixed effects. The incidence of attachment failures was 7.6% of total milkings. Milk production by quarters affected by a milking failure following the failure was numerically greater owing to the longer interval between milkings. When accounting for the effect of milking intervals, milk production by affected quarters following a milking failure was 26% lower than with regular milkings. However, the decrease in milk production by quarters affected by milking failures was more severe as DIM increased. Average and peak milk flows by quarters affected by a milking failure were lower than when milkings occurred normally. However, milk production recovered its former level within seven milkings following a milking failure. Uneven frequency (weekly CV of milking intervals >27%) decreased daily milk yield, and affected multiparous more negatively than primiparous cows.
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The generation of large numbers of samples during early drug discovery has increased the demand for rapid and selective methods of analysis. Liquid chromatography-tandem mass spectrometry (LC-MS-MS), because of its sensitivity, selectivity, and robustness, has emerged as a powerful tool in the pharmaceutical industry for many analytical needs. This work presents a high-throughput selected reaction monitoring LC-MS bioanalytical method for the determination of idoxifene, a selective estrogen receptor modulator, and its pyrrolidinone metabolite in clinical human plasma samples. The described method uses short, small-bore columns, high flow rates, and elevated HPLC column temperatures to perform LC separations of idoxifene and its metabolite within 10 s/sample. Sequential injections were accomplished with a 215/889 multiple probe liquid handler (Gilson, Inc.), which aspirates eight samples simultaneously and performs its rinse cycle parallel to sample injection, resulting in minimum lag time between injections. This high-throughput method was applied to the determination of idoxifene and its metabolite in clinical human plasma samples. Sample preparation employed liquid/liquid extraction in the 96-well format. Method validation included determination of intra- and interassay accuracy and precision values, recovery studies, autosampler stability, and freeze-thaw stability. The LOQ obtained was 10 ng/mL for idoxifene and 30 ng/mL for the metabolite. Using idoxifene-d5 as an internal standard, idoxifene showed acceptable accuracy and precision values at QC level 1 (QC1, 15 ng/mL), level 2 (QC2, 100 ng/mL), and level 3 (QC3, 180 ng/mL) (85.0% accuracy +/- 12.0% precision, 95.1 +/- 4.9%, and 90.3 +/- 4.7%, respectively). The pyrrolidinone metabolite also showed acceptable accuracy and precision values (using no internal standard for quantitation) at QC1 (60 ng/mL), QC2 (100 ng/mL), and QC3 (180 ng/mL) (104.9 +/- 14.4%, 91.1 +/- 13.0%, and 90.8 +/- 12.2%, respectively). The validated method was applied to the analysis of 613 human clinical plasma samples. An average run time of 23 s/sample (approximately 37 min/ 96-well plate or over 3,700 sample/day) was achieved. The successful validation presented indicates that rapid methods of analysis can efficiently and reliably contribute to the fast sample turnaround required for high sample number generating processes.
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In this study, an image-guided system for oral implant placement was assessed. A specially designed mechanical tool has been elaborated to transfer the preoperative implant axis planned on 3-dimensional imagery into a surgical template by a numerically controlled drilling machine. The main drawback of image-guiding systems is the use of preoperative computed tomography, which is expensive and delivers high radiation doses. Therefore, in this study the image-guiding system was coupled with a cone-beam tomograph that significantly decreased both cost and radiation doses. Three edentulous models were used. To determine the accuracy of the system, the ability of a 1.8-mm diameter drill to enter a 2.0-mm diameter, 10-mm-long titanium tube inserted on the model with no contact was verified. Because the drill entered the tubes with no contact and went beyond the end of the tube, the transfer error was less than 0.2 mm for translation and less than 1.1 degrees for rotation. The method presented here is low cost and high precision compared to other technological solutions such as tracking. Further assessment in the surgical field should lead to daily use of this system for flapless surgery, to prepare a prosthesis prior to surgery for immediate loading, to reduce risk of injuring critical anatomical structures and to eliminate manual placement error.
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