Analysis and maintenance of common fault of lower limbs intelligent feedback training system / 中国医学装备

To explore the causes and solutions of common faults in the operation of the of Yi Kang A1 series lower limb intelligent feedback training system,and to conduct a comparative study on the structural principle and fault maintenance of the two models.Through the analysis of equipment spasm error,USB disconnection error,inability to access the game,black screen of display,splash screen or no display,standing numerical deviation and proprioceptive numerical deviation and other failure cases,gradually investigate software setting,hardware inspection,sensitivity setting,USB connection testing,game file testing,VGA interface testing,angle sensor testing and pressure sensor testing,etc.,to handle and solve the faults in a timely manner to ensure the equipment in good condition,to improve the normal use rate of equipment and ensure the timely rehabilitation of patients.

Identifying Root Causes of Important Service Failures across Medical Examination Processes with Integration of 4M1E, ITLV, GRA, DEMATEL and FMEA.

Medical examination plays an essential role in most medical treatment processes, and thus, the quality of service relevant to medical examination has great impact on patient satisfaction. The targeted hospital has long been faced with the problem that patient satisfaction of its medical examination department is below average. An assessment model, integrating 4M1E, ITLV, GRA, DEMATEL and FMEA, was developed in this study to identify the root causes of important service failures across medical examination processes, where (1) a cause-and-effect diagram was enhanced with 4M1E, identifying the list of failure modes relevant to service quality over the medical examination process with the 4M1E analysis framework, (2) FMEA experts were enabled to report their assessment results in their preferred ways by using the ITLV scheme, (3) causes of failure to failure modes with was figured out with DEMATEL, and (4) the evaluation results were improved by integrating GRA. Experimental results obtained by the proposed approach are compared with several benchmarks, and it was observed that (1) the results obtained by the proposed model are more suitable when FMEA experts prefer using different assessment languages versus other approaches; (2) the proposed model can figure out the key root causes according to their impact on overall failure modes.

[Causes of failure in autologous sperm preservation in the human sperm bank and countermeasures].

OBJECTIVE: To analyze the causes of failure in autologous sperm cryopreservation (ASCP) in the human sperm bank and propose some countermeasures to improve the success rate of ASCP and promote it in human sperm banks. METHODS: We retrospectively analyzed the reasons for and causes of failure in ASCP 1 156 males undergoing ASCP in the Human Sperm Bank of Guangdong Province from January 1, 2016 to December 31, 2019. RESULTS: Of the 1 156 cases of ASCP, 857 (74.1%) succeeded and 299 (25.9%) failed, with a failure rate of 56.1% (96/171) in the microdissection testicular sperm extraction (micro-TESE) group, 29.9% (67/224) in the reproduction insurance group, 21.2% (27/100) in the non-tumor disease group and 17.2% (109/525) in the tumor group, with statistically significant difference between the four groups (χ2 = 109.926, P < 0.01). The causes of failed ASCP included failure to extract semen (14.0% ï¼»42/299ï¼½), failure to meet the standard of sperm cryopreservation (67.6% ï¼»202/299ï¼½), giving up ASCP for low semen quality (7.4% ï¼»22/299ï¼½), and giving up ASCP for some other reasons (11.0% ï¼»33/299ï¼½), including worry about the reliability of cryopreservation technology (6.0% ï¼»18/299ï¼½), suspicion about the complexity of the ASCP procedures (3.0% ï¼»9/299ï¼½) and expectation for fertility recovery after chemotherapy withdrawal (2.0% ï¼»6/299ï¼½). CONCLUSIONS: In view of different causes of failure in ASCP, human sperm banks can provide individualized cryopreservation schemes, including guidance with masturbation or the use of sperm extraction instrument in sperm extraction, strengthening sperm preservation-related education and the awareness of reproduction protection and earlier sperm preservation among cancer patients, promoting the cryopreservation of microsamples of motile sperm by microsample or single sperm freezing, and development of testis tissue cryopreservation to preserve the fertility of children with cancer.

El ciclo repetitivo en la Odontología Restauradora / The repetitive cycle in Restorative Dentistry

Los cambios en la vida, así como también en el campo de la Odontología, deben ser para mejorar siempre en todos los aspectos posibles. Y muchos de los cambios recientes en la Odontología Restauradora están encaminados a la utilización de materiales estéticos para remplazo de restauraciones metálicas previas, sin generar certeza total de ser mejores opciones. Esto ha generado un marcado incremento en la tendencia a practicar, más enfáticamente, el remplazo de restauraciones previas (AU)

Changes in life, as so in the field of Dentistry, should always be for the improvement on most possible aspects. Many of the recent changes in Restorative Dentistry are focus on the use of cosmetic materials to replace previous metallic restorations, without total certainty of being better options. This has generated a marked increase in the tendency to practice, more emphatically, the replacement of previous restorations (AU)

[The causes of Latarjet surgery failure and the revision surgeries].

OBJECTIVE: To review the causes of Latarjet surgery failure and various revision surgeries, in order to provide the reference for the revision of treatment options for Latarjet surgery failure. METHODS: Literature on the causes of Latarjet surgery failure and revision surgeries was extensively reviewed and analyzed. RESULTS: Latarjet surgery is widely used in clinical practice for recurrent anterior dislocation of shoulder with glenoid defects, especially for the defects of more than 25%. The main reasons for its failure are ununion, bone resorption, graft dislocation, trauma, and graft fracture, etc. The revision surgeries are diverse, the standard treatment has not yet been formed. The revision surgeries include open iliac bone grafting, microscopic Eden-Hybinette surgery, soft tissue reconstruction, open or arthroscopic bone grafting, etc. The differences among the revisions are mainly reflected in grafts, complications, and their costs. CONCLUSION: Latarjet surgery is difficult to operate and requires high technical requirements for the surgeons. It is necessary to continuously improve the surgical technology to reduce the complications related to Latarjet surgery and its revision surgery.

Analysis of the time-varying Cox model for the cause-specific hazard functions with missing causes.

This paper studies the Cox model with time-varying coefficients for cause-specific hazard functions when the causes of failure are subject to missingness. Inverse probability weighted and augmented inverse probability weighted estimators are investigated. The latter is considered as a two-stage estimator by directly utilizing the inverse probability weighted estimator and through modeling available auxiliary variables to improve efficiency. The asymptotic properties of the two estimators are investigated. Hypothesis testing procedures are developed to test the null hypotheses that the covariate effects are zero and that the covariate effects are constant. We conduct simulation studies to examine the finite sample properties of the proposed estimation and hypothesis testing procedures under various settings of the auxiliary variables and the percentages of the failure causes that are missing. These simulation results demonstrate that the augmented inverse probability weighted estimators are more efficient than the inverse probability weighted estimators and that the proposed testing procedures have the expected satisfactory results in sizes and powers. The proposed methods are illustrated using the Mashi clinical trial data for investigating the effect of randomization to formula-feeding versus breastfeeding plus extended infant zidovudine prophylaxis on death due to mother-to-child HIV transmission in Botswana.

An issue of identifying longitudinal biomarkers for competing risks data with masked causes of failure considering frailties model.

In this paper, we consider joint modeling of repeated measurements and competing risks failure time data to allow for more than one distinct failure type in the survival endpoint. Hence, we can fit a cause-specific hazards submodel to allow for competing risks, with a separate latent association between longitudinal measurements and each cause of failure. We also consider the possible masked causes of failure in joint modeling of repeated measurements and competing risks failure time data. We also derive a score test to identify longitudinal biomarkers or surrogates for a time-to-event outcome in competing risks data which contain masked causes of failure. With a carefully chosen definition of complete data, the maximum likelihood estimation of the cause-specific hazard functions and of the masking probabilities is performed via an expectation maximization algorithm. The simulations are used to explore how the number of individuals, the number of time points per individual, and the functional form of the random effects from the longitudinal biomarkers considering heterogeneous baseline hazards in individuals influence the power to detect the association of a longitudinal biomarker and the survival time.

Rotating-hinge knee prosthesis as a viable option in primary surgery: Literature review & meta-analysis.

BACKGROUND: Rotating-hinge knee replacements are usually reserved for revision surgeries, when the extent of soft tissue loss makes a constrained implant more suitable. They remain an uncommon choice in primary surgery when the soft tissue loss is not as extensive. METHODS: We completed a systematic review and meta-analysis to assess patients who underwent a Total Knee Replacement (TKR) with the rotating-hinge prosthesis in the primary setting. We searched PubMed and Embase for articles published in the ten years prior June 2017: Prosthesis survival rates, causes of failure, and clinical/functional scores were the primary outcomes. Twenty-one articles met the inclusion criteria for meta-analysis. Articles were grouped into (1) non-tumour (n=11) and (2) tumour indications (n=10). Survival data was summarized in forest plots, generated using Stata. RESULTS: We found that for certain indications the prosthesis has impressive survival rates and functional outcomes. Short-term (1-5 year) prosthesis survival in non-tumour cases was 92% (95% CI, 87-98%) and 77% (95% CI, 68-87%) in tumour cases. Mid-term (6-10 year) survival was 82% (95% CI, 74-89%) and 69% (95% CI, 57-81%) in non-tumour and tumour studies respectively. In analysis of clinical scores, patients showed a significant improvement in their pain score. Infection was the most commonly cited cause of prosthesis failure in both non-tumour and tumour studies, attributing to 31.5% and 37.6% of failures respectively. Aseptic loosening, dislocation and fracture were also commonly cited complications. CONCLUSION: We concluded that the rotating-hinge knee prosthesis is a viable option in primary surgery when there is extensive soft tissue destruction surrounding the joint. LEVEL OF EVIDENCE: I.

Revision Anterior Cruciate Ligament Reconstruction: Analysis of the Causes of Failure, Associated Injuries and Clinical Results / 대한정형외과학회잡지

PURPOSE: The aim of this study was to analyze the causes of failure after a primary anterior cruciate ligament reconstruction (ACLR), associated injuries, and the clinical results of revision ACLR. MATERIALS AND METHODS: This study evaluated 46 patients (46 knees), who were followed at least two years after revision ACLR. The evaluations included the causes of failure after primary ACLR, associated injuries, 2000 International Knee Documentation Committee (IKDC) subjective knee scores, Lachman test, Pivot shift test, and KT-1000 arthrometer measurement. RESULTS: The most common cause of failure was trauma (27 patients, 58.7%) and 19 failures (19 patients, 41.3%) were caused using an inappropriate surgical technique. The associated injuries were meniscus tears in 29 cases (63.0%) and articular cartilage injuries of Outerbridge grade II to IV in 19 cases (41.3%). The IKDC scores, Lachman test, Pivot shift test, and KT-1000 arthrometer measurements were improved significantly at the final follow-up. CONCLUSION: The most common cause of failure after primary ACLR was trauma. One stage revision ACLR resulted in relatively satisfactory stability but less satisfactory clinical function than the primary reconstruction, as reported previously, which is believed to be due to the more associated injuries.

Regulatory Experience with In Vivo In Vitro Correlations (IVIVC) in New Drug Applications.

In the past two decades, in vitro in vivo correlation (IVIVC) has been considered an important tool for supporting biowaivers, setting dissolution acceptance criteria, and more recently in the Quality by Design (QbD) framework promoting the establishment of clinically meaningful drug product specifications using dissolution as the endpoint. Based on our review experience at the FDA, for the purposes of this article, we analyzed the current state of regulatory submissions containing IVIVC approaches and discussed the successes and failures from the perspectives of study design to methodology. In the past decade, the overall acceptance rate of the IVIVC submissions is about 40%. Moreover, the number of IVIVC studies seen in the submissions per year is not increasing. Establishing clinically meaningful drug product specifications through the linkages between the identified critical quality attributes and in vivo performance is key for developing a quality drug product. To achieve this goal, there is an imminent need for addressing the issues behind a low success rate in IVIVC development. The results from the current analysis revealed that special considerations should be taken in areas such as (1) selection of appropriate number/kind of formulations for IVIVC development/validation, (2) construction of exploratory plots to guide model building and selection, (3) investigation of the reasons of inconclusive predictability, (4) improvement on the quality and richness of the data, and (5) avoidance of over parameterization. The development and incorporation of biopredictive dissolution methods and the use of non-conventional approaches, including mechanistic/physiologically based approaches, should be explored to increase the likelihood of IVIVC success.

External dacryocystorhinostomy in consultants and fellows - a comparison of the causes of failure.

PURPOSE: Failure of primary dacryocystorhinostomy (DCR) often requires revision surgery to inspect the cause of failure and re-establish anatomic patency. This study aims to specifcally compare the anatomical causes of failure noted during revision DCR of primary external DCR (EX-DCR) and compare the difference between consultants and fellows. METHODS: A retrospective review of 37 patients who underwent revision of a primary external approach DCR over a 7-year-period in a University Hospital. All primary surgery was performed by either a consultant surgeon or senior oculoplastic fellow. Details of the initial pathology prior to primary DCR and grade of operating surgeon were collected along with perioperative surgical findings. The cause of failure of the initial surgery was classified according to perioperative findings. Failure was classified as either inappropriately sized/located ostium or fibrous/membranous soft tissue obstruction of the newly created ostium. RESULTS: The cause of failure of the initial surgery was soft tissue obstruction in 43.3% and an inappropriately sized/located ostium in 56.7%. In those patients whose primary surgery was performed by a consultant, 73.3% were found to have a soft tissue obstruction and 26.7% were found to have an inappropriately sized/ located ostium. In contrast, if initial surgery was performed by a fellow, 22.7% were found to have a soft tissue obstruction and 77.3% an inappropriately sized/ located ostium (p =0.002). CONCLUSIONS: Where the primary surgeon has been a trainee there is a trend toward inadequately sized or located ostium being the most likely causative factor in failure of primary EX-DCR.  Hippokratia 2015; 19 (3): 216-218.

Clinical Analysis of Failed Back Surgery Syndrome

One hundred thirty-five patients undergone microdiscectomy of lumbar disc disease were analysed with soft-ware program which designed for effective analysis for spinal in-patients since February, 1990. Owing to that program, all the patients could be easily analyzed and get a regular follow-up. The surgical result was evaluated by our own score rating system which consists of 4 items:1) Frequency of medication, 2) Degree of social activity, 3) Post-operative symptom compared to pre-operative state and 4) Patient's satisfaction with the operation. According to that system, 21 patients(15.6%) were estimated with failure following microdiscectomy. Among them 6 patients of psychosocial problem, 4 patients of technical errors and 2 patients of recurrence were an important causes of failure. For the purpose of effective surgery for lumbar disc surgery, a careful analysis of the cases of surgical failure should be attempted and also a regular follow-up can be importment factor for more accurate estimation of surgical result.