Conventional Evacuation Research Articles

Pulmonary recruitment maneuver to reduce pain after laparoscopy: a meta-analysis of randomized controlled trials.

We investigated the impact of pulmonary recruitment maneuver in reducing shoulder pain after laparoscopic procedure. We conducted a systematic review of the literature using Medline (1966-2014), Scopus (2004-2014), Popline (1974-2014), www.ClinicalTrials.gov (2008-2014), and Google Scholar (2004-2014) along with reference lists of electronically retrieved studies. Statistical meta-analysis was performed using the RevMan 5.1 software. Six studies were included in the present systematic review, involving 571 patients. Among them, 291 (51 %) were offered a pulmonary recruitment maneuver, and 280 patients (49 %) were treated with conventional evacuation of pneumoperitoneum that included either passive evacuation or gentle pressing of the abdominal walls with the trocar ports open. The introduction of a pulmonary recruitment maneuver significantly decreased postoperative shoulder pain 12 h (435 patients, REM, MD -1.55, 95 % CI -2.01, -1.10), 24 h (435 patients, REM, MD -1.59, 95 % CI -2.00, -1.18), and 48 h post-operatively (335 patients, REM, MD -0.93, 95 % CI -1.37, -0.50). We also identified evidence of a potential beneficial effect in the reduction of postoperative upper abdominal pain. However, discrepancies in the interpretation of abdominal pain among the included studies precluded meta-analysis of this index. According to the results of our meta-analysis, pulmonary recruitment maneuver seems to be an easily performed, potentially preventive measure of post-laparoscopic shoulder pain. Further research is mandated, however, in the field, because firm results are precluded by the small number of included studies.

Ant Colony Optimization Model for Tsunamis Evacuation Routes

AbstractNatural disasters such as earthquakes and tsunamis foster the creation of effective evacuation strategies to prevent the loss of human lives. This article proposes a simulation model to find out optimum evacuation routes, during a tsunami using Ant Colony Optimization (ACO) algorithms. ACO is a discrete optimization algorithm inspired by the ability of ants to establish the shortest path from their nest to a food source, and vice versa, using pheromones. The validation of the model was carried out through two drills, which were conducted in the coastal town of Penco, Chile. This town was strongly affected by an 8.8 Mw earthquake and tsunami over February 2010. The first drill was held with minimum information, leaving the population to act randomly and intuitively. The second drill was carried out with information provided by the model, inducing people to use the optimized routes generated by the ACO algorithm. The results showed that, in case of an emergency, conventional evacuation routes showed longer escape times compared to those produced by the model developed in this research.

P02.06: Ultrasound based criteria for the selection of women for hysteroscopic removal of retained products rather than conventional suction curettage

Objectives: Conventional evacuation of retained products of conception (RPOC) is a blind technique which may not remove focal RPOC and is associated with perforation and adhesion risks. Ultrasound (USS) guided evacuation of retained products of conception (ERPC) is a commonly used alternative but we hypothesised that for focal retained tissue following miscarriage, termination of pregnancy (TOP) or delivery hysteroscopic removal of tissue under direct visualisation was an effective and safe alternative which allows intraoperative confirmation of an empty uterus. Methods: For 15 months women with small well-defined intrauterine focal mixed hyperechogenic tissue, with or without vascularity, following miscarriage, TOP or delivery were selected for hysteroscopic management. Under general anaesthesia an 8 mm saline resectoscope without an active electrode was used. Operative findings, procedures, complications, repeat USS and histology are reported. Results: 15 patients were identified retrospectively. Initial presentation was miscarriage (6), TOP (3) and post delivery (6). In 4/15 findings followed blind ERPC. Mean AP diameter of tissue was 17.3 mm (range 4.3–29 mm). In 15/15 (100%) USS findings were confirmed by direct visualisation of frond-like pale tissue or an isolated nodule at hysteroscopy. 1/15 (7%) was complicated by uterine perforation. In 15/15 (100%) blood loss was minimal. Histology confirmed RPOC in 12/15 (80%), implantation site reaction in 2/15 (13%) and chronic endometritis in 1/15 (7%). 7/7 who returned for follow up at 8/52 had an empty uterine cavity confirmed. Conclusions: The ultrasound criteria perform well in identifying focal RPOC. The 7% negative histology may be due to false positive USS or sample collection problems. We propose prospective comparison of USS guided ERPC with hysteroscopy.

マルチエージェントモデルによる大規模ホールにおける避難性状の予測―歩行者シミュレーションシステムＳｉｍＴｒｅａｄの実務的利用可能性の検証―

The purpose of this paper is to examine the prediction performance and practical usability of Multi-agent pedestrian simulation system. As an example, evacuation flow of about 10000 people from large-scale assembly facilities is simulated. Major results are as follows;1) At the seats lined up orthogonally to the aisle, farther seats from egress of aisle remains to the last. 2) At the point two pedestrians flow merges, the flow become more densely.3) In case flow become densely, if there is extra space, pedestrians expand the walking area and decrease density to walk by maximum speed.Those features are described quite obviously as movies and a lot of perceptions are acquired which cannot be acquired by conventional evacuation calculation methods.

Proposed Framework for Simultaneous Optimization of Evacuation Traffic Destination and Route Assignment

In the conventional evacuation planning process, evacuees are assigned to fixed destinations mainly on the basis of geographical proximity. However, the use of such prespecified destinations (an origin-destination table) almost always results in less-than-optimal evacuation efficiency because of uncertain road conditions, including traffic congestion, road blockage, and other hazards associated with the emergency. By relaxing the constraint of assigning evacuees to prespecified destinations, a one-destination evacuation (ODE) concept has the potential to improve evacuation efficiency greatly. To this end, a framework for the simultaneous optimization of evacuation traffic distribution and assignment is proposed. The ODE concept can be used to obtain an optimal destination and route assignment by solving a one-destination (1D) traffic assignment problem on a modified network representation. When tested for a countywide special event-based evacuation case study, the proposed 1D model presents substantial im...

Proposed Framework for Simultaneous Optimization of Evacuation Traffic Destination and Route Assignment

In the conventional evacuation planning process, evacuees are assigned to fixed destinations mainly on the basis of geographical proximity. However, the use of such prespecified destinations (an origin–destination table) almost always results in less-than-optimal evacuation efficiency because of uncertain road conditions, including traffic congestion, road blockage, and other hazards associated with the emergency. By relaxing the constraint of assigning evacuees to prespecified destinations, a one-destination evacuation (ODE) concept has the potential to improve evacuation efficiency greatly. To this end, a framework for the simultaneous optimization of evacuation traffic distribution and assignment is proposed. The ODE concept can be used to obtain an optimal destination and route assignment by solving a one-destination (1 D) traffic assignment problem on a modified network representation. When tested for a countywide special event–based evacuation case study, the proposed 1 D model presents substantial improvement over the conventional multiple-destination ( nD) model and can potentially reduce overall evacuation time by more than 60%. More important, this framework can be easily implemented and its efficiency enhanced simply by instructing evacuees to head for destinations resulting from the 1 D simulations run beforehand.

Evacuating flat glass panels

A method of evacuating flat glass panels through a small pumpout tube is described. In order to avoid breakage, the end of this pumpout tube, which is located outside a bakeout oven, has to be mounted in an O-ring fitting, which exerts little force on the tube during evacuation and bakeout. This is achieved first by allowing axial movement of the tube within the O-ring fitting, and second by attaching the vacuum fitting to a bracket, which in turn is fixed to a metal vacuum cup on the glass panel inside the oven. This method has several advantages over conventional evacuation techniques, including enabling the pumpout tube to be situated in a protected location in the edge of the glass panel, and permitting the panel to be baked at high temperatures.