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Seeking help for transdiaphragmatic approach to lung wedge resection

My surgeon performed a wedge resection of the lung using a transdiaphragmatic approach. however he went in through an incision already made by another surgeon that removed the diaphragm.
The only codes i am familiar with are VATS, wedge or thoracotomy wedge resections. Any advice?
Thank you

Medical Billing and Coding Forum

Diagnostic or Therapeutic Wedge

I am not very confident in this part of my coding and I want to make sure I am coding this correctly. The op note is below and I want to code it wit 32608: :confused::confused:

History of an abdominal GIST tumor s/p resection a few years ago. As part of her monitoring she was found to have a right lower lobe nodule. I saw the patient in the office and offered her surgery. The plan was to remove the nodule through a VATS approach. If it represented a new lung cancer, I would proceed with a completion lobectomy. Risks and benefits of the procedure were explained to the patient preoperatively. She understood the risks and agreed to proceed.

1. Right video assisted thoracoscopy
2. Right lower lobe wedge resection (via VATS) of lung nodule
3. Placement of left radial aline

The patient was brought to the operating room and his identity was confirmed using two methods. The procedure was also confirmed. The patient was placed in the supine position on the OR table. After the induction of general anesthesia, a left aline was placed by the first assistant. The patient was placed in the lateral decubitus position with the right side up. Three small incisions were made to access the mass. The first incision was made below the tip of the scapula, the second incision was made in the anterior axillary line in the 5th intercostal space and the third incision was made midway between these two incisions. Using the videoscope and a grasper, the inferior pulmonary ligament was first divided to help mobilize the lung. Next two graspers were used to palpate the lung. Eventually a hard lesion was found in the periphery of the lower lobe. This was held with one of the graspers, while a stapler was placed through the other incision. One firing of the 45 stapler was used to remove this lesion via a wedge resection. This was sent to pathology, where frozen section showed no malignancy. The pleural space was irrigated out with saline. All bleeding was controlled. A 28F chest tube was placed through one of the incisions to the apex. The other two incisions were closed in layers. The patient tolerated the procedure without difficulty.

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Exports Increased Lighting Inside Decryption – China Medical Air Cushion – Medical Wedge Pillow

General Administration of Customs announced in September this year table of key commodities for money. The table shows from January to September this year, my lamps, lighting fittings and parts total exports amounted to 666,487.2 million U.S. dollars, up 15.6%. Exports in September which was 106,596.1 million.
Customs data show that the previously announced this year and lighting equipment, parts and components exports the first 8 months of the year growth rate of 14.1%, the first 7 months was 13.4%, compared to 13.9% throughout the first half. Year rate of increase, if only in respect, for the first nine months of our lamps, lighting fittings and parts exports can be said is fun to watch. But if we look at what the chain growth rate, the situation is not optimistic.
6,7,8,9 four months of this year, China’s lighting equipment and spare parts exports were 368,965.1 million, 88,330.5 million, 102,729.8 million and 106,596.1 million. If this set of figures for a way to express?? Measured using the chain growth rate, then the month of 7, the chain growth rate of 24.9%, 16.3% in August, September, compared with 3.8% of the poor. From the chain growth rate, nearly four months of our lamps, lighting fittings and parts export growth rate has been declining, but declined sharply. Correspondingly, the ring than the development speed of 124.9 percent from July to September plunged to 103.8%, close to “marking time” the bottom line.
The author wrote on September 16 by the “lighting export growth and global economic recession,” one article, he predicted that China’s lighting industry in September export growth is unlikely to force a chain reaction, in today’s perspective, this has been denied . From the above comparative data we have seen, the month of the chain 7, the growth rate as high as 24.9% in August compared to 16.3%, down 8.6 percentage points; and September’s 3.8% lower than in August by 12.5 percentage points not only did not rebound strong, but “strong decline.” This indicates that the lighting industry in China’s exports slowed dramatically at the moment.
Mainly due to a slowdown in global economic conditions lead to weak overseas markets slump, the market downturn is the most direct reflection of market demand and product sales decline. This is reflected in the customs of the tables, the comparative data is the continued decline.
In contrast to market conditions, the increase of data can only be a reference, a continuous period of time ring current market conditions than the data is the most authentic reflection. Lamps, lighting fittings and parts exports during the period of chain growth rate fell sharply, indicating weakness in overseas markets have full access to the state, although this does not rule out other factors which influence, for example, the depreciation of U.S. dollar, etc.. The weakness in overseas markets, the manufacturer of its direct impact is the deterioration of the living environment.
Compared to last year, China’s lamps, lighting fixtures and parts exports, of course, is growing, but growth is still at a relatively high level, but this is the inevitable industry. This does not reflect the true current situation of industrial development period. The chain growth data can well reflect the industry at the present stage of development, the chain growth and chain growth rate can be said that an industry in the development of “instantaneous velocity.” Down the chain of data describe the present time our lamps, lighting fittings and parts export growth is slowing. And if this situation has been maintained, then, my lamps, lighting fittings and parts exports, there may even be negative. This is clearly not conducive to the development of China’s lighting industry.
In Measuring the lamps, lighting fittings and parts export situation, the rising up of data and the data continues to decline, the chain can be a singing “cop” a sing “bad cop.” “Cop” Let us see the vitality and hope, “bad cop” Let us see the problems and shortcomings, which the unity of the two, is a true reflection of the status quo.

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Nyquist Frequency – Medical Seat Cushions – Medical Wedge Pillow Manufacturer

The aliasing problem
In principle, a Nyquist frequency just larger than the signal bandwidth is sufficient to allow perfect reconstruction of the signal from the samples. However, this reconstruction requires an ideal filter that passes some frequencies unchanged while suppressing all others completely (commonly called a brickwall filter). Such a filter is both unattainable in practice and, even in theory, introduces unwanted time domain artifacts such as ringing artifacts.
Signal frequencies higher than the Nyquist frequency will encounter a “folding” about the Nyquist frequency, back into lower frequencies. For example, if the sample rate is 20 kHz, the Nyquist frequency is 10 kHz, and an 11 kHz signal will fold, or alias, to 9 kHz. However, a 9 kHz signal can also fold up to 11 kHz in that case if the reconstruction filter is not adequate. Both types of aliasing can be important.
When attainable filters are used, some degree of oversampling is necessary to accommodate the practical constraints on anti-aliasing filters: instead of a brickwall, one has flat response in the passband up to a point called the cutoff frequency or corner frequency, (pass all frequencies below there unchanged), then gradual rolloff in a transition band, finally suppressing signals above a certain point completely or almost completely in the stopband. Thus, frequencies close to the Nyquist frequency may be distorted in the sampling and reconstruction process, so the bandwidth should be kept below the Nyquist frequency by some margin (frequency headroom) that depends on the actual filters used.
For example, audio CDs have a sampling frequency of 44100 Hz. The Nyquist frequency is therefore 22050 Hz, which is an upper bound on the highest frequency the data can unambiguously represent. If the chosen anti-aliasing filter (a low-pass filter in this case) has a transition band of 2000 Hz, then the cut-off frequency should be no higher than 20050 Hz to yield a signal with negligible power at frequencies of 22050 Hz and greater.
To avoid aliasing, the Nyquist frequency must be strictly greater than the maximum frequency component within the signal. If the signal contains a frequency component at precisely the Nyquist frequency then the corresponding component of the sample values cannot have sufficient information to reconstruct the Nyquist component in the continuous-time signal because of phase ambiguity. In such a case, there would be an infinite number of possible and different sinusoids (of varying amplitude and phase) of the Nyquist frequency component that are represented by the discrete samples: see Sampling theorem: Critical frequency.
Other meanings
Early uses of the term Nyquist Frequency, such as those cited above, are all consistent with the definition presented in this article. Some later publications, including some respectable textbooks, call the signal bandwidth or twice the signal bandwidth the Nyquist frequency; still others refer to the Nyquist rate (twice the signal bandwidth) as Nyquist frequency; these are distinctly minority usages.
References
^ Ulf. Grenander (1959). Probability and Statistics: The Harald Cramr Volume. Wiley. http://books.google.com/books?id=UPc0AAAAMAAJ&q=%22nyquist+frequency%22+date:0-1965&dq=%22nyquist+frequency%22+date:0-1965&as_brr=0&ei=R0LsRtqLN6HApgLT8726Dw&pgis=1. “The Nyquist frequency is that frequency whose period is two sampling intervals.” 
^ Harry L. Stiltz (1961). Aerospace Telemetry. Prentice-Hall. http://books.google.com/books?id=cro8AAAAIAAJ&q=%22nyquist+frequency%22+date:0-1965&dq=%22nyquist+frequency%22+date:0-1965&as_brr=0&ei=R0LsRtqLN6HApgLT8726Dw&pgis=1. “the existence of power in the continuous signal spectrum at frequencies higher than the Nyquist frequency is the cause of aliasing error” 
^ B. V. Korvin-Kroukovsky (1961). Theory of Seakeeping. Society of Naval Architects and Marine Engineers. http://books.google.com/books?id=W7Q8AAAAIAAJ&q=%22nyquist+frequency%22+date:0-1965&dq=%22nyquist+frequency%22+date:0-1965&as_brr=0&ei=R0LsRtqLN6HApgLT8726Dw&pgis=1. “The Nyquist frequency is often called the folding frequency or cut-off frequency” 
^ Michael J. Roberts (2004). Signals and Systems: Analysis Using Transform Methods and MATLAB. McGraw-Hill Professional. ISBN 0072499427. http://books.google.com/books?id=c2oN_GozNPoC&pg=PA503&dq=highest-frequency-present-in-a-signal+nyquist-frequency&lr=&as_brr=0&ei=aNGWR5vPN56ktgON2_jnBA&sig=c2t2D_p_8eYTSpQh_AkV1FG1hLo#PPA503,M1. 
^ Uwe Windhorst and Hkan Johansson (1999). Modern Techniques in Neuroscience Research. Springer. ISBN 3540644601. http://books.google.com/books?id=cjCnNtIhjMQC&pg=PA630&dq=bandwidth+nyquist-frequency&lr=&as_brr=0&ei=8c6WR6G1LqLstAOsqPjnBA&sig=vVqDAkDdIdrcoirjCWZdPTIOpHQ. 
^ Jonathan M. Blackledge (2003). Digital Signal Processing: Mathematical and Computational Methods, Software Development and Applications. Horwood Publishing. ISBN 1898563489. http://books.google.com/books?id=G_2Zh7ldQIIC&pg=PA93&dq=intitle:digital+intitle:signal+intitle:processing+nyquist-frequency&lr=&as_brr=0&ei=EsiWR8GAIYOUtgO865HoBA&sig=0nPyEIzaULnMF_UsY6TjPI6SN6w. 
^ Paulo Sergio Ramirez Diniz, Eduardo A. B. Da Silva, Sergio L. Netto (2002). Digital Signal Processing: System Analysis and Design. Cambridge University Press. ISBN 0521781752. http://books.google.com/books?id=L9ENNEPbZ8IC&pg=PA24&dq=intitle:digital+intitle:signal+intitle:processing+bandwidth+nyquist-frequency&lr=&as_brr=0&ei=8MmWR8DJF6CQtwOu4_znBA&sig=JFC3km12VpmWY6RyusmB594ZTQQ. 
See also
Nyquist rate
Kell factor
Sampling frequency
Superoscillation
Signal
Categories: Digital signal processing

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Sara Little Turnbull – China Medical Seat Cushions – Medical Wedge Pillow

Early life and education
Sara Finkelstein was born in Manhattan and raised in Brooklyn. Her mother introduced her to the use of color and form by arranging fruits and vegetables in bowls. She attended Parsons School of Design on scholarships from the School Art League of NYC and the National Council of Jewish Women, graduating in 1939.
Because she was 4’11” in height, she acquired the nickname “Little Sara,” and then began to call herself Sara Little professionally. She married James R. Turnbull (then executive vice president of Monsanto Chemical) in 1965, but used the name Sara Little for her entire career.
Career
House Beautiful
After college, Sara Little worked at Marshall Fields as a bench designer and assistant art director, then became art director at Blaker Advertising Agency. She was eventually hired as an editorial assistant at House Beautiful magazine, where she wrote the “Girl with a Future” column until she rose to the position of Decorating Editor, which she held for nearly two decades.
At House Beautiful, she anticipated and helped develop the American post-World War II domestic lifestyle. By asking, “how we could help these people put their lives back together through ideas in our magazine?” she encouraged readers to utilize more informal space in the home (in what eventually became known as the family room), share living space with a roommate, and organize small spaces for maximum domestic efficiency (she lived for 20 years in a 400 square foot hotel room from which she also ran her international consulting practice).
Product Design
In 1958, Little left the magazine world and formed Sara Little Design Consultant. At the time, she wrote a trade article for Housewares Review entitled “Forgetting the Little Woman” (although she often referred to this article in subsequent interviews as “When Will The Consumer Become Your Customer?”). Her main argument was that most companies created products for retailers, instead of considering the people who were actually going to use them. The story caught the attention of a few prominent CEO’s and executives, including the heads of General Mills, 3M and the Corning Glass consumer products division. All three companies eventually hired her as a product research consultant to assist in finding new applications for technologies developed for the war effort. She helped create disposable medical and antipollution masks made from non-woven fibers, nutritious soybean candy, and the ubiquitous freezer-to-oven CorningWare that was developed from a material originally used on missile cones.
During her 65-year design career she provided advice on strategic design, consumer awareness, and cultural change to an international slate of companies such as: Procter & Gamble, Coca-Cola, General Mills, Macy, Neiman Marcus, Marks & Spencer, American Can, DuPont, Ford, Nissan, Pfizer, Revlon, Elizabeth Arden, Lever Brothers, Motorola, NASA and Volvo. She consulted on a range of domestic products including housewares, home storage systems, food, counters that cook, microwave cooking products, personal care, medication delivery systems, cosmetics, fabric processes (knit and non-wovens), space suits, furniture, toys, decoration and packaging, household cleaning products, pet care, tapes and adhesives, and car interiors.
Many of her ideas arose from her intense interest in different cultures and the natural world. A self-trained cultural anthropologist, she traveled frequently to destinations such as Borneo, Malaysia, the Philippines, India and Kenya, always on the lookout for how people and animals solved the problems of everyday living. Her design for a pot lid was inspired by observing cheetahs grasping their prey in the wild. t always starts with a fundamental curiosity, she said of her quest for innovative product design. hen I can’t find the answer in a book, I go out and search for it. The excitement of my life is that I have always jumped into the unknown to find what I needed to know.2] In another case, she began the design process for a burglar-proof lock by interviewing thieves in jail.
In 1971, she established the Sara Little Center for Design Research at the Tacoma Art Museum in Washington State to archive and display her collection of over 5,000 artifacts gathered during her travels. The collection includes body coverings and accessories, food preparation and dining implements, textiles, fine and folk art, much of which had influenced her concepts for domestic product design. The collection was deaccessioned from the Tacoma Art Museum in 2003 and is being re-established in Seattle, WA for design scholarship and educational purposes.
Process of Change: Laboratory for Innovation and Design
In 1988, Little founded and for the next 18 years directed the Process of Change: Laboratory for Innovation and Design at the Stanford Graduate School of Business. The Laboratory tracked changing trends in more than 375 areas including education, healthcare, aging, sexuality, food and nutrition, housing, clothing, and manufacturing. Little used this information to fuel her design concepts. “The quality of life of a people dictates what they design, what they make,” she said. “It’s a reflection of life itself.”
In her work with students at Stanford, Little continually emphasized digging deep into the “why” of a product before leaping into the “how,” in order to avoid designing products that only addressed superficial symptoms rather than the deeper need. he designer is the conscience of the company. We can’t expect anyone else to fill this role. That why the Process of Change Laboratory delineated the need to know more. Design requires a background of scholarship, otherwise it remains a visual trick.10]
Teaching, Awards and Honors
In addition to her work at Stanford, Sara Little has been a guest lecturer at schools such as Parsons School of Design, Rhode Island School of Design, MIT, Harvard, Illinois School of Technology, Copenhagen Business School, University of Washington, San Francisco State University and University of California Berkeley.
She received a Distinguished Designer Fellowship from the National Endowment for the Arts in 1988; the Trailblazer Award from the National Home Fashion League (1980), and an honorary doctorate from Academy of Art University (2003). In 2008, Chrysler Corporation established the Chrysler Sara Little Turnbull Scholarship at Academy of Art University. The Modern Art Council of the San Francisco Museum of Modern Art designated her a “Bay Area Living Treasure” in 2001. In 2006, at the age of 89, Sara Little received the Lifetime Achievement Award from Icograda (International Congress of Graphic Design Associations).
Board Service
1948: American Institute of Decorators “Design Associate”
1951-54: Alumni Board, Parsons School of Art and Design
1965-70: Board of Trustees, Parsons School of Art and Design
1990-? Board of Director, Corporate Design Foundation
1991: Board of Directors, Long Term Care Implementation Committee at the Age Center Alliance, Inc. (Palo Alto, CA)
1995: Advisory Member, National Design Forum
2004: Board of Directors, Cooper Hewitt Museum and Committee for the Arts
Footnotes
^ a b c d Vienne, Veronique (November 2000) “The Why of It All”, Metropolis Magazine
^ a b c d “Stanford’s Sarah (sic) Little Turnbull on Design”, Corporate Design Foundation
^ Sara Little Turnbull website
^ Speaking Freely: An Evening with Remarkable Women, KQED Television
^ “Laboratory Director Shuts Red Door”, November 2006, Stanford Business Magazine
^ Tacoma Art Museum website
^ Sara Little Turnbull faculty page, Stanford University
^ Knight, Heather (January 28, 2000) “Mother of Invention”, San Francisco Chronicle
^ Interview with Sara Little Turnbull at TAXI: The Global Creative Network website, 2006
^ Video interview with Sara Little Turnbull conducted in 2006 by Paula Rees, special trustee for Sara Little Turnbull
^ Academy of Art University website
^ “Spreadsheet One: The GSB’s Living Treasure,” February 2002, Stanford Business Magazine
^ “Icograda Design Week in Seattle” AIGA (American Institute of Graphic Arts) website
External links
Sara Little Turnbull official website
Categories: Design | American designers | Product design | Industrial design | American industrial designers | 1917 births | Living people

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India Needs Rapid Technological Upgrading – Medical Cushion – Medical Wedge Pillow Manufacturer

Technology upgrading slow, weak infrastructure and high cost structure of the Indian textile industry will be the main factors concerned.
According to a study revealed that by 2010, India will be the world’s total textile and clothing exports account for 8% of market share to reach 50 billion U.S. dollars.
According to PHDCCI the end of the Multi Fibre Agreement on the Indian textile and clothing industry, because of the inherent cost and operational advantages, India’s textile export market in 2010 will grow to about 655 billion rupees, while the present bit 400 billion rupees.
As good garment production, apparel will be the engine of export growth in India, because the average unit price of garments to achieve the highest of high value-added ingredients.
In the era after the multi-fiber agreement, India’s textile and clothing market in the U.S. and EU market share of the increase will be sufficient. U.S. and EU markets are India’s major export markets.
Only the United States, India’s apparel market share estimates from the current 4% to 15%. In the EU clothing market, India’s market share is expected to increase from 50% increase from the current 6% to 9%. India’s share of EU textile market is estimated from the current 9% to 11% of the post-quota era.
This optimism is based on a favorable position in which India obtained as Indonesia to take advantage of low-cost, better use of domestic production of fabrics and other inputs advantage.
India’s textiles and clothing than the comparative advantages of China in Southeast Asia and neighboring countries high. India’s comparative advantage to 4.67, and China reached 3.18. In the clothing, India has a comparative advantage to 3.90, and China 3.64. Indonesia, South Korea, Malaysia, the Philippines, Thailand and Viet Nam’s comparative advantage in textiles 1.98,2.49,0.36,0.41,1.16,1.12 respectively, while India’s comparative advantage is 4.67.
India’s textile industry’s major competitors will fully help the textile sector, the post-quota era because they can open up viable economic scale.
Indian fashion industry with high added value is another advantage, because the Indian textile industry to the fashion trend for the development of the world to change.
PHDCCI study warned that the cost structure, slow technological upgrading and weak infrastructure can hurt India’s competitive position.
In the cost structure, PHDCCI study found that many Southeast Asian countries, especially China, without the function of labor costs in total output in the clothing industry in India, the proportion reached 21.1%, Vietnam 9%, South Korea 15%, China reached 18.2%. As the greater part of India’s exports of low price, which is important to provide efficiency and productivity.
PHDCCI study also warned that the relatively slow technology upgrade will affect large-scale production of market quality. This is based on the cost of other competitors in India, compared with the findings obtained.
Cost of capital in the proportion of total output in the textile industry in India was 6.7%, 7.8% in the garment industry, than China, and the cost of capital in the proportion of total output of 12.2% in the clothing industry, in the textile industry as 12.0%.
Weak infrastructure of India, PHDCCI study found, it will impact India’s textile export bottlenecks. Waiting time in ports 8-12 days. For India, the United Kingdom the opportunity to maximize the use of railway, roads, ports and power facilities should be upgraded to a state of war.
In the post-quota era, the developed countries markets will be open, but the developed countries may re-acquisition non-tariff barriers, such as environmental conditions, social clauses, safety standards to protect them textile and apparel industries. India India, providing quality certification and take the best of the world, in government and industry collaboration between the importance of comprehensive.

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