Introduction: Hysterectomy is one of the most common surgeries performed in the United States with more than 600,000 procedures annually. It has been estimated that in 2011, there were more than 64,000 surgeries performed in an outpatient setting. The highest rate of 0.46% (464/100,000 adult women) has been reported in Maine. The average length of stay was 0.65 days for laparoscopic and 0.79. FOXPRO Programming Software for Mac The Sound Programming Utility is an easy-to-use application providing you with complete management of sounds in your FOXPRO game call. With this application you can: add new sounds, remove sounds, reorganize sounds, manage your sound categories (only for models that feature category support), print sound labels, backup your sounds, and more. Apple quickly issued an update to iOS 7 and iOS 6, but took longer to issued an update for Mac OS X, despite Apple confirming that the same SSL/TSL security flaw was also present in OS X. Apple Mac OS X High Sierra. 139622 views 205870 downloads. Wide HD Standard Mobile Dual. 3.93/5; Purple Color Burst. 157678 views 232596 downloads.

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Home > All MaineHealth > Maine Medical Center > 686

Document Type

Poster

Publication Date

5-1-2019

Institution/Department

Nursing

MeSH Headings

Robotic Surgical Procedures, Hysterectomy, Patient Discharge

Abstract

Introduction:

Hysterectomy is one of the most common surgeries performed in the United States with more than 600,000 procedures annually . It has been estimated that in 2011, there were more than 64,000 surgeries performed in an outpatient setting. The highest rate of 0.46% (464/100,000 adult women) has been reported in Maine. The average length of stay was 0.65 days for laparoscopic and 0.79 days for vaginal hysterectomies [1]. Traditionally, hysterectomies have been performed as an inpatient procedure to manage postoperative pain and monitor complications such as bleeding, anemia and return of bowel function. Development of minimally invasive surgery techniques with minimal blood loss, decreased postoperative pain and recovery time, and faster return of bowel function have, however, significantly shortened hospital stays [2]. The robotic surgical platform for minimally invasive surgery was approved by the American College of Obstetrics and Gynecology in 2005, and since then the number of these procedures has continually increased [3]. Today, the feasibility and safety of same-day discharges have been well established for patients undergoing minimally invasive hysterectomy after laparoscopic and robotic surgeries [4]. However, despite the reported positive findings, the percentage of patients who are discharged on the same-day vary from 16% to 90%. Reasons for post-operative hospital admission include nausea and vomiting, inadequate pain control, postoperative urinary retention, inadequate home support, and patient preference [2]. The purpose of this retrospective study was to identify and describe predictors for same-day and non-same-day discharge after robotic hysterectomy in a 637 licensed-bed Magnet® designated tertiary care teaching hospital.

Recommended Citation

Fox, Heidi and Hyrkas, Kristiina, 'Predictors for Discharge After Robotic Hysterectomy – A Retrospective Analysis' (2019). Maine Medical Center. 686.
https://knowledgeconnection.mainehealth.org/mmc/686

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Obstetrics and Gynecology Commons, Surgery Commons

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No One Lives Forever 2: A Spy in H.A.R.M.'s Way is a first-person shooter video game developed by Monolith Productions and published by Sierra Entertainment, released for Windows in September 30, 2002, later ported to MacOS in 2003. It is the second game in the No One Lives Forever series, the sequel to the 2000 game The Operative: No One Lives Forever.

The story follows spy Cate Archer as she once again takes up arms against the international criminal organization H.A.R.M. Throughout the game, Cate Archer is sent to exotic locales, such as a ninja village, a secret submarine base, and a trailer park in Ohio during a tornado. A whole new range of uniquely designed gadgets and weapons are also introduced, including a blowtorch disguised as a can of hair spray and a robotic bomb disguised as a kitten. A spin-off to the game, entitled Contract J.A.C.K., was released in 2003.

Gameplay[edit]

As in the first game, missions can be completed through action, stealth, or a combination of these methods. In many cases, the missions are more open ended. While the original game contained several missions that required the player to not to be detected or avoid setting off alarms, the sequel contained only a few objectives that required complete stealth. However, to counter this, No One Lives Forever 2: A Spy in H.A.R.M.'s Way utilizes respawning enemies more often than the original to encourage the player to complete the missions in a surreptitious manner. The game's AI is designed with a Goal-Oriented Action Planning architecture where the enemies themselves have more control over the actions they perform.^[1]

Plot[edit]

The game focuses on tensions rising between United States and Soviet Union over the tiny, but strategic Isle of Khios. A year after the events of the first game, Jones, now the sole Commander of U.N.I.T.Y., is taking a vacation and leaves Bruno Lawrie, the Temporary Director of U.N.I.T.Y., in charge.

U.N.I.T.Y. agent Cate Archer is sent to Japan to investigate a rumored international crime convention expected to take place in the pastoral village of Inotakimura. There, she locates another U.N.I.T.Y. agent Isamu Hatori, who tells Cate to photograph the meeting's participants, including the Director, H.A.R.M.'s leader, without arousing their suspicion. After Cate photographs the meeting's participants, as Hatori tasked her to, she is stabbed by a ninja named Isako, who leaves her for dead.

After the opening credits, Cate is hospitalized by U.N.I.T.Y. and is restored back to health by U.N.I.T.Y.'s staff scientist, Dr. Otto Schenker. After Cate's recovery, the U.S. military advisers, Issac Barnes and General Morgan Hawkins, inform Cate and Bruno of H.A.R.M.'s and the Soviets' plan regarding Project: Omega to prepare their invasion for the small island of Khios. Meanwhile, H.A.R.M. agent Dmitrij Volkov is now immobilized in a full-body cast and using a wheelchair due to a skiing accident.

Cate travels to Siberia where she uncovers information about Project: Omega and sabotages the radio tower and power plant. After collecting information regarding Project: Omega, she is ambushed by H.A.R.M. and the Soviets, but manages to escape by destroying a bridge. After her mission in Siberia, Cate and Bruno learn that the Soviets and H.A.R.M. work together to turn the island into the world's first Communist vacation spot with a five-star hotel. Cate travels to Akron, Ohio, and investigates the house belonging to a man, Melvin Blitzny, a vacuum cleaner salesman who serves as a double agent between H.A.R.M. and U.N.I.T.Y. to impersonate former U.N.I.T.Y agent Tom Goodman. After she recovers information about Project: Omega, she is ambushed by Isako's ninjas as she escapes the Blitzny residence. A tornado hits the area and Cate takes down Isako's ninjas before following Isako to a trailer home as it is lifted by a tornado. Cate and Isako engage in a sword fight until the trailer's ceiling rips off, sending Isako into the tornado.

After being recovered from the tornado incident, Cate and her ally, Magnus Armstrong, head to India where they meet Armstrong's old friend, Kamal, a former member of H.A.R.M.'s Indian branch. With Kamal's help, Cate is hired by H.A.R.M., and gains access to their vault, where she collects more documents about Project: Omega. Soon after, Cate and Armstrong are captured by one of H.A.R.M.'s most deadly operatives, Pierre, the self-proclaimed Mime King. Cate and Armstrong escape by welding one of the cage's bolts, and fight their way out of India. During their escape, Armstrong tries to grab Pierre but only succeeds in removing his heavy black cloak and mask, revealing his true form as a mime midget riding a unicycle. Cate and Armstrong try to chase him riding a tricycle, but fail to apprehend Pierre.

Later, Cate and Armstrong head to Antarctica to explore a base there and uncover H.A.R.M.'s intentions with Project: Omega. There, Cate learns that Project: Omega consists of turning soldiers into Super-Soldiers, which were indestructible cyborg-like fighting machines. Cate encounters the first test subject, a Super-Soldier named Lt. Anders, an ex-military officer who believes Cate is his daughter, Abigail. Lt. Anders chases Cate and destroys large parts of the base, but Cate manages to escape after Armstrong heroically grabbed the Lt., allowing her to escape before H.A.R.M. arrives.

Meanwhile, the Director learns of Cate's efforts in India, and sends a team of Super-Soldiers to destroy H.A.R.M.'s Indian headquarters as punishment. The punishment also provides H.A.R.M an ideal field test for the Super-Soldiers before they are sent to Khios on their primary mission. Cate immediately returns to Calcutta, India, but finds that the Super-Soldiers already arrived. The only thing Cate can do is try to get everyone to safety.

Cate then returns to U.N.I.T.Y. and gives Doctor Schenker the technical specifications she recovered from the Antarctic facility so that Doctor Schenker can devise how to stop the Super-Soldiers. Doctor Schenker loses his glasses, so after Cate finds Doctor Schenker's glasses in a café, the U.N.I.T.Y. headquarters is attacked by Pierre's mimes. Cate takes down the mimes and then proceeds to rescue Armstrong, who is reportedly captured and located at a H.A.R.M undersea base, unaware that Pierre placed a telephone bug in Doctor Schenker's office. Cate arrives at H.A.R.M.'s undersea headquarters and makes her way to the lower level to rescue Armstrong who is trapped in a Super-Soldier pod. Cate takes down Pierre and his mimes, but after she frees Armstrong, Lt. Anders, who is also freed from the pod, destroys parts of the undersea base, causing it to implode. Cate and Armstrong escape the drowning base, but as they reach the Director's private deck they discover that the escape pod is jammed. Armstrong himself releases the pod as he travels to surface in the drowning undersea base. The escape pod is then captured by a H.A.R.M. submarine on its way back up to the surface.

Cate is now held in H.A.R.M.'s secret artificial volcano lair, and escapes after she recovers additional plans for Project: Omega and sabotages the lair. Cate re-encounters and defeats Volkov, who falls into a lava pit. Cate reaches the surface, and discovers that H.A.R.M.'s lair is built directly beneath the Japanese village of Inotakimura. There, Cate battles Isako and her ninjas, and defeats her. The Director arrives and attempts to kill Isako but Cate saves Isako by throwing a ninja star at the Director, disarming him.

Cate is then sent to Khios, where she embarks on her final mission to stop Project: Omega. Unfortunately for her, the island is being overrun by H.A.R.M. and Soviet troops with Super Soldiers. The U.S launches a nuclear missile to destroy the Soviet held Khios, prompting a Third World War. Cate uses the specially devised Anti Super-Soldier Serum (ASSS) to defeat the Super Soldiers, drowns the H.A.R.M. submarine and successfully repels the invasion. Project: Omega is put to a stop once and for all when Lt. Anders, who escaped the submarine, destroyed the missile before it crashed in the island as he plummets to the ocean below. In a short cutscene after the game credits, the Director's mother rebukes his actions and Volkov tells the Director he quits. The game ends with the Director swearing revenge for Cate and U.N.I.T.Y.

Development[edit]

The source code for the game engine was released by Monolith Productions and Sierra Entertainment as part of the No One Lives Forever 2 Toolkit to allow the player to create levels, models, music, sounds, and more.^[2] and is currently available for download.^[3]Microsoft Visual C++ 6.0 is needed for compilation.

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Reception[edit]

No One Lives Forever 2: A Spy in H.A.R.M.'s Way received critical acclaim upon its release with an aggregate score of 91.03% on GameRankings^[4] and 91/100 on Metacritic.^[5]GameSpot named it the second-best computer game of September 2002, behind Battlefield 1942.^[6]

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The game won several awards, including Game of the Year from GameSpy.^[7] The game also received a nomination for the prestigious Excellence in Writing Game Developers Choice Award, but lost to Tom Clancy's Splinter Cell.^[8] The editors of Computer Games Magazine named No One Lives Forever 2 the best computer game of 2002, tied with Battlefield 1942. They wrote that it is 'the Godfather II of game sequels, and it further cements Monolith's spot at the top of the 3D gaming world.' The game also won the magazine's 'Best Music', 'Best Writing' and 'Best AI' awards.^[9] It was nominated for PC Gamer US's '2002 Best Action Game' and Computer Gaming World's 'Action Game of the Year' awards, both of which ultimately went to Medal of Honor: Allied Assault.^[10][11] The latter magazine's editors called it 'among the funniest and most entertaining games of 2002.'^[11]

No One Lives Forever 2 won GameSpot's annual 'Best Single-Player Action Game on PC' award, and was nominated in the 'Best Sound on PC', 'Best Graphics (Technical) on PC', 'Best Graphics (Artistic) on PC' and 'Game of the Year on PC' categories.^[12]

Legacy and fan-made re-release[edit]

In 2017, both the original game and the sequel were released with fan-made patches as free downloads at the No One Lives Forever Revival Project.^[13]

References[edit]

1. ^Orkin, Jeff. 'Applying Goal-Oriented Action Planning to Games'(PDF). Retrieved June 3, 2020.
2. ^'No One Lives Forever 2 Toolkit'. GamersHell. May 5, 2003. Archived from the original on October 17, 2018. Retrieved June 3, 2020.
3. ^'No One Lives Forever 2 Toolkit'. Mod DB. August 5, 2010. Retrieved June 3, 2020.
4. ^ ^ab'No One Lives Forever 2: A Spy in H.A.R.M.'s Way'. GameRankings. Retrieved 2011-11-24.
5. ^ ^ab'No One Lives Forever 2: A Spy in H.A.R.M.'s Way'. Metacritic. Retrieved 2011-11-24.
6. ^The Editors of GameSpot (October 5, 2002). 'GameSpot's Game of the Month, September 2002'. GameSpot. Archived from the original on September 18, 2003.
7. ^'GameSpy's PC Overall Game of the Year'. GameSpy. Archived from the original on 2004-02-13.
8. ^8th annual Game Developers Choice AwardsArchived 2008-03-28 at the Wayback Machine
9. ^Staff (March 2003). 'Best of the Year 2002; 12th Annual Computer Games Awards'. Computer Games Magazine (148): 58–61.
10. ^Staff (March 2003). 'The Ninth Annual PC Gamer Awards'. PC Gamer US. 10 (3): 48–50, 54, 58, 60, 66, 68, 70.
11. ^ ^abStaff (April 2003). 'Computer Gaming World's 2002 Games of the Year'. Computer Gaming World (225): 83–86, 88, 89, 92–97.
12. ^GameSpot Staff (December 30, 2002). 'GameSpot's Best and Worst of 2002'. GameSpot. Archived from the original on February 7, 2003.
13. ^https://www.rockpapershotgun.com/2017/07/05/no-one-will-sell-no-one-lives-forever-so-lets-download-it/

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External links[edit]

• No One Lives Forever 2: A Spy in H.A.R.M.'s Way at MobyGames
• No One Lives Forever 2: A Spy in H.A.R.M.'s Way at IMDb