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Aim.- To identify what determinants influence the prevalence and accuracy of nursing diagnosis documentation in clinical practice. Background.- Nursing diagnoses guide and direct nursing care. They are the foundation for goal setting and provide the basis for interventions. The literature mentions several factors that influences nurses- documentation of diagnoses, such as a nurse-s level of education, patient-s condition and the ward environment. Design.- Systematic review. Method.- MEDLINE and CINAHL databases were searched using the following headings and keywords: nursing diagnosis, nursing documentation, hospitals, influence, utilisation, quality, implementation and accuracy. The search was limited to articles published between 1995-October 2009. Studies were only selected if they were...

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In dual-energy projection radiography with double exposures, rapid energy switching is mandatory to eliminate motion artifacts, but it is costly for use in a clinical environment. We developed a system with practical exposure intervals at reasonable cost by modifying a condenser-type X-ray generator. A commercially available system for digital radiography (Fuji Computed Radiography, FCR) was used to subtract images. This report dealt with technical factors to obtain adequate kV and mAs settings in this technique.

UK PubMed Central (United Kingdom)

BackgroundHealth-Related Quality of Life assessment is widely used in clinical research, but rarely in clinical practice. Barriers including practical difficulties administering...Full Text Available

UK PubMed Central (United Kingdom)

The likelihood that past experience will produce correct guides to current practice depends on the signal-to-noise ratio for the clinical problem of interest. If the signal-to-noise ratio is high, the...Full Text Available

UK PubMed Central (United Kingdom)

PURPOSE: To determine the risk factors and clinical signs of Curvularia keratitis and to evaluate the management and outcome of this corneal phaeohyphomycosis. METHODS: We reviewed clinical and laboratory...Full Text Available

UK PubMed Central (United Kingdom)

Incorporation of clinical decision support (CDS) capabilities is required to realize the greatest benefits from computerized provider order entry (CPOE) systems. Discussions at a conference on CDS in...Full Text Available

UK PubMed Central (United Kingdom)

The objective of this study was to evaluate the effect of pregabalin in painful cervical or lumbosacral radiculopathy treated in Primary Care settings under routine clinical practice. An observational,...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundThere is a dearth of data relating UK general practice workload to personal and social markers of individual patients.AimTo test whether there is a significant association...Full Text Available

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Heavy ions used for biomedical studies fragment when they pass through matter. It is known that different fragments cause different types of biological damage. In this paper, results pertaining to differrent kinds of secondary fragments produced by a /sup 28/Si beam at 463 MeV/nucleon in its interaction with nuclear emulsion are presented. It is observed that the production frequencies of secondary fragments are independent of the target. Partial production cross sections and fluences of the secondary fragments are also discussed. The partial production cross sections for different fragments at three lower energy ranges are practically the same within their statistical errors except for the cross section for Li fragments, which is larger by almost a factor of 1.5 at the lowest energy investigated. The dose contributions of the primary Si beam and its components at different points of the Bragg curve are presented for two different energy ...

UK PubMed Central (United Kingdom)

The success of monoclonal antibodies in clinical practice is dependent on good design. Finding a suitable target is the most important part as other properties of the antibody can be altered by genetic...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundAdequate pain assessment is critical for evaluating the efficacy of analgesic treatment in clinical practice and during the development of new therapies. Yet the currently...Full Text Available

UK PubMed Central (United Kingdom)

The effect of growth phase on expression of virulence-associated factors was studied by Northern hybridization in an M1T1 clinical isolate of Streptococcus pyogenes. Expression of M...Full Text Available

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Consultant and advanced practice are relatively new concepts in radiography. There is evidence to show that as the career progression framework is being adopted the numbers of consultant and advanced practitioners in radiography are growing with the latter growing at a faster rate. The article considers the concept of advanced and consultant practice and the education requirements to support development. Preparation for an advanced practice role begins at the practitioner stage. Masters' level programmes are available to support the development of advanced practice. Education needs to be flexible as new advanced practice roles emerge. It is necessary to take practitioners beyond a defined modality to include leadership and people skills. These are essential for those aspiring to become consultants. Consultants require a high level of clinical knowledge ...

British Library Electronic Table of Contents (United Kingdom)

Despite the many advances in scientific research over the last several decades, cutting edge technologies and therapeutics often take many years to find their way into widespread use. The dissemination and uptake of best practices into clinical care is sometimes a neglected component of research that is essential to improve the population?s health. Type 2 translational research, sometimes called ?Proof in Practice Research,? seeks to maximize the yield of what has been learned from the bench and from carefully controlled clinical trials and to extend those benefits to a larger population. One aspect of type 2 translational research, sometimes called evidence implementation or implementation science, applies what has been learned about clinical medicine to achieve best practices across prov...

British Library Electronic Table of Contents (United Kingdom)

BackgroundAlthough self-expandable metal stent (SEMS) insertion is widely used for relief of malignant colorectal obstructions, the immediate technical and clinical failure rates of SEMSs and the associated risk factors remain largely unknown. ObjectiveTo identify rates and factors predictive of technical and clinical failure of SEMSs when their use is attempted for the decompression of malignant colorectal obstruction. DesignRetrospective chart review. SettingA tertiary-care academic medical center in South Korea. PatientsThis study involved a total of 412 patients with malignant colorectal obstruction in whom SEMS insertion was attempted. InterventionPlacement of colonic SEMSs. Main Outcome MeasurementsTechnical success and immediate and long-term clinical success rates. ResultsTechnical...

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In electron beam therapy, tissue overdose due to electrons backscattered from lead has been profusely studied. To quantify this dose enhancement effect, an electron backscatter factor (EBF) wasdefined as the ratio of dose at the tissue-inhomogeneity interface with and without the scatterer present. The dependence of the EBF on energy at the scatterer surface is not well known for energies lower than 3 MeV which is the most frequent clinical situation. In this work, we have done Monte Carlo calculations with the GEANT code to study EBF in lead at this energy range. The applicability of this code and the developed procedure for dose estimation has been experimentally verified. The dependence of the EBF on the beam energy incident on the scatterer has been studied for different nominal beam energies incident at the phantom's surface. The results show a trend of increase of EBF with the beam energy incident on the scatterer between 0.5 and ...

UK PubMed Central (United Kingdom)

BackgroundIt is well documented that the translation of knowledge into clinical practice is a slow and haphazard process. This is no less true for dental healthcare than other types...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundAlthough propofol is commonly used for general anaesthesia of normothermic patients in clinical practice, little information is available in the literature regarding the...Full Text Available

UK PubMed Central (United Kingdom)

Continuing Medical Education (CME) is a requirement among practicing physicians to promote continuous enhancement of clinical knowledge to reflect new developments in medical care. Previous research...Full Text Available

UK PubMed Central (United Kingdom)

Multimodality imaging with PET/CT and SPECT/CT has become commonplace in clinical practice and in preclinical and basic medical research. Do other combinations of imaging modalities have a similar...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundCavernous hemangiomas are the most frequent neoplasms of the liver and in routine clinical practice they often need to be differentiated from malignant tumors and other...Full Text Available

UK PubMed Central (United Kingdom)

Broth disk elution procedures represent one of the most practical means for clinical laboratories to perform routine antibiotic susceptibility tests on anaerobic bacteria. The accuracy of five disk...Full Text Available

UK PubMed Central (United Kingdom)

Premature circuit clotting is a major problem in daily practice of continuous renal replacement therapy (CRRT), increasing blood loss, workload, and costs. Early clotting is related to bioincompatibility,...Full Text Available

UK PubMed Central (United Kingdom)

Little is known about how sociodemographic factors relate to children’s chronic pain. This paper describes the pain, health, and sociodemographic characteristics of a cohort of children...Full Text Available

UK PubMed Central (United Kingdom)

Delirium occurs in up to 65% of older hip fracture patients. Developing delirium in hospital has been associated with a variety of adverse outcomes. Trials have shown that multi-component preventive...Full Text Available

British Library Electronic Table of Contents (United Kingdom)

Purpose Skilled placement of peripherally inserted central catheters (PICC) has a profound impact on patient well-being and costs of care. The use of ultrasound-guided methods and prescribed training for cannulation skills are evidence-based practice recommendations. The purpose of this study was to compare two methods of PICC instruction on the acquisition of applied skills. Methods Residents were randomly assigned to one of two groups (N?=?16/16) of this blind-rater study and were trained to perform ultrasound-guided PICC cannulation using either simulation or apprenticeship methods. All residents were assessed placing a PICC in applied clinical patient care. Results Residents who completed simulation training had significantly better transfer of skills to applied clinical practice than ...

International Nuclear Information System (INIS)

Background: In an effort to standardise radiological practices in the Republic of Ireland, current legislation states that 'written protocols for every type of standard radiological practice shall be established'. In order to fulfil this requirement the Irish Medical Council recommends the protocols issued by the Commission of European Communitees (CEC) for adoption in the country. Whilst this document does provide good guidance with regard to various radiographic factors, patient shielding instructions are notably ambiguous. The aim of this study was to remove some of this ambiguity by defining the optimal method of positioning patient shielding in antero-posterior (AP) and lateral lumbar spine radiographic examinations. These projections were chosen on the basis of their area of coverage being in close to and in some cases including the reproductive organs. They also represent the highest source of collective population ...

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Electron spin resonance (ESR) dosimetry of irradiated chicken legs is based on the additive dose or the calibration curve methods. In both cases the practical assumption is made that the behaviour of the chicken bone does not depend on factors such as temperature during irradiation, storage conditions and dose rate. So the aim of the present work was to investigate to what extent the above mentioned factors could influence the post-irradiation dose assessment using the ESR technique. (author).

British Library Electronic Table of Contents (United Kingdom)

Summary Objective To evaluate the cost-effectiveness of an educational outreach intervention to improve primary respiratory care by South African nurses. Methods Cost-effectiveness analysis alongside a pragmatic cluster randomised controlled trial, with individual patient data. The intervention, the Practical Approach to Lung Health in South Africa (PALSA), comprised educational outreach based on syndromic clinical practice guidelines for tuberculosis, asthma, chronic obstructive pulmonary disease, pneumonia and other respiratory diseases. The study included 1999 patients aged 15 or over with cough or difficult breathing, attending 40 primary care clinics staffed by nurses in the Free State province. They were interviewed at first presentation, and 1856 (93%) were interviewed 3 months late...

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In the last 40 years, significant advances have been made in the understanding of the neurophysiologic processes involved in the experience of trauma and pain. This knowledge, together with the rapid growth and understanding in the behavioral health sciences, has expanded to include a much better appreciation of how these fields are converging and contribute to a process called neuroplasticity. These basic mechanisms common to all patients have important implications for clinical outcome and for improving clinical practice. This article is written for clinicians who manage patients with sacroiliac joint dysfunction, a specific type of nonspecific low back pain.

UK PubMed Central (United Kingdom)

Between 1946 and 1976 over 9,000 women with breast cancer were seen within one year of diagnosis at the A. Maxwell Evans Clinic (AMEC) in Vancouver, British Columbia. By 1978, 275 had a subsequent diagnosis...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundA deficiency of specific glycosylphosphatidyl inositol-anchored proteins in paroxysmal nocturnal hemoglobinuria may be responsible for most of the clinical features of...Full Text Available

UK PubMed Central (United Kingdom)

AIM: To investigate clinical characteristics associated with the presence of irritable bowel syndrome (IBS) symptoms in hemodialysis (HD) patients.METHODS: This was a cross-sectional study. A...Full Text Available

UK PubMed Central (United Kingdom)

The earliest clinical evidence of diabetic nephropathy is microalbuminuria. Progression from microalbuminuria to overt nephropathy occurs in 20-40% within a 10-year period with approximately 20% of...Full Text Available

International Nuclear Information System (INIS)

From view on Organization Behavior theory, the concept, development and affecting factors of safety culture are introduced. The focuses are on the establishment, development and management practice for safety culture at Daya Bay NPP. A strong safety culture, also demonstrated, has contributed greatly to improving performance at Daya Bay

International Nuclear Information System (INIS)

The lifetime of technical constructions is determined by many factors. Technical, operational and technological aspects all help to define the term 'lifetime'. Examples from practical operation of steam turbines are considered for a discussion of 'lifetime', and methods of analysis are described. (TK/AK).

Science.gov (United States)

This article provides an historical look at how programs and practices for students with emotional or behavior disorders (E/BD) have been evaluated since 1964, leading to a codified, although not universally recognized, set of recommendations for evaluating best practices for students with E/BD set out by The Peacock Hill Working Group (1991). The authors contend that, in addition to the programmatic features of best practice, the addition of the quality indicators and standards for research in special education add a critical dimension for examining the quality of the scientific research of identified best practices. Taken together, these set of recommendations and quality indicators represent the state of the art in program evaluation for best practice and programs for students with E/BD. The goal of this article is to outline the current recommendations and apply them to current ...

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Objective.The interest of dental research in metal-free restorations has been rising in the last 20 years following the introduction of innovative all-ceramic materials in the daily practice. In particular, high strength ceramics and related CAD/CAM techniques have widely increased the clinical indications of metal-free prostheses, showing more favourable mechanical characteristics compared to the early ceramic materials.The purpose of the present paper is providing a brief review on the all-ceramic dental materials, evaluating pros and cons in the light of the most recent scientific results and of the authors? clinical experience.Materials. A structured review of the literature was given on the basis of medical and engineering papers published in the last decades on the use of dental cera...

International Nuclear Information System (INIS)

In radiotherapy treatment planning, convolution/superposition algorithms currently represent the best practical approach for accurate photon dose calculation in heterogeneous tissues. In this work, the implementation, accuracy and performance of the FFT convolution (FFTC) and multigrid superposition (MGS) algorithms are presented. The FFTC and MGS models use the same 'TERMA' calculation and are commissioned using the same parameters. Both models use the same spectra, incorporate the same off-axis softening and base incident lateral fluence on the same measurements. In addition, corrections are explicitly applied to the polyenergetic and parallel kernel approximations, and electron contamination is modelled. Spectra generated by Monte Carlo (MC) modelling of treatment heads are used. Calculations using the MC spectra were in excellent agreement with measurements for many linear accelerator types. To speed up the calculations, a number of calculation techniques were ...

International Nuclear Information System (INIS)

The goal of this lecture is to give an overview of important concepts connected to organisational factors and to provide an understanding of mechanisms by which they can contribute to safe or unsafe behaviour of people. The lecture gives examples of ways to organise work, organisational deficiencies and good practices applied in safety oriented organisations. The lecture also gives an introduction to international work and Finnish national regulation connected to organisation and management. (orig.)

International Nuclear Information System (INIS)

Many factors influence radon-222 influx and radon-daughter concentrations in underground uranium mines. A brief review of some of these factors is presented. Current radon-222 and radon-daughter control principles and practices for US underground uranium mine atmospheres are discussed and a brief review of the applicability of other possible control methods such as rock sealants, radon-222 removal, and radon-daughter removal is given.

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New values of the factors required to convert the reading of a radiation dosemeter calibrated in terms of air kerma (or exposure) into absorbed dose to water for medium-energy x-radiation were given in a code of practice published by the International Atomic Energy Agency in 1987. These are not considered to possess sufficient support from other sources. It is therefore recommended that the F-factors given or codes of practice should continue to be used. Values of backscatter factors for low-energy x-radiation (below 140 kV) in Supplement 17 of the British Journal of Radiology appear to be inaccurate. New values based on Monte Carlo calculations, and supported by new experimental data, are given for use in radiotherapy. (author).

Science.gov (United States)

Background: Accountability demands are increasingly pushing school leaders to explore more data and do more sophisticated analyses. Data-driven decision making (DDDM) has become an emerging field of practice for school leadership and a central focus of education policy and practice. Purpose: This study examined principals' DDDM practices and identified the factors influencing DDDM using the theoretical frame of information use environments. Participants: Participants were 183 public high school principals in a Midwestern state. Research Design: The research design was cross-sectional survey research. Data Collection and Analysis: Survey instruments were developed and administered to principals. Structural equation modeling was conducted to determine what factors significantly affect principals' DDDM practices in different leadership dimensions. Findings: ...

Science.gov (United States)

OBJECTIVE To identify patients with gestational diabetes mellitus (GDM) who will need antenatal insulin treatment (AIT) by using a risk-prediction tool based on maternal clinical and biochemical characteristics at diagnosis. RESEARCH DESIGN AND METHODS Data from 3,009 women attending the Royal Prince Alfred Hospital GDM Clinic, Australia, between 1995 and 2010 were studied. A risk engine was developed from significant factors identified for AIT using a logistic regression model. RESULTS A total of 51% of GDM patients required AIT. Ethnicity, gestation at diagnosis, HbA(1c), fasting and 60-min glucose oral glucose tolerance test, BMI, and diabetes family history were significant independent determinants of AIT. Notably, only 9% of the attributable risk for AIT can be explained by the clinical factors studied. A modeled risk-scoring system was therefore a poor predictor of AIT. ...

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The world of antibiotic drug discovery and development is driven by the necessity to overcome antibiotic resistance in common Gram-positive and Gram-negative pathogens. However, the lack of Gram-negative activity among both recently approved antibiotics and compounds in the developmental pipeline is a general trend despite the fact that the plethora of covered drug targets are well-conserved across the bacterial kingdom. Such intrinsic resistance in Gram-negative bacteria is largely attributed to the activity of multidrug resistance (MDR) efflux pumps. Moreover, these pumps also play a significant role in acquired clinical resistance. Together, these considerations make efflux pumps attractive targets for inhibition in that the resultant efflux pump inhibitor (EPI)/antibiotic combination d...

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The purpose of this note is to provide guidance to those who have duties under the Health and Safety at Work Act and other relevant legislation. It gives guidance on the practical application of legislation, concerning radiotherapy equipment. Two particular issues arise out of the requirements of Regulation 33 of the Ionising Radiations Regulations 1985 (IRR85) in relation to equipment which is used for medical exposures. These are the requirement to select, install and maintain this type of equipment in such a way that it is capable of restricting, so far as reasonably practicable, the medical exposure of any person where this is compatible with the intended clinical purpose, including the need to ensure that equipment used for radiotherapy is properly calibrated, and the requirement to notify the Health and Safety Executive (HSE) when an incident occurs involving a malfunction or defect in any 'radiation ...

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Variability in production is one of the largest factors that negatively impacts construction project performance. A common construction practice to protect production systems from variability is the use of buffers (Bf). Construction practitioners and researchers have proposed buffering approaches for different production situations, but these approaches have faced practical limitations in their application. A multiobjective analytic model (MAM) is proposed to develop a graphical solution for the design of Work-In-Process (WIP) Bf in order to overcome these practical limitations to Bf application, being demonstrated through the scheduling of repetitive building projects. Multiobjective analytic modeling is based on Simulation?Optimization (SO) modeling and Pareto Fronts concepts. Simulation...

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For charged particle irradiations, the response of an imaging plate (IP) changes around the Bragg peak. Therefore, an appropriate compensation is necessary for the evaluation of dose distribution formed by charged particles such as protons. In this paper, the response of IPs to clinical proton beams is investigated. An experimentally-obtained depth-dose distribution (an ordinary Bragg curve) by a silicon semiconductor detector (SSD) is employed to evaluate the compensation factors as a function of proton penetrating depth, i.e. residual range. A typical dose distribution in a water phantom formed by an L-shaped bolus is measured by IPs and corrected by using the information of those compensation factors; the residual proton range is successfully calculated by the pencil beam algorithm at an arbitrary point. The results show a good agreement with the measurements by the SSD within the rms error of 3.0%.

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The doctorate in Counselor Education and Supervision is the terminal degree in the field of counselor education within the U.S. The authors surveyed CACREP-accredited doctoral programs to assess department characteristics, clinical experience and credentials, research experience, and the admission, retention, and evaluation of students. Results indicated that the PhD was a preferable degree to other degree offerings. Programs were found to be diverse in their policies and procedures relating to admissions and retention, time to complete the program, and student expectations. International students and faculty representation was found to be sparse in CACREP-doctoral programs. Implications for future research and practice are offered.

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For over 50 years, electron beams have been an important modality for providing an accurate dose of radiation to superficial cancers and disease and for limiting the dose to underlying normal tissues and structures. This review looks at many of the important contributions of physics and dosimetry to the development and utilization of electron beam therapy, including electron treatment machines, dose specification and calibration, dose measurement, electron transport calculations, treatment and treatment-planning tools, and clinical utilization, including special procedures. Also, future changes in the practice of electron therapy resulting from challenges to its utilization and from potential future technology are discussed. (review)

International Nuclear Information System (INIS)

The clinical and radiographic features of the intermediate form of osteopetrosis in two sibs are presented in which the disorder appears to have been inherited as a recessive trait. Although this form of osteopetrosis has been poorly delineated, its recognition is practically important in order to give an accurate prognosis. This paper also presents an unusual complication of bilateral avascular necrosis of the femoral head in the younger sib. Radiographic changes of the femoral heads suggest those of Legg-Calve-Perthes disease, though the possibility of avascular necrosis following unrecognized femoral neck fracture is not completely excluded. (orig.).

International Nuclear Information System (INIS)

The utilization of the Ellis-formula for the determination of the tolerance of normal connective tissue is described. Beyond this, the formula is adapted to so-called critical organs. The individual suppositions implicated by the Ellis-formula are commented. Because of the verifyable congruency of the Ellis-formula with data obtained in clinical practice also by other authors, this conception is presented for the provisional determination of the limits of tolerance of normal tissue together with a computerized programme elaborated for use in different therapeutic techniques. (orig.).

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The quality insurance in radiotherapy in the frame of highly complex technical process as Intensity modulated radiotherapy (I.M.R.T.) needs independent control of the delivered dose to the patient. Actually, up to now, most of the radiotherapy treatments rely only on computed dosimetry through a rather complicated series of linked simulation tool. This dosimetry approach requires also qualified treatment means based on cautious quality insurance procedures. However, erroneous parameters could be difficult to detect and systematical errors could happen leading to radiotherapy accidents. In this context, in vivo dosimetry has a critical role of final control of the delivered dose. As many beam incidences and ports are used for any photon therapy treatment, external control could be very tedious and time consuming. Therefore, innovations are needed for in vivo dosimetry to provide ergonomic and efficient tools for these controls. This paper presents a review of technologies and products ...

UK PubMed Central (United Kingdom)

PurposeTo describe clinical data and to characterize mutations in the transforming growth factor beta-induced (TGFBI) gene in patients from three unrelated Chilean...Full Text Available

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The UK Pipelines Safety Regulations require the pipeline operator to ensure that a pipeline, once decommissioned, does not become a source of danger. Elsewhere, Regulatory Authorities require consideration of the possible issues which pipeline decommissioning may raise. This paper considers current practice with respect to pipeline decommissioning and abandonment, and sets out the range of factors which the operator must take into account. (author)

British Library Electronic Table of Contents (United Kingdom)

Purpose - The purpose of this paper is to critically explore business-to-business critical success factors (B2B CSFs) for small and medium-sized enterprises (SMEs) operating in the Chinese B2B marketplace, evaluate the findings, and use the generated CSFs to propose a framework to assist in the marketing management of B2B in China. The proposed framework provides a guideline for academics and practitioners and highlights the significant role of each factor in developing and sustaining effective B2B electronic commerce (B2B e-commerce) practice for SMEs. Design/methodology/approach - The proposed framework is constructed by combining the empirical findings and B2B literature. The quantitative (online survey) was targeted at, proprietors, chief executive officers, managing directors, general...

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Abstract Background: Obstructive sleep apnea (OSA), a highly prevalent condition, is independently associated with increased risks of developing type 2 diabetes mellitus (T2D) and metabolic syndrome. It is unclear, however, if the severity of OSA has any impact on glycemic control among patients with T2D. We therefore aimed to determine the independent association between OSA severity and glycosylated hemoglobin (HbA1c) in patients with T2D. Methods: This was an observational cross-sectional study of 52 consecutive patients attending the diabetes obesity clinic between January 2008 to February 2010 with risk factors for sleep apnea and who underwent polysomnography study. Clinical, demographic, and lifestyle data were recorded using a questionnaire. Results: Prevalence of OSA in this clini...

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Abstract Routinely used prognostic factors fail to predict clinical outcome in a significant proportion of breast cancer patients, implying that they can not detect some important biological characteristics. Chromosomal changes have been described in breast carcinomas for many years but their significance is not clear. We compared chromosomal changes with clinico-pathological characteristics and clinical outcome in 203 breast cancer patients with a follow-up of 9-18 years. Combining data from classical cytogenetics and flow cytometry revealed chromosomal abnormalities in 142 cases (70%). Of these, 51 (35.9%) contained two or more cytogenetically abnormal clones. Polyclonality was significantly associated with poor breast-cancer-specific survival (P = 0.03) within 5 years, independent of tu...

Science.gov (United States)

The purpose of this study is to examine the cross-ethnic measurement equivalence of the "Child Behavior Checklist" (CBCL) for 6- to 18-year-olds (2001, parent version) using a sample of African American special needs adopted children, along with a comparison group of Caucasian American special needs adopted children. Reliability and multiple sources of postdictive criterion-related validity were analyzed, and a confirmatory factor analysis of the CBCL within and between participating groups was performed. The results indicate that for practical purposes, the CBCL items appear reliable but not valid in terms of assessing the mental health profiles of both African American and Caucasian youth. These findings are significant because they have important implications for the practical utility of the CBCL in the field for adopted youth. (Contains 6 tables.)

Science.gov (United States)

The role of nurse practitioner has been established because of a shortage of doctors. In May 2007, the first cohort of 582 nurse practitioners were licensed in Taiwan. The post of nurse practitioner in Taiwan is formally moving towards systematization and the most urgent matters in that regard are the sorting out of contentious issues and the establishment of clear job descriptions. Competence in critical thinking and problem-based learning is important and has to be improved with practice. The application of teaching assessment tools such as direct observation procedural skills (DOPS), objective structured clinical examination (OSCE), miniclinical evaluation exercises (Mini-CEX), and 360 degree assessments may contribute to the improvement of nurse practitioners' skills in conducting research, appraising evidence-based nursing literature, and developing teaching strategies and advanced systems by making policy clear, evaluating, auditing and ...

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Most of the tissue banks in the Asia Pacific region have been using ionising radiation at 25 kGy to sterilise human tissues for save clinical usage. Under tissue banking quality system, any dose employed for sterilisation has to be validated and the validation exercise has to be a part of quality document. Tissue grafts, unlike medical items, are not produced in large number per each processing batch and tissues relatively have a different microbial population. A Code of Practice established by the International Atomic Energy Agency (IAEA) in 2004 offers several validation methods using smaller number of samples compared to ISO 11137 (1995), which is meant for medical products. The methods emphasise on bioburden determination, followed by sterility test on samples after they were exposed to verification dose for attaining of sterility assurance level (SAL) of 10{sup -1}. This paper describes our experience in using the IAEA Code of ...

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Success in improving treatment outcomes in childhood cancer has been achieved almost exclusively through multicenter and multidisciplinary clinical and applied research over several decades. While biologically rational as well as empirical approaches have led to combination chemotherapy and multimodality approaches to therapy, which have given rise to evidence-based practice standards, similar scientific rigor has not always been as evidently applied to modalities utilized to assess initial disease burden and, more important, response to investigational approaches to therapy. As the empirical approach to therapeutic advances has likely maximized its benefit, future progress will require translation of biologic discovery most notably from the areas of genomics and proteomics. Hence, attempts to improve efficacy of therapy will require a parallel effort to minimize collateral damage of future therapeutic approaches, and such a parallel approach ...

British Library Electronic Table of Contents (United Kingdom)

Radiation protection in medicine has unique aspects and is an essential element of medical practice. Medical uses of radiation occur throughout the world, from large cities to rural clinics. It has been estimated that the number of medical procedures using radiation grew from about 1.7 billion in 1980 to almost 4 billion in 2007. In spite of these large numbers, there are many parts of the world without adequate equipment, where the ability to perform additional medical procedures would likely result in a net benefit. Medicine accounts for more than 99.9% of the per caput effective dose from man-made sources. The goal in medical exposure is not to give the lowest dose, but to provide the correct dose to enable the practitioner to make the diagnosis or cure a tumour. Too little or too much ...

International Nuclear Information System (INIS)

A newly developed method to support tissue characterization in routine MR imaging is presented. It represents a compromise between the practical requirements of clinical routine (short measurement time, multisection imaging) and the necessary accuracy of the relaxation parameter evaluation. The sequence employed is a modification of the PHAPS technique and works with two excitation pulses. It allows the simultaneous acquisition of all measurement data for the subsequent T1, T2, and rho evaluations. T1 is determined with a specially designed computation formula based on four signal ratios. A multiexponential T2 analysis is performed with use of 28 echoes. From these parameters, relative proton density can be computed.

British Library Electronic Table of Contents (United Kingdom)

Abstract Intense controversy surrounds the management of disorders of sex development, particularly in relation to the validity of parental consent for genital surgery and the removal of gonadal tissue carried out during infancy or childhood. Past practices have been heavily criticised on ethical grounds by patient advocacy organisations, who have demanded a moratorium on these kinds of operations unless authorised by a court. Some doctors and hospital administrators have been influenced by the controversy and have referred cases to the Family Court of Australia, where a series of judgements have now established legal precedents that apply across Australia, restricting the circumstances in which parents can give consent for surgery. An alternative approach is to use a hospital-based Clinic...

British Library Electronic Table of Contents (United Kingdom)

Abstract Rationale, aims and objectives- Finding ways to incorporate disparate types of evidence into research syntheses has the potential to build a better evidence base for clinical practice and policy. Yet conducting such mixed research synthesis studies is challenging. Researchers have to determine whether and how to use adjusted and unadjusted quantitative findings in combination with each other and with qualitative findings. Methods- Among quantitative findings, adjustment for confounding, either via study design or statistical analysis, can be a considerable source of heterogeneity. Yet there is no consensus about the best way to synthesize findings resulting from different methods for addressing confounding. When synthesizing qualitative and quantitative findings, additional consid...

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In this study the greenhouse impact of the total Finnish forest sector was considered, which means that the estimated emissions and sink effects from exported forest products were also included. The forest biomass is and seems to be in the next decades the most important factor in the carbon balance of the total forest sector. The development alternatives of forest industries and waste management practices has still a remarkable influence on the greenhouse impact of the Finnish forest sector. The waste management practices in the future has an important influence on the emissions but the exact net greenhouse impact of the landfills is still uncertain. However, the methane emissions from existing landfills can be reduced essentially by gas recovery. Increased incineration and energy recovery of wood waste (and replacing fossil fuel use by it) is also a future alternative for reducing the greenhouse effects in the forest ...

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Objectives: Acupuncture has served as a major complementary and alternative therapy that supplements conventional medicine and is the subject of growing public interest. This study was conducted to estimate the usage rate of acupuncture as a supplemental treatment in acute ischaemic stroke patients and to identify factors associated with the choice to use this therapy. Methods: Using the registry of stroke patients admitted to an academic medical centre in Korea, the use of acupuncture therapy was recorded and analysed, along with the patients' socio-demographic characteristics, hospital access variables, risk factors for ischaemic stroke and clinical characteristics. The data were analysed using descriptive statistics, chi-square tests and multiple logistic regression analyses. Results: O...

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Background: Incidence, characteristics and predictive factors of transient ST-segment changes after DC shock are poorly known. Methods: 91 consecutive pts referred for external cardioversion of atrial fibrillation (AF) (61 men, 69+/-10yo) were prospectively included. The presence of ST elevation or depression was assessed on 12 lead-ECG immediately after the first DC shock. Correlations with DC shock characteristics (monophasic/biphasic and energy), clinical variables, echocardiographic parameters, biological parameters, medications, anesthesic drugs as well with morphological features were made. Results: 18 and 20 pts underwent 200J or 300J monophasic and 53 pts 200J biphasic DC shocks. We found an incidence of 48% for ST-segment changes: 35% for ST elevation and 13% for ST depression. ST...

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Abstract Recently, a study of patients with rheumatoid arthritis who developed herpes zoster while taking a tumor necrosis factor (TNF)- inhibitor reported a decreased incidence of postherpetic neuralgia. The objective of this study was to investigate whether patients on TNF- inhibitors who developed herpes zoster have a lower incidence of subsequent development of postherpetic neuralgia. A retrospective review of herpes zoster patients on TNF- inhibitors (infliximab, etanercept, or adalimumab) was conducted in 12 dermatology clinics. Medical records of such patients were reviewed thoroughly to confirm herpes zoster and TNF- inhibitors and any subsequent development of postherpetic neuralgia (pain score -3 out of 10 after 90 days of shingles onset) was noted. A total of 206 cases were revi...

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Structural engineering implies four factors particularly relevant to sonics: airborne noise abatement, insulation of plumbing, by-pass insulation and noise absorption (noise abatement). These are exemplified with special regard to methodical and/or product-specific noise pollution abatement measures. Besides, reference is made to DIN standards 4109 providing both engineers with practical advice and pipe fitters or plumbers with concrete examples for application. VDI recommendations 3733 convey essential knowledge of how to properly apply sonic principles in the planning, design and installation of pipes. (BR).

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The various factors that affect the open-circuit voltage ([ital V][sub oc]) of a two-terminal GaInP[sub 2]/GaAs tandem cell are examined. These include a) an anomalous problem associated with the GaAs bottom cell and b) back surface passivation of the thin GaInP[sub 2] top cell. Solutions to these problems are presented and yield tandem [ital V][sub oc]s close to the practical theoretical limits.

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Customer Relationship Management (CRM) systems can help organizations manage customer interactions more effectively. Like many new technologies, CRM has been accompanied by vendor hype and stories of implementation failure. Work on critical success factors (CSFs) should encourage more appropriate implementation practice; however many CSF studies conclude with a list of factors but provide little further guidance. In particular, there is a need for stronger theoretical models of the entire CRM innovation process which can be used by managers to understand better the underlying causes of success and failure. This paper adopts a novel approach to this problem by firstly developing a conceptual model of CRM innovation and then converting this model into a dynamic simulation model. Some early s...

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The problem of buried steelwork in cargo hold insulation has been investigated by several using empirical methods. These efforts have resulted in correction factors that serve as a useful aid in the complex task of estimating the K-value of a ship`s cargo holds for the correct dimensioning of the refrigeration plant. Today, the advent of the digital computer has established numerical methods of analysis as a common working tool among practicing engineers. For estimating the flow in cases of buried steelwork that cannot be handled by correction factors, this is an effective approach. This study is an analytical/numerical investigation of the effect that buried steelworks have on the heat leakage across cargo hold walls. It aims at providing enlightenment on the physical significance of the parameters influencing the problem and developing practically simple methods for predicting the heat leakage across ...

International Nuclear Information System (INIS)

Combination of radiotherapy and chemotherapy (CRC) is actually one important way of research in oncology. Theoretical advantages are: (1) Spatial cooperation; (2) Additivity, which is only obtained if the toxicity of each modality are different; (3) Supra-additivity, which needs a rigorous in vitro definition; the only way to prove it is to make an isobologram analysis. This model has however, some limitations: qualitative variable could not be used, results could be different, depending on the cell line and isoeffect chosen...In fact, a supra-additivity was only demonstrated for cis platinum and etoposide. Interactions mechanisms were: (1) at the molecular level, creation of new lesions or inhibition of radiation lesions repair; (2) At the cellular level, either cytokinetic cooperation with S-phase dependent drugs, or synchronization for the drugs which blocked the cells in M-phase; (3) At the tissular level, reoxygenation, cycle redistribution. In clinical ...

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The aims of the study were to develop and test the psychometric properties of the Thai Family Health Routines (TFHR) scale, a 70-item self-report questionnaire used to measure the health of Thai families through their routine behaviors in daily life. Development of the TFHR was based on the structural domains of Denham's Family Health Model. The TFHR scale was initially composed of 85 items and tested on 1,040 families living in the central region of Thailand. The confirmatory factor analysis, with an acceptable factor structure model, yielded 70 items aligned with six factors: self-care, safety and prevention, mental health behavior, family care, family caregiving, and illness care routines. The preliminary psychometric properties demonstrated that the TFHR scale had satisfactory internal consistency, criterion validity, and construct validity. The test results suggested that the TFHR scale has potential benefits for ...

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Eight patients, one male and seven females, with no pre-existing hypothalamic-pituitary disease, who developed symptoms of hypopituitarism following cranial irradiation for nasopharyngeal carcinoma were studied 5 years or more after radiotherapy. All were GH deficient. Four of the patients with no GH response during insulin tolerance tests (ITT) showed increased GH in response to synthetic human growth hormone releasing factor (GRF-44). Four patients had impaired cortisol responses to ITT, and gradual but diminished cortisol responses to ovine corticotrophin releasing factor (CRF-41). There was no significant difference between mean peak increments in response to ITT and those in response to CRF-41. TSH responses to TRH were delayed in five and absent in two patients; four of these had low free T4 index. Prolactin was raised in all seven women and increased further in response to TRH. Two patients had impaired gonadotrophin responses to LHRH. ...

International Nuclear Information System (INIS)

To raise the efficiency of the redox method and decrease the amount of radioactive wastes, a possibility of improving the decontamination process for NPP heat exchanger tubes made of stainless steel is studied. In the home practice the redox method of equipment decontamination is carried out as a multi-cycle process. In each cycle the surface is treated first with a permanganate alkaline solution ther with an oxalic acid solution, with a condensate washing-at between the treatments. Using samples cut out of the steam generator pipelines of the first and third power units of the Novovoronezh NPP the effect of the oXalic acid concentration, as well as washout time and conditions on the decontamination factor are studied. On the basis of analysis of the obtained data a conclusion is drawn that using oxalic acid of low concentrations and increasing its concentrations from cycle to cycle maximum decontamination factor values can ...

International Nuclear Information System (INIS)

A suspension-firing type radioactive waste incineration system is developed and cold demonstration testing of ceramic filters for the system are carried out. The incineration system, which is useful for a wide variety of waste materials, can serve to simplify the facilities and to reduce the costs for waste disposal. The incineration system can be used for drying-processing of concentrated waste liquids and disposal of flame resistant materials including ion exchange resins and rubber, as well as for ordinary combustible solid materials. An on-line backwash system is adopted to allow the ceramic filters to operate stably for a long period of time. For one-step filtering using the ceramic filter, the decontamination factor is greater than 10"5 for the processing of various wastes. In a practical situation, there exist vapor produced by the spray drier and the cladding in used ion exchange resin, which act to increase the decontamination ...

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Bacterial attachment-effacement (att-eff) is emerging as an important virulence characteristic common to both enteropathogenic Escherichia coli (EPEC) and enterohemorrhagic E. coli (EHEC). The contribution of the plasmid-encoded EPEC adherence factor to the production of mucosal lesions and diarrhea was investigated in gnotobiotic piglets. Bacterial att-aff in the intestinal mucosa of piglets infected with plasmid-cured EPEC strain E2348/69 (O127) was indistinguishable from that in piglets infected with the parent strain, but the distribution of lesions was different; it occurred in the small intestines of 6 of 7 piglets infected with the parent strain compared with only 2 of 11 (P = 0.006) infected with the plasmid-cured strain. Plasmid-encoded factors in EPEC and EHEC strains did not appear to contribute to bacterial competition with normal gut microflora. Of 13 strains belonging to five EPEC serogroups, O55, O142, O26, O119, and O111, 3 ...

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Perforated thermoplastic masks are used to provide patients immobilization. This procedure inserts a material in the path of the radiation beam, that attenuates and modifies the beam fluence and flatness. The present study evaluates the increase in skin dose as a result of using thermoplastic masks. Relative doses were measured on the surface of a solid water phantom, in the presence and absence of masks. These masks were stretched according to deformation patterns observed in clinical routine. The measurements were obtained with a plane-parallel chamber (Markus type 23343) and radiochromic film (EBT Gafchromic) for 6MV X-rays from a linear accelerator, and for a radiation beam from a cobalt therapy unit. The results showed that thermoplastic masks, whose thickness varied between 2 and 3 mm, increased the dose on the surface by a factor of 3. Due to the variations in the skin dose distribution, clinical procedures were ...

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Background: the authors report on the conception and first clinical application of a donut-shaped high-dose configuration for proton therapy (PT). This approach allows one to intensify target volume dose coverage for targets encompassing a critical, dose-limiting structure - like here, the cauda equina -, whilst delivering minimal dose to other healthy structures surrounding the target, thereby reducing the integral dose. Methods and results: intensity-modulated PT methods (IMPT) for spot scanning were applied to create and deliver a donut-shaped high-dose configuration with protons, allowing treating > 75% of the target with at least 95% of the prescribed dose of 72.8 CGE, whilst restricting dose to the cauda equina to 60-65 CGE. Integral dose was lower by a factor of 3.3 as compared to intensity-modulated radiotherapy with photons (IMXT). Conclusion: IMPT and spot scanning technology allow a potentially clinically ...

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One of the issues identified in the US Nuclear Regulatory Commission`s Nuclear Plant Aging Research program plan is the need to understand the state of ``mothballed`` or other out-of-service equipment to ensure subsequent safe operation. Programs for proper storage and preservation of materials and components are required by NRC regulations (10 CFR 50, Appendix B). However, materials and components have been seriously degraded due to improper storage, protection, or layup, at facilities under construction as well as those with operating licenses. Pacific Northwest Laboratory has evaluated management of aging for unstarted or mothballed nuclear power plants. The investigations revealed that no uniform guidance in the industry addresses reactor layup. In each case investigated, layup was not initiated in a timely manner, primarily because of schedule uncertainty. Hence, it is reasonable to assume that this delay resulted in accelerated aging of some safety-significant structures, ...

International Nuclear Information System (INIS)

Gastrointestinal lymphomas are almost exclusively of a non Hodgkin's type. The Western form is characterized by a higher incidence of stomach location (50 %), a MALT type (mucosa associated lymphoid tissue) (40 %), a B-cell type (90 %), and a high grade (55 %). Chronic infection with Helicobacter pylori is an important risk factor. Mediterranean lymphomas form a particular clinical and pathological entity with diffuse involvement of the small bowel and are frequently being associated with a chronic malabsorption disorder. Eradication of Helicobacter pylori in early lymphomas, and the use of tetracyclines in early Mediterranean lymphomas, have been shown to induce durable remissions. For more advanced gastric lymphomas, treatment usually consists of anthracycline-based chemotherapy followed by involved field radiotherapy. Surgery is usually reserved for complications such as perforation or bleeding, or in some selected cases for salvage after ...

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PMID:10488815

KoreaScience (Korea)

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PMID:1354044

KoreaScience (Korea)

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The incidence of hilar cholangiocarcinoma is very rare worldwide. Radical resection is the only prognostic factor for long survival in patients with hilar cholangiocarcinoma. Postoperative radiation therapy can improve local control and survival rates for patients with palliative resection, but it remains controversial in patients with radical resection. Biliary drainage can effectively release bile duct obstruction for the majority of patients with locally advanced disease, and may even prolong survival when combined with radiation therapy. Radiation therapy includes extrernal beam therapy alone, external beam therapy with intraluminal brachytheapy and new radiation technique, such as three dimentional conformal therapy and intensity modulated radiation therapy. The propective randomized clinical study is needed for further investigation in the role of combined modality therapy especially for hilar cholangiocarcinoma. (authors)

British Library Electronic Table of Contents (United Kingdom)

The optimal management of men with very favorable clinicopathological factors who develop biochemical recurrence (BCR) after radical prostatectomy (RP) has not been previously reported. Both local and systemic recurrences are unlikely in this cohort. This study examines their management and outcomes. Between October 2000 to March 2010, 1627 men underwent open RP by a single surgeon. In all, 448 (27.5%) met the following criteria for extremely low risk disease: preoperative PSA level <10?ng?ml?1, clinical stage T1c/T2a, Gleason score ?6, estimated cancer volume in the surgical specimen ?5% and no evidence for positive surgical margin. Undetectable PSA was defined as ?0.04?ng?ml?1. BCR was defined as PSA ?0.2?ng?ml&#...

British Library Electronic Table of Contents (United Kingdom)

Male infertility, characterized by hypogonadism, decreased semen quality or ejaculatory dysfunction, accounts for approximately 20% of infertility cases. Obesity and metabolic dysfunction have been identified, among other causal factors, to contribute to male infertility. In the context of the Western world's `obesity epidemic', this article discusses three main biological mechanisms linking obesity to impaired male reproductive function: hypogonadism, testicular heat stress/hypoxia-induced apoptosis and endocrine disruption by `obesogens'. Among these, obesity-induced hypogonadism is undoubtedly the most clinically significant and is easily assessed. Rapidly expanding areas of research in this area include leptin modulation of kisspeptins and hypothalamic-pituitary-testicular hormone path...

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Objective: A growing body of data from genetic, immunological and clinical studies indicates an involvement of the immune system in the pathophysiology of schizophrenia and suggests that the modulation of the cytokine system by antipsychotics may be one cause for the improvement of psychotic symptoms. However, the influence of the typical antipsychotics chlorpromazine and haloperidol, and the effect of typical and atypical antipsychotics on the TSST-1-stimulated blood cell secretion of cytokines, and specifically the interleukin (IL)-17 production have not been studied so far, although IL-17 is a leading pro-inflammatory cytokine. Method: We measured levels of IL-1@b, IL-2, IL-4, IL-6, IL-17 and tumor necrosis factor-@a (TNF-@a) in stimulated blood of 10 healthy female subjects in a whole ...

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Abstract Purpose: To compare the safety and efficiency of conventional monopolar, plasmakinetic and holmium laser transurethral resection of bladder tumor (CM-TURBT, PK-TURBT and HoL-TURBT) while managing primary non-muscle invasive bladder cancer. Patients and Methods: From 2005 to 2009, 173 patients with primary non-muscle invasive bladder cancer underwent endoscopic surgery. Among them, 51 patients underwent CM-TURBT, 58 patients underwent PK-TURBT, and 64 patients underwent HoL-TURBT. All patients were divided into three risk groups (low, intermediate, and high) based on the European Association of Urology guidelines and prognostic factors of recurrence. Clinical data, included preoperative, operative, and postoperative management and follow-up, were recorded. Results: Patient demograp...

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SNAP25 occurs on chromosome 20p12.2, which has been linked to schizophrenia in some samples, and recently linked to latent classes of psychotic illness in our sample. SNAP25 is crucial to synaptic functioning, may be involved in axonal growth and dendritic sprouting, and its expression may be decreased in schizophrenia. We genotyped 18 haplotype-tagging SNPs in SNAP25 in a sample of 270 Irish high-density families. Single marker and haplotype analyses were performed in FBAT and PDT. We adjusted for multiple testing by computing q values. Association was followed up in an independent sample of 657 cases and 411 controls. We tested for allelic effects on the clinical phenotype by using the method of sequential addition and 5 factor-derived scores of the OPCRIT. Nine of 18 SNPs had P values <...

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The survival of acetabular components depends on several factors: wear, osteolysis and septic or aseptic loosening. Osteolysis seems to be the main cause for concern in cementless arthroplasties. Acetabular osteolysis results from particle debris and segmental unloading of acetabular bone by rigid sockets. We investigated a cementless elastic monoblock socket with regard to acetabular osteolysis and aseptic loosening in a cohort of young patients. We evaluated 158 hip arthroplasties with a minimum follow-up of ten?years (ten to 18) and a mean age of 42?years (18?50). The overall revision rate at 14?years was 80% with a 98% survival rate for aseptic loosening. The mean polyethylene wear rate was 0.11?mm/year. Progressive acetabular osteolysis was seen in 3% of patients evaluated. In conclus...

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In consistency with the increasing requests from Member States for establishing radiotherapy programmes, an IAEA Technical Co-operation project was initiated in Latin America aimed at improving the physical aspects (as a complement to the clinical issues) of quality assurance in radiotherapy; this ARCAL XXX project (RLA/6/032) was classified as a Model Project of the IAEA. Among the important outcomes of the project were (i) the training of a considerable number of medical physicists in hospitals of the region, (ii) the development of a protocol for quality control procedures, and (iii) the organization of quality audit site visits (to the participant countries) where the implementation in hospitals of the developed quality control procedures is verified. The present publication is the protocol for quality control of the physical aspects of radiotherapy. It contains detailed procedures on what should be measured by a medical physicist in a radiotherapy treatment ...

International Nuclear Information System (INIS)

Despite its great usefulness in the performance of the recording procedures prescribed by the X-Ray Ordinance the dose-area product is much less frequently measured for X-ray exposures than during fluorscopic examinations. The great multitude of measuring units, mainly on account of different scales of the measuring equipments themselves, is a cause of uncertainty in clinical routine and should be eliminated as far as the circumstances would permit. As the determination of the organ dose is relevant only in very few cases and does not necessarily require previous measurements of the dose-area product, these are of limited practical value in the assessment of individual radiation exposures during radiographic examinations. The measurements may, however, be very helpful in determinations of the radiation dose to the total population, if the future retrievability of the values obtained is ensured. In addition to some measuring values showing past ...

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Hepatobiliary scintigraphy is the only non-invasive technique providing real-time assessment of hepatocytes function and bile progression from the liver to the intestine; for this reason it is of great importance in the study of jaundice and many other disorders of the liver and the biliary tract in children. Ultrasonography is the initial method of evaluating the intra- and extrahepatic bile ducts dilatation: the differential diagnosis between biliary atresia and neonatal hepatitis cannot however be done without hepatobiliary scintigraphy. Cystic fibrosis patients also require hepatobiliary scintigraphy; liver and biliary tract disease can really occur independently of the underlying disease severity and the presence of steatorrhoea. Hepatobiliary imaging in children who have undergone liver transplantation is of major importance; it can assess vascularity, parenchymal function biliary drainage, possible presence of a bile leak and obstruction; it has very good sensitivity and ...

Science.gov (United States)

Cerebral angiography, pneumoencephalography, and radioisotope brain scan with their differing diagnostic abilities have provided the neurologist and neurosurgeon with extremely valuable diagnostic techniques. It is doubtful, however, if any of these now conventional methods had the enormous impact on the practice of neurology that computer assisted axial tomography (C.A.T.) is beginning to have. Here, for the first time, is a test which, without significant risk or discomfort, can demonstrate some normal intracranial (and intraorbital) structures, can demonstrate some normal intracranial pathology and, in many cases, can make the potentially dangerous contrast studies unnecessary. After only a few months experience with C.A.T. in a clinical setting, it has become obvious that there will have to be a reappraisal of the accepted investigative work-up of many conditions. While it is too early to have formulated strict criteria for the use of ...

International Nuclear Information System (INIS)

Objective: To evaluate the quality and usefulness of direct digital radiography system in roentgenogram of chest in clinical practice. Methods: 1000 cases of chest roentgenograms with digital radiography and high kV conventional radiography were selected for analysis by 3 senior radiologists. Results: 1. With digital radiography system, the quality of chest film was assessed as grade A in 50.6%, grade B in 38.5%, grade C in 10.9%, and no waste film. 2. With conventional high kV radiography, the quality of chest film was assessed as grade A in 41.1%, grade B in 44.1%, grade C in 13.3%, and waste film in 1.5%. The direct digital radiography was statistically superior to the conventional high kV radiography. 3. The fine structure of the lungs could be revealed in 100.0% of chest roentgenogram with direct digital radiograph system, which was significantly higher than that acquired with the conventional high KV radiography (78.6%, P < 0.001). ...

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The University of Maryland at Baltimore was awarded a grant from the Department of Energy to test a specially modified incinerator to burn biomedical radioactive waste. In preparation for the incinerator, the Radiation Safety Office devised a comprehensive plan for its safe and effective use. The incinerator plan includes a discussion of regulations regarding on-site incineration of radioactive waste, plans for optimum use in burning four principal waste forms, controlled air incineration technology, and standard health physics safety practices; a use plan, including waste categorization and segregation, processing, and ash disposition; safety procedures, including personnel and area monitoring; and methods to evaluate the incinerator's effectiveness by estimating its volume reduction factors, mass and activity balances, and by determining the cost effectiveness of incineration versus commercial shallow land burial.

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Current medical visualization technology intended for positional guidance in surgical applications may only ever have limited utility in the operating room due to the preexisting visual requirements of surgical practice. Additionally, visual systems impose limits as a result of their high latency, poor image resolution, problems with stereopsis and physical strain upon the user. Audio technology is relatively unexamined in the broad range of available methodologies for medical devices. The potential to translate surgical instrument position into audio feedback presents a novel solution to the human factors and engineering problems faced by visual display technology because audio technology employs a rich and as yet unburdened sensory modality. We describe an experimental system we have developed for investigating this new interface design approach using commercially available hardware. PMID:10173065

International Nuclear Information System (INIS)

One of the significant factors of neutron radiographic image degradation is scattering blur from the object. A practical method is described to enhance image quality by eliminating the overlapping of scattered thermal neutrons component from the objects in ETRR-2 neutron radiography facility, using aluminum Gd-coated antiscatter grid. The MCNP code was used to determine the optimum grid dimensions that will reduce the scattered thermal neutrons from the object. An experiment was performed to determine the optimum grid height and irradiation time that gives the best image with acceptable geometric unsharpness. Using the MCNP code it was found that 97% of the scattered neutrons were removed by the grid. The wall dimensions and Gd coating are so small that the facility resolution cannot detect the image pattern superposition on the film.

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Increase in power utility loads in industrialized countries, as well as developing countries, demands a higher level of transmission line voltage. Radio interference (RI) problems have been determined to be a limiting factor in selecting the size of transmission line conductors. Transmission line noise is primarily caused by corona discharges in the immediate vicinity of the conductor. It has been observed that discharges occur during both half-cycles of the applied voltage, but positive corona is usually predominant at AM radio frequencies range with practical high-voltage and extra high-voltage transmission lines. The corona radio noise effect is highly dependent upon the presence of particles on the surface of the conductor and the increase of the electrical gradient beyond the breakdown value of the air. Therefore, corona radio noise varies significantly with the weather and atmospheric conditions and generally increases by 10 to 30 dB in ...

International Nuclear Information System (INIS)

Increase in power utility loads in industrialized countries, as well as developing countries, demands a higher level of transmission line voltage. Radio interference (RI) problems have been determined to be a limiting factor in selecting the size of transmission line conductors. Transmission line noise is primarily caused by corona discharges in the immediate vicinity of the conductor. It has been observed that discharges occur during both half-cycles of the applied voltage, but positive corona is usually predominant at AM radio frequencies range with practical high-voltage and extra high-voltage transmission lines. The corona radio noise effect is highly dependent upon the presence of particles on the surface of the conductor and the increase of the electrical gradient beyond the breakdown value of the air. Therefore, corona radio noise varies significantly with the weather and atmospheric conditions and generally increases by 10 to 30 dB in ...

Energy Technology Data Exchange (ETDEWEB)

Impacts of gas pipeline rights-of-way (ROWs) through wetlands depend on types of habitat, construction techniques, final elevations, ROW maintenance practices, soil composition, and local climate. In some instances factors unrelated to the presence of the pipeline may have greater impacts on wetland modification than does the pipeline itself. At one site, the required seeding program inhibited natural reestablishment of wetland plants; at another, downstream construction resulted in a major disruption to the adjacent wetland habitat. This paper discusses observation from 13 study sites, each zero to 30 years old, that are located in seven Eastern States.

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Reasons for variation in transfusion practice in orthopedic surgery are not well understood. This systematic review identified and appraised the quality of the literature in this area to assess the impact of factors associated with the use of allogeneic red blood cell (RBC) transfusion in orthopedic procedures. MEDLINE and EMBASE databases were searched for relevant English language publications. Articles containing a range of MeSH and text terms regarding ''blood transfusion,'' ''predictors,'' and ''multiple logistic regression'' were retrieved. Articles that focused on patients undergoing orthopedic procedures and that met prespecified inclusion criteria were appraised in terms of potential bias and the appropriateness of statistical approach. A total of 3641 citations were retrieved, an...

Science.gov (United States)

;Table of Contents: Legal authority; Summary of proposed regulations; Industry definition and waste streams; Industry description; Data and information gathering; Selection of pollutant parameters; Drilling wastes-characterization, control, and treatment technologies; Produced water-characterization, control, and treatment technologies; Miscellaneous waste-characterization, control, and treatment technologies; Cost and pollutant loading determination of drilling fluids and drill cuttings; Compliance cost and pollutant load determination of produced water; Compliance cost and pollutant load determination of well treatment, workover, and completion fluids; Cost and pollutant loading determination of deck drainage; Options selection-rationale and total costs; Pretreatment standards; Non-water quality environmental impacts and other factors; Best Management Practices; and Appendices.

British Library Electronic Table of Contents (United Kingdom)

Purpose - This article aims to examine approaches by academic libraries in demonstrating return on investment (RoI). Design/methodology/approach - As a participant in a recent international RoI study, the author reviews the various difficulties in developing a suitable methodology. Findings - Using grant income as the basis for demonstrating RoI, it was found that wide differences in results may be attributable to a number of factors related to the parent organisation, the availability of grant funding and the country of the study. Research limitations/implications - Further work is necessary to arrive at a suitable methodology for a diverse range of academic libraries. Practical implications - Library managers are alerted to issues and problems surrounding the development of return on inv...

British Library Electronic Table of Contents (United Kingdom)

Meta-analysis to investigate the joint effect of multiple factors in the aetiology of a disease is of increasing importance in epidemiology. This task is often challenging in practice, because studies typically concentrate on studying the effect of only one exposure, sometimes may report the interaction between two exposures, but rarely address more complex interactions that involve more than two exposures. In this paper, we develop a meta-analysis framework that combines estimates from studies of multiple exposures. A key development is an approach to combining results from studies that report information on any subset or combination of the full set of exposures.The model requires assumptions to be made about the prevalence of the specific exposures. We discuss several possible model spec...

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A new algorithm for the design of decentralized output feedback stabilizers for large-scale electric power systems is presented in this paper. In the proposed approach, the generators which are most effective for stabilizer applications are first identified by using participation factors. Then an efficient algorithm based on decentralized pole assignment is proposed for the determination of the parameters of the power system stabilizers which, due to the difficulty associated with the communication among the geographically dispersed generating stations in a large power system, are essentially decentralized compensators using local generator outputs as their feedback signals. The proposed method is computationally efficient and can be applied to any large-scale system. The simplicity and effectiveness of the proposed method are demonstrated by an example of stabilizer design for a practical power system.

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BACKGROUND: Glyphosate resistance has been confirmed in 58 populations of Lolium rigidum (Gaud.), a major weed of crops in southern Australia. Extensive use of glyphosate in conjunction with minimal soil disturbance has been identified as high risk for resistance to that herbicide. Land managers need a simple method for rapid assessment of the risk of resistance occurring as a result of past and proposed future management practices. Modelled on risk assessment nomographs, a simple calculator for indicating the risk of evolved glyphosate resistance in L. rigidum is described.RESULTS: The calculator uses the generations since first use and the frequency of use of glyphosate in combination with historical cultivation levels as critical factors for determining the risk of glyphosate resistance...

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High-energy ionizing radiation is a prominent modality for the treatment of many cancers. The approaches to electron dose calculation can be categorized into semi-empirical models (e.g. Fermi-Eyges, convolution-superposition) and probabilistic methods (e.g. Monte Carlo). A third approach to dose calculation has only recently attracted attention in the medical physics community. This approach is based on the deterministic kinetic equations of radiative transfer. We derive a macroscopic partial differential equation model for electron transport in tissue. This model involves an angular closure in the phase space. It is exact for the free streaming and the isotropic regime. We solve it numerically by a newly developed HLLC scheme based on Berthon et al (2007 J. Sci. Comput. 31 347-89) that exactly preserves the key properties of the analytical solution on the discrete level. We discuss several test cases taken from the medical physics literature. A test case with an academic ...

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When total mesorectal excision (TME) is accurately performed, dysfunction, theoretically, does not occur. However, there are differences among individuals in the running patterns and the volumes of nerve fibers, and if obesity or a narrow pelvis is present, nerve identification is difficult. Currently, the rate of urinary dysfunction after rectal surgery ranges from 33% to 70%. Many factors other than nerve preservation play a role in minor incontinence. Male sexual function shows impotence rates ranging from 20% to 46%, while 20%-60% of potent patients are unable to ejaculate. In women, information on sexual function is not easily obtained, and there are more unknown aspects than in men. As urinary, sexual, and defecation dysfunction due to adjuvant radiotherapy have been reported to occur at a high frequency, the creation of a protocol that enables analysis of long-term functional outcome will be essential for future clinical trials. In the ...

International Nuclear Information System (INIS)

Techniques for reducing computation time in 3D photon dose calculations are addressed with specific emphasis given to the convolution/superposition approach. A single polyenergetic superposition model calculating absorbed dose per incident photon fluence (Gy cm"2) was developed in terms of TERMA and a total energy deposition kernel (a total point spread function). A novel approach was devised for reducing calculation time. The method, named the CF method, was based on the use of a conventional, fast model (here a modified power-law method was used) for the generation of 3D dose distributions on a fine dose matrix. Superposition calculations were carried out on a coarse matrix and calculation speed was increased simply by reducing the number of calculations. A set of correction factors was derived on the coarse grid from the ratio of the dose values from superposition to those from the conventional algorithm. These were interpolated onto the fine matrix and used to ...

British Library Electronic Table of Contents (United Kingdom)

Objective. So far, few data are available to characterize the flare history of patients with gout. The objective of this study was to describe the frequency and risk factors of gout flares with special consideration of the comorbidity. Methods. A cohort study was conducted in a UK general practice database (The Health Improvement Network) including all patients aged 20-89 years diagnosed with incident gout between the years 2000 and 2007. Results. In this study, 23 857 incident gout patients (mean age 61.9 years) were included, overall incidence rate was 2.68 (95% CI 2.65, 2.72) per 1000 person-years. The proportion of patients with at least one flare during the follow-up period (mean 3.8 years) was 36.9% (n = 8806). A history of ischaemic heart disease [hazard ratio (HR) 1.12 (95% CI 1.06...

Energy Technology Data Exchange (ETDEWEB)

This report presented an analysis of incidents gathered by the Canadian upstream oil and gas industry committee in relation to explosive atmospheres in wellbores, vessels, tanks, and piping systems. The aim of the report was to develop industry recommended practices for oil and gas industry fires and explosions. Two accident theory models were used to set out the relationships between hazards, defenses, and losses. Three levels of defenses were identified based on organizational, local workplace, and human factors. An organizational responsibility approach was used to examine the activities of key people with the system. Incidents were analyzed based on an expanded fire triangle used to identify fire and explosion hazards. The study showed that the ignition of hydrocarbons into the air was a factor in nearly 50 per cent of the incidents. A lack of understanding of liquid-hydrocarbon properties was demonstrated in incidents ...

Science.gov (United States)

The objective of this study was to simplify the opacifying mixing process of the bone cement and contrast used for percutaneous vertebroplasty (PVP). We performed a biomechanical study of polymethyl methacrylate (PMMA) (Corinplast{sup TM} 3) using three different mixtures of PMMA, monomer, and contrast: group I, 2:1; group II, 3:2; group III, 3:2:1 ratio of powder/monomer/iodinated contrast (Omnipaque). In vitro biomechanical testing of ultimate compressive strength was carried out in all samples. Following the conclusion of a proper bone cement mixture regimen drawn from the in vitro study, PVP was performed in 125 patients: 58 with cancer, 12 with hemangioma, and 54 with osteoporotic fracture. The ultimate compressive strength in group III was decreased by 38% compared to groups II and I. Proper fluoroscopic visualization was achieved in all PVP procedures using this mixture. There were no major complications associated with injection of the cement mixture. Complete (CR) and partial ...

Energy Technology Data Exchange (ETDEWEB)

Phase-contrast imaging with a practical cone-beam X-ray tube has been realized for clinical use in digital mammography using computed radiography (CR). To perform phase-contrast imaging, the X-ray detector must be distanced from an object so that the phase-contrast image achieves magnification; in a mammography unit dedicated to phase-contrast imaging, the magnification ratio is 1.75. When using an X-ray tube with a 0.1-mm focal spot, it appears that the penumbra in magnification blurs both projected images and the phase contrast, which generates an edge effect. However, where the sampling pitch of the CR plate is 43.75 {mu}m, the blur stretches the width of the phase contrast so that unit pixels in the detector can capture it. Note that the width of an ideal phase contrast using an X-ray point source results in a phase contrast too narrow for detection with CR. In addition to phase contrast improving image quality, a re-scaling effect ...

International Nuclear Information System (INIS)

The purpose of this study was to clarify the benefits of digital lateral chest radiogram. In the basic study, the modulation transfer factor (MTF) and the wiener spectra (WS) of conventional screen film (CSF) and Fuji computed radiography (FCR) were measured. The visibility of the simulated nodules on FCR using 3 human bodies was subjectively compared with that on CSF by 13 observers. In the clinical study, the visibility of the normal structures on FCR was subjectively compared with that on CSF using 50 lateral chest radiograms by 10 observers. The diagnostic performance to detect pulmonary nodules on FCR was also compared with that on CSF using each 30 positive and negative cases by 8 observers. In the basic study, the MTF of FCR was superior to that of CSF, and the WS of FCR displayed in half size was superior to that of CSF. In all exposure conditions, the visibility of the nodules on FCR in the pulmonary apex was inferior to that on CSF, ...

Energy Technology Data Exchange (ETDEWEB)

Background: EGFR (epidermal growth factor receptor) and VEGF (vascular endothelial growth factor) inhibitors confer clinical benefit in metastatic colorectal cancer when combined with chemotherapy. An emerging strategy to improve outcomes in rectal cancer is to integrate biologically active, targeted agents as triple therapy into chemoradiation protocols. Material and methods: cetuximab and bevacizumab have now been incorporated into phase I-II studies of preoperative chemoradiation therapy (CRT) for rectal cancer. The rationale of these combinations, early efficacy and toxicity data, and possible molecular predictors for tumor response are reviewed. Computerized bibliographic searches of Pubmed were supplemented with hand searches of reference lists and abstracts of ASCO and ASTRO meetings. Results: the combination of cetuximab and CRT can be safely applied without dose compromises of the respective treatment components. ...

International Nuclear Information System (INIS)

The genetically significant dose (GSD), per Caput mean bone marrow dose (CMD), leukemia significant dose (LSD) and malignancy significant dose (MSD) from medical diagnostic X-ray examinations in Japan were estimated based on a 1979 nationwide survey of randomly sampled hospitals and clinics. The population risk estimates were carried out using the resultant values of GSD, LSD and MSD. In the risk estimates, the significant factors, namely, the relative child expectancy, the leukemia significant factor and the malignancy significant factor, for patients were assumed to be same as those of general population. The risk factors used were 185 x 10"-"6 rad"-"1 for genetic risk of all generations, 20 x 10"-"6 rad"-"1 for fatal leukemia and 165 x 10"-"6 rad"-"1 for fatal malignant diseases, respectively. The resultant annual population doses per person were 15 mrad (0.15 mGy) for GSD, 107 ...

UK PubMed Central (United Kingdom)

Patients who fail to attend initial appointments reduce clinic efficiency. To maximize attendance by newly referred outpatients, we introduced a mandatory group orientation clinic for all new patients...Full Text Available

UK PubMed Central (United Kingdom)

The Clinical Summary is a Web-based application for accessing the clinical database at the Massachusetts General Hospital. The application has been developed to give physicians in our health care community...Full Text Available

UK PubMed Central (United Kingdom)

PURPOSE The Wells rule is widely used for clinical assessment of patients with suspected deep vein thrombosis (DVT), especially in the secondary care setting. Recently a new clinical decision...Full Text Available

International Nuclear Information System (INIS)

Objective: To investigate the relationship between endothelial vasoactive factors and development of systemic sclerosis (SSc). Methods: Blood circulating endothelial cell count (CEC, with density gradient precipitation method); plasma endothelin (ET), thromboxane B2 (TXB2 ), 6-keto-prostaglandin F1? concentrations (all above three with RIA); nitric oxide (NO) contents (with Griss method) and plasma intercellular adhesion molecule-1 (ICAM-1), p-selectin (P-S) contents (with ELISA) were measured in 52 patients with systemic sclerosis (SSc) both before and after treatment with prostaglandin E1 and 30 controls. Results: Plasma ET, TXB2, ICAM-1, P-S contents and CEC were significantly higher and plasma NO, 6-K-PGF1? contents were significantly lower in all the patients with SSc before treatment than those in the controls, After treatment, the patients with satisfactory responses (n=33) had the abnormal plasma values of these parameters greatly corrected (vs before ...

International Nuclear Information System (INIS)

In order to practice design-by-analysis of thermohydraulics design of BWR fuel rod bundles, the subchannel analysis would play a major role. There, one of the immediate concerns is improvement in its predictive capability of boiling transition phenomena on the fuel rod surface. This capability strongly depends on the modeling of thermohydraulics phenomena of interests: 1) vapor-liquid redistribution by inter-subchannel exchanges due to the diversion cross flow, turbulent mixing and void drift, 2) liquid film behaviors, 3) transition of two-phase flow regimes, 4) droplet entrainment and deposition and 5) spacer-droplet interactions. These are considered to be five key factors in understanding the BT in BWR fuel rod bundles. This paper describes a progress and current status in the second year of the three year project on developing generalized boiling transition models with the above five key factors being focused on. A ...

UK PubMed Central (United Kingdom)

A questionnaire on the development of specialist clinics was distributed to the members of the Association of British Neurologists and completed by 104 members (85 consultants). Half of the respondents...Full Text Available

Energy Technology Data Exchange (ETDEWEB)

A tunable diode laser is used to obtain infrared spectra of carbon dioxide in biological materials. The spectral resolution is sufficient to readily distinguish differing isotopic species. The technique may prove useful in clinical tests.

UK PubMed Central (United Kingdom)

In 2005, the American Medical Informatics Association undertook a set of activities relating to clinical decision support (CDS), with support from the office of the national coordinator and the Agency...Full Text Available

UK PubMed Central (United Kingdom)

PurposeTo evaluate the clinical characteristics and outcomes of cataract surgery in highly myopic Korean subjects.MethodsWe retrospectively reviewed...Full Text Available

Energy Technology Data Exchange (ETDEWEB)

Purpose: The nint version of the licensing regulation for medical doctors (Approbation Regulation (AR)) sets a benchmark in terms of practical experience, interdigitation of preclinical and clinical studies, interdisciplinary approach, economic efficiency, independence of students, added new teaching and learning modalities, and ongoing evaluation of the progress of the medical students. It is the aim to implement these major points of the AR in a model course for diagnostic radiology and radiation protection within the scope of the Virtual University of Bavaria and test them in practice. Materials and Methods: In cooperation with residents and board certified radiologists, students developed the virtual course 'Web-Based Training (WBT) Radiology' in diagnostic radiology and radiation protection for students in the first clinical semester. A representative target group taken from the ...

International Nuclear Information System (INIS)

Purpose: Patients with ataxia-telangiectasia (A-T) show greatly increased radiation sensitivity and cancer predisposition. Family studies imply that the otherwise clinically silent heterozygotes of this autosomal recessive disease run a 3.5 to 3.8 higher risk of developing cancer. In vitro studies suggest moderately increased cellular radiation sensitivity of A-T carriers. They may also show elevated clinical radiosensitivity. We retrospectively examined patients who presented with severe adverse reactions during or after standard radiation treatment for mutations in the gene responsible for A-T, ATM, considering a potential means of future identification of radiosensitive individuals prospectively to adjust dosage schedules. Material and Methods: We selected 20 cancer patients (breast, 11; rectum, 2; ENT, 2; bladder, 1; prostate, 1; anus, 1; astrocytoma, 1; Hodgkins lymphoma, 1) with Grade 3 to 4 (RTOG) acute and/or late tissue radiation side ...

International Nuclear Information System (INIS)

This work come along of the necessity to utilize an unique High-Energy Electron Linear Accelerator (10 MV) for radiant treatments which require higher doses in the surface levels of tissue. It is analyzed the interposition of acrylic degraders (spoilers) in the beam, especially for opposed and parallel fields in the cases of head and neck. It was analyzed the possible combinations of the following parameters: 1) Field sizes defined at isocenter (100 cm) 6 x 6 cm"2, 8 x 8 cm"2 and 10 x 10 cm"2 ; 2) Surface-spoiler distance (DSS) of 4, 7 and 10 cm; 3) Spoilers with different thickness 1.1 and 1.5 cm. It was observed a displacement of the maximum dose toward the surface, and an increase in the percentile doses in the build-up zone when the spoiler is nearing and/or increasing its thickness. It is verified that the use of spoilers, support the symmetry and plane of the beam inside of the clinically acceptable margins. When the results obtained are analyzed then it is ...

International Nuclear Information System (INIS)

Intracranial atherosclerosis is a major cause of ischemic stroke, and depending on the studied population, it accounts for 8%-15% of all strokes that are due to cerebral atherosclerosis. The prognosis of patients with symptomatic intracranial stenoses seems to depend on the location and extent of intracranial atherosclerosis. Currently, the primary treatment in intracranial atherosclerosis is the control of vascular risk factors such as hypertension, diabetes, hypercholesterolemia, and smoking. Secondary prevention with antiplatelet therapy has been shown to reduce the risk of subsequent vascular events in patients who have suffered a recent ischemic stroke or transient ischemic attack (TIA). Unfortunately, a significant number of patients with intracranial atherosclerosis continue to suffer from repeated strokes or TIA despite maximal medical treatment. Although endovascular revascularization for symptomatic intracranial stenoses remains at the investigational ...

Science.gov (United States)

Erectile dysfunction following radical prostatectomy remains a frequent problem despite the development of nerve-sparing techniques. This erectile dysfunction is believed to be neurogenic, enhanced by hypoxia-induced structural changes which result in additional veno-occlusive dysfunction. Recently, daily use of intracavernous vasoactive substances and oral use of PDE5-inhibitors have been clinically studied for treatment of postprostatectomy erectile dysfunction. Since these studies showed benefits of "penile rehabilitation therapy," these effects have been studied in a preclinical setting. We reviewed experimental literature on erectile tissue preserving and neuroregenerative treatment strategies, and found that preservation of the erectile tissue by the use of intracavernous nitric oxide donors or vasoactive substances, oral PDE5-inhibitors, and hyperbaric oxygen therapy improved erectile function by antifibrotic effects and preservation of smooth muscle. ...

International Nuclear Information System (INIS)

Central Nervous System (CNS) involvement, whether primary by the Human Immunodeficiency Virus - HIV - itself, or secondary (toxoplasmosis or lymphoma) is remarkably frequent in AIDS, in 40 to 70% of cases, depending upon the author. In order to study the natural history of this illness, a cohort of 25 asymptomatic seropositive patients have been established. Every 6 months these patients undergo biological and clinical examinations, as well as Magnetic Resonance brain scans. After two examinations at a 6 month's interval, the first results are reported. Out of these 25 cases, 9 present anomalies: One patient with diffuse cerebral atrophy and 8 others with high signal intensity areas on T2 weighted sequences, like those of the Multiple Sclerosis. No relationship could be demonstrated between the existence of these lesions and various criteria such as age, sex, risk factors and T4 cells count. The nature of these lesions is not lear. They ...

International Nuclear Information System (INIS)

Annual medical examinations are conducted by Brookhaven National Laboratory (BNL) for a population of Marshallese who were accidentally exposed to radioactive fallout in 1954, for a comparison population, and for all inhabitants of the atolls of Rongelap and Utirik. Disease surveillance includes analysis of serum samples. Elevated serum uric acid (SUA) levels are common along Pacific populations, and modifying environmental factors have been investigated as a cause for this finding. The authors have studied SUA levels of people living in the Marshall Islands, and have found elevated values similar to those reported for other Micronesian populations. The nearly Gaussian distribution of individual serum uric acid values for men, and for women less than or equal to45 years of age, indicates that the elevation is due to a regularized increase in serum uric acid rather than to a subpopulation that has pathologic hyperuricemia. The higher serum uric acid levels appear, ...

Science.gov (United States)

SNAP25 occurs on chromosome 20p12.2, which has been linked to schizophrenia in some samples, and recently linked to latent classes of psychotic illness in our sample. SNAP25 is crucial to synaptic functioning, may be involved in axonal growth and dendritic sprouting, and its expression may be decreased in schizophrenia. We genotyped 18 haplotype-tagging SNPs in SNAP25 in a sample of 270 Irish high-density families. Single marker and haplotype analyses were performed in FBAT and PDT. We adjusted for multiple testing by computing q values. Association was followed up in an independent sample of 657 cases and 411 controls. We tested for allelic effects on the clinical phenotype by using the method of sequential addition and 5 factor-derived scores of the OPCRIT. Nine of 18 SNPs had P values Irish family sample. Although we failed to replicate this in an independent sample, this gene should be further tested in other samples. PMID:19806613

DEFF Research Database (Denmark)

PURPOSE OF REVIEW: To review the recent literature on the prognostic value of biomarkers of liver fibrosis and impaired liver function in patients with chronic hepatitis C with or without HIV coinfection. RECENT FINDINGS: A combination of standard blood tests seems to be useful in identifying patients at risk of liver-related complications. Findings from studies investigating the validity of the Model for End-Stage Liver Disease (MELD) score in HIV-infected liver transplant candidates are conflicting. Two large studies of HIV/hepatitis C virus (HCV) coinfected patients have shown that plasma levels of the fibrosis marker hyaluronic acid are a strong predictor of clinical complications. A smaller study found hyaluronic acid and two other fibrosis tests, aspartate aminotransferase-to-platelet ratio index (APRI) and Fib-4, to be independent predictors of mortality when included in models with the MELD or the Child-Pugh-Turcotte scores. SUMMARY: Although the data are ...

International Nuclear Information System (INIS)

The mathematical calculation to obtain a radon diffusion coefficient from measured radon transient-diffusion data is usually done by fitting a difference equation to the data. The difference equation is obtained through transformation of the time-dependent diffusion equation based on Fick's law. But, actual measured transient-diffusion data often have much scatter. Therefore just fitting over the whole range of the measured data through the method of least squares may not always be valid, because the method offers mathematical interpretation rather than a physical one. Instead, the actual radon diffusion coefficients must be otherwise obtainable from measured radon transient data. Taking this viewpoint, the present paper claims that about a 90% leveling-off time is often easily discernible regardless of the shape of the radon transient curve obtained from the measured data and it can be a decisive factor for determining the radon diffusion coefficient. ...

CERN Document Server

Two-tier networks, comprising a conventional cellular network overlaid with shorter range hotspots (e.g. femtocells, distributed antennas, or wired relays), offer an economically viable way to improve cellular system capacity. The capacity-limiting factor in such networks is interference. The cross-tier interference between macrocells and femtocells can suffocate the capacity due to the near-far problem, so in practice hotspots should use a different frequency channel than the potentially nearby high-power macrocell users. Centralized or coordinated frequency planning, which is difficult and inefficient even in conventional cellular networks, is all but impossible in a two-tier network. This paper proposes and analyzes an optimum decentralized spectrum allocation policy for two-tier networks that employ frequency division multiple access (including OFDMA). The proposed allocation is optimal in terms of Area Spectral Efficiency (ASE), and is ...

Science.gov (United States)

In this paper the authors describe the ways poststructuralist discourses assisted us to reading and reflection on data collected as part of a traditional survey-style research study. The study--generated in response to widespread concern about falling male enrolment rates at the authors' regional university--focused upon factors affecting rural male school-leavers' decisions about postschool destinations, and upon these students' attitudes to higher education. In the paper that follows, the authors contest the dominant discourses that are frequently drawn on to explain differences in male and female higher education enrolment trends. They then focus upon the features of two of the more dominant stories that students told to explain this 'difference': stories about 'real men', and stories about the value of the 'practical' over the 'theoretical'. In addition, they present another story that draws upon girls' views of higher education. Together, ...

International Nuclear Information System (INIS)

As part of their corporate policy on environmental protection, Chevron, has taken an approach to work collaboratively with other industry members, universities and government agencies in phytoremediation research. The petroleum industry is interested in the integration of phytoremediation with the many biotechnology treatment technologies currently being used by the industry. Phytoremediation is a complex technology that does not just transfer wastes to another site, but offers in-situ final use and disposal treatment at sites anywhere in the world. Sites for potential remediation range from abandoned large refineries, chemical plants, or small urban gas stations. Research has focused on the cleanup of metals and hydrocarbons in diverse types of soil, water and groundwater conditions. This includes research into remediation of petroleum contaminants such as total petroleum hydrocarbon (TPH), polynuclear aromatic hydrocarbons as well as benzene in soil and the mechanism that occurs in ...

International Nuclear Information System (INIS)

This paper presents an overview of issues related to surface water contamination arising from uranium mining activities in the Alligator Rivers Region (ARR) of northern Australia, and a program of research and monitoring that must assess the potential and actual effects on ecosystem and human health. The program of assessing effects on aquatic ecosystems involves a four-tiered approach including the derivation of local water quality guideline trigger values, direct toxicity assessment of mine waters prior to their release, creekside or in situ monitoring for early warning of adverse effects during mine water release, and longer-term monitoring of macroinvertebrate and fish communities. Bioaccumulation in aquatic biota is also assessed, and is an issue of importance not only to ecosystem health, but also to the health of local Aboriginal people. The aquatic animals they consume represent potential sources of radiological dose, and as a result, a major component of the program to assess ...

Science.gov (United States)

We have calculated the on-axis spectrum of spontaneous radiation emitted by an electron moving along a planar undulator that has a magnetic profile along the axis that approximates a square wave. (This could be obtained in practice by driving a ferromagnetic undulator into saturation by excessive current in the windings.) We find considerable enhancement of the harmonic radiation spectrum. We compare the harmonic power emitted by an electron moving through an undulator having a sine-wave field profile with the radiation emitted from an undulator having a square-wave profile; the latter is approximated by the first three Fourier components of the undulator magnetic field profile along the axial direction. Examples are computed for 40MeV electrons taking K < 1, for spontaneous radiation emitted along the axis of the system. The emission at harmonics f > 1 is greatly enhanced for the approximate square-wave magnetic profile: the ratio of the power emitted at f=5 ...

International Nuclear Information System (INIS)

Over the past few years, NPCIL has performed comprehensive Level-1 Probabilistic Safety Assessment (PSA) for a 220 MWe Pressurised Heavy Water Reactor (PHWR) at Kakrapar Atomic Power Station (KAPS) and for the first 540 MWe PHWR at Tarapur Atomic Power Project (TAPP- 3 and 4). The major objective of these PSAs was to present an integrated picture of the safety of the plant to identify and understand key plant vulnerabilities. As a result of the availability of these PSAs, there is a desire to use them to operate the plants in the most efficient manner practicable. In recent years, the operation of Indian Nuclear Power Plants has been characterized by improved availability/capacity factors and reduced forced outages. Frequency of planned outages is also being reduced. In order to achieve this, the PSAs are now being used as an engineering tool for optimization of Technical Specifications with regard to Allowed Outage Time (AOT) and Surveillance ...

Science.gov (United States)

Optical measurement of the Doppler shift of laser backscatter, using a near-IR, visible, or ultraviolet laser, is potentially more robust and field reliable than coherent, heterodyne measurement with an IR laser. The direct measurement of the displacement of Fabry-Perot interference fringes is possible, but entails expensive, technically challenging, imaging detectors. The 'edge technique' permits Doppler shift measurements with relatively simple detectors and detector electronics, and has been implemented with Fabry-Perot etalons and with atomic line filters. Simple analytical models of the fringe imaging and edge detection techniques are presented, permitting ready calculation of the potential performance of either, for various atmospheric conditions and for various lidar hardware configurations. The predictions of the analytical models are confirmed by computer models, which in turn allow more detailed considerations of complicating factors such as solar ...

Energy Technology Data Exchange (ETDEWEB)

The 'high-tension distribution line design support system' was developed for the 'work design support system'. This support system is composed of the work outline editor for preparing work details and facility data and the inference engine for preparing practical design plans, and can check system conditions such as voltage drop and deviation from technical standards automatically. The work outline editor takes charge of selection of work items, selective input of system information, and setting of some conditions such as pole position and reserved load onto a system diagram. The inference engine provides the design plan automatically based on the information inputted by the editor. For the design of high-tension distribution line, such various factors as local condition and load sharing of distribution systems should be considered. This design support system attains efficient processing by not total ...

Energy Technology Data Exchange (ETDEWEB)

An evaporator using a hydrophobic membrane made from a polytetrafluoroethylene (PTFE) was developed to improve DF (Decontamination Factor) and to reduce evaporator size. The membrane distillation, provided by the evaporator, is a new technique for liquid purification. Fundamental experiments were carried out to develop the membrane filter (tube type, outer diameter, 8 mm; membrane thickness, 500 {mu}m) for radioactive liquid treatment. The continuous operation test using actual liquid waste was also made during about 3,000 h. (This is almost equal to the operation time of an actual evaporator per year.) The evaporation rate decreased with increase an operation time due to contamination of waste impurity. But the rate was recovered by washing the membrane with hot water and then drying it. DF was over 10{sup 4} which is ten times larger than that for a conventional system. A pilot plant (capacity, 200 kg-liquid waste/h) was constructed and its performance test was ...

CERN Document Server

Chandra and XMM surveys show that the fraction of obscured AGN decreases rapidly with increasing luminosity. Although this is usually explained by assuming that the covering factor of the central engine is much smaller at luminous QSOs, the exact origin of this effect remains unknown. We perform toy simulations to test whether photo-ionisation of the obscuring screen in the presence of a strong radiation field can reproduce this effect. In particular, we create X-ray spectral simulations using a warm absorber model assuming a range of input column densities and ionization parameters. We fit instead the simulated spectra with a simple cold absorption power-law model that is the standard practice in X-ray surveys. We find that the fraction of absorbed AGN should fall with luminosity as $L^{-0.16\\pm0.03}$ in rough agreement with the observations. Furthermore, this apparent decrease in the obscuring material is consistent with the dependence of ...

Energy Technology Data Exchange (ETDEWEB)

The /sup 252/Cf-source-driven neutron noise analysis method has been tested in a wide variety of experiments that have indicated the broad range of applicability of the method. The neutron multiplication factor k/sub eff/ has been satisfactorily detemined for a variety of materials including uranium metal, light water reactor fuel pins, fissile solutions, fuel plates in water, and interacting cylinders. For a uranyl nitrate solution tank which is typical of a fuel processing or reprocessing plant, the k/sub eff/ values were satisfactorily determined for values between 0.92 and 0.5 using a simple point kinetics interpretation of the experimental data. The short measurement times, in several cases as low as 1 min, have shown that the development of this method can lead to a practical subcriticality monitor for many in-plant applications. The further development of the method will require experiments oriented toward particular applications ...

International Nuclear Information System (INIS)

Purpose: Various published reports involving intensity-modulated radiotherapy (IMRT) plans developed using automated optimization (inverse planning) have demonstrated highly conformal plans. These reported conformal IMRT plans involve significant target dose inhomogeneity, including both overdosage and underdosage within the target volume. In this study, we demonstrate the development of optimized beamlet IMRT plans that satisfy rigorous dose homogeneity requirements for all target volumes (e.g., #+-#5%), while also sparing the parotids and other normal structures. Methods and Materials: The treatment plans of 15 patients with oropharyngeal cancer who were previously treated with forward-planned multisegmental IMRT were planned again using an automated optimization system developed in-house. The optimization system allows for variable sized beamlets computed using a three-dimensional convolution/superposition dose calculation and flexible cost functions derived from combinations of ...

Science.gov (United States)

PMID:12886534

Science.gov (United States)

PMID:20681969

Science.gov (United States)

PMID:21732206

Wastenet

for municipal waste iron ore sinter plants incinerators for clinical waste facilities of the non-ferrous metal

KoreaScience (Korea)

Full Text Available

KoreaScience (Korea)

Full Text Available

KoreaScience (Korea)

Full Text Available

Science.gov (United States)

PMID:20091983

International Nuclear Information System (INIS)

Background: the fact that therapeutic irradiation can induce significant stenosis in the arteries of the head, neck, and chest, as welt as in the aorta and the iliac arteries, is familiar in daily practice and well documented in the literature. By contrast, radiation-induced renal artery stenosis seems to be a less widely known complication. Patients and methods: the sudden onset of medically refractory arterial hypertension and coma in a 27-year-old man is reported, who had been treated at age 20 with chemotherapy and radiotherapy for Ewing's sarcoma in the lumbar region. This treatment had been performed at the hospital of Sion, Switzerland in 2001. Also, the relevant literature from 1965 to 2007 is reviewed to underscore various aspects of this problem and to demonstrate the clinical relevance of renal artery stenosis as a potential long-term sequela of radiotherapy. Conclusion: radiation-induced renal artery stenosis has only rarely been ...

Science.gov (United States)

PMID:21398174

CERN Document Server

Single-case and Small-n Experimental Designs

CERN Document Server

Safe operation of research reactors and critical assemblies

International Nuclear Information System (INIS)

... blood serum patients radioimmunoassay sampling tracer techniques isotope

CERN Document Server

Improving Low-Reading Ages in the Secondary School

International Nuclear Information System (INIS)

Inherent to helical tomotherapy is a dose variation pattern that manifests as a 'ripple' (peak-to-trough relative to the average). This ripple is the result of helical beam junctioning, completely unique to helical tomotherapy. Pitch is defined as in helical CT, the couch travel distance for a complete gantry rotation relative to the axial beam width at the axis of rotation. Without scattering or beam divergence, an analytical posing of the problem as a simple integral predicts minima near a pitch of 1/n where n is an integer. A convolution-superposition dose calculator (TomoTherapy, Inc.) included all the physics needed to explore the ripple magnitude versus pitch and beam width. The results of the dose calculator and some benchmark measurements demonstrate that the ripple has sharp minima near p=0.86(1/n). The 0.86 factor is empirical and caused by a beam junctioning of the off-axis dose profiles which differ from the axial profiles as well as a long scatter tail ...

International Nuclear Information System (INIS)

The potential application of radioisotopes are not discussed in this review of trypanosome pathogenesis in cattle. Initially, structural changes in the lymphoid system are characterized by marked proliferation and germinal centre formation, whereas in long-standing infections the lymphoid organs become depleted. These changes appear associated with immunodepression. Anaemia dominates the clinical disease syndrome in bovine trypanosomiasis. It develops with the onset of parasitaemia and is largely haemolytic, resulting from increased red blood cell destruction by phagocytosis. Several factors may be involved in this process including haemolysins produced by the trypanosome, immunological mechanisms, fever, disseminated intravascular coagulation and an expanded and active mononuclear phagocytic system. During this phase of the disease, cattle respond well to chemotherapy. However, in later phases of the disease, when trypanosomes cannot be ...

Energy Technology Data Exchange (ETDEWEB)

Due mainly to competitive pressures, the practice of offering electric and telephone service under contracts or special tariffs negotiated individually between a utility and its customers has increased in importance in recent years. Moreover, the practice is likely to become still more widespread in the future. This creates questions of public policy that are of interest to regulators and ratepayers alike such as how to supervise the practice, how to encourage utilities to compete while preventing cross-subsidization and anticompetitive behavior, and how the practice will ultimately affect utilities and ratepayers. This report sheds light on the topic by describing approaches that have been taken by the various regulatory commissions and by providing a framework for analyzing such contractors.

International Nuclear Information System (INIS)

Full text: The general population is daily exposed to chronic, low doses of ionizing radiation (IR) from both natural and artificial sources. The biological consequences of acute, high dose IR exposure can be readily determined; however, the nature and significance of low dose, low dose-rate IR effects are still the subject of debate. Confounding the issue, are the phenomena collectively referred to as the Radiation-induced Bystander Effect (RIBE). The RIBE describes a collection of in vitro observations that suggest the presence of a soluble, transmissible factor(s) released from irradiated cells that can induce a biological response in un-irradiated cells. The induction, nature and magnitude of the RIBE varies between cell culture systems, radiation sources and end-points measured. Efforts to confirm the presence of the RIBE in vivo have been confined to in vivo-like culture systems and limited work with tumour and bone-marrow transplantation models. Validation ...

International Nuclear Information System (INIS)

Purpose: To assess the prognostic value of biologic (p53, Ki-67) and clinical factors in squamous cell carcinoma of the oropharynx after radical surgery and postoperative radiotherapy (RT). Methods and Materials: Between 1985 and 1995, a total of 102 patients with 104 tumor sites were entered onto the study. Fifty-five primary tumors (53%) involved the tonsils, 26 (25%) the soft palate, and 23 (22%) the base of the tongue. Median age was 53 years (range 36-80 years). The clinical T- and N-categories (UICC 1997) were: T1 (30), T2 (47), T3 (22), T4 (5), N0 (33), N1 (28), N2 (42), and N3 (1). Histologically-clear margins were achieved in all patients by initial surgery. Postoperative RT to the primary and regional lymphatics was given, to a total of 60 Gy in 6 weeks, and single daily fractions of 2 Gy. The expression of the nuclear p53- and Ki-67-labeling index (LI) was investigated by immunostaining using the monoclonal ...

International Nuclear Information System (INIS)

... dose rates inhalation iodine 134 krypton 88 nuclear decay quality factor

International Nuclear Information System (INIS)

Purpose/Objective: At present, treatment verification between portal and reference images is performed based on manually-identified features by radiation oncologist, which is both time-consuming and potentially error-prone. There is a demand for the computerized verification procedure in clinical application. The purpose of this study is to develop a computerized portal verification scheme for pelvic treatment fields. Materials/Methods: The automated verification system involves image acquisition, image feature extraction, feature matching between reference and portal images and quantitative evaluation of patient setup. Electronic portal images with a matrix size of 256 x 256 and 12 bit gray levels were acquired using a liquid matrix electronic portal imaging device. Simulation images were acquired by digitizing simulation films using a TV camera into images with 256 x 256 matrix and 8 bit gray levels. Initially a Canny edge detector is applied to identify the ...

UK PubMed Central (United Kingdom)

PurposeWe conducted a comparative study of Clinical Target Volume (CTV) definition of pelvic lymph nodes by multiple GU radiation oncologists looking at the levels...Full Text Available

UK PubMed Central (United Kingdom)

The clinical management of adults with low-grade gliomas (LGGs) remains a challenge. There is no curative treatment, and management of individual patients is a matter of deciding optimal timing as well...Full Text Available

UK PubMed Central (United Kingdom)

Randomized clinical trials are designed with stopping boundaries to guide data monitoring committees with their decision making concerning ongoing trials. In particular, when extremely positive results...Full Text Available

Energy Technology Data Exchange (ETDEWEB)

The planned spallation source can be of considerable significance for biomedical basic research and for clinically relevant diagnostic and therapeutic applications. The following gives a brief description and explanations for its possible use in clinical medicine: I. Treatment of Malignant Tumors II. Production of Isotopes for Biochemical Investigations in Living Organisms for Diagnostic Purposes.

International Nuclear Information System (INIS)

This paper discusses the clinical application and main objective of testicular imaging. The authors present cases that represent a spectrum of the abnormalities which might be detected by testicular imaging, with special attention given to testicular torsion and the acute diseases which may mimic it clinically. Accuracy of the test is noted.

UK PubMed Central (United Kingdom)

The ubiquity and ease of use of the Web have made it an increasingly popular medium for communication of health-related information. Web interfaces to commercially available clinical information systems...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundThe aim of this study is to examine how clinicians and patients negotiate clinical need and treatment decisions within a context of finite resources. Dental implant treatment...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundThe lack of adequate randomized clinical trials (RCT) has hindered identification of new therapies that are safe and effective for patients with primary focal segmental...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundHepatitis A virus (HAV) strains detected in environmental and clinical samples were analysed to characterize the genotypes of HAV circulating in Greece. Fifty (50) sewage...Full Text Available

UK PubMed Central (United Kingdom)

Objectives: The authors designed and implemented a clinical data mart composed of an integrated information retrieval (IR) and relational database management system (RDBMS).Design:...Full Text Available

UK PubMed Central (United Kingdom)

We sought to determine the prevalence of metabolic syndrome (MS) in patients with acute myocardial infarction and its effect on clinical outcomes. Employing data from the Korea Acute Myocardial Infarction...Full Text Available

UK PubMed Central (United Kingdom)

Purpose:The oral chemotherapy cycle management program (CMP) provides clinical management support to patients receiving certain oral chemotherapies. The CMP includes a dose-monitoring...Full Text Available

UK PubMed Central (United Kingdom)

This paper presents HEARTVIEW - a knowledge base (KB) that offers aid for clinical research in cardiology. This KB is an essential component of the medical workstation MW2000, now under development...Full Text Available

UK PubMed Central (United Kingdom)

The clinical significance, Gram stain reaction, and genus affiliation of Gardnerella vaginalis have been controversial since Gardner and Dukes described the organism as the cause of "nonspecific vaginitis,"...Full Text Available